bluuebunny/crossref_metadata_2025_split huggingface dataset:
Facial Nerve Translocation for Low Tension Neurorrhaphy to Masseteric Nerve
Authors: Hetzler Laura , MacDowell Sara , Trahan Jason , Arriaga Moises , McDaniel Lee S. 
Published: May 2019

Introduction:
The techniques of facial reanimation are continually evolving in search of the ideal method for rehabilitating the paralyzed face. In the past, alternative cranial nerve motor nuclei have been used to power facial musculature. The trigeminal nerve is gaining popularity as a promising nerve to drive facial motion, particularly in the lower face.

Objectives:
This article describes a low-tension technique of using the transposed facial nerve to the trigeminal nerve (masseteric branch) for facial reanimation.

Methods:
Six patients over 2.5 years were treated with facial nerve translocation with division at the geniculate and direct neurorrhaphy to the motor branch of the masseter. Patients were evaluated by physical examination, measurement of oral commissure excursion using MEEI FACE-gram software, video assessment, Sunnybrook Facial Grading System, Facial Disability Index, and Facial Clinimetric Evaluation Scale (FaCE).

Results:
Patients demonstrated early motion within 4 months postoperatively and were placed into facial physical therapy. All demonstrated improvements in oral competence, strong oral commissure excursion with good symmetry, speech improvements, and variable results in facial tone. Synkinesis to the smile antagonists in the lower face was noted and treated with chemodenervation in three of six. No upper division synkinesis was noted.

Conclusion:
The motor branch of the trigeminal nerve is an effective option for facial reanimation via facial nerve translocation and end-to-end neurorrhaphy. Variable results in facial tone were noted with excellent oral commissure excursion. This procedure is safe in the reoperated mastoid.
Efficacy of an antiadhesive agent for the prevention of intra-abdominal adhesions after radical gastrectomy
Authors: Kim Sung Geun , Song Kyo Young , Lee Han Hong , Kim Eun Young , Lee Jun Hyun , Jeon Hae Myung , Jeon Kyung Hwa , Jin Hyung Min , Kim Dong Jin , Kim Wook , Yoo Han Mo , Kim Jeong Gu , Park Cho Hyun 
Published: May 2019

Abstract

Background:
Guardix-SG is a poloxamer-based antiadhesive agent. The aim of this study was to investigate its efficacy in preventing abdominal adhesions in gastric cancer patients undergoing gastrectomy. Few clinical studies have reported that antiadhesive agent reduces the incidence of adhesion after gastrectomy.

Methods:
We conducted a multicenter trial from June 2013 and August 2015 in patients with gastric adenocarcinoma undergoing radical gastrectomy. Patients were randomly assigned to the Guardix treatment or control group. Postoperative adhesions were diagnosed based on postoperative symptoms, plain x-ray films, and computed tomography. The primary endpoint of the study was the incidence of small bowel obstruction in the first postoperative year. The secondary end-point was the safety of Guardix-SG.

Results:
The study included 109 patients in the Guardix group and 105 patients in the control group. The groups were similarly matched with pathological stage, operation type, anastomosis method, midline incision length, and the extent of lymph node dissection. Eight in the Guardix group and 21 in the control group experienced intestinal obstruction during the 1-year follow-up period. The cumulative incidence of small bowel obstruction was significantly lower in the Guardix group compared to that seen in the control group (4.7% vs 8.6% at 6 months and 7.3% vs 20% at 1 year; P = .007, log-rank test). There were no differences in postoperative complications and adverse events.

Conclusion:
Guardix-SG significantly decreased the incidence of intestinal obstruction without affecting the incidence of postoperative complications.
The “safe zone” for infrapectineal plate-screw fixation of quadrilateral plate fractures
Authors: He Li , Sun Yun , Hou Zhiyong , Zhang Qian , Hu Yinghua , Bai Xiangjun , Yi Chengla 
Published: May 2019

Abstract
Extra-articular screw placement in the true pelvis for fixing quadrilateral plate fractures remains challenging. We aimed to define the “safe zone” on the quadrilateral surface to facilitate safe plate-screw placement.
Twenty cadaveric hemipelves were sectioned and assembled to define the projection of the acetabular boundary on the quadrilateral surface. Three lines (X, Y, and Z) were drawn tangent to the projection, with X parallel to the iliopectineal line, Y perpendicular to the iliopectineal line, and Z parallel to the posterior border of the ischial body. Then, the distances between X and the iliopectineal line (D1), Y and the sacroiliac joint (D2), and Z and the posterior border of the ischium (D3) could be used to determine a “safe zone” on the quadrilateral surface for screw insertion. We included 15 patients whose conditions satisfied the definition of a comminuted quadrilateral plate fracture and applied two-ended buttress plates for treatment in accordance with this “safe zone.”
The average D1 was 50.0 mm, the average D2 was 30.6 mm, and the average D3 was 12.4 mm. For all 15 patients with comminuted quadrilateral fracture who were treated, no intraoperative or postoperative screw penetration of the acetabulum was identified, and no loss of reduction was observed during an average follow up of 17.7 months.
The “safe zone” established in this study simplifies extraarticular screw placement for managing quadrilateral plate fractures in the true pelvis. As a result, two-ended buttress plate fixation in the true pelvis becomes safe, therefore, treatment with two-ended buttress plates may represent a viable alternative to single-ended elastic fixation in the management of comminuted quadrilateral fractures.
Radiological and clinical findings of isolated meningeal Rosai–Dorfman disease of the central nervous system
Authors: Wen Jia-Hua , Wang Chao , Jin Yun-Yun , Xu Duo , Jiang Biao , He Xiao-Juan , Min Jie 
Published: May 2019

Abstract
Rosai–Dorfman disease (RDD) with isolated central nervous system (CNS) involvement is an extremely rare disease. Most RDD of the CNS present as dural-based mass mimicking meningioma and other common lesions, which makes preoperative accurate diagnosis of great difficulty. We searched the pathology database in our hospital and 3 cases of RDD with isolated CNS involvement were finally included in our study. Radiological and clinical findings of these three cases were retrospectively analyzed. The lesions of 2 cases were dura-based against the cerebral convexity, presenting as a sheet-shaped thickened dura mater, another case was located just across the cerebral falx, the dural display in the center was intact. The 3 cases showed low signal intensity on T2-weighted image, obviously enhanced, significantly surrounding edema and finger-like protuberance but no invasion of the brain parenchyma or no sign of hyperplasia or sclerosis of the surrounding cranial bones. In conclusion, when we come across a disease that mimicking meningioma, especially when it manifests as the above radiological features, we should considered it might be a kind of proliferative disease of the meninges, such as RDD.
Factors affecting in-hospital delay of intravenous thrombolysis for acute ischemic stroke
Authors: Chai Erqing , Li Changqing , Jiang Lei 
Published: May 2019

Abstract
This study was designed to investigate the factors affecting the in-hospital delay of intravenous thrombolysis (IVT) for acute ischemic stroke (AIS).
Two hundred and forty-eight consecutive AIS patients treated with intravenous administration of alteplase in Gansu Provincial Hospital from December 2014 to August 2018 were enrolled retrospectively in this study. According to door-to-needle (DTN) time, the patients were divided into either a delay group (DTN time > 60 minutes; n = 184) or a non-delay group (DTN time ≤60 minutes; n = 64). The baseline data, laboratory tests, onset-to-door (OTD) time, door-to-accepting time (DTA), door-to-imaging time (DTI), and decision-making time in both groups were recorded. Multivariate logistic analysis was performed to analyze the data.
There were significant differences in previous history of cerebral ischemic attack, emergency system admission, education degree of decision makers, annual income, admission National Institutes of Health Stroke Scale (NIHSS), OTD time, DTA time, decision-making time between the 2 groups (all P < .05). Other baseline data and clinical features showed no significant difference between 2 groups (P > .05). Multivariate logistic regression analysis revealed that the risk of in-hospital delay was lower for the higher NIHSS score (OR = 0.775, 95% CI: 0.644-0.933, P = .007), the longer OTD time (OR = 0.963, 95% CI: 0.937-0.991, P = .010), the shorter decision-making time (OR = 1.224, 95% CI: 1.004-1.492, P = .045).
This study suggested that NIHSS score, OTD time and decision-making time are the independent factors affecting the in-hospital delay of IVT for AIS.
IgA nephropathy associated with erythrodermic psoriasis
Authors: Zhang Li , Xue Shuai , Yu JinYu , Si HeNan , Xu Ying , Li Jia , Ma FuZhe , Xu ZhongGao 
Published: May 2019

Abstract

Rationale:
Cases about IgAN associated with EP are rare and the pathogenesis is poorly understood. We reported a 74-year-old Chinese male who suffered the IgAN and EP at the same time and explored a possible pathophysiologic link and points toward the possible pathogenesis.

Patient concerns:
The patient complained deteriorating symptoms (erythrodermia, skin pruritus, and pain) of psoriasis and obvious pitting edema on his legs.

Diagnosis:
The patient was diagnosed as IgAN and EP concurrently according to medical history, physical examination, laboratory test, and pathology.

Interventions:
Intravenous dexamethasone (5 mg/day) and oral ciclosporin (200 mg twice a day).

Outcomes:
The patient's symptoms of psoriasis and IgA nephropathy improved obviously after 11-day treatment and discharged from the hospital.

Lessons:
IgAN should be considered when the patient is diagnosed as EP. The combination of dexamethasone and ciclosporin may be effective option for patients with IgAN and EP concurrently.
Endometriosis presenting with recurrent massive hemorrhagic ascites and diagnosed by core needle biopsy
Authors: Wang Xue , Li Yiling , Tong Jing , Chang Bing , Zhang Yi , Liu Yanjun , Bing Hao , Guo Liping , Li Dan 
Published: May 2019

Abstract

Rationale:
Recurrent massive hemorrhagic ascites secondary to endometriosis is extremely rare in the medical literature.

Patient concerns:
We report the case of a 24-year-old nulliparous woman presenting with severe abdominal distention, massive ascites, moderate anemia, menstrual pain, and an elevated CA-125 level.

Diagnosis:
We found a thickened peritoneum in the left lower abdomen by ultrasound during the follow-up period, and endometriosis was subsequently diagnosed by performing core needle biopsy (CNB).

Interventions and outcomes:
The patient received medical treatment for endometriosis and had a good response to the treatment.

Lessons:
This is the first case in which endometriosis ectopic to peritoneum was diagnosed by CNB. Endometriosis should be considered a differential diagnosis when recurrent massive hemorrhagic ascites occur. CNB should be valued as a method for diagnosing endometriosis.
Effectiveness of physical therapy on the suboccipital area of patients with tension-type headache
Authors: Jiang Wenbin , Li Zhe , Wei Ning , Chang Wenli , Chen Wei , Sui Hong-Jin 
Published: May 2019

Abstract

Background:
There has been a lot of research on physical therapy for tension-type headaches. However, the efficacy of physical therapy on the suboccipital region remains unclear.

Objective:
To establish the effectiveness of physical therapy on the suboccipital area of patients with tension-type headache.

Methods:
Databases including Cochrane Library, Medline/Pubmed, CNKI, Embase, and Google Scholar were searched. After independent study selection by 2 authors, data were extracted and collected independently. On 1 hand, authors compared the treatment of the suboccipital area with control group. On the other hand, the efficacy of several physical therapy techniques on the suboccipital region was compared. The quality of the included studies was assessed using the Cochrane Handbook. RevMan 5.3 software was used for data analysis. The primary outcome measures were the cervical range of motion, the visual analog scale, and headache disability inventory.

Results:
Six randomized controlled trials with a total of 505 participants were included. Suboccipital soft-tissue inhibition technique (SIT) + occiput-atlas-axis global manipulation (OAA) was more effective than SIT in increasing craniocervical extension at 4 weeks post-treatment, the overall mean differences (MD) was 3.61, 95% confidence interval (CI) (0.89–6.34). There was no difference at 8 weeks post-treatment (MD 2.38, 95% CI −1.02 to 5.78, P = .17). SIT was more effective than SIT + OAA in increasing cervical flexion at 4-week post-treatment (MD −3.36, 95% CI −6.65 to −0.05). SIT + OAA was more effective than SIT on decreasing intensity of pain at 4-week post-treatment (MD −0.91, 95% CI −1.78 to −0.04), but no difference at 8-week (MD −0.43, 95% CI −1.18 to 0.33, P = .27). SIT + OAA was more effective than SIT in reducing the functional score of the headache disability inventory at 4-week post-treatment (MD −4.47, 95% CI −8.44 to −0.50). These results may indicate that the SIT + OAA combined therapy is more effective in short term (4-week), no major difference in longer term (8-week).

Conclusion:
Combined therapy may be more suitable for the treatment of tension-type headache.
Salvage therapy for subclavian artery perforation resulting in mediastinal hematoma during percutaneous coronary intervention
Authors: Li Wenhua , Shi Hongjian , Li Yong 
Published: May 2019

Abstract

Rationale:
Transradial access (TRA) is a widely used technique during percutaneous coronary intervention (PCI). However, mediastinal and cervical hematomas, the rare and severe complications of transradial approach, have extremely high mortality rates. To the best of our knowledge, there were no medical literatures about the successful anticoagulation reversal procedure of mediastinal hematoma in PCI till now.

Patient concerns:
We here present a 54-year-old male Han patient who underwent PCI. Immediately after PCI, he reported an episode of neck and chest discomfort, dyspnea, cough recurrence, and cold sweats. Emergency chest computed tomography (CT) revealed a perforation of the subclavian artery resulting in a large mediastinal hematoma with potentially lethal tracheal compression.

Diagnosis:
A diagnosis of the large mediastinal hematoma was made based on the enhanced computed tomography.

Interventions:
The patient was successfully managed with palliative therapy of anticoagulation reversal instead of a covered stent graft and surgical operation.

Outcomes:
Angiography confirmed the absence of leakage after anticoagulation reversal. The patient had an apparent remission of clinical dyspnea. Follow-up CT confirmed an almost entire absorption of the mediastinal hematoma 35 days postdischarge.

Lessons:
The current case highlights the importance of anticoagulation reversal as well as careful guidewire and guide catheter manipulation by the radial approach. Early evaluation, prompt identification, appropriate treatment, and close monitoring are all essential for invasive cardiology.
Compare the efficacy of acupuncture with drugs in the treatment of Bell's palsy
Authors: Zhang Rongchao , Wu Tao , Wang Ruihui , Wang Dong , Liu Qi 
Published: May 2019

Abstract

Background:
Bell's palsy or idiopathic facial paralysis is an acute facial paralysis caused by the inflammation of facial nerve. Several previous studies showed that acupuncture was beneficial in the treatment of facial paralysis. However, its effectiveness is still controversial compared with drug therapy. Therefore, this systematic review and meta-analysis was performed to assess the efficacy of acupuncture for Bell's palsy.

Methods:
This is a systematic review and meta-analysis of clinical studies among patients with Bell's palsy. We did a systematic literature search in PubMed, Embase, and the Cochrane Register of Controlled Trials to identify studies comparing the efficacy of acupuncture and drug treatment in treating facial paralysis. The search was last updated on July 2018.

Results:
The study included 11 randomized controlled trials with an overall sample of 1258 individuals. Acupuncture treatment was associated with an increased cure rate [relative risk (RR) = 1.77, 95% confidence interval (CI): 1.41–2.21], with significant heterogeneity in the pooled results (I2 = 67%, P = .0008). There was a significant difference in total effective rate in acupuncture and drug treatment for Bell's palsy (RR = 1.18,95% CI: 1.07–1.31), with substantial heterogeneity (I2 = 90%, P < .00001).

Conclusion:
Although there was not enough evidence to prove its safety, acupuncture seems to be an effective therapy for Bell's palsy. Results of the present meta-analysis showed that acupuncture was associated with increased cure rate and total effective rate of the treatment of Bell's palsy in comparison with drugs. However, the results should be interpreted cautiously, because of the poor quality and heterogeneity of the included studies. In the future, more and more high quality randomized controlled trials (RCT) are needed to prove the safety and effectiveness of acupuncture.
Magnetic stimulation for female patients with stress urinary incontinence, a meta-analysis of studies with short-term follow-up
Authors: Peng Liao , Zeng Xiao , Shen Hong , Luo De-yi 
Published: May 2019

Abstract

Background:
To determine the efficacy of magnetic stimulation (MS) in female patients with stress urinary incontinence (SUI) by performing a meta-analysis on peer-reviewed randomized controlled trails (RCTs).

Methods:
PubMed, Embase, and Cochrane library were retrieved for any peer-reviewed original articles in English. Databases were searched up to July 2018. Included studies investigated effects of MS on SUI. The data were analyzed by review manager 5.3 software (Cochrane Collaboration, Oxford, UK).

Results:
A total of 4 studies involving 232 patients were identified and included in present meta-analysis. Compared with the sham stimulation, the MS group had statistically significantly fewer leaks/3 days (MD = −1.42; 95%CI: −2.42 to −0.59; P = .007), less urine loss on pad test (g.)/24 h (MD = −4.99; 95%CI: −8.46 to −1.53; P = .005), higher QoL scores (MD = 0.42; 95%CI: 0.02–0.82; P = .009), and lower ICIQ scores (MD = −4.60; 95%CI: −5.02 to −4.19; P < .001). MS presented higher cure or improvement rate, with a statistically significant improvement in UDI and IIQ-SF scores compared to sham stimulation. No MS-related adverse effects were reported in study.

Conclusion:
MS leads to an improvement in SUI without any reported safety concerns and an improvement in patient quality of life. The long-term outcome of this technique remains unclear and is the subject of ongoing research.
Brain education-based meditation for patients with hypertension and/or type 2 diabetes
Authors: Lee Seung-Ho , Hwang Sun-Mi , Kang Do-Hyung , Yang Hyun-Jeong 
Published: May 2019

AbstractBackground:Hypertension and type 2 diabetes are chronic diseases, which generally require lifetime care. Meditation and yoga can be complementary to pharmacological therapies according to the scientific evidences so far. Brain education-based meditation (BEM) is a technique, which has been known to change brain structure, psychology, and physiology of healthy adult participants. This randomized, nonblinded pilot trial aimed to examine whether BEM affects the conditions of patients with hypertension and/or type 2 diabetes compared with health education classes.Methods:We randomly allocated 48 patients with hypertension and/or type 2 diabetes to BEM (n = 24) or health education (n = 24) classes in the Ulsan Junggu Public Health Center in Korea, where the classes were run during the same period and explored the impact of 8-week practice on the serum glutamic-oxaloacetic transaminase, serum glutamic pyruvic transaminase, gamma glutamyl transpeptidase, creatinine, high-density lipoprotein cholesterol, and low-density lipoprotein (LDL) cholesterol. Total RNA was extracted to examine inflammatory gene expressions from the whole blood using PAXgene blood RNA System. In addition, self-reports on mental/physical health were evaluated. The Student'sttest, chi-squared test, and analysis of covariance were used for statistical analysis.Results:The number of people who participated until the completion of the study was 14 in the control and 21 in the BEM group. After 8 weeks, LDL cholesterol level was significantly decreased in the BEM group after the intervention (13.82 mg/dL reduction,P < .05), while it was not significantly altered in the control group. The expression of inflammatory genes was significantly reduced after 8 weeks of the BEM training (0.3-, 0.5-, and 0.2-fold change forNFKB2,RELA, andIL1B, respectively, allP < .05). In the item analysis of mental/physical health self-reports, a significant improvement was confirmed as follows: increases in focus, confidence, relaxation, and happiness; decreases in fatigue, anger, and loneliness (allP < .05). There were no important adverse events or side-effects by BEM intervention.Conclusion:Compared to health education, BEM helps lower LDL cholesterol level and the inflammatory gene expression in the patients with hypertension and/or type 2 diabetes. Moreover, BEM induces positive effects on the self-reported mental/physical states, warranting further study.
Diagnostic efficacy of smear plus liquid-based cytology for EUS-FNA of solid pancreatic lesions
Authors: Itonaga Masahiro , Murata Shin-Ichi , Hatamaru Keiichi , Tamura Takashi , Nuta Junya , Kawaji Yuki , Maekita Takao , Iguchi Mikitaka , Kato Jun , Kojima Fumiyoshi , Yamaue Hiroki , Kawai Manabu , Okada Ken-Ichi , Hirono Seiko , Shimokawa Toshio , Tanioka Kensuke , Kitano Masayuki 
Published: May 2019

Abstract
Liquid-based cytology (LBC) is a thin-layer slide preparation procedure that was developed to overcome the cell crowding and contamination associated with smear cytology (SC). The present study compared diagnostic efficacy between SC alone and SC combined with LBC (SLBC) using endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) samples of pancreatic lesions.
We retrospectively analyzed data derived from 311 consecutive patients. Specimens obtained via EUS-FNA from 179 patients between December 2011 and May 2016 were analyzed by SC, and those obtained from 132 patients between June 2016 and October 2017 were analyzed by SLBC. The 2 groups were compared in terms of adequate sample rate, diagnostic accuracy, sensitivity, and specificity using propensity score matching.
SC and SLBC were compared using propensity score-matching in 204 patients (n = 102 per group). The adequate sample rate did not differ significantly between SLBC (100%) and SC (99.0%, P = 1). Diagnostic sensitivity, negative predictive value and accuracy were better for SLBC than for SC in terms of cytological (93.2% vs 67.4%, 68.4% vs 23.1%, and 94.1% vs 69.6%, P < .01 each, respectively) and cytohistological (95.5% vs 81.5%, 76.5% vs 34.6%, and 96.1% vs 82.4%, P < .01, P = .02, and P < .01, respectively) analyses.
SLBC improves the diagnostic efficacy of EUS-FNA for pancreatic lesions compared to LBC.