bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sex hormone therapy's effect on dry eye syndrome in postmenopausal women
Authors: Liu Chao , Liang Kun , Jiang Zhengxuan , Tao Liming 
Published: October 2018

Abstract

The purpose of the study t
o assess the efficacy of sex hormone therapy in the treatment of dry eye syndrome in postmenopausal women.
The following electronic databases were searched without language restrictions: PubMed, Embase, Cochrane, and the Chinese Biomedical Database. Two reviewers collected all the literature, which was searched for relevance in English and Chinese from January 1990 to July 2017. Both of the reviewers screened documents independently, identifying the studies that met the inclusion criteria. Then, the included studies were evaluated, and the data were extracted and conversed dependently. Finally, Review Manager 5.3 (offered by the Cochrane collaboration) was used to complete the meta-analysis. An integrated mean difference (MD) with its corresponding 95% confidence interval (CI) was calculated.
A total of 358 patients with dry eye were enrolled in 7 randomized controlled trials (RCTs). We observed statistically significant improvements in the Schirmer's test scores (MD, 2.06; 95% CI, 0.74–4.46; I
2 = 97%; P = .006) after sex hormone treatment. However, the scores for tear breakup time (TBUT) (MD, 1.28; 95% CI, −1.03 to 4.68; I
2 = 99%; P = .21) and the ocular comfort index (OCI) (MD, −1.12; 95% CI, −4.42 to 1.98; I
2 = 95%; P = .48) were not improved.
This meta-analysis of 7 RCTs suggests that sex hormone therapy may be associated with better Schirmer's test scores. However, no significant differences were detected in the TBUT and OCI test scores. Consequently, sex hormone therapy has a potentially useful role in the effective management of postmenopausal women with dry eye syndrome.
99mTc-MIBI single photon emission computed tomography/computed tomography for the incidental detection of rare parathyroid carcinoma
Authors: Chen Zejun , Fu Jingjing , Shao Qing , Zhou Bin , Wang Feng 
Published: October 2018

Abstract
This study aimed to evaluate the characteristics of parathyroid carcinoma and to validate the diagnostic value of 99mTc-methoxyisobutylisonitrile (MIBI) single photon emission computed tomography/x-ray computed tomography (SPECT/CT) for differentiating between parathyroid carcinoma and hyperparathyroidism. Four consecutive patients with suspected primary hyperparathyroidism were enrolled in this study and underwent 99mTc-MIBI SPECT/CT, ultrasonography, enhanced CT, and MRI. Serum parathyroid hormone (PTH) and calcium were measured. All primary and recurrent lesions showed high focal uptake on 99mTc-MIBI image, whereas metastatic lymph nodes gave false negative results. The serum PTH was 165.14 ± 90.26 pmol/L, which declined rapidly after surgery. One patient with a persistently high PTH (147.5 pmol/L) after surgery presented with multiple lymphadenopathy in the neck. Higher expression of chromogranin A (CgA) further confirmed parathyroid carcinoma as a rare endocrine tumor. Parathyroid carcinoma is thus usually diagnosed incidentally based on nonspecific multiorgan symptoms of hypercalcemia and hyperparathyroidism. 99mTc-MIBI SPECT/CT may help to localize the parathyroid carcinoma, while MRI is valuable for detecting metastasis. Serum PTH and CgA serve as circulating biomarkers in parathyroid carcinoma, and raised levels of PTH and CgA together with locoregional lymphadenopathy may indicate parathyroid carcinoma. Further studies are needed.
Application of lower limb nerve block combined with slow induction of light general anesthesia and tracheal induction in elderly hip surgery
Authors: Shi Zheng-Yuan , Jiang Chun-Nan , Shao Gang 
Published: October 2018

Abstract

Background:
This study aims to evaluate the effectiveness and safety of lower limb nerve block combined with slow induction of light general anesthesia and tracheal intubation in hip surgery in the elderly.

Methods:
Thirty elderly patients who underwent hip surgery under the lower limb nerve block were randomly divided into 2 groups: slow induction of light general anesthesia and tracheal intubation group (group M), and laryngeal mask light general anesthesia group (group H). After undergoing total intravenous anesthesia without muscle relaxants, all patients received sciatic nerve, lumbar plexus, and paravertebral nerve blocks. The hemodynamic situations, dosage of anesthetics, time for awakening and extubation (or laryngeal mask removal), and incidence of respiratory adverse reactions in the induction period were recorded.

Results:
Compared with baseline levels, the difference in mean arterial pressure (MAP) value at each time point after intubation/laryngeal mask removal in both groups was not statistically significant (P > .05). Furthermore, the time for awakening and extubation/laryngeal mask removal, and anesthetic dosage were significantly decreased in group M, when compared with group H (P < .05). For the incidence of adverse reactions, the incidence of poor sealing and hypoxia was significantly lower in group M than in group H (P < .05), and the incidence of sore throat was significantly lower in group H than in group M (P < .05).

Conclusion:
Lower limb nerve block combined with slow induction of light general anesthesia and tracheal intubation was associated with smaller anesthetic dosage, and shorter duration of anesthesia induction and extubation/laryngeal mask after surgery.
Neck xanthogranuloma mimicking malignancy in a patient with diabetes mellitus
Authors: Chen Tzu-Pai , Yi Wan-Ling , Liu Chiang-Shin , Lin Yu-Hsuan 
Published: October 2018

Abstract

Rationale:
Xanthogranulomatous inflammation (XGI) is a rare inflammatory process, which mostly affects the kidney and gallbladder. It usually simulates an aggressive neoplastic process. Occurrences in the neck are extremely rare and would usually be associated with a preexisting cyst or glandular tissues.

Patient concerns:
A 49-year-old diabetic patient presented with a right painful neck mass for a week. The pretreatment computed tomography (CT) imaging with contrast demonstrated a huge ill-defined heterogeneous-enhanced lesion abutting surrounding musculatures and great vessels. Both fine needle aspiration (FNA) and ultrasound-guided core biopsy of the neck mass showed inflammatory cells only.

Diagnoses:
Histologic evaluation found granulation tissue with histiocytes and occasional Touton giant cells confirming the diagnosis of xanthogranuloma.

Interventions:
Open excisional biopsy demonstrated a yellowish mass-like lesion with abscess inside.

Outcomes:
The patient recovered from the disease without posttreatment comorbidities.

Lessons:
This case highlights the need for physicians to maintain awareness of this clinical entity and delayed- or overtreatment should be avoided in these patients due to preoperative ambiguous diagnosis.
Rivaroxaban improves hidden blood loss, blood transfusion rate and reduces swelling of the knee joint in knee osteoarthritis patients after total knee replacement
Authors: Zhang Yi-Min , Liu Jian-Yong , Sun Xue-Dong , Zhang Miao , Liu Xiao-Guang , Chen Xiu-Li 
Published: October 2018

Abstract
Osteoarthritis (OA) is the third most common diagnosis made by general practitioners in older patients. The purpose of the current study is to investigate effects rivaroxaban had on both hidden blood loss and blood transfusion rate (BTR) in patients with knee OA (KOA) after going through a total knee replacement (TKR).
Between the time periods of December 2011 up until January 2015, a total of 235 patients underwent TKR and were selected to be assigned to either the rivaroxaban or nonanticoagulant groups. Coagulation function indexes before surgery and following administration of rivaroxaban, total blood loss, hidden blood loss, dominant blood loss, blood transfusion volume, hemoglobin reduction, degree of postoperative pain (visual analogue scale), the degree of knee swelling, and range of motion following surgery were all recorded. Hospital for special surgery (HSS) scores offered an objective evaluation for the knee joint functions before surgery at the intervals of 2 weeks and after surgery at intervals of 3 months, 6 months, 12 months, and 24 months.
Patients in the rivaroxaban group had shown a higher hidden blood loss, as well as a higher BTR, compared to those involved in the nonanticoagulant group. BTR was found to have been 49.59% in the rivaroxaban group, and 35.09% for the nonanticoagulant group. Patients in the rivaroxaban group had lower degrees of knee swelling than those involved in the nonanticoagulant group. There was no deep vein thrombosis (DVT) detected in the rivaroxaban group, whereas 5 DVT cases were detected in the nonanticoagulant group. In the rivaroxaban group, the HSS scores of the knee joint functions were remarkably higher at the 2-week mark in succession to the surgery than those involved with the nonanticoagulant group.
This overall data demonstrated that KOA patients after TKR had presented with a higher hidden blood loss, BRT, and lower swelling degrees of the knee joint after being treated by the rivaroxaban.
Relationship between the anxiety/depression and care burden of the major caregiver of stroke patients
Authors: Hu Ping , Yang Qing , Kong Lingna , Hu Luanjiao , Zeng Lingqiong 
Published: October 2018

Abstract
To investigate the anxiety/depression of caregivers of stroke patients.
This study used a cross-sectional survey design and convenience sampling.
Totally, 117 caregivers of stroke patients were enrolled. Data were collected from questionnaires. Hamilton anxiety scale, Hamilton depression scale, and Zarit caregiver burden interview were performed. Multiple linear regression and correlation analysis were used.
The anxiety score, depression score and total burden score of 117 stroke caregivers were 16.56 ± 8.02, 18.63 ± 9.39, and 25.88 ± 10.35, respectively. Anxiety symptoms, mild to moderate depressive symptoms, and severe depressive symptoms were found in 43.9%, 26.5%, and 27.4% of the caregivers, respectively. Daily care time and medical payment method were influencing factors for anxiety and depression (P < .05). Both anxiety and depression were positively correlated with total care burden score (P < .01).
Anxiety and depression are common in the caregivers of stroke patients and are closely related to care burdens. In this regard, appropriate home care guidance, psychological counseling and social support should be provided to the caregivers to reduce their physical and mental burden.
Induction therapy for clinical stage T2N0M0 esophageal cancer
Authors: Lv Hong-Wei , Xing Wen-Qun , Shen Si-Ning , Cheng Ji-Wei 
Published: October 2018

Abstract

Objective:
It is still controversial whether patients with clinical T2N0M0 (cT2N0M0) esophageal cancer are treated with induction therapy. The aim of this study was to determine the effect of induction therapy on cT2N0M0 esophageal cancer.

Methods and materials:
We searched PubMed, Embase, the Cochrane Library, and Medline databases from inception up to May 1, 2017. This meta-analysis was performed to compare odds ratios (OR) for 5-year overall survival (OS), pathologically understaged and overstaged after esophagectomy.

Results:
Eight retrospective studies of 2646 patients were included in the meta-analysis. Data showed that no statistically significant difference in 5-year over survival was observed between induction therapy group and direct operation group. The pooled OR and 95% confidence interval (CI) for 5-year OS were 0.92 (95% CI = 0.72–1.18; P = .52). Whereas, compared with induction therapy group, direct operation group had more pathologically understaged and less overstaged after esophagectomy.

Conclusions:
Currentclinical staging for T2N0M0 esophageal carcinoma remains inaccurate. In this study, we found that direct operation group had more pathologically understaged and less overstaged after esophagectomy compared with induction therapy group. Induction therapy could degrade the tumor staging but not improve the patient's survival.
Comparing stand-alone oblique lumbar interbody fusion with posterior lumbar interbody fusion for revision of rostral adjacent segment disease
Authors: Zhu Guangduo , Hao Yingjie , Yu Lei , Cai Yingchun , Yang Xiaowei 
Published: October 2018

Abstract
Spinal fusion has become a standard treatment for symptomatic intervertebral degenerative disc disease. The present study aimed to compare perioperative parameters, clinical outcomes, and radiographic results of stand-alone oblique lumbar interbody fusion (OLIF) with posterior lumbar interbody fusion (PLIF) for the revision of rostral adjacent segment disease (ASD) following prior posterior lumbar fusion.
Thirty-six patients who underwent revision surgeries for rostral ASD were retrospectively reviewed. Among them, 17 patients underwent stand-alone OLIF (OLIF group) and 19 patients underwent PLIF (PLIF group). The length of operation, intraoperative hemorrhage, bed rest duration, and length of hospital stay were compared between the 2 groups. Clinical results were evaluated with the Oswestry Disability Index (ODI) and visual analog scale (VAS). Radiological results were evaluated with disc height (DH), foraminal height (FH), retrolisthesis index (RI), and lumbar lordosis (LL), as well as the fusion rate and cage subsidence. Follow-up results at 1 week, 3 months, and 12 months postoperatively were compared between the 2 groups.
The OLIF group had less intraoperative blood loss, shorter operative time, bed rest time, and hospital stay than did the PLIF group (P < .05). The OLIF group had lower VAS scores for back pain than the PLIF group at 1 week and 3 months postoperatively (P < .05), and lower VAS scores for leg pain than the PLIF group at 1 week postoperatively (P < .05). The OLIF group had lower ODI than the PLIF group at 1 week and 3 months postoperatively (P < .05). No significant differences were found in DH and FH between the 2 groups preoperatively (P > .05); the OLIF group showed higher DH and FH than the PLIF group at all time points (P < .05). No significant differences were found in RI and LL between the 2 groups at any time point. All patients achieved fusion at 12 months postoperatively, and cage subsidence was not observed in either group.
OLIF is effective and safe for the treatment of rostral ASD following prior posterior lumbar fusion, and is superior to PLIF in terms of perioperative parameters, short-term clinical outcomes, and DH restoration, with similar fusion and reduction rates.
Comparison of diabetes risk estimate in the cities of Riyadh and Amman
Authors: Alghwiri Alia A. , Alghadir Ahmad , Awad Hamzeh , Anwer Shahnawaz 
Published: October 2018

Abstract
A significant rise in the prevalence of type 2 diabetes mellitus (T2DM) in the Middle-east and North Africa (MENA) region has seen over the last few decades. The present observational study aimed to evaluate and compare the risk of developing T2DM in the cities of Riyadh and Amman using the Arab Diabetes Risk Assessment Questionnaire (ARABRISK).
The ARABRISK was administered in a total of 1116 healthy male and female individuals in the age group of 40 to 74 years with no prior history of diabetes in the city of Riyadh (Saudi Arabia) and Amman (Jordan). ARABRISK is an Arabic version of the Canadian Diabetes Risk Assessment Questionnaire (CANRISK), which was adapted and validated for the use in Arab-speaking individuals in Saudi Arabia and Jordan.
The participants from Amman region had higher mean total ARABRISK score compared to the Riyadh region for all categories of ARABRISK. However, the difference was significant in both low- and high-risk categories (P = .02 and P = .01, respectively) but not significant for moderate category (P = .17). In the Riyadh population, female participants had significantly higher ARABRISK total scores compared to male in both moderate- and high-risk categories (P = .01). However, in the Amman population, male participants had significantly higher ARABRISK total scores compared to female in both low- and moderate-risk categories (P = .01).
The present study suggested an increased risk of developing T2DM in the cities of Riyadh and Amman. However, the population of Amman had a higher risk of developing T2DM compared to the population of Riyadh.
Indocyanine green angiography for preserving the ureteral branch of the uterine artery during radical hysterectomy
Authors: Long Ying , Yao Yao , Yao De-sheng 
Published: October 2018

Abstract

Rationale:
Conventional radical hysterectomy is frequently associated with postoperative ureteral ischemic necrosis, urinary fistula, stenosis, and kidney seeper. Some have suggested that preserving the ureteral branch during radical hysterectomy may reduce the incidence of ureteral complications. However, the feasibility of such preservation has not been explored using intraoperative imaging techniques.

Patient concerns:
Two cervical cancer patients aged 45 and 53 years were selected to undergo surgery in our hospital in October 2017. Both patients showed normal function of major organs and no special treatment was deemed necessary based on their subjective symptoms and preoperative examination.

Diagnoses:
Both patients were diagnosed with cervical cancer in stage Ib1 according to the staging scheme of the International Federation of Gynecology and Obstetrics (FIGO 2009).

Interventions:
Two patients underwent ureteral branch-sparing radical hysterectomy. During surgery, indocyanine green (ICG) fluorescence angiography was used to identify the ureteral branch and evaluate perfusion of the uterine artery, its ureteral branch and the ureter.

Outcomes:
The uterine artery and ureteral branch were clearly labeled by green fluorescence, as were the distal serous layer of the ureter and tissue supplied by the ureteral branch. During 4-month follow-up, neither patient suffered hydronephrosis, ureteral fistula or stricture.

Lessons:
ICG angiography is a useful intraoperative imaging technique for identifying the ureteral branch and evaluating the branch-sparing surgery. Based on real-time angiography, sparing the ureteral branch can maintain blood supply to the ureter distal serous layer and neighboring tissues.
Patient quality of recovery on the day of surgery after propofol total intravenous anesthesia for vitrectomy
Authors: Na Se Hee , Jeong Kyu Hee , Eum Dahae , Park Jin Ha , Kim Min-Soo 
Published: October 2018

Abstract

Background:
Vitrectomy under general anesthesia is considered as a candidate for ambulatory surgery. An anesthetic method with high quality of postoperative recovery should be selected for successful ambulatory surgery. We thus compared quality of postoperative recovery on the day of vitrectomy using the Quality of Recovery (QoR)-40 questionnaire between propofol total intravenous anesthesia (propofol group) and desflurane inhalation anesthesia (desflurane group) as the 2 representative anesthetic methods.

Methods:
Eighty-four patients (20–80 years old) undergoing elective vitrectomy under general anesthesia were randomized into 2 groups. The propofol group received propofol and remifentanil using effect-site target-controlled infusion (TCI), and the desflurane group received desflurane inhalation and remifentanil using effect-site TCI. We assessed quality of recovery at 6 hours after surgery through interviews using the QoR-40 questionnaire. We also collected data related to recovery and complications during emergence and recovery period.

Results:
The median of QoR-40 score on the day of surgery was significantly higher in the propofol group than that in the desflurane group (181.0 vs 169.5, respectively; P = .033). In particular, propofol group had significantly higher scores for physical comfort and physical independence dimensions. The amount of remifentanil administered was significantly higher, and the emergence time was significantly longer in propofol group. However, there were no significant differences in other complications between the 2 groups.

Conclusions:
Propofol total intravenous anesthesia provided significantly better quality of recovery on the day of surgery than desflurane inhalation anesthesia.
A large retroperitoneal lipoblastoma
Authors: Sakamoto Saki , Hashizume Naoki , Fukahori Suguru , Ishii Shinji , Saikusa Nobuyuki , Yoshida Motomu , Masui Daisuke , Higashidate Naruki , Tsuruhisa Shiori , Ozono Shuich , Tanigawa Masahiko , Naito Yoshiki , Tanaka Yoshiaki , Yagi Minoru 
Published: October 2018

Abstract

Introduction:
Lipoblastoma is a rare benign soft tissue tumor that occurs most commonly in infants and children. However, retroperitoneal lipoblastomas are rare, occurring in <5% of cases. We report a case of large retroperitoneal lipoblastoma and the largest collection of known retroperitoneal lipoblastomas in children in the literature.

Case presentation:
A 3-year-old girl presented with left abdominal mass. Magnetic resonance imaging (MRI) revealed a soft tissue mass measuring 12 × 8 × 6 cm in the retroperitoneal region. The mass had a clearly defined margin and a reticular pattern with an interposing fat component. Based on these findings, the mass was suspected to be a soft-tissue tumor, most likely lipoblastoma.
Laparotomy with resection of the retroperitoneal mass was performed. The tumor was easily dissected from the retroperitoneal space without injury to surrounding structure.
A histopathological examination demonstrated the mature proliferation of adipocytes and spindle-shaped cells separated by fibrovascular septa accompanied by myxoid changes. The cells were separated into lobules by septa, and areas of immature adipocytes showing a signet-ring or multivacuolar appearance were present at the periphery. Histopathological diagnosis was lipoblastoma. Follow-up at 6 months revealed no evidence of recurrence.

Conclusion:
Retroperitoneal lipoblastoma is rare and tends to be large in size when diagnosed at presentation. Complete resection should not be delayed, as impingement on the surrounding structures is imminent.
Isolated extradural Rosai–Dorfman disease causing the spinal cord compression
Authors: Li Yongning , Wang Xin , Gao Jun , Yu Shuangni , Li Zhimin 
Published: October 2018

Abstract

Rationale:
Rosai-Dorfman disease (RDD) is a rare benign histiocytic disease that is commonly characterized by massive painless cervical lymphadenopathy and systemic manifestations. Isolated extranodal involvement, especially spinal involvement, is extremely rare.

Patient concerns:
A 28-year-old man presented with intermittent dorsodynia and bilateral lower-limb weakness and numbness. A magnetic resonance scan (MRI) showed an extradural lesion of the T6-T9 thoracic spine that lead to cord compression.

Diagnoses:
Histopathological findings showed distinctive emperipolesis and immunohistochemistry results that were positive for cluster of differentiation CD68 and S100. Therefore, we diagnosed the Rosai-Dorfman disease.

Interventions:
we performed a nearly total surgical resection and a limited T6-T9 laminectomy.

Outcomes:
Postoperatively, the patient's symptoms were partially relieved and experienced no recurrence during the 6-month follow-up. The preoperative diagnosis of isolated spinal RDD still remains challenging.

Lessons:
Thus, we should consider RDD in the differential diagnosis of the central nervous system. Besides surgical resection, the treatment also included radiation, chemotherapy or monoclonal antibodies. However, the optimal treatment remains controversial. Therefore, we should exert all our energies on the exploration of etiology and adjuvant therapy for this disease.