bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of clinical outcomes and safety between laminectomy with instrumented fusion versus laminoplasty for the treatment of multilevel cervical spondylotic myelopathy
Authors: Lin Xiang , Cai Jie , Qin Chuan , Yang Qinghua , Xiao Zengming 
Published: February 2019

Abstract

Study design:
Systematic review and meta-analysis.

Objectives:
Posterior laminectomy with instrumented fusion and laminoplasty are widely used for the treatment of multilevel cervical spondylotic myelopathy (MCSM). There is great controversy over the preferred surgical method. The purpose of this study is to evaluate the clinical outcomes and safety between laminectomy with instrumented fusion and laminoplasty for the treatment of MCSM.

Methods:
Related studies that compared the effectiveness of laminectomy with instrumented fusion and laminoplasty for the treatment of MCSM were acquired by a comprehensive search in PubMed, Embase, the Cochrane library, CNKI, VIP, and WANFANG up to April 2018. Included studies were evaluated according to eligibility criteria. The main endpoints included: preoperative and postoperative Japanese Orthopedic Association (JOA) scores, preoperative and postoperative visual analog scale (VAS), preoperative and postoperative cervical range of motion (ROM), preoperative and postoperative cervical curvature index (CCI), overall complication rate, C5 nerve palsy rate, axial symptoms rate, operation time and blood loss.

Results:
A total of 15 studies were included in this meta-analysis. All of the selected studies were of high quality as indicated by the Newcastle–Ottawa scale (NOS). Among 1131 patients, 555 underwent laminectomy with instrumented fusion and 576 underwent laminoplasty. The results of this meta-analysis indicated no significant difference in preoperative and postoperative JOA scores, preoperative and postoperative VAS, preoperative and postoperative CCI, preoperative ROM and axial symptoms rate. However, compared with laminoplasty, laminectomy with instrumented fusion exhibited a higher overall complication rate [RR = 1.99, 95% confidence intervals (CI) (1.24, 3.21), P <.05], a higher C5 palsy rate [RR = 2.22, 95% CI (1.30, 3.80), P <.05], a decreased postoperative ROM [SMD = −1.51, 95% CI (−2.14, −0.88), P <.05], a longer operation time [SMD = 0.51, 95% CI (0.12, 0.90), P <.05] and increased blood loss [SMD = 0.47, 95% CI (0.30, 0.65), P <.05].

Conclusion:
These results suggested that both posterior laminectomy with instrumented fusion and laminoplasty were determined to be effective for MCSM. However, laminoplasty appeared to allow for a greater ROM, lower overall complication and C5 palsy rates, shorter operation time and lower blood loss. Future well-designed, randomized controlled trials are still needed to further confirm our results.
Prognostic and clinicopathological value of MUC1 expression in colorectal cancer
Authors: Li Chao , Liu Tao , Yin Libin , Zuo Didi , Lin Yuyang , Wang Lei 
Published: February 2019

Abstract

Background:
Accumulating evidence supports the overexpression of mucin 1 (MUC1) in colorectal cancer (CRC), but the value of elevated MUC1 expression remains controversial. Here, we evaluated the prognostic and clinicopathological value of MUC1 expression in CRC.

Materials and methods:
The Web of Science, PubMed, Embase, Cochrane Library, and Wanfang databases, as well as the China Biology Medicine disc (CBMdisc) and China National Knowledge Infrastructure (CNKI) were searched for studies on MUC1 expression and prognosis of CRC through July 20, 2018. The pooled relative risks (RRs) and hazard ratios (HRs) with 95% confidence intervals (95% CIs) were calculated to evaluate the prognostic and clinicopathological value of MUC1 expression in CRC. The Revman version 5.3 package and STATA, version 12 were employed for pooled analysis and analysis of publication bias.

Results:
This meta-analysis included 16 published studies. The combined analysis showed that CRC patients with high MUC1 expression had a worse clinical outcome in overall survival (OS) (HR = 1.51, 95% CI = 1.30–1.75, P <.00001). In addition, high MUC1 expression was associated with higher TNM stage (RR = 1.44, 95% CI = 1.17–1.77, P = .0007), greater depth of invasion (RR = 1.30, 95% CI = 1.10–1.53, P = .002), and lymph node metastasis (RR = 1.47, 95% CI = 1.20–1.80, P = .0002) of CRC. However, the elevated MUC1 expression was not related to disease-free survival/recurrence-free survival (DFS/RFS) (HR = 1.51, 95% CI = 0.78–2.89, P = .22), histological grade (RR = 1.15, 95% CI = 0.96–1.38, P = .12), gender (RR = 0.95; 95% CI = 0.83–1.08, P = .44), tumor size (RR = 1.11, 95% CI = 0.85–1.44, P = .44), tumor site (RR = 1.01, 95% CI = 0.88–1.16, P = .84), or mucinous component (RR = 0.83, 95% CI = 0.60–1.14, P = .24) in CRC.

Conclusion:
Our findings indicated that high MUC1 expression represents a marker of poor prognosis in CRC. Meanwhile, elevated MUC1 expression was associated with advanced TNM stage, greater depth of invasion, and lymph node metastasis.
Helicobacter pylori infection combined with non-alcoholic fatty liver disease increase the risk of atherosclerosis
Authors: Yu Lo-Yip , Hu Kuang-Chun , Liu Chun-Jen , Hung Chung-Lieh , Bair Ming-Jong , Chen Ming-Jen , Wang Horng-Yuan , Wu Ming-Shiang , Shih Shou-Chuan , Liu Chuan-Chuan 
Published: February 2019

Abstract
Atherosclerosis has severe consequences on human health. Carotid artery plaques are a condition typically caused by atherosclerosis. Previous studies showed that nonalcoholic fatty liver disease (NAFLD) and Helicobacter pylori (H pylori) are risks factors for carotid artery plaque formation. We hypothesize that the combination of NAFLD with H pylori infection increases the risk of carotid artery plaque formation.
A total of 4669 subjects aged > 40 years who underwent routine health checkups between January 2006 and December 2015 were retrospectively reviewed. A serial examination, including abdominal ultrasound, carotid artery ultrasound and esophago-gastroduodenoscopy (EGD), and biopsy urease testing, was conducted.
In total, 2402 subjects were enrolled. There were no differences in H pylori infection status among patients with or without NAFLD. There was a trend of more participants with both NAFLD and H pylori infection (number [N]=583) presenting carotid artery plaque (N = 187,32.08%) than participants without NAFLD and H pylori infection (N = 589) who presented plaque formation (N = 106, 18.00%). Participants who had both H pylori infection and NAFLD had the highest risk of any carotid artery plaque (odds ratio [OR], 1.93; 95% confidence interval [CI], 1.413–2.636) based on a multivariate logistic regression analysis. This analysis also showed that age >60 years, male sex, low-density lipoprotein (LDL) >130 mg/dL, and H pylori infection were independent risk factors for concomitant NAFLD and carotid artery plaque formation.
The combination of H pylori infection and NAFLD increases carotid artery plaque formation. H pylori eradication and NAFLD control may be warranted to prevent carotid artery plaque formation.
Circadian variations in electric current responses at ryodoraku points across the waking stage
Authors: Bae Jang-Han , Ku Boncho , Bae Se-Eun , Kim Jaeuk U. 
Published: February 2019

AbstractHuman body undergoes the 24-hour daily rhythm in response primarily to light and darkness. The circadian rhythms of biomarkers reflect bodily conditions including the prognosis of some pathologies. As a sensitive index of sympathetic nervous response (SNR), electrodermal activity (EDA) is a recent research topic in healthcare industry as a noninvasive and easy-access biosignal. The EDA response at Ryodoraku points (RPs) is of potential clinical usage in relation to SNR and meridian theory, but still remains in its primitive development stage.In this study, the 24-hour variations of EDA for 14 hospitalized participants were monitored over 3 days using a Ryodoraku device, and a circadian model of EDA was constructed using a cosinor analysis based on the linear mixed effect model.As a result, EDA at every RP showed a circadian cycle with its value the lowest in the morning and increased gradually until the late afternoon, and monotonically decreased again until the next morning. Circadian variations were observed in EDAs of all 12 RPs. However, Ryodoraku-specific features were not detected. Midline estimating statistic of rhythm (MESOR) values in men and young group were higher than in women and old group, and cosinor analysis showed significant circadian rhythms, especially for men and young groups. Especially, circadian variation in EDA in the young group went above 35% of the MESOR value.It implies that the circadian rhythm should be considered for the Ryodoraku analysis to examine bodily conditions or the prognosis of some pathologies.
Bilateral vocal fold immobility in a single tertiary hospital in northern Taiwan
Authors: Shen Shang-Po , Chang Hung-Yang , Chang Jui-Hsing , Hsu Chyong-Hsin , Peng Chun-Chih , Lee Kuo-Sheng 
Published: February 2019

Abstract
To determine the natural history of patient with bilateral vocal fold immobility (BVFI), and to identify the factors or predictors associated with the tracheostomy and duration of cannulation for those who require tracheostomy.
A retrospective review was carried out at a single tertiary referral center over a 23-year period of infants less than 1 year old who presented with BVFI. All information related to sex, etiology, gestational age at birth, vocal fold (VF) position at diagnosis, presence of concomitant airway disease, age at attainment of VF movement, age at decannulation, and current tracheostomy status were recorded to perform descriptive and comparative analyses.
Forty-one patients were enrolled, and the tracheostomy rate was 80.5% (33/41). Those with a median VF position had a higher rate of tracheostomy in comparison with those with a paramedian VF position (P = .003). Among patients who underwent tracheostomy, 77.4% (24/31) were eventually decannulated. The median duration of cannulation was 4.4 years (range: 0.8 − 10.7 years). Those who were found to have attainment of VF movement at less than 1-year-old had a shorter duration of cannulation than others (mean: 1.9 years vs 5.2 years, P < .001). The mortality rate of those patients who received tracheostomy was 9.7% (3/31).
Although a high tracheostomy rate was found in BVFI patients, most of them underwent decannulation. The earlier attainment of VF movement is achieved, the shorter duration of cannulation is required. This information is important for physicians while following up BVFI patients who have undergone tracheostomy.
A case report of a giant mature teratoma of the thyroid gland in a young girl
Authors: Lv Zhibao , Bai Xiaoling , Sheng Qingfeng , Liu Jiangbin , Wu Yibo 
Published: February 2019

Abstract

Rationale:
Teratomas are extremely rare in the thyroid gland. A cervical teratoma presenting as a cystic or mixed thyroid lesion can be easily confused with a thyroglossal duct cyst. It is difficult for pediatricians to differentiate between these 2 types of lesions.

Patients concerns:
A 2-year-old girl who presented a growing thyroid mass for 14 months showed a mass in her left thyroid lobe under contrast-enhanced computed tomography (CT).

Diagnosis and interventions:
Ultrasonography found a mass of 5 × 3.5 cm within the left lobe of the thyroid gland, and the sonogram revealed areas with echo-free and mixed-echo patterns. There was no accumulation of technetium-99m pertechnetate on the thyroid scintigraphy (cold thyroid nodule). CT scan showed a mass (5.0 × 3.0 × 2.5 cm in size) that extended from the left thyroid lobe to the anterior mediastinum with no evident enhancement and clear margins that contained calcifications. Complete excision without intraoperative capsule disruption was achieved. Histologically, the thyroid mass was diagnosed as a mature teratoma.

Outcomes:
The postoperative course was uneventful after follow-ups for 2 years, and the patient had no inflammatory signs or evidence of recurrence.

Lessons:
Thyroid teratoma is rare in infants and is usually benign; however, some thyroid teratomas are malignant and inclined to relapse. The authors emphasize that thyroid teratomas in children should be included in the differential diagnosis of cystic lesions located in the head and neck area. Complete resection is essential for good outcomes. In addition, long-term follow-ups are warranted to follow the complications of the malignant or recurrent disease.
Comparison of effectiveness between complete internal limiting membrane peeling and internal limiting membrane peeling with preservation of the central fovea in combination with 25G vitrectomy for the treatment of high myopic foveoschisis
Authors: Wang Lifei , Wang Yanhui , Li Yalin , Yan Zhongyang , Li Yunhuan , Lu Lu , Lu Tianxiang , Wang Xin , Zhang Shengjuan , Shang Yanxia 
Published: February 2019

Abstract
Vitrectomy combined with internal limiting membrane peeling (ILMP) treats high myopic foveoschisis with good results, but there is a risk of iatrogenic macular holes, which may be reduced by preserving the internal limiting membrane of the central fovea. This study compared complete ILMP with partial ILMP, both combined with 25G vitrectomy, for the treatment of high myopic foveoschisis.
Thirty-three cases (33 eyes) of high myopic foveoschisis were retrospectively analyzed. They underwent 25G vitrectomy combined with C3F8 gas filling; Group A (20 patients, 20 eyes) underwent complete ILMP, while Group B (13 patients, 13 eyes) underwent partial ILMP to preserve the internal limiting membrane of the central fovea. Patients were followed up for 6 months and underwent best corrected visual acuity (BCVA), intraocular pressure, diopter, slit lamp microscopy, indirect ophthalmoscope, A-mode and/or B-mode ultrasound, and optical coherence tomography. Surgical complications were recorded.
Up to the last follow-up, the BCVA improved and central fovea thickness (CFT) was lower compared with before surgery in both groups (All P < .05). There were no significant differences in BCVA and CFT at each time point between the groups (P > .05). Most of the postoperative retinas of the 2 groups were completely reattached, with disappearance of the macular retinoschisis cavity. Two patients in the Group A and none in the Group B developed a macular hole during follow-up (P = .508).
The results did not support the superiority of partial ILMP over complete ILMP in reduced incidence of macular hole. Both methods had a similar curative effect.
Sex differences in the relationship between cognitive impairment and overweight or obesity in late life
Authors: Noh Hye-Mi , Han Junhee , Kim Yeo Jin , Jung Jin-Hyung , Roh Yong Kyun , Song Hong Ji 
Published: February 2019

AbstractThe relationship between body weight changes in late life and cognitive function is controversial.We investigated whether weight gain or loss in late life affected cognitive function in community-dwelling older adults over a 3-year period.Our study used data from the Survey of Living Conditions and Welfare Needs of Korean Older Persons and included 3859 subjects (aged ≥65 years) with normal cognition at baseline. At baseline and the 3-year follow-up, body weight and height were measured, and cognitive function was assessed using the mini-mental state examination. Based on their body mass index (BMI) at baseline and follow-up, we divided the subjects into 4 groups: weight gain (baseline BMI <23 kg/m2and follow-up BMI ≥23 kg/m2); weight loss (baseline BMI ≥23 kg/m2and follow-up BMI <23 kg/m2); stable overweight/obese (BMI ≥23 kg/m2at both visits); and stable non-overweight/obese (BMI <23 kg/m2at both visits). Incidence rates (IRs) of cognitive impairment per 100 persons and IR ratios (IRRs) were calculated for each group and adjusted for confounding variables.At the 3-year follow-up, 610 cases of cognitive impairment (15.8%) were identified. The stable overweight/obese group had the lowest IR (14.0, 95% confidence interval [CI] 12.45–15.71) and was therefore used as the reference group when calculating IRRs for cognitive impairment. When men and women were evaluated separately, IRs between groups were significantly different only for women. The stable non-overweight/obese group (IRR 1.65, 95% CI 1.22–2.22) and the weight gain group (IRR 1.93, 95% CI 1.24–3.01) had higher IRs than those in the stable overweight/obese group. As a gain or loss of adiposity, the IR of the weight gain group (IRR 1.17, 95% CI 0.74–1.84) was not different from that of the stable non-overweight/obese group. Also, the IR of weight loss group (IRR 1.09, 95% CI 0.71–1.67) was not significantly different from that of the stable overweight/obese group.We suggest that overweight or obese older women at baseline had cognitive benefits. However, additional gain or loss of adiposity in late life did not affect the risk of cognitive impairment.
Nucleostemin expression in breast cancer is a marker of more aggressive phenotype and unfavorable patients’ outcome
Authors: Sami Manal M. , Hachim Mahmood Y. , Hachim Ibrahim Y. , Elbarkouky Ahmed H. , López-Ozuna Vanessa M. 
Published: February 2019

Abstract
Cancer stem cells (CSCs) are postulated to play significant role in the pathogenesis, progression as well as drug resistance of breast cancer. Nucleostemin (NS) is thought to be a key molecule for stemness, and the clinical impact of NS immunoreactivity in breast cancer can indicate its actual role and future therapeutic potentials.
The current study is an observational study with an attempt to evaluate the correlation between NS expression (protein and gene expression levels) and different clinicopathological attributes of invasive breast cancer. For that reason, we investigated NS immunohistochemistry expression on commercial tissue microarray (TMA) of 102 patients and 51 archival specimens from patients admitted to Saqr Hospital, Ras Al Khaimah and diagnosed in Al Baraha Hospital, Dubai, UAE. In addition, the association between NS (GNL3) gene expression and different prognostic parameters as well as patient outcome was also evaluated using 2 large publicly available databases.
Interestingly, we found NS expression to be associated with less differentiated and more advance stage. In addition, NS expression was significantly higher in larger size (P = .001) and LN-positive tumors (P = .007). Notably, NS expression was significantly correlated to P53 positive (P = .037) status. Furthermore, NS was found to be more expressed in the highly aggressive breast cancer subtypes including human epidermal growth factor receptor 2 (HER-2) and triple negative breast cancer (TNBC) subtypes. Moreover, our results also showed that high GNL3 gene expression to be associated with poor patient outcome and higher chances of tumor recurrence.
Our results highlight NS expression as a marker of aggressive phenotype and poor outcome and indicate its possible use as a potential target for CSC-associated breast cancer management.
The value of neutrophil to lymphocyte ratio and gamma-glutamyl transpeptidase to platelet ratio in patients with hepatocellular carcinoma
Authors: Hu Zuojian , Chen Huaping , Chen Siyuan , Huang Zhili , Qin Shanzi , Zhong Jianing , Qin Xue , Li Shan 
Published: February 2019

Abstract
Our study aimed to evaluate the value of neutrophil to lymphocyte ratio (NLR) and gamma-glutamyl transpeptidase to platelet ratio (GPR) in patients with hepatocellular carcinoma (HCC).
A total of 565 patients with pathological diagnosis of HCC were retrospectively analyzed and 414 patients diagnosed with cirrhosis were treated as a control group. All clinical materials were collected from the First Affiliated Hospital of Guangxi Medical University.
The preintervention NLR, GPR, and α-fetoprotein (AFP) were significantly higher in HCC patients than in the controls (P
NLR < .000, P
GPR < .000, P
AFP < .000). The NLR and GPR were correlated with the Barcelona clinic liver cancer (BCLC) stages, Child-Pugh grades, and tumor size, but not with Edmondson–Steiner grades. Combined use of NLR or GPR with AFP produced larger area under the curve (AUC) (AUCNLR+AFP = 0.916; AUCNLR+AFP = 0.953) than NLR (P < .000), GPR (P < .000), or AFP (P < .000) used alone.
The preintervention hematologic parameters (NLR and GPR) studied herein were associated with the BCLC stages of HCC. Combined use of NLR or GPR with AFP may improve early detection and diagnosis of HCC.
Circulating microRNAs in adrenal tumors
Authors: Igaz Peter 
Published: February 2019

Purpose of review
Circulating microRNAs represent promising minimally invasive markers of several diseases including tumors. As the preoperative diagnosis of different adrenal tumors is difficult, for example, diagnosis of adrenocortical or adrenomedullary malignancy, circulating microRNAs might be helpful in their clinical management.

Recent findings
Observations regarding the applicability of circulating microRNAs isolated both from unfractionated plasma or serum and from extracellular vesicle preparations for the diagnosis of adrenocortical malignancy have been published. Data show that circulating microRNA might be exploited for monitoring adrenocortical cancer progression. Circulating microRNA profiles of adrenal myelolipoma have also been published that might be useful for differentiating adrenocortical cancer and adrenal myelolipoma in dubious cases.

Summary
In this review, recent advances in the field of circulating microRNAs in adrenal tumors are discussed.
Emergency Neurology Oral Cases for Trainee Assessment and Education
Authors: Loochtan Aaron I. , Spector Andrew R. , Sinha Saurabh R. , Lerner David P. 
Published: February 2019

Objectives:
Neurological emergencies comprise much of neurology residency, but there may be a lack of clinical experience. For our program, oral examinations have been used to assess resident readiness for additional clinical independence. In this study, we examined the perceptions of learners and examiners of oral case examinations.

Methods:
Six attending physicians administered case-based oral examinations to 8 trainees. Each case involved a chief complaint and progressed through a clinical encounter. Following the examination, each attending physician and trainee completed an online 5-point Likert scale survey of content and educational value. Statistical analysis of point assignment based on Likert scale responses was performed.

Results:
Six attendings (100% response) and 7 trainees (87.5% response) completed the assessment. The trainees assessed all 6 cases. Residents had negative responses for 3 cases with specific concern in “feedback” and “learning experience.” Residents responded with less positive response than attendings for “The case is easy to understand and progressed in a logical fashion” (3.90 for residents vs. 4.83 attendings; P=0.015) and “The case complexity is appropriate for level of training” (4.14 vs. 4.83; P=0.033). Attendings noted better understanding of trainees thought processes following oral examinations. Trainees noted feedback as the most useful component of case-based assessments.

Conclusions:
Case-based assessment in neurology training allows for rapid evaluation of trainees’ abilities to critically think. There is general agreement from attendings and trainees that case-based assessment is a useful and positive learning tool. The responses from this survey are being used to modify the cases for future examinations.