bluuebunny/crossref_metadata_2025_split huggingface dataset:
Successful treatment of genotype 3 hepatitis C infection in a noncirrhotic HIV infected patient on chronic dialysis with the combination of sofosbuvir and velpatasvir
Authors: Begovac Josip , Krznarić Juraj , Bogdanić Nikolina , Močibob Loris , Zekan Šime 
Published: December 2018

Abstract

Rationale:
Data on anti-HCV therapy in patients on dialysis is still evolving. Sofosbuvir is mainly eliminated through the renal route and there is controversy about its use in these patients.

Patient concerns:
We describe a 53-year-old male patient with HCV genotype 3 and human immunodeficiency type 1 (HIV) infection on chronic dialysis. HIV infection was diagnosed in 1987 and since July 2007 the patient was compliant with his antiretroviral therapy (ART) and had an undetectable plasma HIV viral load on all follow-up measurements. The patient was known to have HCV infection since 1997 but has never been treated for chronic hepatitis C. Because of progressive renal impairment dialysis started in 2005.

Diagnosis:
Before anti-HCV treatment commenced the patient liver transient elastography (FibroScan) indicated F3 fibrosis (stiffness, 11.6 kPa) and his HCV RNA viral load was 320,798 IU/mL (Abbott RealTime HCV assay).

Intervention:
Fixed dose combination of sofosbuvir/velpatasvir (400 mg/100 mg) for 11 weeks.

Outcomes:
Twelve weeks after treatment cessation HCV RNA was undetectable, hence the patient achieved a sustained virologic response. The drugs were well tolerated and the patient did not report any side effects.

Lessons:
Sofosbuvir/velpatasvir may be an option for HCV genotype 3 infection in patients coinfected with HIV on long-term dialysis.
Ventilator for the treatment of acute respiratory distress syndrome
Authors: Gao Yan , He Ya-long 
Published: December 2018

Abstract

Background:
Ventilator has been reported to treat acute respiratory distress syndrome (ARDS). However, its efficacy is still inconclusive. This systematic review and meta-analysis study aims to evaluate its efficacy and safety for the treatment of patients with ARDS.

Methods:
The electronic databases of Cochrane central register of controlled trials (CENTRAL), EMBASE, MEDILINE, CINAHL, allied and complementary medicine database (AMED) and 4 Chinese databases will be used to search relevant literature from their inception to the present to evaluate the efficacy and safety of ventilator for ARDS without the language restrictions. This study will only consider randomized controlled trials (RCTs) of ventilator for the treatment of ARDS. The Cochrane risk of bias tool will be utilized to assess the quality of the included RCTs studies. The primary outcomes include arterial blood gases values (recorded once a day) and ventilator settings. The secondary outcomes will include the Acute Physiology and Chronic Health Evaluation II, Simplified Acute Physiology Score, quality of life, cost, death, and any other adverse events. The summary results will be performed by using the models of random-effects or fixed-effects based on the heterogeneity of the included RCTs.

Results:
The results will be disseminated to peer-reviewed journals for publication. This study does not need ethics approval, because of no individual data will be involved. The results of this study will help clinicians and health policy-makers to refer for the policy or guideline making.

Conclusion:
The results of this systematic review and meta-analysis study may provide helpful evidence for the efficacy and safety of ventilator for ARDS.

Systematic review registration:
PROSPERO CRD42018 115409.
A systematic review of phenytoin intoxication induced by compound phenytoin sodium, ephedrine hydrochloride and theophylline tablets in China
Authors: Zhang Lingxia , Li Zhenfei , Ma Gaiying , Han Xu , Li Cancan , Shan Mingyue , Chen Liping 
Published: December 2018

Abstract

Objective:
In this study, we aimed to review the literature on phenytoin intoxication induced by compound phenytoin sodium, ephedrine hydrochloride and theophylline tablets (CPEHTT).

Method:
A literature search was performed in the following databases: WANFANG DATA, HowNet, National Library Reference and Consultation Alliance, Full-text Database of Foreign Medical Journals, PubMed and Ovid. The search terms were “Compound Phenytoin Sodium, ephedrine Hydrochloride and Theophylline Tablets,” and “poisoning,” or “toxicity,” in Chinese and in English.

Result:
Ten articles including 104 patients with CPEHTT intoxication were identified. The ages of the patients ranged from 52 to 82 years. Sixty-seven patients were male and thirty-seven patients were female (the male/female ratio, approximately 2:1). The most common clinical manifestations were dizziness (85%) and ataxia (85%), followed by limb weakness (65%), diplopia (25%), binocular horizontal nystagmus (24%), limb numbness (13%), nausea and vomiting (12%), somnolence (10%), tremor and high muscle tension (7%), lag in response (5%), dysarthria (6%), choking cough (2%), auditory hallucination and visual fantasy (1%), and involuntary movement (1%). All patients had chronic lung disease, and the most common disease was chronic bronchitis. The dosage ranged 4 to 15 tablets per day with medication duration of more than 1 year for most patients.

Conclusion:
The CPEHTT intoxication caused by phenytoin toxicity represents a drug safety problem in China. The common clinical manifestations, serum phenytoin concentrations, and associated factors of CPEHTT intoxication are important for diagnosis and prevention. These findings may help guide clinicians to correctly attend to the use of CPEHTT and avoid its toxicity.
Fuling Sini decoction for patients with chronic heart failure
Authors: Huang Lijie , Cai Hairong , Zhuang Jieqin , Chen Yanhong , Jin Zilin , Zhang Haobo , Gao Huanjia 
Published: December 2018

Abstract

Background:
Chronic heart failure (CHF) is one of the most important cardiovascular diseases worldly, with high morbidity and mortality. Fuling Sini decoction (FSD) has been used in the management of CHF widely in China, while its effective evidence is not clear. A systematic review and meta-analysis to evaluate FSD for CHF is lacking. Hence, we propose a protocol for systematic evaluation of its efficacy and safety for CHF.

Methods:
We will search the following electronic databases from inception to October 2018, including EMBASE, Cochrane Center Registration Controlled trials (Cochrane Library), PubMed, Medline, WHO International Clinical Trials Registry Platform, China Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), and Wan-fang database. Only randomized controlled trials (RCTs) of FSD alone or combined with other management for CHF will be included. Two independent reviewers will screen the literature and extract data according to the Cochrane Handbook method. The assessment of bias risk, data synthesis, subgroup analysis, and meta-analyses and finally meta-analysis will be performed by using RevMan V.5.3.5 software.

Results:
This systematic review will provide high-quality evidence and may be the first to evaluate efficacy and safety of FSD in the treatment of CHF.

Conclusion:
This systematic review will provide evidence for judging whether FSD is an effective management for CHF or not.

PROSPERO registration number:
CRD 42018110210.
FIB-4 index serves as a noninvasive prognostic biomarker in patients with hepatocellular carcinoma
Authors: Zhang Yi , Wang Rong , Yang Xianjin 
Published: December 2018

Abstract

Background:
Liver fibrosis index FIB-4 has been reported to be linked with hepatocellular carcinoma (HCC) prognosis, but the results were not consistent. This study aimed to synthetically explore the relationship between FIB-4 and clinical outcomes of HCC.

Methods:
A number of online databases were searched for relevant articles published before March 1, 2018. Hazard ratios (HRs) with 95% confidence intervals (95% CIs) were calculated to assess the prognostic value of the FIB-4 index in patients with HCC using Stata SE 12.0.

Results:
Eight articles (including 10 cohort studies) with 3485 HCC patients were finally included for analysis. The pooled results showed that FIB-4 index was significantly associated with overall survival (OS) for patients with HCC (HR = 1.74, 95% CI: 1.41–2.07, P <.001). And HCC patients with higher FIB-4 score were at significantly greater risk of recurrence 1.53 (95% CI: 1.29–1.78, P <.001). Subgroup analysis based on the treatment, stage and analysis type also confirmed the prognostic values of the FIB-4 score for OS and recurrence-free survival (RFS) in HCC.

Conclusions:
FIB-4 index might be a useful predictive marker in patients with HCC.
PRISMA—efficacy and safety of lixisenatide for type 2 diabetes mellitus
Authors: Wei Zhen-gang , Wang Man-cai , Zhang Hui-han , Wang Zhe-yuan , Wang Gen-nian , Wei Feng-xian , Zhang Ya-wu , Xu Xiao-dong , Zhang You-cheng 
Published: December 2018

Abstract

Objective:
We aimed to systematically evaluate the efficacy and safety of lixisenatide in patients with type 2 diabetes mellitus.

Methods:
PubMed, EMBASE, Cochrane Library, ClinicalTrials.gov, Google, Web of Science and the Chinese Science Citation Database were searched up to March 2018. Randomized controlled trials determining the efficacy and safety of lixisenatide in patients with type 2 diabetes mellitus were eligible for inclusion. Two authors independently extracted the data in a prespecified Microsoft Excel spreadsheet. A meta-analysis was performed using Review Manager 5.3 software. Weighted mean difference (WMD) and relative risk (RR) together with their corresponding 95% confidence intervals (CIs) were estimated, and only the random effects model was used in order to achieve a more conservative estimate of the efficacy and safety.

Results:
Fourteen multicenter randomized controlled trials involving 11,947 patients were eligible for inclusion. Compared to placebo, lixisenatide could more significantly reduce the level of HbA1c (WMD=-0.44; 95% confidence interval [CI] [-0.55,-0.33]), and a higher proportion of lixisenatide-treated patients achieved the HbA1c level of < 7.0% (RR = 1.89, 95% CI [1.75–2.03]) and < 6.5% (RR = 3.03, 95% CI [2.54–3.63]) than the placebo-treated patients. Lixisenatide was also associated with a significant reduction in fasting plasma glucose and 2-hour postprandial plasma glucose levels. The risks for any adverse events, gastrointestinal adverse events, and symptomatic hypoglycemia significantly increased in the lixisenatide-treatedment group compared to those in the placebo group. However, lixisenatideit did not increase the risks of serious adverse events, death, or severe hypoglycemia.

Conclusions:
Lixisenatide was more effective than placebo in patients with type 2 diabetes mellitus, and the mild-to-moderate adverse events were found to be tolerated during the follow-up.
Investigation of the clinical significance and prognostic value of microRNA-145 in human hepatocellular carcinoma
Authors: Li Ping , Fan Hua , He Qiang 
Published: December 2018

Abstract
We aimed to investigate the clinical significance and prognostic value of miR-145 in hepatocellular carcinoma (HCC).
HCC tissue samples and adjacent normal liver tissues were obtained from 139 patients diagnosed with HCC. The relationships between the expression level of miR-145 and clinicopathologic factors were evaluated by Chi square test. Kaplan–Meier survival analysis with the log-rank test was used to evaluate the association between miR-145 expression and HCC prognosis.
miR-145 was significantly down-regulated in HCC tissues compared with the adjacent noncancerous tissues (P < .001). Its expression level was significantly correlated with tumor size (P = .010), tumor number (P = .033), lymph node metastasis (P < .000), TNM stage (P < .001) and tumor differentiation (P < .001). Kaplan–Meier curves with log rank test showed that the overall survival of the patients with low miR-145 expression was significantly shorter in comparison with the high miR-145 expression patients (P = .043). Furthermore, multivariate analysis using the Cox proportional hazards model for all variables showed that miR-145 expression was an independent prognostic factor for overall survival (P = .033).
Our results indicate that low expression of miR-145 is an independent poor prognostic factor for patients with HCC. Further investigations are needed to confirm our findings.
Increased serum levels of MIC1/GDF15 correlated with bone erosion in spondyloarthritis
Authors: Song Yingyu , Cui Yang , Zhang Xiao , Lin Haobo , Zhang Guangfeng , Zeng Hui , Zeng Yonghan 
Published: December 2018

Abstract

Introduction:
To assess the association between growth differentiation factor-15 (GDF15) and radiographic features including bone marrow edema and bone erosion in Spondyloarthritis (SpA).

Methods:
Patients with SpA (n = 120) receiving treatment in the Guangdong General Hospital, China, between August 2012 and December 2016 were retrospectively included. Serum of patients and healthy controls (n = 30) were collected and GDF15 levels were measured using ELISA. Inflammation was assessed by C-reactive protein (CRP), and magnetic resonance imaging (MRI) of the sacroiliac joint using Spondyloarthritis Research Consortium of Canada score and a method of dichotomy to assess fat metaplasia, bone erosion, and ankylosis. Radiographs of the pelvis were scored using the modified New York (mNY) score.

Results:
Serum GDF15 levels were higher in SpA patients compared to controls (503.52 ± 222.92 vs. 190.86 ± 104.18 pg/mL, P < .0001). Patients who suffered from bone erosion on MRI had higher levels of GDF15 (525.72 [186.33, 801.62]vs. 428.06 [255.15, 670.98] pg/mL, P = .0375). There was a positive correlation between serum GDF15 and CRP (r = 0.5442, P < .0001). Moreover, GDF15 levels were related to CRP levels (r = 0.5658, P < .0001) in those X-ray scores were III, according to 1984mNY criteria. Receiver operating characteristic (ROC) analysis showed that GDF15 levels above 501.98pg/mL could predict presence of bone erosion on MRI.

Conclusion:
The present study suggested that serum GDF15 levels are higher in SpA patients than in healthy controls. The GDF15 level was correlated with CRP and may be a surrogate biomarker in bone erosion.
A comparative study of ultrasonic scalpel (US) versus conventional metal clips for closure of the cystic duct in laparoscopic cholecystectomy (LC)
Authors: Ai Xiao-Ming , Ho Li-Chen , Yang Nian-Yin , Han Lu-Lu , Lu Jin-Jing , Yue Xiong 
Published: December 2018

Abstract

Background:
laparoscopic cholecystectomy (LC) has become the gold standard surgery for benign gallbladder diseases. Metal clips are conventionally used to secure the cystic duct and artery, while monopolar electrocautery (ME) predominates during laparoscopic dissection. ultrasonic scalpel (US) has already been explored for sealing the cystic duct and artery as a sole instrument, which has been regarded as a reasonable alternative to clips. The aim of this study was to investigate the safety and effectiveness of US versus clips for securing the cystic duct during LC.

Methods:
We identified eligible studies in PubMed, Medline, Cochrane Library, Embase, and SpringerLink up to 1st May 2018, together with the reference lists of original studies. Meta-analysis was conducted using STATA 14.0. Q-based chi-square test and the I
2 statistics were utilized to assess heterogeneity among the included studies. A P-value below .05 was set for statistical significance. Forest plots of combined Hazard ratios (HRs) with 95% confidence intervals (CIs) were also generated.

Results:
Eight studies met eligibility criteria in this meta-analysis eventually. A total of 1131 patients were included, of whom 529 were contained in the US group, compared to 602 in the clips group, which showed a significant difference (P = .025) without substantial statistical heterogeneity (I
2 = 0.0%). No statistical significance was revealed regarding age (I
2 = 0.0%, P = .957), and sex (I
2 = 0.0%, P = .578) between both groups. The operative time and hospital stay in the US group were significantly shorter than that in the clips group, with I
2 = 95.0%, P = .000 and I
2 = 72.8%, P = .005, respectively. Concerning conversion (I
2 = 48.6%, P = .084), perforation (I
2 = 12.0%, P = .338), along with bile leakage (I
2 = 0.0% P = .594), and overall morbidity (I
2 = 19.1%, P = .289), comparison between both groups exhibited no statistical significance.

Conclusions:
US enabled shorter operative time and hospital stay during LC, compared with clips. Additionally, US was comparable to clips regarding conversion, perforation, along with bile leakage and overall morbidity. Therefore, our meta-analysis concluded that US is clinically superior to the conventional clips in some aspects, or is at least as safe and effective as them, concerning closure of the cystic duct and artery.
Successful treatment of colorectal liver metastasis harboring intrahepatic cholangiocarcinoma
Authors: Cheng Xiaofei , Zhao Feng , Chen Dong , Yang Piao , Zhong Weixiang , Xu Xiangming , Wang Weilin 
Published: December 2018

Abstract

Rationale:
Colorectal liver metastasis develops in 50% of patients diagnosed with colorectal cancer, whereas concurrent intrahepatic cholangiocarcinoma (ICC) and colorectal liver metastases is extremely rare.

Patient concerns:
A 72-year-old man was referred to our hospital complaining of abdominal discomfort, diarrhea, and weakness over the last month.

Diagnoses:
Colorectal liver metastases concurrent intrahepatic cholangiocarcinoma (ICC).

Interventions:
The patient was treated with mFOLFOX6 (5-fluorouracil 2400 mg/m2, leucovorin 400 mg/m2, and oxaliplatin 85 mg/m2) plus bevacizumab 5 mg/kg every 2 weeks for 2 months. However, chemotherapy was not effective for the liver S3 lesion in our case. The possibility of ICC was considered based on the multidisciplinary team (MDT) mode, together with an anomalous increase in cancer antigen 19-9 and a history of hepatolithiasis.

Outcomes:
Simultaneous resection of the colon cancer and liver tumors was performed at 6 weeks after discontinuing bevacizumab. Colorectal liver metastases concurrent ICC was confirmed by postoperative pathology. The patient's disease-free survival time is currently >14 months.

Lessons:
This is the first case report of the diagnosis and timely treatment of colorectal liver metastases harboring ICC. These results suggest that multiple primary tumors should be considered as a differential diagnosis when imaging or laboratory test results are abnormal.
Prostate cancer laparoscopic port site metastasis
Authors: Jundt Michael C. , Broski Stephen M. 
Published: December 2018

Abstract

Introduction:
Laparoscopic port site metastases are a rare but clinically important cause of biochemically recurrent prostate adenocarcinoma. C-11 choline, among other prostate-specific positron emission tomography (PET) radiotracers, has improved radiologist confidence in these otherwise difficult-to-detect sites of recurrence.

Patient Concerns:
A 62-year-old male presented with biochemically recurrent prostate adenocarcinoma after undergoing robotic-assisted radical prostatectomy 5 years earlier.

Diagnosis:
C-11 choline positron emission tomography/computed tomography (PET/CT) demonstrated a choline-avid soft tissue nodule associated with a laparoscopic port site in the right rectus abdominis muscle, with correlative findings on prior magnetic resonance imaging, and biopsy confirming a prostate adenocarcinoma metastasis.

Interventions:
The patient was initiated on chemohormonal therapy.

Outcomes:
His prostate-specific antigen (PSA) became undetectable following chemohormonal therapy. A follow-up C-11 choline PET/CT demonstrated complete resolution of prior abnormal radiotracer activity in the right rectus abdominis muscle.

Lessons:
Port site metastases in prostate adenocarcinoma are rare; however, those who treat prostate cancer patients should be aware of this phenomenon as the number of minimally invasive oncologic procedures increase. C-11 choline PET, among other prostate-specific PET probes, has become an important tool in evaluating patients with biochemically recurrent prostate adenocarcinoma, identifying site-specific metastases in a majority of patients.
Oncological markers CA-125, CA 19-9 and endometriosis
Authors: Fiala Ludek , Bob Petr , Raboch Jiri 
Published: December 2018

Abstract
The endometrium tissue is functionally androgen related which plays an important role in women's fertility regulation. In addition recent findings show that endometrium related pathology is closely linked to disrupted androgen biosynthesis and associated regulatory functions. These findings also suggest that androgens might play an important role in endometrium related cancer pathology with significant implications for treatment.
Based on these findings, we have assessed 50 female outpatients with endometriosis and the clinical investigations were focused on biochemical serum analysis of DHEAS, oncological markers CA-125 and CA 19-9, estradiol, thyreothropic hormone, and prolactin.
The results show significant Spearman correlations of CA-125 and CA 19-9 with dehydroepiandrosterone- DHEA-S (R = 0.52 resp. R = 0.49).
This result represents 1st reported finding documenting androgen related increase of CA-125 and CA 19-9 levels as significant markers of endometrium pathology and it is possible to assume that these potential biomarkers could have clinical importance with respect to timely diagnosis.
Efficacy and safety of Tianmabianchunzhigan in mild to moderate vascular dementia
Authors: Tian Jinzhou , Shi Jing , Wei Mingqing , Li Ting , Ni Jingnian , Zhang Xuekai , Zhang Meng , Li Yang , Wang Yongyan 
Published: December 2018

Abstract

Background:
Vascular dementia (VaD) is the 2nd most common subtype of dementia after Alzheimer disease. Currently, there are no medications approved for treating patients with VaD. Tianmabianchunzhigan (TMBCZG) tablet is an active ingredient extracted from Gastrodia that has been reported to improve memory and other cognition. And the TBMCZG has been approved clinical trial with patients with VaD by center for drug evaluation of China (CFDA). To evaluate the efficacy, safety, and tolerability of TMBCZG tablets in the treatment of mild to moderate VaD, we designed and reported the methodology for a 24-week, randomized, double-blind, parallel, placebo-controlled, multicenter trial.

Methods:
A total of 160 patients with mild to moderate VaD will be enrolled. After a 2-week run-in period, the eligible patients will be randomized to receive either TMBCZG high-dose group (TBMCZG 3 tablets, twice per day); TMBCZG middle-dose group (TMBCZG 2 tablets and placebo 1 tablet twice per day); TMBCZG low-dose group (TMBCZG 1 tablet and placebo 2 tablets, twice per day); placebo group (placebo 3 tablets, twice per day) for 24 weeks, with a follow-up 12 weeks after withdrawn drug treatment. The primary efficacy measurement will be the vascular dementia assessment scale-cognitive subscale and the Clinical Dementia Rating-Sum of the Boxes scale. The secondary efficacy measurements will include the mini mental state examination and activities of daily living. Adverse events will also be reported.

Discussion:
This randomized trial will be the 1st rigorous study on the efficacy and safety of TMBCZG tablets for treating cognitive symptoms in patients with VaD using a rational design.

Trial registration:
ClinicalTrials.gov NCT03230071. Registered on July 26, 2017.