bluuebunny/crossref_metadata_2025_split huggingface dataset:
A simple method for preventing graft detachment during phacoemulsification cataract surgery after Descemet stripping automated endothelial keratoplasty
Authors: Hsu Shiuh-liang , Lee Po-yen , Chiu Li-yi 
Published: January 2019

Abstract

Rationale:
Graft detachment and endothelial cell damages are 2 major concerns for cataract surgeries in cases after Descemet stripping automated endothelial keratoplasty (DSAEK). We invented a simple but innovative method to anchor the DSAEK graft with sutures during the surgery to avoid possible graft detachment.

Patient concerns:
We present a 59-year-old male who had done DSAEK surgery. Due to progressed blurry vision due to cataract, he underwent sequential cataract surgery 1 year after DSAEK surgery. We applied the method to the patient successfully and the result was satisfying.

Diagnosis:
Cataract post-DSAEK surgery.

Interventions:
At the beginning of surgery, we made 4 radial fixation sutures with Nylon 10-0 though cornea-DSAEK graft at paracentral point and then through limbus. The sutures were located at 45°, 135°, 225°, and 315°. At the end of surgery, 4 fixation sutures were removed.

Outcomes:
The DSAEK graft was kept well attached during and after the surgery. Only low-grade corneal edema was found postoperation.

Lessons:
We provide this special method and applied it to our patient successfully. By using our method, surgeons can reassure graft adhesion during and after surgery, especially for those need cataract surgery after DSAEK surgery.
Nonobstructive coronary artery myocardial infarction complicated by heart failure, ventricular aneurysm, and incessant ventricular arrhythmia
Authors: Li Beibei , Ming Zhixu , Wu Jing , Zhang Mingyou 
Published: January 2019

Abstract

Rationale:
Myocardial infarction with nonobstructive coronary artery (MINOCA) is one of the common causes of cardiac related death. While patients with MINOCA usually do not need coronary artery intervention treatments, the prognosis could be worsened if the condition is not appropriately managed. This report describes a case of MINOCA patient suffered with multiple complications.

Patient concerns:
A 63-year-old female was admitted to the emergency department with acute onset of chest pain, electrocardiogram showed ST segment elevation in precordium leads.

Diagnosis:
Emergency coronary artery angiogram no significant coronary artery stenosis being observed. The diagnosis of MINOCA was established. She subsequently developed ventricular thrombus, heart failure, and ventricular arrhythmia.

Interventions:
The patient's ventricular tachycardia (VT) was refractory to different treatments. Due to the presence of a ventricular thrombus, epicardial ablation was performed but the VT recurred. The patient was then successfully treated with an implantable cardioverter defibrillator and surgical removal of the ventricular aneurysm.

Outcomes:
The patient was free of events during the 3-month follow-up period after the surgery.

Lessons:
MINOCA can occur with multiple complications, and surgical removal of a ventricular aneurysm can successfully recover the cardiac geometry during contraction leading to an improvement of the left ventricular bump function, as well as the removal of the potentially pathological loci of the VT.
Interferon-induced transmembrane protein-3 rs12252-CC is associated with low differentiation and progression of hepatocellular carcinoma
Authors: Hou Yuli , Zhang Yonghong , Qin Ling , Zhang Chi , Wang Shanshan , Chen Dexi , Li Ang , Lou Jinli , Yu Yanhua , Dong Tao , Li Ning , Zhao Yan 
Published: January 2019

Abstract
Interferon-induced transmembrane protein 3 (IFITM3) is a component of ISG (Interferon-Stimulated Gene) family. The association between IFITM3 and hepatocellular carcinoma (HCC) has been reported. While the relationship between this genetic variation and the progress of HCC remains unclear. To address this issue, we explore the relationship between the IFITM3-rs12252 genetic variants and the progression of HCC in this study.
A total of 336 candidates were enrolled in the study, including 156 patients with HBV related HCC and 180 patients with chronic Hepatitis B infections or liver cirrhosis. Liver cirrhosis or chronic hepatitis B were diagnosed with clinical characteristics and staging, laboratory testing, and imaging results of viral infection and hepatic damage. Polymerase chain reaction (PCR) was employed to determine the gene polymorphism of IFITM3, and analyzed with the GraphPad Prism v 5.
The patients with HCC had a significantly higher proportion of IFITM3 rs12252-CC as compared with the patients with chronic HBV infection or liver cirrhosis. Moreover, the distribution of CC genotype in HCC patients with low differentiation was significantly higher than that in those with high differentiation. Furthermore, the patients with CC genotype were found with bigger tumor size, higher percentage of vascular thrombosis, higher distribution of low differentiation and higher 5-year relapse rate than those with CT/TT genotypes.
This study indicates a correlation between the IFITM3-rs12252 CC genotype and the progression of HCC.
The diagnosis and treatment of cardiac lymphangioma
Authors: Diao Wen-Jie , Shi Chao , Liu Ge , Liu Xue-Gang , Li Hai-Hui , Meng Jin-Jin , Shi Yu , Chang Ming-Ming , Liu Yi-Yao 
Published: January 2019

Abstract

Rationale:
Cardiac lymphangioma is a rare disease. Until now, there have been only a few cases of cardiac lymphangioma reported in the literature.

Patient concerns:
We report the case of a 57-year-old female patient with cardiac lymphangioma from atrial septum.

Diagnosis:
Color Doppler echocardiography was performed, which revealed a tumor occupying a large amount of space in the left and right atrium.

Interventions:
The patient underwent thoracoscopic cardiac tumor resection under general anesthesia according to the procedure used for benign tumors.

Outcomes:
The patient recovered completely and was discharged home. Follow-up color Doppler echocardiography scans obtained from 6 months to 2 years after the operation showed no recurrent mass.

Lessons:
Once the tumor is detected, surgical treatment should be implemented as soon as possible.
Multifocal intraosseous hemangioma
Authors: Yao Kai , Tang Fan , Min Li , Zhou Yong , Tu Chongqi 
Published: January 2019

Abstract

Rationale:
Multifocal intraosseous hemangioma, which affects multiple body parts, is rare. The selection of appropriate lesion sites for biopsy and effective treatment in multifocal intraosseous hemangioma is challenging. Here, we report a case of multifocal intraosseous hemangioma.

Patient concerns:
A 49-year-old woman was admitted to our department with a chief complaint of aggravated lumber pain for 10 days.

Diagnoses:
Radiographic imaging revealed lesions involving the bilateral ribs, lumbar vertebrae, ilium, pubis, and proximal femur. Open biopsy in the ilium established the pathological diagnosis of intraosseous hemangioma.

Interventions:
For the symptomatic lumbar spine, the patient selected radiotherapy as the initial treatment.

Outcomes:
As of the one-year follow-up, no symptoms of recurrence have been observed.

Lessons:
This rare case demonstrates the importance of the selection of the appropriate lesion to confirm the diagnosis and effective treatment for patients with multifocal disease. Radiotherapy plays an important role in the treatment of patients with symptomatic vertebral hemangiomas without neurologic deficits.
Infection of finger caused by Morganella morganii leading to digital amputation
Authors: Li Di , Gao Wenshan , Niu Yanan , Zhao Pei , Zheng Wenkui , Li Cong Jie 
Published: January 2019

AbstractRationale:Digital infection is a common disease in clinic, featured by pain and swelling of digits. As far as we know, no article has reported a case of digital infected byMorganella morganii.Patient concerns:A 58-year-old Chinese female complains about whitlow with pain and swelling for 2 weeks. She has a history of diabetes for 10 years. She received incision and drainage before coming to our hospital and preoperative X-ray of left ring finger presented no bone eroded.Diagnosis:She is diagnosed with infection of ring finger caused byM morganiiin our hospital.Interventions:We perform aggressive operative debridement and drainage firstly. Meanwhile, we provide tissue samples for diagnosis and the result indicatesM morganiiinfection. Then, she is treated with anti-infection therapy and regulation of diabetes. However, 1 week after first surgery, her condition deteriorate presenting bone erosion in distal phalanx of ring finger from X-ray. Considering severity of illness, we decide to perform digital amputation.Outcomes:At 3-month follow-up, the patient has a satisfactory result and X-ray shows no bone eroded.Lessons:Clinicians should considerM morganii, which is rare in hand infection, as a cause of digital infection. This case reminds us that some whitlow is dangerous, amputation should be considered if necessary.
Regional cerebral hypoperfusion after acute sleep deprivation
Authors: Zhou Fuqing , Huang Muhua , Gu Lili , Hong Shunda , Jiang Jian , Zeng Xianjun , Gong Honghan 
Published: January 2019

Abstract
Previous neuroimaging studies have shown that functional changes occur after acute sleep deprivation, which suggest detrimental effects of a lack of sleep on the intrinsic functional architecture of the brain. We aimed to identify regional resting perfusion changes in subjects with acute sleep deprivation.
Thirty-three healthy subjects with habitual good sleep participated in 36 hours (2 days and 1 night) of sleep deprivation and then underwent the attention network test and pseudo-continuous arterial spin labeling scanning. Regional cerebral blood flow was used to compare cerebral perfusion before and after sleep deprivation. Correlation analyses of regional perfusion changes and scores on the attention network test were performed.
Compared with the baseline (n = 20) scans, the scans of subjects after sleep deprivation (n = 26) revealed a slower response time (549.99 milliseconds vs 603.36 milliseconds; t = −2.301; P = .028) and a significantly higher lapse rate (0.88% vs 22.85%; t = −2.977; P = .006). The sleep deprivation subjects showed lower cerebral blood flow (CBF) in the left parahippocampal gyrus/fusiform cortex (pHipp/Fus), right pHipp/Fus, and right prefrontal cortex (PFC) relative to the baseline subjects (Gaussian random field correction, voxel level P < .01, and cluster level P < .05). Although no significant relationships were observed between the altered regional CBF (rCBF) values and the attention network test scores, the receiver-operating characteristic and leave-one-out cross-validation analyses revealed that significant decreases in rCBF in the bilateral pHipp/Fus and right PFC could discriminate between sleep deprivation and good sleep status.
We observed that rCBF was reduced after 36 hours (2 days and 1 night) of sleep deprivation. Our preliminary findings suggest an acute vulnerability to hypoperfusion due to lack of sleep.
Prognostic value of pretreatment albumin to bilirubin ratio in patients with hepatocellular cancer
Authors: Xu Yi-Xin , Wang Yi-Bo , Tan Yu-Lin , Xi Cheng , Xu Xue-Zhong 
Published: January 2019

Abstract

Background:
Hepatic function is closely associated with prognosis in patients with hepatocellular cancer (HCC). In this study, a meta-analysis of the published studies was performed to assess the prognostic value of ALBI grade in HCC patients.

Methods:
Databases, including PubMed, EMbase, Web of Science, and Cochrane Library were retrieved up to August 2018. The primary outcome was OS and secondary outcome was DFS, the prognostic impact of which was assessed by using hazard ratio (HRs) with corresponding 95% confidence intervals (CIs). The enrolled studies were analyzed by using STATA version 12.0 software.

Results:
A total of 22,911 patients with HCC in 32 studies were included. Our results demonstrated that high pretreatment ALBI is associated with poor OS (HR = 1.719, 95%CI: 1.666–1.771, P = .000, univariate results; HR = 1.602, 95%CI: 1.470–1.735, P = .000, multivariate results) and poor DFS (HR = 1.411, 95%CI: 1.262–1.561, P = .000, univariate results; HR = 1.264, 95%CI: 1.042–1.485, P = .000, multivariate results). Meanwhile, when the analysis was stratified into subgroups, such as treatment methods, sample size, geographic area, and ALBI grade, the significant correlation in ALBI and poor long-term survival was not altered.

Conclusion:
High pretreatment ALBI is closely associated with poor prognosis in HCC, and High ALBI should be treated as an ideal predictor during hepatocellular therapy.
Acupuncture for chronic uncomplicated musculoskeletal pain associated with the spine
Authors: Xu Tao , Zhou Siyuan , Zhang Yutong , Yu Yang , Li Xiang , Chen Jiao , Du Jiarong , Wang Ziwen , Zhao Ling 
Published: January 2019

Abstract

Background:
Chronic uncomplicated neck pain, back pain, and lower back pain, with incidences of 18%, 17.7% and 36%, respectively. Although these three conditions occur in different parts of the body, we can summarize them as chronic uncomplicated musculoskeletal pain associated with the spine (CMPS) in accordance with the pathogenesis. Acupuncture is often used to treat them. We aim to conduct a systematic review to evaluate the efficacy of acupuncture for patients experiencing CMPS.

Methods:
The following electronic databases will be searched from inception to Mar 2019: Cochrane Central Register of Controlled Trials, Web of Science, ScienceDirect, PubMed, MEDLINE, EMBASE, Springer, WHO International Clinical Trials Registry Platform, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, VIP Chinese Science and Technology Periodical Database, and Wanfang Database. All randomized controlled trials published in English or Chinese related to acupuncture for CMPS will be included. The primary outcome will be the visual analog scale. Adverse events will be evaluated as secondary outcomes for safety evaluation. Study selection, data extraction, and assessment of study quality will be performed independently by two reviewers. RevMan V.5.3.5 software will be used for the assessment of risk of bias and data synthesis.

Results:
This study will provide a high-quality synthesis of current evidence of acupuncture for CMPS from visual analog scale.

Conclusion:
The conclusion of our study will provide an evidence to judge whether acupuncture is an effective intervention for patients suffered from CMPS.

Ethics and dissemination:
Formal ethical approval is not required, as the data are not individualized. The findings of this systematic review will be disseminated in a peer-reviewed publication and/or presented at relevant conferences.

PROSPERO registration number:
CRD42018114806.
Rechallenge capecitabine after fluoropyrimidine-induced cardiotoxicity in rectal cancer
Authors: Peng Tao , Ouyang Yulu , Tong Kanger 
Published: January 2019

AbstractRationale:Fluoropyrimidine-induced cardiotoxicity is a rare but potentially serious toxicity. The most common symptom is anginal chest pain.Patient concerns:A 35-year-old woman was diagnosed with rectal cancer with metastasis to the liver.Diagnosis:A computed tomography scan showed a 9.3 × 4.5-cm predominantly hypodense lesion within the left lobe of the liver and thickening of the rectum. Liver biopsy showed moderately differentiated adenocarcinoma with necrosis involving the liver parenchyma, and immunohistochemistry for mismatch repair proteins indicated that the tumor was positive for MutL Homolog 1, MutS Homolog 2, MutS Homolog 6, and Protein Homolog 2. Rectal biopsy indicated moderately differentiated adenocarcinoma.Interventions:She received chemotherapy of fluorouracil 1600 mg/m2, leucovorin 500 mg/m2, and irinotecan 100 mg/m2every week. During the second cycle of chemotherapy, she developed severe anginal chest pain. We replaced fluorouracil with capecitabine 1500 mg (3 pills) a day every 2 weeks, with 1 week off, with irinotecan 100 mg/m2on day 1 and bevacizumab 5 mg/kg at 200 ml/h for 30 min every 2 weeks. She was treated with chemotherapy for approximately 6 months.Outcomes:The liver lesion showed a significant response to chemotherapy, so she underwent resection of the liver tumor and rectum. After the surgery, she received radiation therapy to the rectal area, and 3 months of chemotherapy were administered prior to colostomy reversal.Lessons:Although the mechanism of fluoropyrimidine-induced cardiotoxicity is still uncertain, our case provides clinical evidence that cardiotoxicity could be a dose-related complication. Reducing the dose of fluoropyrimidine should be considered as a strategy after fluoropyrimidine-induced cardiotoxicity. However, this must be discussed with a multidisciplinary team including oncologists and cardiologists. Close monitoring of serial biomarkers and echocardiography are necessary for early diagnosis of cardiotoxicity.
Efficacy and safety of pinaverium bromide combined with flupentixol-melitracen for diarrhea-type irritable bowel syndrome
Authors: Qin Lifeng , Qin Jinmei , Yang Qian , Lv Xiaoping , Huang Liyi 
Published: January 2019

Abstract

Background:
There are many trials on the combination of Pinaverium bromide (PB) and Flupentixol-melitracen (FM) in the treatment of diarrhea-type irritable bowel syndrome (IBS-D), but the sample sizes are small, and the research conclusions are inconsistent. Thus, a meta-analysis was performed, aiming to evaluate the efficacy and safety of this combination therapy in patients with IBS-D.

Methods:
A systematic literature search was conducted in 7 databases covering the period up to July 2018 to identify randomized controlled trials (RCTs) of PB combined with FM versus PB alone for IBS-D. The primary outcome was the total symptom relief rate. The other outcomes were the adverse events rate, HAMA/SAS score, and HAMD/SDS score. The methodological quality of the RCTs was assessed independently using 6 criteria according to the Cochrane Collaboration. All data were analyzed using Review Manager 5.3.

Results:
Fifteen RCTs with 1487 participants were identified from 2005 to 2018. Compared with PB alone, 15 RCTs showed significant effects of PB plus FM in terms of improved symptom relief in patients with IBS-D (n = 1487, OR = 5.17, 95%CI, 3.79–7.07, P < .00001). Eleven RCTs reported adverse effects in both the PB plus FM and PB groups, there was no statistically significant difference in the adverse events rate between the 2 groups (n = 1207, OR = 2.91, 95%CI, 0.91–9.28, P = 0.07). Two RCTs and 3 RCTs reported HAMA and HAMD scores respectively, and 3 RCTs reported both SAS and SDS scores. After treatment, the above scores in the PB plus FM group were significantly lower than the PB group (all P < .01). However, the trials were deemed to have a medium risk of bias.

Conclusions:
The efficacy of PB combined with FM is superior to PB alone in the treatment of IBS-D, and it is safe for clinical use. However, the conclusions still need to be verified by conducting more large-scale and high-quality RCTs.
Pneumatosis intestinalis and hepatic portal venous gas associated with gas-forming bacterial translocation due to postoperative paralytic ileus
Authors: Tahara Sayumi , Sakai Yasuhiro , Katsuno Hidetoshi , Urano Makoto , Kuroda Makoto , Tsukamoto Tetsuya 
Published: January 2019

Abstract

Rationale:
Pneumatosis intestinalis (PI) and hepatic portal venous gas (HPVG) are rare but potentially lethal conditions in which gas pathologically accumulates in the portal vein and intestinal wall, respectively. Proposed mechanisms include flatus escaping through an injured intestinal mucosa into the submucosa and thence into the portal venous system, or bacterial translocation (BT) of gas-forming enteric microorganisms from the gut into and through the intestinal wall to other organs. However, there has been no clear histopathological evidence to support these hypotheses.

Patient concerns:
A 61-year-old man underwent sigmoidectomy for colonic adenocarcinoma. Postoperatively, he developed paralytic ileus and then had a sudden cardiopulmonary arrest.

Diagnoses:
PI and HPVG were found at autopsy, presumably caused by the postoperative paralytic ileus and associated with BT of gas-forming organisms.

Interventions:
Cardiopulmonary resuscitation was unsuccessful.

Outcomes:
Postmortem imaging indicated the presence of massive PI and HPVG. At autopsy, there was marked intestinal emphysema with diffuse ischemic mucosal necrosis and severe pneumatosis in the stomach and intestine and marked gaseous dilation of the intrahepatic portal veins. Postmortem bacterial cultures revealed enteric bacteria in the peripheral blood and liver tissue.

Lessons:
Postoperative ileus leading to intestinal mucosal damage may be associated with BT of gas-forming enteric bacteria and the rapid onset of PI and HPVG with a lethal outcome.
On-table extubation in neonates undergoing anoplasty: an experience of anesthetic management on the concept of fast-tracking anesthesia
Authors: Cui Yu , Wang Yu , Cao Rong , Liu Kai , Huang Qing-hua , Liu Bin 
Published: January 2019

Abstract
Fast-track anesthesia (FTA) is difficult to achieve in neonates due to immature organ function and high rates of perioperative events. As a high-risk population, neonates require prolonged postoperative mechanical ventilation, which may lead to contradictions in cases where neonatal intensive care unit resources and ventilator facilities are limited. The choice of anesthesia strategy and anesthetic can help achieve rapid postoperative rehabilitation and save hospitalization costs. The authors describe their experience with maintaining spontaneous breathing in neonates undergoing anoplasty without opioids or muscle relaxants.
This retrospective chart review included neonates who underwent anoplasty in the authors’ institution. Twelve neonates who underwent the procedure with atomized 5% lidocaine topical anesthesia around the glottis, combined with sevoflurane sedation and caudal anesthesia facilitating tracheal intubation without opioid and muscle relaxant comprised the FTA group. Ten neonates who underwent the intervention with routine anesthesia techniques in the same period comprised the control group (group C).
The surgical success rate in the FTA group was 91.7%. There were no severe complications related to lidocaine administered around the glottis. Extubation time was significantly shorter in the FTA group than in group C (4 [2.5, 5.2] vs 81.5 [60.6, 96.8], respectively; P < .01). The duration of stay in the surgical intensive care unit (SICU) was longer in group C than in the FTA group (2 [2.0, 2.6] vs 1 [0.9, 2.0], respectively; P = .006,). A statistically significant lower rate of extubation-cough was noted after endotracheal tube removal in the FTA group compared with group C (18% vs 90%, respectively; P < .001). There was no difference in the duration of anesthesia or hospitalization costs between the 2 groups. No neonates required re-intubation after extubation.
On-table extubation via 5% atomized lidocaine topical anesthesia around the glottis for tracheal intubation combined with sevoflurane sedation and caudal anesthesia without opioid and muscle relaxant was feasible in neonates undergoing anoplasty. This reduced time to extubation, length of SICU stay and saved resources. A similar trend in cost savings was also found; nevertheless, more studies are needed to confirm these results.