bluuebunny/crossref_metadata_2025_split huggingface dataset:
Measuring of quality of care in patients with stroke and acute myocardial infarction
Authors: Cho Kyoung Hee , Nam Chung Mo , Lee Sang Gyu , Kim Tae Hyun , Lee Seon-Heui , Park Eun-Cheol 
Published: May 2019

Abstract
Ischemic stroke, hemorrhagic stroke, and acute myocardial infarction (AMI) are diseases with golden hour. This study aimed to identify and compare factors that affect in-hospital mortality in patients with stroke and AMI who admitted via the emergency department.
This study used the Korean National Health Insurance claims data from 2002 to 2013. The study sample included 7693 patients who had an ischemic stroke, 2828 patients who had a hemorrhagic stroke, and 4916 patients with AMI who were admitted via the emergency departments of a superior general hospital and general hospital, did not transfer to another hospital or come from another hospital, and were aged ≥20 years. This study was analyzed by using Cox's proportional hazards frailty model.
Five hundred (6.5%) of 7693 patients with ischemic stroke, 569 (20.1%) of 2828 patients with hemorrhagic stroke, and 399 (8.1%) of 4916 patients with AMI were dead. The clinical factors were associated with in-hospital mortality such as age, CCI, hypertension, and diabetes of patient characteristics. In treatment characteristics, performing PCI and weekday admission was associated with in-hospital mortality (aHR, 0.43; 95% CI, 0.27–0.67; aHR, 1.42; 95% CI, 1.14–1.77, respectively). In hospital characteristics, the volume, the proportion of transferred patient to other hospital and ratio of beds per one nurse was associated with in-hospital mortality.
Clinical factors of patient characteristics, intervention such as performing PCI and reducing ICP of treatment characteristics, and the volume, transferred rate, and the number of nurse of hospital characteristics were associated with in-hospital mortality.
Post-debulking circulating tumor cell as a poor prognostic marker in advanced stage ovarian cancer
Authors: Kim Miseon , Suh Dong Hoon , Choi Jin Young , Bu Jiyoon , Kang Yoon-Tae , Kim Kidong , No Jae Hong , Kim Yong Beom , Cho Young-Ho 
Published: May 2019

Abstract
Circulating tumor cells (CTCs) have received enormous attention as a novel biomarker in various malignant diseases. We investigated the clinical association between the presence of perioperative CTCs and survival outcomes in women with ovarian cancer. In a total of 30 women who were scheduled to undergo a surgical treatment for ovarian cancer, peripheral blood samples were obtained before and after surgery. CTCs were isolated and counted using the optimized tapered-slit filter (TSF) platform. The association between the presence of perioperative CTCs and tumor features was evaluated. The impact of the presence of perioperative CTCs on progression-free survival (PFS) and overall survival (OS) rates were analyzed using a Kaplan–Meier method. The median age was 58 (range, 24–77) years, and the median follow-up period was 31.5 (range, 1–41) months. Overall, the CTC detection rate was not significantly different before and after surgery (76.7% vs 57.1%, P = .673). The presence of postoperative CTCs was not significantly associated with 3-year PFS (29.1% vs 58.3%, P = .130) and OS (84.4% vs 80.0%, P = .559) rates in the whole study population. In advanced stage, PFS rate in patients with postoperative CTCs had lower PFS rates than those without postoperative CTCs, although there was no statistical significance (18.8% vs 57.1%, P = .077). Postoperative CTC was more frequently detected in women who had lymph node involvement than those who did not (7/7 [100%] vs 3/10 [30.0%], P = .010). The presence of postoperative CTCs as detected using the TSF platform seems to be associated with poorer PFS rates in women with ovarian cancer of advanced stage. Further study with a larger population is warranted to validate our study findings.
Probiotic supplements for relieving stress in healthy participants
Authors: Zhang Ning , Liao Xing , Zhang Yanan , Li Menglin , Wang Weiguang , Zhai Shuangqing 
Published: May 2019

Abstract

Background:
Psychological stress is a ubiquitous subjectively negative emotional experience, but excessive psychological stress has adverse effects on the happiness in our lives and physical and mental health, and may cause many health problems. Studies have found that probiotics have a certain role in alleviating negative emotions, reducing abnormal behaviors, improving cognitive function, and also showing the great potential of probiotics in relieving psychological stress. At present, many clinical trials have been carried out to intervene in populations with psychological stress with probiotic supplements, but there still lack of targeted systematic review and meta-analysis.

Methods and analysis:
The Cochrane Central Register of Controlled Trials, Embase, MEDLINE, Psycoinfo, Cumulative Index to Nursing and Allied Health Literature will be searched to obtain the eligible randomized controlled trials published up to March 1, 2019. Meanwhile, the references to relevant publications will also be reviewed to identify other studies, and will re-search before finial summary for analysis. EndNote X7 will be used as a document manager for duplicate checking and screening of literature. The risk of bias will be assessed and the date of included studies will be analyzed by Revman V5.3.5.

Results:
The primary outcome will be subjective stress level, general mild psychiatric symptoms of participants. The secondary outcome will be cortisol level and adverse effects likely to be related to treatment.

Conclusion:
The systematic review and meta-analysis will provide evidence to assess the efficacy and safety of probiotics in relieving psychological stress.

PROSPERO registration number:
PROSPERO CRD42019122930.
Impact of renal dysfunction on surgical outcomes in patients with aortic dissection
Authors: Fan Pei-Yi , Chen Chao-Yu , Lee Cheng-Chia , Liu Kuo-Sheng , Wu Victor Chien-Chia , Fan Pei-Chun , Chang Ming-Yang , Chang Jason Chih-Hsiang , Tian Ya-Chung , Chen Shao-Wei 
Published: May 2019

Abstract
Preoperative renal dysfunction is associated with mortality in patients who undergo coronary artery bypass graft and valve surgery. However, the role of preoperative renal dysfunction in type A aortic dissection (TAAD) remains unclear. This study aimed to evaluate the impact of preoperative renal dysfunction on the outcome of surgical intervention in patients with TAAD.
We retrospectively studied the outcomes of 159 patients with TAAD who were treated at a tertiary referral hospital between 2005 and 2010. The demographics and surgical details of patients were analyzed according to their renal function. Risk factors for outcomes were analyzed using multivariable logistic regression. Thirty-two of the patients (20.1%) had preoperative serum creatinine of 1.5 mg/dL or more. The multivariable logistic regression model revealed independent risk factors of in-hospital mortality to be renal dysfunction (odds ratio [OR], 3.79; 95% confidence interval [CI], 1.64–8.77), preoperative shock (OR, 8.75; 95% CI, 2.83–27.02), and bypass time (OR, 1.008; 95% CI, 1.003–1.013). In addition, patients with renal dysfunction exhibited a lower 90-day survival rate than did patients without the condition (P of log-rank test = .005).
Preoperative renal dysfunction may have a critical role in the surgical outcomes of patients with TAAD. Additional large-scale investigations are warranted.
Clinical efficacy of orthopilot navigation system versus conventional manual of total hip arthroplasty
Authors: Jia Jianguo , Zhao Qun , Lu Pei , Fan Guiyong , Chen Hao , Liu Chaoqun , Liu Jinlian , Chen Sheng , Jin Zhengshuai 
Published: May 2019

Abstract

Background:
To compare the clinical efficacy between Orthopilot navigation system and conventional manual surgery in total hip arthroplasty (THA).

Methods:
Electronic databases were searched to identify randomized controlled trials (RCTs) investigating Orthopilot navigation system versus conventional manual in patients undergoing THA. Outcome measurements include anteversion angle, inclination angle, preoperative leg length discrepancy, postoperative leg length discrepancy and femoral offset. Statistical software Stata 12.0 was used for data-analysis.

Results:
A total of 5 studies were finally included in this meta-analysis. The results showed that the conventional manual group have a less anteversion angle than that in Orthopilot navigation system group (weighted mean difference (WMD) = 4.67, 95% confidence interval (CI) = 3.53, 5.82, P = .000). And pooled analysis showed that the inclination angle in Orthopilot navigation group was less than that in conventional manual group (WMD = −4.19, 95% CI = −8.00, −0.37, P = .031). There was no significant difference between the preoperative leg length discrepancy and postoperative leg length discrepancy (P > .05). Orthopilot navigation system compared with conventional manual procedure was associated with decreased of femoral offset by 2.76 (WMD = −2.76, 95%CI = −3.90, −1.62, P = .000).

Conclusion:
Both Orthopilot navigation system and conventional THA result in significant improvements in patient function with similar overall complication rates and have their own edges in cup position.
Post-traumatic stress disorder in living donors after pediatric liver transplantation
Authors: Zhang Yimao , Wang Junxiang , Jin Shuguang , Xiang Bo , Yang Jiaying , Li Kewei , Huang Bing , Lai Wei , Yan Lunan , Zhao Jichun 
Published: May 2019

Abstract
Liver transplantation can lead to post-traumatic stress disorder (PTSD) in recipients, but the risk factors associated with PTSD in living donors are unknown. To investigate this progression in pediatric living donors, a cross-sectional investigation was carried out.
All participants completed 2 questionnaires: a PTSD self-rating scale (PTSD-SS) and a validated Chinese version of the Medical Outcomes Study Short Form-36 (SF-36). Clinical and demographic data were collected from medical records and self-report questionnaires. Univariate analysis was conducted to identify statistical differences.
The prevalence of full PTSD (all symptom clusters) and partial PTSD (2 out of 3 symptom clusters) was 12.1% and 31.1%, respectively. Those with an educational status of elementary school (P = .001), who were donors to their children (P = .008), who were in the first 6 months after transplant (P < .001), or were involved in transplants where the recipients had severe complications (P = .02) were more likely to have higher PTSD-SS scores than other groups. The non-PTSD group had a higher health-related quality-of-life score compared with the full and partial PTSD groups in the domains of physical function, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, and mental health. In addition, the occurrence of PTSD was related to a poorer quality of life.
The occurrence of PTSD was common in living donors after pediatric liver transplantation. Those with a lower educational status, who were donors to their children, were in the first 6 months after transplant, or were involved in transplants where the recipients had severe complications were most likely to experience PTSD. Post-traumatic stress symptom severity was significantly associated with a poorer quality of life after transplant.
Pathological response and serum VEGF changes during chemoradiotherapy for esophageal carcinoma
Authors: Wang Jian , Yu Jing-Ping , Ni Xin-Chu , Sun Zhi-Qiang , Sun Wei , Nie Bin , Sun Su-Ping , Wang Jian-Lin 
Published: May 2019

Abstract
The aim of this study was to observe pathological response and change in serum vascular endothelial growth factor (VEGF) in esophageal carcinoma (EC) during chemoradiotherapy (CRT).
Eighty-nine patients diagnosed with EC were treated with radiotherapy at the Department of Radiotherapy of the Second People's Hospital of Changzhou between May 2008 and December 2014, including 65 patients with CRT. Gastroscopy and pathological examination were conducted 4 weeks afterwards. The pathological responses were classified as complete response (CR) and non-CR. Serum samples were collected from the patients before radiotherapy, during week 4 of radiotherapy, and 1 week after radiotherapy. The VEGF changes were classified as increase, stable, and decrease.
The median overall survival (OS) and median progression-free survival (PFS) in the pathological CR group was significantly longer than that of the non-CR group (P < .001). The 1-, 3-, and 5-year OS rates in the non-CR group were lower than that in the CR group (P < .05). Moreover, the 1-, 3-, and 5-year PFS rates in the non-CR group were lower than that in the CR group (P < .05). VEGF serum level was decreased during and after radiotherapy compared with pre-radiotherapy, and the differences were statistically significant (P < .05). The 1-, 3-, and 5-year OS rates in the increased group were lower than that in the decreasing group (P < .05). Moreover, the 1-, 3-, and 5-year PFS rates in the increasing group were lower than that in the decreasing group (P < .05). Pathological response (P < .05), serum VEGF trend (P < .05), and tumor-node-metastasis stage (P < .05) in response to CRT were factors that influenced patient prognosis.
Pathological response and serum VEGF change during CRT can predict prognosis of nonsurgical patients with EC. Monitoring these changes is of significance in individualized treatment.
What is the position of pulmonary arterial hypertension-specific drug therapy in patients with Eisenmenger syndrome
Authors: Li Qiang , Kuang Hong-Yu , Wu Yu-Hao , Lu Tie-Wei , Yi Qi-Jian 
Published: May 2019

Abstract

Background:
It is commonly reported a limitation of therapeutic strategy in Eisenmenger syndrome (ES) historically. This qualitative systematic review is conducted to evaluate the safety and efficacy of pulmonary arterial hypertension-specific drug therapy (PAH-SDT) for ES patients for a clinical therapeutic strategy based on evidence.

Methods:
PubMed, EMBASE, and the Cochrane Library databases have been systematically reviewed up to January 2019. Two reviewers independently conducted a literature search, quality evaluation, and data extraction. The occurrence of death, deterioration, and adverse events (AEs) has respectively been described as a count or percentage. Meta-analysis was conducted by Stata 15.1, and weighted mean differences (WMD) with 95% confidence intervals (CI) were recorded for continuous data. Randomized-effect model or fixed-effect model was applied according to the heterogeneity test.

Results:
Fifteen citations recruiting 456 patients associated with ES were eventually pooled, which involved 4 RCTs, 6 prospective studies, and 5 retrospective studies. Within the first year, it indicated PAH-SDT significantly ameliorated exercise capacity in 6-minute walk distance (6MWD) (I
2 = 60.5%; WMD: 53.86 m, 95% CI [36.59, 71.13], P < .001), functional class (FC) (WMD = –0.71, 95% CI [–0.98, –0.44], P < .001) and Borg dyspnea index (WMD = –1.28, 95% CI [–1.86, –0.70], P < .001), in addition to hemodynamics, especially mean pulmonary arterial pressure by 5.70 mmHg (WMD = –5.70 mmHg, 95% CI [–8.19, –3.22], P < .001) and pulmonary vascular resistance by 4.20 wood U (WMD: –4.20, 95% CI [–7.32, –1.09], P = .008), but unsatisfactory effects in oxygen saturation at exercise (P = .747). In a prolonged medication, bosentan, a dual ERA, has been proved acting an important role in improving exercise tolerance of patients with ES (6MWD: I
2 = 47.5%; WMD: 88.68 m, 95% CI [54.05, 123.3], P < .001; FC: I
2 = 0.0%; WMD = –0.65, 95% CI [–1.10, –0.19], P = .006). While a nonsignificant change of 6MWD was noted in a long-term therapy of ambrisentan (P = .385). There existed rare evidence about the efficacy and safety of macitentan, phosphodiesterase-5 inhibitors (PDE5i), and prostanoids in a prolonged medication. Most AEs were recorded as mild to moderate with PAH-SDT, but about 4.3% individuals treated with endothelin receptor antagonists (ERAs) suffered from serious ones, and 3.9% suffered from death.

Conclusions:
This systematic review and meta-analysis proved PAH-SDT as a safe and effective role in ES in an early stage. However, in a long-term treatment, bosentan has been supported for a lasting effect on exercise tolerance. A further multicenter research with a large sample about pharmacotherapy of ES is necessary.
Open reduction and plate fixation compared with non-surgical treatment for displaced midshaft clavicle fracture
Authors: Qin Miao , Zhao Shishun , Guo Wenlai , Tang Li , Li Hangyu , Wang Xuejie , Zhu Zhe , Sun Tianwen 
Published: May 2019

Abstract

Backgrounds:
There is no consensus concerning whether surgery or non-surgical treatment is preferred for displaced midshaft clavicle fracture. We performed a meta-analysis of randomized controlled trials (RCTs) to compare healing effects and cosmetic results between surgery and non-surgery.

Methods:
We retrieved RCTs regarding open reduction and plate fixation (ORPF) and non-surgical method for the treatment of displaced midshaft clavicle fracture published before June 2018 from PubMed, EMBASE and Cochrane Library. The difference between the two treatments was comparatively discussed in aspects of nonunion, malunion, functional outcome, cosmetic results, and complications.

Results:
Nine RCTs were included. The results showed that ORPF is advantageous over the non-surgical treatment in terms of nonunion rate (RR, 0.11[95%CI, 0.06–0.23]), malunion rate (RR, 0.16[95%CI, 0.08–0.35]), appearance dissatisfaction rate (RR, 0.35[95%CI 0.23–0.55]), and shoulder appearance defect rate (RR, 0.06[95%CI, 0.02–0.17]). The non-surgical treatment showed lower rate of complication (RR, 1.60[95%CI, 1.02–2.53]) and no significant differences were found between the 2 treatment groups with respect to functional outcome (disabilities of the arm, shoulder and hand (DASH) questionnaire score) (MD, −4.17[95%CI, −9.35 to 1.01]).

Conclusions:
This meta-analysis updated previous results. The current findings suggested that ORPF yielded better efficacy than conservation treatment for displaced midshaft clavicle fracture from perspectives of fracture healing and appearance.
Endoscopic and microscopic findings of gastrointestinal tract in Henoch–Schönlein purpura
Authors: Han Yeeun , Jin So-Young , Kim Dong Won , Jeen Yoon Mi , Kim Yon Hee , Choi In Ho 
Published: May 2019

Abstract
Asia has the highest incidence of Henoch–Schönlein purpura (HSP). Although 50% to 75% of patients with HSP manifest gastrointestinal (GI) symptoms, endoscopic, and pathologic findings of HSP have been rarely reviewed in Asia.
Patients diagnosed with HSP who had undergone endoscopic biopsy from GI tract (GIT) in Soonchunhyang University Seoul Hospital from 2000 to 2018 were evaluated and 25 cases with 44 biopsies from upper GI tract (U-GIT) or lower GI tract (L-GIT) were enrolled. Their clinical and endoscopic findings and histologic findings of endoscopic biopsy were reviewed.
Of the 25 patients, 15 were males and 10 were females. There were 6 children and 19 adults. The most common GI symptom was abdominal pain (20/25), followed by loose stool or diarrhea (9/25). Biopsied sites included 19 from U-GIT (9 stomach and 10 duodenum) and 25 from L-GIT (7 terminal ileum, 1 cecum, 4 ascending, 1 transverse, 2 descending, 7 sigmoid, and 3 rectum). Erythema/petechia was the most common endoscopic finding in U-GIT, while erosion/ulceration was the most common one in L-GIT. In U-GIT, extravasted red blood cell (RBC) (14/19) was the most common histologic finding, while leukocytoclastic vasculitis (LCV)/capillarities were identified in 7 specimens, including 5 duodenum samples. In endoscopic investigations of L-GIT, erosion/ulceration (9/14) was predominantly identified. The most common histologic finding was also extravasted RBC (22/25), while LCV/capillarities were noted in 10 specimens, including 5 specimens from terminal ileum.
The HSP commonly involves GIT. Histologic findings of our cases were not significantly different from results of previous studies in Western countries. However, endoscopic and pathologic characteristics of HSP have been rarely reviewed in Asia. Herein, we share experience of endoscopic biopsy of GIT in patients with HSP.
Migration of a double J stent into the inferior vena cava
Authors: Jiang Changyi , Fu Shi , Chen Jian , Chen Yong , Chen Deqiang , Mishra Prashant , Ni Xiaohui , Ke Changxing 
Published: May 2019

Abstract

Introduction:
Intravascular migration of a double J stent into the inferior vena cava is an uncommon complication. The management of such complication is less reported in the literature. This study aimed to reveal the diagnosis and treatment process of migration of a double J stent into the inferior vena cava.

Patient concerns:
A 53-year-old male patients was transferred to our hospital because of migration of a double J stent into the inferior vena cava after left-side pyelolithotomy.

Diagnosis:
In accordance with manifestations on computed tomography urography, the patient was diagnosed with migration of a double J stent into the inferior vena cava.

Interventions:
Percutaneous nephroscope under C-arm guidance was performed to remove the migrated stent. After the operation, the patient was treated with continued anticoagulants and antibiotics.

Outcomes:
The migrated stent was removed successfully without any complications, and a new double J stent was placed and its location was confirmed under C-arm. The patient was discharged in good condition and the follow-up was uneventful.

Conclusion:
Intravascular migration of a double J stent into the inferior vena cava is an uncommon complication. Radiologic imaging after placement of ureteral stent is critical for prevention of this complication. Percutaneous nephroscope under C-arm guidance is a safe and effective approach to remove the migrated DJS in the IVC.
Effectiveness and safety of lactobacilli in children with functional constipation
Authors: Yang Wenhao , He Tao , Zhang Weijian , Gu Li , Tu Renyuan , Liu Hanmin 
Published: May 2019

Abstract

Background:
Constipation is one of the most common diseases in children and it is also a significant healthcare burden, more than many other common childhood diseases. For some children, 1st-line treatment cannot relieve their constipation and their constipation symptoms maybe continue to adolescence. So, alternative treatment options such as lactobacilli are needed. However, the effectiveness and safety of lactobacilli is still unclear. To investigate this question, we conduct a systematic review and meta-analysis.

Methods:
The protocol followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. Three main databases (PubMed, Embase, and the Cochrane Library) will be searched to December 20, 2018 for randomized controlled trials investigating the effects and safety of lactobacilli for constipation in children with no language restrictions. In addition, a manual search of the references of relevant published studies will also be considered.
Two independent reviewers will conduct studies selection, data extraction, and risk of bias assessment. The primary outcome is defecation frequency, treatment success (bowl movement >3 times per week). The 2nd outcome is stool consistency, incidence of abdominal pain, patients using laxatives, and adverse events.

Results:
The results will provide useful information about the effect and safety of lactobacilli for constipation in children.

Conclusion:
The findings of this study will be published in a peer-reviewed journal.

PROSPERO registration number:
CRD42019125913