bluuebunny/crossref_metadata_2025_split huggingface dataset:
Synchronous isolated splenic metastasis from cancer of hepatic flexure of colon
Authors: Zhao Huiying , Zhong Weixiang , Chen Dong , Cheng Xiaofei 
Published: April 2019

Abstract

Rationale:
Isolated splenic metastasis from colorectal cancer is very rare, as metastatic colorectal cancer involving the spleen is usually a manifestation of widely disseminated disease. Splenectomy is the best therapeutic option for this entity and probably the only chance for radical cure.

Patient Concerns:
A 73-year-old male presented with abdominal distension and dark red bloody stool of 6-month duration.

Diagnoses:
Synchronous isolated splenic metastasis from colorectal cancer.

Interventions:
Based on multidisciplinary team (MDT) mode, the patient underwent the primary hepatic flexure tumor resection due to his poor general condition. One month after surgery the patient began treatment with Xelox (capecitabine 1000 mg/m2, oxaliplatin 130 mg/m2) every 3 weeks. The patient underwent isolated splenic metastasis resection successfully by laparoscopic after four courses of chemotherapy.

Outcomes:
The patient's postoperative course was uneventful and he completed four courses of postoperative chemotherapy using the original chemotherapy regimen Xelox (capecitabine 1000 mg/m2, oxaliplatin 130 mg/m2). The patient was subsequently followed up every 3 months and no signs of recurrence were noted in a recent examination.

Lessons:
To the best of our knowledge, this is the first case report of isolated splenic metastasis from colorectal cancer in China. It is also the first case in which treatment was overseen by an MDT. The possibility of splenic metastasis should be considered in cases in which colorectal cancer is associated with a splenic lesion, despite its rarity. Splenectomy and adjuvant chemotherapy are the optimal therapeutic approaches, as such an approach prolongs survival and palliates the disease.
Prediction of ISUP grading of clear cell renal cell carcinoma using support vector machine model based on CT images
Authors: Sun Xiaoqing , Liu Lin , Xu Kai , Li Wenhui , Huo Ziqi , Liu Heng , Shen Tongxu , Pan Feng , Jiang Yuqing , Zhang Mengchao 
Published: April 2019

Abstract

Background:
To explore whether radiomics combined with computed tomography (CT) images can be used to establish a model for differentiating high grade (International Society of Urological Pathology [ISUP] grade III–IV) from low-grade (ISUP I–II) clear cell renal cell carcinoma (ccRCC).

Methods:
For this retrospective study, 3-phase contrast-enhanced CT images were collected from 227 patients with pathologically confirmed ISUP-grade ccRCC (155 cases in the low-grade group and 72 cases in the high-grade group). First, we delineated the largest dimension of the tumor in the corticomedullary and nephrographic CT images to obtain the region of interest. Second, variance selection, single variable selection, and the least absolute shrinkage and selection operator were used to select features in the corticomedullary phase, nephrographic phase, and 2-phase union samples, respectively. Finally, a model was constructed using the optimal features, and the receiver operating characteristic curve and area under the curve (AUC) were used to evaluate the predictive performance of the features in the training and validation queues. A Z test was employed to compare the differences in AUC values.

Results:
The support vector machine (SVM) model constructed using the screening features for the 2-stage joint samples can effectively distinguish between high- and low-grade ccRCC, and obtained the highest prediction accuracy. Its AUC values in the training queue and the validation queue were 0.88 and 0.91, respectively. The results of the Z test showed that the differences between the 3 groups were not statistically significant.

Conclusion:
The SVM model constructed by CT-based radiomic features can effectively identify the ISUP grades of ccRCC.
Prenatal diagnosis of de novo monosomy 18p deletion syndrome by chromosome microarray analysis
Authors: Qi Hong , Zhu Jianjiang , Zhang Shaoqin , Cai Lirong , Wen Xiaohui , Zeng Wen , Tang Guodong , Luo Yao 
Published: April 2019

Abstract

Rationale:
Monosomy 18p deletion syndrome refers to a rare chromosomal disorder resulting from the part deletion of the short arm of chromosome 18. Prenatal diagnosis of de novo 18p deletion syndrome is a challenge due to its low incidence and untypical prenatal clinical presentation.

Patient concerns:
Three cases received amniocentesis due to increased nuchal translucency (INT), high risk for Down syndrome, and INT combined intrauterine growth retardation (IUGR), respectively.

Diagnosis:
The 3 cases were diagnosed with de novo monosomy 18p deletion syndrome by amniocentesis and chromosome microarray analysis (CMA).

Interventions:
Karyotype analysis and CMA were used to analyze the abnormal chromosome.

Outcomes:
Case 1 and case 2 revealed 13.87 and 12.68 Mb deletions by array-CGH analysis, respectively. Case 3 revealed 6.9 Mb deletions in 18p11.32p11.31 and 7.5 Mb deletions in 18p11.23p11.21 by single nucleotide polymorphism array. All of the pregnancies were terminated due to the abnormal chromosome.

Lessons:
The fetal phenotype of monosomy 18p deletion syndrome shows great variability and may not be evident during the pregnancy. CMA may be served as an effective tool for the diagnosis of prenatal monosomy 18p deletion syndrome diagnosis.
Efficacy of ivabradine for heart failure
Authors: Xue En-zhong , Zhang Ming-hui , Liu Chun-li 
Published: April 2019

Abstract

Background:
Previous clinical trials have reported that ivabradine can effectively treat heart failure (HF). However, no systematic review has explored its efficacy and safety for HF. This systematic review will aim to evaluate the efficacy and safety of ivabradine for the treatment of patients with HF.

Methods:
We will search the literature from the following electronic databases from inception to the January 31, 2019: Cochrane Central Register of Controlled Trials, EMBASE, MEDILINE, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, VIP Information, and Wanfang Data. All randomized controlled trials (RCTs) of ivabradine for HF will be fully considered for inclusion without any restrictions. Additionally, grey literature including clinical trial registries, dissertations, and reference lists of included studies, conference abstracts will also be searched. Two researchers will review these literatures, extract data, and assess risk of bias of included RCTs separately. Data will be pooled by either fixed-effects model or random-effects model, and meta-analysis will be conducted if it is appropriate.

Results:
The primary outcome is all-cause mortality. The secondary outcomes comprise of change in body weight, urine output, change in serum sodium, and all adverse events.

Conclusions:
The results of this study will summary provide up-to-dated evidence for assessing the efficacy and safety of ivabradine for HF.

Ethics and Dissemination:
It is not necessary to acquire ethical approval for this systematic review, because no individual patient data will be used in this study. The results of this systematic review will be published through peer-reviewed journals.

Systematic review registration:
PROSPERO CRD42019120814.
Elastic stabile intramedullary nailing (ESIN) of diaphyseal femur fractures in children and adolescents
Authors: Frei Benjamin , Mayr Johannes , de Bernardis Gaston , Camathias Carlo , Holland-Cunz Stefan , Rutz Erich 
Published: April 2019

Abstract
Elastic stabile intramedullary nailing (ESIN) is a well-established method to stabilize diaphyseal fracture of the femur (DFF) in children. We aimed to evaluate the minimal medullary canal diameter (MMCD) of the fractured femur relative to the diameter of the nails. We also analyzed the real anteversion angle (AVA) of the affected femur in comparison to the healthy femur.
We retrospectively reviewed the medical records and plain X-ray images of children aged 2–15 years treated with ESIN for unstable femoral shaft fractures between 2004 and 2012. We measured MMCD on preoperative plain X-ray images. Nail diameter (ND) and any postoperative complications were extracted from the medical records. At follow-up conducted at a median of 40 months (range: 4–103 months) after the operation, we obtained Dunn X-ray images of both hips. Particular emphasis was placed on postoperative torsional differences in relation to age, weight, and maturity of the growth plate.
We analyzed the relationship between postoperative rotational malalignment and the ratio of ND to MMCD.
Median age of the 22 children at the time of injury was 7.5 years (range: 2–15 years). Median body weight was 25 kg (range: 13–57 kg). Median MMCD amounted to 8.6 mm (range: 5.5–11.0 mm). Median ND/MMCD was 36.9% (range: 27.3%–47.4%). Radiological analyses revealed a median of 27.0° (range: −22.0° to +49.0°) of real AVA in the affected leg and 32.5° (range: 18.0°–48.0°) in the healthy leg.
Three children (13.6%) experienced a grade III complication (Clavien–Dindo classification of surgical complications; CDCSC). Two of these children suffered retrotorsion of the femoral neck, while the third child experienced diminished anteversion.
Overall, 3 of 22 children (13.6%) suffered a CDCSC-grade III complication (i.e., retrotorsion of the femoral neck in two children and diminished anteversion of the femoral neck in one child). We recommend obtaining Dunn images at the end of the operation to confirm correct rotational alignment after stabilization with ESIN. Further prospective studies are required to confirm our findings.
Uterine-preserving pelvic organ prolapse surgery using the UPHOLD LITE vaginal support system
Authors: Chang Chia-Pei , Hsu Fang-Kuo , Lai Man-Jung , Chang Wen-Hsun , Lee Na-Rong , Lee Hui-Ling , Horng Huann-Cheng , Wang Peng-Hui 
Published: April 2019

Abstract
This article aims to evaluate the safety and outcome of women with pelvic organ prolapse (POP) treated by a minimally invasive bilateral sacrospinous hysteropexy (UPHOLD LITE Vaginal Support System, Boston Scientific) without concomittent anti-incontinence surgery.
This retrospective study was conducted between 2014 and 2016. Evaluated items included surgical parameter and postoperative outcome.
Three hundred thirteen women with POP were eligible and 22 were excluded because of history of either or more following situations, such as hysterectomy, mesh augmentation, previous anti-incontinence procedures, and radical pelvic surgery before. With a median follow-up of 26 months, surgery-related morbidity rate was 23.7% (69/291), including 1 with bladder injury (0.3%), 2 with hematoma (0.7%), 8 with urinary tract infection (2.8%), 48 with voiding dysfunction (16.5%) and 10 with mesh problems (3.4%). Among these morbidities, 12 patients (4.1%) needed surgical intervention, including 6 for mesh problems, 1 for bladder injury, 2 for hematoma, and 3 for anti-incontinence surgery. The difference of pelvic organ prolapse quantification (POP-Q) stage before and after surgery showed a statistical significance (anterior portion from 1.36 ± 2.60 to −2.69 ± 0.26, posterior portion from −1.29 ± 2.08 to −2.46 ± 0.62, and cervix portion from 2.03 ± 4.80 to −6.98 ± 2.26, all P < .001). At the end of August 2018, re-intervention rate for POP recurrence was 2.1% (n = 6), including abdominal sacrocolpopexy (n = 1), anterior repair (n = 1), vaginal total hysterectomy and uterine-sacral ligament suspension (n = 1), vaginal total hysterectomy and LeFort (n = 1), LeFort (n = 1), and pessary support (n = 1).
Because some women developed postoperative lower urinary tract symptom, preoperative evaluation, including careful and detailed history taking, and urodynamic evaluation is suggested. After adequate counseling, uterine-preserving sacrospinal ligament suspension by UPHOLD LITE Vaginal Support System surgery could be considered in the management of women with POP, because of its high successful rate (97.9%) and low morbidity rate.
Postoperative adverse events in patients with diabetes undergoing orthopedic and general surgery
Authors: Wang Jinjing , Chen Kang , Li Xueqiong , Jin Xinye , An Ping , Fang Yi , Mu Yiming 
Published: April 2019

Abstract
Factors that may result in the occurrence of adverse clinical events in diabetic patients during the postoperative period are not entirely clear. This study evaluated factors that may cause adverse events following elective orthopedic or general surgery.
Patients with diabetes who underwent orthopedic or general surgery between January 2010 and October 2015 were retrospectively selected from the General Hospital of People's Liberation Army database. Factors associated with postoperative adverse events were analyzed using multivariable logistic regression.
Among 1525 patients included, mean age was 63.5 ± 10.8 years and mean duration of diabetes was 8.8 ± 6.6 years. Among them, 49.9% underwent orthopedic surgery and 50.1% underwent general surgery. Postoperatively, 118 (7.7%) patients had adverse events, including delayed extubation (n = 43, 36.4%), circulatory disorder (n = 15, 12.7%), respiratory and circulatory abnormalities (n = 23, 19.5%), nonhealing of the incision (n = 11, 9.3%), infections at other sites (n = 15, 12.7%), other complications (n = 8, 6.8%), and death (n = 3, 2.5%). Multivariable regression analysis showed that age >65 years old [odds ratio (OR) = 2.23, 95% confidence interval (CI): 1.25–3.98], male sex (OR = 2.14, 95% CI: 1.24–3.38), postoperative peripheral blood glucose (OR = 1.13, 95% CI: 1.13–1.82), diabetic complications (OR = 2.41, 95% CI: 1.36–4.28), abnormal kidney function (OR = 2.73, 95% CI: 1.13–6.58) and general surgery (OR = 1.48, 95% CI: 1.11–5.26) were associated with the occurrence of postoperative adverse events.
In patients with diabetes undergoing intermediate or major elective surgery, older age, male sex, high postoperative peripheral blood glucose, diabetic complications, abnormal kidney function, and general surgery type were associated with the occurrence of postoperative adverse events.
Efficacy of carboplatin plus S-1 for the treatment of non-small cell lung cancer
Authors: Han Lei , Wei Zhou-Xia , Lv Yu-Feng , Jiang Ai-Ying 
Published: April 2019

Abstract

Background:
Non-small cell lung cancer (NSCLC) is the most common lung cancer. Numerous clinical studies have reported that the combination of carboplatin and S-1 (CS) can be used to treat NSCLC effectively. However, no systematic review has been conducted to assess its efficacy and safety for NSCLC. This systematic review aims to evaluate the efficacy and safety of CS for treatment of patients with NSCLC.

Methods:
This study will retrieve the following electronic databases from inception to the February 1, 2019: Cochrane Library, EMBASE, MEDILINE, CINAHL, AMED, and 4 Chinese databases without any language limitations. This systematic review will include randomized controlled trials (RCTs) and case-control studies for assessing the efficacy and safety of CS for the treatment of NSCLC. Cochrane risk of bias will be used as methodological quality assessment for each qualified study. The RevMan V.5.3 software will be utilized to synthesize the data and conduct the meta-analysis if it is allowed. The data will be pooled by using the random-effects model or fixed-effects model.

Results:
The primary outcome is overall response rate. The secondary outcomes are overall survival, progression-free survival, the disease control rate, and any adverse events.

Conclusion:
It will provide latest evidence to determine the efficacy and safety of CS for treatment of patients with NSCLC.

Ethics and dissemination:
No research ethic approval is needed in this study because this study will not analyze individual patient data. The results are expected to disseminate through peer-reviewed journals.

Systematic review registration:
PROSPERO CRD42019124860.
A comparison of the efficacy of Chinese herbal medicines in the treatment of primary dysmenorrhea
Authors: Gao Li , Xiao Zhuoran , Jia Chunhua , Wang Wei 
Published: April 2019

Abstract

Introduction:
Chinese herbal medicines (CHM) have been commonly used in the treatment of primary dysmenorrhea in East Asia. Several systematic reviews have been conducted to assess the clinical efficacy of CHM in the treatment of primary dysmenorrhea. However, their comparative efficacy is still unclear. Therefore, the purpose of this study is to conduct a network meta-analysis (NMA) to systematically compare the advantages of different CHM in the treatment of primary dysmenorrhea.

Methods and analysis:
The following electronic databases will be searched in this study: Web of Science, PubMed, Cochrane Library, Chinese Biomedical Literature Database, Chinese National Knowledge Infrastructure, Chinese Scientific Journal Database, and Wan-fang Database. Search terms include (Chinese herbal medicine or Chinese patent medicine or medicinal plants or phytotherapy or traditional medicine or Chinese herbal drugs or plant extracts or herbal medicine or herbal extract or herb or traditional Chinese medicine) and (primary dysmenorrhea or dysmenorrhea or painful menstruation) and (randomized controlled trial). The language will be limited to Chinese and English, and the search date will be up to May 2019. The included studies must be randomized controlled trials (RCTs) with patients diagnosed with primary dysmenorrhea. CHM must be used as interventions in the experimental group. While in the control group, studies that used a different herbal medicine, nonsteroidal anti-inflammatory drugs (NSAIDs), or placebo will be included. The primary outcomes include clinical efficacy and visual analog scale (VAS), and the secondary outcomes include adverse events and quality of life. Four reviewers will independently extract the data and assess the qualities of the studies. Statistical analysis will be conducted with R package for each outcome.

Ethics and dissemination:
Ethical approval is not required as this NMA is based on published studies. The completed NMA will be published in a peer-reviewed scientific journal.

Trial registration number:
PROSPERO CRD42018095254.
Clinical significance of wound infiltration with ropivacaine for elderly patients in china underwent total laparoscopic radical gastrectomy
Authors: Zhu ZhiPeng , Chen BoRong , Ye WeiPeng , Wang ShengJie , Xu GuoXing , Pan ZiRong , Zeng JunJie , Luo Qi , Jun You , Huang ZhengJie 
Published: April 2019

Abstract
The study aimed to evaluate analgesic effects and postoperative recovery of ropivacaine wound infiltration for elderly patients in China after total laparoscopic radical gastrectomy.
We retrospectively received clinical data of 132 elderly patients who received total laparoscopic gastrectomy and tracheal intubation general anesthesia from cancer center of First Affiliated Hospital of Xiamen University between September 2014 and September 2017, patients were divided into 2 groups according to local injection of drug: group I (ropivacaine group, 0.5% ropivacaine, 40 mL in total, n = 69), group II (control group, no analgesic, n = 63). The demographics, postoperative pain using numeric ratings scale (NRS), rescue analgesics as well as incidence of complications were investigated.
Significantly lower pain scores were observed in group I than in group II at 6, 12, 24, and 48 h postoperatively; the use of remedy analgesia was less in group I than in group II; there was no statistical significance in the incidence of surgical-related complications between the 2 groups. The recovery time were shorter in group I than in group II, meanwhile, postoperative hospital stay, medical expenses, and anesthesia-related complications were significantly less in group I than in group II.
This is a review of ropivacaine infiltration use in the elderly patients underwent total laparoscopic radical gastrectomy. This analysis describes the postoperative analgesic effect and postoperative recovery of wound infiltration with ropivacaine. Multicentered large sample prospective randomized controlled study is needed to evaluate the feasibility, security, and economic practicality.
Role of sortilin in lipid metabolism
Authors: Conlon Donna M. 
Published: April 2019

Purpose of review
Sortilin, encoded SORT1 gene at chromosome 1p13.3, is a multiligand receptor that traffics protein from the Golgi to the endosomes, secretory vesicles, and the cell surface. Genome-wide association studies (GWAS) revealed an association between sortilin and reduced plasma LDL-cholesterol (LDL-C) as well as reduced coronary artery disease (CAD). This review explores the various lipid metabolism pathways that are affected by alterations in sortilin expression.

Recent findings
The effects of increased hepatic sortilin on plasma LDL-C levels are mediated by increased clearance of LDL-C and decreased very LDL (VLDL) secretion because of increased autophagy-mediated lysosomal degradation of apolipoproteinB100. Sort1 knockout models have shown opposite VLDL secretion phenotypes as well as whole body lipid metabolism in response to diet challenges, leading to confusion about the true role of sortilin in the liver and other tissues.

Summary
The regulation of VLDL secretion by hepatic sortilin is complex and remains incompletely understood. Further investigation to determine the specific conditions under which both hepatic sortilin and total body sortilin cause changes in lipid metabolism pathways is needed.
Cost-effectiveness of Pancreatic Cancer Surveillance in High-Risk Individuals
Authors: Corral Juan E. , Das Ananya , Bruno Marco J. , Wallace Michael B. 
Published: April 2019

Objective
The aim of the study was to perform an economic analysis to identify the clinical and cost determinants of pancreatic cancer (PC) surveillance in high-risk individuals (HRIs).

Methods
A Markov model was created to compare the following 3 strategies: no screening, endoscopic ultrasound (EUS), and magnetic resonance imaging (MRI) screening. Patients were considered HRIs according to the Cancer of the Pancreas Screening consortium recommendations. Risk for developing PC, survival, and costs data were obtained from the Surveillance, Epidemiology, and End Results and Medicare databases. Surveillance effectiveness was obtained from a recent meta-analysis.

Results
Analysis of a cohort with fivefold relative risk of PC higher than the US population showed that MRI is the most cost-effective strategy. For those with the highest risk (>×20 relative risk), EUS became the dominant strategy. Our model was impacted by cost and imaging performance, but still cost-effective within the range reported in literature. Threshold analysis showed that if MRI increases greater than US $1600, EUS becomes more cost-effective. Once patients reached the age of 76 years, “no screening” was favored. Both surveillance strategies were cost-effective over a wide range of willingness to pay.

Conclusions
Abdominal imaging followed by pancreatectomy is cost-effective to prevent PC in HRIs, favoring MRI in moderate risk cases but EUS in those with highest risk.