bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of drugs treatment in patients with endometrial hyperplasia with or without atypia: A systematic review and network meta-analysis
Authors: Yao Yingsha , Xu Shuhang , Wang Ting , Jiang Ruoan 
Published: September 2024

Background:
Endometrial hyperplasia (EH) is a hyperplastic endometrial lesion with irregular gland size, increased glands, and increased glandular interstitial ratio. During follow-up, some EH progressed further to endometrial cancer. It is crucial to provide timely treatment for EH and improve the overall prognosis of EH patients.

Methods:
We searched the PubMed, ClinicalTrials.gov., and Embase databases for studies published from their inception to March 31, 2023. The methodological quality of each study was evaluated in accordance with the Cochrane Collaboration’s tool for assessing the risk of bias. The RevMan5.3 software provided by the Cochrane Collaboration was used for direct meta-analysis statistical analysis; and the relative risk and 95% confidence interval along with the mean difference and 95% confidence interval, were used as evaluation indexes.

Results:
We included 21 randomized controlled trials involving a total of 2276 women with EH, 6 studies were of high quality, and 15 were of moderate quality. The blinding of subjects and intervention providers was identified as the main source of potential bias. Six interventions were addressed in the network meta-analysis: medroxyprogesterone acetate (MPA), plus metformin, norethisterone (NET), levonorgestrel-releasing intrauterine system (LNG-IUD), megestrol acetate, and other drugs. In the direct meta-analysis, we found the probability of endometrial complete regression (CR) in the LNG-IUD group to be significantly higher than those in the NET. In the network meta-analysis, we found the probability of CR in the NET group to be significantly lower than those in the MPA and plus metformin groups, the probability of CR in the LNG-IUD group to be significantly higher than those in the NET, the probability of CR in the other drugs group to be significantly higher than those in the LNG-IUD. The NET group had the lowest incidences of endometrial complete regression, plus metformin could have a better outcome.

Conclusion:
According to the 21 randomized controlled trials included in this study, MPA is the most effective for EH endometrial outcome when applied as a single agent, while the combination of metformin can achieve a more significant effect.
A case of metachronous triple primary carcinoma complicated with pulmonary tuberculosis: Case report and review
Authors: Chen Ying , Luo Shu , Zheng Quan , Yu Qing , Liu Chunxia , Tang Rui , Chen Fei , Zhang Yan 
Published: September 2024

Rationale:
Multiple primary malignant neoplasms with tuberculosis are rare. The interaction between tuberculosis and tumor remains unclear. Moreover, the treatment of multiple primary tumors combined with tuberculosis is relatively complicated. Herein, we report a case of metachronous triple primary carcinoma complicated with pulmonary tuberculosis.

Objective:
This report aims to analyze the clinical characteristics of 3 primary tumors combined with tuberculosis. We report the long-term survival of this patient after personalized treatment and this patient have a good quality of life.

Diagnoses and interventions:
A 55-year-old male patient was diagnosed with squamous cell carcinoma of the lower thoracic esophagus (cT4bN1M0 IVA) and received concurrent chemoradiotherapy, followed by 2 cycles consolidate chemotherapy. During the follow-up, he was diagnosed with secondary tuberculosis (TB) and accepted anti-TB treatment. During anti-TB treatment, he was diagnosed with squamous cell carcinoma of the oropharynx (cT1N0M0 I P16(‐)), then he received radical radiation therapy. However, within a year, the patient was diagnosed with oral squamous cell carcinoma (cT3N0M0 IIIA). He accepted an individualized chemotherapy with paclitaxel combined with capecitabine. Moreover, immunohistochemistry of the patient’s 3 biopsies indicated positive P53 expression.

Outcomes:
Since the patient suffered from esophageal cancer, oropharyngeal cancer, and oral floor cancer, no tumor recurrence or metastasis was observed. And he has a good quality of life. Tuberculosis, TP53 mutation, radiotherapy, smoking, and drinking history may be risk factors for multiple primary tumors.

Lessons:
The treatment of multiple primary tumors combined with pulmonary tuberculosis is complicated. Individualized treatment allows patients to achieve long-term survival while also having a good quality of life. Limitations in this case: surgery may be an alternative strategy for the patient, but the patient refused surgery.
Effect of health literacy on hospital readmission among patients with heart failure: A protocol for systematic review and meta-analysis
Authors: Xiao Lei , Zhang Fan , Cheng Cong , Yang Ningling , Huang Qi , Yang Yuan 
Published: September 2024

Background:
Patients with heart failure have a high rate of health literacy deficiency, and their hospital readmission is a great burden. Whether health literacy affects hospital readmission remains controversial.

Objective:
To investigate the impact of health literacy on hospital readmission among heart failure patients.

Method:
Relevant keywords were used to search for Chinese and English literature from Web of Science, PubMed, Cochrane Library, China National Knowledge Infrastructure, VIP Database for Chinese Technical Periodicals, Digital Journal of Wanfang Data, and Chinese BioMedical Literature Database. Newcastle-Ottawa Scale was used to assess the quality of the studies. Statistical analysis was performed using Stata 15.0, the fixed effect model was used to calculate the pooled effect estimate, and Begg’s and Egger’s tests were applied to assess the presence of publication bias.

Results:
Nine studies, involving 4093 heart failure patients, were included in this study. The overall rate of inadequate health literacy was 40.3%. Among these articles, 6 were included in the meta-analysis to calculate the pooled effect. The results indicated that, when compared with patients with adequate health literacy, those with inadequate health literacy had a relative risk of hospital readmission of 1.01, which increased to 1.14 after adjusting for follow-up time, the result was not significant (P = .09).

Conclusions:
About 2 out of 5 heart failure patients had inadequate health literacy, and there was no statistical association between health literacy and hospital readmission among these patients. This finding should be carefully considered and confirmed in further studies.
Evaluation of the efficacy of perioperative tranexamic acid in patients with pelvic and acetabular fractures: A systematic review and meta-analysis
Authors: Yin Yijie , Jiang Jiabao , Zou Chang , Huang Shenbo , He Shuai , Kenmegne Guy Romeo , Yu You , Fang Yue 
Published: September 2024

Background:
Tranexamic acid (TXA) is commonly used to reduce perioperative bleeding in various surgeries, including acetabular and pelvic fractures treated with open reduction and internal fixation (ORIF). However, research on TXA’s effectiveness and safety in this context is conflicting. To address this, we conducted a systematic review and meta-analysis on TXA’s efficacy and safety in patients with acetabular and pelvic fractures undergoing ORIF.

Methods:
We systematically searched Cochrane, PubMed, and EMBASE databases until August 30, 2023. Our evaluation of TXA focused on 6 domains: estimated blood loss (EBL), blood transfusion units, transfusion rates, thromboembolic events, other complications, and surgery duration. Data from these studies were analyzed using RevMan Manager 5.4.

Results:
This study included 4 randomized controlled trials with 179 patients with acetabular and pelvic fractures treated with TXA. The analysis showed that TXA did not significantly reduce EBL, packed red blood cell transfusion units, blood transfusion rates, or surgery duration. There was no significant difference in thromboembolic events or other postoperative complications, like surgical wound issues, pneumonia, heterotopic ossification, and sciatic nerve injuries, between the TXA and control groups.

Conclusion:
TXA did not demonstrate a significant benefit in reducing perioperative bleeding or complications in patients treated with ORIF for acetabular and pelvic fractures. The utilization of TXA in such clinical scenarios remains a topic necessitating further rigorous investigation to delineate its role in this clinical setting.
Rupture of fetal membrane in ectopic tubal pregnancy: A case report and literature review
Authors: Wang Zhiqiang , Zhang Chun 
Published: September 2024

Rationale:
Ruptured tubal pregnancies occurring in the second trimester are rare; yet, they pose a critical risk of life-threatening hemorrhage. This study aims to highlight the importance of timely surgical intervention in such cases to prevent fatal outcomes. The case underscores the diagnostic and therapeutic challenges that arise when distinguishing between tubal and abdominal pregnancies, particularly in the presence of hemoperitoneum, which can obscure imaging results.

Patient Concerns:
We present a case involving the spontaneous rupture of a tubal pregnancy at 15 weeks and 3 days of gestation. The patient exhibited elevated beta-human chorionic gonadotropin levels. Initial transabdominal ultrasound suggested an abdominal pregnancy, and computed tomography scans supported these findings.

Diagnoses and Interventions:
Urgent midline laparotomy revealed the condition to be a tubal pregnancy, contrary to initial imaging. The surgical procedure included the removal of the gestational sac and the affected fallopian tube, followed by abdominal closure. Hemoperitoneum was noted to compromise the accuracy of imaging modalities, complicating the preoperative diagnosis.

Outcomes:
Histopathological examination confirmed the diagnosis of tubal pregnancy. The patient had an uneventful recovery and was discharged 7 days post-surgery with stable hemoglobin levels.

Lessons:
This case underscores the importance of considering the differential diagnosis of abdominal versus tubal pregnancy in the presence of hemoperitoneum, due to their differing clinical management needs. It offers insights that may guide clinicians in the timely diagnosis and treatment of advanced tubal pregnancies, where prompt surgical intervention is critical.
Postoperative hungry bone syndrome in primary hyperparathyroidism: A case report
Authors: Li Bin , Lv XiaoXu , Li XiaoMing , Hou XiaoZhi , Xu FengLei 
Published: September 2024

Rationale:
Hungry bone syndrome (HBS) is a forgotten and underdiagnosed cause. Postoperative HBS refers to patients with high bone turnover before surgery, but after surgery, the inhibition of osteoclast resorption by intact parathyroid hormone suddenly decreases, resulting in a sudden increase in the amount of calcium resorbed by the bone, and a rapid, severe and persistent hypocalcemia, which may be accompanied by hypophosphatemia and hypomagnesemia. We present a case with information about HBS and related complications after parathyroidectomy (PTX).

Patient concerns:
The patient was a 57-year-old woman who presented to the hospital with “pain in both ankles for more than 3 years and in both knees for more than 2 years.”

Diagnoses:
A parathyroid mass was found preoperative. Unilateral resection of the lesion was performed under general anesthesia. On gross examination, the mass was reddish brown in color, about 2.9 × 2.5 × 2.3 cm, with abundant blood supply. Postoperative pathology diagnosed parathyroid adenoma.

Interventions:
The patient was diagnosed with HBS on day 3 post-PTX, which lasted for 9 days.

Outcomes:
After active calcium supplementation and other pharmacological interventions, her test parameters gradually returned to normal and she was discharged on the 13th day after surgery.

Lessons:
Using the case of a patient with primary hyperparathyroidism with HBS lasting 9 days after PTX for diagnosis and management, we aimed to summarize possible predictors and perioperative management strategies to reduce the incidence, severity, and duration of postoperative HBS.
Comparison of the effects of dry needling and spinal manipulative therapy versus spinal manipulative therapy alone on functional disability and endurance in patients with nonspecific chronic low back pain: An experimental study
Authors: Khan Kashmala , Ahmad Ashfaq , Mohseni Bandpei Muhammad Ali , Kashif Muhammad 
Published: September 2024

Background:
Low back pain (LBP) is a global musculoskeletal ailment. Over the past few years, dry needling (DN) has garnered interest from both physical therapists and patients. Physical therapy commonly employs spinal manipulation to alleviate persistent LBP and other musculoskeletal disorders. The aim of this study was to investigate the effects of spinal manipulation alone and in combination with DN on functional disability and endurance in individuals suffering from chronic nonspecific LBP.

Methods:
Patients of both genders who had chronic nonspecific LBP and who had not received physical therapy within the last 3 months were included in this single-blind, randomized controlled trial using purposive sampling. All participants were randomly assigned to either the experimental (SMT + DN) or control (SMT alone) group using computer-generated random numbers. The data were analyzed using the Statistical Package for Social Sciences (SPSS) version 23.0. For between-group comparisons, the Mann–Whitney U test was used. A P-value < .05 was considered to indicate statistical significance.

Results:
The analysis of the difference between the 2 groups revealed that the mean ± standard deviation (SD) for the SMT alone group was 16.09 ± 3.963 at baseline and 12.66 ± 3.801 at 8 weeks, whereas for the DN + ST group, it was 13.67 ± 3.904 at baseline and 10.92 ± 3.534 at 8 weeks, with a P-value of .003. Thus, the RMDQ score improved gradually in both groups, and the mean endurance score reported for the ST group was 2.5 to 4.5, while that reported for the DN + ST group was 3.1 to 5.1.

Conclusion:
The results of this study showed that both therapies effectively reduced LBP. When comparing the effects of spinal manipulation alone to those of spinal manipulation combined with DN, the latter showed significantly greater benefits.
The effect of multiple single cannulation technique on complications of arteriovenous fistulae: A meta-analysis
Authors: Shu Peng , Wang Xia , Wen Zhuping , Li Chenchen , Luo Yiqi , Xu Fang 
Published: September 2024

Objective:
To evaluate the effect of multiple single cannulation technique on the complications of arteriovenous fistula.

Methods:
A comprehensive literature search was conducted to investigate the impact of multiple single cannulation technique on the complications of arteriovenous fistula. The search was performed in both Chinese and English databases including Wanfang Medicine, China National Knowledge Infrastructure, Vip, Pubmed, Embase, and The Cochrane Library, with a search period up to December 20, 2023. Following literature screening and data extraction, the quality of the included studies was assessed using the Cochrane Bias Assessment Tool for Randomized Controlled Trials. Statistical analysis was performed using Review Manager version 5.3.

Results:
Thirteen papers, totaling 1299 patients, were included in the analysis. The experimental group consisted of 646 patients, while the control group had 595 patients. The meta-analysis revealed that the multiple single cannulation technique was more effective than rope ladder cannulation and buttonhole cannulation in reducing the incidence of angiomas (odds ratio [OR] = 0.19; 95% confidence interval [CI] = 0.10–0.35), stenosis (OR = 0.22; 95% CI 0.13–0.39), thrombosis (OR = 0.17; 95% CI = 0.07–0.39), and blood seepage (OR = 0.13; 95% CI = 0.08–0.21) of arteriovenous fistulas (P < .05). Additionally, it was found to increase the success rate of nurses’ single cannulation (OR = 4.20; 95% CI = 1.78–9.95) of arteriovenous fistulas (P < .05).

Conclusion:
Multiple single cannulation technique could effectively reduce the incidence of complications of arteriovenous fistula, improve the success rate of cannulation, prolong the life span of arteriovenous fistula, and prolong the survival cycle of hemodialysis patients.
Effect of long-term pharmacological treatments on Alzheimer disease: A systematic review and network meta-analysis
Authors: Deng Xiaoyan , Li Daishun 
Published: September 2024

Background:
To analyze and compare the pharmacological treatments for Alzheimer disease (AD), we will conduct a systematic review and network meta-analysis focusing on their efficacy and safety over a duration exceeding 1 year.

Methods:
We searched the databases of PubMed, Scopus, EMBASE, Web of Science, the Cochrane Central Register of Controlled Trials, and CNKI until July 30, 2023, for randomized controlled trials (RCTs) evaluating pharmacological treatments for AD.

Results:
Seventeen RCTs, comprising 7214 participants, investigated the efficacy of the following drugs: Donepezil, Rivastigmine, Galantamine, Memantine, Ginkgo biloba extract (EGb), Atorvastatin-calcium and Vitamin B in the treatment of AD. The network meta-analysis resulted indicated that placebo demonstrated greater effectiveness compared to Atorvastatin-calcium 80 mg (mean different [MD] = ‐6.93, confidence interval [CI] −11.57, −2.29) and Rivastigmine 12 mg (MD = ‐3.33, CI −6.56, −0.09). EGb120 mg exhibited a greater improvement in cognition compared to Atorvastatin-calcium 80 mg (MD = 7.77, CI 2.07, 13.46) and Rivastigmine 12 mg + EGb120 mg (MD = 9.92, CI 1.32, 17.22). EGb 120 mg emerged as the most efficient intervention for cognition, while placebo demonstrated the least harm over a period exceeding 1 year.

Conclusions:
In this network meta-analysis of studies of patients with AD and a follow-up period of at least 1 year, EGb 120 mg demonstrated cognitive benefits, while placebo posed the least harm for AD. More RCTs are required to address the uncertainty surrounding the efficacy of medication.
Comparison of electromagnetic navigation bronchoscopy localization and CT-guided percutaneous localization in resection of lung nodules: A protocol for systematic review and meta-analysis
Authors: Tan Yan , Shen Shuijun , Wang Canyun , Zhou Qiaojuan , Jing Qifeng 
Published: September 2024

Background:
This study aimed to evaluate the efficacy and safety between electromagnetic navigational bronchoscopy (ENB) and computed tomography (CT)-guided percutaneous localization before resection of pulmonary nodules.

Methods:
Pubmed, Embase, Web of Science, and the Cochrane Library databases were searched from January 1, 2000 to April 30, 2022, for relevant studies. Two reviewers conducted the search, selection, and extraction of data from eligible studies. The risk of bias was assessed using the Newcastle–Ottawa Scale. The primary outcome was the localization success rate, and the secondary outcomes were the pneumothorax incidence and localization time. The meta-analysis was performed by Review Manager 5.4. The protocol for the meta-analysis was registered on PROSPERO (Registration number: CRD42022345972).

Results:
Five cohort studies comprising 441 patients (ENB group: 185, CT group: 256) were analyzed. Compared with the CT-guided group, the ENB-guided group was associated with lower pneumothorax incidence (relative ratio = 0.16, 95% confidence interval [CI]: 0.04–0.65, P = .01). No significant differences were found in location success rates (relative ratio = 1.01, 95% CI: 0.98–1.05, P = .38) and localization time (mean difference = 0.99, 95% CI: −5.73 to 7.71, P = .77) between the ENB group and CT group.

Conclusion:
Both ENB and CT-guided are valuable technologies in localizing lung nodules before video-assisted thoracoscopic surgery based on current investigations. ENB achieved a lower pneumothorax rate than the CT-guided group. In our opinion, there is no perfect method, and decision-making should be given the actual circumstances of each institute. Future prospective studies in the form of a randomized trial are needed to confirm their clinical value.
Identification of hepatic metastasis from an unrevealed adenoid cystic carcinoma by PET/CT: A case report
Authors: Liang Ze , Ding Yi , Sui He , Wu Mei , Jin Yongmin , Wen Weibo 
Published: September 2024

Rationale:Adenoid cystic carcinoma is a rare malignant tumor of the salivary glands, with few reports of metastasis to the liver in the literature. We present a case where an isolated hepatic lesion of adenoid cystic carcinoma was identified using18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT).Patient concerns:A 76-year-old male experienced abdominal pain and underwent an enhanced CT scan and magnetic resonance imaging, which revealed a liver mass. Subsequent18F-FDG PET/CT identified hypermetabolic lesions in both the left and right lobes of the liver, suggesting malignancy, with no other abnormalities detected.Diagnoses:A liver biopsy confirmed the diagnosis of adenoid cystic carcinoma.Interventions:No intervention.Outcomes:Following confirmation of the diagnosis, the patient chose to discontinue treatment and was discharged.Lessons:Hepatic metastasis from adenoid cystic carcinoma may be detected before the identification of the primary lesion.18F-FDG PET/CT plays a critical role in differentiating benign from malignant liver tumors, selecting potential biopsy sites, and assessing the extent of metastatic disease.
Red stripe on left forearm after stung by fish gill: A case report
Authors: Yu Ching-Hsiang , Su Yu-Jang 
Published: September 2024

Rationale:
Acute infectious lymphangitis represents a common complication of cellulitis, typically attributed to streptococcal infections after damaged skin integrity.

Patient concern:
This is a 51-year-old woman with a medical history of relapsing polychondritis, managed with steroid and methotrexate therapy in the outpatient department. She presented with a progressive redness and swelling of the left hand, accompanied by purulent discharge, persisting for 5 days. The patient had sustained a small cutting wound from the gill of a narrow-barred Spanish mackerel (Scomberomorus commerson) while cooking previously

Diagnosis:
Lymphangitis and cellulitis of the left forearm were diagnosed. A distinctive red streak was identified on the skin covering the palmaris longus muscle, consistent with the anatomical course of the median forearm lymphatic channel.

Interventions:
The patient received empirical intravenous ciprofloxacin (400 mg every 12 hours) and was subsequently admitted to the infectious disease ward. During hospitalization, the antibiotic regimen was adjusted to ceftazidime on the fourth day (2 g every 8 hours). The redness and swelling in the hand and arm gradually improved, and her blood culture showed no bacteria growth

Outcomes:
She was recovered and discharged on the seventh day with a prescription for oral clindamycin (150 mg every 6 hours).

Lessons:
A red stripe along the lymphatic route indicates acute lymphangitis and requires hospitalization for parenteral antibiotics.