bluuebunny/crossref_metadata_2025_split huggingface dataset:
Application of multimodal standardized analgesia under the concept of enhanced recovery after surgery in laparoscopic radical colorectal cancer surgery
Authors: Cao Lu , Zhang Le , Chen Baoyu , Yan Likun , Shi Xianpeng , Tian Lifei 
Published: May 2024

AimsTo observe the efficacy and safety of multimodal standardized analgesia in patients undergoing laparoscopic radical colorectal cancer surgery.MethodsA prospective, double-blind, randomized study of patients who were admitted to our hospital between December 2020 and March 2022 with a diagnosis of colorectal cancer and who intended to undergo elective laparoscopic radical colorectal cancer surgery was conducted. The participants were randomly divided into two intervention groups, namely, a multimodal standardized analgesia group and a routine analgesia group. In both groups, the visual analogue scale (VAS) pain scores while resting at 6 h, 24 h, 48 h and 72 h and during movement at 24 h, 48 h and 72 h; the number of patient controlled intravenous analgesia (PCIA) pump button presses and postoperative recovery indicators within 3 days after surgery; the interleukin-6 (IL-6) and C-reactive protein (CRP) levels on the 1st and 4th days after surgery; and the incidence of postoperative adverse reactions and complications were recorded.ResultsCompared with the control group, the multimodal standardized analgesia group had significantly lower VAS pain scores at different time points while resting and during movement (P&lt;0.05), significantly fewer PCIA pump button presses during the first 3 postoperative days (P&lt;0.05), and significantly lower IL-6 and CRP levels on the 1st postoperative day (P&lt;0.05). There was no statistically significant difference in the time to out-of-bed activity, the time to first flatus, the IL-6 and CRP levels on the 4th postoperative day or the incidence of postoperative adverse reactions and complications between the two groups (P &gt;0.05).ConclusionFor patients undergoing laparoscopic radical colorectal cancer surgery, multimodal standardized analgesia with ropivacaine combined with parecoxib sodium and a PCIA pump had a better analgesic effect, as it effectively inhibited early postoperative inflammatory reactions and promoted postoperative recovery and did not increase the incidence of adverse reactions and complications. Therefore, it is worthy of widespread clinical practice.
Case report: A rare DLST mutation in patient with metastatic pheochromocytoma: clinical implications and management challenges
Authors: Li Chang , Han Liang , Song Yuming , Liu Rui 
Published: May 2024

BackgroundPheochromocytoma is one of the most hereditary human tumors with at least 20 susceptible genes undergoing germline and somatic mutations, and other mutations less than 1% -2%. In recent years, other rare mutations have gradually been discovered to be possibly related to the pathogenesis and metastasis of pheochromocytoma. Most patients with pheochromocytoma experience common symptoms like headaches, palpitations, and sweating, while some may have less common symptoms. The diversity of symptoms, genetic mutations, and limited treatment options make management challenging.Case presentationA 53-year-old woman was hospitalized after experiencing episodic epigastric pain for one month. A mass was found in her right adrenal gland and she underwent robot-assisted laparoscopic surgery, revealing a pheochromocytoma. At the 16-month follow-up, multiple metastatic lesions consistent with metastatic pheochromocytoma were found. A germline mutation in the dihydrolipoamide succinyltransferase (DLST) gene (c.330 + 14A&gt;G) was detected, and despite trying chemotherapy and adjuvant therapy, the patient had a limited response with an overall survival of 27 months.ConclusionsDLST mutation is one of the rare pheochromocytoma-related mutated genes, and genetic sequencing is crucial for effective clinical management.
A hybrid protocol CLAG-M, a possible player for the first-line therapy of patients with mixed phenotype acute leukemia. A Polish Adult Leukemia Group experience
Authors: Karasek Magdalena , Armatys Anna , Skarupski Marek , Bołkun Łukasz , Budziszewska Katarzyna , Drozd-Sokołowska Joanna , Zarzycka Ewa , Mensah-Glanowska Patrycja , Gajewska Małgorzata , Hałka Janusz , Kopacz Agnieszka , Prejzer Witold , Chyrko Olga , Wróbel Tomasz , Wierzbowska Agnieszka , Sobas Marta 
Published: May 2024

IntroductionMixed-phenotype acute leukemia (MPAL) is a rare disease with poor prognosis. So far, no standard approach has been established as the “know-how” of MPAL is based only on retrospective analyses performed on small groups of patients.Materials and methodsIn this study, a retrospective analysis of the outcomes of adult MPAL patients included in the PALG registry between 2005 and 2024 who received the CLAG-M hybrid protocol as induction or salvage therapy was performed.ResultsSixteen of 98 MPAL patients received CLAG-M: eight as first-line and eight as salvage therapy. In the first line, two patients achieved partial response (PR), and six achieved complete remission (CR), of whom four successfully underwent allogeneic hematopoietic stem cell transplantation (alloHSCT). Two patients who did not undergo alloHSCT promptly relapsed. Within the whole group, the overall response rate (ORR) was 75% (n = 12/16). With the median follow-up of 13 months, six out of eight patients remain in CR, however, two of them died due to acute graft versus host disease. Out of eight patients who received CLAG-M in the second line, four patients (50%) obtained CR. AlloHSCT was conducted in seven cases, six of which were in CR. Only two patients remained in CR at the time of the last follow-up. Tolerance to treatment was good. The median times for severe neutropenia and thrombocytopenia were 22 days (range, 16–24) and 17 days (range, 12–24), respectively. Overall, grade 3-4 infections were observed in 12 cases, and all infections presented successful outcomes.ConclusionsCLAG-M is an effective first-line salvage regimen for MPAL with an acceptable safety profile. Early achievement of CR with prompt alloHSCT allows for satisfactory disease control.
Interleukin-41: a novel serum marker for the diagnosis of alpha-fetoprotein-negative hepatocellular carcinoma
Authors: Li Yazhao , Wang Haoyu , Ren Danfeng , Li Jingyu , Mu Zihan , Li Chaoyi , He Yongchao , Zhang Jiayi , Fan Rui , Yin Jiayuan , Su Jiaojiao , He Yinli , Yao Bowen 
Published: May 2024

BackgroundFor the lack of effective serum markers for hepatocellular carcinoma(HCC) diagnosis, it is difficult to detect liver cancer and identify its recurrence early.MethodsDatabases were used to analyze the genes potentially associated with alpha-fetoprotein(AFP). ELISA assay was used to detect the serum IL-41 in HCC, liver metastases, hepatitis, and healthy people. Immunohistochemical staining was used to analyze the relative quantification of IL-41 in HCC and paracancer tissues. Various survival curves were plotted according to clinical pathological data and helped us draw the ROC curve of IL-41 diagnosis of HCC.ResultsThe serum expression of IL-41 was highest in AFP negative HCC patients and significantly higher than that in AFP positive HCC and metastatic cancer patients. There was a significant negative correlation between elevated serum IL-41 and AFP(&lt;1500ng/ml). The clinicopathological features suggested that the serum IL-41 level was significantly correlated with capsule invasion, low differentiation and AFP. High serum expression of IL-41 suggests poorer survival and earlier recurrence after resection, and IL-41 upregulated in patients with early recurrence and death. The expression of IL-41 was higher in HCC tissues of patients with multiple tumors or microvascular invasion. The ROC curve showed that serum IL-41 had a sensitivity of 90.17 for HCC and a sensitivity of 96.63 for AFP-negative HCC, while the specificity was higher than 61%.ConclusionIL-41 in serum and tissue suggests poor prognosis and postoperative recurrence in HCC patients and could be a new serum diagnostic marker for AFP negative patients.
Nomograms for metastasis of non-sentinel lymph nodes or more than three lymph nodes in patients with one or two positive sentinel lymph nodes
Authors: Wang Xue-Er , Bi Zhao , Zhang Jin , Wang Yong-Sheng 
Published: May 2024

PurposeThe purpose of this study was to provide advice for the indication of regional nodal irradiation (RNI) in patients with one to two positive sentinel lymph nodes (SLNs) without axillary lymph node dissection (ALND).MethodsWe conducted a retrospective study in Shandong Cancer Hospital, Fudan University Shanghai Cancer Center, and West China Hospital. Logistic analysis was performed in order to explore the influencing factors of positive non-SLNs (NSLNs) and &gt;3 positive nodes among patients with one to two SLNs+. Then, nomograms were constructed.ResultsBetween May 2010 and 2020, among the 2,845 patients with one to two SLNs+ undergoing ALND (1,992 patients in the training set and 853 patients in the validation set), there were 34.3% harbored NSLNs+ and 15.6% harbored &gt;3 positive nodes. Multivariate analysis showed that cN stage, the number of positive/negative SLN, pathological tumor stage, lympho-vascular invasion (LVI), multicenter, and molecular subtypes were significantly associated with NSLN metastasis. Similarly, multivariate analysis also showed that cN stage, the number of positive/negative SLNs, pathological tumor stage, and LVI could be independent predictors of &gt;3 positive nodes. Then, nomograms for NSLN metastasis and &gt;3 positive nodes were constructed using these parameters, respectively.ConclusionsThe nomograms will be useful in estimating positive NSLNs and &gt;3 positive nodes, and they might provide advice for the optimization of RNI.
Left bundle branch pacing and cardiac remodeling in HF patients with type 2 diabetes mellitus: epigenetic pathways and clinical outcomes
Authors: Sardu Celestino , Vittoria Marfella Ludovica , Giordano Valerio , Lepre Caterina Claudia , D’Amico Giovanbattista , Volpicelli Mario , Contaldi Carla , Galiero Raffaele , Caturano Alfredo , Casolaro Flavia , Sasso Ferdinando Carlo , Uran Carlo , Cozzolino Domenico , Nicoletti Maddalena , Signoriello Giuseppe , Paolisso Giuseppe , Marfella Raffaele 
Published: May 2024

BackgroundLeft bundle branch (LBB) pacing could achieve cardiac resynchronization therapy (CRT) in patients who cannot be resynchronized via the placement of the left ventricle (LV) lead into the coronary sinus. LBB pacing could improve cardiovascular outcomes in heart failure (HF) patients with LBB block who are affected by type 2 diabetes mellitus (T2DM).Study hypothesisLBB pacing could increase the number of CRT responders and lead to the best clinical outcomes in HF patients with T2DM, inducing cardiac remodeling and improving left ventricle ejection fraction (LVEF) via microRNA (miR) modulation.MethodsIn a multicenter observational study, we enrolled 334 HF patients with LBB block and an indication to receive LBB pacing for CRT. In these patients, we evaluated the CRT responder rate, clinical outcomes, and miR expression at 1 year of follow-up.ResultsAt 1 year of follow-up, we had 223 responders (66.8%), 132 hospitalizations for HF (39.5%), 24 cardiac deaths (7.2%), and 37 all-cause deaths (11.1%), with a higher rate of HF hospitalizations (77 (69.4%) vs 55 (24.7%), p &lt; 0.05), and cardiac deaths (13 (11.7% vs 11 (4.9%), p &lt; 0.05) in non-responders vs responders. At the end of follow-up, we found the lowest expression of miR-26, miR-29, miR-30, miR-92, and miR-145 in LBB-pacing non-responders vs responders (p &lt; 0.05), and a direct correlation between miR-30 (0.340, [0.833–1.915]; p 0.001), the 6-minute-walking test (6MWT; 0.168, [0.008–0.060]; p 0.011), angiotensin-receptor-neprilysin inhibitors (ARNI; 0.157, [0.183–4.877]; p 0.035), sodium-glucose-transporter-2 inhibitors (0.245, [2.242–7.283]; p 0.001), and LVEF improvements. C reactive protein (CRP) inversely correlated with LVEF improvement (−0.220, [-(0.066–0.263)]; p 0.001). ARNI (1.373, CI 95% [1.007–1.872], p 0.045), miR-30 (2.713, CI 95% [1.543–4.769], p 0.001), and 6MWT (1.288, CI 95% [1.084–1.998], p 0.001) were predictors of LBB pacing responders at 1 year of follow-up.ConclusionLBB-pacing responders evidenced miR modulation, which was linked to significant improvement of the cardiac pump. Specifically, miR-30 was linked to cardiac pump improvement and predicted responders at 1 year of follow-up in patients with T2DM.
Exploration of the mechanism of Traditional Chinese Medicine for anxiety and depression in patients with diarrheal irritable bowel syndrome based on network pharmacology and meta-analysis
Authors: Bai Chen , Wang Junyi , Wang Yifan , Liu Haoqi , Li Jiaxiu , Wang Siyi , Bai Zhen , Guo Rongjuan 
Published: May 2024

BackgroundThe efficacy of Chinese herbal medicine (CHM) in managing irritable bowel syndrome with diarrhea (IBS-D) accompanied by anxiety and depression remains uncertain. Thus, a systematic review was carried out employing meta-analysis and network pharmacology to ascertain the efficacy and underlying mechanisms of CHM therapy.MethodsBy conducting a systematic review, including literature search, screening, and data extraction, we identified 25 randomized controlled trials to assess CHM’s effectiveness in treating irritable bowel syndrome alongside anxiety and depression. Network pharmacology was utilized to scrutinize the metabolite utility of CHM in addressing this condition. Potential primary mechanisms were synthesized using information sourced from the PubMed database.ResultsTwenty-five studies, including 2055 patients, were analyzed, revealing significant treatment efficacy for IBS-D in the trial group compared to controls [OR = 4.01, 95% CI (2.99, 5.36), I2 = 0%] Additionally, treatment for depression [SMD = −1.08, 95% CI (-1.30, −0.86), p &lt; 0.00001, I2 = 68%; SDS: SMD = -1.69, 95% CI (-2.48, −0.90), p &lt; 0.0001, I2 = 96%] and anxiety [HAMA: SMD = -1.29, 95% CI (-1.68, −0.91), p &lt; 0.00001, I2 = 89%; SAS: SMD = -1.75, 95% CI (-2.55, −0.95), p &lt; 0.00001, I2 = 96%] significantly improved in the trial group. Furthermore, the trial group exhibited a significantly lower disease relapse rate [OR = 0.30, 95% CI (0.20, 0.44), p &lt; 0.00001, I2 = 0%]. CHM treatment consistently improved IBS severity (IBS-SSS) and symptom scores. Network pharmacology analysis identified key chemical metabolites in traditional Chinese medicine formulations, including Beta-sitosterol, Stigmasterol, Quercetin, Naringenin, Luteolin, Kaempferol, Nobiletin, Wogonin, Formononetin, and Isorhamnetin. Utilizing the STRING database and Cytoscape v3.9.0 software, a protein-protein interaction (PPI) network revealed the top eight key targets: IL-6, TNF, PPARG, PTGS2, ESR1, NOS3, MAPK8, and AKT1, implicated in anti-inflammatory responses, antioxidant stress modulation, and neurotransmitter homeostasis maintenance.ConclusionChinese Herbal Medicine (CHM) offers a promising and safe treatment approach for patients dealing with Diarrheal Irritable Bowel Syndrome (IBS-D) accompanied by anxiety and depression; thus, indicating its potential for practical implementation. The most active metabolites of CHM could simultaneously act on the pathological targets of IBS-D, anxiety, and depression.The diverse scope of CHM’s therapeutic role includes various aspects and objectives, underscoring its potential for broad utilization.
A systematic review of personality and musculoskeletal disorders: evidence from general population studies
Authors: Quirk Shae E. , Koivumaa-Honkanen Heli , Honkanen Risto J. , Mohebbi Mohammadreza , Stuart Amanda L. , Heikkinen Jeremi , Williams Lana J. 
Published: May 2024

IntroductionWe conducted a systematic review to evaluate the quality and extent of evidence on associations between personality disorders (PDs) and musculoskeletal disorders (MSDs) in population-based studies, since these disorders are leading causes of disease burden worldwide.MethodsA search strategy of published, peer-reviewed and gray literature was developed in consultation with a liaison librarian and implemented for Embase, CINAHL Complete, Medline Complete, and PsycINFO via the EBSCOhost platform from 1990 to the present and CORDIS and ProQuest Dissertations &amp; Theses Global, respectively. The inclusion criteria were as follows: I) general population participants aged ≥15 years; II) self-report, probable PD based on positive screen, or threshold PD according to the DSM-IV/5 (groupings: any, Clusters A/B/C, specific PD) or ICD-10/11; III) MSDs identified by self-report or ICD criteria (arthritis, back/neck conditions, fibromyalgia, osteopenia/osteoporosis) and III) cohort, case-control, and cross-sectional study designs. Two reviewers independently screened articles and extracted the data. Critical appraisal was undertaken using the Joanna Briggs Institute checklists for systematic reviews of etiology and risk. A descriptive synthesis presents the characteristics of included studies, critical appraisal results, and descriptions of the main findings. This review adhered to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines.ResultsThere were 11 peer-reviewed, published articles included in this review (n = 9 cross-sectional and n = 2 case-control studies); participants were ≥18 years in these studies. No published gray literature was identified. Semi-structured interviews were the most common method to ascertain PDs; all studies utilized self-reported measures to identify MSDs. Overall, we detected limited and conflicting evidence for associations between PDs and MSDs.DiscussionThe main result may be explained by lack of population-based longitudinal evidence, heterogenous groupings of PD, and few comparable cross-sectional and case-control studies. Strengths of the review include a comprehensive search strategy and a discussion of mechanisms underlying possible associations between PDs and MSDs.ConclusionsThe quality of most studies included in this review that examined associations between PD and MSDs in general population adults was high. However, the results demonstrated limited and conflicting evidence for these associations, in part, due to lack of comparable evidence, which should be addressed in future research.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42021243094.
Communal nesting shapes the sex-dependent glutamatergic response to early life stress in the rat prefrontal cortex
Authors: Mottarlini Francesca , Rizzi Beatrice , Targa Giorgia , Buzzelli Valeria , Di Trapano Melania , Rullo Laura , Candeletti Sanzio , Ciccocioppo Roberto , Fattore Liana , Romualdi Patrizia , Fumagalli Fabio , Trezza Viviana , Caffino Lucia 
Published: May 2024

IntroductionEarly social environment, either positive or negative, shapes the adult brain. Communal nesting (CN), a naturalistic setting in which 2-3 females keep their pups in a single nest sharing care-giving behavior, provides high level of peer interaction for pups. Early social isolation (ESI) from dam and siblings represents, instead, an adverse condition providing no peer interaction.MethodsWe investigated whether CN (enrichment setting) might influence the response to ESI (impoverishment setting) in terms of social behavior and glutamate system in the medial prefrontal cortex (mPFC) of adult and adolescent male and female rats.ResultsPinning (a rewarding component of social play behavior) was significantly more pronounced in males than in females exposed to the combination of CN and ESI. CN sensitized the glutamate synapse in the mPFC of ESI-exposed male, but not female, rats. Accordingly, we observed (i) a potentiation of the glutamatergic neurotransmission in the mPFC of both adolescent and adult males, as shown by the recruitment of NMDA receptor subunits together with increased expression/activation of PSD95, SynCAM 1, Synapsin I and αCaMKII; (ii) a de-recruiting of NMDA receptors from active synaptic zones of same-age females, together with reduced expression/activation of the above-mentioned proteins, which might reduce the glutamate transmission. Whether similar sex-dependent glutamate homeostasis modulation occurs in other brain areas remains to be elucidated.DiscussionCN and ESI interact to shape social behavior and mPFC glutamate synapse homeostasis in an age- and sex-dependent fashion, suggesting that early-life social environment may play a crucial role in regulating the risk to develop psychopathology.
Long-term gastrointestinal symptoms and sleep quality sequelae in adolescents after COVID-19: a retrospective study
Authors: Yang Wei-Lin , Wang Qi , Wang Ying , Sun Shaopeng , Shen Yan , Yu Lei-Min 
Published: May 2024

ObjectiveTo evaluate the long-term gastrointestinal (GI) symptoms and sleep quality sequelae in adolescents with COVID-19.MethodsBetween June and July 2023, an online survey was done in Xiaoshan District, Hangzhou City, Zhejiang Province, China, using the GI Symptom Rating Scale (GSRS) and the Pittsburgh Sleep Quality Inventory (PSQI).ResultsGI symptoms in COVID-19 patients increased by 11.86% compared to before infection, while sleep quality decreased by 10.9%. Over time, there was a significant increase in the cumulative incidence rate of GI symptoms and sleep disorders (p &lt; 0.001). Follow-up of COVID-19 positive patients within 6 months of infection showed that GI symptoms and sleep quality began to ease starting from the first month after infection. Further analysis indicated a significant linear relationship between the severity of GI symptoms and sleep quality (R &gt; 0.5, p &lt; 0.001). Moreover, females, older age, and higher education were identified as risk factors influencing the long-term effects of COVID-19.ConclusionSARS-CoV-2 affects GI symptoms and sleep quality in adolescents during both the acute phase and post-infection periods. Over time, these symptoms gradually alleviate. A significant correlation exists between GI symptoms and sleep quality.
Blood cadmium level as a risk factor for chronic pain: NHANES database 1999–2004
Authors: Mi Panpan , Dong Haoran , Chen Shengle , Gao Xuan , Cao Xu , Liu Yong , Wang Huijie , Fan Guofeng 
Published: May 2024

ObjectiveThe escalating prevalence of chronic pain poses a substantial socio-economic burden. Chronic pain primarily stems from musculoskeletal and nervous system impairments. Given cadmium's known toxicity to these systems, our study sought to investigate the correlation between blood cadmium levels and chronic pain.MethodsThe cross-sectional study was conducted from the National Health and Nutrition Examination Survey (NHANES, 1999–2004), and comprised US adults who participated in a chronic pain interview. We employed logistic regression models and smooth curve fitting to elucidate the relationship between blood cadmium levels and chronic pain.ResultsOur findings revealed a linear association between blood cadmium levels and chronic pain. Compared to the lower blood cadmium tertile 1 (&lt;0.3 ug/dL), the adjusted odds ratios (ORs) for tertile 2 (0.3–0.4 ug/dL), and tertile 3 (≥0.5 ug/dL), were 1.11 (0.96–1.29) and 1.2 (1.03–1.39), respectively. Sensitivity analyses corroborated these results.ConclusionElevated levels of blood cadmium are associated with a heightened risk of chronic pain among adults in the United States. Mitigating cadmium exposure could potentially decrease the risk of chronic pain, thereby enhancing strategies for chronic pain prevention and management.