bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute ischemic stroke with a diagnosis of Marfan syndrome: A report of 3 cases in multifaceted settings
Authors: Chen Licong , Liu Yuan , Jiang Jianhua , Fang Qi , Zhang Quanquan 
Published: May 2024

Rationale:
Marfan syndrome (MFS), which is a dominantly inherited connective tissue disease resulting from a mutation in the FBN1 gene, exhibits variable manifestations affecting the cardiovascular, musculoskeletal, ophthalmologic, and pulmonary systems. Notably, neurologic deficiency, which involves ischemic or hemorrhagic stroke, is a rare but severe manifestation. The safety of rt-PA treatment for ischemic stroke caused by MFS is still under discussion.

Patient concerns:
In the current report, we discuss 3 atypical MFS cases presented as acute ischemic stroke, compared to those exhibiting cardiovascular and musculoskeletal abnormalities.

Diagnoses:
Three patients were diagnosed with acute ischemic stroke accompanied by MFS based on clinical manifestations, imaging examinations, and genetic testings.

Interventions:
The first case underwent intravenous thrombolytic therapy with rt-PA, the second case received antiplatelet therapy, and the third case received anticoagulant therapy and perfusion therapy.

Outcomes:
The neurologic deficiency of all three patients showed improvement upon discharge, and there were no symptoms of recurrence observed during the follow-up period.

Lessons subsections:
MFS is a rare etiology in young people with embolic stroke of undetermined source. Physicians should take MFS into consideration when they observe the characteristic symptoms during a consultation. The potential pathogenesis of ischemic stroke secondary to MFS may include cardio-embolism, arterial dissection, and hypoperfusion. Although intravenous thrombolysis is a promising therapy to treat acute ischemic stroke, further examinations should be conducted to rule out contraindications in patients with a suspicion of MFS.
Evaluating the impact of Sacubitril/valsartan on diastolic function in patients with heart failure: A systematic review and meta-analysis
Authors: Li Jinfu , Song Yanbin , Chen Fengyun 
Published: May 2024

Background:
Heart failure is a common and severe condition, often complicated by diastolic dysfunction. Current standard therapies such as ACEIs and ARBs have limited efficacy in managing diastolic function. Sacubitril/Valsartan, an emerging therapy, warrants rigorous investigation to elucidate its impact on diastolic function in heart failure patients.

Methods:
This systematic review and meta-analysis were conducted adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and utilized the PICO schema. Searches were performed on 4 databases—PubMed, Embase, Web of Science, and Cochrane Library—without temporal restrictions. Inclusion and exclusion criteria were strictly defined, and quality assessments were conducted using the Cochrane Collaboration Risk of Bias tool. Both fixed-effects and random-effects models were used for statistical analysis, depending on inter-study heterogeneity assessed by I
2 statistics and Chi-square tests.

Results:
Out of 1129 identified publications, 8 studies met the criteria and were included in the meta-analysis. These studies consisted of both randomized controlled trials and cohort studies and featured diverse global populations. Significant reductions were found in the echocardiographic parameter E/e’ ratio and LAVi upon treatment with Sacubitril/Valsartan compared to standard therapies, with mean differences of −1.38 and −4.62, respectively, both with P values < .01.

Conclusions:
This meta-analysis demonstrates that Sacubitril/Valsartan significantly improves diastolic function parameters in heart failure patients compared to standard treatments. These findings underscore the potential benefits of Sacubitril/Valsartan in the management of heart failure, particularly for patients with diastolic dysfunction.
Clinical study on the treatment of Qingfei Paidu Granules combined with nondrug therapy for asymptomatic patients with novel coronavirus
Authors: Ling Li , Xu Zeyu , Yin Fang , Zhang Yi , Sun Yongning 
Published: May 2024

Background:
The COVID-19 pandemic, ongoing for over 2 years with evolving viral strains, including the highly infectious Omicron variant, underscores the pivotal role of Traditional Chinese Medicine (TCM) in pandemic intervention. Qingfei Paidu Granules (QFPG) are incorporated into the national TCM diagnosis and treatment protocol. This study aims to assess the clinical effectiveness of QFPG combined with nonpharmacological interventions in asymptomatic novel coronavirus infection.

Materials and Methods:
Using a full-group randomized controlled trial, asymptomatic individuals from 3 wards of Fangcang Hospital were randomly assigned to 3 groups, each comprising 150 cases: F1, the nonpharmacological treatment group, receiving only Five Elements Music Therapy and Gongfa Therapy; F2, the comprehensive treatment group, receiving QFPG treatment combined with Five Elements Music Therapy and Gongfa Therapy; and F3, the pharmacological treatment group, receiving only QFPG treatment. The treatment duration for each group was 6 days. Clinical efficacy and safety among different treatment groups were observed, including the conversion time of COVID-19 nucleic acid detection, duration of hospitalization, conversion rate from mild to moderate cases, and occurrence of adverse events.

Results:
All 450 participants were included and completed the study. The conversion rates on the first day of treatment were 10.7%, 30%, and 11.3% for the F1, F2, and F3 groups, respectively. Compared to F1, both F2 and F3 showed shortened first conversion time and time to double negative results, with first conversion times of 1.92 days for F2 and 2.29 days for F3. Additionally, the time in F2 was shorter compared to F3. Hospitalization duration was shortened in both F2 and F3 compared to F1, with no statistically significant difference between F2 and F3. The conversion rate from mild to moderate cases was lower in both F2 and F3 compared to F1, but the difference between F2 and F3 was not significant.

Conclusion:
Combining QFPG with traditional Chinese nonpharmacological interventions effectively shortened the conversion time of COVID-19 nucleic acid detection and reduced the conversion rate from asymptomatic infection to mild/moderate cases. This treatment approach is worth promoting in the management of asymptomatic patients during pandemics.

Trial Registration:
ClinicalTrials.gov, ChiCTR2200059007.
Diagnostic performance of acoustic radiation force impulse for acute pancreatitis: A meta-analysis
Authors: Wang Wen Jie , Zhang Li Wei , Feng Shun Yi 
Published: May 2024

Objective:
The objective of this meta-analysis is to evaluate the diagnostic performance of acoustic radiation force impulse (ARFI) in acute pancreatitis (AP) patients.

Methods:
PubMed, Web of Science, Embase, Wanfang, Chinese Biological Medicine databases, and Chinese Biomedical Literature Service System were searched for relevant studies to explore the potential diagnostic performance of ARFI in AP from inception to November 2023. STATA 14.0 was used to analyze the standardized mean difference (SMD) with 95% confidence interval (CI), pooled sensitivity, specificity, area under the curve, meta-regression analysis, sensitivity analysis, and publication bias.

Results:
Nine studies, involving 533 AP patients and 585 healthy controls, were included. AP patients had significantly higher ARFI levels than healthy controls (SMD: 3.13, 95% CI: 1.88–4.39, P = .001). The area under the curve of ARFI for diagnosing AP was 0.99 (95% CI: 0.98–1.00), with 98% sensitivity and 94% specificity. Meta-regression identified the study region and study period as the sources of heterogeneity. Sensitivity analysis showed that the exclusion of any single study did not materially alter the overall combined effect. No evidence of publication bias was observed in the included studies.

Conclusion:
This meta-analysis demonstrated that ARFI exerted satisfactory diagnostic performance in AP.
Six-gene prognostic signature for non-alcoholic fatty liver disease susceptibility using machine learning
Authors: Zhang Xiang , Zhou Chunzi , Hu Jingwen , Hu Jingwen , Ding Yueping , Chen Shiqi , Wang Xu , Xu Lei , Gou Zhijun , Zhang Shuqiao , Shi Weiqun 
Published: May 2024

Background:
nonalcoholic fatty liver disease (NAFLD) is a common liver disease affecting the global population and its impact on human health will continue to increase. Genetic susceptibility is an important factor influencing its onset and progression, and there is a lack of reliable methods to predict the susceptibility of normal populations to NAFLD using appropriate genes.

Methods:
RNA sequencing data relating to nonalcoholic fatty liver disease was analyzed using the “limma” package within the R software. Differentially expressed genes were obtained through preliminary intersection screening. Core genes were analyzed and obtained by establishing and comparing 4 machine learning models, then a prediction model for NAFLD was constructed. The effectiveness of the model was then evaluated, and its applicability and reliability verified. Finally, we conducted further gene correlation analysis, analysis of biological function and analysis of immune infiltration.

Results:
By comparing 4 machine learning algorithms, we identified SVM as the optimal model, with the first 6 genes (CD247, S100A9, CSF3R, DIP2C, OXCT 2 and PRAMEF16) as predictive genes. The nomogram was found to have good reliability and effectiveness. Six genes’ receiver operating characteristic curves (ROC) suggest an essential role in NAFLD pathogenesis, and they exhibit a high predictive value. Further analysis of immunology demonstrated that these 6 genes were closely connected to various immune cells and pathways.

Conclusion:
This study has successfully constructed an advanced and reliable prediction model based on 6 diagnostic gene markers to predict the susceptibility of normal populations to NAFLD, while also providing insights for potential targeted therapies.
Uncovering the molecular mechanism of Mume Fructus in treatment of Sjögren’s syndrome
Authors: Sun Zhongli , Deng Lilin , Xu Zhoujie , Yang Kun , Yu Penglong 
Published: May 2024

Background:
Modern medicine has no cure for the xerostomia caused by the early onset of Sjögren’s syndrome. Mume Fructus is a common Chinese herbal medicine used to relieve xerostomia. However, the molecular mechanisms of the effects of Mume Fructus are unknown. In this study, network pharmacology and molecular docking were used to investigate the mechanisms of action of Mume Fructus on Sjögren’s syndrome.

Materials and method:
The Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform database was used to identify the active components and targets of Mume Fructus, and the UniProt database was used to identify the genes encoding these targets. SS-related targets were also identified from the GeneCards and OMIM databases. By finding the intersection of the targets of the compounds and the targets of Sjögren’s syndrome, the predicted targets of Mume Fructus in the treatment of Sjögren’s syndrome were obtained. Further investigation of the active compounds and their targets was carried out by constructing a network of “medicine-candidate compound-target-disease” using Cytoscape 3.7.2, the Protein-Protein Interaction network using the STRING database and Cytoscape 3.7.2, and key targets were identified by Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis on R software. Finally, molecular docking was used to verify the affinity of the candidate compounds to the key targets.

Results:
Quercetin, beta-sitosterol, and kaempferol in Mume Fructus interact with AKT1, IL-6, IL-1B, JUN, CASP3, and MAPK8. These results suggest that Mume Fructus exerts its therapeutic effects on the peripheral gland injury of Sjögren’s syndrome and its secondary cardiovascular disease and tumorigenesis through anti-inflammatory, anti-oxidant, and anti-tumor pathways.

Conclusion:
With network pharmacology, this study systematically identified the main active components, targets, and specific mechanisms of the therapeutic effects of Mume Fructus on Sjögren’s syndrome, providing both a theoretical basis and research direction for further investigations on Mume Fructus.
Acute cardiac tamponade after Endostar treatment of non-small cell lung cancer: A case report
Authors: Dong Wanhui , Wang Mingxing , Zhu Pei , Sun Qingming , Wu Dezhen 
Published: May 2024

Rationale:
Recombinant human endostatin (Endostar) is extensively utilized in China for the clinical management of patients with driver gene-negative non-small cell lung cancer (NSCLC) at stage TNM IV. This report describes the case of a lung cancer patient treated exclusively with Endostar maintenance therapy, who experienced a rapid deterioration in respiratory function.

Patient concerns:
The case involved a patient with a pathologically confirmed squamous cell carcinoma of the left lung, treated in our department. Following 1 month of albumin-bound paclitaxel chemotherapy and localized radiotherapy for the left lung lesion, the patient initiated treatment with a single agent, Endostar 30mg, on October 19, 2021. The medication was administered via intravenous infusion over a 7 days.

Diagnosis:
On October 23, 2021, the patient exhibited symptoms of chest constriction, discomfort, coughing, and sputum production. By October 28, the patient presented with pronounced dyspnea and respiratory distress. An emergency CT scan detected pericardial tamponade and significant deviations in several blood parameters from pretreatment values.

Interventions:
Percardial puncture and catheter drainage were recommended as therapeutic intervention.

Outcomes:
Considering the patient advanced age, the patient and their family opted to refuse this medical procedure, leading to the patient unfortunate demise on November 2, 2021.

Lessons:
Medical professionals should remain vigilant for the potential, albeit rare, risk of Endostar inducing acute pericardial tamponade, a severe and potentially fatal complication.
Internal fistula stenosis with true pseudoaneurysm formation in a patient on maintenance hemodialysis: A case report
Authors: Tong Xiaoya , Ran Yan , Da Jingjing , Hu Ying , Yuan Jing , Rui Yan 
Published: May 2024

Background:
Arteriovenous fistula stenosis can directly lead to the formation of autologous arteriovenous fistula aneurysms (AVFAs), but the coexistence of true and pseudoaneurysms is relatively rare. The coexistence of true and pseudoaneurysms increases the risk of rupture of the arteriovenous fistula and complicates subsequent surgical intervention, potentially posing a threat to the patient’s life, and thus requires significant attention.

Case presentation:
The patient presented with arteriovenous fistula (AVF) after hemodialysis 6 years ago. 2 years ago, the patient presented with a mass that had formed near the left forearm arteriovenous fistula and gradually increased in size. Preoperatively, the AVF stenosis was identified as the cause of the mass formation, and the patient was operated on. First, the blood flow was controlled to reduce the pressure at the aneurysm, and then the incision was enlarged to separate the AVF anastomosis from the mass area. The stenotic segment of the true and pseudo aneurysms and cephalic vein was removed and the over-dilated proximal cephalic vein was locally narrowed and subsequently anastomosed with the proximal radial artery to create AVF. The patient was dialyzed with an internal fistula the next day and showed no clinical manifestations related to end-limb ischemia.

Conclusion:
We removed a true pseudoaneurysm in AVF and secured the patient’s vascular access. This report provides an effective strategy to manage this condition.
Comparison of the pleiotropic effect of atorvastatin and rosuvastatin on postmenopausal changes in bone turnover: A randomized comparative study
Authors: Braszak-Cymerman Anna , Walczak Marta K. , Oduah Mary-Tiffany , Ludziejewska Aleksandra , Bryl Wiesław 
Published: May 2024

Background:
Statins are the first-line treatment for dyslipidemia, which is a major modifiable risk factor for atherosclerotic cardiovascular disease. Studies have shown that in addition to the beneficial lipid-lowering effect, statins also exhibit a number of pleiotropic effects that may find application in other diseases, including osteoporosis. This study aimed to assess the effect of statins on bone turnover, as measured by the concentration of bone turnover markers, and to compare the effect of atorvastatin as a lipophilic statin and rosuvastatin as a hydrophilic statin.

Methods:
This study included 34 postmenopausal women aged < 65 years with newly diagnosed dyslipidemia requiring statin therapy. Patients were randomly assigned to receive a statin drug. Statins were initiated at standard doses of 5 to 10 mg of rosuvastatin and 20 mg of atorvastatin. The levels of C-terminal telopeptide of type I collagen as a bone resorption marker and N-terminal propeptide of procollagen type I as a marker of bone formation, lipid concentrations and other biochemical parameters were assessed at baseline and after 6 and twelve months of treatment.

Results:
There were no statistically significant differences between the levels of bone turnover markers before and 6 months after statin implementation (P > .05) - for all patients or subgroups according to statin use. Analysis of the results showed that after 12 months, there was a statistically significant decrease in N-terminal propeptide of procollagen type I concentration in all subjects (P = .004). By statin subgroup, a statistically significant decrease in N-terminal propeptide of procollagen type I was observed only in patients receiving rosuvastatin (P = .012) and not in those receiving atorvastatin (P = .25). Moreover, changes in bone turnover markers did not correlate with changes in lipid concentrations.

Conclusions:
These results may indicate the superiority of atorvastatin over rosuvastatin in inhibiting adverse changes in bone turnover in postmenopausal women. Confirmed by studies involving a larger population, the observed differences might find particular applications in clinical practice, and the choice of atorvastatin over rosuvastatin for women could be considered in the early postmenopausal period to reduce the risk of osteoporosis and subsequent osteoporotic fractures.
Trends and focal points in pelvic floor reconstruction for pelvic organ prolapse: A bibliometric analysis
Authors: Kong Min , Shi Yueyue , Wang Zhuo , Hao Yao , Djurist Ngenzi Richard , Li Yan 
Published: May 2024

Objective:
This study aims to investigate the current research trends and focal points in the field of pelvic floor reconstruction for the management of pelvic organ prolapse (POP).

Methods:
To achieve this objective, a bibliometric analysis was conducted on relevant literature using the Citespace database. The analysis led to the creation of a knowledge map, offering a comprehensive overview of scientific advancements in this research area.

Results:
The study included a total of 607 publications, revealing a consistent increase in articles addressing pelvic floor reconstruction for POP treatment. Most articles originated from the United States (317 articles), followed by Chinese scholars (40 articles). However, it is important to note that the overall number of articles remains relatively low. The organization with the highest publication frequency was the Cleveland Clinic in Ohio, where Matthew D. Barber leads the academic group. Barber himself has the highest number of published articles (18 articles), followed by Zhu Lan, a Chinese scholar (10 articles). Key topics with high frequency and mediated centrality include stress urinary incontinence, quality of life, impact, and age. The journal with the largest number of papers from both domestic and international researchers is INT UROGYNECOL J. The study’s hotspots mainly focus on the impact of pelvic floor reconstruction on the treatment and quality of life of POP patients. The United States leads in this field, but there is a lack of cooperation between countries, institutions, and authors. Moving forward, cross-institutional, cross-national, and cross-disciplinary exchanges and cooperation should be strengthened to further advance the field of pelvic floor reconstructive surgery for POP research.
Meta-analysis of the association between dietary inflammation index and C-reactive protein level
Authors: Hua Rongyu , Liang Guanmian , Yang Fangying 
Published: May 2024

Background:
There have been various clinical studies on the effect of dietary inflammatory index (DII) on circulating inflammatory biomarkers, but the findings from these are contradictory. The aim of the present study was to clarify any association.

Methods:
The PubMed, Embase, Web of Science and Cochrane Library database were searched for relevant studies from inception February 2021. There were no language restrictions. Two investigators independently selected eligible studies. Measures of association were pooled by using an inverse-variance weighted random-effects model. The heterogeneity among studies was examined using the I
2 index. Publication bias, sensitivity and subgroup analyses were also performed.

Results:
A total of 13 cross-sectional studies were identified, involving 54,813 participants. The adjusted pooled OR of C-reactive protein (CRP) levels for the highest (the most pro-inflammatory diet) versus lowest (the most anti-inflammatory diet) DII categories was 1.25 (95% CI: 1.18–1.32; I2
= 59.4%, P = .002). Subgroup analyses suggested the main source of study heterogeneity was the geographic area (Asia, Europe, or USA) and CRP levels (>3 mg/L or others). This finding was remarkably robust in the sensitivity analysis.

Conclusion:
The meta-analysis suggests that more pro-inflammatory DII scores were positively associated with CRP, the DII scores can be useful to assess the diet inflammatory properties and its association with low-grade inflammation.