bluuebunny/crossref_metadata_2025_split huggingface dataset:
Proficiency of virtual reality simulator training in flexible retrograde ureteroscopy renal stone management
Authors: CAI Jian-liang , ZHANG Yi , SUN Guo-feng , LI Ning-chen , YUAN Xue-li , NA Yan-qun 
Published: January 2024

BackgroundMinimally invasive flexible ureteroscopy techniques have widely adopted in the management of patients with renal stones. We performed this study to investigate the value of virtual reality simulator training in retrograde flexible ureteroscopy renal stone treatment for catechumen.MethodsThirty catechumen, included 17 attending physicians and 13 associate chief physicians, were selected for study. The trainees first underwent 1-hour basic training to get familiar with the instrument and basic procedures, then followed by 4-hour practice on virtual reality simulators. Before and after the 4-hour training, all trainees undertake an assessment with task 7 program (right low pole calyces stone management). We documented for each trainee the total time of procedure, time of progressing from the orifice to stone, stone translocation and fragmentation time, laser operate proficiency scale, total laser energy, maximal size of residual stone fragments, number of trauma from the scopes and tools, damage to the scope and global rating scale (GRS). The proficiency of this training program was analyzed by the comparison of the first and second assessment outcomes.ResultsSignificant improvement was observed in retrograde flexible ureteroscopy management of renal stone on virtual reality simulators after finishing the 4 hour special-purpose training. This was demonstrated by improvement in total procedure time ((18.37±2.59) minutes vs. (38.67±1.94) minutes), progressing time from the orifice to stone ((4.00±1.08) minutes vs. (13.80±2.01) minutes), time of stone translocation ((1.80±0.71) minutes vs. (6.57±1.01) minutes), fragmentation time ((4.43±1.25) minutes vs. (13.53±1.46) minutes), laser operate proficiency scale (8.47±0.73 vs. 3.77±0.77), total laser energy ((3231.6±401.4) W vs. (5329.8±448.9) W), maximal size of residual stone fragments ((2.66±0.39) mm vs. (5.77±0.63) mm), number of trauma from the scopes and tools (3.27±1.01 vs. 10.37±3.02), damage to the scope (0 vs. 0.97±0.76) and GRS (29.27±2.95 vs. 9.87±2.21). The differences between the first and the second assessment were all statistically significant (allP<0.01).ConclusionThe virtual reality simulator training program can help the trainees to rapidly improve their retrograde flexible ureteroscopy skill in renal stone treatment.
Large and giant medial sphenoid wing meningiomas involving vascular structures: clinical features and management experience in 53 patients
Authors: YANG Jun , MA Shun-chang , LIU Yan-hong , WEI Lin , ZHANG Chun-yang , QI Jian-fa , YU Chun-jiang 
Published: January 2024

Background
Large and giant medial sphenoid wing meningiomas that are located deeply in the skull base where they are closely bounded by cavernous sinus, optic nerve, and internal carotid artery make the gross resection hard to achieve. Also, this kind of meningiomas is often accompanied by a series of severe complications. Therefore, it was regarded as a formidable challenge to even the most experienced neurosurgeons. This study aimed to investigate the clinical features and management experience of patients with large and giant medial sphenoid wing meningiomas.

Methods
In this study, 53 patients (33 female and 20 male, mean age of 47.5 years) with large and giant medial sphenoid wing meningiomas were treated surgically between April 2004 to March 2012, with their clinical features analyzed, management experience collected, and treatment results investigated retrospectively.

Results
In this study, gross total resection (Simpson I and II) was applied in 44 patients (83%). Fifty-three patients had accepted the routine computed tomography scan and magnetic resonance imaging scan as postoperative neuroradiological evaluation. Their performance showed surgical complications of vascular lesions and helped us evaluate patients’ conditions, respectively. Meanwhile, the drugs resisting cerebral angiospasm, such as Nimodipine, were infused in every postoperative patient through vein as routine. As a result, 11 patients (21%) were found to have secondary injury of cranial nerves II, III, and IV, and nine patients got recovered during the long-term observing follow-up period. Temporary surgical complications of vascular lesions occurred after surgery, such as cerebral angiospasm, ischemia, and edema; 24 patients (45%) appeared to have infarction and dyskinesia of limbs. Overall, visual ability was improved in 41 patients (77%). No patient died during the process.

Conclusions
Microsurgical treatment may be the most effective method for the large and giant medial sphenoid wing meningiomas. The surgical strategy should focus on survival and postoperative living quality.
Receptor interacting protein 1 involved in ultraviolet B induced NIH3T3 cell apoptosis through expression of matrix metalloproteinases and reactive oxygen species production
Authors: YAN Yan , LI Li , XU Hao-Xiang , PENG Shi-Guang , QU Tao , WANG Bao-Xi 
Published: January 2024

Background
Receptor interacting protein 1 (RIP1), which plays a key role in apoptosis, cell survival and programmed cell necrosis, is one of the most important proteins in the RIP family. The purpose of this study was to investigate the roles of RIP1 in the apoptosis, the generation of reactive oxygen species (ROS) and the expression of matrix metalloproteinases (MMPs) induced by ultraviolet B (UVB) in fibroblasts.

Methods
siRNA targeting RIP1 was used to silence RIP1 expression in the NIH3T3 fibroblasts. The mRNA and protein levels of MMP-1 and MMP-3, caspase-3 and -8 activities, and ROS activities were determined by reverse transcriptase-quantitative polymerase chain reaction (RT-qPCR), immunoblotting, caspase activity assay, immunofluorescence, and flow cytometry.

Results
The mRNA and protein expressions of MMP-1 and MMP-3 were significantly increased in RIP1 deficient NIH3T3 cells at 24 hours after UVB treatment. At 24 hours after exposure to UVB, RIP1 deficient NIH3T3 cells presented apoptotic morphology, and the apoptosis rate was significantly increased accompanied by pronounced increase in caspase-8 and -3 activities. ROS production was inhibited by UVB at 12 hours in RIP1 deficient NIH3T3 cells.

Conclusion
RIP1 is involved in NIH3T3 cell damage induced by UVB via participating in the apoptosis, expression of MMPs and ROS production.
Efficacy and safety of icotinib in Chinese patients with advanced nonsmall cell lung cancer after failure of chemotherapy
Authors: Shao Lan , Zhang Beibei , He Chunxiao , Lin Baochai , Song Zhengbo , Lou Guangyuan , Yu Xinmin , Zhang Yiping 
Published: January 2024

Background
The preclinical experiments and several clinical studies showed icotinib, an oral epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, in Chinese patients with advanced non-small cell lung cancer (NSCLC) who failed previous chemotherapy. We performed a retrospective study of the efficacy and safety of icotinib monotherapy in a different and more recent sample of Chinese patients.

Methods
The clinical data of 149 patients with advanced NSCLC who were admitted to Zhejiang Cancer Hospital from August 1, 2011 to July 31, 2012 were retrospectively analyzed. All patients were given icotinib treatment after the failure of previous chemotherapy. Univariate and multivariate analyses were conducted based on the Kaplan Meier method and Cox proportional hazards model.

Results
The objective response rate was 33/149 and disease control rate was 105/149. No complete response occurred. Median progression free survival (PFS) with icotinib treatment was 5.03 months (95% CI: 3.51 to 6.55). Median overall survival was 12.3 months (95% CI: 10.68 to 13.92). Multivariate analysis showed that the mutation of EGFR and one regimen of prior chemotherapy were significantly associated with longer PFS. At least one drug related adverse event was observed in 65.8% (98/149) of patients, but mostly grade 1 or 2 and reversible and none grade 4 toxicity.

Conclusions
Icotinib monotherapy is an effective and well tolerated regimen for Chinese patients with NSCLC after the failure of chemotherapy. It is a promising agent and further study with icotinib in properly conducted trials with larger patient samples and other ethnic groups is warranted.
A preliminary study of genes related to concomitant chemoradiotherapy resistance in advanced uterine cervical squamous cell carcinoma
Authors: AN Ju-sheng , HUANG Man-ni , SONG Yong-mei , LI Nan , WU Ling-ying , ZHAN Qi-min 
Published: January 2024

Background
Tumor intrinsic chemoradiotherapy resistance is the primary factor in concomitant chemoradiotherapy failure in advanced uterine cervical squamous cell carcinoma. This study aims to identify a set of genes and molecular pathways related to this condition.

Methods
Forty patients with uterine cervical squamous cell carcinoma in International Federation of Gynecology and Obstetrics stage IIb or IIIb, treated with platinum-based concomitant chemoradiotherapy between May 2007 and December 2012, were enrolled in this trial. Patients included chemoradiotherapy resistant (n=20) and sensitive (n=20) groups. Total RNA was extracted from fresh tumor tissues obtained by biopsy before treatment and microarray analysis was performed to identify genes differentially expressed between the two groups.

Results
Microarray analysis identified 108 genes differentially expressed between concomitant chemoradiotherapy resistant and sensitive patients. Functional pathway cluster analysis of these genes revealed that DNA damage repair, apoptosis, cell cycle, Map kinase signal transduction, anaerobic glycolysis and glutathione metabolism were the most relevant pathways. Platelet-derived growth factor receptor alpha (PDGFRA) and protein kinase A type 1A (PRKAR1A) were significantly upregulated in the chemoradiosensitive group, while lactate dehydrogenase A (LDHA), bcl2 antagonist/killer 1 (BAK1), bcl2/adenovirus E1B 19 kDa interacting protein 3 (BNIP3), single-strand-selective monofunctional uracil-DNA glycosylase 1 (SMUG1), and cyclin-dependent kinase 7 (CDK7) were upregulated in the chemoradiotherapy resistant group.

Conclusion
We have identified seven genes that are differentially expressed in concomitant chemoradiotherapy resistant and sensitive uterine cervical squamous cell carcinomas, which may represent primary predictors for this condition.
Overactive bladder symptom score to evaluate efficacy of solifenacin for the treatment of overactive bladder symptoms
Authors: Liu Ming , Wang Jianye , Yang Yong , An Ruihua , Wen Jianguo , Guan Zhichen , Zheng Shaobin , Wang Dongwen , Song Bo , Liao Limin , Guo Hongqian , Xiao Jiaquan , Sun Yinghao , Shen Zhoujun , Kong Chuize , He Dalin , Huang Yiran , Wang Xiaofeng , Zhang Xu , Li Hanzhong , Huang Jian , Zhao Xiaokun , Zeng Puqing , Song Xishuang , Ye Zhangqun 
Published: January 2024

Background
Overactive bladder (OAB) is a series of symptoms with high prevalence in elderly people. This study was conducted using the overactive bladder symptom score (OABSS) to evaluate the efficacy of solifenacin succinate for the treatment of OAB.

Methods
This was a prospective, multicenter, single-arm, 12-week study that enrolled 241 OAB patients. The patients received 5-10 mg/day solifenacin. Changes in OABSS, symptoms from voiding diary, perception of bladder condition (PPBC) score, international prostate symptom score (IPSS) and quality of life (QOL) were evaluated at weeks 0, 4, and
12. The relationship between OABSS and PPBC score or parameters of voiding diary was also evaluated.

Results
At baseline, the mean OABSS for all patients was 9.41±2.40, and was reduced significantly at week 12 (-3.76 points; 61.21%, P <0.0001). The OABSS subscore, PPBC score, IPSS, and QOL were also significantly reduced during the study (P <0.0001). The overall incidence of adverse events was 19.91% (44 cases). The gastrointestinal system was the most commonly affected (11.31%). Around 5.88% of the cases had adverse events related to the genitourinary system. There was a strong correlation between OABSS and urinary symptoms that was recorded in the 3-day voiding dairy.

Conclusions
We showed that solifenacin was clinically effective for relieving OAB symptoms, considering the balance between efficacy, patients' well-being, and tolerability. OABSS integrates four OAB symptoms into a single score and can be a useful tool for research and clinical practice.
Decorin prevents the development of CCl4-induced liver fibrosis in mice
Authors: Ma Rui , He Shilin , Liang Xiao , Yu Hong , Liang Yuelong , Cai Xiujun 
Published: January 2024

Background
Liver fibrosis normally progresses to cirrhosis and destroys the normal architecture of the liver, resulting in liver dysfunction and irreversible cirrhosis. The aim of this study was to investigate the anti-fibrosis effect and the possible underlying mechanisms of decorin.

Methods
The mice model of liver fibrosis was induced by intraperitoneal injection of 50% (v/v) of carbon tetrachloride (CCl4) diluted in olive oil (1 ml/kg body weight) once every 2 days for 5 weeks. Three weeks after injecting CCl4 intraperitoneally, mice were randomly divided into normal control with vehicles only (olive oil), mouse model given CCl4 only, and CCl4 plus decorin (DCN, 250 μg/kg). Two weeks later, all the mice were sacrificed and their liver tissues were analyzed for the expressions of genes related to liver fibrosis and under hematoxylin-eosin staining, Masson staining, and immunohistochemical staining of all groups. Aspartate transaminase, alanine transaminase, and total bilirubin of the serum were determined for evaluation of the liver function.

Results
Exogenous protein decorin could reduce liver fibrosis induced by CCl4 in mice. The degree of fibrosis in the experimental group was alleviated, and the contents of collagen fibers were lower in the experimental group than those of the control group. In addition, expressions of transforming growth factor β1 and α-smooth muscle actin decreased in the experimental group.

Conclusions
Taking liver fibrosis model of mouse as the experimental target and by injecting exogenous protein decorin into the model, we confirmed that decorin could inhibit the expression of proteins related to fibrosis and reduce the formation of liver fibrosis in mice.
Effect of superior retinacular artery damage on osteonecrosis of the femoral head
Authors: LIU Bao-yi , ZHAO De-wei , YU Xiao-bing , YANG Lei , GUO Lin , WANG Ben-jie 
Published: January 2024

Background
Osteonecrosis of the femoral head (ONFH) is the result of dysfunctional blood supply, but associations between specific damaged arteries, imaging changes and clinical sign require more understanding. We investigated characteristics of ONFH that pertain to blood supply, imaging appearance, and clinical feature to judge the prognosis of ONFH.

Methods
Clinical data were collected for 92 patients (118 hips) with ONFH, including gender, age, duration of pain (from initial clinical presentation to arthroplasty), cause, stage, and classification. Magmatic resonance imaging and X-rays were obtained of all patients to diagnose ONFH. The sizes of lesions were classified by necrotic index. The location of necrosis was classified as Type A, B, or C using the grading system by magmatic resonance imaging and X-rays. All hips were imaged with digital subtraction angiography to visualize their blood-supply characteristics. Hips were divided into groups based on the source artery for femoral head damage: superior retinacular artery (S), inferior retinacular artery (I), and combined superior and inferior retinacular arteries (S+I). Via digital subtraction angiography, imaging appearances and clinical data in three groups were compared.

Results
ONFH was caused by damage in either the superior or inferior retinacular artery, or both, in all of 118 hips. The group with only inferior retinacular artery damage reported longer hip pain duration than the other groups. The probability of the lesion extending laterally to the acetabular edge in group S was much more than it in group I. Necrosis indices of the patients in S and S+I were higher than those in group I.

Conclusions
ONFH associated with interruption of the superior and inferior retinacular arteries in this study. When the former alone was damaged, the necrosis of the volume was larger, the risk of femoral head collapse was higher and the time from initial clinical presentation to arthroplasty was shorter.
Management of postoperative instrumented spinal wound infection
Authors: FANG Xiu-tong , Wood Kirkham B. 
Published: January 2024

Background
Wound infection following spinal instrumented surgery is a frequent complication. The optimal treatment of acute deep wound infection following spinal instrumentation fusion remains controversial because of variability in cohort identification, definition of an infection, and the instrument used to measure outcomes. This retrospective study evaluated the clinical curative effect for postoperative spinal infection after instrumented spine fusion with extensive debridement, or implant removal.

Methods
From January 2004 to October 2009, 851 patients were identified who underwent surgical treatment of spinal diseases. The medical records of patients who developed infections were reviewed in detail.

Results
Of 851 patients, 41 (4.9%) developed an infection. Thirty-three were acute, and eight were delayed. Acute infected cases were managed with antibiotic therapy, and aggressive debridement of the wound and soft tissues leaving all instrumentation in situ in all but one patient. The most common symptoms of acute infection included: posterior incisional drainage (26 of 33 patients), back pain (22 of 33 patients) and fever (13 of 33 patients). Among patients with delayed onset infection, five of eight patients had local pain, four of eight patients had incision drainage, and one patient had a prolonged period of intermittent fever. The most frequent causative organism for postoperative spinal infection following spine surgery is Staphylococcus aureus. Pseudarthrosis was noted in long-term follow-up in four of 41 patients.

Conclusions
We recommend irrigation and debridement, no instrumentation removal, and, if necessary, repeat debridement followed by delayed primary closure for the treatment of acute deep infection with instrumentation.
Combined action of C-reactive protein and lipid profiles on risk of hypertension and prehypertension in Mongolian adults in Inner Mongolia, China
Authors: Zhang Shihui , Xu Tian , Peng Yanbo , Peng Hao , Wang Aili , Wang Guiyan , Wang Dali , Zhang Yonghong 
Published: January 2024

Background
Many studies have suggested that C-reactive protein (CRP) and blood lipids are associated with hypertension and cardiovascular disease (CVD). However, few studies discussed the combined action of CRP and blood lipids on the risk of hypertension and prehypertension. This study aimed to investigate the combined action of CRP and lipid profiles on the risk of hypertension and prehypertension in Mongolian adults from Inner Mongolia, China.

Methods
The systolic and diastolic blood pressure, height, weight and waist circumference were measured and factors such as smoking, alcohol intake, family history of hypertension, etc., were investigated and CRP, low-density lipoprotein cholesterol (LDL-C), triglycerides (TG) were tested for 2 534 Mongolian adults aged ≥20 years. The subjects were divided into four subgroups, namely CRP <median and LDL-C (TG) <median subgroup, CRP <median and LDL-C (TG) >median subgroup, CRP >median and LDL-C (TG) <median subgroup and CRP >median and LDL-C (TG) >median subgroup. The ORs (95% CIs) of hypertension and prehypertension for the subgroups were calculated by univariate and multivariate analysis.

Results
The multivariate adjusted ORs (95%CIs) of hypertension/prehypertension were 1.389 (0.979–1.970)/1.151(0.865–1.531), 1.666 (1.159–2.394)/1.431 (1.060–1.930), 1.756 (1.242–2.484)/1.770 (1.321–2.372), for CRP <median and LDL-C >median subgroup, CRP >median and LDL-C <median subgroup, and CRP >median and LDL-C >median subgroup, respectively, compared with CRP <median and LDL-C <median subgroup. Similarly, the multivariate adjusted ORs (95% CIs) of hypertension/prehypertension were 2.032 (1.394–2.963)/1.442 (1.047–1.988), 1.412 (0.960–2.079)/1.596 (1.166–2.184), and 2.197 (1.595–3.027)/1.730 (1.321–2.266) for CRP <median and TG >median subgroup, CRP >median and TG <median subgroup, and CRP >median and TG >median subgroup, respectively, compared with CRP <median and TG <median subgroup. The risks of hypertension and prehypertension were the highest in the CRP >median and LDL-C (TG) >median subgroup among the four subgroups.

Conclusions
Subjects with both CRP >median and LDL-C (TG) >median had highest risks of hypertension and prehypertension among all subjects. This study appeared to indicate that the combined action of elevated CRP and elevated LDL-C (TG) further increase the risks of hypertension and prehypertension among Mongolian population.
Diagnosis of Fanconi anemia in children with atypical clinical features: a primary study
Authors: LIU Rong , HU Tao , LI Jun-hui , LIANG Chao , GU Wei-yue , SHI Xiao-dong , WANG Hong-xing 
Published: January 2024

Background
Fanconi anemia is a severe congenital disorder associated with mutations in a cluster of genes responsible for DNA repair. Arriving at an accurate and timely diagnosis can be difficult in cases of Fanconi anemia with atypical clinical features. It is very important to increase the rate of accurate diagnosis for such cases in a clinical setting. The purpose of this study is to explore the clinical diagnosis of Fanconi anemia in children with atypical clinical features.

Methods
Six cases of Fanconi anemia with atypical clinical features were enrolled in the study, and their clinical features were recorded, their FANCA gene transcription was assessed by RT-PCR, and FANCA mutations and the ubiquitination of FANCD2 protein were analyzed using DNA sequencing and western blotting respectively.

Results
All six cases showed atypical clinical features including no apparent deformities, lack of response to immune therapy, and progressively increasing bone marrow failure. They also have significantly increased fetal hemoglobin, negative mitomycin-induced fracture test results, and carry a FANCA gene missense mutation. Single protein ubiquitination of FANCD2 was not observed in those patients.

Conclusion
The combination of clinical features, FANCA pathogenic gene mutation genotype and the absence of FANCD2 protein ubiquitination are helpful in the accurate and timely diagnosis of Fanconi anemia in children.
Advances and disputes of posterior malleolus fracture
Authors: FU Su , ZOU Zhen-yu , MEI Gang , JIN Dan 
Published: January 2024

Objective
The objective of this article is to summarize the development of evaluation and treatment of posterior malleolus fracture (PMF).

Data sources
Data used in this review were mainly from English literature of PubMed data base.

Study selection
Articles were included in this review if they were related to the PMF or trimalleolar fracture.

Results
No consensus was found regarding what sizes of posterior malleolus fragments would lead to ankle instability thus affecting prognosis and should be fixed. X-ray measurement is unreliable, while CT scan is widely recommended and it can recognize the occult posterior malleolus fractures associated with tibia shaft fractures, which are always undetected previously. Direct posterior malleolus fixation is suitable to stabilize syndesmotic injury. The basic and clinical researches support direct reduction and buttress plate fixation of posterior malleolus fracture through the posterolateral approach. Operative indications and timing of weight bearing are still in discussion.

Conclusions
Knowing whether ankle instability occurs and the proper methods to diagnose, evaluate, and operate can help manage the fracture. Further biomechanical research on ankle stability and clinical study to compare various treatment methods are required.