bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of adrenalectomy in recurrent Cushing's disease
Authors: DING Xue-fei , LI Han-zhong , YAN Wei-gang , GAO Ying , LI Xiao-qiang 
Published: January 2024

Background
Cushing's disease is a pituitary-dependent type of Cushing's syndrome. Treatment consists of pituitary surgery or radiotherapy, but the recurrence rate at 10 years is as high as 40%. Adrenalectomy is considered an effective treatment to refractory Cushing's disease. The objective of this study was to examine the efficacy of laparoscopic adrenalectomy and open adrenalectomy in Cushing's disease, focusing on reversing the sequelae of hypercortisolism and improving patients’ quality of life.

Methods
Forty-three patients (29 women, 14 men) with recurrent Cushing's disease after transsphenoidal operation underwent laparoscopic (n=32) or open (n=11) adrenalectomy from 2000 to 2008. Surgical results were evaluated for all the 43 patients. Patients completed a follow-up survey, including the short-form 36-item (SF-36) health survey.

Results
All the 43 patients achieved clinical reversal of hypercortisolism after adrenalectomy. Time to symptom resolution varied from a few weeks to up to 3 years. Most physical changes had resolved by a mean of 8 months after surgery. These conditions were not significantly different between the laparoscopy and open groups. Median length of hospital stay was shorter in the laparoscopy group (4 vs. 9 days; P <0.001). Median follow-up was 48.5 months. Of the 34 (79%) patients available for follow-up, 22 (65%) had adrenocorticotropic hormone levels >200 ng/ml and 6 (27%) had clinical Nelson syndrome. Four patients died by 75 months after surgery. Using SF-36, 30 (88%) patients reported they felt their health status was good to excellent compared with 1 year before adrenalectomy; however, they showed significantly lower scores in all the 8 SF-36 parameters compared with the general population. No significant difference emerged in SF-36 scores between the laparoscopy and open groups.

Conclusions
Adrenalectomy showed high survival and clinical benefits in recurrent Cushing's disease patients. Despite patient-reported improvement in health after adrenalectomy, patients continue to experience poor health status compared with the general population.
Dynamic change of mother-source neutralizing antibodies against enterovirus 71 and coxsackievirus A16 in infants
Authors: MAO Qun-ying , LIAO Xue-yan , YU Xiang , LI Nan , ZHU Feng-cai , ZENG Ying , LIANG Zheng-lun , LI Feng-xiang , WANG Jun-zhi , LU Feng-min , ZHUANG Hui 
Published: January 2024

Background
Enterovirus 71 (EV71) and coxsackievirus A16 (Cox A16) are major causative agents for hand, foot and mouth disease (HFMD). Studies indicate that the frequent HFMD outbreaks result in a few hundreds children's death in China in recent years. The vaccine and other research for HFMD need to be developed urgently. The aims of our study were: to explore dynamic development of mother-source neutralizing antibodies against EV71 and Cox A16 in infants from Jiangsu Province, China, and to provide the fundamental data for further establishing of corresponding immunization course.

Methods
Peripheral blood samples were collected from 133 of parturient women once immediately before delivery and their infants at two and seven months of age. Method of micro-dose cytopathogenic effect was used to measure neutralizing antibodies against EV71 and Cox A16, respectively.

Results
Seropositive rates of anti-EV71 and anti-Cox A16 in prenatal women were 79.7% (106/133) and 92.5% (123/133), respectively; geometric mean titers (GMTs) were 29.0 and 61.9; 75.9% (101/133) prenatal women were both positive in anti-EV71 and anti-Cox A16; seropositive rates of anti-EV71 and anti-Cox A16 were 25.6% (34/133) and 38.3% (51/133) in infants at two months of age; GMTs were 12.3 and 18.0, respectively. GMTs of anti-EV71 were significantly higher for infants at seven months (82.6) compared with that at two months (P <0.05), showing infants had inapparently infected by EV71 during two to seven months. Although only one offspring (0.75%) at seven months was found having anti-Cox A16 transfered from maternal, this observation suggested no maternal antibody may remain in infants at seven months.

Conclusions
The prevalence of EV71 and Cox A16 were relatively high in Jiangsu Province. Bivalent vaccine against both EV71 and Cox A16 should be developed, and the ideal time point for prime immunization for infants is around 2–5 months of age.
Role of Toll-like receptor 4 and human defensin 5 in primary endocervical epithelial cells
Authors: MA Jing-mei , YANG Hui-xia 
Published: January 2024

Background
Endocervical epithelial cells play early roles in the defense of upper female genital tract to pathogens. Toll-like receptors (TLRs) and human defensins (HD) have recently been identified as fundamental components of the innate immune responses to bacterial pathogens. We aimed to use in vitro model of human primary endocervical epithelial cells (HPECs) to investigate their roles in innate immune response of the endocervix.

Methods
TLR4 expression and distribution in HPECs and endocervix were investigated by immunofluorescence (IF). Cultured HPECs were divided into lipopolysaccharide (LPS) group which were treated by LPS for 0, 24 and 48 hours, and control group without treatment. At each time point, the levels of HD5, IL-6 and TNF-α in supernants were determined by ELISA. TLR4 and HD5 expressions of cells were detected by Western blotting simultaneously. HD5 expression pattern was also compared between the HeLa cell line and HPECs.

Results
Endocervix tissue surface and HPECs expressed TLR4. After incubated with LPS, HPECs expressed significantly higher levels of TLR4 than control group, especially after 24 hours (P <0.01), however decreased after 48 hours with a similar level of TLR4 expression compared with control group. LPS could upregulate the secretion of HD5, IL-6 and TNF-α in a time-dependent manner (24 hours: P <0.05; 48 hours: P <0.01, compared with control group). Intracellular HD5 expression levels decreased over time. HD5 expression patterns in HPECs were different from HeLa cell line.

Conclusions
To respond to LPS stimulation, HPECs may function in the mucosal immune defense through TLR4 activation and HD5 secretion. HPEC is considered a significant model for immunological study.

Chin Med J 2010;123(13):1762–1767
Evaluation of the traditional Chinese medicine Shensongyangxin capsule on treating premature ventricular contractions: a randomized, double-blind, controlled multicenter trial
Authors: ZOU Jian-gang , ZHANG Jian , JIA Zhen-hua , CAO Ke-jiang 
Published: January 2024

Background
Premature ventricular contraction (PVC) is one of the most common kinds of arrhythmias for which the treatment falls into dilemma. Previous clinical application showed that the traditional Chinese Medicine Shensongyangxin (SSYX) capsule is efficacious for the treatment of PVCs. This randomized clinical trial aimed to further evaluate the efficacy and safety of SSYX capsule on treating PVC.

Methods
The subjects who had frequent PVCs with or without organic heart disease and normal cardiac function were enrolled in the study. The primary endpoint was the change of PVC numbers after eight-week medication with SSYX capsule. The secondary endpoints included change of clinical symptoms related to PVCs and the safety evaluation of SSYX capsule. Totally 188 PVC patients were randomly enrolled in the non-organic heart disease PVCs trial and orally took either SSYX capsules or analogues (three times per day, 4 capsules one time). A total of 671 PVCs patients were randomly enrolled in the organic heart disease PVCs trial, and orally took either SSYX capsules (three times per day, 4 capsules one time) or mexiletine tablet (three times per day, 150 mg one time). The PVCs were monitored and calculated with 24-hour Holter electrocardiogram. Routine blood, liver and kidney function were tested before and after medication with SSYX capsule.

Results
SSYX capsules significantly decreased the PVCs numbers and alleviated the related symptoms in patients with or without organic heart disease. In non-organic heart disease group, SSYX capsules and the placebos decreased the PVCs from 12 561.34±9 777.93 to 4806.87±6507.17, and 12 605.69±8736.34 to 10 364.94±9 903.41, respectively. The total effective rate was 74.2% and 28.9% in SSYX and placebo groups (P<0.001). In organic heart disease group, SSYX capsule and mexiletine decreased the PVCs from 8641.01±8923.57 to 3853.68±7096.42, 8621.61±8367.74 to 5648.29±8667.38, respectively. The total effective rate was 65.8% and 50.7% in SSYX and mexiletine groups (P<0.001). In addition, SSYX capsule significantly alleviated PVCs-related symptoms such as palpitations, chest tightness, insomnia, fatigue, and night sweats. No adverse cardiac events were observed except some slight gastrointestinal side effects during the study.

Conclusions
Compared with placebo or mexiletine, SSYX capsules have significant therapeutic efficacy in reducing PVCs numbers and alleviate PVCs-related symptoms.
Relationship of RhoA signaling activity with ezrin expression and its significance in the prognosis for breast cancer patients
Authors: MA Li , LIU Yue-ping , ZHANG Xiang-hong , GENG Cui-zhi , LI Zeng-huai 
Published: January 2024

Background
We have recently reported that RhoA may regulate the invasion and metastasis of breast cancer cells as an upstream signal of ezrin in vitro. In this study, we examined the relationship of RhoA signaling activity with ezrin expression in breast cancer and its prognostic significance in patients with breast cancer.

Methods
Paraffin tumor sections of breast cancer were collected retrospectively from 487 patients diagnosed between 2001 and 2004. Immunohistochemical methods were used to detect the expression of RhoA, phosphorylated (activated) RhoA, and ezrin.

Results
Ezrin overexpression was detectable in 15.2% of 487 invasive breast cancers. The majority (85.1%) of ezrin-overexpressing tumors coexpressed phosphorylated RhoA; 78.8% of tumors with phosphorylated RhoA cooverexpressed ezrin. Patients whose cancers showed overexpression of ezrin or expression of phosphorylated RhoA had shorter survival rates.

Conclusions
RhoA activation is important in human breast cancer due to its upregulation of ezrin; thus, agents that target phosphorylated RhoA may be useful in the treatment of tumors with ezrin overexpression.
Technical points of total laparoscopic choledochal cyst excision
Authors: Shao-cheng LÜ , SHI Xian-jie , WANG Hong-guang , LU Fang , LIANG Yu-rong , LUO Ying , JI Wen-bin , ZHAO Zhi-ming 
Published: January 2024

Background
Choledochal cyst excision and biliary enteric reconstruction constitute the best therapy for choledochal cyst. And laparoscopy is currently used to cure this disease now.

Methods
We retrospectively analyzed the clinical data of 34 cases of total laparoscopic choledochal cyst excision between January 2007 and August 2011. All patients underwent in vitro Roux-en-Y hepatoenterostomy.

Results
All 34 patients underwent successful total laparoscopic choledochal cyst excision. The operation time was 200-360 minutes. The duration of hospital stay was 3-7 days. Follow-up observations lasted 1-56 months. One patient developed an anastomotic stoma stricture, but no other cases had postoperative complications. No patients died.

Conclusion
Total laparoscopic choledochal cyst excision is safe and feasible.
The learning curve for laparoscopic splenectomy for massive splenomegaly: a single surgeon’s experience
Authors: WU Zhong , ZHOU Jin , CAI Yun-qiang , LIU Shi-an , PENG Bing 
Published: January 2024

Background
Laparoscopic splenectomy (LS) for massive splenomegaly is more technically challenging than for a normal-sized spleen. The purpose of this study was to determine the effect of operative experience on perioperative outcomes of LS for massive splenomegaly.

Methods
Between January 2008 and December 2010, 36 consecutive patients who were diagnosed with massive splenomegaly underwent LS in our department. The perioperative outcomes were evaluated for evidence of a learning curve effect. Patients were divided into three groups (1, 2, and 3) of 12 consecutive patients, and outcomes of each group were compared.

Results
The mean operative time decreased significantly from 252 minutes of Group 1 to 179 minutes of Group 3. The estimated blood loss and length of post-operative hospital stay showed a similar trend. No significant differences were found in the splenic length and weight, transfusion rate, or average amount of drainage. In this cohort, there were three cases with surgical complications and one conversion to open laparotomy.

Conclusions
The first 24 cases constitute the early stage of the learning curve for LS for massive splenomegaly. LS for massive splenomegaly is a technically challenging operation with a long learning curve, and strategies for developing training programs must address these challenges.
Microvascular permeability of brain astrocytoma with contrastenhanced magnetic resonance imaging: correlation analysis with histopathologic grade
Authors: Jia Zhong-zheng , Geng Dao-ying , Liu Ying , Chen Xing-rong , Zhang Jun 
Published: January 2024

Background
The degree of pathological microvascular proliferation is an important element in evaluation of the astrocytoma grade. This study was aimed to quantitatively assess the microvascular permeability of brain astrocytoma with the volume transfer constant (Ktrans) and volume of extravascular extracellular space per unit volume of tissue (Ve) from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and to evaluate the effectiveness of the Ktrans and Ve in the grading of astrocytoma.

Methods
The highest values of the Ktrans and Ve of 67 patients with astrocytoma (27 with grade II, 12 with grade III, and 28 with grade IV) were obtained. The comparisons of the differences of the Ktrans and Ve between the different grades were conducted using the Mann-Whitney rank-sum tests. Spearman's rank correlation coefficients were determined between Ktrans values, Ve values and astrocytoma grades. Receiver operating characteristic (ROC) curve analyses were performed to determine the cut-off values for the Ktrans and Ve to distinguish between the different grades of astrocytoma.

Results
There were significant differences (P<0.001) between the different grades in the Ktrans values and Ve values, except for grades III and IV. The Ktrans values and Ve values were both correlated with astrocytoma grades (both P<0.001). The ROC curve analyses showed that the cut-off values for the Ktrans and Ve provided the best combination of sensitivity and specificity in distinguishing between grade II and grade III or IV astrocytomas.

Conclusions
DCE-MRI can play an important role in assessing the microvascular permeability and the grading of brain astrocytoma.
Evaluation of neuromuscular activity in patients with obstructive sleep apnea using chin surface electromyography of polysomnography
Authors: YIN Guo-ping , YE Jing-ying , HAN De-min , WANG Xiao-yi , ZHANG Yu-huan , LI Yan-ru 
Published: January 2024

Background
It is believed that defects in upper airway neuromuscular control play a role in sleep apnea pathogenesis. Currently, there is no simple and non-invasive method for evaluating neuromuscular activity for the purpose of screening in patients with obstructive sleep apnea. This study was designed to assess the validity of chin surface electromyography of routine polysomnography in evaluating the neuromuscular activity of obstructive sleep apnea subjects and probe the neuromuscular contribution in the pathogenesis of the condition.

Methods
The chin surface electromyography of routine polysomnography during normal breathing and obstructive apnea were quantified in 36 male patients with obstructive sleep apnea. The change of chin surface electromyography from normal breathing to obstructive apnea was expressed as the percent compensated electromyography value, where the percent compensated electromyography value = (normal breath surface electromyography - apnea surface electromyography)/normal breath surface electromyography, and the percent compensated electromyography values among subjects were compared. The relationship between sleep apnea related parameters and the percent compensated electromyography value was examined.

Results
The percent compensated electromyography value of the subjects varied from 1% to 90% and had a significant positive correlation with apnea hypopnea index (R
2=0.382, P <0.001).

Conclusions
Recording and analyzing chin surface electromyography by routine polysomnography is a valid way of screening the neuromuscular activity in patients with obstructive sleep apnea. The neuromuscular contribution is different among subjects with obstructive sleep apnea.
Increased interleukin-23 is associated with increased disease activity in patients with rheumatoid arthritis
Authors: GUO Ying-ying , WANG Nai-zhi , ZHAO Shuai , HOU Lin-xin , XU Yan-bing , ZHANG Ning 
Published: January 2024

Background
Interleukin-23 (IL-23) is a pro-inflammatory cytokine that is thought to be central to the development of autoimmune diseases. This study was conducted to determine whether or not the serum concentration of IL-23 is elevated in patients with rheumatoid arthritis (RA), and to determine the relationship between the IL-23 level and disease activity in RA patients.

Methods
Serum samples were obtained from 59 patients with RA and 30 healthy controls. The clinical parameters of disease activity were determined, including the 28-joint disease activity score (DAS28), C-reactive protein (CRP), rheumatoid factor (RF) levels, and the degree of bony erosions based on X-rays. The levels of IL-23 and IL-17 were determined by enzyme-linked immunosorbent assay (ELISA). The correlations between the serum levels of IL-23 and disease activity parameters of patients with RA were determined.

Results
The serum IL-23 level was significantly elevated in patients with RA compared to healthy controls. The serum IL-23 levels in the RA patients correlated with IL-17 and CRP levels, and the DAS28. The levels of IL-23 based on X-ray classification phase I, II, III, and IV were gradually elevated in RA patients.

Conclusions
The levels of serum IL-23 in RA patients were higher than in healthy controls. Thus, elevated serum IL-23 levels may be useful markers to detect active RA. In addition, IL-23 is involved in disease progression and bony erosions in patients with RA.
Biomechanical comparisons between a new avascular necrosis of femaral head stem based on Chinese patients with avascular necrosis and two other designs
Authors: Zhang Qiang , Cheng Cheng-kung , Wei Hung-wen , Dong Xiang , Chen Yi-ting , Lai Yu-shu , Wang Yan 
Published: January 2024

Background
There is a relatively high failure rate of the femoral component in patients with avascular necrosis at the intermediate-term follow-up. Improving the geometrical fit of the femoral stem against the medullary canal may help to provide long-term survivorship of the hip replacement for patients with avascular necrosis.

Methods
We designed a specific stem, based on morphometric studies of proximal femoral canals in Chinese avascular necrosis patients and evaluated the stem by finite element analyses, comparing the novel stem with two commercially available and commonly used stems.

Results
The morphometric data from avascular necrosis patients showed specific geometric differences in the proximal femoral canal, including profile curves in both the sagittal and coronary planes than the patients with femoral neck fracture. The shorter stemmed prostheses (Fitmore® and our stem) performed better than the longer stemmed prosthesis (VerSys®).

Conclusions
This is the first study to investigate the femoral geometries of Chinese avascular necrosis patients. Our stem provides better stability and is theoretically beneficial to bone ingrowth, which may increase the long-term stability and fixation of the implant.
Human adipose-derived mesenchymal stem cells: a better cell source for nervous system regeneration
Authors: Han Chao , Zhang Liang , Song Lin , Liu Yang , Zou Wei , Piao Hua , Liu Jing 
Published: January 2024

Background
In order to suggest an ideal source of adult stem cells for the treatment of nervous system diseases, MSCs from human adipose tissue and bone marrow were isolated and studied to explore the differences with regard to cell morphology, surface markers, neuronal differentiation capacity, especially the synapse structure formation and the secretion of neurotrophic factors.

Methods
The neuronal differentiation capacity of human mesenchymal stem cells from adipose tissue (hADSCs) and bone marrow (hBMSCs) was determined based on nissl body and synapse structure formation, and neural factor secretion function. hADSCs and hBMSCs were isolated and differentiated into neuron-like cells with rat brain-conditioned medium, a potentially rich source of neuronal differentiation promoting signals. Specific neuronal proteins and neural factors were detected by immunohistochemistry and enzyme-linked immunosorbent assay analysis, respectively.

Results
Flow cytometric analysis showed that both cell types had similar phenotypes. Cell growth curves showed that hADSCs proliferated more quickly than hBMSCs. Both kinds of cells were capable of osteogenic and adipogenic differentiation. The morphology of hADSCs and hBMSCs changed during neuronal differentiation and displayed neuron-like cell appearance after 14 days' differentiation. Both hADSCs and hBMSCs were able to differentiate into neuron-like cells based on their production of neuron specific proteins including β-tubulin-III, neuron-specific enolase (NSE), nissl bodies, and their ability to secrete brain derived neurotrophic factor (BDNF) and nerve growth factor (NGF). Assessment of synaptop hysin and growth-associated protein-43 (GAP-43) suggested synapse structure formation in differentiated hADSCs and hBMSCs.

Conclusions
Our results demonstrate that hADSCs have neuronal differentiation potential similar to hBMSC, but with a higher proliferation capacity than hBMSC. Adipose tissue is abundant, easily available and would be a potential ideal source of adult stem cells for neural-related clinical research and application.