bluuebunny/crossref_metadata_2025_split huggingface dataset:
Kinetics of serum HBsAg in Chinese patients with chronic HBV infection with long-term adefovir dipivoxil treatment
Authors: Li Minran , Xi Hongli , Wang Qinhuan , Hou Fengqin , Huo Na , Zhang Xiaxia , Li Fang , Xu Xiaoyuan 
Published: January 2024

Background
Knowledge on Hepatitis B surface antigen (HBsAg) kinetics in chronic hepatitis B (CHB) patients with long-term adefovir dipivoxil (ADV) treatment is limited. The aims of this study were to investigate HBsAg kinetics in patients with chronic hepatitis B virus (HBV) infection treated with long-term ADV and to evaluate different characteristics between patients with and without HBsAg loss.

Methods
We retrospectively evaluated HBsAg kinetics in 24 Chinese patients with chronic HBV infection who achieved continuous virologic suppression during ADV therapy. HBV genotype was determined at baseline. Liver biochemistry, hepatitis B e antigen status, serum HBV DNA, and HBsAg levels were measured at baseline, 6 months, and once every year thereafter.

Results
Of these 24 patients, 3, 1, and 20 patients were followed up for 3, 5, and 6 years, respectively. Baseline serum HBsAg level had a moderate correlation with baseline HBV DNA level (r=0.52, P=0.01). The median rate of HBsAg reduction during the therapy period was 0.08 lg IU·ml-1·y-1. Baseline serum HBsAg level was significantly higher than other time points (P ranges from 0.046 to 0.002). The HBsAg reduction rate during the first year was similar to that in other years (P>0.05). The HBsAg reduction rate during the first year in patients with eventual HBsAg loss was significantly faster than that in patients without HBsAg loss (P=0.005).

Conclusions
Serum HBsAg levels in Chinese CHB patients receiving long-term ADV demonstrated a gradual reduction. Patients with eventual HBsAg loss had a significantly faster HBsAg reduction rate during the first year than those without HBsAg loss.
An experimental study on thymus immune tolerance to treat surgical brain injury
Authors: Zheng Yongtao , Kang Jianmin , Liu Baolong , Fan Weijia , Wu Qiaoli , Luo Kai , Yan Hua 
Published: January 2024

Background
Many researches demonstrate that the secondary brain injury which is caused by autoimmune attack toward brain antigens plays an important role in surgical brain injury (SBI). Although traditional immunosuppression can reduce autoimmune attack, it will lower the body immunity. Immune tolerance, by contrast, not only does not lower the body immunity, but also could lighten autoimmunity. This study used thymus tolerance to develop an immune system that is tolerant to autologous cerebrospinal fluid (CSF) and autologous brain tissue so that autoimmune injury can be suppressed following the disruption of the blood-brain barrier, thereby reducing brain damage.

Methods
Eighty experimental rabbits were divided into five groups by random number table method: 16 in SBI group (group A), 16 in SBI+CSF drainage group (group B), 16 in SBI+CSF drainage+PBS injection group (group C), 16 in SBI+CSF drainage+CSF intrathymic injection group (group D), and 16 in SBI+brain homogenate intrathymic injection group (group E). Rabbits’ CSF was drained in group B; was drained and injected PBS into thymus in group C; was drained and injected CSF into thymus in group D; and was injected brain homogenate in group E. Half of the rabbits in each group were phlebotomized on 1st, 3rd, 7th, and 14th days to observe the changes in IL-l, TGF-β by ELISA test, and CD4CD25 regulatory T cells ratio by flow cytometry, and in other animals brain tissues were taken on 7th day for exploring FasL expression by RT-PCR. The least significant difference (LSD) test was used to make paired comparisons; P <0.05 was considered statistically significant.

Results
The levels of FasL, TGF-β, and the ratios of CD4CD25 regulatory T cells in groups D and E were apparently higher than those in other three groups (P <0.05). Likewise, the levels of IL-1 in these two groups were lower than the other three groups (P <0.05). Moreover, the ratios of CD4CD25 regulatory T cells and the levels of TGF-β in groups B and C were higher than those in group A, but the level of IL-1 was lower than that in group A (P <0.05). There was no significant difference between groups B and C, and groups D and E.

Conclusion
Thymic injection of CSF and brain homogenate may be able to reduce inflammation after SBI, so thymus immune tolerance may be a useful therapy to treat SBI.
Analysis of clinical efficacy of different initial antimicrobial treatment in healthcare associated pneumonia patients in emergency department
Authors: Cao Guohui , Chen Xuyan , Wu Sheng 
Published: January 2024

Background
Community acquired pneumonia (CAP) is one of the most common infectious disease in emergency department. In 2005 the concept of healthcare associated pneumonia (HCAP) was proposed by the ATS/IDSA guidelines. The clinical features and microbiology of HCAP are different from CAP, however, the initial antimicrobial treatment is still controversial. We aimed to compare the clinical efficacy between HCAP patients treated initially with HCAP guideline-concordant antimicrobial agents and those with CAP guideline-concordant antimicrobial agents.

Methods
We conducted a retrospective observational study on HCAP patients who were admitted to emergency department between December 2011 and December 2012. Patients were divided into 2 groups according to their different initial antimicrobial treatment. We compared clinical features, distribution of pathogen, severity, days and spending on intravenous antimicrobial, length and charge of hospitalization and clinical outcomes, and meanwhile analyzed the clinical efficacy as well.

Results
Of the 125 HCAP patients, 55 patients received CAP guideline-concordant antimicrobial agents and 70 received HCAP agents. The major pathogens were Klebsiella pneumoniae, methicillin-resistant staphylococcus aureus (MRSA), Pseudomonas aeruginosa and Escherichia coli. The 2 groups were similar at baseline, including old age, comorbidities, Pneumonia Severity Index scores, APACHE scores, and length of intravenous antimicrobial use and hospitalization duration, and in-hospital mortality. Overall efficacy rate occurred in 70.0% of HCAP agent patients and 50.9% of CAP agent patients (P=0.029). Antimicrobial charge and total hospital charge for HCAP agent patients were significantly higher than that for CAP agent patients.

Conclusions
Initial treatment of HCAP patients in emergency department with HCAP guideline-concordant antimicrobial could increase clinical efficacy rate, as well as antimicrobial charge and total hospital charge, but was not associated with shortening the length of stay, or lowering in-hospital mortality.
Rapid resolution of subdural hematoma after targeted epidural blood patch treatment in patients with spontaneous intracranial hypotension
Authors: Wang Jin , Zhang Dan , Gong Xiangyang , Ding Meiping 
Published: January 2024

Background
Subdural hematoma (SDH) is a common complication of spontaneous intracranial hypotension (SIH). To date, the management of SDH caused by SIH remains controversial. In this paper, we reviewed the clinical course of SDH in patients with SIH, and discuss the underlying mechanism and attributing factors for rapid resolution of subdural hematomas after epidural blood patch (EBP) surgery.

Methods
We retrospectively reviewed a cohort of seventy-eight SIH patients diagnosed and treated with targeted EBP in our neurology center. Patients who received early CT/MRI follow-up after EBP operation were included.

Results
A series of four cases of SIH complicated with SDHs were evaluated. Early follow-up neuroimages of these patients revealed that SDHs could be partially or totally absorbed just two to four days after targeted epidural blood patch treatment.

Conclusion
Targeted epidural blood patch can result in rapid hematoma regression and good recovery in some patients with a combination of SDH and SIH.
A comparative study of calcium sulfate artificial bone graft versus allograft in the reconstruction of bone defect after tumor curettage
Authors: Yongkun Yang , Xiaohui Niu , Qing Zhang , Lin Hao , Yi Ding , Hairong Xu 
Published: January 2024

BackgroundCavity reconstruction after benign bone tumor removal is varied and controversial. Allograft is widely used but is associated with complications. New bone substitutes, such as calcium sulfate artificial bone, have been introduced for bone tumor operation. However, the bone healing response of artificial bone has not been compared with allograft bone. We therefore compared calcium sulfate grafts (study group) with bone allografts (control group) for the treatment of benign bone tumors.MethodsWe retrospectively reviewed 50 patients who underwent calcium sulfate reconstruction and 50 patients who underwent allograft cancellous bone reconstruction. The two groups were well matched. The mean follow-up time of the study group was 19.9 (12–55) months. We investigated bone healing response, complications, and factors affecting bone healing.ResultsAt the last follow-up, 84% (42/50) of cases in the study group and 62% (31/50) of cases in the control group had achieved clinical healing (P=0.013). The initial healing rate showed no significant difference between the two groups (100% vs. 96%,P=0.153). The mean healing times for calcium sulfate and allograft bone were 9.6 (3–42) months and 13.8 (3–36) months, respectively (P<0.01). Complications in the study group were minor and resolved. Implant volume was a significant factor affecting bone healing.ConclusionThe calcium sulfate bone substitute showed a satisfactory healing outcome and safety profile in reconstruction of bone defects after benign bone tumor curettage, especially in smaller cavities.
One-year outcomes of percutaneous renal denervation for the treatment of resistant hypertension: the first Chinese experience
Authors: Dong Hui , Jiang Xiongjing , Liang Tuo , Zou Yubao , Guan Ting , Meng Peng , Song Lei , Zhang Huimin , Wu Haiying , Xu Bo , Yang Yuejin , Gao Runlin 
Published: January 2024

BackgroundAs a novel device-based approach targeting the renal sympathetic nerves, percutaneous renal denervation (RDN) has been shown to be effective and safe for reducing blood pressure. However, while considerable data on RDN have been obtained from Western populations, there is limited findings from East Asian populations. The purpose of this study was to evaluate one-year outcomes of RDN for the treatment of resistant hypertension in Chinese patients.MethodsBetween February and August 2012, 14 patients (mean age 39±8 years, 10 males) with resistant hypertension underwent successful RDN at the Fuwai Hospital. All 14 patients were followed up at 1, 3, 6 and 12 months postprocedure. Blood pressure, use of antihypertensive agents, renal function, and complications were investigated.ResultsBaseline values included mean office blood pressure of 164/103±14/10 mmHg, mean 3.9±0.6 anti-hypertensive agents, and an estimated glomerular filtration rate of (79±19) ml·min-1·1.73 m-2. Office blood pressure after the procedure was reduced by -14/-10, -17/-11, -21/-12, and -24/-14 mmHg at 1, 3, 6, and 12 months respectively, and the reduction of the number of antihypertensive agents at the above corresponding time points was -1.3, -1.5, -1.7 and -1.8 respectively (allP<0.001). The mean reduction of 24-hour ambulatory blood pressure was similar to the reduction of office blood pressure at the four corresponding time points. Renal function did not significantly change at any time point (allP>0.05). No clinical complications were observed at 12-month follow-up.ConclusionThis study showed that RDN seems to be effective in reducing blood pressure of Chinese patients with resistant hypertension, with minimal adverse events at 12-month follow-up.
Transoral endoscopic thyroidectomy with central neck dissection: experimental studies on human cadavers
Authors: Guo Peiyi , Tang Zhiping , Ding Zihai , Chu Guoliang , Yao Huosheng , Pan Tao , Wang Huaqiao 
Published: January 2024

Background
With the development of natural orifice trans-luminal endoscopic surgery, studies on transoral video-assisted thyroidectomy in preclinical experiments (e.g., human anatomy and animal trials) were progressing gradually. From 2009 to 2011, embalmed human cadavers were dissected to define the anatomical location, surgical planes, and related neural and vascular structures to create a safe transoral access to the front cervical spaces. Recently, experimental transoral endoscopic thyroidectomy was performed to verify the feasibility of this approach on 15 fresh specimens.

Methods
Fifteen specimens were placed in the supine position with slight neck extension. Endoscopic incision was made on the midline between the Wharton's duct papillae and two other incisions were made on mandibular first premolar buccal mucosa. Sublingual combined bilateral vestibular tunnels were created from oral cavity to the cervical region. The neck subplatysmal working space was insufflated with CO2 at 6–8 mmHg. The bilateral thyroid lobes and central lymph nodes were dissected under craniocaudal view.

Results
Three incisions were made in the oral cavity without any incisions on the body surfaces. The distance from the oral cavity to front neck region was the shortest. Bilateral thyroid lobes and central neck region were fully resected via transoral approach. This approach provided a craniocaudal view, in which retrosternal thyroid gland and lymph nodes were easily accessible. The recurrent laryngeal nerve could be identified safely on the inferior cornu of the thyroid cartilage. The only structure at risk was the mental nerve. Camera motion was somewhat limited by the maxillary dentition. The volume of harvested thyroid nodule through sublingual tunnel in the fifteen human cadavers was (40±15) cm3.

Conclusion
The transoral procedure is progressive and innovative which not only gives the best cosmetic result and minimal access trauma but also provides a craniocaudal view.
Prostasin gene polymorphism at rs12597511 is associated with severe preeclampsia in Chinese Han women
Authors: Luo Dong , Zhang Yanyan , Bai Yi , Liu Xijing , Gong Yunhui , Zhou Bin , Zhang Lin , Luo Linli , Zhou Rong 
Published: January 2024

Background
Preeclampsia, characterized by hypertension and proteinuria, is a multifactorial disease associated with shallow invasion of trophoblast cells and inadequate spiral artery remodeling. Trophoblast and tumor cells have similar invasion mechanism. Prostasin is closely related to tumor development, invasion and metastasis and influences blood pressure through activating epithelial sodium channel. The effect of prostasin on the pathogenesis of preeclampsia remains unclear. This study investigated the association of prostasin gene at rs12597511 with severe preeclampsia.

Methods
A single nucleotide polymorphism, rs12597511, was tested with polymerase chain reaction and restriction-fragment length polymorphism analyses in 179 severe preeclampsia patients and 222 normal pregnant women.

Results
The frequencies of TC + CC genotypes were significantly higher in severe preeclampsia group compared with in control group (the adjusted odds ratio was 2.030, 95% confidence interval 1.195–3.449, P=0.009). The C allele of rs12597511 was present significantly more often among women with severe preeclampsia (P=0.001). Genotyping analysis showed that the C allele of rs12597511 could confer a risk for severe preeclampsia.

Conclusion
The higher frequency of C allele of prostasin gene at rs12597511 is associated with severe preeclampsia.
Distinct characteristics and new prognostic scoring system for Chinese patients with Waldenström macroglobulinemia
Authors: Yi Shuhua , Cui Rui , Li Zengjun , An Gang , Qi Junyuan , Zou Dehui , Zhang Peihong , Chen Huishu , Wang Jianxiang , Chang Hong , Qiu Lugui 
Published: January 2024

Background
Waldenström macroglobulinemia (WM) is an uncommon lymphoid malignancy. The characteristics and prognosis of WM have never been systematically studied in the East.

Methods
We analyzed the clinical characteristics and the prognostic factors of 90 Chinese WM patients, and compared them with the Western reports.

Results
The median age was 62 years old with a male-to-female ratio of 3.74. The most common symptoms at diagnosis were fatigue (77.8%) and bleeding (20%), while only 6 patients (6.7%) were asymptomatic. In the univariate analysis, age >62 years, thrombocytopenia, leucopenia, cytopenias ≥2, and high risk on the international prognostic scoring system for WM were the adverse risk factors, but only age >62 years and ≥2 cytopenias were the independent prognostic factors in the multivariate analysis. Using age <62 years and ≥2 cytopenias, three significantly different prognostic groups could been distinguished, with 5-year overall survival of 71.6%, 48.6%, and 17.0% (P <0.001).

Conclusion
Distinct characteristics exist in WM in China compared to the West and we describe a new simple prognostic model for newly diagnosed WM patients.
Clinical features and management of postural tachycardia syndrome in children: a single-center experience
Authors: Li Jiawei , Zhang Qingyou , Hao Hongjun , Jin Hongfang , Du Junbao 
Published: January 2024

Background
The incidence of postural tachycardia syndrome (POTS) has been increasing in children and adolescents, while clinical characteristics of POTS in the pediatric population are not fully understood.

Methods
An observational study was performed in 150 pediatric patients aged between 5 and 18 years who underwent head-up tilt test (HUTT) with the diagnosis of POTS at Peking University First Hospital from March 2008 to August 2013. Demographic data, clinical presentation, autonomic parameters, laboratory findings, and treatments were recorded.

Results
POTS in children commonly occurred in the age of 7–14 years. Dizziness (84.00%) was the most common symptom, followed by weakness (72.00%) and orthostatic syncope (62.67%). Positive family history of orthostatic intolerance (OI) was found in 24.64% of children with POTS. And 33.09% of them had preceding infection history as precipitating events. Ten percent of them suffered from orthostatic hypertension. Hyperadrenergic status was documented in 51.28% of 39 patients who were tested for the standing norepinephrine levels. More than half of POTS patients, with 24-hour urinary sodium level <124 mmol/24 hours, were suitable for treatment of salt supplementation. At least 25.74% of POTS patients were of positive acetylcholine receptor (AChR) antibody. Low iron storage in children with POTS was relatively rare. Most patients responded well to treatments, 43.51% of patients recovered, while 7.63% of them had relapse after symptoms disappeared.

Conclusions
POTS is a relatively common condition with complex pathophysiology and heterogeneous clinical manifestation. A comprehensive therapeutic regimen is recommended for the treatment.
Urinary albumin excretion rate: a risk factor for retinal hard exudates in macular region in type 2 diabetic patients
Authors: Wang Shaocheng , Lin Siyong , Cao Xi , Zheng Yuezhong , Wang Jinyang , Lu Na , Yang Jinkui 
Published: January 2024

Background
The various risk factors for retinal hard exudates are still poorly understood in type 2 diabetic patients. The aim of this study was to determine the association between urinary albumin excretion rate (UAER) and hard exudates in macular region in north Chinese patients.

Methods
A total of 272 patients (272 eyes) were enrolled for this study, including 154 subjects from group 1 (mild hard exudates), 91 subjects from group 2 (moderate hard exudates) and 27 subjects from group 3 (severe hard exudates) confirmed using colour fundus photography, optical coherence tomography (OCT) as well as slit-lamp biomicroscopy with 78 diopter (D) lens. Each participant underwent a comprehensive assessment that included biochemical, clinical characteristics test and detailed ophthalmic evaluation. One-way analysis of variance (ANOVA) test and chi-square test were performed to analyze the fasting blood glucose (FBG), glycated hemoglobin (HbA1c), total cholesterol (TC), low density lipoprotein (LDL), high density lipoprotein (HDL), triglycerides (TG), full blood counts, urinary albumin excretion rate (UAER), blood creatinine (CREA), duration of diabetes, body mass index (BMI), systolic blood pressures (SBP) and diastolic blood pressures (DBP) between groups. Ordinal logistic regression analysis was further performed in order to eliminating the possible confounding factors.

Results
Three groups were matched in terms of age and gender. Risk factors which showed significant difference between groups include FBG (P <0.001), HbA1c (P <0.001), LDL (P <0.001), UAER (P <0.001), duration of diabetes (P=0.001), TC (P=0.005), SBP (P=0.026), CREA (P=0.004) and haemoglobin (Hb) (P=0.012). There was no significant difference between groups for the TG, HDL, DBP, platelet, total white blood cells and BMI. Using ordinal Logistic regression analyses, of all the variables, HbA1c, LDL and UAER which were independent risk factor for hard exudates showed a significantly odds ratio of 1.25, 3.07, and 1.39, respectively. There were also significant differences in UAER level between patients with mild, moderate, severe hard exudates groups (P <0.001).

Conclusions
UAER was an independent risk factor associated with retinal hard exudates in macular region in type 2 diabetic patients. This study highlights the need for close monitoring and fundus examination for hard exudates in patients with elevated UAER to prevent irreversible visual loss.