bluuebunny/crossref_metadata_2025_split huggingface dataset:
Coronary stenting does not improve the long-term cardiovascular outcome of patients with mild to moderate renal insufficiency
Authors: XIE Di , HOU Yu-qing , HOU Fan-fan , ZHANG Wei-ru , LI Yong , GUO Zhi-gang , GUO Zhi-jian , ZHANG Xun 
Published: January 2024

Background
Several studies have shown that coronary stenting reduces the frequency of clinical and angiographic restenosis in patients with mild to moderate renal insufficiency. However, less is known about the long-term benefits of stent use in this population. This study was aimed to determine the impact of coronary stenting on extended (5 years) long-term outcomes of patients with chronic renal insufficiency.

Methods
The study included 602 consecutive patients who underwent successful percutaneous coronary intervention with stenting. Renal insufficiency was defined as an estimated glomerular filtration rate <60 ml·min-1·1.73 m-2. The major adverse cardiac events were compared for patients with (n=160) and without (n=442) renal insufficiency.

Results
After the third year of follow-up, nonfatal myocardial infarction and revascularization rates were significantly increased in patients with renal insufficiency compared with those without renal dysfunction (16.9% vs 7.7%, P=0.001; 29.4% vs 15.8%, P <0.001). In patients who had recurrent cardiovascular events, a significantly higher rate of de novo stenosis revascularization was found in patients with renal insufficiency than without renal insufficiency (57.7% vs 22.7%, P <0.001), while there was no significant difference in target lesion revascularization between the groups (51.9% vs 43.6%, P=0.323). Multivariate analysis demonstrated an independent impact of the presence of renal insufficiency on the major adverse cardiac events (hazard ratio: 1.488, 95% confidence interval: 1.051-2.106, P=0.025) and de novo stenosis (hazard ratio: 5.505, 95% confidence interval: 2.151-14.090, P <0.001).

Conclusions
The late major adverse cardiac events, after successful coronary stenting, is increased in patients with an estimated glomerular filtration rate <60 ml·min-1·1.73 m-2. This might be associated with increased risk of de novo stenosis in this population.
The utilization status of aspirin for the secondary prevention of ischemic stroke
Authors: KE Xian-jun , YU Yong-fei , GUO Zhen-li , XU Kang , HAI Hong , ZHANG Ai-he , JIANG Hong , PENG Hong 
Published: January 2024

Background
The present study was aimed to investigate the usage of aspirin for the secondary prevention of ischemic stroke, evaluate the correlated factors, and analyze the reasons for not taking and irregularly taking aspirin.

Methods
The patients in this group were all stroke survivors who have formerly been diagnosed with a cerebral infarction or transient ischemic attack (TIA) in our hospital. We investigated their use of aspirin over a three-year period following their hospitalization. According to the patients' aspirin usage, they were divided into treatment and non-treatment groups. In addition, the reasons for not taking or irregularly taking aspirin were analyzed in the two groups.

Results
A total of 1240 patients were studied, including 367 (29.60%) in the treatment group and 873 (70.40%) cases in the non-treatment group. In addition, 201 (16.20%) cases in the treatment group had been regularly taking aspirin (50-325 mg of aspirin daily) for 1 to 3 years or longer. The results demonstrated that the main reasons for not taking aspirin in this study were related to patients' concerns regarding the side effects of taking aspirin (46.45%), as well as the doctors' inadequacy in informing their patients to take aspirin (38.71%). The major reasons for patients to irregularly take aspirin were that the doctors did not notify the length of aspirin usage to their patients (41.57%), and that doctors did not prescribe aspirin upon the patients' follow-up visit (26.51%).

Conclusion
The most effective way to increase patient's compliance for aspirin consumption is to promote the guidelines for stroke treatment and to relay these advances in stroke therapy to the patient.
Fluid therapy for severe acute pancreatitis in acute response stage
Authors: MAO En-qiang , TANG Yao-qing , FEI Jian , QIN Shuai , WU Jun , LI Lei , MIN Dong , ZHANG Sheng-dao 
Published: January 2024

Background
Fluid therapy for severe acute pancreatitis (SAP) should not only resolve deficiency of blood volume, but also prevent fluid sequestration in acute response stage. Up to date, there has not a strategy for fluid therapy dedicated to SAP. So, this study was aimed to investigate the effects of fluid therapy treatment on prognosis of SAP.

Methods
Seventy-six patients were admitted prospectively according to the criteria within 72 hours of SAP onset. They were randomly assigned to a rapid fluid expansion group (Group I, n=36) and a controlled fluid expansion group (Group II, n=40). Hemodynamic disorders were either quickly (fluid infusion rate was 10-15 ml·kg-1·h-1, Group I) or gradually improved (fluid infusion rate was 5-10 ml·kg-1·h-1, Group II) through controlling the rate of fluid infusion. Parameters of fluid expansion, blood lactate concentration were obtained when meeting the criteria for fluid expansion. And APACHE II scores were obtained serially for 72 hours. Rate of mechanical ventilation, incidence of abdominal compartment syndrome (ACS), sepsis, and survival rate were obtained.

Results
The two groups had statistically different (P <0.05) time intervals to meet fluid expansion criteria (Group I, 13.5±6.6 hours; Group II, (24.0±5.4) hours). Blood lactate concentrations were both remarkably lower as compared to the level upon admission (P <0.05) and reached the normal level in both groups upon treatment. It was only at day 1 that hematocrit was significantly lower in Group I (35.6%±6.8%) than in Group II (38.5%±5.4%) (P<0.01). Amount of crystalloid and colloid in group I ((4028±1980)ml and (1336±816)ml) on admission day was more than those of group II ((2472±1871)ml and (970±633)ml). No significant difference was found in the total amount of fluids within four days of admission between the two groups (P>0.05). Total amount of fluid sequestration within 4 days was higher in Group I ((5378±2751)ml) than in Group II ((4215±1998)ml, P <0.05). APACHE II scores were higher in Group I on days 1, 2, and 3 (P <0.05). Rate of mechanical ventilation was higher in group I (94.4%) than in group II (65%, P <0.05). The incidences of abdominal compartment syndrome (ACS) and sepsis were significantly lower in Group II (P <0.05). Survival rate was remarkably lower in Group I (69.4%) than in Group II (90%, P <0.05).

Conclusions
Controlled fluid resuscitation offers better prognosis in patients with severe volume deficit within 72 hours of SAP onset.
Effects of prior freezing or drying on the swelling behaviour of the bovine cornea
Authors: HUANG Yi-fei , Meek Keith M. , WANG Li-qiang , WANG Da-jiang 
Published: January 2024

Background
Frozen or dried corneal grafts are commonly used for stromal transplantation such as lamellar keratoplasty (full or partial thickness), keratophakia, epikeratophakia. Structural properties are important for the final optical results of these surgeries but the effects of freezing/thawing and drying/rehydration on the properties of the stroma are known little compared with the corneal endothelium, mainly because of lack of non-invasive technique to evaluate the stromal structure. This study aimed to investigate the swelling and structural properties of the bovine corneal stroma following freezing or drying by X-ray diffraction which was a non-invasive technique and could give ultra-structural information in hydrated tissues.

Methods
Bovine corneas were either frozen at -40°C or dried to constant weight in a dessicator over silica gel. Swelling was carried out by placing the corneas into dialysis tubing and equilibrating them against various concentrations of polyethylene glycol (PEG) to obtain a range of tissue hydrations. This method minimises the loss of soluble tissue components during the swelling process. Synchrotron X-ray diffraction was used to measure the average intermolecular spacing, the interfibrillar spacing and the fibril diameter as a function of hydration. Changes in light scattering were detected using a microdensitometer.

Results
Freezing and thawing of the cornea caused an increase in light scattering by 63.9% at tissue hydration (H)=3.4, and by 50.0% at H=4.9. Repeated freezing and thawing causes further increased by 38.9% at the second time and another 36.0% at the third time (P <0.05). There was a tendency for both the frozen and the dried corneas to lose some swelling ability, achieving hydrations respectively of 10% and 18% below those of fresh corneas at 0 PEG. There were no changes in the fibril diameters, interfibrillar or intermolecular spacings as measured by X-ray diffraction in the equilibrated fresh, pre-frozen and pre-dried corneas.

Conclusions
The increase in light scattering and the loss of swelling ability after freezing and thawing probably results from structural changes following the close association of the collagen molecules and fibrils whilst the tissue is in the dry or frozen state. Some unknown changes in the extracellular matrix between the collagen fibrils may also play a role in the light scattering. The equilibration technique may improve the quality of rehydrated corneal graft or lenticules used for corneal surgeries.
Classification and management of the tandem ossification of the posterior longitudinal ligament and flaval ligament
Authors: GUO Jiong-jiong , YANG Hui-lin , Cheung Kenneth M.C. , TANG Tian-si , Luk Keith D.K. 
Published: January 2024

Objective
To provide appropriate guidelines for treatment of tandem ossification of the posterior longitudinal ligament (OPLL) and flaval ligament (OFL).

Data sources
Published articles about OPLL and OFL were selected using Medline and Embase electronic databases.

Study selection
An English literature search from January 1980 to December 2006 was conducted. Because many reported cases were incorporated in OFL studies, the key words for search were OFL or OFL and OPLL. The first step revealed 93 studies of which 13 reports of tandem OPLL and OFL (tandem ossification) were selected.

Results
All studies were case series or case report and advocated that the primary therapy for tandem ossification should be operative. The clinical outcomes of surgery were evaluated in most reports, predominantly using the JOA scores. Gender is the only factor which has prognostic value. A higher proportion of women was found in the failure group. A two- stage classification of tandem ossification was developed to relate diagnosis to outcome.

Conclusions
All patients with suspected ossification of the spinal ligaments should undergo routine MRI screening of the whole spine. The correlation of the classification with surgical treatments needs further studies to validate its usefulness.
Diagnosis and treatment of melamine-associated urinary calculus complicated with acute renal failure in infants and young children
Authors: SUN Ning , SHEN Ying , SUN Qiang , LI Xu-ran , JIA Li-qun , ZHANG Gui-ju , ZHANG Wei-ping , CHEN Zhi , FAN Jian-feng , JIANG Ye-ping , FENG Dong-chuan , ZHANG Rui-feng , ZHU Xiao-yu , XIAO Hong-zhan 
Published: January 2024

Background
Infants in some areas of China developed urinary lithiasis after being fed with powdered milk that was tainted with melamine in 2008 and very small proportion of the infants developed acute renal failure caused by urinary tract calculus obstruction. The aim of this article was to summarize clinical characteristics, diagnosis and treatment of infants with urinary calculus and acute renal failure developed after being fed with melamine tainted formula milk.

Methods
Data of infant patients with urinary calculus and acute renal failure due to melamine tainted formula milk admitted to the Beijing Children's Hospital Affiliated to the Capital Medical University and the Xuzhou Children's Hospital in 2008 were used to analyze the epidemiological characteristics, clinical manifestations, imaging features as well as effects of 4 types of therapies.

Results All the 34 infants with urinary calculus were complicated with acute renal failure, their blood urea nitrogen (BUN) was (24.1±8.2) mmol/L and creatinine (Cr) was (384.2±201.2) μmol/L. The chemical analysis on the urinary calculus sampled from 15 of the infants showed that the calculus contained melamine and acidum uricum. The time needed for the four types of therapies for returning Cr to normal was (3.5±1.9) days for cystoscopy group, (2.7±1.1) days for lithotomy group, (3.8±2.3) days for dialysis group, and (2.7±1.6) days for medical treatment group, which had no statistically significant difference (P=0.508). Renal failure of all the 34 infants was relieved within 1 to 7 days, averaging (3.00±1.78) days.

Conclusions
Melamine tainted formula milk may cause urinary calculus and obstructive acute renal failure. It is suggested that firstly the patients with urinary calculus complicated with acute renal failure should be treated with dialysis or medication to correct electrolyte disturbance, in particular hyperkalemia, and then relieve the obstruction with available medical and surgical methods as soon as possible. It was observed that the short-term prognosis was satisfactory.
Continuous epidural block of the cervical vertebrae for cervicogenic headache
Authors: HE Ming-wei , NI Jia-xiang , GUO Yu-na , WANG Qi , YANG Li-qiang , LIU Jing-jie 
Published: January 2024

Background
Cervicogenic headache (CEH) is caused by a structural abnormality in the cervical spine. Available treatments for CEH include medical therapy, local botulinum toxin injection, cervical epidural corticosteroid injection, and surgery. The objective of this study was to investigate the safety and efficacy of a continuous epidural block of the cervical vertebra.

Methods
Medical records were retrospectively analyzed for 37 patients diagnosed with CEH treated by a continuous epidural block of the cervical vertebra with lidocaine, dexamethasone, and saline (5 ml/min) for 3–4 weeks and triamcinolone acetonide 5 mg once weekly for 3–4 weeks. Pain was measured via the visual analogue scale (VAS) in combination with quality of life assessment. Outcome measures were patient-reported days with mild or moderate pain, occurrence of severe pain, and the daily oral dosages of non-steroidal anti-inflammatory drug use (NSAID).

Results
In the 3 months immediately preceding placement of the epidural catheter, the mean number of days with mild or moderate pain was 22.0±4.3. The mean occurrence of severe pain was (3.20±0.75) times and the mean oral dosage of NSAID was (1267±325) mg. During the first 6 months after epidural administration of lidocaine and corticosteroids, the mean number of days with mild or moderate pain, the mean occurrence of severe pain, and the mean daily oral dosages of NSAIDs were significantly decreased compared to 3-month period immediately preceding treatment (P <0.01). By 12 months post-treatment, no significant difference in these three outcome measures was noted.

Conclusions
Continuous epidural block of the cervical vertebra for patients with CEH is effective for at least six months. Further research is needed to elucidate mechanisms of action and to prolong this effect.

Chin Med J 2009;122(4):427–430
Clinical assessment for three routes of hysterectomy
Authors: ZHU Lan , LANG Jing-he , LIU Chun-yan , SHI Hong-hui , SUN Zhi-jing , FAN Rong 
Published: January 2024

Background
Hysterectomy is a very common surgery in gynecology. Ideal surgery for hysterectomy is microinvasive with few complications. There are three major routes of hysterectomy that are currently used. The aim of this study was to identify the differences of peri-operative outcome among the patients who underwent the three different approaches.

Methods
One hundred and one women undergoing hysterectomy for myoma had the procedure performed by laparoscopic assisted vaginal hysterectomy (LAVH), total vaginal hysterectomy (TVH) or total abdominal hysterectomy (TAH) in a randomized study. We compared the course of peri-operative and post-operative outcome for the three different approaches. Results were evaluated by linear regression analysis, Fisher's exact test and Student's t test for independent samples.

Results
The operation time among the three procedures was not significantly different (P >0.05). The amount of blood loss in the TVH group was less than in the LAVH and TAH groups (P <0.05). The pain score 3 hours after operation in the LAVH group was significantly lower than in the TAH and TVH groups (P <0.001). The pain scores in the LAVH and TVH groups were lower than in the TAH group at 24 and 48 hours after operation (P <0.01). The women who underwent LAVH and TVH had a shorter hospitalization stay (P <0.001). The highest body temperature after operation in the TAH group was higher than that in LAVH and TVH groups (P <0.001).

Conclusions
LAVH and TVH are better procedures for women requiring hysterectomy. The peri-operative and post-operative courses of TVH are better than LAVH, excluding the pain score 3 hours after operation. Vaginal hysterectomy is the most cost-effective approach but the final choice for the route of hysterectomy can depend on many factors such as gynecological disease, patients’ health status and experiences of the gynecologist.
Clinical features and linkage analysis for a Chinese family with autosomal dominant central areolar choroidal dystrophy
Authors: MA Kai , YANG Xiu-fen , HAN Cui , ZHANG Ning , XU Jun , LIU Shou-bin , LU Hai , Snellingen Torkel , WANG Ning-li , LIU Ning-pu 
Published: January 2024

Background
A Chinese family with autosomal dominant central areolar choroidal dystrophy (CACD) was identified.
The purpose of this study was to collect the clinical findings from the family and to identify the genetic entity by linkage analysis.

Methods
Forty-three individuals from 3 generations of the family underwent ophthalmologic examinations, including best-corrected visual acuity, examination of the anterior segments, and inspection of the ocular fundus after pharmacologic mydriasis. Affected family members further underwent color vision test, color fundus photography, fluorescein angiography, automated perimetry, and electroretinography. The family was followed up for 30 months.
Peripheral venous blood or buccal swabs were collected from each family member and genomic DNA was extracted.
Linkage analysis was performed for candidate genes or loci using microsatellite markers.

Results
Seven family members in 3 continuous generations were diagnosed as having autosomal dominant CACD.
The family showed progressive development of the disease, affecting both male and female. Age of onset of visual disturbances varied between 11 and 50 years. Phenotypic variability among affected individuals was apparent and ranged from relatively normal-appearing fundus with mild parafoveal pigment mottling to geographic atrophy of the macula. Fluorescein angiography showed hyperfluorescent parafoveal changes in early stage or well-demarcated area of chorioretinal atrophy with enhanced visibility of the residual underlying choroidal vessels in the late stage. Peripheral retina and visual fields were normal in affected individuals. Electroretinogram showed normal or mild reduction in the photopic amplitude. Eight candidate genes (STGD4, RCD1, peripherin/RDS, GUCA1A, RIMS1, UNC119, GUCY2D, and AIPL1) and two genetic loci (4p15.2-16.3, and 17p13) were excluded to be responsible for the disease by linkage analysis.

Conclusions The clinical findings of this Chinese family with CACD shared similarities with previously reported families of other ethnicities. Linkage analysis excluded the known genes and genetic loci, indicating genetic heterogeneity of the disease.
Efficacy and safety of intra-aortic balloon pump-assisted interventional therapy in different age groups of patients with acute coronary syndrome
Authors: WANG Shou-li , LIU Ming-xin , WANG Xiao-zeng , WANG Bin , JING Quan-min , WANG Zu-lu , WANG Dong-mei , MA Ying-yan , WANG Geng , LUAN Bo , ZHAO Xin , HAN Ya-ling 
Published: January 2024

Background
Currently intra-aortic balloon pump (IABP) has been widely used in patients with acute coronary syndrome (ACS) who undergo percutaneous coronary intervention (PCI). However, few studies have been done with regard to the clinical outcome and safety of IABP in assisting PCI in aged patients with ACS. The purpose of the present study was to evaluate the safety of IABP in different age groups of patients with ACS.

Methods
Data on 292 ACS patients who received IABP-assisted PCI in Shenyang General Hospital of People's Liberation Army were retrospectively analyzed. More specifically, the successful rate, mortality and complications associated with the treatment were compared between the senior (≥60 years old) and the non-senior (<60 years old) groups of patients.

Results
The attack rate of non-ST segment elevation ACS was significantly higher in the senior group than in the non-senior group (38.8% vs 21.1%, P <0.01). The incidence of the IABP-associated complications was not significantly different between both groups (P >0.05).

Conclusion
The clinical outcome and safety of IABP-assisted PCI in the elderly patients were comparable to that for the non-elderly patients.
Metabolic syndrome in patients with atrial fibrillation in the absence of structural heart disease from a tertiary hospital in China
Authors: TANG Ri-bo , GAO Ling-yun , DONG Jian-zeng , LIU Xiao-hui , LIU Xing-peng , WU Jia-hui , LONG De-yong , YU Rong-hui , DU Xin , MA Chang-sheng 
Published: January 2024

Background
Metabolic syndrome (MetS) and atrial fibrillation (AF) are causally related. This study aimed to determine the prevalence of MetS in patients with AF in the absence of structural heart disease from a tertiary hospital in China.

Methods
In a single center, 741 inpatients with AF in the absence of structural heart disease prior to catheter ablation were retrospectively reviewed. Among them, 588 (79.4%) patients had paroxysmal AF. Subgroup analyses were performed in paroxysmal AF and persistent/permanent AF.

Results
MetS was found in 343 (46.3%) patients (200 males, 143 females); 0, 1, 2, 3, 4, 5 components of the MetS were found in 59 (8.0%), 140 (18.9%), 199 (26.9%), 203 (27.4%), 103 (13.9%) and 37 (5.0%) patients, respectively. The prevalences of overweight/obesity, high blood pressure, high glucose level, high triglyceride level and low high density lipoproteins cholesterol level were 53.8%, 47.6%, 23.2%, 40.6% and 72.1%, respectively. The prevalence of MetS was not significantly different between the paroxysmal AF group and the persistent/permanent AF group (44.6% vs 52.9%, P=0.064). The five components of MetS except overweight/obesity (69.3% vs 49.8%, P <0.001) were not significantly different between the aforementioned two groups. The left atrium diameter increased with the sum of the MetS components. The left atrium diameter in the MetS group was significantly higher than that in the non-MetS group both in patients with paroxysmal AF and in patients with persistent/permanent AF.

Conclusions The prevalence of MetS in patients with AF prior to catheter ablation is high. Further study and prevention are needed.