bluuebunny/crossref_metadata_2025_split huggingface dataset:
P1 gene of Mycoplasma pneumoniae in clinical isolates collected in Beijing in 2010 and relationship between genotyping and macrolide resistance
Authors: TIAN Xiu-jun , DONG Yan-qing , DONG Xiao-pei , LI Jing-yi , LI Dan , JIANG Yue , XIN De-li 
Published: January 2024

Background

Mycoplasma pneumoniae is a common pathogen that caused community-acquired pneumonia (CAP). P1 protein served as major adhesion and immunodominant protein in Mycoplasma pneumoniae, but little about P1 gene was learned and the relationship between P1 genotype and macrolide resistance has yet to be explored.

Methods
The DNA sequence of the entire P1 gene from 35 strains isolated from clinical specimens collected in Beijing, China, in 2010 was determined. The resulting sequences were checked for known macrolide resistance mutations, such as A2063G, A2064G, C2617G in domain V of 23S rRNA. Antibiotic susceptibility test was done to further identify macrolide resistant strains.

Results
Thirty-four clinical strains were type 1, and were identical to type 1 reference strain MP129. Only one clinical strain, MpYYM22, was type 2, and proved to be variant 2c. One synonymous point mutation in the P1 type 1 gene from two isolates was identified relative to the MP129 P1 sequence at nucleotide position (nt) 552 (C>A), while another two isolates had missense mutations at nt 2504 (G>A). This point mutation caused an amino acid change from glycine to glutamic acid. An AGT tri-nucleotide variable-number tandem repeat (VNTR), coding for serine and repeating 6-11 times, up to 15-16 times, was found in the region between the RepMP4 and RepMP2/3 elements in the 35 isolates examined. All 35 clinical strains, including MpYYM22, demonstrated macrolide resistance with the range of minimum inhibitory concentration (MIC) of erythromycin from 64 to 256 μg/ml, having an A2063G transition in domain V of the 23S rRNA gene.

Conclusions
P1 type 1 was the dominant type of Mycoplasma pneumoniae in Beijing in 2010, although variant 2c strains were present. More samples are needed to determine whether there is a relationship between the P1 genotype and macrolide resistance, as the 35 strains examined did not allow a conclusive result. However, the AGT tri-nucleotide VNTR may be a more informative locus for multi-locus VNTR analysis.
Efficacy and safety of Changfu peritoneal dialysis solution: a multi-center prospective randomized controlled trial
Authors: ZHOU Jian-Hui , NI Zhao-Hui , MEI Chang-Lin , YU Xue-Qing , LIU Fu-You , MIAO Li-Ning , LIU Zhi-Hong , YUAN Weijie , ZHANG Ai-Ping , LIN Hong-Li , CHEN Meng-Hua , CHEN Jiang-Hua , ZHANG Jin-Yuan , HE Ya-Ni , CHEN Jian , ZHAO Jiu-Yang , DING Xiao-Qiang , LI Ying , LI Rong-Shan , XIE Ru-Juan , LIU Wen-Hu , XING Chang-Ying , WANG Rong , DENG Yue-Yi , CAO Xue-Ying , CAI Guang-Yan , MOU Shan , MAO Zhi-Guo , YANG Xiao , LIU Hong , SUN Jing , YU Yu-Sheng , LIU Jun , SHI Shu-Mei , LI Long-Kai , TIAN Na , ZHANG Xiao-Hui , ZHOU Wei , YANG Jie , ZHANG Yong , SUN Jing-Di , JI Jun , ZHANG Tao , YAN Yan , LIU Xiao-Gang , WANG Gang , ZHANG Li , ZHANG Hong , LUO Jian-Hua , CHEN Xiang-Mei 
Published: January 2024

Background
A multi-center large scale study is needed to confirm the efficacy and safety of domestic peritoneal dialysis (PD) solutions. Some researchers believe that 6 L/d is enough for adequate dialysis, but there is no multi-center prospective study on Chinese population to confirm this. In this study, we evaluated the efficacy and safety of domestic PD solution (Changfu) and its difference between 6 L and 8 L dosage.

Methods
Adult PD patients who had taken PD therapy for at least one month were selected and divided into four groups according to two dialysis solution brands and two dialysis dosages, i.e., 6 L dose with Changfu dialysis solution, 6 L dose with Baxter dialysis solution, 8 L dose with Changfu dialysis solution, and 8 L dose with Baxter dialysis solution. After 48 weeks, the changes of primary and secondary efficacy indices were compared between different types and different dosages. We also analyzed the changes of safety indices.

Results
Changes of Kt/V from baseline to 48 weeks between Changfu and Baxter showed no statistical differences; so did those of creatinine clearance rate (Ccr). Normalized protein catabolic rate (nPCR) from baseline to 48 weeks between Changfu and Baxter showed no statistical differences; so did those of net ultrafiltration volume (nUF) and estimated glomerular filtration rate (eGFR). Changes of nPCR from baseline to 48 weeks between 6 L and 8 L showed no statistical differences; so did those of nUF and eGFR. The decline of Kt/V from baseline to 48 weeks in 6 L group was more than that in 8 L group. Change of Ccr was similar. During the 48-week period, the mean Kt/V was above 1.7/w, and mean Ccr was above 50 L·1.73 m-2w-1. More adverse events were found in Changfu group before Changfu Corporation commenced technology optimization, and the statistical differences disappeared after that.

Conclusions
The domestic PD solution (Changfu) was proven to be as effective as Baxter dialysis solution. During 48-week period, a dosage of 6 L/d was enough for these patients to reach adequate PD. Clinical study promotes technological optimization, further helps to improve the safety indices of the medical products.
Preoperative prediction of survival in resectable gallbladder cancer by a combined utilization of CA 19–9 and carcinoembryonic antigen
Authors: Yu Tunan , Yu Hong , Cai Xiujun 
Published: January 2024

Background
Currently, all frequently used staging systems in gallbladder cancer (GBC) are based on postoperative pathological examinations. In patients undergoing curative operation, there is no effective method to predict survival preoperatively. In this study, we explored whether a combined utilization of two tumor biomarkers, namely carbohydrate antigen 19–9 (CA 19–9) and carcinoembryonic antigen (CEA), could give a preoperative prediction of survival in resectable GBC.

Methods
Seventy-three patients who underwent radical resection for GBC were included in this study. A retrospective analysis of clinical-pathological data was conducted.

Results
By multivariate analysis, CA 19–9 elevation (P <0.05) and CEA elevation (P <0.001) were discovered as two individual factors for postoperative survival. By a combined utilization, patients were divided into three groups: patients with elevation of CEA (group I), patients with elevation of CA 19–9 but without CEA (group II), and patients with nonelevations of either CA 19–9 or CEA (group III). The cumulative 5-year survival rates in groups I, II, and III were 0, 14.0%, and 42.8%, respectively (P <0.05).

Conclusions
By a combined utilization of CA 19–9 and CEA, individualized prediction of survival is available in resectable GBC before operation. Extended radical operation brings the most prognostic benefits in patients with nonelevations of either CA 19–9 or CEA. However, if operation would be in a larger-scale destructive manner, careful consideration of surgical decisions should be made in patients with elevation of tumor biomarkers, especially CEA.
Self-monitoring of blood glucose in type 2 diabetic patients in China: current status and influential factors
Authors: Yuan Li , Guo Xiaohui , Xiong Zhenzhen , Lou Qingqing , Shen Li , Zhao Fang , Sun Zilin , Li Jianwei 
Published: January 2024

Background
Self-monitoring of blood glucose (SMBG) by individuals with type 2 diabetes (T2D) is crucial for long-term health, yet numerous cultural, economic and health factors can reduce SMBG. Most studies on SMBG adherence have come out of the US and Europe, and their relevance to Asia is unclear. The aims of the present study were to assess the current state of SMBG in China and analyze demographic and diabetes-related characteristics that may influence it.

Methods
In this multi-center, cross-sectional study, 5 953 individuals with T2D from 50 medical centers in 29 provinces across China filled out a standardized questionnaire that requested information on demographic characteristics, education level, occupation, income, lifestyle risk factors, duration of diabetes, chronic complications, and frequency of SMBG. Respondents were also asked whether their glycosylated hemoglobin (HbA1c) had been checked in the past 6 months. The most recent values for fasting plasma glucose, 2-hour postprandial blood glucose and HbA1c were recovered from medical records.

Results
Only 1 130 respondents (18.98%) performed SMBG with the recommended frequency, while 4 823 (81.02%) did not. In fact, nearly 2 105 (35.36%) reported never performing SMBG. In the subset of 3 661 individuals on insulin therapy, only 266 (7.27%) performed SMBG at least once a day, while 1 210 (33.05%) never performed it. In contrast, 895 of 2 292 individuals (39.05%) on diet/exercise therapy or oral hypoglycemic therapy never performed it. Multivariate Logistic regression identified several factors associated with SMBG adherence: female gender, higher education level, higher income, longer T2D duration and education about SMBG.

Conclusions
SMBG adherence in our Chinese population with T2D was less frequent than that in developed countries. Several factors influence SMBG adherence: gender, education level, income, T2D duration, therapy regimen and exposure to education about SMBG.
Anatomical references for tibial sagittal alignment in total knee arthroplasty: A comparison of three anatomical axes based on 3D reconstructed CT images
Authors: SHAO Jun-jie , Vail Thomas Parker , WANG Qiao-jie , SHEN Hao , CHEN Yun-su , WANG Qi , JIANG Yao , ZHANG Xian-long 
Published: January 2024

Background
This study was designed to analyze three tibial axis reference lines including the anterior tibial cortex (ATC) line, the fibular line (FL), and the anatomical axis of tibia (AAT) line, to determine which line most closely parallels the mechanical axis (MA) of the tibia in the sagittal plane. The clinical relevance of the study is that through finding a reliable landmark on the leg, a surgeon may minimize posterior tibial slope measurement errors thereby and improving the technique for assuring proper alignment of total knee arthroplasty.

Methods
The material for this study included CT scans of the tibia from 85 consecutive patients and 168 knees (78 without osteoarthritis (OA) and 90 knees with OA). Measurements of the angles between the tibial mechanical axis and each of three reference lines in the sagittal plane were carried out using 3D imaging software.

Results
Mean angles of 168 knees were as follows: aMT (3.96±0.85)°, aMF (0.70±0.58)°, and aMA (1.40±0.66)°, (aMT: an angle between MA and ATC, aMF: an angle between MA and FL, aMA: an angle between MA and AAT. All above-mentioned angles were measured in the sagittal plane of tibia) and the aMF was significantly smaller than the others (P <0.0001). The mean value of the medial tibial slope angle vs. the MA was (9.19±3.97)°, and this was significantly larger than the mean lateral slope angle of (6.62±4.23)° (P <0.0001). The difference between aMF without OA and with OA was not statistically significant (P=0.5015) and the association between the aMT and aMA was strong (r=0.82, P <0.01).

Conclusions
FL was more closely parallel to the MA of tibia, and more showed less variation between OA and non-OA controls than ATC and AAT lines. Furthermore, the amount of posterior slope in medial plateau was greater than that in lateral plateau. The findings of this analysis suggest that when using the anterior tibial cortex line as is commonly done with extramedullary tibial resection guides, the tibial resection should be sloped approximately four degrees more posteriorly.
Atorvastatin attenuates involvement of RhoA/Rho-kinase pathway and NF-κB activation in hypoxic pulmonary hypertensive rats
Authors: Zhang Yan , Dai Li , Wu Shangjie , Chen Ping , Zhao Shuiping 
Published: January 2024

Background
Hypoxic pulmonary hypertension (HPH) contributes to the pathogenesis of cardiopulmonary diseases. Several lines of evidence indicate that the Rho A/Rho-kinase pathway play an important role in the progress of pulmonary hypertension. Stains have been shown exert numerous biological effects that are independent of their cholesterol-lowering property. We hypothesized that the Rho A/Rho-kinase pathway is involved in the pathogenesis of HPH, and that atorvastatin would attenuate involvement of the Rho A/Rho-kinase pathway in a HPH rat model.

Methods
Thirty-two Wistar rats were randomly divided into four groups: control group, hypoxic group, atovastatin group, and normal saline group. The control group was kept in a normoxia environment. The other groups were exposed to hypoxia for three weeks. Atovastatin was administered daily via a gastric gavage in the atovastatin group. We measured the mean pulmonary arterial pressure (mPAP), the ratio of the right ventricular weight to the sum of the weights of the left heart ventricle and septum (RV/(LV+S)), arteriole wall thickness/vascular external diameter (WT%), vascular area/total vascular area (WA%), expression of RhoA and phos-MYPT-1 protein in lung tissue, and NF-κB activation in pulmonary vascular smooth muscle cells.

Results
Compared with the control group, mPAP, RV/(LV+S), WT%, WA%, NF-κB activation, expression of RhoA, and phos-MYPT-1 were increased in the hypoxic and normal saline groups (P<0.05). Compared with the hypoxic group, mPAP, RV/(LV+S), WT%, WA%, NF-κB activation, expression of RhoA, and phos-MYPT-1 were decreased in the atovastatin group (P<0.05). Correlations between phos-MPTY-1 and mPAP, WA%, WT%, and NF-κB activation were all positive.

Conclusions
The Rho A/Rho-kinase pathway plays an important role in the development of HPH. Atorvastatin reversed HPH by inhibiting the activity of Rho A/Rho-kinase and NF-κB.
Morel-Lavallee lesion
Authors: Li Hui , Zhang Fangjie , Lei Guanghua 
Published: January 2024

Objective
To review current knowledge of the Morel-Lavallee lesion (MLL) to help clinicians become familiar with this entity. Familiarization may decrease missed diagnoses and misdiagnoses. It could also help steer the clinician to the proper treatment choice.

Data sources
A search was performed via PubMed and EMBASE from 1966 to July 2013 using the following keywords: Morel-Lavallee lesion, closed degloving injury, concealed degloving injury, Morel-Lavallee effusion, Morel-Lavallee hematoma, posttraumatic pseudocyst, posttraumatic soft tissue cyst.

Study selection
Chinese and English language literatures relevant to the subject were collected. Their references were also reviewed.

Results
Morel-Lavallee lesion is a relatively rare condition involving a closed degloving injury. It is characterized by a filled cystic cavity created by separation of the subcutaneous tissue from the underlying fascia. Apart from the classic location over the region of the greater trochanter, MLLs have been described in other parts of the body. The natural history of MLL has not yet been established. The lesion may decrease in volume, remain stable, enlarge progressively or show a recurrent pattern. Diagnosis of MLL was often missed or delayed. Ultrasonography, computed tomography, and magnetic resonance imaging have great value in the diagnosis of MLL. Treatment of MLL has included compression, local aspiration, open debridement, and sclerodesis. No standard treatment has been established.

Conclusions
A diagnosis of MLL should be suspected when a soft, fluctuant area of skin or chronic recurrent fluid collection is found in a region exposed to a previous shear injury. Clinicians and radiologists should be aware of both the acute and chronic appearances to make the correct diagnosis. Treatment decisions should base on association with fractures, the condition of the lesion, symptom and desire of the patient.
Elevated levels of mitochonrial respiratory complexes activities and ATP production in 17-β-estradiol-induced prolactin-secretory tumor cells in male rats are inhibited by melatonin in vivo and in vitro
Authors: WANG Bao-qiang , YANG Quan-hui , XU Rong-kun , XU Jian-ning 
Published: January 2024

Background
Our earlier studies indicate that melatonin inhibits the proliferation of prolactinoma and induces apoptosis of pituitary prolactin-secreting tumor in rats. Melatonin has also been shown to induce apoptosis and to reduce the production of ATP in breast tumor cells. This study analyzed the levels of the four mitochondrial respiratory complexes and the production of ATP and also the effects of melatonin treatment of prolactinoma.

Methods
In the in vivo study, mitochondria were harvested from control pituitaries or prolactinoma collected from the pituitaries of melatonin- and 17-β-estradiol (E2)-treated male rats. In the in vitro study, prolactinoma cells mitochondria were harvested. Activities of the four mitochondrial respiratory complexes were assayed using fluorometer. ATP production of prolactinoma cells was estimated using bioluminescent methods.

Results
Elevated levels of four mitochondrial respiratory complexes activities and ATP production were recorded in prolactinoma cells. Moreover, in both in vivo and in vitro studies, melatonin inhibited the activities of mitochondrial respiratory complexes and the production of ATP in prolactinoma cells.

Conclusions
There is a link between mitochondrial function increase and tumorigenesis. Melatonin induces apoptosis of pituitary prolactin-secreting tumor of rats via the induction of mitochondrial dysfunction and inhibition of energy metabolism.
Correlation between the coverage percentage of prosthesis and postoperative hidden blood loss in primary total knee arthroplasty
Authors: Gao Fuqiang , Guo Wanshou , Sun Wei , Li Zirong , Wang Weiguo , Wang Bailiang , Cheng Liming , Kush Nepali 
Published: January 2024

Background
The aim of this study was to determine the relationship between prosthesis coverage and postoperative hidden blood loss (HBL) in primary total knee arthroplasty (TKA).

Methods
A total of 120 patients who had undergone unilateral TKA from August 2012 to May 2013 were retrospectively studied. The Gross formula was used to calculate the amount of HBL. Routine standard anteroposterior (AP) and lateral X-ray films of the knee joint were taken postoperatively and used to measure the percentages of coronal femoral and of coronal and sagittal tibial prosthetic coverage. Then Pearson's correlation analysis was performed to assess the correlations between the percentages of prosthetic coverage for each AP and lateral position and HBL on the first and third postoperative days.

Results
The volumes of HBL on the first and third postoperative days after TKA were (786.5±191.6) ml and (1 256.6±205.1) ml, respectively, and lateral X-ray film measurements of percentages of coronal femoral, tibial coronal, and sagittal prosthetic coverage were (87.9±2.5)%, (88.5±2.2)%, and (89.1±2.3)%, respectively. Pearson's correlation analysis showed statistically significant correlations between percentages of total knee prosthetic coverage for each AP and lateral position and volumes of HBL on the first and third postoperative days (P <0.05).

Conclusions
HBL after TKA correlates with degree of prosthetic coverage. To some extent, the size of the surfaces exposed by osteotomy determines the amount of HBL. Choice of the appropriate prosthesis can significantly reduce postoperative HBL. Designing individualized prostheses would be a worthwhile development in joint replacement surgery.
A randomized double-blinded sham-controlled trial of α electroencephalogram-guided transcranial magnetic stimulation for obsessive-compulsive disorder
Authors: Ma Xiaoyan , Huang Yueqin , Liao Liwei , Jin Yi 
Published: January 2024

Background
Obsessive-compulsive disorder (OCD) is a highly prevalent and devastating psychiatric condition. Repetitive transcranial magnetic stimulation (rTMS) is a potential and non-invasive treatment for OCD. Diverse efficacies of rTMS have been reported in different locations or frequencies of the stimulation. The main objective of this study was to assess the treatment effect for OCD with alpha electroencephalogram (αEEG)-guided TMS over dorsal lateral prefrontal cortex bilaterally.

Methods
There were 25 OCD patients in the αTMS treatment group and 21 OCD patients in the sham control group. Each subject received 10 daily treatment sessions (5 days a week). The αTMS group had significant reduction in scores of Yale-Brown Obsessive Compulsive Scale and Hamilton Rating Scale for Anxiety (HAMA) compared with the control group at the end of 2-week treatment and 1-week follow-up. Analysis of variance with repeated measures was used to test the effects between the two groups.

Results
Significant difference in scores of obsession and HAMA were found between the two groups after treatment. No significant difference in scores of Hamilton Rating Scale for Depression was found between the two groups after the treatment, but statistical significance was shown at the end of 1-week follow-up.

Conclusions
αEEG-guided TMS may be an effective treatment for OCD and related anxiety. Delayed response to αTMS in depression suggests that it might be secondary to the improvement of primary response in OCD and anxiety.
Risk factors associated with emergency peripartum hysterectomy
Authors: Jin Rong , Guo Yuna , Chen Yan 
Published: January 2024

Background
Use of an emergency peripartum hysterectomy (EPH) as a lifesaving measure to manage intractable postpartum hemorrhage (PPH) appears to be increasing recently around the world, and the indications for EPH have changed. The object of this study is to identify risk factors associated with EPH.

Methods
We conducted a case-control study of 21 patients who underwent EPH because of intractable PPH between January 1, 2005 and June 30, 2013, at the International Peace Maternity and Child Health Hospital Shanghai Jiao Tong University, School of Medicine (IPMCH). The parametric t-test, chi-square tests and Logistic regression models were used for analysis to identify the risk factors. The results were considered statistically significant when P<0.05.

Results
There were 89 178 deliveries during the study period. Twenty-one women had an EPH, with an incidence of 24 per 100 000 deliveries. The loss of blood during postpartum hemorrhage of the EPH group was (5 060.7±3 032.6) ml, and that of the control group was (2 040.8±723.5) ml. There was a significant difference of PHH between the EHP group and the control group (P=0.001). Independent risk factors for EPH from a logistic regression model were: disseminated intravascular coagulation (DIC) (OR: 9.9, 95% CI 2.8-34, P=0.003), previous cesarean section (OR: 5.27; 95% CI: 1.48-17.9, P=0.009), placenta previa (OR: 6.9; 95% CI 1.6-2.9, P=0.008), the loss of PPH (OR: 1.001; 95% CI 1.001-1.002, P=0.002), placenta accreta (OR: 68; 95% CI 10-456, P=0.004), the use of tocolytic agents prenatally (OR: 6.55, 95% CI 1.34-32.1, P=0.049), and fetal macrosomia (OR: 6.9, 95% CI 1.25-38, P=0.049).

Conclusion
Significant risk factors of EPH are DIC, placenta previa, PPH, previous cesarean delivery, and placenta accrete, the use of tocolytic agents prenatally, and fetal macrosomia.