bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostic accuracy of various glomerular filtration rates estimating equations in patients with chronic kidney disease and diabetes
Authors: LI Hai-xia , XU Guo-bin , WANG Xue-jing , ZHANG Xu-chu , YANG Jian-mei 
Published: January 2024

Background
The equations for estimating glomerular filtration rate (GFR) based on creatinine have been found to have limitations and have not been generalizable across all populations. Equations based on cystatin C provide an alternative method to estimate GFR. Whether the equation based on cystatin C alone or combined creatinine would improve GFR estimates has not been validated among Chinese patients with chronic kidney disease (CKD) and diabetes. The aim of this study was to compare the performance of the modification of diet in renal disease (MDRD) equation based on creatinine with the five cystatin C-based formulae for estimation of GFR in patients with CKD and diabetes.

Methods
A total of 166 patients with CKD and 91 patients with type 2 diabetes were enrolled in this study. Cystatin C was measured by using the particle-enhanced immunonephelometric method and estimated formulae proposed by five different investigator teams (Stevens, Ma, Rule, Macisaac and Perkins). The plasma clearance of 99mTc-DTPA was determined as measured GFR (mGFR).

Results
For CKD patients, the bias and accuracy for the Ma and Macisaac equations were superior compared with the MDRD, and the mean results for the Ma formula were closer to mGFR than the other equations in CKD stages 2-5. The differences between Macisaac and mGFR in CKD stages 2-4 were significantly less than those in CKD stage 1 or 5. Stevens and Rule's formulae revealed a similar bias and accuracy compared with the MDRD equation. The MDRD formula had a higher accuracy in CKD stages 3-5 as compared with the results in other stages. For diabetic patients, the mean results between Macisaac and mGFR were closer than those of other equations in mGFR ≥90 ml·min-1·1.73 m-2 stage. In GFR 60-89 ml·min-1·1.73 m-2 stage, the MDRD formula showed the smallest difference compared with other equations. All equations overestimated GFR in the cases with GFR <60 ml·min-1·1.73 m-2 stages. The MDRD formula had a greater accuracy within 50% of mGFR than the equations based on cystatin C in diabetic patients. Perkins formula showed a large positive bias and low accuracy, therefore it may not be suitable for assessing GFR in patients with CKD and diabetes.

Conclusions
The formulae for estimating GFR based on cystatin C or creatinine have different trends and accuracies in patients with CKD and diabetes, especially in patients with various GFR levels. The equations based on cystatin C provide less accurate results than MDRD formulae, at least in the diabetic patients. Therefore, whether the formulae based on cystatin C are superior to MDRD formula requires further investigation in large diverse populations.
Ningbo thyroid dysfunction prevalence study: a cross-sectional survey in an employees-cohort
Authors: MAO Yu-shan , LIU Zhi-min , CHEN Chang-xi , ZHU Zhong-wei , HONG Zhong-li 
Published: January 2024

Background
The prevalence and the spectrum of thyroid dysfunction in the mainland of China are not adequately understood. We performed a population-based study to determine the prevalence of major thyroid dysfunctions including overt and subclinical hyper- and hypothyroidism in a stable cohort.

Methods
All active and retired employees aged 20 years and older (11 067) of Sinopec Zhenhai Refining & Chemical Company in Ningbo participated in the cross-sectional survey with a questionnaire and blood samples.

Results
A total of 10 405 individuals attended for screening. Using biochemical definitions 95.5% were euthyroid. The prevalence of former diagnosed hyperthyroidism was 1.1% in females and 0.4% in males, hypothyroidism 1.7% and 0.3%, and thyroid surgery 1.2% and 0.3%, respectively. In both sex the prevalence increased with age. Twenty-four percent of individuals with thyroid surgery or medications had abnormal thyroid-stimulating hormone (TSH) levels. In individuals without a history of thyroid disease, the prevalence of pathological TSH values in females and males were TSH ≥10 mU/L 0.60% and 0.29%; TSH 4.8–9.9 mU/L 5.71% and 2.25%; TSH <0.3 mU/L 0.87% and 0.41%, respectively. Overt hyper- and hypothyroidism were uncommon (0.2%, 0.3%, respectively). The prevalence of subclinical hyper- and hypothyroidism was 0.4% and 3.4%, respectively. Subclinical hypothyroidism was more common in females (male 2.4% vs. female 5.8%, P <0.001) and with increasing age (P <0.001).

Conclusions
The prevalence of thyroid dysfunction is 4.5% in the cohort. Among individuals with thyroid medications or surgery, only 75.7% were within the normal range of TSH. These results indicate that thyroid dysfunction is common in Chinese adults.
Role of extracellular signal-regulated kinase in regulating expression of interleukin 13 in lymphocytes from an asthmatic rat model
Authors: LI Yuan-yuan , LIU Xian-sheng , LIU Chang , XU Yong-jian , XIONG Wei-ning 
Published: January 2024

Background
The extracellular signal-regulated kinase (ERK) is widely expressed in mammal cells and involved in airway proliferation and remodeling in asthma. In this study, we intend to explore the role of ERK in the expression of the Th2 cytokine, interleukin 13 (IL-13) in lymphocytes in asthma.

Methods
Forty Sprague-Dawley rats were randomly divided into two groups: normal control and asthmatic groups. Peripheral blood lymphocytes were isolated and purified from the blood of each rat and divided into five groups: control, asthmatic lymphocytes, asthmatic cells stimulated with ERK activator epidermal growth factor (EGF), or with ERK inhibitor PD98059, or with EGF and PD98059 together. The expression of phosphorylated-ERK (p-ERK) was observed by immunocytochemical staining, the expression of ERK mRNA was determined by reverse transcriptase-PCR, IL-13 protein in supernatants was measured by ELISA.

Results
(1) The ERK mRNA level and the percentage of cells with p-ERK in lymphocytes from asthmatic rats were significantly higher than those in normal controls, and were significantly increased by EGF administration. This effect of EGF was significantly inhibited by PD98059 pretreatment. (2) IL-13 protein in supernatants of asthmatic lymphocytes was higher than that produced by normal control lymphocytes, and was significantly increased by EGF treatment. This EGF effect was partly blocked by PD98059 pretreatment. (3) There was a significant positive correlation between the percentage of cells with p-ERK in peripheral blood lymphocytes and IL-13 protein in supernatants of lymphocytes from asthmatic rats.

Conclusions
In asthma the ERK expression and activation levels were increased, as was the protein level of IL-13. The ERK signaling pathway may be involved in the increased expression of the Th2 cytokine IL-13 in asthma.
Changes in immunological function after treatment with transarterial chemoembolization plus radiofrequency ablation in hepatocellular carcinoma patients
Authors: Guan Hai-tao , Wang Jian , Yang Ming , Song Li , Tong Xiao-qiang , Zou Ying-hua 
Published: January 2024

Background
Different strategies for hepatocellular carcinoma (HCC) may have distinct effects on the immune system. The aim of this research was to investigate changes in the immunological function after transcatheter arterial chemoembolization (TACE) plus radiofrequency ablation (RFA) in HCC patients.

Methods
A total of 51 consecutive HCC treatment-naïve patients was enrolled in this study and 20 healthy subjects served as controls. The therapeutic strategy was selected according to the tumor stage and general conditions. TACE was performed in 25 cases, TACE plus RFA in 17 and RFA in nine. All the patients underwent routine examinations and peripheral blood was harvested for the detection of lymphocyte subset by flow cytometry 1 day before, and 2 and 4 weeks after the treatment. The serum levels of alpha-fetoprotein (AFP), ALT and AST were also measured before and 4 weeks after treatment for the evaluation of therapeutic efficacy and liver function impairment.

Results
When compared with healthy controls, the CD4/CD8 ratio and the number of B cells and natural killer (NK) cells were significantly decreased in HCC patients before treatment (P <0.05). When compared with before treatment, the CD4+ cells and CD4/CD8 ratio decreased but CD8+ cells increased in the TACE group (P <0.05); the CD4/CD8 ratio and NK cells decreased but CD8+ cells increased in the TACE-RFA group (P <0.05); the CD3+ cells, CD4+ cells, CD4/CD8 ratio and NK cells increased in the RFA group (P <0.05). Significant differences in the CD3+ cells, CD8+ cells, CD4/CD8 ratio and NK cells were observed among groups (P <0.05). Moreover, the AFP level decreased and transaminase level increased in all groups (P <0.05). Differences of pre and post treatment between groups were statistically significant (P =0.016, 0.025, 0.018 respectively).

Conclusions
Immunity was compromised in HCC patients; TACE and TACE plus RFA lowered immunologic function to a certain extent. RFA improved it accompanied by a protective effect on liver function.
Comparison of the effect of posterior lumbar interbody fusion with pedicle screw fixation and interspinous fixation on the stiffness of adjacent segments
Authors: LI Chun-de , SUN Hao-lin , LU Hong-zhang 
Published: January 2024

Background
Adjacent segment degeneration could seriously affect the long-term prognosis of lumbar fusion. Dynamic fixation such as the interspinous fixation, which is characterized by retaining the motion function of the spinal segment, has obtained satisfactory short-term effects in the clinical setting. But there are few reports about the biomechanical experiments on whether dynamic fixation could prevent adjacent segment degeneration.

Methods
The surgical segments of all 23 patients were L4/5. Thirteen patients with disc herniation of L4/5 underwent Wallis implantation surgery, and 10 patients with spinal stenosis of L4/5 underwent posterior lumbar interbody fusion (PLIF). L3-S1 segmental stiffness and displacement were measured by a spine stiffness gauge (SSG) device during surgery when the vertebral plate was exposed or during spinal decompression or internal fixation. Five fresh, frozen cadavers were used in the self control experiment, which was carried out in four steps: exposure of the vertebral plate, decompression of the spinal canal, implantation of a Wallis fixing device, and PLIF of L4/5 after removing the Wallis fixing device. Then, L3-S1 segment stiffness was measured by an SSG device.

Results
The experiments showed that the average stiffness of the L4/5 segment was (37.1±8.9) N/mm after exposure of the vertebral plate, while after spinal decompression, the average stiffness fell to (26.2±7.1) N/mm, decreasing by 25.8% (P <0.05). For the adjacent segments L3/4 and L5/S1, their stiffness showed no significant difference between the L4/5 segment decompression and the exposure of the vertebral plate (P >0.05). After Wallis implantation of L4/5, the stiffness of the cephalic adjacent segment L3/4 was (45.8±10.7) N/mm, which was 20.5% more than that after the exposure of the vertebral plate (P <0.05); after L4/5 PLIF surgery, the stiffness of L3/4 was (35.3±10.7) N/mm and was decreased by 12.4% more than that after the exposure of the vertebral plate (P <0.05). The stiffness of the cephalic adjacent segment L3/4 after fixation in the Wallis group was significantly higher than that of the PLIF group (P <0.05). Cadaver experiments showed that the stiffness of the cephalic adjacent segment in the Wallis group was significantly higher than that of the PLIF group after L4/5 segment fixation (P <0.05); the stiffness of the L5/S1 segment showed no significant difference between PLIF surgery and Wallis implantation (P >0.05).

Conclusions
After interspinous (Wallis) fixation, the stiffness of the cephalic adjacent segment increased. After PLIF with pedicle screw fixation, the stiffness of the cephalic adjacent segment decreased. An interspinous fixation system (Wallis) has a protective effect for cephalic adjacent segments for the immediate post-operative state.
Outcome of contralateral C7 nerve transferring to median nerve
Authors: GAO Kai-ming , LAO Jie , ZHAO Xin , GU Yu-dong 
Published: January 2024

Background
Contralateral C7 (cC7) transfer had been widely used in many organizations in the world, but the outcomes were significantly different. So the purpose of the study was to evaluate the outcome of patients treated with cC7 transferring to median nerve and to determine the factors affecting the outcome of this procedure.

Methods
A retrospective review of 51 patients with total root avulsion brachial plexus injuries who underwent cC7 transfer was conducted. All of the surgeries were performed with two surgery stages and median nerve was the recipient nerve. The cC7 nerve was used in three different ways. The entire C7 root was used in 11 patients; the posterior division together with the lateral part of the anterior division was used in 15 patients; the anterior or the posterior division alone was used in 25 patients. The mean follow-up period was 6.9 years.

Results
The efficiency of the surgery in these 51 patients was 49.02% in motor and 62.75% in sensory function. The patients with entire C7 root transfer obtained significantly better recovery in both motor and sensory function than the patients with partial C7 transfer. The best function recovery could be induced if the interval between the two surgery stages was 4-8 months.

Conclusions
cC7 transfer is an effective procedure in repairing median nerve. But using the entire C7 root transfer can obtain better recovery; so we emphasize using the entire root as the donor. The optimal interval between two surgery stages is 4-8 months.
Comparison between Doppler echocardiography and hot-film anemometry in measuring the turbulent shear stress downstream of artificial mitral valves: a methodological study
Authors: SUN Yi , LI Rui-jie , LI Gan-niu , LI Bin , WANG Yu , MA Run-wei , YANG Bai-hui , LU Sen-lin , ZHANG Gui-min 
Published: January 2024

Background
Turbulent shear stress (TSS) plays an important role in the research of fluid dynamics of heart valves. This study aimed to perform a quantitative study of TSS downstream of porcine artificial mitral valves in order to verify the correlation of hot-film anemometry (HFA) and Doppler echocardiography combined with computer-aided image analysis for the detection of TSS.

Methods
A porcine model of mitral valve replacement was established. HFA and Doppler ultrasound techniques were used to directly and indirectly measure TSS-relevant parameters of the artificial mitral valve following different mitral valve replacements: different approaches were used to reserve the subvalvular apparatus of the mitral valve. A correlation analysis was then carried out.

Results
There was a significant correlation between the HFA and Doppler ultrasound combined with computer-aided image analysis of the TSS at the same time and at the same site. No significant difference was found in the TSS measured by the two methods.

Conclusions
Compared with HFA, Doppler echocardiography combined with computer-aided image analysis is a safe, non-invasive, and real-time method that enables accurate and quantitative detection of TSS downstream in vivo, objectively reflecting the flow field downstream of the artificial mitral valve. Doppler ultrasound combined with computer-aided image analysis can be employed for quantitatively evaluating the downstream hemodynamic performance of the mitral valve.
Association of NFATc1 gene polymorphism with ventricular septal defect in the Chinese Han population
Authors: SHEN Lei , LI Zhong-zhi , SHEN A-dong , LIU Hui , BAI Song , GUO Jian , YUAN Feng , LI Xiao-feng 
Published: January 2024

Background
Congenital heart disease (CHD) is a diverse group of diseases determined by genetic and environmental factors. Considerable research has been done on genes associated with the development of the heart. Recently, focus is on the role of transcription factor NFATc1 in the development of proper valve and septa. As part of a larger study, high density single nucleotide polymorphism (SNP) scanning was used to explore the relationship between NFATc1 gene polymorphism and susceptibility to ventricular septal defect (VSD) in the Chinese Han population.

Methods
One hundred and ninety-two pediatric patients with congenital VSD and 192 matching healthy control subjects were studied. The haplotype reconstructions were calculated by PHASE2.0 software. Haploview software was used to perform linkage disequilibrium assessment and define haplotype blocks. The algorithm used for defining the blocks was the confidence interval method.

Results
The NFATc1 gene region can be divided into 11 haplotype blocks. Strong linkage disequilibrium existed within blocks 6, 8, 9, and 11. Three SNPs (rs7240256, rs11665469, and rs754505) within the NFATc1 gene had significant correlation with VSD by single marker association analysis. In addition, two haplotypes correlated with VSD.

Conclusions

NFATc1 is associated with the occurrence of VSD and it may be a predisposing gene to CHD in Han Chinese. This finding has set a direction for further genetic and functional studies.
Prevalence and clinical prognosis of heteroresistant vancomycin-intermediate Staphylococcus aureus in a tertiary care center in China
Authors: WANG Yan , HU Yun-jian , AI Xiao-man , XU Hong-tao , SUN Tie-ying 
Published: January 2024

Background
The emergence of heteroresistant vancomycin-intermediate Staphylococcus aureus (hVISA) is increasingly challenging the methods for detection in diagnostic microbiology laboratories. However, the report of hVISA is rare in China. This study summarizes the prevalence and clinical features associated with hVISA infections at our institution and the local impact they have on clinical outcome.

Methods
A total of 122 methicillin-resistant Staphylococcus aureus (MRSA) isolates which were of the causative pathogens were collected. One hundred and two patients for whom we had full information of MRSA pneumonia were included. Isolates of MRSA were collected using PCR to detect the mecA gene. Both Etest and macro Etest were performed to screen for hVISA. The Staphylococcal chromosome cassette mec (SCCmec) types were determined by multiplex PCR strategy. Logistic regression analysis was used to determine the risk factors.

Results
Among the 122 MRSA isolates collected, 25 (20.5%) strains were identified as hVISA. There were 119 (97.5%) SCCmec III isolates, two (1.6%) SCCmec II isolates, and one (0.8%) SCCmec V isolate. The 30-day mortality of MRSAhospital acquired pneumonia (HAP) was 37.3%, and 62.5% for hVISA-HAP. Vancomycin treatment was the independent risk factor of hVISA. Factors independently associated with 30-day mortality in all patients were acute physiology and Chronic Health Evaluation (APACHE) II score >20, multiple lobe lesions, and creatinine clearance rate (CCR) <15 ml/min.

Conclusions
The prevalence of hVISA is 20.5% at our institution. hVISA-HAP patients had a poor clinical outcome. Vancomycin treatment was the independent predictors for hVISA infection. Factors independently associated with 30-day mortality in all patients were APACHE II score >20, multiple lobe lesions and CCR <15 ml/min.
Comparison of immunohistochemistry with fluorescence in situ hybridization in determining the human epidermal growth factor receptor 2 status of breast cancer specimens: a multicenter study of 3 149 Chinese patients
Authors: Han Xiaohong , Shi Yuankai , Ma Li , Lyu Zheng , Yang Hongying , Yao Jiarui , Li Jian , Li Bo , Qin Yan 
Published: January 2024

Background
Accurate detection of human epidermal growth factor receptor 2 (HER2) expression and gene amplification is crucial for the application of HER2-specific therapy and for evaluating the response of patients with breast cancer. A uniform and standard procedure of immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) needs to be established for evaluating the HER2 status in breast cancer tissues for the treatment of patients with real HER2-positive tumors. The present multicenter study was aimed to examine the HER2 status in breast cancer specimens from Chinese patients using both IHC and FISH methods.

Methods
A multicenter study was performed on the HER2 status in 3 149 breast cancer specimens from different ethnic populations and areas in China by IHC and FISH assays. The potential association of HER2 status with demographic and clinical characteristics was analyzed.

Results
The positive rates for HER2 over-expression and HER2 amplification were 23.3% and 27.5% in this study, respectively. The concordance between IHC and FISH was 71.2% (κ=0.494, P <0.001). Furthermore, 72.9% of specimens with IHC 2+ were negative to FISH. The discordance rates among laboratories were from 5% to 28% for IHC and 1% to 16% for FISH. HER2 amplification was associated significantly with advanced tumor stage (III or IV, P=0.002), large tumor size (>5 cm, P=0.002), moderate and poor histological grades (P <0.0001), post-menopause (P <0.0001), ER-PR- (P=0.002), and having ≥4 lymph nodes affected (P <0.0001) in this population. The positive rates of HER2 amplification in specimens from Man and Hui Chinese were significantly higher than that in other Chinese populations. There are slightly higher positive rates of HER2 expression and amplification in Chinese patients with breast cancer.

Conclusion
These findings may provide new insights into understanding the epidemiological features of HER2 expression and amplification, and may be valuable for clinical practice.
Inactivation of Smad4 is a prognostic factor in intrahepatic cholangiocarcinoma
Authors: YAN Xue-qiang , ZHANG Wei , ZHANG Bi-xiang , LIANG Hui-fang , ZHANG Wan-guang , CHEN Xiao-ping 
Published: January 2024

Background
Smad4 is found mutated in many cancers. It acts as a tumor suppressor in the regulation of TGF-β signaling pathway. The objective of this work was to study the expression of Smad4 in intrahepatic cholangiocarcinoma (ICC) and its relationship with the biological behavior and prognosis of the disease.

Methods
Forty-nine paraffin-embedded ICC specimens and nine normal liver tissues were analyzed by immunohistochemical methods using Smad4 monoclonal antibodies. The expression of Smad4 was compared with the clinical pathological characteristics of the patients.

Results
The expression of Smad4 was 100% positive in normal liver tissues, which was higher than that in the ICC (44.9%). Negative labeling of the Smad4 protein was found in 26.1% (6/23) of well-differentiated ICCs and 61.5% (16/26) of poorly to moderately differentiated ICCs, and 34.3% (12/35) and 71.4% (10/14) showed negative Smad4 labeling (P=0.018) of ICC at pathological Tumor Node Metastasis (pTNM) stage I-II and pTNM stage III-IV separately. Furthermore, 72% (8/11) of lymph node metastatic ICCs and 73.3% (11/15) of intrahepatic metastatic ICCs showed negative labeling of the Smad4 protein. The loss of Smad4 expression in those metastatic ICCs was significantly more severe compared with non-metastatic ICCs (P=0.000).

Conclusions
The expression of Smad4 was associated with the histological grade, clinical stage, and metastasis of ICC (P <0.05). The detection of Smad4 may be helpful in determining the degree of malignancy and prognosis of ICC.