bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparing verum and sham acupoint catgut embedding for adults with obesity: A systematic review and meta-analysis of randomized clinical trials
Authors: Yue Jin-huan , Li Xiao-ling , Zhang Yu-ying , Yang Guan-hu , Mah Jeffrey Zhong-xue , Li Ang , Zhao Wei-wei , Wang Yu-lin , Zhang Qin-hong , Huang Jia-qi 
Published: February 2024

Background:
Previous clinical trials have reported that acupoint catgut embedding (ACE) is a useful modality for weight loss. However, no study has specifically investigated the effectiveness and safety of comparing verum and sham ACE in adults with obesity. Thus, this study aimed to evaluate the effectiveness and safety of comparing verum and sham ACE in obese adults.

Methods:
A comprehensive literature search was conducted in the electronic databases of PUBMED, EMBASE, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang, China Science and Technology Journal Database, and China Biomedical Literature Service System from inception to April 1, 2022. Randomized clinical trials that focused on evaluating the effectiveness of comparing verum and sham ACE in adults with obesity were included. The primary outcomes included reduction in body weight, body mass index, hip circumference, and waist circumference. The secondary outcomes consisted of a decrease in body fat percentage and the occurrence rate of adverse events. The methodological quality of the included randomized clinical trials was evaluated using the Cochrane Risk-of-bias tool. Statistical analysis was performed using RevMan 5.4 software.

Results:
Six trials involving 679 adults with obesity were included in this study and entered in the data analysis of systematic review and meta-analysis. Results of the meta-analysis revealed significant reduction in body weight (mean difference [MD] = −1.68, 95% confidence intervals (CI) [−2.34, −1.01], I
2 = 51%, P < .001), body mass index (MD = −0.51, 95% CI [−0.81, −0.21], I
2 = 74%, P < .001), hip circumference (MD = −1.11, 95% CI [−1.67, −0.55], I
2 = 0%, P < .001), waist circumference (MD = −2.42, 95% CI [−3.38, −1.45], I
2 = 68%, P < .001), and decrease in body fat percentage (MD = −0.83, 95% CI [−1.30, −0.36], I
2 = 16%, P < .001) in comparing verum and sham ACE. However, no significant difference was identified in AEs (odds ratio = 1.53, 95% CI [0.80, 2.95], I
2 = 0%, P = .20) between the 2 groups.

Conclusion:
ACE is effective in the treatment of obesity in adults with safety profile. Further studies with higher quality and larger sample size are warranted to confirm the current findings.
Successful treatment of refractory ascites in a patient with liver cirrhosis combined with hepatic artery-portal vein malformation: A case report
Authors: Ge Zhenyu , Wang Kai , Zhang Zhaomei , Zhang Xiaoqian , Sun Peng , Chen Ning , Tan Yang , Shen Tingting , Dai Hongsheng , Li Wenwen 
Published: February 2024

Introduction:
Hepatic artery-portal vein malformation is rarely encountered in clinical practice. Here, we reported a case of liver cirrhosis combined with hepatic artery-portal vein malformation with refractory ascites as the main symptom. And it was successfully treated by us. The present case demonstrates the role of hepatic artery-portal vein malformation in cirrhotic ascites and the importance of early diagnosis and interventional treatment. This article may provides some experience for the treatment of such patients.

Patient concerns:
The patient was a 72-year-old woman with a 40-year history of Hepatitis B virus surface antigen positivity who sought medical advice with a chief complaint of abdominal distension for 1 week.

Diagnoses:
Enhanced abdominal computed tomography imaging of this patient revealed liver cirrhosis, splenomegaly, esophageal and gastric varices, massive ascites, and a low-density area in the S4 segment of the liver with an ambiguous boundary. Widening of the left branch of the portal vein was evident, and the portal vein was highlighted in the arterial phase and the venous phase. Digital subtraction angiography revealed substantial thickening of the left hepatic artery, and the administered contrast agent drained through the malformed vascular mass to the thickened left portal vein. Liver cirrhosis combined with hepatic artery-portal vein malformation were diagnosed. And we considered that the artery-portal vein malformation in this patient might be caused by cirrhosis.

Interventions:
The patient was applied diuretics, entecavir and transcatheter embolization.

Outcomes:
The patient ascites did not resolve significantly when treated with diuretics alone. After the transcatheter embolization, the patient ascites relieved remarkably.

Conclusion:
The patient underwent transcatheter embolization for hepatic artery-portal vein malformation, after which her ascites resolved with good short-term curative efficacy. So, the patients who suffered from liver cirrhosis combined with hepatic artery-portal vein malformation and refractory ascites, should be active on transcatheter embolization.
Ileal perforation involvement in Wegener granulomatosis comorbid with COVID-19 infection: A case report and review of the literature
Authors: Shao Huijuan , Liu Dong , Zheng Xiaofeng , Zhang Jiucong , Li Wenbo , Chen Peng , Qian Zhen , Yang Jie , Liu Dongmei 
Published: February 2024

Rationale:
Granulomatosis with polyangiitis (GPA) is a systematic autoimmune disease. The typical clinical involvement of GPA entails the upper and lower respiratory tracts, and the kidneys. Gastrointestinal (GI) involvement is uncommon and unless detected and treated promptly, may lead to life-threatening complications such as perforation. We aim to review all available publications since the first description in 1982 dealing with GI perforation in patients with Wegener granulomatosis and draw attention to this serious situation.

Patient concerns:
We present a 54-year-old man diagnosed with GPA who presented initially with nasal symptoms and suffered ileal perforation following Corona Virus Disease 2019 infection. We also review previously reported patients with Wegener granulomatosis who had GI perforation to investigate the perforation site and period, pathology, diagnosis, and treatment methods.

Diagnoses and Interventions:
The case of a GPA-diagnosed patient who presented initially with nasal symptoms and suffered ileal perforation following Corona Virus Disease 2019 infection. We recommended a renal puncture biopsy, steroids, and immunosuppressants to improve the patient condition. The patient and his family refused these treatment recommendations.

Outcomes:
Our patient exhibited continued progressive vascular inflammatory changes and eventual irreversible systemic damage. These sequelae were attributed to the patient declining prednisolone and immunosuppressant therapy.

Lessons:
GI perforation is rare in GPA but severe complication. Consequently, we recommend that early diagnosis and treatment with steroid hormones and immunosuppressants for GPA patients with GI perforation.
Diagnosis and evaluation of elderly-onset myasthenia gravis: A case report
Authors: Tachikawa Takako , Takeshima Shinichi , Kawate Nobuyuki 
Published: February 2024

Rationale:
Patients with elderly-onset myasthenia gravis can have a good prognosis with appropriate diagnosis and response, although it is difficult to differentiate between exacerbations of myasthenia gravis in elderly patients and age-related changes. Therefore, it is important for physicians to understand the clinical characteristics and safe assessment methods for patients with elderly-onset myasthenia gravis.

Patient concerns:
An 82-year-old male diagnosed with myasthenia gravis 6 months prior had no difficulty in daily living. After falling on a golf course, he was diagnosed with a right femoral neck fracture on the 1st day and underwent right total hip replacement surgery on the 12th day, being transferred to our hospital for rehabilitation therapy on the 32nd day. However, immediately after transfer, the patient showed fatigability during training and difficulty swallowing food.

Diagnoses:
This case was diagnosed as an exacerbation of myasthenia gravis.

Interventions:
Pyridostigmine was initiated with the expectation of immediate effect on the 54th day.

Outcomes:
His symptoms and physical functions improved immediately, and walking distance and food intake increased. From this clinical course, it was judged that immunosuppressive therapy was indicated as a transition to generalized myasthenia gravis. For this reason, he was discharged after arranging postdischarge visits to the department of neurology, accordingly.

Lessons:
A better understanding of the characteristics of elderly-onset myasthenia gravis may allow for relatively safe assessment of the condition and improve its diagnosis and treatment.
Huge uterine abscess after myomectomy: A case report
Authors: Wen Biwei , Yu Xiaomin , Yin Yue , Zhao Runan , Liu Yuhuan 
Published: February 2024

Rationale:
Uterine abscess is a rare gynecologic entity and only a few cases have been reported so far. This study aimed to describe our clinical experience in this case. Initially, hematoma was diagnosed without detail previous medical record. Finally, laparotomy was performed due to refractory fever and highly possible diagnosis of uterine abscess. We successfully performed a hysterectomy and the patient had an uneventful recovery.

Patient concerns:
A 44-year-old nulliparous woman underwent myomectomy in the local hospital, 45 days ago. She complained of irregular fever (up to 40 °C) without abdominal pain since the surgery.

Diagnoses:
Due to lack of her detail medical record, equivocal images and her strong intention to preserve uterus, she was misdiagnosed with hematoma and treated with antibiotic treatment. Finally, intraoperative findings revealed that the huge myometrial abscess contained a mass of pus.

Interventions:
Laparotomy was performed due to refractory high-grade fever and highly possible diagnosis of uterine abscess. Total hysterectomy was performed to avoid the possibility of life-threatening sepsis.

Outcomes:
The postoperative course was uneventful and the patient was discharged 10 days after surgery.

Lessons:
Complete imaging examinations are recommended prior myomectomy to facilitate the differential diagnosis of postoperative complications. In addition, several measures, such as maintaining aseptic conditions during surgery and postoperative drainage, play a critical role in preventing nosocomial infections. Rare uterine abscess is often mistaken for hematoma with fever. If the patient develops high fever after myomectomy, accompanied by a mass in the myometrium, the possibility of infection or even abscess formation should not be excluded. For women who need to preserve their fertility, the early diagnosis and timely administration of appropriate medication is crucial for preventing uterine loss.
Preoperative prediction of microsatellite instability status: development and validation of a pan-cancer PET/CT-based radiomics model
Authors: Wang Menglu , Peng Mengye , Yang Xinyue , Zhang Ying , Wu Tingting , Wang Zeyu , Wang Kezheng 
Published: February 2024

Objective
The purpose of this study is to verify the feasibility of preoperative prediction of patients’ microsatellite instability status by applying a PET/CT-based radiation model.

Methods
This retrospective study ultimately included 142 patients. Three prediction models have been developed. The predictive performance of all models was evaluated by the receiver operating characteristic curve and area under the curve values. The PET/CT radiological histology score (Radscore) was calculated to evaluate the microsatellite instability status, and the corresponding nomogram was established. The correlation between clinical factors and radiological characteristics was analyzed to verify the value of radiological characteristics in predicting microsatellite instability status.

Results
Twelve features were retained to establish a comprehensive prediction model of radiological and clinical features. M phase of the tumor has been proven to be an independent predictor of microsatellite instability status. The receiver operating characteristic results showed that the area under the curve values of the training set and the validation set of the radiomics model were 0.82 and 0.75, respectively. The sensitivity, specificity, positive predictive value and negative predictive value of the training set were 0.72, 0.78, 0.83 and 0.66, respectively. The sensitivity, specificity, positive predictive value and negative predictive value of the validation set were 1.00, 0.50, 0.76 and 1.00, respectively. The risk of patients with microsatellite instability was calculated by Radscore and nomograph, and the cutoff value was −0.4385. The validity of the results was confirmed by the decision and calibration curves.

Conclusion
Radiological models based on PET/CT can provide clinical and practical noninvasive prediction of microsatellite instability status of several different cancer types, reducing or avoiding unnecessary biopsy to a certain extent.
18F-FDG PET/CT characteristics of IASLC grade 3 invasive adenocarcinoma and the value of 18F-FDG PET/CT for preoperative prediction: a new prognostication model
Authors: Yang Hanyun , Liu Xinran , Wang Lijuan , Zhou Wenlan , Tian Ying , Dong Ye , Zhou Kemin , Chen Li , Wang Meng , Wu Hubing 
Published: February 2024

Objective
This study is performed to investigate the imaging characteristics of the International Association for the Study of Lung Cancer grade 3 invasive adenocarcinoma (IAC) on PET/CT and the value of PET/CT for preoperative predicting this tumor.

Materials and methods
We retrospectively enrolled patients with IAC from August 2015 to September 2022. The clinical characteristics, serum tumor markers, and PET/CT features were analyzed. T test, Mann–Whitney U test, χ2 test, Logistic regression analysis, and receiver operating characteristic analysis were used to predict grade 3 tumor and evaluate the prediction effectiveness.

Results
Grade 3 tumors had a significantly higher maximum standardized uptake value (SUVmax) and consolidation-tumor-ratio (CTR) (P < 0.001), while Grade 1 - 2 tumors were prone to present with air bronchogram sign or vacuole sign (P < 0.001). A stepwise logistic regression analysis revealed that smoking history, CEA, SUVmax, air bronchogram sign or vacuole sign and CTR were useful predictors for Grade 3 tumors. The established prediction model based on the above 5 parameters generated a high AUC (0.869) and negative predictive value (0.919), respectively.

Conclusion
Our study demonstrates that grade 3 IAC has a unique PET/CT imaging feature. The prognostication model established with smoking history, CEA, SUVmax, air bronchogram sign or vacuole sign and CTR can effectively predict grade 3 tumors before the operation.
Evaluation of prostate-specific membrane antigen expression in locally advanced or metastatic breast carcinoma with 68Ga-PSMA-11 positron-emission tomography/computed tomography imaging for potential theranostics
Authors: Parghane Rahul V. , Suralkar Tejal , Nikam Dilip , Basu Sandip 
Published: February 2024

Background and aim
Prostate-specific membrane antigen (PSMA) is ubiquitously expressed in tumor-associated neovasculature and may be a potential theranostic in many solid cancers, including breast carcinoma (BC). Herein, we analyzed the presence of PSMA in BC, through qualitative and quantitative parameters on 68Ga-PSMA-11 positron-emission tomography/computed tomography (PET/CT), across various hormonal subtypes.

Methods
This study examined 41 female patients of BC. All underwent 68Ga-PSMA-11 PET/CT. For qualitative analysis, a visual estimation of PSMA expression was performed as per miPSMA scoring system (VISION trial) and a score ≥2 was considered eligible for lutetium-177 (177Lu)-PSMA-617 radioligand therapy (Lu-PRLT). For quantitative analysis, maximum standardized uptake values (SUVmax) were determined and ratios >1 for SUVmax lesion to SUVmax liver were considered eligible for Lu-PRLT. PSMA expression was correlated with hormonal status using Chi-square test. The sensitivity, specificity and area under curve (AUC) of PSMA expression were determined using receiver-operating characteristics analysis (P < 0.05).

Results
A total of 19 patients (46.3%) and 15 patients (36.7%) in stage IV were found eligible for Lu-PRLT based on qualitative and quantitative analyses, respectively. Strong PSMA expression was detected in triple-negative and hormonal receptors-negative/human epidermal growth factor receptor 2-positive status on qualitative PSMA expression analysis. A sensitivity of 65.5%, specificity of 93.3% and AUC of 0.857 for SUVmax 6.5 on 68Ga-PSMA-11 PET/CT were detected for PSMA expression for considering Lu-PRLT.

Conclusion
We found a modest number of BC patients suited for Lu-PRLT, indicating that PSMA PET/CT imaging may be a valuable modality for selecting theranostics in a carefully selected group of breast carcinoma.
Malaria prevention in children: an update
Authors: Friedman-Klabanoff DeAnna J. , Adu-Gyasi Dennis , Asante Kwaku Poku 
Published: February 2024

Purpose of review
Malaria cases and deaths decreased from 2000 to 2015 but remain increased since 2019. Several new developments and strategies could help reverse this trend. The purpose of this review is to discuss new World Health Organization (WHO) guidelines and recent research on malaria prevention in children.

Recent findings
Fifteen countries have now rolled out seasonal malaria chemoprophylaxis (SMC) in children at highest risk for severe malaria, and new WHO recommendations provide more flexibility for SMC implementation in terms of target age groups, geographic region, and number of cycles. Recent studies confirm that malaria burden in school aged children, and their contribution to transmission, is high. New guidelines permit expanded chemoprevention options for these children. Two vaccines have been approved for use in malaria endemic countries, RTS,S/AS01E and R21/Matrix-M. Additionally, pyrethroid-chlorfenapyr bed nets are being deployed to combat resistant mosquitoes.

Summary
While challenges remain in malaria control towards elimination, new guidelines and recently approved vaccines offer hope. Monitoring for continued vaccine and chemoprevention effectiveness, and for possible epidemiologic shifts in severe malaria presentation and deaths as additional prevention efforts roll out will be paramount.
Nicardipine or Nitroprusside for Postoperative Blood Pressure Control in Infants After Surgery for Congenital Heart Disease: Single-Center Retrospective Noninferiority and Cost Analysis, 2016–2020*
Authors: Wong Rudolph J. , Mruk Allison L. , Grimaldi Lisa M. , Patel Reena , Mirea Lucia , Engelhardt Kevin P. 
Published: February 2024

OBJECTIVES:
Postoperative hypertension frequently occurs after surgery for congenital heart disease. Given safety concerns when using calcium channel blockers in infants along with the cost and side-effect profile of nitroprusside, we retrospectively assessed our experience of using nicardipine and nitroprusside for postoperative blood pressure control in infants who underwent surgery for congenital heart disease. We also investigated the cost difference between the medications.

DESIGN:
This study was a single-center retrospective, pre-post chart review of patients who had surgery for congenital heart disease between 2016 and 2020. The primary aim was a noninferiority comparison of achievement of blood pressure goal at 1-hour post-initiation of an antihypertensive agent. Secondary comparisons included achievement of blood pressure goal at 2 hours after medication initiation, Vasoactive-Inotropic Score (VIS), and blood transfusion, crystalloid volume, and calcium needs.

SETTING:
Academic quaternary-care center.

PATIENTS:
Infants under 1 year old who required treatment for hypertension with nitroprusside (n = 71) or nicardipine (n = 52) within 24 hours of surgery for congenital heart disease.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
We failed to identify any difference in proportion of patients that achieved blood pressure control at 1-hour after medication initiation (nitroprusside 52% vs. nicardipine 54%; p = 0.86), with nicardipine noninferior to nitroprusside within a 15% margin. Of patients who did not achieve control at 1-hour post-medication initiation, receiving nicardipine was associated with blood pressure control at 2 hours post-medication initiation (79% vs. 38%; p = 0.003). We also failed to identify an association between antihypertensive types and mean VIS scores, blood transfusion volumes, crystalloid volumes, and quantities of calcium administered. Index cost of using nitroprusside was 16 times higher than using nicardipine, primarily due to difference in wholesale cost.

CONCLUSIONS:
In our experience of achieving blood pressure control in infants after surgery for congenital heart disease (2016–2020), antihypertensive treatment with nicardipine was noninferior to nitroprusside. Furthermore, nicardipine use was significantly less expensive than nitroprusside. Our contemporary practice is therefore to use nicardipine in preference to nitroprusside.
Selective Myectomies Alone versus Selective Myectomies Combined with Neurectomies in Postparetic Synkinesis: Comparing Outcomes
Authors: Sanchez Cristina V. , Gault Natalie A. , Gopalan Tulasi A. , Rozen Shai M. 
Published: February 2024

Background:
In postparetic synkinesis, muscle tone imbalance between upper and lower lip depressors and elevators results in the inability to produce an effective smile. Surgical treatments to improve smile focus on restoring tonicity balance between perioral muscles by weakening hypertoned muscles through selective myectomies or selective neurectomies. The goal of this study was to compare objective outcomes between selective myectomies alone with those of selective myectomies combined with selective neurectomies.

Methods:
A retrospective cohort study was performed on postparetic synkinesis patients who underwent depressor anguli oris (DAO) myectomies or DAO and platysma myectomies with selective neurectomies. Objective outcomes included preoperative and postoperative analyses of smile measures (excursion, angle, and dental show) and botulinum toxin type A administration (periorbital and platysmal).

Results:
Thirty-seven patients underwent DAO myectomies only (myectomy group), and 18 patients underwent DAO and platysma myectomies with selective neurectomies (myectomy-neurectomy group). Within-group analyses showed significant angle improvement in both groups (P < 0.05) and improved smile excursion in the myectomy-neurectomy group (P < 0.05). Between-group comparisons showed significant closed mouth smile excursion improvement (difference in means, −1.14 mm; 95% CI, −2.19 to −0.09 mm; P = 0.034) and a significant decrease in platysmal botulinum toxin type A administration (difference in means, 27.36 units; 95% CI, 18.72 to 36.00 units; P < 0.001) in the myectomy-neurectomy group compared with the myectomy group.

Conclusions:
This study suggests that selective myectomies and selective myectomies with selective neurectomies provide overlapping and differing benefits to perioral synkinesis. Selective neurectomies and platysma myectomy provided slightly improved excursion and significantly decreased botulinum injections to the platysma.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.