bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perioperative and long-term outcome of thymectomy for myasthenia gravis: comparison of surgical approaches and prognostic analysis
Authors: LIU Cheng-wu , LUO Meng , MEI Jian-dong , ZHU Yun-ke , PU Qiang , MA Lin , CHE Guo-wei , LIN Yi-dan , WU Zhu , WANG Yun , KOU Ying-li , LIU Lun-xu 
Published: January 2024

Background
Thymectomy is an established treatment for myasthenia gravis (MG), and video-assisted thoracoscopic surgery (VATS) thymectomy has become an acceptable surgical procedure. This study aimed to compare the results of VATS thymectomy and open thymectomy and to identify the prognostic factors after thymectomy.

Methods
The clinical data of 187 consecutive thymectomies performed between July 2000 and December 2009 were retrospectively reviewed; 75 open thymectomies and 112 VATS thymectomies. Clinical efficacy and variables influencing outcome were assessed by Kaplan-Meier survival curves and Cox proportional hazards regression analysis.

Results
The operative blood loss in the VATS group was significantly less than that in the open group ((62.14±55.43) ml vs. (137.87±165.25) ml, P <0.05). The postoperative crisis rate increased with the severity of preoperative MG and the prescription dose of anticholinesterase. Complete follow-up information of patients more than 12 months after the thymectomy was obtained on 151 cases, 89 cases from the VATS group and 62 cases from the open group, with a mean follow-up period of 59.3 months, range from 12 to 117 months. Complete stable remission (CSR) was the end point for evaluation of the treatment results. The overall five-year CSR rate was 57.5%. Two good prognostic factors were identified; preoperative prescription of anticholinesterase alone (P=0.035) and non-thymomatous MG (P=0.003). The five-year CSR rate of the ocular type of MG reached a high level of 67.4%.

Conclusions
Thymectomy can achieve good long-term CSR in MG, and VATS is an ideal alternative method. High-dose prescription of anticholinesterase and the advanced stage by Myasthenia Gravis Foundation of America (MGFA) classification have higher risks of postoperative crisis. Preoperative prescription of anticholinesterase alone and non-thymomatous MG are good prognostic factors. Thymectomy should also be considered for the ocular type of MG.
Perioperative factors related to prognosis of regular hepatectomy in comparison with irregular hepatectomy
Authors: Feng Zhiqiang , Li Hongqi , Zhang Jinqian , Xu Lining , Xiao Mei , Huang Zhiqiang , Zhang Hongyi 
Published: January 2024

Background
The aim of this research was to analyze the perioperative factors of regular hepatectomy and irregular hepatectomy. The superiority of the clinical application of the two methods was compared in the perioperative period.

Methods
From 1986 to 2011, 1798 patients underwent consecutive liver resections with regular hepatectomy and irregular hepatectomy at the Air Force General Hospital of People's Liberation Army and the General Hospital of Chinese People's Liberation Army. Their medical documentation was investigated retrospectively.

Results
In patients on whom regular hepatectomy and irregular hepatectomy were performed, there was no significant difference in perioperative blood loss, complications, in-hospital mortality, hospital stay, and so on. But in regular hepatectomy, operating time was an independent risk factor (P <0.001, OR=1.004).

Conclusions
There was no significant difference between the perioperative risk of regular hepatectomy and that of irregular hepatectomy.
Dual-energy computed tomography angiography for evaluating the renal vascular variants
Authors: TAO Xiao-feng , ZHU Jing-qi , WU Ying-wei , TANG Guang-yu , SHI Yu-zhen , ZHANG Lei , LIN Yi , WANG Zhong-qiu 
Published: January 2024

Background
Recognizing renal vascular variants preoperatively is important in order to avoid vascular complications during surgery. This study aimed to investigate the renal vascular variants with dual-energy computed tomography (DECT) angiography to provide valuable information for surgery.

Methods
A total of 378 patients underwent DECT. The number, size, course and relationships of the renal vessels were retrospectively observed from the scans. Anomalies of renal arteries and veins were recorded and classified. Multiplanar reformations (MPR), maximum intensity projections (MIP), and volume renderings (VR) were used for analysis.

Results
In 378 patients (756 kidneys), renal artery variations were discovered and recorded in 123 kidneys (16.3%, 123/756) of 106 patients (28.0%, 106/378). Type IB (early branches of the only one main renal artery) and IC (accessory renal artery with only one main renal artery) were found most frequently with an incidence of 11.4% (43/378) and 14.5% (55/378). The incidence of renal artery variations in the left kidney was not statistically different than in the right kidney (12.4% vs. 11.1%). The incidence of renal vein variations was detected in 104 patients (27.5%, 104/378). The incidence of venous variants in the right kidney was higher than in the left kidney (20.1% vs. 7.4%), but left renal vein variations were more complex. Variants of the left renal vein were detected in 28 patients including type 1 (circumaortic left renal vein) in eight cases, type 2 (retroaortic left renal vein) in seven cases, type 3 (abnormal reflux) in six cases, type 4 (late venous confluence of left renal vein) in five cases, and type 5 (rare type) in two cases. The frequency of left renal vein variation associated with the left renal accessory artery was significantly higher than with early branches of the left renal artery (P=0.037).

Conclusions
The renal vascular variants are rather common and complex. DECT angiography can demonstrate the precise anatomy of the renal vessels, which is a benefit for renal transplantation or other renal operations
Screening for Parkinson syndrome in a Chinese rural population: re-examination of a historic questionnaire
Authors: LIU Ying , FAN Jin-hu , CHEN Wen , NIE Zhi-yu , QIAO You-lin , ZHANG Lin 
Published: January 2024

Background
Standardized screening tools for Parkinson syndrome have not been developed for non-western populations. This study aimed to validate the Copiah County questionnaire (CCQ) as a screening instrument in a Chinese rural population.

Methods
All participants of a previously reported prevalent study were interviewed using CCQ. The participants who answered yes to at least one item on CCQ were defined as positive. The Parkinson's disease (PD) diagnosis was established using United Kingdom Parkinson's disease Brain Bank Clinical diagnosis criteria (UKPDBBC) and served as a gold standard to determine the sensitivity, specificity, and positive and negative predictive values (PPV, NPV) for the questionnaire.

Results
Among 16 130 participants, 2872 (17.8%) were screened positive for CCQ and 13 258 negative (82.2%). Among the 697 participants diagnosed as having Parkinson syndrome, 605 were positive for CCQ, and 92 were negative, leading to a sensitivity of 86.8%. Out of the 15 433 non-Parkinson syndrome participants, 13 166 were negative to CCQ, giving a specificity of 85.3%. Among the 2872 participants screened positive, 605 were diagnosed with Parkinson syndrome, and their PPV was 21.1%. For the 13 258 participants screened negative on CCQ, 92 were diagnosed with Parkinson syndrome and 13 166 did not have Parkinson syndrome, leading to a NPV of 99.3%.

Conclusions
CCQ appeared to have satisfactory statistical parameters to serve as a screening instrument for Parkinson syndrome in this rural Chinese population. Further studies may prove the utility of this short questionnaire in Parkinson syndrome screening among Chinese populations including those residing in rural areas.
An increased ratio of Th2/Treg cells in patients with moderate to severe asthma
Authors: SHI Yu-heng , SHI Guo-chao , WAN Huan-ying , AI Xiang-yan , ZHU Hai-xing , TANG Wei , MA Jia-yun , JIN Xiao-yan , ZHANG Bo-ying 
Published: January 2024

Background
Recent studies have shown that T helper type-2 (Th2) cells can induce the apoptosis of CD4+CD25+ Treg cells or resist the immunosuppressive effect of Treg cells. We hypothesize that an imbalance of Th2/Treg is present in patients with allergic asthma.

Methods
Twenty-two patients with mild asthma, 17 patients with moderate to severe asthma, and 20 healthy donors were enrolled. All patients were allergic to house dust mites. The proportion of peripheral blood CD4+CD25+ Treg cells and Th2 cells were determined by flow cytometry. The concentration of interleukin (IL)-10, transforming growth factor (TGF)-β and IL-4 in plasma was determined by enzyme linked immunosorbent assay. In these subjects, peripheral blood mononuclear cells from 17 mild asthmatic patients, 13 moderate to severe asthmatic patients and 14 healthy donors were acquired and expression of forkhead box P3 (Foxp3) and GATA-3 mRNA was detected by reverse-transcriptase polymerase chain reaction.

Results
Compared with healthy donors and patients with mild asthma, the percent of CD4+CD25+ Treg cells and plasma IL-10 levels were decreased in patients with moderate to severe asthma. There were no significant differences in Foxp3 mRNA expression among three groups, but a downward trend seen among patients with asthma. However, the percent of Th2 cells, IL-4 levels and expression of GATA-3 mRNA was markedly higher in patients with mild and moderate to severe asthma than in the control group. The ratio of Th2/Treg and their cytokines was increased in allergic asthma, especially for moderate to severe asthma. The ratio of GATA-3/Foxp3 mRNA was also increased in allergic asthma. In patients with moderate to severe asthma, the percentage of peripheral blood Treg cells was negatively correlated to the percentage of Th2 cells and IL-4 levels.

Conclusions
The decline of CD4+CD25+ Treg cells in patients with moderate to severe asthma may play an important role in progress of the disease. Furthermore, the deficiency of CD4+CD25+ Treg cells was associated with the over-expression of Th2 response.
Epidemiology of opportunistic invasive fungal infections in China: review of literature
Authors: LIAO Yong , CHEN Min , Hartmann Thomas , YANG Rong-ya , LIAO Wan-qing 
Published: January 2024

Objective
To summarize the recent findings on the epidemiology of medically important, opportunistic invasive fungal infections (IFIs) in China and discuss the relevant social, economical reasons and medical factors.

Data sources
We performed a comprehensive search of both English and Chinese literatures of opportunistic IFIs from China up to April 2012.

Study selection
Relevant literatures involving researches and cases/case series were identified, retrieved and reviewed.

Results The incidence of opportunistic IFIs in China was steadily increasing. The incidence and mortality of IFIs were different in patients with various underlying conditions/diseases, from 4.12% to 41.18% and 9.8% to 60.0%, respectively. Candida species, Aspergillus species and Cryptococcus neoformans species complex were the most frequent isolated pathogens. Other uncommon opportunistic IFIs were also been reported, including trichosporonosis, mucormycosis, hyalohyphomycosis (hyaline hyphomycetes) and phaeohyphomycosis (dematiaceous hyphomycetes). Reports of Chinese patients differed from those of many other countries as there were a higher number of patients without identifiable underlying diseases/conditions.

Conclusions
Because of the rapid economic development, changing population structure and a growing number of immunocompromised hosts with risk factors, today opportunistic IFIs in China have a significant impact on public health, associated with high morbidity/mortality and higher care costs. Now information related to the epidemiology of opportunistic IFIs in China is still sparse, so we need more organized groups of clinical scientists performing related researches to help the clinicians to obtain more accurate epidemiological characteristics.

Chin Med J 2013;126 (2): 361-368
Assessment of a five-color flow cytometric assay for verifying automated white blood cell differentials
Authors: HUANG Chun-mei , YU Lian-hui , PU Cheng-wei , WANG Xin , WANG Geng , SHEN Li-song , WANG Jian-zhong , CUI Wei 
Published: January 2024

Background
White blood cell (WBC) counts and differentials performed using an automated cell counter typically require manual microscopic review. However, this last step is time consuming and requires experienced personnel. We evaluated the clinical efficiency of using flow cytometry (FCM) employing a six-antibody/five-color reagent for verifying automated WBC differentials.

Methods
A total of 56 apparently healthy samples were assessed using a five-color flow cytometer to verify the normal reference ranges of WBC differentials. WBC differentials of 622 samples were also determined using both a cell counter and FCM. These results were then confirmed using manual microscopic methods.

Results
The probabilities for all of the parameters of WBC differentials exceeded the corresponding normal reference ranges by no more than 7.5%. The resulting WBC differentials were well correlated between FCM and the cell counter (r >0.88, P <0.001), except in the case of basophils. Neutrophils, lymphocytes, and eosinophils were well correlated between FCM and standard microscopic cytology assessment (r >0.80, P <0.001). The sensitivities of FCM for identification of immature granulocytes and blast cells (72.03% and 22.22%, respectively) were higher than those of the cell counter method (44.92% and 11.11%, respectively). The specificities of FCM were all above 85%, substantially better than those of the cell counter method.

Conclusion
These five-color FCM assays could be applied to accurately verify abnormal results of automated assessment of WBC differentials.
Effect of topotecan on retinocytoma cell apoptosis and expression of Livin and PTEN
Authors: ZHANG Meng , SHAN Bao-en , YUAN Nai-fen , LIU Wei 
Published: January 2024

Background
Retinocytoma (RB) is a very common intraocular malignant tumor during infancy. Chemotherapy has gradually been used as the first-line treatment for intraocular RB in recent years. In this study, Livin and PTEN expressions were observed in the RB tissue, along with the growth-inhibiting and apoptosis-induced effects of topotecan (TPT) on RB HXO-Rb44 cell strain. This study aimed to investigate the antigrowth effects of TPT on RB cell strain HXO-Rb44.

Methods
Max-Vision™ rapid immunohistochemistry was adopted to detect Livin and PTEN expressions in the normal retina and in RB, and their relationship with RB clinicopathologic features was analyzed. Human RB cell strain HXO-Rb44 was cultivated and passaged. MTT method was used to measure the survival rates of HXO-Rb44 cell strains under various TPT concentrations. IC50 values were calculated. Flow cytometry was used to detect the effects of various TPT concentrations on HXO-Rb44 cell apoptosis. Western blotting was used to detect the differences of Livin and PTEN protein expressions during cell apoptosis.

Results
The positive expressions of Livin and PTEN in the RB group were obviously different from those in the normal control group. In RB tissue, Livin expression was relevant to PTEN expression. TPT could significantly induce the occurrence of cell apoptosis and had a dependent relationship with drug concentration. Livin and PTEN expression levels varied with the extension of the effect time of TPT based on Western blotting analysis.

Conclusions
Livin and PTEN have high and low expression levels in the RB tissue, respectively. Both of them have key roles in RB occurrence and development. TPT could induce human RB cell strain HXO-Rb44 cell apoptosis, and its mechanism is associated with the inhibition of Livin and PTEN expressions.
Use of real-time polymerase chain reaction for the diagnosis of Pneumocystis pneumonia in immunocompromised patients: a meta-analysis
Authors: Summah Hanssa , Zhu Ying-gang , Falagas Matthew E , Vouloumanou Evridiki K , Qu Jie-ming 
Published: January 2024

Background
The diagnosis of Pneumocystis pneumonia (PCP) in immunocompromised patients is still challenging today due to the absence of an in vitro culture system and the low diagnostic accuracy of microscopic examinations. Herein, we performed a meta-analysis to evaluate the accuracy of real-time polymerase chain reaction (PCR) in the diagnosis of PCP.

Methods
We searched Web of Knowledge and Medline from 1990 to May 2010 for studies reporting diagnostic accuracy data regarding the use of real-time PCR in the diagnosis of PCP in immunocompromised patients.

Results
Ten individual studies were included. Overall, the sensitivity of real-time PCR was 97% (95% CI: 93%-99%); the specificity was 94% (95% CI: 90%-96%). The area under the HSROC curve (95% CI) for real-time PCR was 0.99 (0.97-0.99). In a subgroup analysis regarding studies involving HIV patients among the study population, the sensitivity and specificity were 97% (95% CI: 93%-99%) and 93% (95% CI: 89%-96%), respectively. Regarding studies using Bronchoalveolar lavage (BAL) samples only: sensitivity =98% (95% CI: 94%-99%); specificity =93% (95% CI: 89%-96%), respectively. Regarding studies using microscopy as a reference standard: sensitivity =97% (95% CI: 92%-99%); specificity =93% (95% CI: 88%-96%). However, high between-study statistical heterogeneity was observed in all analyses.

Conclusions
Real-time PCR has a good diagnostic accuracy and may provide a useful adjunctive tool for the diagnosis of PCP in immunocompromised patients. Further studies are needed in order to identify any differences in the diagnostic performance of real-time PCR in HIV and non-HIV immunocompromised patients.
Hypertonic saline resuscitation contributes to early accumulation of circulating myeloid-derived suppressor cells in a rat model of hemorrhagic shock
Authors: LU Yuan-qiang , GU Lin-hui , ZHANG Qin , JIANG Jiu-kun , MOU Han-zhou 
Published: January 2024

Background
Hemorrhagic shock is usually associated with complicated immune and inflammatory responses, which are sometimes crucial for the prognosis. As regulators of the immune and inflammatory system; proliferation, migration, distribution and activation of myeloid-derived suppressor cells (MDSCs) are intimately linked to the inflammation cascade.

Methods
In a model of severe hemorrhagic shock, thirty-five rats were randomly divided into control, sham, normal saline resuscitation (NS), hypertonic saline resuscitation (HTS), and hydroxyethyl starch resuscitation (HES), with seven in each group. MDSCs were analyzed by flow cytometric staining of CD11b/c+Gra+ in peripheral blood mononuclear cells (PBMC), spleen cell suspensions, and bone marrow nucleated cells (BMNC). Simultaneously, the expressions of arginase-1 (ARG-1) and inducible nitric oxide synthase (iNOS) mRNA in MDSCs were evaluated by quantitative reverse transcription-polymerase chain reaction (qRT-PCR).

Results
In the early stage after hemorrhagic shock, fluid resuscitation and emergency treatment, the MDSCs in the PBMC of NS, HTS and HES groups markedly increased, and MDSCs in BMNC of these groups decreased accordingly, significantly different to the control group. In hemorrhagic shock rats infused with HTS at the early resuscitation stage, MDSCs in PBMC increased about 2 and 4 folds, and MDSCs in BMNC decreased about 1.3 and 1.6 folds, as compared to the sham group respectively, with statistically significant difference. Furthermore, compared to the NS and HES groups, the MDSCs in PBMC of HTS group increased 1.6 and 1.8 folds with statistically significant differences; the MDSCs decrease in BMNC was not significant. However, there was no statistically significant difference in MDSCs of spleen among the five groups. In addition, compared to the control, sham, NS and HES groups, the ARG-1 and iNOS mRNA of MDSCs in PBMC, spleen and BMNC in the HTS group had the highest level of expression, but no statistically significant differences were noted.

Conclusions
In this model of rat with severe and controlled hemorrhagic shock, small volume resuscitation with HTS contributes to dramatically early migration and redistribution of MDSCs from bone marrow to peripheral circulation, compared to resuscitation with NS or HES.
Tactics used by HIV-1 to evade host innate, adaptive, and intrinsic immunities
Authors: LU Lu , YU Fei , DU Lan-ying , XU Wei , JIANG Shi-bo 
Published: January 2024

Objective
To review the mechanisms by which HIV evades different components of the host immune system.

Data sources
This review is based on data obtained from published articles from 1991 to 2012. To perform the PubMed literature search, the following key words were input: HIV and immune evasion.

Study selection
Articles containing information related to HIV immune evasion were selected.

Results
Although HIV is able to induce vigorous antiviral immune responses, viral replication cannot be fully controlled, and neither pre-existing infected cells nor latent HIV infection can be completely eradicated. Like many other enveloped viruses, HIV can escape recognition by the innate and adaptive immune systems. Recent findings have demonstrated that HIV can also successfully evade host restriction factors, the components of intrinsic immune system, such as APOBEC3G (apolipoprotein B mRNA-editing enzyme, catalytic polypeptide-like 3G), TRIM5α (tripartite motif 5-α), tetherin, and SAMHD1 (SAM-domain HD-domain containing protein).

Conclusions
HIV immune evasion plays an important role in HIV pathogenesis. Fully understanding the tactics deployed by HIV to evade various components of the host immune systems will allow for the development of novel strategies aimed toward the prevention and cure of HIV/AIDS.
Volumetric magnetic resonance imaging classification for Alzheimer's disease based on kernel density estimation of local features
Authors: YAN Hao , WANG Hu , WANG Yong-hui , ZHANG Yu-mei 
Published: January 2024

Background
The classification of Alzheimer's disease (AD) from magnetic resonance imaging (MRI) has been challenged by lack of effective and reliable biomarkers due to inter-subject variability. This article presents a classification method for AD based on kernel density estimation (KDE) of local features.

Methods
First, a large number of local features were extracted from stable image blobs to represent various anatomical patterns for potential effective biomarkers. Based on distinctive descriptors and locations, the local features were robustly clustered to identify correspondences of the same underlying patterns. Then, the KDE was used to estimate distribution parameters of the correspondences by weighting contributions according to their distances. Thus, biomarkers could be reliably quantified by reducing the effects of further away correspondences which were more likely noises from inter-subject variability. Finally, the Bayes classifier was applied on the distribution parameters for the classification of AD.

Results
Experiments were performed on different divisions of a publicly available database to investigate the accuracy and the effects of age and AD severity. Our method achieved an equal error classification rate of 0.85 for subject aged 60-80 years exhibiting mild AD and outperformed a recent local feature-based work regardless of both effects.

Conclusions
We proposed a volumetric brain MRI classification method for neurodegenerative disease based on statistics of local features using KDE. The method may be potentially useful for the computer-aided diagnosis in clinical settings.