bluuebunny/crossref_metadata_2025_split huggingface dataset:
Postoperative dystocia of the gastric bursa after LRYGB: A case report
Authors: Yu Hang , Kang Xing , Sun Xitai 
Published: February 2024

Rationale:
Laparoscopic Roux-en-Y gastric diversion is one of the most widely used surgical procedures for weight reduction and metabolic surgery, which is a hybrid approach to restrict intake and reduce absorption. Despite the successful completion of laparoscopic Roux-en-Y gastric diversion, 10% to 20% of patients still experience regained body mass or other complications.

Patient concerns:
The patient had regained weight after all the RYGB surgeries, and after diet and exercise control, the results were not good, so she came to our department for treatment.

Diagnoses:
Dilatation of the gastric pouch was observed on iodinated water imaging of the upper gastrointestinal tract and on abdominal CT.

Interventions:
We report 2 patients with dilated gastric bursa after RYGB, both female, who underwent gastric diversion revision.

Outcomes:
Both patients in this case underwent laparoscopic gastric diversion correction to improve weight rebound. Their quality of life improved significantly after treatment. There were no grade 3/4 treatment-related adverse events during the treatment period.

Lessons:
The above cases suggest that patients who regain weight after RYGB should routinely undergo preoperative upper gastrointestinal endoscopy and upper gastrointestinal iodine hydrography in order to observe the muscle tone of the patient’s gastric bursa and the degree of dilatation of the gastrointestinal anastomosis and consider whether to correct the dilated gastric bursa intraoperatively before converting to LSG.
Case report: Streptomycin combined with dacronin in painless magnifying endoscopy
Authors: Zhou Zheng 
Published: February 2024

Rationale:
To analyze the effect of streptomyces protease combined with dyclonine in painless magnifying endoscopy.

Patient concerns:
A total of 100 patients who underwent magnification endoscopy in our hospital from January 2021 to June 2022 were retrospectively analyzed.

Diagnoses:
The diagnoses were made by painless magnifying endoscopy and narrow-band imaging combined with pathological findings.

Interventions:
The patients were divided into the observation group and control group, the observation group was streptomyces protease combined with dyclonine group, and the control group was dyclonine group, 50 cases in each group. The visibility score under gastroscopy was compared between the 2 groups, and the morphological classification of gastric pit and collecting veins was observed. The detection rates of small lesions and early cancer were compared between the 2 groups. The examination time and adverse reactions were compared between the 2 groups.

Outcomes:
Compared with the control group, the streptomyces protease combined with dyclonine group had better clear visibility and a higher detection rate of small lesions, but there was no significant difference in early cancer detection rate between the 2 groups. The examination time of streptomyces protease combined with dyclonine group was relatively prolonged, but there was no significant difference in the incidence of adverse reactions between the 2 groups.

Lessons:
Streptomyces protease combined with dyclonine plays a certain role in painless magnifying gastroscopy, which can improve the visibility of gastroscopy, improve the detection rate of small lesions, help to find gastric dysplasia and early gastric cancer diagnosis, and does not increase the incidence of adverse reactions.
Efficacy and safety of compound glycyrrhizin in combination with conventional therapy in treatment of vitiligo: A systematic review and meta-analysis of randomized controlled trials
Authors: Jian Yang , Wang Xiaoyu , Li Yunming , Fu Dali , Gong Yalin , Shi Huiqing 
Published: February 2024

Background:
Vitiligo is an acquired chronic depigmentary disorder affecting approximately 0.5% to 1% of individuals worldwide. The compound glycyrrhizin (CG), a complementary medicine, has been reported for treatment of vitiligo, but the evidence has not been systematically evaluated. We systematically assessed the efficacy and safety of CG in combination with conventional therapy for the treatment of vitiligo.

Methods:
We searched Embase, Web of Science, PubMed, The Cochrane Library, Chinese BioMedical Literature Database (CBM), Wanfang Data, China National Knowledge Infrastructure (CNKI), and VIP information from inception to July 2022. Randomized controlled trials comparing CG combined with conventional therapy with conventional therapy alone for vitiligo were included in our analysis. The primary outcome was treatment response, which defined as >50% repigmentation rate of vitiligo after treatment. The secondary outcome was incidence of adverse events. Meta-analysis was performed using the Review Manager 5.4 software. Statistical heterogeneity was evaluated with chi-square and I
2 statistics, dichotomous data were expressed as risk ratios (RR) with 95% confidence intervals using the Mantel–Haenszal method.

Results:
Thirty-nine studies enrolling with 3994 participants were subjected to this review. The results of our meta-analysis indicated that addition of CG had superior effectiveness on repigmentation rate than phototherapy (RR = 1.28; P < .001), immunosuppressant (RR = 1.76; P < .001), traditional Chinese medicine (RR = 1.38; P < .001), combination of phototherapy and immunosuppressant (RR = 1.42; P < .001), and combination of phototherapy and traditional Chinese medicine (RR = 1.37; P < .001). In addition, CG did not increase the incidence of adverse events for vitiligo (RR = 0.79; P = .05).

Conclusions:
CG as a complementary medicine has a potential benefit in treatment of vitiligo. However, since the methodological flaws in the studies we included, more high-quality randomized controlled trials are warranted.
Comprehensive review of ST-segment elevation myocardial infarction: Understanding pathophysiology, diagnostic strategies, and current treatment approaches
Authors: Elendu Chukwuka , Amaechi Dependable C. , Elendu Tochi C. , Omeludike Eunice K. , Alakwe-Ojimba Chisom E. , Obidigbo Babajide , Akpovona Otite L. , Oros Sucari Yuliana Paola , Saggi Sehajmeet Kaur , Dang Kanishk , Chinedu Chinedu P. 
Published: February 2024

ST-Segment Elevation Myocardial Infarction (STEMI) is a life-threatening medical emergency characterized by complete coronary artery occlusion, leading to myocardial ischemia and subsequent necrosis. Over the years, STEMI has remained a significant cause of morbidity and mortality worldwide, necessitating a comprehensive understanding of its pathophysiology, accurate diagnostic strategies, and effective treatment approaches.
This review article aims to thoroughly analyze the current knowledge surrounding STEMI, emphasizing key aspects crucial for optimizing patient outcomes. Firstly, the pathophysiology of STEMI will be explored, elucidating the sequence of events from coronary artery plaque rupture to thrombus formation and occlusion. This section will also cover the underlying risk factors contributing to STEMI development, including atherosclerosis, hypertension, and diabetes.
Secondly, the diagnostic modalities for STEMI will be critically evaluated. Traditional electrocardiography remains the cornerstone of STEMI diagnosis. Still, advancements in imaging techniques such as cardiac magnetic resonance imaging and coronary angiography have enhanced accuracy and allow for better risk stratification.
Furthermore, the review will delve into the latest treatment approaches for STEMI. Prompt reperfusion therapy through primary percutaneous coronary intervention or thrombolytic therapy is essential in restoring blood flow and salvaging the jeopardized myocardium. The role of adjunctive medical treatment, including antiplatelet agents, beta-blockers, and statins, will also be discussed in post-STEMI management.
Clinical application value of hepatitis B virus basal core promoter 1762/1764 and GGTII and GGT in patients with HBV-DNA-positive primary liver cancer
Authors: Qiu Shunhua , Jin Lifen , Yang Dan , Zhang Dewen 
Published: February 2024

Background:
Hepatitis B virus (HBV) is closely related to the occurrence and development of primary liver cancer (PLC). The early diagnosis of PLC is difficult. The study explored the clinical application value of the HBV gene basal core promoter (BCP) region 1762/1764 combined with gamma-glutamyl transpeptidase (GGT) and its isozyme II (GGTII) in PLC.

Methods:
From June 2017 to June 2021, 145 hepatitis B surface antigen-positive and HBV DNA-positive patients were enrolled in the Third People Hospital of Zigong. Of them, 67 were chronic hepatitis B (CHB) patients, 30 were liver cirrhosis patients, and 48 were patients with hepatitis B-associated PLC. The HBV BCP 1762/1764 mutation was detected through the amplification refractory mutation system fluorescence PCR method, and GGTII was detected using the double-antibody sandwich method.

Results:
The results showed that the serum GGT activity, GGTII level, aspartate aminotransferase (AST) activity, AST/alanine aminotransferase (ALT) ratio, GGT/ALT ratio, and GGT/AST ratio were significantly different between the PLC and CHB groups. Statistically significant differences in serum GGT activity, AST activity, and GGT/ALT ratio were observed between the PLC and LC groups. The BCP 1762/1764 mutation rate between the PLC and CHB groups was statistically significant. The GGTII level in the early PLC (stage I + II) group and the advanced PLC (stage III + IV) group was higher than that in the N-PLC group. Serum GGT activity in the early PLC and advanced PLC groups was higher than that in the N-PLC group. The area under the curve of the receiver operator characteristic curve of GGT and GGTII for diagnosing PLC was 0.775 (95% confidence interval [CI] [0.697, 0.854]) and 0.608 (95% CI [0.512, 0.704]), respectively. The area under curve of GGT and GGTII for diagnosing early PLC was 0.732 (95% CI [0.620, 0.845]) and 0.579 (95% CI [0.452, 0.706]), respectively.

Conclusion:
HBV gene BCP 1762/1764 mutation, GGT, and GGTII may be related to PLC occurrence. The HBV gene BCP region 1762/1764 combined with GGT has certain clinical diagnostic values for PLC and early PLC. However, GGTII is not a good indicator of early PLC and is more relevant to advanced PLC.
A primary pediatric acute myelomonocytic leukemia with t(3;21)(q26;q22): A case report
Authors: Duan Jia-xin , Liu Fang , Chang Li , Che Guang-lu , Yang Qiu-xia , Teng Jie , Jian Hui , Liu Xiao-juan , Lai Shu-yu 
Published: February 2024

Rationale:
The rare t(3;21)(q26;q22) translocation results in gene fusion and generates multiple fusion transcripts, which are typically associated with therapy-related myelodysplastic syndrome, acute myeloid leukemia, and chronic myelogenous leukemia. Here, we report a rare case of de novo acute myelomonocytic leukemia in a young child with t(3;21)(q26;q22).

Patient concerns:
A 2-and-a-half-year-old female patient presented with abdominal pain, cough, paleness, and fever for 3 weeks, without any history of malignant diseases.

Diagnoses:
Chest computed tomography revealed pneumonia. Bone marrow smear confirmed acute myelomonocytic leukemia. Cytogenetic analysis and Sanger sequencing identified RUNX1-MECOM and RUNX1-RPL22 fusion genes as a result of t(3;21)(q26;q22).

Interventions:
The patient received 3 courses of chemotherapy, but bone marrow smear examination showed no remission. According to the wishes of the patient family, the allogeneic hematopoietic stem cell transplantation (Allo-HSCT) was chosen.

Outcomes:
The patient did not experience any adverse reactions after Allo-HSCT. The red blood cells and platelets increased without transfusion. The pneumonia recovered after antibiotic treatment.

Lessons:
The patient recovered well after Allo-HSCT. Therefore, for patients with RUNX1-MECOM and RUNX1-RPL22 fusion genes, transplantation may be a good choice when chemotherapy is not effective.
Effect of 25 hydroxyvitamin D on attention deficit and hyperactivity in school-age children with ADHD
Authors: Yang Juan , Yuan Huozhong , Qiu Ruijuan , Fu Xiaoqin 
Published: February 2024

Background:
To observe the serum levels of 25 hydroxyvitamin D [25 (OH) D] in healthy school-age children and children with attention deficit hyperactivity disorder (ADHD) and to analyze the effects of serum 25 (OH) D on the symptoms of attention deficit and hyperactivity in school-age children with ADHD.

Methods:
According to the Diagnostic and Statistical Manual of Mental Disorders DSM-IV diagnostic criteria for ADHD in children, 80 healthy children aged 6 years or less than 10 years old and children diagnosed with ADHD in the Department of Rehabilitation Medicine, Department of Pediatrics and Department of Physical Examination of our hospital were randomly selected as research subjects. The serum 25 (OH) D level, attention deficit hyperactivity (Swanson, Nolan, and Pelham, version IV [SNAP-IV] parental version) score and Conners child behavior (PSQ) index were observed and compared between the 2 groups. In addition, the children with ADHD whose serum 25 (OH) D was lower than normal were treated with supplemental VitD3, and the changes in serum 25 (OH) D, SNAP-IV parental score and PSQ index of ADHD children were observed and compared.

Results:
Serum 25(OH)D was insufficient or deficient in 26 healthy children, but the SNAP-IV score and PSQ index were normal. Serum 25(OH)D was lower than normal in 69 patients in the ADHD group, which was negatively correlated with SNAP-IV score (r = −0.3479, P = .0034) and negatively correlated with PSQ index (r = −0.3566, P = .0026). After vitamin D3 (VitD3) supplementation in 69 children with serum 25(OH)D levels lower than the normal ADHD group, it was found that the SNAP-IV score (r = −0.4654, P = .0037) and PSQ index (r = −0.5680, P = .0002) of 34 children with ADHD were negatively correlated with the increase in serum 25(OH)D. The SNAP-IV score and PSQ index of the other 35 children with ADHD showed no correlation with the increase in serum 25 (OH) D (P > .05).

Conclusion subsections:
Serum 25(OH)D levels lower than normal are more common in school-age children, and levels lower than normal are not the key pathogenic factor of ADHD in school-age children, but serum 25(OH)D levels lower than normal may be the upregulation factor of attention deficit and hyperactivity disorder expression in some school-age children with ADHD. The lower level of serum 25(OH)D may be closely related to the severity of ADHD symptoms in some children.
A case report of anterior mediastinal angiomyolipoma that invaded the left thoracic cavity
Authors: Bai Dong , Liang Yuanzi , Liu Wenting , Liu Yanhan , Wang Zhiqun 
Published: February 2024

Rationale:
Angiomyolipoma is a mesenchymal tumor composed of blood vessels, smooth muscle, and mature adipose tissue. It is most commonly found in the kidney, and is rare outside the kidney, especially in the mediastinum. Only about 12 cases have been reported worldwide so far.

Patient concerns:
We report a young female patient who had been found with a left thoracic mass for 19 years. In the past 19 years, the patient had no chest pain, dyspnea and other symptoms, but this time she visited the doctor because of cough, and there were no other clinical signs.

Diagnoses:
The patient underwent computed tomography plain scan and enhanced scan after admission with imaging manifestations of a mixed density mass in the left chest cavity, calcification and fat density in the inside, and tortuous blood vessels after enhancement. Combined with imaging, the diagnosis was teratoma, not excluding hamartoma.

Interventions:
The patient underwent a central open thoracic giant mass resection.

Outcomes:
The postoperative pathology confirmed that it was angiomyolipoma originating from anterior mediastinum invasion of the left chest cavity, and no clear recurrence was seen after 1 year of postoperative follow-up.

Lessons:
Angiomyolipomas in the mediastinum are rare, especially those that invade the thorax. This article describes the clinical, imaging and pathological features of the patient in detail, which improves the understanding of the disease of clinical and imaging doctors, and provides a basis for the differential diagnosis of mediastinal lesions.
Application on perioperative ERAS concept in elderly lung cancer patients undergoing surgery
Authors: Zhang Ming , Cai Ping 
Published: February 2024

Investigating the applying effects of the enhanced recovery after surgery (ERAS) in the perioperative period of elderly lung cancer patients undergoing the surgery. We randomly selected 98 elderly patients with lung cancer who were admitted to our hospital and underwent surgery from January 2022 to September 2023 as study subjects. The control group received conventional care during the perioperative period, and the intervention group received ERAS-guided care measures. The differences in perioperative-related indices, pulmonary function, pain level, inflammatory factors, and postoperative complication rates between these 2 groups were compared. The postoperative extubation time, the activity time since getting out of bad and hospital stay were lower in the observation group than those in the control group (P
< .05). At 3 days postoperatively, the FEV1, forced vital capacity and maximum ventilation volume of these 2 groups were lower than those of their same groups before surgery, and those of the observation group were higher than those of the control group (P
< .05). At 3 days postoperatively, the numerical rating scale in both groups were lower than those of their same groups at 6 hours postoperatively, and the numerical rating scale of the observation group was lower than that of the control group (P
< .05). At 3 days postoperatively, tumor necrosis factor-α, IL-6, and CRP in both groups were higher than those in their same groups before surgery, and those of the observation group was lower than those of the control group (P
< .05). The incidence of postoperative complications in the observation group was lower than that in the control group (P
< .05). ERAS applied in the perioperative period of elderly lung cancer patients undergoing surgery can shorten the hospital stay, promote the postoperative recovery on pulmonary function, alleviate inflammation, and reduce the risk of postoperative complications.
A systemic lupus erythematosus patient with persistent elevated conjugated bilirubin as the initial symptom: A case report
Authors: Liu Jun , Shen Tingting , Li Long , Li Xingyi , Zhao Fang , Liu Xiaoxia , Zhang Shan , Wu Pengjia , Li Na , Zeng Jiashun 
Published: February 2024

Rationale:
While some systemic lupus erythematosus (SLE) patients may experience varying degrees of liver function abnormalities, only a small portion of these cases have clinical significance, and the majority of patients typically exhibit low levels of serum bilirubin. However, in this article, we present a case of a middle-aged female patient with SLE who exhibited persistent skin jaundice as her initial symptom, offering a fresh perspective on diagnosing and treating patients who exhibit unexplained liver dysfunction and SLE combined with liver injury.

Patient concerns:
A 45-year-old woman was initially admitted to the hospital due to yellowing of the skin and sclera, and her symptoms did not improve significantly during treatment. The results were abnormal after relevant immunological tests.

Diagnoses:
Persistent non-conjugated bilirubin elevation due to lupus hepatitis.

Interventions:
The use of methylprednisolone sodium succinate (40 mg/Qd) and mycophenolate mofetil (0.75 g/d) suppressed immunity, polyolefin choline (20 mL/d) and glutathione (0.6 g/Qd) improved liver function, and nutritional support therapy.

Outcomes:
After 2 weeks of treatment, a significant decrease in the yellow skin and sclera of the patient was observed.

Lessons:
Most clinicians overlook that liver function abnormalities are the main manifestation of SLE, resulting in many patients not receiving timely treatment. This study highlights the importance that SLE is also a cause of abnormal liver function.
Successful endotracheal intervention for primary tracheal acinic cell carcinoma: A case report and literature review
Authors: Huang Shuhui , Peng Xinru , Li Hailong , Zhao Jiale , Hou Jia 
Published: February 2024

Introduction:
Primary tracheal acinic cell carcinoma (ACC) is an exceptionally rare malignancy, posing challenges in understanding its clinical behavior and optimal management. Surgical resection has traditionally been the primary treatment modality, but we present a compelling case of tracheal ACC managed with endotracheal intervention, challenging conventional approaches.

Patient Concerns:
A 53-year-old woman presented with shortness of breath, cough, and hemoptysis. Enhanced computed tomography revealed an obstructive tracheal lesion, leading to her referral for further assessment.

Diagnosis:
Microscopic evaluation, immunohistochemistry, and clinical assessments confirmed primary tracheal ACC, an exceedingly rare condition with limited clinical insights.

Interventions:
We utilized rigid bronchoscopy to perform endotracheal intervention, successfully resecting the tumor and restoring tracheal patency. Postoperatively, the patient received no radiotherapy or chemotherapy.

Outcomes:
The patient achieved complete recovery, with 24-month follow-up examinations indicating no recurrence or metastatic disease. Only minimal scar tissue remained at the resection site.

Conclusion:
This case demonstrates the potential of endotracheal intervention as a curative approach for primary tracheal ACC, minimizing invasiveness and preserving tracheal function. Collaborative research efforts and extensive case reporting are crucial for advancing our understanding of this rare malignancy and optimizing treatment strategies for improved patient outcomes.
Invasive cellular blue nevus in the cervical spine: A case report
Authors: Rao Xianfeng , Kang Zhengwen , Chen Jianwei , Wang Tong , Ma Mengyao , Yang Shuwen , Wu Zetao , Wang Bo , Zhang Qiusheng 
Published: February 2024

Introduction:
Cellular blue nevus is an uncommon neoplasm in the spine.

Patient concerns:
Here, we present a case of a 24 years old male with a 2 months history of numbness in the right upper limb and shoulder.

Diagnosis:
Cervical spine and subcutaneous tissue invasive cellular blue nevus.

Interventions:
The patient underwent C4 laminectomy and partial C3 and C5 laminectomy for total resection of the lesion. Histopathology revealed a nodular tumor with unclear boundaries, which was composed of heavily pigmented dendritic cells and more pigmented spindle cells.

Outcomes:
There was no recurrence during 3 years follow-up.

Conclusion:
Invasive cellular blue nevus of the spine can be wrongly diagnosed as spinal meningeal melanocytoma and meningeal melanoma due to its special cell behavior and rarity. Therefore, it is important to understand its pathological and clinical characteristics to avoid over-treatment.