bluuebunny/crossref_metadata_2025_split huggingface dataset:
Systematic review and meta-analysis of the efficacy and safety of adjunctive use of tirofiban in patients treated with endovascular therapy for acute ischemic stroke at different embolic sites
Authors: Liu Chenxi , Yang Xun , Liu Mingsu , Wang Jinping , Li Guangqing 
Published: October 2023

Background:
The use of tirofiban as an adjunct to endovascular therapy (EVT) for acute ischemic stroke has been controversial. We aimed to assess the differences in safety and efficacy of EVT adjuvant to tirofiban in patients with anterior circulation stroke (ACS) and posterior circulation stroke (PCS).

Methods:
We systematically searched Pubmed, Embase, Cochrane Library, and Web of Science. Cohort studies and randomized controlled trials that compared treatment with tirofiban combined with EVT and EVT alone were included in our meta-analysis. The safety outcomes were symptomatic intracranial hemorrhage, and 3-month mortality. The efficacy outcomes were good functional outcome, excellent functional outcome, and successful recanalization (mTICI ≥ 2b). We performed subgroup analyses of anterior and posterior circulation strokes.

Results:
We included 15 studies with 4608 patients. For safety outcomes, tirofiban significantly reduced 3-month mortality in the ACS subgroup (odd ratio [OR] = 0.80, 95% confidence interval [CI] = 0.65–0.98, P = .03) without increasing the rate of symptomatic intracranial hemorrhage (OR = 1.12, 95% CI = 0.88–1.44, P = .35). In the PCS subgroup, tirofiban significantly reduced 3-month mortality (OR = 0.63, 95% CI = 0.50–0.80, P = .0001) and symptomatic intracranial hemorrhage (OR = 0.60, 95% CI = 0.37–0.95, P = .03). For efficacy outcomes, in the ACS subgroup, tirofiban significantly improved good functional outcome (OR = 1.24, 95% CI = 1.06–1.45, P = .008) but did not improve recanalization (OR = 1.17, 95% CI = 0.93–1.47, P = .17) and excellent functional outcome (OR = 1.19, 95% CI = 0.97–1.46, P = .10). In the PCS subgroup, tirofiban significantly improved recanalization rate (OR = 1.94, 95% CI = 1.43–2.65, P < .0001) and did not improve good functional outcome (OR = 1.03, 95% CI = 0.81–1.30, P = .81) and excellent functional outcome (OR = 0.84, 95% CI = 0.58–1.20, P = .34).

Conclusion:
In acute ischemic stroke patients undergoing EVT, tirofiban improves good functional outcomes in ACS patients and increases recanalization rates in PCS patients on the 1 hand, reduces mortality, and does not increase the risk of symptomatic intracranial hemorrhage on the other. Tirofiban is safe and effective in both anterior circulation stroke and posterior circulation stroke patients undergoing EVT. More large multicentre randomized controlled studies are needed in the future.
Identification of key genes associated with poor prognosis and neoplasm staging in gastric cancer
Authors: Wang Shuoshan , Yang Xiansheng , Liu Chang , Hu Jinlun , Yan Mei , Ding Chan , Fu Yue 
Published: October 2023

Background:
Gastric cancer (GC) is highly biologically and genetically heterogeneous disease with poor prognosis. Increasing evidence indicates that biomarkers can serve as prediction and clinical intervention. Therefore, it is vital to identify core molecules and pathways participating in the development of GC.

Methods:
In this study, GSE54129, GSE56807, GSE63089, and GSE118916 were used for identified overlapped 75 DEGs. GO and Kyoto Encyclopedia of Genes and Genomes pathway analysis showed DEGs mainly enriched in biological process about collagen-containing extracellular matrix and collagen metabolic. Next, protein-protein interaction network was built and the hub gene was excavated. Clinicopathological features and prognostic value were also evaluated.

Results:
Hub genes were shown as below, FN1, COL1A2, COL1A1, COL3A1, COL4A1, COL6A3, COL5A2, SPARC, PDGFRB, COL12A1. Those genes were upregulation in GC and related to the poor prognosis (except COL5A2, P = .73). What is more, high expression indicated worse T stage and tumor, node, metastasis stage in GC patients. Later, the results of 25 GC tumor specimens and 34 normal tissues showed that FN1, COL3A1, COL4A1, SPARC, COL5A2, and COL12A1 were significantly upregulated in cancer samples.

Conclusion:
Our study systematically explored the core genes and crucial pathways in GC, providing insights into clinical management and individual treatment.
The metabolic influence of duodenal mucosal resurfacing for nonalcoholic fatty liver disease
Authors: Chuang Te-Jung , Ko Chung-Wang , Shiu Sz-Iuan 
Published: October 2023

Background:
Nonalcoholic fatty liver disease (NAFLD) or nonalcoholic steatohepatitis (NASH) is a leading cause of chronic liver disease worldwide with decreased life expectancy. Duodenal mucosal resurfacing (DMR) has been associated with metabolic improvement in glycemic and hepatic parameters of type 2 diabetes, but the metabolic impact of DMR for NAFLD/NASH remains inconclusive. We conducted a meta-analysis to investigate metabolic effects of DMR in patients with NAFLD/NASH.

Methods:
Three major bibliographic databases were reviewed for enrollment of trials prior to January 28, 2022. We included adults with biopsy-proven NAFLD/NASH or liver magnetic resonance imaging proton density fat fraction (MRI-PDFF) >5% at baseline and focused on the metabolic difference of MRI-PDFF at 12 weeks, and HbA1c or homeostatic model assessment index for insulin resistance (HOMA-IR) at 24 weeks.

Results:
Two studies involved a total of 67 participants for analysis. When compared with pre-intervention status, mean difference of MRI-PDFF, HbA1c, and HOMA-IR after DMR were −2.22 (95% CI: −12.79~8.34), −0.32% (95% CI: −0.80~0.16), and 0.15 (95% CI: −5.11~5.41) without statistical significance.

Conclusions:
For patients with NAFLD/NASH, DMR has the trend to improve liver fat at 12 weeks, and glycemic control in terms of HbA1c level at 24 weeks based on a very low quality of evidence.
Central retina thickness measured with spectral-domain optical coherence tomography in Parkinson disease: A meta-analysis
Authors: Lee Yong Woo , Lim Myung-Nam , Lee Jae Yeon , Yoo Yung-Ju 
Published: October 2023

Background:
Optical coherence tomography (OCT) can detect visual alterations associated with Parkinson disease, such as damage to the retinal nerve fiber layer or changes in retinal vasculature. Macula thinning in association with Parkinson disease (PD) remains controversial. Therefore, we conducted a meta-analysis to investigate the central retina thickness in PD measured using spectral-domain OCT (SD-OCT).

Methods:
We searched PubMed and the Excerpta Medica database to identify studies that compared macular thickness between patients with PD and healthy controls published before July 31, 2021. A random-effects model was used to examine PD-associated changes in macular thickness. Meta-regression analysis was performed by assessing heterogeneity, publication bias, and study quality.

Results:
Thirty-two studies with a cross-sectional design were selected, including 2118 patients with PD and 2338 controls. We identified significant differences in the thickness of the ganglion cell–inner plexiform layer (standardized mean difference [SMD], –0.41; 95% confidence interval [CI], –0.66 to –0.16; I2 = 80%), ganglion cell complex (SMD, –0.33; 95% CI, –0.50 to –0.17; I2 = 0%), and of all inner and outer sectors of the macula (SMD range, –0.21 to –0.56; all P < .05) between patients with PD and controls.

Discussion:
These results corroborate the increased prevalence of changes in OCT measures in individuals with PD, highlighting the efficacy of SD-OCT–determined macular thickness as a biomarker for PD. Our findings may provide helpful guidelines for clinicians in rapidly evolving areas of PD diagnosis.
FZD7: A potential biomarker for endometriosis
Authors: Lan Suwei , Zhang Zhengmao , Li Qing 
Published: October 2023

Background:
Endometriosis is a chronic inflammatory, benign disorder that often co-occurs with adenomyosis and/or leiomyoma. The overall incidence of endometriosis in reproductive period women was nearly 10%. However, the exact mechanisms of endometriosis-associated pathogenesis are still unknown.

Methods:
In this study, we aimed to investigate whether Frizzled-7 (FZD7) would effectively promote the development of endometriosis. The microarray-based data analysis was performed to screen endometriosis-related differentially expressed genes. This process uncovered specific hub genes, and the nexus of vital genes and ferroptosis-related genes were pinpointed. Then, we collected human endometrial and endometriotic tissues from patients with endometriosis of the ovary (n = 39) and control patients without endometriosis (n = 10, who underwent hysterectomy for uterine fibroids) to compare the expression of FZD7.

Results:
These findings indicated that the expression of FZD7 was high compared with normal endometrium, and FZD7 may promote the progression of endometriosis.

Conclusion:
FZD7 may serve as a potential therapeutic target for endometriosis treatment.
Hemosiderin induced acute kidney injury requiring hemodialysis in patients with paroxysmal nocturnal hemoglobinuria: A case report
Authors: Choi Heejung , Yim Hyunee , Lee Min-Jeong 
Published: October 2023

Rationale:
Paroxysmal nocturnal hemoglobinuria (PNH) is a rare hematopoietic stem cell disease with features of hemolytic anemia, thrombosis, and bone marrow failure. Due to intravascular hemolysis and hemoglobinuria, renal dysfunction is often accompanied in PNH patients.

Patient concerns:
A 25-year old woman presenting gross hematuria after coronavirus disease 2019 infection was admitted to our medical center. She had mild nausea and headache. She was diagnosed with iron deficiency anemia few years ago and had no other underlying disease. Her laboratory findings showed acute kidney injury (AKI) and severe anemia, with evidences of hemolysis.

Diagnosis:
Renal biopsy was done to determine the cause of renal failure and the result was acute tubular necrosis with deposition of golden pigments, hemosiderin. With pathologic result and laboratory finding of hemolysis, we did flow cytometry for PNH, and the patient was finally diagnosed with PNH.

Interventions:
With AKI and oliguria, the patient started to take hemodialysis.

Outcomes:
After taking 5 sessions of hemodialysis, the patient’s renal function was recovered from AKI. With diagnosis of PNH, the patient is now being treated with complement C5 inhibitor.

Lessons:
This challenging case tells us that we should consider the first manifestation of PNH as a cause of severe AKI requiring hemodialysis in a patient with anemia and evidence of hemolysis.
Expression and significance of effector proteins NLRP3 and gasdermin D N-terminal protein in the pyrolysis pathway in breast cancer
Authors: Wu Ligao , Wu Xia , Liu Jinjie , Huang Yuanli , Zhu Qing 
Published: October 2023

Objectives:
To detect the expression and significance of GSDMD-N (gasdermin D N-terminal) in breast cancer, along with pyroptosis effector protein NLRP3 (nucleotide-binding oligomerization domain-like receptor protein 3), and determine their relationship with the clinicopathological characteristics of breast cancer.

Methods:
From January 2014 to December 2014, NLRP3 and GSDMD-N expression in 90 breast carcinoma organism samples and 30 paracancer tissues in the Department of Pathology. The First Affiliated Hospital of Bengbu Medical College was assessed using immunohistochemistry. The method of Kaplan–Meier was employed for the sake of comparing the survival between NLRP3 and GSDMD-N protein low and high expression groups. Among the breast cancerous organisms, the relationship between the expression of NLRP3 and GSDMD-N, corresponding adjacent tissues, and various clinicopathological features was analyzed using the χ
2 and Spearman rank correlation tests.

Results:
In the 90 breast cancer tissue samples, the pyrolysis pathway effector proteins GSDMD-N and NLRP3 were actively associated; and, expression intensities of NLRP3 and GSDMD-N were shown to be correlated with breast cancer. In addition, the clinicopathological features of patients were shown to be correlated with breast cancer. Notably, the higher the expressions of NLRP3 and GSDMD-N, the lower the risk of death of patients with breast cancer and the better the prognosis.

Conclusion:
The expression of the pyrolysis effector proteins NLRP3 and GSDMD-N in breast cancer tissues may take the lead in tumor prognosis in patients with breast cancer.
Clinical feature and genetic mutation of KBG syndrome diagnosed in neonatal period: A case report
Authors: Zhang HaoZheng , Guo Xuening , Yang Chun , Zhang Kaihui , Wang Dong , Wang Juan , Liu Yi , Kang Lili , Liu Qinghua , Li Xiaoying 
Published: October 2023

Rationale:
KBG syndrome (KBGS, OMIM: 148050), a rare genetic disorder, is clinically characterized by megalodontia, short stature, skeletal abnormalities, and nervous system manifestations. In the study, we explore the clinical and genetic characteristics of one neonate suffering KBGS caused by ANKRD11 gene mutation.

Patient concerns:
The proband, a female, was born prematurely at 31 + 2 weeks. There were repeated infections and abdominal distension in the first month after birth, and the platelets could not rise to normal. Head ultrasound showed intracranial brain injury and intracranial hemorrhage.

Diagnoses:
Sequencing revealed that there was a heterozygous mutation in exon 9 of the ANKRD11 gene (NM_013275.5) for the child, c.1896_1897delTA (p.H632Qfs*30), which was a de novo mutation and has not been reported. Combining clinical features and genetic results, the proband was diagnosed as KBGS.

Interventions and outcomes:
The brain sonography on day 4 after birth showed brain injury and intracranial hemorrhage. Therefore, 140 mg of bovine lung surfactant was administered through endotracheal intubation in addition to ventilator-assisted ventilation. Antibiotic treatment was also given till the inflammatory indicators of the infant returned to normal levels. The following-up of 1-year-6-month showed that the language, motion and height of development is slight falling behind the children of the same age.

Lessons:
This is the first case of KBGS was diagnosed in the neonatal period, which provides a reference for the child to receive timely and correct treatment.
CDK4/6 inhibitors for hormone receptor-positive/human epidermal growth factor receptor 2 negative advanced breast cancer: A rapid health technology assessment
Authors: Gu Hangye , Chen Yaqing , Xie Zeyu , Chen Yong 
Published: October 2023

Object:
Based on the best available evidence, rapid health technology was used to assess 4 CDK4/6 inhibitors approved for marketing in China. This assessment aims to provide a reference basis for the selection of drugs by medical institutions in China and to promote the rational use of drugs in the clinic.

Methods:
Depending on the Rapid Guidelines for Drug Evaluation and Selection in Chinese Medical Institutions (the Second Edition), a percentage quantitative scoring approach was used to objectively score the pharmacological properties, efficacy, safety, economy, and other attributes of CDK4/6 inhibitors.

Results:
The composite score rankings were, in descending order, 78.09 points for abemaciclib, 78.04 points for palbociclib, 72.15 points for dalpiciclib, and 69.24 points for ribociclib by integrating the result of the 5 dimensions.

Conclusion:
Until the clinical studies, guideline recommendations, prices, and many other aspects of this assessment are updated, abemaciclib and palbociclib, which have the top 2 scores, can be used as a priority recommendation for Chinese medical institutions to select CDK4/6 inhibitors and optimize the use of the drug catalog based on the scoring results of this assessment.
Effect of comprehensive nursing intervention on the outcomes of in vitro fertilization in patients with polycystic ovary syndrome: A randomized controlled study
Authors: Zhang Lin , Yin Cao-Qing , Sun Shi-Jie , Teng Xue-Qin , Li Dong-Yan , Sun Jie , Cui Yuan-Yong 
Published: October 2023

Objective:
To explore the effects of comprehensive nursing intervention on in vitro fertilization (IVF) and pregnancy outcomes in patients with polycystic ovary syndrome (PCOS).

Method:
A total of 130 patients with PCOS admitted to our hospital from April 2021 to March 2023 were selected as the research subjects. They were evenly divided according to a random number table method. The control group received routine care for the patients, while the study group received comprehensive care for the patients. The IVF, pregnancy outcomes, negative emotional changes, serum and follicular fluid (FF) amyloid-related protein and C-reactive protein (CRP) levels of the 2 groups of patients were compared.

Result:
The data on IVF rate and pregnancy rate in the study group were significantly better than those in the control group (P < .05). The SAS and SDS scores of the study group patients after intervention were significantly lower than those of the control group (P < .05). After intervention, the levels of serum and FF amyloid associated protein and CRP in the study group were significantly lower than those in the control group (P < .05).

Conclusion:
Patients with PCOS who receive comprehensive care can increase their probability of IVF, improve their pregnancy outcomes, and have a positive significance in reducing negative emotions.
Integrating psychosocial and behavioral interventions into type 1 diabetes care
Authors: Pyatak Elizabeth A. , Khurana Anya R. 
Published: October 2023

Purpose of review
To identify recent literature evaluating the efficacy of psychosocial and behavioral interventions for people with type 1 diabetes (T1D).

Recent findings
Interventions generally produce benefits for psychosocial and behavioral outcomes, and some also positively impact glycemia. Addressing psychosocial concerns during routine provider visits had mixed results; some studies found that structured tools improved well being, while others found they could derail conversations, or contribute to worsening glycemia due to a lack of time to review medical concerns. Integrating behavioral health providers in routine care, however, had a positive impact on glycemic outcomes. Stepped care interventions show promise for both children and adults, as they maximize available resources while contributing to improved well being. Group interventions, delivered either virtually or in-person, demonstrated benefits for diabetes distress, depressive symptoms, family conflict, and health behaviors, but had limited impact on positive parenting skills. Gaps in the current literature include limited research among adults and no research among older adults, as well as a lack of pragmatic research emphasizing implementation of effective interventions.

Summary
A wide range of interventions have demonstrated positive impacts on well being among people with T1D; more research is needed to identify strategies to routinely integrate psychosocial and behavioral support in clinical care.
Circulating cell-free DNA and its association with cardiovascular disease: what we know and future perspectives
Authors: Thorsen Steffen Ullitz , Moseholm Kristine Frøsig , Clausen Frederik Banch 
Published: October 2023

Purpose of review
The aim of this review is to explore a possible link between cell-free DNA (cfDNA) and cardiovascular disease (CVD), which may hold valuable potential for future diagnostics.

Recent findings
cfDNA has become topic of high interest across several medical fields. cfDNA is used as a diagnostic biomarker in cancer, prenatal care, and transplantation. In addition, cfDNA may play an unrecognized role in biological processes that are involved in or underlying various disease states, for example, inflammation. Elevated levels of cfDNA are associated with various elements of CVD, cardio-metabolic risk factors, and autoimmune diseases. Mitochondrial cfDNA and neutrophil extracellular traps may play distinct roles. Total circulating cfDNA may reflect the unspecific accumulation of stressors and the organism's susceptibility and resilience to such stressors. As such, cfDNA, in a stressful situation, may provide predictive value for future development of CVD. We suggest exploring such possibility through a large-scale prospective cohort study of pregnant women.

Summary
There is no doubt that cfDNA is a valuable biomarker. For CVD, its potential is indicated but less explored. New studies may identify cfDNA as a valuable circulating cardiovascular risk marker to help improve risk stratification.
Extraosseous Uptake and Multiple Metastases of Splenic Composite Hemangioendothelioma on 99mTc-MDP Scintigraphy
Authors: Huang Wenpeng , Zhou Yuhan , Yang Qi , Li Liming , Kang Lei 
Published: October 2023

Abstract
Composite hemangioendothelioma is a rare disease that exhibits biological potency ranging from benign to low-grade malignancy, and hepatic and bone metastases are even rarer. Here, we present the imaging findings of a 65-year-old man with splenic composite hemangioendothelioma and multiple metastases. A bone scan revealed abnormal uptake of 99mTc-MDP in multiple bones and spleen, whereas enhanced CT demonstrated splenic lesions with low density and mild enhancement. Based on pathological examination, the patient was diagnosed with splenic composite hemangioendothelioma with bone metastasis.
Uptake of 68Ga-PSMA in Avascular Necrosis of the Femoral Head in a Patient With Prostate Cancer
Authors: Okudan Berna , Seven Bedri , Sayan Haluk 
Published: October 2023

Abstract
A 69-year-old man with prostate cancer treated with radical prostatectomy underwent 68Ga-PSMA PET/CT due to biochemical recurrence. Increased radiotracer uptake in the prostate bed suggestive of local recurrence was detected. The right hip also displayed increased 68Ga-PSMA activity, which was consistent with the avascular necrosis findings on MRI.
Discordant Uptake of Leg Thrombi Versus Pulmonary Emboli on 68Ga-FAPI-46 PET/CT
Authors: Cho Sang-Geon , Park Chan , Kim Jahae , Kim Kang Bin , Kim Hyung Yoon 
Published: October 2023

Abstract
Fibroblast activation protein inhibitor (FAPI) PET is gaining clinical relevance for visualizing activated fibroblasts in various diseases. Here, we report discordant FAPI uptake between venous thrombi of the lower extremities and pulmonary emboli. An 86-year-old man complained of left leg swelling and acute dyspnea; he was diagnosed with deep vein thrombosis involving the left femoral vein and acute pulmonary thromboembolism. Positive FAPI uptake was observed only in the thrombi of the left femoral vein, but not in the pulmonary emboli. Such discrepancies may indicate different thrombus constituents and chronologies even in the same patient.
Comparison of 18F-FDG and 68Ga-FAPI PET/CT in a Patient With Hepatic Perivascular Epithelioid Cell Neoplasm
Authors: Li Zhuoyuan , Su Dan , Zhou Sihui , Wang Yudi , Chen Yue 
Published: October 2023

Abstract
The prevalence of hepatic perivascular epithelioid cell neoplasm (PEComa) is extremely low, and imaging diagnosis is very difficult. We presented 18F-FDG and 68Ga-FAPI PET/CT findings in a 58-year-old woman with pathologically confirmed hepatic PEComa. The tumor showed intense 68Ga-FAPI uptake but only mild 18F-FDG activity on PET/CT studies. This case suggested that 68Ga-FAPI PET/CT might be a useful tool for evaluation of hepatic PEComa with remarkable tumor-to-liver ratios.