bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of the flaps made by femtosecond laser and automated keratomes for sub-bowman keratomileusis
Authors: ZHAI Chang-bin , TIAN Lei , ZHOU Yue-hua , ZHANG Qing-wei , ZHANG Jing 
Published: January 2024

BackgroundThin-flap laserin situkeratomileusis (LASIK) is the new trend of refractive error correction surgery, the formation of corneal flap is crucial for a success of LASIK surgery. This study aimed to assess and compare the variations of LASIK flap created by the IntraLase femtosecond laser, Moria One Use-Plus SBK and Moria M2 Single-Use 90 μm-head microkeratome using Anterior segment optical coherence tomography (Visante OCT).MethodsOne hundred and sixty-one eyes of 81 consecutive patients were enrolled in this prospective study and randomly divided into three groups depending on the flap creation method: flap creation with the the IntraLase femtosecond laser (IntraLase group, 59 eyes), flap creation with the Moria One Use-Plus SBK (SBK group, 44 eyes), and flap creation with the Moria M2 Single-Use 90 μm-head microkeratome (M2SU90 group, 58 eyes). The nominal flap thickness was 110 μm for all patients and for the three devices. One month after surgery, Visante OCT was used to measure the flap thickness at 20 locations on each cornea and the results were assessed for uniformity, regularity, and accuracy.ResultsAt 1 month after surgery, the mean central flap thickness was (111±3) μm in the IntraLase group, (114±8) μm in the SBK group, and (118±13) μm in the M2SU90 group respectively. The flaps in the IntraLase group and the SBK group were more regular, showing an almost planar configuration, than the meniscus-shaped flaps in the M2SU90 group. The maximum deviation from the intended flap thickness (110 μm) was 6 μm in the IntraLase group, 10 μm in the SBK group, and 20 μm in the M2SU90 group respectively. A difference greater than 20 μm was observed in 0.42% of measurements in the IntraLase group; 2.95% of the measurements in the SBK group and 21.12% of measurements in the M2SU90 group.ConclusionsThe flaps created by the IntraLase femtosecond laser and Moria One Use-Plus SBK are more uniform; more regular, and more accurate than those created by the Moria M2 Single-Use 90 μm-head microkeratome. The first two methods can make precise flaps for Sub-Bowman Keratomileusis.
Clinical features of retinal diseases masquerading as retrobulbar optic neuritis
Authors: JIANG Li-bin , SHEN Ce-ying , CHEN Fei , YAN Wei-yu , LAI Timothy Y. Y. , WANG Ning-li 
Published: January 2024

Background
Managements of optic neuritis (ON) included high-dose corticosteroids or combined with systemic immunomodulatory agents. It was important to make a correct diagnosis of ON before initiation of treatment. The purpose of the study was to report and analyze the clinical features of retinal diseases in patients who were misdiagnosed as having retrobulbar ON.

Methods
Retrospective review of 26 patients (38 eyes) initially diagnosed with retrobulbar ON but were ultimately diagnosed with retinal or macular diseases. Data obtained from fundus examination, fluorescence fundus angiography (FFA), automated static perimetry, full-field electroretinogram (ffERG), multifocal electroretinogram (mfERG), and optical coherence tomography (OCT) were evaluated.

Results
Thirty-eight eyes of 26 patients were found to have misdiagnosis of retrobulbar ON, based on normal or slight abnormal fundus findings and abnormal visual evoked potentials (VEP). The mean age of the patients was 34 years and the correct diagnosis of the patients included acute zonal occult outer retinopathy (AZOOR, 15 eyes, 14 patients), occult macular dystrophy (OMD, 8 eyes, 4 patients), cone or cone-rod dystrophy (10 eyes, 5 patients), acute macular neuroretinopathy (AMNR, 3 eyes, 2 patients), and cancer-associated retinopathy (CAR, 2 eyes, 1 patient).

Conclusion
When attempting to diagnose retrobulbar ON in clinical practice, it is crucial to carry out necessary examinations of the retinal function and morphology to decrease misdiagnosis.
Recombinant human thrombopoietin in combination with cyclosporin A as a novel therapy in corticosteroid-resistant primary immune thrombocytopenia
Authors: CUI Zhong-guang , LIU Xin-guang , QIN Ping , HOU Ming , WU Shao-ling , PENG Jun , ZHAO Hong-guo , WANG Hong-yi , ZHAO Chun-ting 
Published: January 2024

Background
The management of patients with refractory immune thrombocytopenia (ITP) is challenging, as there is no standard treatment option. The aim of this study was to investigate the efficacy of recombinant human thrombopoietin (rhTPO) in combination with cyclosporin A (CsA) for the management of patients with corticosteroid-resistant primary ITP. Methods Thirty-six patients with corticosteroid-resistant ITP were randomly divided into an observation group and control group. In the observation group, 19 patients received subcutaneous injection of rhTPO at a dose of 1 μg/kg (300 U/kg) once daily up to day 14. Simultaneously they also received oral CsA at a dose of 1.5-2.0 mg/kg twice daily for three months. In the control group, rhTPO alone was administered subcutaneously at 1 μg/kg once daily in the other 17 ITP patients for 14 consecutive days and then the treatment was withdrawn.

Results
There was no significant difference in the response rate at the end of the first week after treatment initiation between the observation group and the control group (63.2% vs. 58.8%, P >0.05), neither was there at the end of the second week (89.5% vs. 94.1%, P >0.05). However, the relapse rate in the observation group was significantly lower than that in control group at the end of the first (17.7% vs. 50.0%, P <0.05), second (29.4% vs. 68.8%, P <0.05) and the third month (29.4% vs. 87.5%, P <0.01). In addition, rhTPO plus CsA were well tolerated and adverse events recorded were mild.

Conclusions
Combination therapy with rhTPO and CsA was effective in the management of patients with corticosteroid-resistant ITP, with a relatively short time to response and low recurrence rate. It might be considered as a potential second-line treatment regimen for ITP.
Efficacy and safety of insulin treatment in type 2 diabetes using a new index called glucose safety control index
Authors: CAI Xiao-ling , LUO Ying-ying , HAN Xue-yao , JI Li-nong 
Published: January 2024

Objective
To recommend an index named glucose safety control index (GSCI) to evaluate the efficacy and safety for insulin regimens.

Data sources
We searched databases for primary studies published in English. The main search concepts were type 2 diabetes, insulin treatment, premixed insulin, premixed insulin analogs, basal inuslin, basal inuslin analogs, bolus insulin, bolus insulin analogs, safety and efficacy.

Study selection
Studies were eligible for inclusion if they met all of the following criteria: (1) type 2 diabetic patients aged >18 years were included; (2) random control studies with at least 12 weeks of follow-up; (3) different insulin regimens were evaluated.

Results
When long-acting basal insulin therapy compared with neutral protamine Hagedorn (NPH) insulin therapy, the proportion of GSCI%A1c ratio more than 1 was 100%, the proportion of GSCIΔA1c ratio more than 1 was 94.44%. When premixed insulin therapy compared with oral hypoglycemic agents plus basal insulin therapy, the proportion of GSCI%A1c ratio more than 1 was 45.5%, the proportion of GSCIΔA1c ratio more than 1 was 38.9%. When premixed insulin therapy compared with oral hypoglycemic agents, the proportion of GSCI%A1c ratio less than 1 was 100%, the proportion of GSCIΔA1c ratio more than 1 was 50%. When premixed insulin therapy compared with basal-bolus insulin therapy, the proportion of GSCI%A1c ratio more than 1 was 37.5%, the proportion of GSCIΔA1c ratio more than 1 was 50%.

Conclusion
According to the GSCI ratio, long-acting basal insulin therapy tended to be superior to NPH therapy, oral hypoglycemic agents plus basal insulin therapy tended to be superior to premixed insulin therapy, noninsulin antidiabetic agents and premixed insulin therapy was comparable, and basal-bolus insulin therapy tended to be superior to premixed insulin therapy in type 2 diabetes.
Clinical outcome of ileal pouch-anal anastomosis for chronic ulcerative colitis in China
Authors: Gang Liu , Hongqiu Han , Tong Liu , Qiang Fu , Yongcheng Lyu 
Published: January 2024

BackgroundThe incidence of chronic ulcerative colitis (CUC) in China is remarkably increasing, while little information on surgical treatment has been reported. This study aimed to completely describe and analyze the clinical outcome of restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) for CUC in China.MethodsNinety-five consecutive patients, who suffered CUC and had surgical indications, were carefully selected. All patients underwent IPAA. Data on patient characteristics, surgical indications, surgical details, postoperative complications, functional outcome, and quality of life were collected.ResultsThe mean patient age at the time of the operation was 32 years. Twenty-nine (31%) patients underwent an emergency operation, and 66 (69%) underwent elective procedures. Four patients with severe dysplasia underwent operations, but no carcinoma was histologically confirmed. A two-stage operation was performed in 87 (92%) patients, and a hand-sewn technique was applied in 88 (93%) patients. Sixteen patients (17.0%) experienced early complications, and there was a significant difference between the emergency surgery group and the elective group (31.0% vs. 10.6%, respectively;P<0.01). Five (5.3%) patients developed pouchitis as a late complication. The mean stool frequency after the operation was 4.6 (2-11) during the first 24 hours and 1.5 (0-4) overnight. According to the Kirwan grading scale, 87 (91.8%) patients showed satisfactory anal continence function. The quality of life improved significantly from a preoperative mean value of 0.28-0.61 before ileostomy closure to 0.78 after ileostomy closure (P<0.01) according to the Cleveland Global Quality of Life index.ConclusionsIPAA is an effective and safe surgical procedure for patients with CUC in China. However, some characteristics, such as the low incidence of pouchitis, require further study.
HIV and syphilis infections among street-based female sex workers in China, 2010-2012
Authors: Li Dongmin , Wang Lu , Lin Wen , Li Peilong , Wang Lan , Guo Wei , Ge Lin , Ding Zhengwei , Cui Yan , Wang Ning 
Published: January 2024

Background
Female sex workers (FSW) were high-risk population for HIV and other sexually transmitted diseases (STD) earlier, and now are an important driver of the HIV/AIDS epidemic in China. Sentinel surveillance for FSW was set up to monitor the trend of HIV prevalence and risk behavior-related HIV infection. This study collected the data on street-based FSW from HIV sentinel surveillance system to understand HIV and syphilis infections, risk behaviors, and intervention in China from 2010 to 2012.

Methods
The study population was the street-based FSW who were recruited for the national HIV integrated biological and behavioral surveillance between 2010 and 2012. Demographic information, HIV-related risk behaviors, and HIV and syphilis testing results were described and trend analysis was performed.

Results
Between 2010 and 2012, the number of street-based FSW surveyed was 3725, 3425, and 3335, respectively. HIV knowledge awareness rate significantly increased from 74.6% in 2010 to 76.8% in 2011 and 82.2% in 2012 (P <0.01). More FSW consistently used condom in the last month (49.0% in 2010; 51.0% in 2011; and 59.0% in 2012) and in the last commercial sex (72.0% in 2010; 78.5% in 2011; and 80.0% in 2012) over time. The proportions of individuals who received HIV testing in the last year were 31.2% (2010), 37.0% (2011), and 36.9% (2012) (P-trend <0.01). HIV prevalence rate changed from 1.5% in 2010 to 1.4% in 2011 and 2.3% in 2012 (P-trend=0.01). Syphilis prevalence rate was 6.9%, 7.2%, and 7.1% in the same period. The top three provinces with the highest average HIV prevalence rates over the 3 years were Guangxi (5.9%), Yunnan (4.2%), and Sichuan (1.2%).

Conclusions
Street-based FSW are at high risk of HIV and syphilis infections. Intervention efforts need to target street-based FSW who are of old age and minority, who use illicit drugs and have syphilis infection.
A novel, recovery, and reproducible minimally invasive cardiopulmonary bypass model with lung injury in rats
Authors: LI Ling-ke , CHENG Wei , LIU Dong-hai , ZHANG Jing , ZHU Yao-bin , QIAO Chen-hui , ZHANG Yan-bo 
Published: January 2024

Background
Cardiopulmonary bypass (CPB) has been shown to be associated with a systemic inflammatory response leading to postoperative organ dysfunction. Elucidating the underlying mechanisms and developing protective strategies for the pathophysiological consequences of CPB have been hampered due to the absence of a satisfactory recovery animal model. The purpose of this study was to establish a good rat model of CPB to study the pathophysiology of potential complications.

Methods
Twenty adult male Sprague-Dawley rats weighing 450-560 g were randomly divided into a CPB group (n=10) and a control group (n=10). All rats were anaesthetized and mechanically ventilated. The carotid artery and jugular vein were cannulated. The blood was drained from the right atrium via the right jugular and transferred by a miniaturized roller pump to a hollow fiber oxygenator and back to the rat via the left carotid artery. Priming consisted of 8 ml of homologous blood and 8 ml of colloid. The surface of the hollow fiber oxygenator was 0.075 m2. CPB was conducted for 60 minutes at a flow rate of 100-120 ml• kg-1· min-1 in the CPB group. Oxygen flow/perfusion flow was 0.8 to 1.0, and the mean arterial pressure remained 60-80 mmHg. Blood gas analysis, hemodynamic investigations, and lung histology were subsequently examined.

Results
All CPB rats recovered from the operative process without incident. Normal cardiac function after successful weaning was confirmed by electrocardiography and blood pressure measurements. Mean arterial pressure remained stable. The results of blood gas analysis at different times were within the normal range. Levels of IL-1β and TNF-α were higher in the lung tissue in the CPB group (P <0.005). Histological examination revealed marked increases in interstitial congestion, edema, and inflammation in the CPB group.

Conclusion
This novel, recovery, and reproducible minimally invasive CPB model may open the field for various studies on the pathophysiological process of CPB and systemic ischemia-reperfusion injury in vivo.
Balloon dilation versus Amplatz dilation during ultrasound-guided percutaneous nephrolithotomy for staghorn stones
Authors: Ren Minghua , Zhang Cheng , Fu Weijun , Fu Yiming , Ma Li , Zhao Weiming , Xu Wanhai , Ni Shaobin 
Published: January 2024

BackgroundAmplatz dilation and balloon dilation are different methods in creating the accesses during percutaneous nephrolithotomy (PCNL). The aim of this study was to review the surgical experiences of managing staghorn calculi by Amplatz dilation and balloon dilation for 3 years.MethodsWe retrospectively analyzed clinical data from 125 patients (129 kidneys) with staghorn kidney stones who underwent PCNL from January 2010 to December 2012, of whom 60 patients underwent Amplatz dilation (AD group) and 65 underwent balloon dilation (BD group) during PCNL.ResultsThe AD and BD groups were similar in age, male-female ratio, stone burden, stone type, hydronephrosis, and proportion of patients who had undergone extracorporeal lithotripsy. However, these two groups showed significant differences in terms of duration of percutaneous access (15.1±3.6) minutes vs. (10.0±3.3) minutes, one-attempt success rate of dilation via a single access 88.9% (72/81) vs. 97.8% (91/93), hemoglobin drop after surgery (3.5±0.9) g/dl vs. (1.7±0.9) g/dl, number of cases requiring intraoperative and postoperative blood transfusion 27.9% (n=17) vs. 13.2% (n=9), changes of central venous pressure before and after surgery (2.3±1.2) cmH2O vs. (1.2±0.7) cmH2O, number of patients who experienced postoperative fever >37.5°C 21 (34.4%) vs. 13 (19.1%) (allP<0.05). No injury of adjacent organs, including pleura, liver, spleen, or bowel, was noted in patients.ConclusionsDuring ultrasound-guided PCNL for staghorn stones, balloon dilation and Amplatz dilation are all effective and safe. Compared with Amplatz dilation, balloon dilation is a better choice, as it has a higher access creation success rate, shorter access creation time less blood loss, and lower proportions of circulatory overload and postoperative fever.
A two-year follow-up for Chinese patients with abdominal aortic aneurysm undergoing open/endovascular repair
Authors: Tao Sun , Hongju Zhang , Yutong Cheng , Su Wang , Ying Tao , Donghua Zhang , Ji Huang , Jingmei Zhang , Zhizhong Li , Mouyue Wang 
Published: January 2024

Background
A number of studies have demonstrated the rates of overall and aneurysm-related mortality and morbidity in Western populations. The cardiovascular risk factors influencing postoperative outcome have been also reported. Until recently, little has been known about the prognosis in this patient cohort in the Chinese population. We evaluated the independent predictors of mortality and morbidity in abdominal aortic aneurysm (AAA) patients undergoing elective surgical treatment and emphasized whether the coronary artery revascularization could have any effect on the overall mortality and morbidity in patients following the current guideline recommendation.

Methods
A total of 386 patients (174 women) undergoing surgery in Beijing Anzhen Hospital from January 2008 to June 2010 were enrolled (mean age (70.6±10.5) years). Kaplan-Meier curves were constructed to compare the mortality and morbidity of AAA patients with coronary artery revascularization and those without. A Cox proportional hazards model was constructed to identify clinical factors associated with two-year outcomes. The primary outcomes were death from any cause, the pre-specified morbidity was re-hospitalization for pulmonary conditions, congestive heart failure, angina, ischemic/hemorrhagic stroke.

Results
During the two-year follow-up, 34 patients died and 65 experienced re-hospitalization with pulmonary conditions, congestive heart failure, angina, or ischemic/hemorrhagic stroke. Kaplan-Meier survival analysis showed that the AAA patients with cardiac revascularization had no higher incidence of overall mortality and major morbidity than those without (log-rank test P=0.35 and P=0.40, respectively). Cox proportional hazards regression analysis showed that level of lowdensity lipoprotein (HR, 4.06; 95% CI: 1.19-18.7, P=0.027) and AAA size (HR, 2.18; 95% CI: 1.28-11.65, P=0.036) were independently associated with the incidence of overall mortality. Long-term use of angiotensin converting enzyme inhibitors, statins, AAA size and systolic blood pressure were independent predictors of the secondary pre-specified outcomes.

Conclusions
Coronary artery revascularization following the guideline recommendations did not increase the mortality and morbidity of Chinese with AAA who were undergoing repair. Absence of angiotensin converting enzyme inhibitors and statins, AAA size, and systolic blood pressure were powerful predictors of the clinical events.
Normal blood D-dimer concentrations: do they exclude pulmonary embolism?
Authors: Guo Zhiguo , Ma Qingbian , Zheng Yaan , Zhang Yumei , Ge Hongxia 
Published: January 2024

Background
Although pulmonary embolism (PE) with normal blood D-dimer (DD) concentrations is considered rare, in practice the incidence may be greater than is generally believed. Overlooking PE is potentially dangerous. The aim of this study was to explore the incidence and clinical features of PE with normal DD concentrations.

Methods
We retrospectively analyzed the records of 29 patients with PE and normal DD concentrations from the past seven years. We here compare relevant clinical characteristics of these patients with those of patients with PE and abnormal DD concentrations. We evaluated the probabilities of differences by computing pretest probability scores (Wells score and revised Geneva score).

Results
The frequency of normal DD concentrations in patients with PE was 4%. Previous episode(s) of PE were more common in patients with normal DD concentrations than in those with abnormal DD concentrations (P=0.001). Fever, tachycardia, and tachypnea occurred less frequently in the former group (P<0.05) and time between onset of symptoms and DD testing was longer (P=0.001). The diagnosis of PE was delayed in 22 of the 29 cases. Nineteen and seven cases with normal DD concentrations were classified according to pretest scores as intermediate and low risk, respectively.

Conclusions
PE with normal DD concentrations is uncommon. Although most diagnoses of PE are ruled out by normal DD values, a small number of cases with PE are missed. A combination of pretest probability score and normal DD concentration increases the probability of making the correct diagnosis, but cannot completely exclude patients with suspected PE. When the clinical manifestations cannot be otherwise explained, clinicians should be alert to the possibility of PE with normal DD concentrations in patients with previous episode(s) of PE or a long interval between onset of symptoms and DD testing.
Safety and efficacy of early administration of tirofiban in patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention: a meta-analysis
Authors: Liu Yangchun , Su Qiang , Li Lang 
Published: January 2024

BackgroundTirofiban has been widely used as an adjunctive pharmacologic agent for revascularization in patients undergoing percutaneous coronary intervention, and the outcomes appear attractive. However, the potential benefits from early administration of tirofiban in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI) remain unclear.MethodsWe conducted a search in MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials up to September 2012 without language restriction. A total of eight randomized trials (n=1 577 patients) comparing early (emergency department or ambulance) versus late (catheterization laboratory) administration of tirofiban in STEMI patients undergoing PPCI were included in this meta-analysis. Risk ratio (RR) was computed from individual studies and pooled with random- or fixed-effect models.ResultsThere were no differences in post-procedural Thrombolysis In Myocardial Infarction (TIMI) flow grade 3 and Corrected TIMI Frame Count (RR=1.02, 95% confidence interval (CI): 0.99–1.05,P=0.18; weighted mean difference (WMD)=-0.93, 95%CI: -5.37–3.52,P=0.68, respectively) between the two groups. Similarly, there were no significant differences in the incidence of 30-day mortality (RR=1.69, 95%CI: 0.69–4.13,P=0.25) and re-myocardial infarction (RR=0.71, 95%CI: 0.21–2.35,P=0.57) between early and late administration of tirofiban. As to the safety end points, no significant difference was observed in hospital minor bleeding (RR=1.08, 95%CI: 0.54–2.14,P=0.83) and hospital and 30-day major bleeding between the two groups (RR=0.98, 95%CI: 0.46–2.10,P=0.96;RR=1.32, 95%CI: 0.59–2.97,P=0.49, respectively).ConclusionsEarly administration of tirofiban in patients undergoing PPCI for STEMI was safe, but no beneficial effects on post-procedural angiographic or clinical outcomes could be identified as compared with late administration. Besides the negative finding, more high-quality randomized clinical trials are still needed to explore the efficacy of adequate, earlier administration of tirofiban in patients undergoing PPCI.