bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perioperative outcomes of laparoscopic versus open splenectomy for nontraumatic diseases: a meta-analysis
Authors: Jiang Chen , Rui Ma , Shouzhang Yang , Shuang Lin , Shilin He , Xiujun Cai 
Published: January 2024

BackgroundSurgical treatment has become the standard treatment for nontraumatic diseases of the spleen. This meta-analysis compared the relative merits of laparoscopic splenectomy (LS) with open splenectomy (OS) for nontraumatic splenic diseases.MethodsA literature search was performed to identify studies comparing perioperative outcomes in patients who underwent LS or OS for nontraumatic diseases. Pooled odds ratios (ORs) and weighted mean differences (WMD) with 95% confidence intervals (CIs) were calculated using a fixed- or random-effects model.ResultsThirty-five studies matched the selection criteria. Of the 7 269 patients included 3 981 underwent LS and 3 288 underwent OS for nontraumatic diseases. OS was associated with shorter operation time (WMD=42.65, 95%CI: 25.58-59.73), whereas LS was associated with reduced operative blood loss (WMD=-133.95, 95%CI: -229.02 to -38.88), need for blood transfusion requirement (OR=0.53, 95%CI: 0.39-0.72), overall postoperative morbidity rate (OR=0.44, 95%CI: 0.38-0.51), postoperative mortality rate (OR=0.38, 95%CI: 0.24-0.59), and length of hospital stay (WMD = -2.73, 95%CI: -3.34 to -2.12).ConclusionsLS is superior to OS for nontraumatic diseases, with reduced operative blood loss, need for blood transfusion, postoperative morbidity and mortality rates, and length of hospital stay, although OS is associated with reduced operation time. LS may be a good alternative to OS for patients with nontraumatic splenic diseases.
Anti-inflammatory effects of a synthetic peptide derived from pigment epithelium-derived factor on H2O2-induced corneal injury in vitro
Authors: Yi Lu , Jia Feng , Lili Yang , Hongfeng Tang , Ji Jin , Xun Xu 
Published: January 2024

BackgroundThe common pathological characteristics of corneal injury include inflammatory factors activation, vascular endothelial cells or inflammatory cells infiltration into lesions, corneal edema, corneal neovascularization (CNV), and scar formation. PEDF-34 is the functional fragment of pigment epithelium-derived factor (PEDF) that has anti-angiogenic and anti-inflammatory properties and contains an N-terminal 34-amino acid peptide. This study was to investigate the antiinflammatory effects of PEDF-34 on H2O2-induced corneal injuryin vitro.MethodsAfter cultured in H2O2(0.1 mmol/L) for 2 hours, human corneal fibroblasts (HCFs) and human umbilical vein endothelial cells (HUVECs) were treated with PEDF-34-nanoparticles (NPs) at different concentrations (0.1, 0.5, 1.0, 2.0 μg/ml) or 2.0 μg/ml control-NPs for 24 hours. The viable cells were quantified using the MTT assay. Western blotting or ELISA analysis was performed for measuring the human vascular endothelial growth factor (VEGF) and intercellular adhesion molecule-1 (ICAM-1) expression of both HCFs and HUVECs. VEGF and nuclear factor κB (NF-κB) mRNA levels of HCFs were semi-quantified by RT-PCR.ResultsThe survival rates of HCFs or HUVECs stimulated by H2O2did not decrease significantly (P>0.05) compared to those in the normal conditions. As compared to control-NP group, PEDF-34-NPs had dose-dependent inhibitive effect on HUVECs with the MTT assay, but not HCFs. Western blotting analysis showed that the VEGF and ICAM-1 levels in the HCFs and HUVECs stimulated by H2O2were significantly higher than those in the normal conditions, which were decreased dramatically in those treated with PEDF-34-NPs. RT-PCR analysis revealed that the VEGF mRNA and NF-κB mRNA levels increased in H2O2-stimulated HCFs, while both of them decreased in PEDF-34-NP groups dose dependently.ConclusionsPEDF-34-NPs may play an important role in regulating the NF-κB pathway, inhibiting inflammatory activity. PEDF-34-NPs may be a potential new drug for treating corneal injury in the future.
Interleukin-32, not reduced by salmeterol/fluticasone propionate in smokers with chronic obstructive pulmonary disease
Authors: Du Yipeng , Wang Wei , Yang Wei , He Bei 
Published: January 2024

Background
The interleukin (IL)-32/tumor necrosis factor (TNF) α pathway is supposed to play a key role in the amplification of the immune response in chronic obstructive pulmonary disease (COPD) inflammation. Inhaled corticosteroids (ICS) in combination with long-acting β2-agonists (LABA) have shown airway anti-inflammatory effects in recent studies, but the mechanism is still uncertain.

Methods
Patients were treated in a randomized, open-labeled, parallel group clinical trial with either a combination of salmeterol xinafoate/fluticasone propionate (SF; Seretide, GlaxoSmithKline) Diskus (50/500 μg twice daily) or ipratropium bromide/salbutamol (IS; Combivent, Boehringer Ingelheim) MDI (42 μg/240 μg quartic daily) for 12 weeks. At the start and the end of treatment, induced sputum was collected and the concentration of IL-32 and TNF-α, the number of neutrophils and eosinophils were measured.

Results
Following 12 weeks of treatment, a statistically significant fall from baseline in the concentration of TNF-α in sputum (P=0.004) was seen after treatment with SF but not with IS. However, neither treatment had significant effects on the concentration of IL-32 in sputum. There was a decrease from baseline in the number of sputum neutrophils with SF that approached statistical significance (P=0.028) but not with IS, while the number of sputum eosinophils did not change significantly from baseline in either treatment group. There was a statistically significant decline from baseline in the quality of life as assessed by the St George’s respiratory questionnaire in both the SF (P=0.004) and IS (P=0.030) treatment groups, but no evidence of improvement in lung function was observed in either group.

Conclusion
The sputum TNF-α and neutrophils, but not IL-32 and macrophages, could be reduced by ICS/LABA treatment, suggesting that IL-32 could be involved in the corticosteroid resistance of COPD inflammation.
Association of polymorphisms in the vascular endothelial growth factor gene and its serum levels with diabetic retinopathy in Chinese patients with type 2 diabetes: A cross-sectional study
Authors: Fan Xiaohong , Wu Qunhong , Li Yuan , Hao Yanhua , Ning Ning , Kang Zheng , Cui Yu , Liu Ruohong , Han Liyuan 
Published: January 2024

Background
Vascular endothelial growth factor (VEGF) is a major mediator of angiogenesis, and plays a key role in the pathogenesis of diabetic retinopathy (DR). This study was designed to identify the possible role of VEGF gene polymorphisms in the development of DR in type 2 diabetic patients in Chinese and clarify the relationship between VEGF serum levels and the risk of DR.

Methods
This cross-sectional study included 1 040 Chinese subjects with type 2 diabetes mellitus. There were 372 patients diagnosed with DR in the case group and 668 patients without DR in the control group. DNA from each patient was analyzed for VEGF polymorphisms of -2578A/C (rs699947), -1154G/A (rs1570360), -460C/T (rs833061), +405C/G (rs2010963), and +936C/T (rs3025039) using MassARRAY compact analyzer. The VEGF serum levels were quantified by enzyme-linked immunosorbent assay (ELISA).

Results
No evidence of association was observed between -2578 A/C (rs699947), +405C/G (rs2010963), +936C/T (rs3025039), and DR risk under stringent Bonferroni's correction. However, VEGF serum levels were significantly higher in DR patients than those of control group. The genetic variation of VEGF polymorphisms influenced VEGF serum levels; subjects carrying the VEGF -2578 C/C (rs699947) genotype had greater VEGF serum levels than those carrying the C/A genotype and VEGF serum levels were significantly higher in CC genotype of the +405C/G (rs2010963) compared with those of the other genotypes.

Conclusions
The data did not suggest significant association between the VEGF polymorphisms and DR risk under stringent Bonferroni's correction. However, our study indicated that DR patients have higher VEGF levels than diabetic patients without retinopathy, and -2578A/C (rs699947) and +405C/G (rs2010963) may be important factors in determining serum VEGF levels.
Analysis of operation-related complications of totally laparoscopic aortoiliac surgery
Authors: Qi Lixing , Gu Yongquan , Guo Lianrui , Li Xuefeng , Wu Yingfeng , Cui Shijun , Tong Zhu , Wu Xin , Guo Jianming , Zhang Jian , Wang Zhonggao 
Published: January 2024

Background
Totally laparoscopic aortoiliac surgery has been newly developed in China. It is known as the most complex laparoscopic technique to learn because of its high-risk procedures. Analysis of the operation-related complications of this surgery is supposed to be helpful for the early success of this technique.

Methods
Twelve male patients (56–70 years old) with aortoiliac occlusive disease underwent totally laparoscopic aortoiliac bypass surgery (TLABS) in our institute. Clinical data and operation-related complications were retrospectively analyzed.

Results
Of the 12 patients, TLABS succeeded in nine and conversion to open surgery occurred in three. One of the converted patients finally died of pulmonary infection. Operation-related complications included bleeding from arterial injury, perforation from colonic injury, graft embolism, residual aortic stenosis, and hydronephrosis. Bleeding in two patients and colonic perforation in one patient resulted in three conversions to open surgery. Intraoperative graft embolectomy and postoperative aortic stenting were performed to resolve the thrombus/embolus-referring complications. Left hydronephrosis, which was thought to result from intraoperative injury and treated with ureteric intubation drainage, recovered 6 months after TLABS.

Conclusions
Good understanding and avoidance of operation-related complications are important to guarantee the technical success of TLABS. Immediate conversion to open surgery is necessary for saving the patient's life in case of life-threatening complications.
Prognostic significance of metastatic lymph nodes ratio in patients with gastric adenocarcinoma after curative gastrectomy
Authors: Zhang Meiling , Wang Jian , Shi Wei , Chen Wenjiao , Li Wei , Shu Yongqian , Liu Ping , Lu Kaihua 
Published: January 2024

Background
We evaluated the impact of the number of metastatic lymph nodes and the metastatic lymph nodes ratio (the ratio between metastatic lymph nodes and total dissected lymph nodes, MLNR) in patients with gastric adenocarcinoma following curative gastrectomy and also analyzed the relationship between the number of removed lymph nodes and prognosis in node-negative gastric cancer.

Methods
From January 2005 to December 2010, 1 390 patients who were diagnosed with gastric adenocarcinoma and underwent curative gastrectomy were included. In particular, lymph node metastasis was not present in 515 patients. The number of metastatic lymph nodes and the metastatic lymph nodes ratio were selected for univariate and multivariate analyses to evaluate their influences on the disease outcome. The survival curve was presented according to the number of removed lymph nodes in node-negative gastric cancer using Kaplan-Meier plots.

Results
The overall 5-year survival rate was 54% in this group. Univariate analysis revealed that age category, macroscopic appearance, histological grade, tumor size, depth of primary tumor invasion, number of metastatic lymph nodes, metastatic lymph nodes ratio, tumor, nodes, metastasis-classification (TNM) stage and status of lymphovascular, and vessel invasion have significant impact on survival. The number of metastatic lymph nodes and the metastatic lymph nodes ratio both have significant impact on survival (P <0.001). However, in multivariate analyses, only the metastatic lymph nodes ratio was identified to be an independent prognostic factor (P <0.001). The number of removed lymph nodes in node-negative was a strong prognostic factor of survival, the more lymph nodes dissected, the better the survival.

Conclusions
The metastatic lymph nodes ratio has more significant prognostic value for survival in patients with gastric cancer following curative gastrectomy than the number of metastatic lymph nodes. The number of removed lymph nodes might be an important prognostic factor for gastric cancer without lymph node metastasis.
Re-epithelializaiton by epithelial inoculation with recipient phenotype in heterotopically transplanted rat allografts
Authors: Zheng Hui , Hu Xuefei , Li Chao , Xie Huikang , Gao Wen , Chen Chang 
Published: January 2024

Background
Re-epithelialization has remained a major obstacle in both tracheal and lung transplantations. This study examines the realization of re-epithelialization by epithelial inoculation in a rat heterotopic tracheal transplantation model.

Methods
The original epithelia of tracheas from donor Wistar rats were removed and the tracheas were then inoculated with 106/ml in vitro cultured epithelial cells of the Spraque-Dawley (SD) rat phenotype. These allo-tracheas were then heterotopically transplanted into SD rats. After 28 days, the allo-trachea tissues were recovered and assessed for epithelial morphology and cellular differentiation using immunohistochemical analysis. An additional experimental group was used to compare the outcomes of re-epithelialization in immunosuppressed animals.

Results
Histological examination showed that allografts with epithelial inoculation maintained patent tracheal lumens, which were obliterated in controls. Recipient immunosuppression facilitated the formation of an integrated ciliated epithelial layer, further demonstrated by the presence of a dense cilia population, a well-developed plasma membrane, and readily recognizable intercellular junctions. Epithelial cellular differentiation markers such as cytokeratin 14 and 18, and cystic fibrosis transmembrane conductance regulator (CFTR) were all positive in allografts under immunosuppression.

Conclusion
Concurrent recipient-derived epithelial inoculation with immunosuppression can result in complete re-epithelialization with the recipient phenotype and suppress the luminal obliteration process in heterotopic transplantations.
Clinical and microbiological characterization of Clostridium difficile infection in a tertiary care hospital in Shanghai, China
Authors: Dong Danfeng , Peng Yibing , Zhang Lihua , Jiang Cen , Wang Xuefeng , Mao Enqiang 
Published: January 2024

Background
Over the last decade, Clostridium difficile infection (CDI) has emerged as a significant nosocomial infection, yet little has been reported from China. This study aimed to characterize the clinical and microbiological features of CDI from a hospital in Shanghai.

Methods
Patients with CDI seen between December 2010 and March 2013 were included in this study, of which clinical data were retrospectively collected. The microbiological features of corresponding isolates were analyzed including genotype by multi-locus sequence typing (MLST), antimicrobial susceptibility, toxin production, sporulation capacity, biofilm formation, and motility.

Results
Ninety-four cases of CDI were included during this study period, 12 of whom were severe cases. By reviewing the clinical data, all patients were treated empirically with proton pump inhibitor or antibiotics or both, and they were distributed widely across various wards, most frequently to the digestive ward (28/94, 29.79%). Comparing the severe with mild cases, no significant differences were found in the basic epidemiological data or the microbiological features. Among the 94 isolates, 31 were toxin A-negative toxin B-positive all genotyped as ST37. They generated fewer toxins and spores, as well as similar amounts of biofilm and motility percentages, but exhibited highest drug resistance to cephalosporins, quinolones, macrolide-lincosamide and streptogramin (MLSB), and tetracycline.

Conclusions
No specific clinical genotype or microbiological features were found in severe cases; antimicrobial resistance could be the primary reason for epidemic strains leading to the dissemination and persistence of CDI.
Experimental study on new self and mutual-aiding occlusive dressing for wound
Authors: Liang Xiangdang , Chen Wen , Sun Geng , Liu Shiluan , Cai Hongfei , Zhou Lin 
Published: January 2024

Background
Self and mutual-aiding occlusive dressing is a novel method to treat with the wounds in special circumstances. This study aims to prepare a new antimicrobial adhesive for the dressing and evaluate the application effects of the adhesive.

Methods
The main component of the new antimicrobial adhesive was 5% triclosan / cyanoacrylate (CA) antimicrobial adhesive. The adhesive was modified with carboxylic multi-walled carbon nanotubes (MWCNTs-COOH), multi-walled carbon nanotubes (MWCNTs), hydrophobic nano-silica, nitrile rubber, epoxy resin and polymethyl methacrylate (PMMA) respectively. The bond strength, toughness and viscosity of the modified adhesive in different concentrations were examined to select the optimal modifying material and the best ratio to prepare the new antimicrobial adhesive according to the results. After that, the antimicrobial property of the new antimicrobial adhesive was tested by filter paper method. At last, we disposed the injury models in rats using the new antimicrobial adhesive to examine the application effects.

Results
In individual tests, the bond strength modification performance of 0.064% MWCNTS-COOH is the best, the bond strength is (14.71±1.48) Mpa. 8% nano-silica shows the best toughness modification performance, the Tg is (1.10±0.24)°C. The viscosity modification performance of 8% nano-silica is the best, the viscosity is (15 536.68±28.4) cP. However, consolidating three test results, 6% nano-silica / antimicrobial adhesive has the balanced bond strength, toughness and viscosity. Its bond strength is (14.03±1.92) Mpa, the Tg is (3.60±0.68)°C, and the viscosity is (5 278.87±31.68) cP. The inhibition zone diameter of 6% nano-silica / antimicrobial adhesive and antimicrobial adhesive group in Day 5 is (28.61±0.91) mm versus (28.24±2.69) mm (P >0.05). In animal studies, both in blood routine test and pathological section, 6% nano-silica / antimicrobial adhesive group shows lower white blood cells count than gauze bandage group (P <0.05).

Conclusions
6% nano-silica has the optimal effect of bond strength modification, toughness modification and viscosity modification, and the antimicrobial adhesive modified with it has a good antimicrobial property (resistant staphylococcus aureus).
Postablation neutrophil/lymphocyte ratio correlates with arrhythmia recurrence after catheter ablation of lone atrial fibrillation
Authors: Guo Xueyuan , Zhang Sen , Yan Xianliang , Chen Yingwei , Yu Ronghui , Long Deyong , Sang Caihua , Du Xin , Dong Jianzeng , Ma Changsheng 
Published: January 2024

BackgroundNeutrophil/lymphocyte ratio (NLR) has been proposed as a novel marker of systemic inflammation and oxidative stress. The objective of this study was to ascertain the relationship between levels of NLR and recurrence of lone atrial fibrillation (AF) after catheter ablation.MethodsA total of 379 lone AF patients who underwent catheter ablation were enrolled in the study. The NLR before and after catheter ablation was determined. Cox regression analyses were used to estimate the relationship between NLR and the recurrence of lone AF.ResultsAfter a mean follow-up of (30.5±5.3) months, 124 (32.7%) patients had AF recurrences. The patients who developed AF recurrence had a higher postablation NLR (post-NLR) than patients with no recurrence (5.74±1.55 vs. 4.66±1.27,P<0.001). Multivariate Cox regression analysis revealed that post-NLR (hazard ratio (HR) 1.514, 95% confidence interval (CI) 1.364–1.680,P<0.001), left atrium diameter (HR1.035, 95%CI1.001–1.071,P=0.04) and body mass index (HR1.028, 95%CI1.002–1.054,P=0.03) were independent predictors of AF recurrence. Using a cut-off level of 5.15, post-NLR predicted AF recurrence with a sensitivity of 73% and specificity of 67%.ConclusionsOur results indicate that an elevated post-NLR is associated with a high rate of lone AF recurrence. A simple measurement of NLR may help us to identify high-risk patients who need pharmacologic intervention to prevent recurrence.
Correlation between balloon release pressure and no-reflow in patients with acute myocardial infarction undergoing direct percutaneous coronary intervention
Authors: Wang Yanfei , Yao Min , Liu Haibo , Yang Yuejin , Xie Junmin , Jia Xinwei , Pan Huanjun , Wang Chunyan 
Published: January 2024

BackgroundBalloon release pressure may increase the incidence of no reflow after direct percutaneous coronary intervention (PCI). This randomized controlled study was designed to analyze the correlation between balloon release pressure and no-reflow in patients with acute myocardial infarction (AMI) undergoing direct PCI.MethodsThere were 156 AMI patients who underwent PCI from January 1, 2010 to December 31, 2012, and were divided into two groups according to the stent inflation pressure: a conventional pressure group and a high pressure group. After PCI, angiography was conducted to assess the thrombolysis in myocardial infarction (TIMI) grade with related artery. Examinations were undertaken on all patients before and after the operation including cardiac enzymes, total cholesterol, low-density lipoprotein, blood glucose, homocysteine, â-thromboglobulin (β-TG), Hamilton depression scale (HAMD) and self-rating anxiety scale (SAS). After interventional therapy, the afore-mentioned parameters in both the conventional pressure group and high pressure group were again analyzed.ResultsThe results showed that CK-MB, HAMD, SAS were significantly different (P<0.05) in all patients after PCI, especially the CK-MB in the high pressure group ((25.7±7.6) U/L vs. (76.7±11.8) U/L). CK-MB, HAMD, SAS, and β-TG were comparative before PCI but they were significantly changed (P<0.05) after intervention. No-reflow phenomenon occurred in 13 patients in the high pressure group, which was significantly higher than in the conventional pressure group (17.11% vs. 6.25%,P<0.05).ConclusionIn stent implantation, using a pressure less than 1823.4 kPa balloon to release pressure may be the better choice to reduce the occurrence of no-reflow following direct PCI.
Research approaches to mass casualty incidents response: development from routine perspectives to complexity science
Authors: Weifeng Shen , Libing Jiang , Mao Zhang , Yuefeng Ma , Guanyu Jiang , Xiaojun He 
Published: January 2024

Objective
To review the research methods of mass casualty incident (MCI) systematically and introduce the concept and characteristics of complexity science and artificial system, computational experiments and parallel execution (ACP) method.

Data sources
We searched PubMed, Web of Knowledge, China Wanfang and China Biology Medicine (CBM) databases for relevant studies. Searches were performed without year or language restrictions and used the combinations of the following key words: “mass casualty incident”, “MCI”, “research method”, “complexity science”, “ACP”, “approach”, “science”, “model”, “system” and “response”.

Study selection
Articles were searched using the above keywords and only those involving the research methods of mass casualty incident (MCI) were enrolled.

Results
Research methods of MCI have increased markedly over the past few decades. For now, dominating research methods of MCI are theory-based approach, empirical approach, evidence-based science, mathematical modeling and computer simulation, simulation experiment, experimental methods, scenario approach and complexity science.

Conclusions
This article provides an overview of the development of research methodology for MCI. The progresses of routine research approaches and complexity science are briefly presented in this paper. Furthermore, the authors conclude that the reductionism underlying the exact science is not suitable for MCI complex systems. And the only feasible alternative is complexity science. Finally, this summary is followed by a review that ACP method combining artificial systems, computational experiments and parallel execution provides a new idea to address researches for complex MCI.