bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of radical cystectomy plus adjuvant intraarterial chemotherapy with gemcitabine and cisplatin on locally advanced bladder cancer
Authors: Jiang Lijuan , Zhang Zhiling , Dong Pei , Li Yonghong , Yao Kai , Liu Zhuowei , Han Hui , Qin Zike , Yao Min , Zhou Fangjian 
Published: January 2024

Background
Bladder cancer is the ninth most common cancer in the world; fewer than 15% of transitional-cell carcinoma patients survive 2 years if left untreated. Although radical cystectomy is the standard treatment of choice, much of them relapse and the necessity of adjuvant chemotherapy is still under debate. The aim of the study was to evaluate the efficacy of adjuvant intraarterial chemotherapy (IAC) with gemcitabine and cisplatin (GC) on locally advanced bladder cancer.

Methods
This is a retrospective study on 60 patients with locally advanced bladder carcinoma who underwent radical cystectomy between May 2000 and June 2011. Patients were studied in two groups based on IAC and followed up for up to 5 years.

Results
Among 60 patients, there were 25 patients who underwent IAC (GC) after radical cystectomy (the IAC group) and 35 patients who underwent radical cystectomy alone (the control group). Although not significant, the relapse rates were slightly reduced in the IAC group than in the control group. Patients with IAC had a reduction in mortality compared with patients without IAC over 5 years. Specifically, IAC significantly reduced about 82% of mortality within the first year (hazard ratio=0.18, 95% CI 0.03–0.97, P=0.04). Additionally, IAC was well tolerated and safe. The most common adverse effect was transient myelosuppression (10/25, 40%), which was resolved by various medical treatments.

Conclusions
Compared with radical cystectomy alone, radical cystectomy in combination with adjuvant IAC moderately but significantly reduces 1-year mortality. Our preliminary data showed only marginal benefit for the early survival. However, a randomized clinical study is needed to determine the long-term survival benefit.
Clinical values of intraoperative indocyanine green fluorescence video angiography with Flow 800 software in cerebrovascular surgery
Authors: YE Xun , LIU Xing-Ju , MA Li , LIU Ling-Tong , WANG Wen-Lei , WANG Shuo , CAO Yong , ZHANG Dong , WANG Rong , ZHAO Ji-Zong , ZHAO Yuan-Li 
Published: January 2024

Background
Microscope-integrated near-infrared indocyanine green video angiography (ICG-VA) has been used in neurosurgery for a decade. This study aimed to assess the value of intraoperative indocyanine green (ICG) video angiography with Flow 800 software in cerebrovascular surgery and to discover its hemodynamic features and changes of cerebrovascular diseases during surgery.

Methods
A total of 87 patients who received ICG-VA during various surgical procedures were enrolled in this study. Among them, 45 cases were cerebral aneurysms, 25 were cerebral arteriovenous malformations (AVMs), and 17 were moyamoya disease (MMD). A surgical microscope integrating an infrared fluorescence module was used to confirm the residual aneurysms and blocking of perforating arteries in aneurysms. Feeder arteries, draining veins, and normal cortical vessels were identified by the time delay color mode of Flow 800 software. Hemodynamic parameters were recorded. All data were analyzed by SPSS version 18.0 (SPSS Inc., USA). T-test was used to analyze the hemodynamic features of AVMs and MMDs, the influence on peripheral cortex after resection in AVMs, and superficial temporal artery to middle cerebral artery (STA-MCA) bypass in MMDs.

Results
The visual delay map obtained by Flow 800 software had more advantages than the traditional playback mode in identifying the feeder arteries, draining veins, and their relations to normal cortex vessels. The maximum fluorescence intensity (MFI) and the slope of ICG fluorescence curve of feeder arteries and draining veins were higher than normal peripheral vessels (MFI: 584.24±85.86 vs. 382.94±91.50, slope: 144.95±38.08 vs. 69.20±13.08, P <0.05). The arteriovenous transit time in AVM was significantly shorter than in normal cortical vessels ((0.60±0.27) vs. (2.08±1.42) seconds, P <0.05). After resection of AVM, the slope of artery in the cortex increased, which reflected the increased cerebral flow. In patients with MMD, after STA-MCA bypass, cortex perfusion of corresponding branches region increased and local cycle time became shorter.

Conclusion
Intraoperative ICG video angiography combined with hemodynamic parameter analysis obtained by Flow 800 software appears to be useful for intraoperative monitoring of regional cerebral blood flow in cerebrovascular disease.
Prognostic value of serum galactomannan index in critically ill patients with chronic obstructive pulmonary disease at risk of invasive pulmonary aspergillosis
Authors: He Hangyong , Li Qian , Chang Shuo , Ding Lin , Sun Bing , Li Fang , Zhan Qingyuan 
Published: January 2024

Background
Critically ill chronic obstructive pulmonary disease (COPD) patients admitted to an intensive care unit (ICU) due to respiratory failure are at particularly high risk of Aspergillus infection. The serum galactomannan index (GMI) has proven to be one of the prognostic criteria for invasive pulmonary aspergillosis (IPA) in classical immunocompromised patients. However, the prognostic value of serum GMI in critically ill COPD patients needs evaluation. The purpose of this study is to investigate the prognostic value of serum GMI in patients with severe COPD.

Methods
In this single-center prospective cohort study, serum samples for GMI assay were collected twice a week from the first day of ICU admission to the day of the patients’ discharge or death. Patients were divided into two groups according to their clinical outcome on the 28th day of their ICU admission. Univariate analysis and survival analysis were tested in these two groups.

Results
One hundred and fifty-three critically ill COPD patients were included and were divided into survival group (106 cases) and non-survival group (47 cases) according to their outcome. Univariate analysis showed that the highest GMI level during the first week after admission (GMI-high 1st week) was statistically different between the two groups. Independent prognostic factors for poor outcome in severe COPD patients were: GMI-high 1st week >0.5 (RR: 4.04, 95% CI: 2.17–7.51) combined with accumulative dosage of corticosteroids >216 mg before the RICU admission (RR: 2.25, 95% CI: 1.11–4.56) and clearance of creatinine (Ccr) ≤64.31 ml/min (RR: 2.48, 95% CI: 1.22–5.07).

Conclusions
The positive GMI-high 1st week (>0.5) combined with an accumulative dosage of corticosteroids >216 mg before the ICU admission and a low Ccr may predicate a poor outcome of critically ill COPD patients.
Adiponectin protects the genioglossus of rats against chronic intermittent hypoxia-induced injury via inhibition of endoplasmic reticulum stress
Authors: ZHANG Xiao-feng , HUANG Han-peng , DING Wen-xiao , DING Ning , LU Gan , LIU Jian-nan , ZHANG Xi-long 
Published: January 2024

Background
Obstructive sleep apnea hypopnea syndrome, characterized by chronic intermittent hypoxia (CIH), is closely correlated with genioglossus dysfunction. CIH has been identified to mediate mitochondrial damage in genioglossus. It has been reported that endoplasmic reticulum stress (ERS) could be induced by mitochondrial dysfunction. This study aimed to investigate the role of ERS in CIH-induced genioglossus injury, as well as the possible intervention effect of adiponectin (Ad) supplement in rats.

Methods
Forty-five male Wistar rats were randomly divided into three groups and submitted to room air (group A, n=15) as a control or CIH (groups B and C, n=15, respectively). Throughout the exposure period, intravenous Ad was given in group C; while intravenous normal saline was simultaneously given in groups A and B. After 35-day exposure, genioglossus samples were obtained from the pentobarbital-anaesthetized rats via surgical dissection, following blood sampling. Western blotting was applied to detect expressions of ERS signals and associated apoptotic pathways in genioglossus. Serum adiponectin levels were assessed via enzyme-linked immunosorbent assay (ELISA).

Results
Significant hypoadiponectinemia was revealed in group B only (P <0.05). Compared to those in groups A and C, expressions of markers involved in ERS, such as glucose regulated protein 78 (GRP78), p-PERK, phosphorylated eukaryotic initiation factor 2α (p-eIF2α), phosphorylated inositol-requiring transmembrane kinase/endoribonuclease 1α (p-IRE1α), spliced X-Box binding protein 1 (XBP1s) and activating transcription factor 6 (ATF6), were significantly enhanced in group B (all P <0.01); while no significant difference was shown between groups A and C (all P >0.05). ERS-associated apoptotic pathways were remarkably activated in group B. The involved markers detected as the expression of CCAAT/enhancer binding protein homologous protein (CHOP), B-cell lymphoma/leukemia associatied X protein (BAX) and caspase-12 were significantly elevated (all P <0.01). Transvenous adiponectin supplement improved the above CIH-induced pathological changes in group C.

Conclusion
Beyond hypoadiponectinemia, CIH could enhance ERS and induce activation of ERS-associated apoptotic pathways in genioglossus, which could be significantly improved by adiponectin supplement.
Inhibition of central Na+/H+ exchanger type 3 can alleviate sleep apnea in Sprague-Dawley rats
Authors: Wang Qimin , Zhou Rong , Zhang Cheng , Dong Hui , Ma Jing , Wang Guangfa 
Published: January 2024

Background
Recent studies showed the central Na+/H+ exchanger type 3 (NHE3) has a close relationship with ventilation control. The objective of the study is to investigate the role of NHE3 in sleep apnea in Sprague-Dawley (SD) rats.

Methods
A sleep study was performed on 20 male SD rats to analyze the correlation between the sleep apneic events and total NHE3 protein content and inactive NHE3(pS552) in the brainstem measured by Western blotting. Another 20 adult male SD rats received 3 days of sleep and respiration monitoring for 6 hours a day, with adaption on the first day, 0.5% DMSO microinjection into the fourth ventricle on the second day, and AVE0657 (specific inhibitor of NHE3) microinjection on the third day. Rats were divided into two groups with injection of 5 μmol/L or 8 μmol/L AVE0657 before the sleep study. The effects of AVE0657 on sleep apnea and sleep structure of rats were analyzed through self-control.

Results
The total post-sigh apnea index (TPSAI) and post-sigh apnea index in non-rapid eye movement (NREM) sleep (NPSAI) and total apnea index (AI) in NREM sleep (NAI) were negatively correlated with NHE3(pS552) protein contents in the brainstem (r=-0.534, -0.547 and -0.505, respectively, P<0.05). The spontaneous apnea index in REM sleep (RSPAI) was positively correlated with the level of NHE3(pS552) protein expression in the brainstem (r=0.556, P<0.05). However, the sleep AI had no relationship with total NHE3 protein. Compared with the blank control and microinjection of 0.5% DMSO, 5 μmol/L AVE0657 significantly reduced the total AI and NPSAI (both P<0.05) without a significant effect on sleep architecture. In contrast to blank control and microinjection of 0.5% DMSO, injection of 8 μmol/L AVE0657 significantly reduced the AI and PSAI in NREM and REM sleep (all P<0.05).

Conclusions
The severity of sleep apnea was negatively correlated with central inactive NHE3. A specific inhibitor of NHE3 decreased the sleep AI. Thus, our results indicate that central NHE3 might be a molecular target for sleep apnea treatment, whose inhibitors may be potential therapeutic drugs for sleep apnea.
Augmentation plating in hypertrophic non-union after nail fixation of femoral shaft fracture compared with exchange plating
Authors: Liangjun Jiang , Zhijun Pan , Qiang Zheng 
Published: January 2024

BackgroundAugmentation plating has been used successfully to treat hypertrophic non-union after nail fixation. This study compared the efficacy of augmentation plating and exchange plating for treating hypertrophic non-union of femoral shaft fracture after intramedullary nail fixation.MethodsA total of 12 patients received augmentation plating and 15 patients received exchange plating as treatment for femoral shaft hypertrophic non-union. The procedures were conducted at our medical centre between January 2005 and January 2012. Clinical follow-up was conducted at 2 weeks, 1 month and then monthly until union was achieved to compare union time, operation time, bleeding and complications between the two groups.ResultsAll patients underwent follow-up examinations until fracture union was achieved. The average length of followup time after the second treatment was (18.37±3.28) months. The time needed for union was (4.17±0.94) months in the augmentation plating group and (5.33±1.72) months in the exchange plating group. The operation time was (90.00±17.58) minutes in the augmentation plating group and (160.00±25.35) minutes in the exchange plating group. The amount of blood loss during the operation was (270.00±43.32) ml in the augmentation plating group and (530.00±103.65) ml in the exchange plating group. Both groups showed significant difference (P<0.05) in their results. No complications were reported after the second operation.ConclusionsAugmentation plating after nail fixation could remove local rotation instability, facilitate simple operation, create minimal damage and enable exercise for early functional recovery. Therefore, augmentation plating is excellent for treating hypertrophic non-union after nail fixation in femoral shaft fracture.
What is the real practice of exercise echocardiographic testing in asymptomatic patients with severe aortic stenosis?
Authors: Cho Eun Jeong , Park Sung-Ji , Song Jung-Eun , Kim Seol-Hwa , Lee Yung-Joo , Gak Ji-Hye , Chang Sung-A , Lee Sang-Chol , Park Seung Woo 
Published: January 2024

Background
Although exercise testing has been suggested to help predict clinical outcome, limited data are available to guide how exercise Doppler echocardiography (ECG) can be used clinically in asymptomatic patients with aortic stenosis (AS). The aim of this study was to assess the clinical value of exercise echocardiographic testing in asymptomatic patients with severe AS.

Methods
Symptom-limited treadmill exercise testing using the modified Bruce protocol was performed in 31 asymptomatic patients (mean age (62±11) years) with severe AS (aortic valve area <1 cm2, peak aortic velocity (AV Vmax) >4 m/sec, or a mean transaortic pressure gradient (AV mean PG) >40 mmHg (1 mmHg=0.133 kPa)) with normal left ventricular (LV) systolic function (LV ejection fraction (EF) >50%). Clinical symptoms, vital signs, ECG, and Doppler hemodynamics were obtained during and/or immediately after exercise.

Results
Aortic valve replacement (AVR) was performed in 18 patients during follow-up. The patients who had AVR exhibited higher baseline AV mean PG (51 (35-84) vs. 44 (25.2-57.0) mmHg; P=0.031). There were no significant differences between the AVR group and non-AVR group including exercise duration (7.47 (2.32-11.59) vs. 7.25 (4.06-10.52) minutes, P=0.917), exercise capacity (10.1 (4.6-12.8) vs. 10.1 (7.0-12.8) metabolic equivalents, P=0.675), and an increment in AV mean PG by exercise (18.5 (3.2-48.0) vs. 12.6 (4.4-32.1) mmHg, P=0.366). Univariate regression analysis revealed that independent determinant of AVR was the baseline AV mean PG (P=0.031).

Conclusions
Although additional value of exercise ECG was demonstrated, baseline transaortic mean pressure gradient is the major determinant of AVR. Further large-scale prospective studies are required to determine whether surgery should be recommended in the presence of an abnormal exercise ECG in asymptomatic severe AS.
Association between clinical features and prognosis of patients with limb-shaking transient ischemic attack
Authors: MA Qing-Feng , HUANG Qiang , ZHANG Qian , FAN Chun-Qiu , GUO Xiu-Hai , WU Jian 
Published: January 2024

Objective
This review aims to illustrate the relationship between clinical features and the prognosis of patients with limb-shaking transient ischemic attack (LS-TIA).

Data sources
Relevant articles published in two main Chinese medical periodical databases (China National Knowledge Infrastructure and China Science Periodical Database) from 1986 to June 2013 were identified with keywords “limb shaking” and “transient ischemic attack”.

Study selection
Original articles and case reports about LS-TIA were selected.

Results
A total of 63 cases collected from 19 articles were included in the pooled analysis. LS-TIA presented in two cerebrovascular diseases, of which atherosclerotic high-grade stenosis or occlusion in carotid artery system and moyamoya disease formed 95.2% and 4.8%, respectively. Of 63 patients, 11 (17.5%) were once misdiagnosed as epileptic and prescribed useless antiepilepsy drugs. The multivariable Logistic regression model showed a significant protective effect of patients with revascularization therapy on prognosis, compared with patients treated with drugs (odds ratio 0.20, 95% CI 0.05-0.74, P=0.016).

Conclusions
Chronic carotid artery system hypoperfusion can induce limb(s) shaking, followed by high possibility of ischemic stroke in the same brain territorial. Revascularization of the responsible artery may work better than conservative drug-based therapy.
Advancement of maxillary anterior segment by distraction osteogenesis for severe maxillary retrusion in cleft lip and palate
Authors: Feng Gao , Minlie Yang , Zhenmin Zhao , Xiaomei Sun , Ningbei Yin , Yongqian Wang , Tao Song , Haidong Li , Di Wu , Jiapeng Yin , Yimei Cao , Haizhou Tong 
Published: January 2024

Background
Maxillary anterior segmental distraction osteogenesis (MASDO) is a recently used method for correction of severe maxillary retrusion in cleft lip and palate (CLP) patients. In this article, we evaluated the feasibility of MASDO using rigid external distraction (RED) and rapid orthodontic tooth movement to correct severe maxillary retrusion in CLP patients.

Methods
Fourteen male and five female complete CLP patients between the ages of 18 and 22 years (mean age 19.7 years) at the time of distraction, with severe maxillary retrusion, were treated with the rigid external distraction (RED) device after maxillary anterior osteotomy. Rapid orthodontic tooth movement was started one week after the MASDO. Standard profile photographic, cephalometric films were obtained preoperatively and after therapy. Sella-nasion-point A (SNA) and Sella-nasion-point B (SNB) angles were measured to reflect changes in maxillary and mandibular position, and the distance between anterior nasal spine and posterior nasal spine (ANS-PNS) was measured to represent the maxillary dental arch length.

Results
The SNA angle increased from an average of 74.6° (range 73.0°-78.0°), preoperatively, to 83.4° (range 78.6°-88.0°) after the RED was removed (P <0.01). All cases of severe maxillary retrusion were improved. Nine patients' profiles became harmonious after therapy. One patient had a bimaxillary protrusion deformity and needed further surgery. The regenerate alveolar crest and edentulous space on both segments was almost completely eliminated after rapid orthodontic tooth movement.

Conclusion
MASDO with the RED system and rapid orthodontic tooth movement is a successful way of correcting severe maxillary retrusion in CLP patients.
Application of the multi-planar reconstruction in endovascular treatment of type B aortic dissection
Authors: LI Yong-sheng , HOU Kai , XU Xin , YANG Jue , ZHU Ting , DONG Zhi-hui , YUE Jia-ning , WANG Yu-qi , FU Wei-guo 
Published: January 2024

Background
Although Multi-planar reconstruction (MPR) has been considered a diagnostic imaging technique that observes more perspectives for diseases, few people have applied it surgically. In fact, MPR is also very useful to clinical operation, especially for patients with type B aortic dissection. It helps the surgeon to locate accurately with more information about aortic dissection, so that the safety and effectiveness of operation can be improved. This study examined the application of the MPR in intraoperative DSA imaging for precise positioning by accurately obtaining a crosssection, a spin angle of the coronal plane, and a tilt angle of the sagittal plane in treatment of type B aortic dissection.

Methods
The conventional and the MPR approaches were compared on positioning the aortic arch for surgery. A group of 40 patients (group A) and another group of 42 patients (group B) was sampled. About the comparison of baseline characteristics, a fourfold table χ2 test was conducted on gender, and two independent samples t-test was applied to age between group A and group B. Spin as well as tilt angles for group A were obtained from the patients using both approaches, and their effectiveness was compared with pair t-tests; The MPR data guided stent-grafting in this group. Stent graft placement of group B was based on the conventional approach. Percentages of proximal distributed markers as well as incidences of complications were collected from both groups after stent graft placement. They were also compared with a fourfold table χ2 test.

Results
Gender difference was not found between group A and group B (χ2=0.80, P >0.05), and age difference was not statistically significant (F=2.55, homogeneity of variance, t=−1.46, P >0.05). A significant difference was found between the conventional and the MPR approaches for spin angle (t=9.17) as well as tilt angle (t=2.07), P <0.05. Percentage of proximal distributed markers (5.0%) of group A was significantly lower than that of group B (42.9%), χ2=15.92, P <0.05; and incidence of complications (5.0%) of group A was also significant lower than that of group B (21.4%), χ2=4.76, P <0.05.

Conclusions
Application of the MPR facilitated intraoperative angle adaption and led to satisfactory DSA. It is feasible in endovascular treatment of type B aortic dissection, and can effectively and safely guide surgical operations.
Midterm results of diagnostic treatment and repair strategy in older patients presenting with nonrestrictive ventricular septal defect and severe pulmonary artery hypertension
Authors: Liu Aijun , Li Zhiqiang , Li Xiaofeng , Fan Xiangming , Su Junwu , Zhang Jing , He Yan , Liu Yinglong 
Published: January 2024

Background
Congenital heart disease with severe pulmonary arterial hypertension (SPAH), previously thought to have irreversible pulmonary vascular disease (PVD), has been recently successfully corrected using diagnostic treatment and repair strategy by our surgery team. This study aimed to evaluate the midterm results of a selected cohort of older patients with nonrestrictive ventricular septal defect (VSD) and SPAH using diagnostic treatment and repair strategy.

Methods
The records of 56 patients older than six years with nonrestrictive VSD and SPAH undergoing diagnostic treatment and repair strategy from 2006 to 2012 were retrospectively reviewed. All patients received advanced pulmonary arterial hypertension (PAH) therapy and radical repairs were performed when transcutaneous oxygen saturation (SPO2) increased up to 93%.

Results
There were no operative deaths. SPO2 and baseline six-minute walk test (SMWT) distance of all selected patients increased significantly and mean pulmonary artery pressure (MPAP) regressed significantly after diagnostic treatment and at late follow-up (P<0.01). The incidence of late postoperative PAH was seen in six (10.7%) patients and by Logistic regression analysis, early postoperative PAH was an independent risk factor related to late postoperative PAH.

Conclusions
Diagnostic treatment and repair strategy was effective and safe for treatment of nonrestrictive VSD and SPAH and the midterm results were excellent. Diagnostic treatment strategy was effective in assessing the reversibility of SPAH in older patients associated with nonrestrictive VSD and the PVD in these selective patients is generally reversible.