bluuebunny/crossref_metadata_2025_split huggingface dataset:
High risk factors of brain metastases in 295 patients with advanced breast cancer
Authors: YAN Min , LÜ Hui-min , LIU Zhen-zhen , LIU Hui , ZHANG Meng-wei , SUN Xi-bin , CUI Shu-de 
Published: January 2024

Background
The incidence of brain metastases in patients with breast cancer is approximately 10%—16%, and survival after diagnosis of brain metastases is usually short. This study was designed to evaluate the risk factors associated with brain metastases in advanced breast cancer patients, with a view to help predict patient groups with high risk of brain metastases.

Methods
In total, 295 patients with advanced breast cancer were evaluated. All patients were pathologically confirmed and metastatic lesions were confirmed pathologically or by imaging. All patients were examined at least once every 6 months with head CT or MRI. Patients showing symptoms underwent immediate inspection, and brain metastatic lesions were confirmed by head CT and/or MRI.

Results
At a median follow-up of 12 months from the occurrence of metastases, brain metastases had occurred in 49 patients (16.6%). In our univariate analysis, variables significantly related to increased risk of brain metastases were hormone receptor-negative tumors, epidermal growth factor receptor 2 (HER2)-positive tumors, and multiple distant metastases. Patients with dominant tumor sites in soft tissue, or defined as Luminal A subtype, tended to have a lower risk of brain metastases than patients with visceral metastases, Luminal B subtype, triple-negative subtype or HER2-enriched subtype tumors.

Conclusions
Our results strongly suggest that factors such as Luminal B, triple-negative, and HER2-enriched subtypes are high risk factors for brain metastases. These data, therefore, provide pivotal clinical evidence towards a comprehensive understanding of the risk factors of brain metastases in advanced breast cancer patients.
Anatomical study of endoscope-assisted far lateral keyhole approach to the ventral craniocervical region with neuronavigational guidance
Authors: GUAN Min-wu , WANG Jia-yin , FENG Dong-xia , FU Paul , CHEN Li-hua , LI Ming-chu , ZHANG Qiu-hang , SAMII Amir , SAMII Madjid , KONG Feng , ZHANG Zhi-ping , CHEN Ling 
Published: January 2024

Background
Image-guided neurosurgery, endoscopic-assisted neurosurgery and the keyhole approach are three important parts of minimally invasive neurosurgery and have played a significant role in treating skull base lesions. This study aimed to investigate the potential usefulness of coupling of the endoscope with the far lateral keyhole approach and image guidance at the ventral craniocervical junction in a cadaver model.

Methods
We simulated far lateral keyhole approach bilaterally in five cadaveric head specimens (10 cranial hemispheres). Computed tomography-based image guidance was used for intraoperative navigation and for quantitative measurements. Skull base structures were observed using both an operating microscope and a rigid endoscope. The jugular tubercle and one-third of the occipital condyle were then drilled, and all specimens were observed under the microscope again. We measured and compared the exposure of the petroclivus area provided by the endoscope and by the operating microscope. Statistical analysis was performed by analysis of variance followed by the Student-Newman-Keuls test.

Results
With endoscope assistance and image guidance, it was possible to observe the deep ventral craniocervical junction structures through three nerve gaps (among facial-acoustical nerves and the lower cranial nerves) and structures normally obstructed by the jugular tubercle and occipital condyle in the far lateral keyhole approach. The surgical area exposed in the petroclival region was significantly improved using the 0° endoscope (1147.80 mm2) compared with the operating microscope ((756.28±50.73) mm2). The far lateral retrocondylar keyhole approach, using both 0° and 30° endoscopes, provided an exposure area ((1147.80±159.57) mm2 and (1409.94±155.18) mm2, respectively) greater than that of the far lateral transcondylar transtubercular keyhole approach ((1066.26±165.06) mm2) (P <0.05).

Conclusions
With the aid of the endoscope and image guidance, it is possible to approach the ventral craniocervical junction with the far lateral keyhole approach. The use of an angled-lens endoscope can significantly improve the exposure of the petroclival region without drilling the jugular tubercle and occipital condyle.
New insight into genes in association with asthma: literature-based mining and network centrality analysis
Authors: LIANG Rui , WANG Lei , WANG Gang 
Published: January 2024

Background
Asthma is a heterogeneous disease for which a strong genetic basis has been firmly established. Until now no studies have been undertaken to systemically explore the network of asthma-related genes using an internally developed literature-based discovery approach. This study was to explore asthma-related genes by using literature-based mining and network centrality analysis.

Methods
Literature involving asthma-related genes were searched in PubMed from 2001 to 2011. Integration of natural language processing with network centrality analysis was used to identify asthma susceptibility genes and their interaction network. Asthma susceptibility genes were classified into three functional groups by gene ontology (GO) analysis and the key genes were confirmed by establishing asthma-related networks and pathways.

Results
Three hundred and twenty-six genes related with asthma such as IGHE (IgE), interleukin (IL)-4, 5, 6, 10, 13, 17A, and tumor necrosis factor (TNF)-alpha were identified. GO analysis indicated some biological processes (developmental processes, signal transduction, death, etc.), cellular components (non-structural extracellular, plasma membrane and extracellular matrix), and molecular functions (signal transduction activity) that were involved in asthma. Furthermore, 22 asthma-related pathways such as the Toll-like receptor signaling pathway, hematopoietic cell lineage, JAK-STAT signaling pathway, chemokine signaling pathway, and cytokine-cytokine receptor interaction, and 17 hub genes, such as JAK3, CCR1-3, CCR5-7, CCR8, were found.

Conclusions
Our study provides a remarkably detailed and comprehensive picture of asthma susceptibility genes and their interacting network. Further identification of these genes and molecular pathways may play a prominent role in establishing rational therapeutic approaches for asthma.
Etoricoxib versus indometacin in the treatment of Chinese patients with acute gouty arthritis: a randomized double-blind trial
Authors: Li Ting , Chen Shun-le , Dai Qing , Han Xing-hai , Li Zhan-guo , Wu Dong-hai , Zhang Xiao , Gu Jie-ruo , Yang Nan-ping , Sun Ling-yun , Zhang Miu-jia , Li Xing-fu , Bao Chun-de 
Published: January 2024

Background
Acute gout is an intensely painful, inflammatory arthritis. Although the non-steroidal anti-inflammatory drugs (NSAIDs) are widely used for this condition, the efficacy is based on only a few studies, particularly in China. We tried to assess the safety and efficacy of etoricoxib in the treatment of acute gouty arthritis in China.

Methods
A randomized, double-blind, active comparator study was conducted at 10 sites in China. Patients (n=178; ≥18 years of age) with acute gouty attack (<48 hours) were treated for 5 days with etoricoxib (120 mg/d; n=89) or indometacin (75 mg twice daily; n=89). The primary efficacy end point was self-assessed pain in the affected joint (0-4 point Likert scale) from days 2-5. Secondary end points included investigator assessments of tenderness and swelling, patient/investigator global assessments of response to therapy, and patients discontinuing treatment. Safety was assessed by adverse events (AEs).

Results
Etoricoxib and indometacin had comparable primary and secondary end points. Mean change difference from baseline from days 2-5 was 0.03 (95% confidence interval (CI) -0.19 to 0.25; P=0.6364), which fell within the prespecified comparative bounds of -0.5 to 0.5. No severe AEs were associated with etoricoxib use. Non-severe AEs were mainly digestive and general, and most (73.7%) were mild, although they caused withdrawal of two subjects in the etoricoxib group, due to bilateral renal calculi and uronephrosis of the left kidney (unrelated to etoricoxib) and fever and chills (potentially etoricoxib-related). Overall, AEs were similar, although the absolute number of AEs in the etoricoxib group (n=31) was less than the indometacin group (n=34).

Conclusions
Etoricoxib (120 mg once daily) is effective in treating acute gout, is generally safe and well-tolerated, and is comparable in efficacy to indometacin (75 mg twice daily).
Despite shared susceptibility loci, esophageal squamous cell carcinoma embraces more familial cancer than gastric cardia adenocarcinoma in the Taihang Mountains high-risk region of northern central China
Authors: WEN Deng-gui , YANG Yi , WEN Xiao-duo , SHAN Bao-en 
Published: January 2024

Background
In China, esophageal squamous cell carcinoma (ESCC) and gastric cardia adenocarcinoma (GCA) share susceptibility loci, but different rates of multiple primary cancer and male/female ratio suggest the proportion of familial cancer is not equal.

Methods
The percent of cases with a positive family history, median onset age, rate of multiple primary cancer, and male/female ratio associated with upper, middle, lower third ESCC and GCA were compared to reveal the proportion of familial cancer. The 7267 subjects analyzed constituted all ESCC and GCA cases in whom the cancer was resected with cure intention between 1970 and 1994 at the 4th Hospital of Hebei Medical University.

Results
A positive family history for cancer was most often associated with the multiple primary ESCC and/or GCA cases, e.g. with 42% of the males and 59% of the females. For upper, middle, lower third ESCC and GCA, the percent of cases with a positive family history decreased by 38.5%, 26.3%, 26.5%, and 11.2% in males (P <0.000) and 25.0%, 22.3%, 23.9%, and 9.8% in females (P <0.0001). Median onset age increased from 49, 52, 55, to 56 years old in males and from 50, 53, 55, to 56 years old in females ( both P <0.0001) for upper, middle, lower third ESCC and GCA. Male/female ratio increased from 2.2, 2.1, 2.2, to 6.2:1 for upper, middle, lower third ESCC and GCA (P <0.0001). For upper, middle, lower third ESCC and GCA, the percent of multiple primary cancers decreased from 21.2%, 2.3%, 2.2%, to 1.5% in males and from 14.3%, 2.4%, 3.4%, to 3.1% in females. The preponderance of males, smoking, drinking, or onset-age ≥50 years was significantly higher in GCA than in ESCC, and the difference in the rates of multiple primary cancers between the preponderant and the non-preponderant cases was significant in GCA, but not in ESCC, suggesting non-equal requirement for genetic susceptibility when environmental hazards did not exist.

Conclusions
The proportion of familial cancer in upper gastrointestinal carcinomas decreases by the priamry site of upper, middle, lower third esophagus and gastric cardia. Considering familial and sporadic cancers differ in preventability, screening strategy and recurrence, our findings have basic and clinical implications.
Effects of Naoxintong on atherosclerosis and inducible nitric oxide synthase expression in atherosclerotic rabbit
Authors: Zhong Xiao-nan , Wang Hong-hao , Lu Zheng-qi , Dai Yong-qiang , Huang Jian-hua , Qiu Wei , Shu Ya-qing , Xu Wen , Cheng Chen , Hu Xue-qiang 
Published: January 2024

Background
High levels of nitric oxide (NO) produced by inducible NO synthase (iNOS) have been associated with atherosclerosis processes. Naoxintong is a traditional Chinese medicine for treatment of cerebrovascular and cardiovascular disease. The aim of the present study was to detect and quantify changes of iNOS mRNA and NO levels in the vessel wall after the administration of Naoxintong in an atherosclerotic rabbit model.

Methods
Forty New Zealand white rabbits were randomly divided into five groups (n=8). Rabbits were fed a standard diet (group A), an atherogenic diet consisting of 79% standard feed+1% cholesterol+5% lard+15% egg yolk powder (group B), an atherogenic diet with Naoxintong 0.25 mg·-1·d-1 (group C), an atherogenic diet with Naoxintong 0.5 mg·-1·d-1 (group D), or atherogenic diet with Naoxintong 1.0 mg·-1·d-1 (group E) for 12 weeks.

Results
Supplemented administration of Naoxintong led to a down-regulation of cholesterol (CHOL) (P <0.001) and low-density lipoprotein (LDL) (P <0.001). The trend became more notable as the dose of Naoxintong increased; group C vs. group B (CHOL, P=0.568; LDL-cholesterol (LDL-C), P=0.119), group D vs. group B (CHOL, P=0.264; LDL-C, P=0.027), group E vs. group B (CHOL, P=0.028; LDL-C, P=0.002). Atherosclerotic lesions in aorta were reduced in Naoxintong groups (groups C, D, E) compared to group B. Group B had higher iNOS mRNA (P=0.001) and NO level (P <0.001) than group A. Compared with the atherogenic diet fed-rabbits, Naoxintong supplements decreased the expression of iNOS mRNA (P <0.001) and the NO level (P <0.001) in the vessel wall. Groups given a higher Naoxintong dose exhibited greater benefits. iNOS mRNA and NO levels seemed to be reduced in group C, although the difference did not quite reach statistical significance (iNOS mRNA, P=0.130; NO, P=0.038). iNOS mRNA and NO levels significantly decreased in group D (iNOS mRNA, P=0.019; NO, P=0.018) and group E (iNOS mRNA, P=0.004; NO, P <0.001).

Conclusion
Naoxintong has beneficial effects on atherosclerosis treatment by reducing expression of iNOS mRNA and the NO level in the vessel wall.
Clinical characteristics of patients with labyrinthine fistulae caused by middle ear cholesteatoma
Authors: YANG Juan-mei , CHI Fang-lu , HAN Zhao , HUANG Yi-bo , LI Yi-ke 
Published: January 2024

Background
Labyrinthine fistula (LF) is a very common clinical complication mainly caused by middle ear cholesteatoma. Whether the presence of different degree LF caused by middle ear cholesteatoma aggravates neurosensory hearing loss (NSHL) and what is the degree of the hearing loss caused by LF were still under controversial. This study aimed to investigate whether the LF degree is correlative with the age distribution, disease duration and hearing loss degree for cholesteatomatous patients.

Methods
The files of 143 patients with middle ear cholesteatoma were selected and reviewed in a retrospective study. Seventy-eight patients with LF were divided into three types according to the degree of destruction of labyrinth. Sixty-five patients without LF were randomly chosen for control. Then, we compared the clinical characteristics of patients with or without labyrinthine fistulae caused by middle ear cholesteatoma.

Results
According to the study, cholesteatomatous patients with LF were older and suffered longer disease duration than those without LF. Hearing loss is severe with high frequencies both in patients with and without LF. Moreover, inner ear impairment is correlative with the degree of destruction in labyrinth, and more severe destruction in labyrinth follow the more severe symptoms correlative with inner ear impairment.

Conclusion
Surgical intervention should be performed as early as possible for these cholesteatomatous patients.
Temporal effect of local hyperthermia on murine contact hypersensitivity
Authors: ZHANG Lan , WANG Yi-ru , HONG Yu-xiao , XU Ya-qin , ZHANG Li , LI Xiao-dong , XIAO Ting , LU Dong-qing , CHEN Hong-duo , GAO Xing-hua 
Published: January 2024

Background
The sensitization and elicitation phases are involved in the immunopathogenesis of contact hypersensitivity (CHS). Langerhans cells (LCs) are believed to play pivotal roles in the sensitization stage of CHS. Local hyperthermia on skin induces the migration as well as maturation of epidermal LCs. Although fever-range whole body hyperthermia and local hyperthermia at 43°C prior to sensitization were reported to suppress CHS, the effects of different temperatures and the timing sequence of local hyperthermia on CHS have not been tackled.

Methods
Local hyperthermia was applied to murine dorsal skin 3 days prior to, concurrent with, or 2 days post sensitization with fluorescein isothiocyanate (FITC) in BALB/c mice. Local hyperthermia temperatures at 37°C, 39°C, 41°C and 43°C were applied to mouse dorsal skin and the severity of CHS was calculated by measuring the swelling response of the challenged ears.

Results
Local hyperthermia at 39°C, 41°C and 43°C prior to sensitization reduced the severity of CHS, as compared with that at 37°C. The suppression of CHS was temperature dependant in that higher temperature had a stronger effect. On the contrary, the hyperthermia treatments, either concurrent with or post-sensitization, resulted in an enhanced temperature-dependant ear swelling response.

Conclusions
The severity of murine CHS could be influenced by local hyperthermia at the sensitization stage in a temperature dependant manner. The temporal effect of local hyperthermia suggested a novel factor in interpreting the severity of allergic contact dermatitis.
Assessment of the right and left ventricular function in patients with cor pulmonale using high-definition CT
Authors: Gao Yan , Qin Jian , Du Xiang-ying , Yang Jing , Li Kun-cheng 
Published: January 2024

Background
Cor pulmonale is often associated with changes of structure and function of the right ventricle (RV) and thus further affects functional changes of the left heart. Our study aimed to assess the left ventricular (LV) and RV function in patients with cor pulmonale using high-definition CT (HDCT).

Methods
We prospectively studied 18 cor pulmonale patients determined by the pulmonary function test, clinical examination, chest radiograph, electrocardiogram, and echocardiogram. The subject group was compared to a control group consisting of 18 subjects. The RV and LV functions and RV myocardial mass (MM) were obtained by HDCT in the two groups. The results were compared between the two groups using the independent sample t test. Echocardiographic examination for cardiac function analysis was performed on the same day.

Results
The RV end-diastolic volume (EDV), RV end-systolic volume (ESV) and RV myocardial mass were significantly larger in the 18 cor pulmonale patients than in the control group (P<0.05). The right ventricular ejection fraction (RVEF) was significantly lower in the 18 cor pulmonale patients than in controls (P<0.01). The left ventricular EDV (LVEDV) and LVEF were significantly lower in cor pulmonale patients than in controls (P<0.01). There were strong correlations between MDCT and echocardiography, rRVEF=0.839 and rLVEF=0.916, respectively.

Conclusions
HDCT can accurately quantify RV and LV function. The right ventricular function is impaired in patients with cor pulmonale, while at the same time the left ventricular function is also impaired.
CD8+ Tc-lymphocytes immunodeviation in peripheral blood and airway from patients of chronic obstructive pulmonary disease and changes after short-term smoking cessation
Authors: Yu Mu-qing , Liu Xian-sheng , Wang Jian-miao , Xu Yong-jian 
Published: January 2024

Background
Cigarette smoke induces an acute but persisting inflammation in peripheral blood and airway in chronic obstructive pulmonary disease (COPD), and CD8+ Tc-lymphocytes are considered as a key role in this process. We aimed to investigate the Tc-lymphocytes immunodeviation in system and local airway of COPD patients and changes of the immunodeviation after short-term smoking cessation.

Methods
Peripheral blood (PB) and bronchoalveolar lavage fluid (BALF) were collected from 42 patients (14 COPD patients, 16 smokers with normal lung function and 12 nonsmokers), while PB and induced sputum (IS) were obtained from other 19 patients (10 quitting smokers and 9 continuing smokers) at baseline and follow-up respectively of 4-week smoking cessation. Percentages of CD8+ Tc-lymphocytes (%CD3+) and Tc1/Tc2 ratios were measured by flow cytometry.

Results
Percentages of CD8+ Tc-lymphocytes were higher in COPD patients than those in smokers and nonsmokers in both PB and BALF. Tc1/Tc2 ratio in PB and in BALF from COPD patients was greater than that from smokers and nonsmokers and negatively correlated with FEV1 %pre. When comparing the ratios between PB and BALF, significantly positive correlation was found in COPD patients. Furthermore, after 4-week smoking cessation, percentages of CD8+ Tc-lymphocytes in PB and IS in quitting smokers were decreased compared to that in baseline and continuing smokers, whereas Tc1/Tc2 ratios were not influenced.

Conclusions
CD8+ Tc1-trend immunodeviation profiles occurred in both system and local airway of COPD patients. This exceptional immunodeviation could not be relieved by short-term smoking cessation.
Atorvastatin reduces myocardial fibrosis in a rat model with post-myocardial infarction heart failure by increasing the matrix metalloproteinase-2/tissue matrix metalloproteinase inhibitor-2 ratio
Authors: AN Zhe , YANG Guang , HE Yu-quan , DONG Ning , GE Li-li , LI Shu-mei , ZHANG Wen-qi 
Published: January 2024

Background
The cholesterol-lowering statin drugs have some non-lipid-lowering effects, such as inhibiting myocardial remodeling. However, the underlying mechanism is still unclear.

Methods
The left anterior descending coronary artery was ligated to establish a rat model of heart failure, and the rats were divided into a sham operation (SO) group, myocardial infarction model (Ml) group, and Ml-atorvastatin group. Changes in hemodynamic parameters were recorded after the final drug administration. Histological diagnosis was made by reviewing hematoxylin and eosin (HE) stained tissue. Real-time quantitative polymerase chain reaction (PCR) was performed to determine the expressions of type I and type III collagen, matrix metalloproteinase-2 (MMP-2), and tissue matrix metalloproteinase inhibitor-2 (TIMP-2). Further, primary rat cardiac fibroblasts were cultured and the MTT assay was performed to determine the effect of atorvastatin on cardiac fibroblast proliferation.

Results
The model of heart failure was established and the results of HE staining and Masson's trichrome staining revealed that the rats in the heart failure group showed obvious hyperplasia of fibrotic tissue, which was significantly reduced in the atorvastatin group. Real-time quantitative PCR showed that the Ml group showed a significantly increased expression of type I and type III collagen, MMP-2, and TIMP-2, but a significantly reduced MMP-2/TIMP-2 ratio. Compared with the Ml group, the atorvastatin group showed significantly reduced expression of type I and III collagen, unchanged expression of MMP-2, significantly reduced expression of TIMP-2, and an increased MMP-2/TIMP-2 ratio. We further found that atorvastatin significantly inhibited the Ang ll-induced fibroblast proliferation and the expression of type I and type III collagen in cardiac fibroblasts while increasing the MMP-2/TIMP-2 ratio.

Conclusions
These data suggest that atorvastatin can inhibit cardiac fibroblast proliferation and enhance collagen degradation by increasing the MMP-2/TIMP-2 ratio, thereby inhibiting the formation of myocardial fibrosis in rats with heart failure after myocardial infarction.