bluuebunny/crossref_metadata_2025_split huggingface dataset:
Favorable response of a patient with primary B/myeloid mixed phenotype acute Leukemia to CD19-CAR-T: Case report and literature review
Authors: Wang Lixin , Pang Yanbin , Fang Chuling , Zhao Weiqiang , Xu Yuanyuan , Guo Xiao , Qiao Jingqiao , Mei Junhui , Wang Hongxin , Yu Chuan , Li Yisheng , Tang Zhixiong , Yu Li 
Published: December 2023

Rationale:
Mixed phenotype acute leukemia (MPAL) is a rare and heterogeneous type of leukemia known for its poor prognosis. The optimal treatment strategy for this condition currently lacks consensus, leaving uncertainty in its management. Nonetheless, a potential therapeutic option for patients with refractory MPAL who express target antigens is donor-derived chimeric antigen receptor T (CAR-T) cell therapy.

Patient concerns:
We recently reported a 61-year-old woman with MPAL and elucidated its diagnosis and treatment.

Diagnosis:
The diagnosis of MPAL was established based on the classification of World Health Organization in 2016.

Interventions:
Despite undergoing 3 different acute lymphoblastic leukemia (ALL) regimens and 1 acute myelogenous leukemia (AML) regimen, the patient did not achieve remission. Subsequently, the patient received human CD19-targeted CAR-T cell therapy.

Outcomes:
The patient achieved a successful and complete remission after CAR-T cell therapy. Tragically, 8 months after CAR-T infusion, the patient experienced a relapse characterized by CD19-negative disease and ultimately passed away.

Lessons:
This case underscores the potential efficacy and safety of human-derived CD19 CAR-T cell therapy in treating refractory MPAL. While this particular patient outcome was unfortunate, it suggests that CAR-T cell therapy may still hold promise as a viable treatment option for MPAL patients unresponsive to other therapies. Further research in this field is warranted to determine the most effective treatment strategies for managing this challenging disease.
Effectiveness and safety of probiotics on patients with severe acute pancreatitis: A systematic review and meta-analysis
Authors: Gao Zhiling , Yin Shuomiao , Jin Kui , Nie Weiqun , Wang Longmei , Cheng Ling 
Published: December 2023

Background:
This meta-analysis aimed to assess the efficacy and safety of probiotics in conjunction with early enteral nutrition for the treatment of severe acute pancreatitis (SAP). This study focused on multiple clinical endpoints, including mortality rate, risk of organ failure, and duration of hospital stay.

Methods:
In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The study adhered to the Patient, Intervention, Comparison, Outcome framework and utilized randomized controlled trials to examine the impact of probiotics on patients with SAP. Data extraction and quality assessment were conducted independently by 2 evaluators, with discrepancies resolved collaboratively, or by a third adjudicator. Statistical analyses were performed using chi-square statistics, I
2 metrics, and both fixed- and random-effects models, as dictated by heterogeneity levels.

Results:
The meta-analysis covered 6 randomized controlled trials. Compared to control groups (placebo or standard care without probiotics), probiotics did not significantly reduce mortality rates or organ failure risk. However, they notably shortened hospital stays by a weighted mean difference of −5.49 days (95% confidence interval: −10.40 to −0.58; P = .010). The overall bias risk was low to moderate.

Conclusions:
Probiotics combined with early enteral nutrition did not significantly improve mortality rates or reduce the risk of organ failure in patients with SAP, but shortened hospital stays. Further studies are required to corroborate these findings.
A meta-analysis of adverse effects of retinopathy of prematurity on neurodevelopment in preterm infants
Authors: Fang Lan , Wang Chan , Yang Yanzhang , Feng Jiajia , Chen Fengqin 
Published: December 2023

Background:
Retinopathy of prematurity (ROP) increases with the survival of late preterm infants, but its relationship with neurodevelopmental outcomes in preterm infants remains controversial. To investigate the relationship between ROP and its severity and adverse neurodevelopmental outcomes in preterm infants.

Methods:
We conducted a meta-analysis. All relevant literature before November 2022 were retrieved from PubMed, Embase, Cochrane Library Web of Science, CNKI, CBM, Wan fang Data, and VIP Database. According to the inclusion criteria and exclusion criteria, eligible literature were included to conduct clinical trial quality assessment, and the Newcastle-Ottawa scale was used to evaluate the quality of evidence. Meta-analysis was performed using RevMan5.3. Data extraction, quality assessment, and meta-analysis were performed independently by 2 people. Mean difference or standardized mean difference of motor, language and cognitive scores (Bayley III or Bayley II) were used as effect sizes for continuous data analysis, all of which were represented by 95% CI. For heterogeneity (I
2 ≥ 50% or P < .10), a random effects model was used, otherwise a fixed effects model was used.

Results:
A total of 6 literature were included. The results of the ROP group for motor (comprehensive motor, proportional motor, and fine motor), language and cognitive scores were −5.57 (95%CI, −1.43 to 0.04), −0.95 (95%CI, 1.4–0.50), −1.34 (95% CI, 1.77–0.92), −1.75 (95% CI, 2.26–1.24) and −5.56 (95% CI, 9.56–1.57). Additionally, the results of severe ROP group for motor (comprehensive motor, proportional motor, fine motor), language and cognitive scores were −8.32 (95%CI, −8.91 to 7.74), −1.10 (95%CI, −1.83 to −0.36), −1.08 (95%CI, −1.75 to −0.41), −7.03 (95%CI, −7.71 to 6.35), and −7.96 (95%CI, −8.5 to −7.42).

Conclusions:
The Bayley Scale scores of the ROP group were lower than those of the not ROP group, and the scores of the severe ROP were significantly lower than those of the not severe ROP group. These findings suggest that ROP can indeed delay motor, language and cognitive, especially in severe cases.
Bronchiole adenoma/pulmonary ciliated mucinous nodular papillary tumor: Case series and literature review
Authors: Liu Shanshan , Cai Xiaoshan , Pan Jianliang , Liu Shaoyun , Lin Jianjun , Yue Xianwen 
Published: December 2023

Objective:
To analyze the clinical-pathological characteristics of 3 cases of bronchiolar adenoma/pulmonary ciliary mucinous nodular papillary tumors, and to improve the understanding of bronchiolar adenoma (BA)/ciliated muconodular papillary tumors (CMPT) (bronchiolar adenoma/ciliated muconodular papillary tumor).

Methods:
Retrospective analysis was done on the clinical information, diagnosis, and treatment of 3 instances of BA/CMPT at the Second People’s Hospital of Weifang City. By scanning the CNKI, Wanfang, VIP database, and Pubmed database using the English key words “bronchiolar adenoma, ciliated muconodular papillary tumor,” respectively patients with comprehensive clinical data were gathered, and studies from January 2002 to August 2021 that were relevant to the patients were examined.

Results:
A total of 35 articles and 71 instances were found, including 3 cases in our hospital, for a total of 74 cases. There were 31 males and 43 females among them, ranging in age from 18 to 84 years (average 63 years), and 15 cases had a smoking history. The majority of them were discovered by physical examination and had no clinical symptoms. The majority of the imaging revealed solid nodules with variable forms, with some ground-glass nodules displaying vacuole and bronchial inflation signs. BA/CMPT are generally gray-white, gray-brown solid nodules with obvious boundaries but no envelope with a maximum dimension of 4 to 45 mm (average 10.6 mm) on gross examination. Acinar, papillary, and lepidic formations can be seen under the microscope at high magnification; the majority of these structures are made up of tripartite epithelial components, including basal cells, mucous cells, ciliated columnar cells, and alveolar epithelial cells, demonstrating a variety of combinations. An important basis for diagnosis in immunohistochemistry is the continuous positive basal cell layer that is shown by p63, p40, and CK5/6. BRAF and epidermal growth factor receptor are the genes that are most frequently mutated. All of the patients showed no signs of metastasis or recurrence during follow-up period.

Conclusion:
BA/CMPT is a rare benign tumor of lung epithelium. Because imaging and intraoperative cryosection diagnosis are easy to be misdiagnosed as malignant, it is necessary to further improve understanding and improve immunohistochemistry and genetic examination.
The impact of palliative care on the physical and mental status and quality of life of patients with chronic heart failure: A randomized controlled trial
Authors: Liu Yulan , Tao Liang , Liu Min , Ma Lulu , Xu Yi , Zhao Cui 
Published: December 2023

Background:
Chronic heart failure (CHF) is the terminal stage of several diseases. The present study aimed to investigate the impact of palliative care on the physical and mental status and quality of life of patients with CHF.

Methods:
This single-center randomized controlled clinical trial was conducted at Xiangtan Central Hospital. A total of 103 cases were included and divided into a study group (n = 54) and a control group (n = 49). The control group received usual care, whereas the study group received usual care plus palliative care. Statistical analyses were conducted on Simplified Coping Style Questionnaire, negative emotions, Minnesota Living with Heart Failure Questionnaire scores, and nursing satisfaction before and after intervention in the 2 groups.

Results:
After the intervention, the positive coping style score in the research group was higher than that in the control group, while the negative coping style score was lower than that of the control group (P < .05). After the intervention, the Beck Anxiety Inventory and Beck Depression Inventory-II scores of the 2 groups decreased compared to before the intervention, and the study group had lower scores than the control group (P < .05). After the intervention, the Minnesota Living with Heart Failure Questionnaire scores of the 2 groups decreased compared to those before the intervention, and the study group had lower scores than the control group (P < .05). Nursing satisfaction of the research group (94.44%) was higher than that of the control group (81.63%) (P < .05).

Conclusions:
Adopting palliative care to intervene in CHF patients can effectively regulate their physical and mental state, alleviate negative emotions, transform coping styles towards the disease, and improve their quality of life, with high patient satisfaction.
The prognostic value of Forkhead box P3 regulatory T cells in biliary tract cancer: A systematic review and meta-analysis
Authors: Cai Pengcheng , Wu Zhongli , Yang Xingjian , Wang Na , Yang Yong 
Published: December 2023

Background:
This study aimed to explore the value of tumor-infiltrating Forkhead box P3(FoxP3+) regulatory T cells (Tregs) in evaluating the prognosis of biliary tract cancer.

Methods:
Four electronic databases were searched using 2 computers: PubMed, Embase, Web of Science, and Cochrane Library. The vocabulary and syntax were adapted according to the database. Two researchers independently selected the studies, collected information, and assessed the risk of bias. The Meta-analysis was performed using STATA 17.0, and HR and its corresponding 95% CI were used to evaluate the correlation between FoxP3+ Tregs and the overall survival of patients with biliary tract cancer. In addition, the quality of the included studies was evaluated.

Results:
Ten articles were included in this study. The results of the meta-analysis showed that patients with high FoxP3+ Tregs infiltration had worse overall survival (OS) (HR = 1.34,95% CI 1.16 to 1.71; P < .001). Subgroup analysis of gallbladder carcinoma and cholangiocarcinoma showed that the high infiltration of FoxP3+ Tregs was significantly correlated with the OS of the former (HR = 1.55,95% CI 1.11 to 2.00; P < .001), but not with the OS of the latter (HR = 1.00,95% CI 0.62 to 1.38; P > .05).

Conclusions:
Our meta-analysis reveals that high infiltration of FoxP3 + Tregs is significantly associated with reduced overall survival in gallbladder carcinoma, endorsing their use as a prognostic biomarker for this subtype. In contrast, no significant prognostic correlation was identified for FoxP3+ Tregs in cholangiocarcinoma, indicating the need for subtype-specific evaluation of their prognostic relevance in biliary tract cancers.
Ulcerative colitis coexisting with hepatitis C: A rare occurrence
Authors: Liu Xiaoqiang , Huan Yisen , Wang Yubin , Huang Yingxuan 
Published: December 2023

Introduction:
We describe a rare case of a 54-year-old male diagnosed with both ulcerative colitis (UC) and hepatitis C virus (HCV), posing clinical challenges.

Patient Concerns:
The patient showed worsened UC symptoms, leading to further evaluations.

Diagnosis:
Dual diagnosis of UC and HCV was confirmed through endoscopy and serological tests, ruling out other hepatic causes. Interventions: Treatment involved methylprednisolone for UC and sofosbuvir/velpatasvir for HCV, with attention to drug interactions.

Outcomes:
Significant improvement was observed in both UC symptoms and HCV viral load post-treatment.

Conclusion:
This case underscores the need for nuanced treatment in managing concurrent UC and HCV, considering potential drug interactions and disease impacts.
Contrast-medium injury of spinal cord after cerebral angiography using nonionic contrast agents: A case report and literature review
Authors: Zhuo Shitu , Cao Lijing , Yang Meili , Chen Jixing , Yu Zheng 
Published: December 2023

Introduction:
Contrast-induced spinal cord injury (CIS) is an uncommon yet severe neurological complication following cerebral angiography. It can lead to dire consequences, including limb paralysis, respiratory distress, and even death.

Patient concerns:
After undergoing cerebral angiography, a 41-year-old male initially displayed symptoms of dizziness and blurred vision, which advanced into dysphoria and limb weakness within 3 hours. These initial symptoms diminished by the 12th hour. Yet, 18 hours following the procedure, the patient developed quadriplegia and paresthesia below the T5 level, even though his deep sensory functions persisted unaffected.

Diagnosis:
The magnetic resonance imaging and diffusion weighted imaging scans excluded the presence of cerebrovascular ischemia or subarachnoid hemorrhage. However, the magnetic resonance angiography displayed arterial vasospasms in both posterior cerebral arteries and the V4 segment of the right vertebral artery. The encephalopathy symptoms faded within 12 hours, suggesting a probable contrast-induced encephalopathy diagnosis. An magnetic resonance imaging on day 4 revealed an intensified signal in the spinal cord from C1 to T1. This finding supported the diagnosis of CIS.

Interventions:
Following treatment with mannitol, methylprednisolone, and nimodipine, the patient’s contrast-induced encephalopathy symptoms resolved completely within 12 hours. With a 2-week regimen of aspirin, methylprednisolone, and rehabilitative training, the neurological symptoms from CIS showed steady improvement.

Outcomes:
The symptoms and signs of CIS gradually improved after 2 weeks’ treatment and rehabilitation program.

Conclusion:
Given the grave outcomes of CIS, like limb paralysis, breathing difficulties, and even fatality, it is imperative to remain cautious about this complication, even with the use of modern, less harmful contrast agents.
Endoscopic papillectomy combined with endoscopic retrograde cholangio-pancreatography for duodenal gangliocytic paraganglioma: A case report
Authors: Cai Wenpin , Hu Weitao , Fang Taiyong 
Published: December 2023

Rationale:
Gangliocytic paraganglioma is a rare tumor that can occur in several organs throughout the body. Gangliocytic paraganglioma of the main duodenal papilla is even rarer. This study analyzes and discusses the endoscopic management of a case of gangliocytic paraganglioma of the main duodenal papilla and reviews the relevant literature. It is hoped that this study will increase clinicians’ awareness of this disease.

Patient concerns:
Electron endoscopy reveals a duodenal main papillary tumor, and the patient desires further clarification of the nature of the tumor and the next step in the treatment plan.

Diagnoses:
Duodenal gangliocytic paraganglioma.

Interventions:
As the patient lesion was located in the main duodenal papilla, we successfully performed endoscopic minimally invasive treatment of the tumor by endoscopic papillectomy combined with endoscopic retrograde cholangiopancreatography.

Outcomes:
The patient was discharged after the postoperative removal of the nasobiliary drain and returned to the hospital 2 months later to have the biliary stent removed; the patient was in good general condition at follow-up.

Lessons:
For duodenal main papillary tumor, we need to be alert to the possibility of gangliocytic paraganglioma. Since the tumor is located in the submucosa of the juxta-abdominal region, the preoperative biopsy positivity rate is low, and the tumor is often adjacent to or involves the biliopancreatic duct, endoscopic resection combined with endoscopic retrograde cholangiopancreatography can be considered for diagnosis and treatment.
Gitelman syndrome combined with diabetes mellitus: A case report and literature review
Authors: Huang Xiaoyan , Wu Miaohui , Mou Lunpan , Zhang Yaping , Jiang Jianjia 
Published: December 2023

Rationale:
Gitelman syndrome (GS) is an uncommon autosomal recessive tubulopathy resulting from a functional deletion mutation in the SLC12A3 gene. Its onset is typically insidious and challenging to discern, and it is characterized by hypokalemia, metabolic alkalosis, and reduced urinary calcium excretion. There is limited literature on the diagnosis and management of GS in individuals with concomitant diabetes.

Patient concerns:
A 36-year-old male patient with a longstanding history of diabetes exhibited suboptimal glycemic control. Additionally, he presented with concurrent findings of hypokalemia, hypomagnesemia, hypocalciuria, and metabolic alkalosis.

Diagnosis:
Building upon the patient’s clinical manifestations and extensive laboratory evaluations, we conducted thorough genetic testing, leading to the identification of a compound heterozygous mutation within the SLC12A3 gene. This definitive finding confirmed the diagnosis of GS.

Interventions:
We have formulated a detailed medication regimen for patients, encompassing personalized selection of hypoglycemic medications and targeted electrolyte supplementation.

Outcomes:
Following 1 week of comprehensive therapeutic intervention, the patient’s serum potassium level effectively normalized to 3.79 mmol/L, blood glucose parameters stabilized, and there was significant alleviation of clinical symptoms.

Lessons:
GS has a hidden onset and requires early diagnosis and intervention based on patient related symptoms and laboratory indicators in clinical practice, and personalized medication plans need to be provided according to the specific situation of the patient.
Primary adenomatoid tumor of the adrenal gland: A case report and literature review
Authors: Qi Hong-Feng , Chen Li-Qian , Yang Mai-Qing , Li Xiu-Feng , Zhang Hai-Ning , Zhang Ke-Xin , Xu Hong-Tao 
Published: December 2023

Rationale:
Adenomatoid tumors are rare benign tumors, mainly involving the reproductive tract, such as the epididymis in men and the uterus and fallopian tubes in women. However, a few cases can occur outside the reproductive tract. Herein, we report a rare case of a primary adenomatoid tumor of the adrenal gland.

Patient concerns:
A 50-year-old man underwent ultrasound examination and was found to have a right adrenal mass without elevated blood pressure, weakness after fatigue, frequent nocturnal urination urgency, pain, or a history of hematuria. The patient’s general health was normal. Computed tomography revealed a polycystic mixed-density lesion in the right adrenal region, approximately 7.3 × 4.5 cm in size.

Diagnoses:
Based on the clinical information, morphological features, and immunohistochemistry results, a pathological diagnosis of primary adenomatoid tumor of the adrenal gland was made.

Intervention:
Excision of the right adrenal gland and tumor through the 11 ribs.

Outcomes:
The patient’s postoperative course was uneventful.

Lessons:
Preventing misdiagnosis adenomatoid tumors with other types of adrenal gland tumors or metastatic tumors is imperative. Morphological and immunohistochemical features can help diagnose primary adenomatoid tumors of the adrenal gland.
Do emergency medicine health care workers rate triage level of chest pain differently based upon appearance in simulated patients?
Authors: Coisy Fabien , Olivier Guillaume , Ageron François-Xavier , Guillermou Hugo , Roussel Mélanie , Balen Frédéric , Grau-Mercier Laura , Bobbia Xavier 
Published: December 2023

Background and importanceThere seems to be evidence of gender and ethnic bias in the early management of acute coronary syndrome. However, whether these differences are related to less severe severity assessment or to less intensive management despite the same severity assessment has not yet been established.ObjectiveTo show whether viewing an image with characters of different gender appearance or ethnic background changes the prioritization decision in the emergency triage area.MethodsThe responders were offered a standardized clinical case in an emergency triage area. The associated image was randomized among eight standardized images of people presenting with chest pain and differing in gender and ethnic appearance (White, Black, North African and southeast Asian appearance).Outcome measures and analysisEach person was asked to respond to a single clinical case, in which the priority level [from 1 (requiring immediate treatment) to 5 (able to wait up to 2 h)] was assessed visually. Priority classes 1 and 2 for vital emergencies and classes 3–5 for nonvital emergencies were grouped together for analysis.ResultsAmong the 1563 respondents [mean age, 36 ± 10 years; 867 (55%) women], 777 (50%) were emergency physicians, 180 (11%) emergency medicine residents and 606 (39%) nurses. The priority levels for all responses were 1–5 : 180 (11%), 686 (44%), 539 (34%), 131 (9%) and 27 (2%). There was a higher reported priority in male compared to female [62% vs. 49%, difference 13% (95% confidence interval; CI 8–18%)]. Compared to White people, there was a lower reported priority for Black simulated patients [47% vs. 58%, difference −11% (95% CI −18% to −4%)] but not people of southeast Asian [55% vs. 58%, difference −3% (95% CI −10–5%)] and North African [61% vs. 58%, difference 3% (95% CI −4–10%)] appearance.ConclusionIn this study, the visualization of simulated patients with different characteristics modified the prioritization decision. Compared to White patients, Black patients were less likely to receive emergency treatment. The same was true for women compared with men.