bluuebunny/crossref_metadata_2025_split huggingface dataset:
Albumin combined with neutrophil-to-lymphocyte ratio score and outcomes in patients with acute coronary syndrome treated with percutaneous coronary intervention
Authors: Wei Chen , Fan Wenjun , Zhang Ying , Sun Qiyu , Liu Yixiang , Wang Xinchen , Liu Jingyi , Sun Lixian 
Published: February 2024

Background
Evidence about the association between albumin combined with neutrophil-to-lymphocyte ratio score (ANS) and survival outcomes in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) is rare. This study aimed to evaluate the prognostic value of ANS in patients with ACS undergoing PCI by propensity score matching (PSM) analysis.

Patients and methods
Patients with ACS undergoing PCI were consecutively enrolled in this prospective cohort study from January 2016 to December 2018. The albumin and neutrophil-to-lymphocyte ratio cutoff values for predicting major adverse cardiovascular events (MACEs) were calculated using receiver operating characteristic curves. Survival analysis was performed using Kaplan–Meier estimates, the Cox proportional hazard regression models and PSM. The study endpoint was the occurrence of a MACE, which included all-cause mortality and rehospitalization for severe heart failure during follow-up.

Results
Overall, 1549 patients with adequate specimens were identified and assigned into different groups for comparison. Before and after PSM, the Kaplan–Meier curves showed that a higher ANS value was associated with a higher risk of MACEs (all P < 0.001). The multivariate Cox proportional hazard regression model showed that the ANS (per 1 score increase) [hazard ratio (HR), 2.016; 95% confidence interval (CI), 1.329–3.057; P = 0.001 vs. HR, 2.166; 95% CI, 1.344–3.492; P = 0.002] was an independent predictor for MACEs.

Conclusion
This study tentatively confirms that ANS may be a valuable clinical indicator to identify high-risk ACS patients after PCI. More high-quality prospective studies are needed in the future.
Complete pathologic response to neoadjuvant icotinib in stage IIIA EGFR-mutant lung adenosquamous carcinoma: A case report
Authors: Cai Zhongfu , Huang Jishui , Dai Wenliang , Li Xiaobin , Hong Wencong , Hong Youzhi 
Published: February 2024

Rationale:
Radical surgery offers the best chance of cure, it is critical to expand surgery opportunities for patients with early-stage lung cancer to prolong overall survival. However, evidence is still limited regarding the application of neoadjuvant therapy with EGFR-tyrosine kinase.

Patient:
The patient reported here was a 53-year-old woman with right lower lung adenosquamous carcinoma.

Diagnoses:
The lung cancer was staged as T3N1M0. Tumor genotype disclosed EGFR Exon19 c.2235-2249de p.E746-A750del.

Intervention:
After neoadjuvant treatment with icotinib, she underwent thoracotomy and achieved pathological complete response.

Outcomes:
She is currently receiving adjuvant icotinib therapy without recurrence or metastasis during 18-month follow-up.

Lessons:
Our case indicated that the feasibility of neoadjuvant icotinib in EGFR-mutant lung adenosquamous carcinoma.
Efficacy of quadratus lumborum block in the treatment of acute and chronic pain after cesarean section: A systematic review and meta-analysis based on randomized controlled trials
Authors: Du Honghong , Luo Xiuqin , Chen Min , Shi Siren , Zhao Jianyong 
Published: February 2024

Background:
This analysis aimed to explore the analgesic effects of quadratus lumborum block on acute and chronic postoperative pain among patients undergoing cesarean section.

Methods:
PubMed, Cochrane, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang, and VIP databases for Randomized Controlled Trials (RCTs) that focused on the use of quadratus lumborum block in cesarean section procedures were searched from the inception of the databases until December 2022. Studies were screened based on inclusion and exclusion criteria, and were then conducted for quality assessment and data extraction. Meta-analysis was performed using Stata 15.0 software. Two researchers independently screened the studies, extracted data, and evaluated the risk of bias for the included studies. In case of any disagreements, it was resolved by consultation with a third party opinion.

Results:
A total of 21 studies involving 1976 patients were finally included, with an overall acceptable study quality level. Compared to the control group, the administration of Quadratus Lumborum Block (QLB) resulted in significant reduction in the postoperative 24-hour visual analog scale (VAS) score (WMD = −0.69, 95% CI: −1.03 ~ −0.35, P < .001) and the consumption of opioid analgesics within 24 hours after surgery (WMD = −2.04, 95% CI: −2.15 ~ −1.92, P = .002). The incidence of chronic pain 3 months QLB (OR = 0.41, 95% CI: 0.09 ~ 1.88, P = .253) and 6 months (OR = 0.83, 95% CI: 0.33 ~ 2.07, P = .686) after surgery were observed to increase as compared with the control group.

Conclusions:
The use of QLB for postoperative analgesia after cesarean section, particularly in the relief of acute postoperative pain, had been proven to significantly decrease the VAS score and morphine consumption within the first 24 hours after surgery. However, further studies are needed to determine its impact on managing chronic postoperative pain.
A novel approach to full-mouth rehabilitation of dentinogenesis imperfecta type II: Case series with review of literature
Authors: Zhang Yizhou , Jin Xiaoting , Zhang Zhengyi , Hu Sai , Jiang Wenxiang , Pan Haisong , Zhang Ling , Fu Baiping 
Published: February 2024

Rationale:
Dentinogenesis imperfecta (DI) is an autosomal-dominant disorder. The most common clinical manifestations, including obliterated tooth tissues and severe tooth wear, usually lead to tooth extractions. It remains a great challenge for dentists to preserve the residual tooth tissue and establish the esthetics and occlusion of dentitions.

Patients concerns:
25-year-old twin sisters, who had suffered from dentinogenesis imperfecta type II for more than 10 years, presented with continuous tooth wear and discomfort from wearing a removable partial denture for more than 3 years.

Diagnosis:
Intraoral examination showed extensive tooth wear with enamel exfoliation and typical amber-brown color with an opalescent discoloration. Their panoramic radiographs revealed completely obliterated tooth tissues and severe tooth wear.

Interventions and outcomes:
The dentitions were restored with post-and-core crowns and pin lays after preparing root post paths and pin holes guided by computer-aided design/computer-aided manufacturing (CAD/CAM) procedures, resulting in a successful repair.

Lessons:
Severe tooth wear and tooth tissue obliteration are typical clinical manifestations in DI-affected dentitions, increasing the complexity and difficulty in dental restorations. Early diagnosis and appropriate treatments are essential to achieve a favorable prognosis. CAD/CAM procedures, permitting accurate and effective treatment, possess promising potential in the treatment of DI-affected dentitions.
A case report of cardia carcinoma: Underwent Heller myotomy for Achalasia
Authors: Wen Lin-qi , Wei Da-wei 
Published: February 2024

Background:
One of the risk factors for esophageal adenocarcinoma is achalasia, an esophageal motility disorder that is typically treated surgically through laparotomy or laparoscopic surgery. The risk factors of gastric cardia cancer are also similar to esophageal adenocarcinoma due to the anatomical location of the gastric cardia close to the esophagus. There is currently no clinical evidence that achalching has a correlation with gastric cardia cancer.

Case summary:
We report the case of an 85-year-old female patient was admitted to our department with dysphagia for 6 months. She underwent a dissecting Heller myotomy for pancreatic achalasia in 2006, with occasional postoperative symptoms of reflux and heartburn. Outpatient upper gastrointestinal imaging was suggestive of cardia cancer, and gastroscopic pathological findings were suggestive of moderately-lowly-differentiated adenocarcinoma. The patient was admitted to the operating room on August 30, 2022 to undergo radical pancreatic cancer surgery plus abdominal adhesion release, and postoperative review of the upper gastrointestinal imaging showed a patent anastomosis with no spillage, filling of the residual stomach, and duodenal visualization.

Conclusion:
Postoperative patients with achalasia often have symptoms of reflux, which may be one of the factors for the development of pancreatic cancer in this patient, thus requiring clinicians to pay more attention to the use of antireflux procedures in the surgical treatment of pancreatic achalasia. And the choice of which modality to perform surgery in patients with previous surgical history is also one of the points to be discussed.
Clinical characteristics and follow-up of a newborn with Dubin–Johnson Syndrome: A clinical case report
Authors: Zhang Yanmin , Zuo Wei , Gao Wei 
Published: February 2024

Background:Dubin–Johnson syndrome (DJS) is a rare autosomal recessive liver disorder, characterized by conjugated hyperbilirubinemia. This case report investigates the clinical characteristics and longitudinal outcomes of a neonate diagnosed with DJS.Methods:A newborn presented with elevated bilirubin levels and abnormal liver enzyme readings. Comprehensive genetic evaluation was conducted, which included peripheral blood sample collection from the infant and both parents after obtaining informed consent and high-throughput trio exome sequencing was performed. The genetic analysis revealed 2 significant mutations in theABCC2gene on chromosome 10: the insertion mutationc.4237(exon30)_c.4238(exon30)ins CT, inherited from the father, and the missense mutationc.517(exon5)G > A, inherited from the mother. Both mutations were classified as pathogenic according to the ACMG 2015 guidelines, indicating a compound heterozygous inheritance pattern. The patient’s treatment regimen included phototherapy, which was initiated to address her jaundice upon admission. To support liver function and regulate gut activity, oral ursodeoxycholic acid (20 mg/kg/dose, twice a day) and probiotics were administered. Additionally, a postdischarge medication plan involving a low-dose regimen of phenobarbital (3.5 mg/kg/dose, twice a day) was implemented for 2 weeks.Results:During a 2-year follow-up after discharge, the infant’s bilirubin levels significantly decreased, and liver enzymes, including GGT, progressively normalized.Conclusion:This case report enhances the understanding of DJS in neonates by emphasizing the clinical ramifications of compound heterozygous mutations within theABCC2gene and documenting the evolution of the disease. The gradual normalization of liver function tests suggests potential compensatory mechanisms in response to the genetic abnormalities in neonates with DJS. The correlation between the patient’s genetic profile of compound heterozygosity and her milder clinical phenotype warrants attention, suggesting that this specific genetic configuration may be associated with less severe manifestations of the disease. The necessity for long-term follow-up is highlighted, recognizing that intercurrent stress conditions could influence the hepatic profile and potentially exacerbate symptoms. Such sustained observation is crucial to further delineate the genomic and clinical landscape of DJS, offering opportunities to refine prognostic and therapeutic approaches.
Mucoepidermoid carcinoma of the pancreas: A case report and literature review
Authors: Zhang Huan , Wang Shuyan , Wang Chunnian 
Published: February 2024

Introduction:
Primary mucoepidermoid carcinoma (MEC) is a common malignant neoplasm of the salivary glands, but is very rare in the pancreas. To date, only 10 cases have been reported in the literature. Because MEC of the pancreas is very rare, there is little information about its diagnosis, treatment, and metastasis. Herein, we present the eleventh case and review the relevant literature.

Patient concerns:
A 65-year-old woman presented with a mass in the body of the pancreas and multiple masses in the liver on abdominal magnetic resonance imaging. The patient initially underwent EUS-guided fine-needle aspiration and was diagnosed with adenocarcinoma. After adjuvant chemotherapy, resection of the pancreatic body and tail was performed, and the tissues were pathologically, histologically, and immunochemically examined. Specific strains and gene rearrangements were analyzed.

Diagnosis:
Mucoepidermoid pancreatic cancer.

Intervention:
After a 4-month course of adjuvant chemotherapy, laparoscopic surgery was performed.

Outcomes:
The patient is alive until the submission of this paper.

Conclusion:
We presented a case of mucoepidermoid pancreatic cancer in a 65-year-old woman. Pathological examination revealed that the tumor parenchyma consisted of 3 cell types. There are mainly epidermoid cells, intermediate cells between the basal and epidermoid cells, and mucus-producing cells in varying proportions. Immunohistochemical staining showed that there were different types of cells with unique morphological characteristics. In summary, primary MECs of the pancreas are rare and have poor prognosis. Few studies have been conducted on the diagnosis, treatment, and metastasis of MECs; therefore, further studies are needed to detect them.
Assessment of clinical prognosis improvement in children with concomitant anterior and posterior urethral valves: A case series report
Authors: Mo Zhiqiang , Zhang Weiping , Sun Ning , Tian Jun , Li Minglei , Song Hongcheng , Xie Xianghui 
Published: February 2024

Background:
Concomitant anterior urethral valves (AUVs) and posterior urethral valves (PUVs) is an extremely rare congenital urologic anomaly, which may be easily overlooked in the clinic.

Objective:
This study assessed the prognosis of children with concomitant PUVs and AUVs.

Methods:
The clinical data of inpatients with concomitant AUVs and PUVs in our hospital were collected from January 1983 to June 2022. The clinical manifestations, auxiliary inspection, and treatment were described in detail.

Results:
In total, 6 cases of concomitant AUVs and PUVs in boys were found in our hospital, with ages ranging from 3 months to 9 years; the main clinical manifestation was abnormal urination. Four patients exhibited concomitant AUVs and PUVs preoperatively and underwent simultaneous anterior and posterior urethral valvotomy. Follow-up studies showed that 3 patients’ clinical symptoms substantially improved with well-maintained renal function. One patient died of renal failure. In the other 2 patients, PUVs were initially identified and excised, but their clinical symptoms did not show substantial improvement. Following voiding cystourethrography (VCUG), the AUVs were found and obstructions were then completely relieved. However, 2 patients died of renal failure.

Conclusions:
If urinary symptoms cannot be substantially relieved after posterior urethral valvotomy, VCUG and cystoscopy should be repeated to shorten the interval between anterior and posterior urethral valvotomies to improve patient prognosis.
Long-term debridement effect of denervated large sacrococcygeal pressure injury: A case report
Authors: Lu Yan , Wu Hai-Long , Luo Zong-Jian 
Published: February 2024

Rationale:
Complicated pressure injury in paraplegic patients is common and difficult to manage. Previous case studies have documented short-term management; however, little is known regarding suitable approaches to long-term clearing of extensive pressure injury in the sacrococcygeal area under denervation.

Patient concerns:
A 53-year-old man was bedridden for 1.5 years owing to cervical vertebral fracture-dislocation (C5–C6), resulting in extensive sacrococcygeal pressure injury.

Diagnoses:
On admission, he presented with the injury complicated by infection (stage IV necrosis), and his vital signs were unstable.

Interventions:
The infection was treated with a range of antibiotics, including clindamycin phosphate, metronidazole, cefoperazone sodium, and sulbactam sodium. Debridement of the pressure injury was performed, helping remove the necrotic tissue and stimulate tissue regeneration.

Outcomes:
The patient was discharged after 88 days of hospitalization. The extent of the pressure injury at discharge was reduced compared with that at admission. At 4-month follow-up, the injury was nearly healed, with no signs of any further complications.

Lessons:
This case study suggests that wound debridement is a cost-effective and clinically efficacious approach to long-term complicated pressure injury management.
Acupoint herbal patching for postherpetic neuralgia: A systematic review and meta-analysis
Authors: Pu Bingyu , Lu Xiaoxue , Yu Peilin , Wang Chengjie , Li Juan , Yang Dianhui , Wang Jian 
Published: February 2024

Background:
This study aimed to systematically evaluate the clinical effectiveness and safety of acupoint herbal patching in the treatment of postherpetic neuralgia.

Methods:
Eight databases including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wan-Fang Database, China Biomedical Literature Service System, and Chongqing VIP Chinese Science were searched. The search time was set to October 2023. Two researchers independently screened the literature according to the inclusion and exclusion criteria; extracted the basic information, acupoints, Chinese herbal medicine, pain score, sleep score, depression score, and other information of the subjects, and independently assessed the risk of bias by 2 researchers. Meta-analysis of the included studies was performed using the StataMP 16 software.

Results:
Fifteen studies with 1362 participants were included in this meta-analysis. Ashi is the acupoint frequency at the forefront, and Borneol is the Chinese herbal medicine frequency at the forefront. The acupoint herbal patching group showed significant improvements in visual analog score (SMD: −2.09; 95% Cl: −2.77, −1.42; P < .001), sleep score (SMD: −1.58; 95% Cl: −2.11, −1.05; P < .001), depression score (SMD: −1.61; 95% Cl: −2.22, −0.99; P < .001), Chinese medicine syndrome score (SMD: −2.32; 95% Cl: −2.84, −1.80; P = .06), dermatology life quality index (weighted mean differences: −4.11; 95% Cl: −4.58, −3.63; P = .98), and related laboratory indicators compared to the control group, and the total effective rate was significantly higher (relative risk: 1.20; 95% confidence interval: 1.15, 1.26; P = .99) than the control group. Two studies reported adverse reactions, but the 2 groups were not statistically significant.

Conclusions:
Acupoint herbal patching intervention in postherpetic neuralgia is effective in improving the pain, sleep, anxiety, depression, quality of life of patients, and related laboratory indicators.
Co-infection of Nocardia and Aspergillus fumigatus in a immunosuppressed patient: Case report
Authors: Wang Lei , Liu Yang , Li Hui 
Published: February 2024

Background:

Nocardia and Aspergillus fumigatus are opportunistic pathogenic fungus that has a major impact on the mortality of rheumatoid arthritis patients. Opportunistic infections in immunocompromised patients present diagnostic challenges. Nocardia and A fumigatus are both easily overlooked because of their rarity, leading to delayed diagnosis and treatment.

Case presentation:
We report an infection caused by steroid use in a patient with rheumatoid arthritis. A 76-year-old man with a history of rheumatoid arthritis was admitted to our hospital because of cough, expectoration and fever for 10 days. The patient had low immune function, granulocytopenia, diffuse infiltration could be seen on chest computed tomography, and BAL fluid galactomannan level of 1.3 S/CO. The microbiological findings reflect a possible co-infection with Nocardia and A fumigatus. Voriconazole was used to treat pulmonary aspergillosis, ceftriaxone and Trimethoprim-Sulfamethoxazole were used to treat Nocardia. After timely targeted medication administration, the patient was discharged with a good prognosis.

Conclusion:
Co-infection is more common in immunosuppressed patients and warrants attention in clinical practice. Early diagnosis and treatment can help patients with Co-infection of Nocardia and A fumigatus achieve better prognosis.
All shook up: how the COVID-19 pandemic rocked pediatric asthma care
Authors: Kaplan Carl , Christophides Alexa H. , Kranidis Alexandra M. , Saint-Fleur Ashley L. , Kier Catherine 
Published: February 2024

Purpose of review
Asthma management is a crucial aspect of public health. The landscape of asthma management underwent significant change in the wake of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. These changes greatly affected existing patients, individuals suffering with undiagnosed illness, providers, and the healthcare system as a whole.

Recent findings
Providers had to navigate through the potential risk of exposure while weighing the benefit of office visits for patients. This promoted the rapid uptake of telemedicine and virtual outreach, as well as modifications to acute management and controller therapies. Telehealth allowed for the remote monitoring of these patient populations, increased compliance with home-based self-management, and an emphasis on patient education. Furthermore, the pandemic underscored the importance of proactive asthma management as many individuals were left untreated or undiagnosed for various reasons. It is evident that the SARS-CoV-2 pandemic reshaped the landscape of various components of the healthcare system, including asthma management, necessitating innovative approaches to monitoring and patient education.

Summary
Understanding the lessons learned from this time period is crucial for enhancing the resilience of our health system in the wake of future challenges that may be posed against our system
Approach to acute agitation in the pediatric emergency department
Authors: Foster Ashley A. , Saidinejad Mohsen , Li Joyce 
Published: February 2024

Purpose of review
The complexity of pediatric mental and behavioral health (MBH) complaints presenting to emergency departments (EDs) is increasing at an alarming rate. Children may present with agitation or develop agitation during the ED visit. This causes significant distress and may lead to injury of the child, caregivers, or medical staff. This review will focus on providing safe, patient-centered care to children with acute agitation in the ED.

Recent findings
Approaching a child with acute agitation in the ED requires elucidation on the cause and potential triggers of agitation for optimal management. The first step in a patient-centered approach is to use the least restrictive means with behavioral and environmental strategies. Restraint use (pharmacologic or physical restraint) should be reserved where these modifications do not result in adequate de-escalation. The provider should proceed with medications first, using the child's medication history as a guide. The use of physical restraint is a last resort to assure the safety concerns of the child, family, or staff, with a goal of minimizing restraint time.

Summary
Children are increasingly presenting to EDs with acute agitation. By focusing primarily on behavioral de-escalation and medication strategies, clinicians can provide safe, patient-centered care around these events.