bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical results and intramedullary signal changes of posterior decompression with transforaminal interbody fusion for thoracic myelopathy caused by combined ossification of the posterior longitudinal ligament and ligamentum flavum
Authors: WANG Lin-feng , LIU Fa-jing , ZHANG Ying-ze , SHEN Yong , DING Wen-yuan , XU Jia-xin 
Published: January 2024

Background
Surgical treatment of thoracic myelopathy caused by ossification of the posterior longitudinal ligament (OPLL) and ossification of the ligamentum flavum (OLF) is technically demanding, and the results tend to be unfavorable. Various operative approaches and treatment strategies have been attempted, and posterior decompression with transforaminal thoracic interbody fusion (PTTIF) may be the optimal method with which the anterior-posterior compression was removed in one step. It is comparatively less traumatic with fewer serious complications.

Methods
Sixteen patients with thoracic myelopathy due to concurrent OLF and OPLL at the same level underwent PTTIF. We investigated clinical outcomes and neurological improvements. Magnetic resonance imaging (MRI) was performed on all patients preoperatively and postoperatively, and intramedullary signal changes were evaluated.

Results
The mean operating time was 275 minutes, and the mean operative bleeding amount was 1031 ml. Cerebrospinal fluid leakage occurred in three patients and healed well after repair. Neurological symptom deterioration occurred in one patient, but the patient recovered to nearly the preoperative level after methylprednisolone treatment. The follow-up period ranged from 28 to 47 months. The mean score on the Japanese Orthopedic Association scale improved from 4.3±1.2 preoperatively to 7.3±1.7 at 3 months postoperatively to 8.5±1.5 at the final follow-up (P <0.01), with a recovery rate of (63.6±20.0)%. Postoperative images showed a significant improvement in local kyphosis (P <0.01). Eleven patients (68.8%) showed increased signal intensity (ISI) on preoperative T2-weighted MRI. At the final follow-up, the intramedullary ISI totally recovered in five patients. Neurological improvement was worse in patients with persistent ISI than in the other patients (P <0.05).

Conclusions
PTTIF is an effective therapeutic option for combined OPLL and OLF and provides satisfactory neurological recovery and stabilized thoracic fusion through a single posterior approach. Intramedullary signal changes do not always indicate a poor prognosis; only irreversible ISI is correlated with a poor clinical result.
Association of higher resistin levels with inflammatory activation and endothelial dysfunction in patients with essential hypertension
Authors: FANG Chang , LEI Juan , ZHOU Shu-xian , ZHANG Yu-ling , YUAN Gui-yi , WANG Jing-feng 
Published: January 2024

Background
Some studies have shown that serum resistin levels increase in hypertensive patients. Whether the increase of resistin is related to inflammatory or vascular endothelial function is still unknown. We investigated the relationship of increased resistin levels to inflammatory factors and circulating biomarkers of vascular endothelial function in hypertensive patients.

Methods
One hundred and forty-four nondiabetic patients with new onset, hypertension were recruited. Blood pressure, blood glucose, insulin, resistin, tumour necrosis factor-α (TNF-α), interleukin-6 (IL-6), von Willebrand factor (vWF), endothelin-1 (ET-1) and nitric oxide (NO) were measured. The homeostasis model assessment, insulin resistance index (HOMA-IR) was calculated. Patients were divided into two groups according to the median level of resistin. Cytokine levels and indicators of vascular endothelial function were compared. Multiple linear regression was used to determine factors influencing resistin.

Results
Serum resistin ranged from 2.57 ng/ml to 20.18 ng/ml in hypertensive patients. High resistin group (>8.36 ng/ml) had higher levels of TNF-α, IL-6, vWF and ET-1 but lower level of NO compared with low resistin group (P <0.01). Resistin was positively correlated with body mass index, systolic blood pressure, HOMA-IR, low-density lipoprotein cholesterol, TNF-α and ET-1 but negatively correlated with NO (all P <0.05). Multiple linear regression analysis revealed that HOMA-IR, TNF-α, NO and ET-1 are independent predictors of resistin with standardized regression coefficients of 0.625, 0.368, -0.260 and 0.222, respectively (all P <0.01).

Conclusions
We conclude that higher resistin levels are associated with inflammatory activation and endothelial dysfunction, because patients with essential hypertension have increased TNF-α, IL-6, vWF and ET-1 and decreased NO. Moreover, the statistical association of resistin with TNF-α, NO and ET-1 suggests involvement of resistin in the progression of hypertension by influencing inflammation and endothelial function.
Obstructive sleep apnea is associated with impaired glucose metabolism in Han Chinese subjects
Authors: GU Chen-juan , LI Min , LI Qing-yun , LI Ning , SHI Guo-chao , WAN Huan-ying 
Published: January 2024

Background
Increasingly, evidence from population, clinic-based and laboratory studies supports an independent association between obstructive sleep apnea syndrome (OSAS) and an increased risk of type 2 diabetes; however, this observation has yet to be replicated in China and the potential mechanisms that link these two conditions are not clear.

Methods
A total of 179 Han Chinese subjects were enrolled in this study. All subjects underwent polysomnography, the oral glucose tolerance-insulin releasing test (OGTT-IRT) and serum HbA1c measurement. Indexes including homeostasis model assessment-IR (HOMA-IR), Matsuda index, HOMA-β, early phase insulinogenic index (ΔI30/ΔG30), AUC-I180 and oral disposition index (DIo) were calculated for the assessment of insulin resistance and pancreatic β-cell function.

Results
Based on OGTT, 25.4%, 44.6% and 54.5% subjects were diagnosed having glucose metabolic disorders respectively in control, mild to moderate and severe OSAS groups (P <0.05). Serum HbA1c levels were highest in subjects with severe OSAS (P <0.05). In contrast, compared with normal subjects, HOMA-β, ΔI30/ΔG30 and DIO were lower in severe OSAS group (P <0.05). In stepwise multiple linear regressions, 0-min glucose and HbA1c were positively correlated with the percentage of total sleep time below an oxyhemoglobin saturation of 90% (T90) (Beta = 0.215 and 0.368, P <0.05); 30-min and 60-min glucose was negatively correlated with the lowest SpO2 (LSpO2) (Beta = -0.214 and -0.241, P <0.05). HOMA-β and DIO were negatively correlated with T90 (Beta = -0.153 and -0.169, P <0.05) while body mass index (BMI) was the only determinant of HOMA-IR and Matsuda index.

Conclusions
OSAS is associated with impairment in glucose tolerance and pancreatic β-cell function in Han Chinese subjects while insulin sensitivity is mainly determined by obesity.
Prognosis of 153 patients with decompensated hepatitis B virus-related cirrhosis is improved after 3-year continuous lamivudine treatment
Authors: CHEN Guang-cheng , YU Tao , MIN Xiao-hui , ZHAO Li-na , QING Qing , YUAN Yu-hong , SU Hong , ZHAN Jun , HUANG Kai-hong , CHEN Qi-kui 
Published: January 2024

Background
The long-term effectiveness and safety of lamivudine in patients with decompensated hepatitis B virus-related cirrhosis are still not clear. The present study attempted to describe the clinical outcomes of lamivudine therapy in these special patients over three years.

Methods
This study was a retrospective, controlled cohort study which involved 153 patients with decompensated hepatitis B virus-related cirrhosis. Of these, 86 patients received lamivudine 100 mg daily accompanied with general internal treatment, and the other 67 were given general internal treatment only. Significant clinical responses were recorded after years of antiviral treatment.

Results
The patients in both groups were matched in terms of age, sex and laboratory results at baseline. After years of therapy, the Child-Pugh-Turcotte scores and laboratory values of the patients receiving lamivudine were remarkably improved compared to the patients in the control group. The mortality rate and the incidence of cirrhosis-related complications were much lower in the lamivudine group than in the control group. Genotypic resistance tyrosine, methionine, aspartate, aspartate mutations developed in 26.7 percent of the patients during 3-year lamivudine treatment, and cirrhosis-related death and the hepatocellular carcinoma were more likely to occur in patients with these mutations than in the other patients who were treated with lamivudine.

Conclusions
Continuous long-term lamivudine treatment in patients with decompensated hepatitis B virus-related cirrhosis delays clinical progression, and significantly improves hepatic function and prognosis. However, the use of a retrospective control cohort precludes drawing definitive conclusions.
Poly (ADP-ribose) polymerase inhibitor reduces heart ischaemia/reperfusion injury via inflammation and Akt signalling in rats
Authors: Song Zhao-feng , Chen Dong-yu , Du Bo , Ji Xiao-ping 
Published: January 2024

Background
Poly (ADP-ribose) polymerase (PARP) has been proposed to play an important role in the pathogenesis of heart ischaemia/reperfusion (I/R) injury. 3,4-dihydro-5-[4-(1-piperidinyl)butoxy]-1(2H)-isoquinolinone (DPQ), a potent PARP inhibitor, has cardiac protective effects. Because the underlying mechanisms are not understood, we investigated the effect of DPQ on heart I/R injury and its mechanisms.

Methods
Studies were performed with I/R rats' hearts. DPQ was used to inhibit the activation of PARP. Cardiac function and cellular apoptosis were assessed. The activation of PARP, transcription factor nuclear factor-kappaB (NF-κB), intercellular adhesion molecule-1 (ICAM-1), cyclooxygenase-2 (COX-2) and matrix metalloproteinase-9 (MMP-9) were evaluated. We also evaluated expression of Akt and two of its downstream targets, glycogen synthase kinase-3β (GSK-3β) and forkhead transcription factor FOXO3a.

Results
Administration of DPQ significantly decreased the activation of PARP and cellular apoptosis from (35±5)% to (20±4)% and simultaneously improved the cardiac function. DPQ reduced the expressions of NF-κB, ICAM-1, COX-2 and MMP-9 in rat heart and facilitated the activations of phosphor-Akt, phosphor-GSK-3β and phosphor-FOXO3a.

Conclusion
The protective effects of DPQ were associated with the suppression of inflammation and the activation of the Akt signalling pathways suggesting that the inhibition of poly (ADP-ribose) polymerase reduced heart I/R injury in rats.
Transmission of extensively drug-resistant and multidrug resistant Mycobacterium tuberculosis in families identified by genotyping
Authors: YAN Li-ping , QIN Lian-hua , ZHANG Qing , SUN Hua , HAN Min , XIAO He-ping 
Published: January 2024

Background
Diagnosis and appropriate treatment of multidrug-resistant tuberculosis (MDR-TB) remain major challenges. We sought to elucidate that persons who share a household with drug resistance tuberculosis patients are at high risk for primary drug resistance tuberculosis and how to prevent these outbreaks.

Methods
We used 12-locus mycobacterial interspersed repetitive unit and 7-locus variable-number tandem repeat to identify household transmission of extensively drug resistant and multiple drug resistant Mycobacterium tuberculosis in three families admitted in Shanghai Pulmonary Hospital affiliated with Tongji University. Drug susceptibility tests were done by the modified proportion method in the MGIT 960 system in the same time. Clinical data were also obtained from the subjects' medical records.

Results
All of the six strains were defined as Beijing genotype by the deletion-targeted multiplex PCR (DTM-PCR) identification on the genomic deletion RD105. Strains from family-1 had the same minisatellite interspersed repetitive unit (MIRU) pattern (232225172531) and the same MIRU pattern (3677235). Strains from family-2 had the same MIRU pattern (2212261553323) and the same MIRU pattern (3685134). Strains from family-3 did not have the same MIRU pattern and they differed at only one locus (223326173533, 223325173533), and did not have the same VNTR pattern with two locus differed (3667233, 3677234).

Conclusions
Household transmission exists in the three families. A clear chain of tuberculosis transmission within family exists. Tuberculosis susceptibility should be considered when there is more than one tuberculosis patients in a family. Household tuberculosis transmission could be prevented with adequate treatment of source patients.
Peer reviewing of screening mammography in Taiwan: its reliability and the improvement
Authors: PAN Huay-ben , HSU Giu-cheng , YANG Tsung-lung , HUANG Jer-shyung , CHOU Chen-pin , LIANG Huei-lung , LEE San-kan , CHOU Yi-hong , LI Hung-ju , WONG Kam-fai 
Published: January 2024

Background
Early detection with screening mammography can potentially reduce breast cancer mortality rates. To achieve an efficient screening, a peer review system provides a compensatory double-check reviewing, will hopefully to prevent the omission of detectable lesions and reduce unnecessary recall.

Methods
In 2009, 4643 initial mammographic screenings reported by 74 screening radiologists had negative results with a recall rate of less than 5%. In the same year, 2538 initial positives screened by 18 screening radiologists had a recall rate higher than 15%. Those 7181 randomized screenings were evenly distributed for reassessment by 39 reviewing radiologists. The disagreement of assessments between the reviewers and screening radiologists was recorded. The differential rate was defined as the number of the disagreements divided by the number of audited films reviewed by a screening radiologist. The equality of the differential rates for each screening radiologists with negative and positive assessments was compared by a Chi-square test. The performance of the 39 auditors was measured by the Kendall's tau statistic. P values less than 0.05 were considered statistically significant.

Results
The mean differential rate for screening radiologists of negative assessments was 6.7% (P=0.588), while 35.0% for positive assessments were significant (P <0.001). The result indicated that most of the initial negative assessments reported by the screening radiologists were generally accepted by the reviewers but not the positive assessments. With respect to the 39 reviewers, there was no significant evidence for the association of the difference rates between negative and positive assessments. Nine reviewers were found to have their differential rate for negative and positive assessments larger than the average of the population. Eleven reviewers were found to have their differential rates smaller than the average for both. Thirteen reviewers had their differential rates smaller than the average for negative assessments but larger than the average for positive assessments. The opposite condition was found for six reviewers. The Kendall's tau statistic was 0.038 (P=0.735).

Conclusions
Reviewers usually agreed with the opinion of the initial screening doctors who reported negative findings. Therefore, a 5% recall rate as the lower range of reviewing negatives may be still too high. The recall rate of more than 15% was significantly related to improper interpretation, especially when the differential rate is 25% or higher, a warning to the underperforming screening radiologist is recommended. An ideal reviewer should interpret films independently. Reviewers with tendencies to be followers or contrarians should not be enrolled in the reviewing system.
Impact of depressed left ventricular function on outcomes in patients with three-vessel coronary disease undergoing percutaneous coronary intervention
Authors: GAO Zhan , XU Bo , Kirtane Ajay J. , YANG Yue-jin , YUAN Jin-qing , CHEN Ji-lin , QIAO Shu-bin , WU Yong-jian , QIN Xue-wen , YAN Hong-bin , YAO Min , LIU Hai-bo , CHEN Jue , YOU Shi-jie , GAO Run-lin 
Published: January 2024

Background
Patients with multivessel coronary artery disease and depressed left ventricular ejection fraction (LVEF) represent a high risk group of patients for coronary revascularization. There are limited data on percutaneous coronary intervention treatment in this population.

Methods
Among a cohort of 4335 patients with three-vessel disease with or without left main disease undergoing percutaneous coronary intervention, 191 patients had LVEF <40% (low ejection fraction (EF)) and 4144 patients had LVEF ≥40%. In-hospital and long-term outcomes were examined according to LVEF.

Results
The estimated two-year rates of major adverse cardiac events, cardiac death, and myocardial infarction were significantly higher in the low EF group (19.64% vs. 8.73%, Log-rank test: P <0.01; 10.30% vs. 1.33%, Log-rank test: P <0.01, and 10.32% vs. 2.28%, Log-rank test: P <0.01 respectively), but there was no difference in the rates of target vessel revascularization (6.18% vs. 6.11%, Log-rank test: P=0.96). Using the Cox proportional hazard models, LVEF <40% was a significant risk factor for cardiac death, myocardial infarction, and major adverse cardiac events (OR (95% CI): 4.779 (2.369-9.637), 2.673 (1.353-5.282), and 1.827 (1.187-2.813) respectively), but was not a statistically significant risk factor for target vessel revascularization (OR (95% CI): 1.094 (0.558-2.147)).

Conclusion
Among patients undergoing percutaneous coronary intervention for multivessel coronary artery disease, left ventricular dysfunction remains associated with further risk of cardiac death in-hospital and during long-term follow-up.
Does human papillomavirus infection do harm to in-vitro fertilization outcomes and subsequent pregnancy outcomes?
Authors: YANG Rui , WANG Ying , QIAO Jie , LIU Ping , GENG Li , GUO Yan-li 
Published: January 2024

Background
Some studies suggested that human papillomavirus (HPV) infection could reduce the clinical pregnancy rate and double the spontaneous abortion rate compared with non-infected women after in-vitro fertilization and embryo transfer (IVF-ET). But some other studies showed there was no difference between HPV infected and non-infected groups of ART outcomes. The role of HPV infection in infertile women undergoing IVF treatments has been a controversial issue which this article attempts to investigate.

Methods
This is a retrospective analysis of 3880 infertile women undergoing IVF treatment at Peking University Third hospital reproductive medical center in 2008. Patients with abnormal thin-layer preparation cytologic test (TCT) results who underwent fresh cycle embryo transfer were divided into an HPV positive group (n=56) and an HPV negative group (n=56). The clinical parameters were compared (using Student's t-test and chi-squared test). Univariate and multivariate analyses were taken to see if HPV infection affects the clinical pregnancy rate.

Results
Of the 3880 cases 157 had TCT abnormality (4.0%). Of the 149 patients who had HPV test results, 112 women (81.2%) received a fresh cycle embryo transfer. Each group had 56 cases. The patients were of similar age and BMI, basic hormone levels, and infertile factors were similar. The gonadotropin use, oocyte retrieval number, clinical pregnancy rate, abortion rate and newborn condition were all similar between groups. Analyses showed neither HPV infection nor HPV hybrid capture (HC) II results affected clinical pregnancy rate after IVF treatments, but the FSH level did.

Conclusion
HPV positivity did not appear to impact assisted reproductive technology (ART) success. “Extensive treatment” for HPV before IVF was not recommended because treatment time will increase age and reduce ovarian function, which will lead to inferior IVF outcomes.
Effect of noninvasive positive pressure ventilation on weaning success in patients receiving invasive mechanical ventilation: a meta-analysis
Authors: ZHU Fen , LIU Zi-long , LONG Xuan , WU Xiao-dan , ZHOU Jing , BAI Chun-xue , LI Shan-qun 
Published: January 2024

Background
Noninvasive positive pressure ventilation (NIPPV) has been proposed to shorten the duration of mechanical ventilation in intubated patients, especially those who fail initial weaning from invasive mechanical ventilation (IMV). However, there are also some discrepancies in terms of weaning success or failure, incidence of re-intubation, complications observed during study and patient outcomes. The primary objective of this update was to specifically investigate the role of NIPPV on facilitating weaning and avoiding re-intubation in patients intubated for different etiologies of acute respiratory failure, by comparing with conventional invasive weaning approach.

Methods
We searched randomized controlled trials (RCTs) comparing noninvasive weaning of early extubation and immediate application of NIPPV with invasive weaning in intubated patients from PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Knowledge and Springerlink databases. Records from conference proceedings and reference lists of relevant studies were also identified.

Results
A total of 11 RCTs with 623 patients were available for the present analysis. Compared with IMV, NIPPV significantly increased weaning success rates (odds ratio (OR): 2.50, 95% confidence interval (CI): 1.46-4.30, P=0.0009), decreased mortality (OR: 0.39, 95% CI: 0.20-0.75, P=0.005), and reduced the incidence of ventilator associated pneumonia (VAP) (OR: 0.17, 95% CI: 0.08-0.37, P <0.00001) and complications (OR: 0.22, 95% CI: 0.07-0.72, P=0.01). However, effect of NIPPV on re-intubation did not reach statistical difference (OR: 0.61, 95% CI: 0.33-1.11, P=0.11).

Conclusions
Early extubation and immediate application of NIPPV is superior to conventional invasive weaning approach in increasing weaning success rates, decreasing the risk of mortality and reducing the incidence of VAP and complications, in patients who need weaning from IMV. However, it should be applied with caution, as there is insufficient beneficial evidence to definitely recommend it in terms of avoiding re-intubation.
Completely thoracoscopic lobectomy for the surgical management of bronchiectasis
Authors: ZHOU Zu-li , ZHAO Hui , LI Yun , LI Jian-feng , JIANG Guan-chao , WANG Jun 
Published: January 2024

Background
The feasibility of completing a lobectomy by completely video-assisted thoracoscopic surgery (cVATS) in the management of bronchiectasis is unclear. By retrospectively comparing the outcomes from the lobectomies that used thoracotomy vs. cVATS, we determined the appropriateness of the minimally invasive cVATS approach in the management of bronchiectasis.

Methods
Between June 2001 and October 2010, 60 patients with bronchiectasis underwent surgery, of which 56 lobectomies were performed. All lobectomies were carried out by either thoracotomy or cVATS approach. Pulmonary vessels and bronchi were manipulated by ligation or stapler in the thoracotomy group, while they were dissected by endo-cutters in the cVATS group.

Results
There were 21 patients in the thoracotomy group and 35 patients in the cVATS group. Two cVATS patients (5.7%) converted. The difference in operation time, chest tube duration, lengths of hospitalization, and morbidity were not significantly different between the two groups (P >0.05). The blood loss was less in the cVATS group (P=0.015). A total of 52.4% and 62.9% of patients were postoperatively asymptomatic in the thoracotomy and cVATS groups respectively, and symptomatic improvement was obtained in 38.1% patients by thoracotomy vs. 31.4% patients by cVATS.

Conclusion
cVATS lobectomy is safe and effective for the management of bronchiectasis, especially for the patients with localized lesions.