bluuebunny/crossref_metadata_2025_split huggingface dataset:
Study on MEV90 of 0.5% ropivacaine for US-guided caudal epidural block in anorectal surgery
Authors: Zhang Pei , Chang Hong , Yang Taoran , Fu Yalong , He Xuemei , Li Jun , Yang Mingan , Wang Rurong , Li Xuehan 
Published: January 2023

BackgroundChoosing the appropriate concentration and volume of anesthetics is critical for a successful nerve block. The current study aimed to determine the minimum effective volume (MEV) of 0.5% ropivacaine for US-guided CEB in 90% of patients (MEV90) undergoing anorectal surgery. The aims were to reduce the occurrence of complications associated with a sacral blockade in anorectal surgery, broaden the indications for surgical procedures and treatment, and improve patient satisfaction. This study presents the groundwork for the development of individualized anesthetic programs. We believe that the study would serve as a reference for the use of caudal epidural block (CEB) in lower abdominal surgery for intraoperative and postoperative analgesia.MethodsThis study used a biased coin design (BCD) up-and-down method (UDM). We divided the participants into two groups based on gender, and each group independently performed the biased coin design up-and-down method. We used 0.5% ropivacaine for the first patient in each group; however, the volume was 10 ml for men and 8 ml for women. Therefore, the dose of anesthetics given to each patient was determined by the response of the previous patient. If the block of the previous patient failed, the volume was increased by 2 ml in the following patient. Otherwise, the next subject had an 11% chance of receiving a volume of 2 ml less or an 89% chance of receiving no volume change. We defined a successful block as painless surgery with anal sphincter relaxation 15 min after the drug injection. Enrollment was completed after 45 successful caudal blocks for each group.ResultsCaudal epidural block was successfully performed on 50 men and 49 women. The MEV90 of ropivacaine for CEB was calculated to be 12.88 ml (95% CI: 10.8–14 ml) for men and 10.73 ml (95% CI: 9.67–12 ml) for women. Men had a MEV99 of 13.88 ml (95% CI: 12.97–14 ml), and women had a MEV99 of 11.87 ml (95% CI: 11.72–12 ml).ConclusionWith operability and general applicability, it is possible to increase the success rate of CEB for anorectal surgery to 99% as well as decrease the incidence of anesthesia-related complications. CEB can meet the needs of patients for rapid postoperative rehabilitation, improve patient satisfaction, and lay a solid foundation for postoperative analgesia.
Comparison of pregnancy outcome after fresh embryo transfer between GnRH antagonist and GnRH agonist regimens in patients with thin endometrium
Authors: Zhao Depeng , Xie Rui , Li Xuemei 
Published: January 2023

ObjectiveTo compare the pregnancy outcome after fresh embryo transfer between GnRH antagonist and GnRH agonist regimens in patients with thin endometrium.MethodsThis retrospective study included all fresh embryo transfers following GnRH agonist or GnRH antagonist protocols in patients with thin endometrium from 2016 to 2021. The thin endometrium was defined as an endometrial thickness of 7.5 mm or less on the triggering day. Multivariant regression analysis was applied to assess the association of GnRH agonist or GnRH antagonist regimen with live birth following fresh embryo transfer in patients with thin endometrium.ResultsA total of 69 and 192 cases were, respectively, included in the GnRH antagonist or GnRH agonist group. The stimulation duration was significantly longer by the GnRH agonist protocol than the GnRH antagonist protocol (11.2 ± 2.1 vs. 9.1 ± 1.9 days, P = 0.002). The rates of clinical pregnancy or live birth were significantly lower in the GnRH antagonist group compared to the GnRH agonist group (26.1 vs. 47.9%, P = 0.027; 17.4 vs. 40.1%, P = 0.01, respectively). Multivariable regression analysis demonstrated that GnRH agonist regimen was related to higher live birth rate compared with GnRH agonist protocol [adjusted OR: 2.6, 95% confidence intervals (CI): 1.3–5.3]. No significant difference in miscarriage rate and the neonatal outcome was present between the two protocols.ConclusionOur findings suggest that GnRH agonist protocol results in a higher rate of live birth after fresh embryo transfer than GnRH antagonist protocol in patients with thin endometrium.
Influence of key histological characteristics on 18F-fluorodeoxyglucose /18F-choline positron emission tomography positivity in hepatocellular carcinoma: A machine learning study
Authors: Ghidaglia Jérôme , Laurent Vincent , Sebagh Mylène , Pascale Alina , Durand Emmanuel , Golse Nicolas , Besson Florent L. 
Published: January 2023

PurposeTo determine the characteristics influence of key histological on 18F-fluorodeoxyglucose (18F-FDG) and 18F-choline positron emission tomography (PET) positivity in hepatocellular carcinoma (HCC).Materials and methodsThe 18F-FDG/18F-choline PET imaging findings of 103 histologically proven HCCs (from 62 patients, of which 47 underwent hepatectomy and 15 received liver transplantation) were retrospectively examined to assess the following key histological parameters: Grade, capsule, microvascular invasion (mVI), macrovascular invasion (MVI), and necrosis. Using a ratio of 70/30 for training and testing sets, respectively, a penalized classification model (Elastic Net) was trained using 100 repeated cross-validation procedures (10-fold cross-validation for hyperparameter optimization). The contribution of each histological parameter to the PET positivity was determined using the Shapley Additive Explanations method. Receiver operating characteristic curves with and without dimensionality reduction were finally estimated and compared.ResultsAmong the five key histological characteristics of HCC (Grade, capsule, mVI, MVI, and necrosis), mVI and tumor Grade (I–III) showed the highest relevance and robustness in explaining HCC uptake of 18F-FDG and 18F-choline. MVI and necrosis status both showed high instability in outcome predictions. Tumor capsule had a minimal influence on the model predictions. On retaining only mVI and Grades I–III for the final analysis, the area under the receiver operating characteristic (ROC) curve values were maintained (0.68 vs. 0.63, 0.65 vs. 0.64, and 0.65 vs. 0.64 for 18F-FDG, 18F-choline, and their combination, respectively).Conclusion18F-FDG/18F-choline PET positivity appears driven by both the Grade and mVI components in HCC. Consideration of the tumor microenvironment will likely be necessary to improve our understanding of multitracer PET positivity.
Preclinical evaluation of tolvaptan and salsalate combination therapy in a Pkd1-mouse model
Authors: Song Xuewen , Leonhard Wouter N. , Kanhai Anish A. , Steinberg Gregory R. , Pei York , Peters Dorien J. M. 
Published: January 2023

Background: Autosomal dominant polycystic kidney disease (ADPKD) is the most common genetic disorder and an important cause of end stage renal disease (ESRD). Tolvaptan (a V2R antagonist) is the first disease modifier drug for treatment of ADPKD, but also causes severe polyuria. AMPK activators have been shown to attenuate cystic kidney disease.Methods: In this study, we tested the efficacy of the combined administration of salsalate (a direct AMPK activator) and tolvaptan using clinically relevant doses in an adult-onset conditional Pkd1 knock-out (KO) mouse model.Results: Compared to untreated Pkd1 mutant mice, the therapeutic effects of salsalate were similar to that of tolvaptan. The combined treatment tended to be more effective than individual drugs used alone, and was associated with improved kidney survival (p &lt; 0.0001) and reduced kidney weight to body weight ratio (p &lt; 0.0001), cystic index (p &lt; 0.001) and blood urea levels (p &lt; 0.001) compared to untreated animals, although the difference between combination and single treatments was not statistically significant. Gene expression profiling and protein expression and phosphorylation analyses support the mild beneficial effects of co-treatment, and showed that tolvaptan and salsalate cooperatively attenuated kidney injury, cell proliferation, cell cycle progression, inflammation and fibrosis, and improving mitochondrial health, and cellular antioxidant response.Conclusion: These data suggest that salsalate-tolvaptan combination, if confirmed in clinical testing, might represent a promising therapeutic strategy in the treatment of ADPKD.
Prediction of motor function in patients with traumatic brain injury using genetic algorithms modified back propagation neural network: a data-based study
Authors: Dang Hui , Su Wenlong , Tang Zhiqing , Yue Shouwei , Zhang Hao 
Published: January 2023

ObjectiveTraumatic brain injury (TBI) is one of the leading causes of death and disability worldwide. In this study, the characteristics of the patients, who were admitted to the China Rehabilitation Research Center, were elucidated in the TBI database, and a prediction model based on the Fugl-Meyer assessment scale (FMA) was established using this database.MethodsA retrospective analysis of 463 TBI patients, who were hospitalized from June 2016 to June 2020, was performed. The data of the patients used for this study included the age and gender of the patients, course of TBI, complications, and concurrent dysfunctions, which were assessed using FMA and other measures. The information was collected at the time of admission to the hospital and 1 month after hospitalization. After 1 month, a prediction model, based on the correlation analyses and a 1-layer genetic algorithms modified back propagation (GA-BP) neural network with 175 patients, was established to predict the FMA. The correlations between the predicted and actual values of 58 patients (prediction set) were described.ResultsMost of the TBI patients, included in this study, had severe conditions (70%). The main causes of the TBI were car accidents (56.59%), while the most common complication and dysfunctions were hydrocephalus (46.44%) and cognitive and motor dysfunction (65.23 and 63.50%), respectively. A total of 233 patients were used in the prediction model, studying the 11 prognostic factors, such as gender, course of the disease, epilepsy, and hydrocephalus. The correlation between the predicted and the actual value of 58 patients was R2 = 0.95.ConclusionThe genetic algorithms modified back propagation neural network can predict motor function in patients with traumatic brain injury, which can be used as a reference for risk and prognosis assessment and guide clinical decision-making.
The impact of hemodiafiltration on cognitive function in patients with end-stage renal disease
Authors: Wang Xiaoyan , Chen Xiaohui , Tang Yuting , Zhang Liuping , Wang Yue , Hou Zhenghua , Jang Wenhao , Yuan Yonggui 
Published: January 2023

BackgroundPatients with end-stage renal disease are more likely to suffer cognitive impairment. Cognitive impairment may lead to long-term severe adverse consequences.PurposeTo explore the impact of different blood purification therapy on cerebral blood flow and cognitive functions in end-stage renal disease.Materials and methodsThis prospective study evaluated patients with end-stage renal disease undergoing blood purification from January to March 2021. Matched healthy controls were also included. Participants performed neurocognitive measurements, including a mini-mental state examination, logical memory test-20-minutes delayed, verbal fluency test, digit span test, clock drawing test, and stroop color and word test C. In addition, we tested plasma amyloid-β protein levels, serum Fe and hemoglobin levels in blood samples. Cerebral blood flow was measured using pulsed pseudocontinuous arterial spin labeling. We analyzed and compared the correlation between cognitive function, biomarkers, and cerebral blood flow between patients and healthy subjects, as well as between patients with different treatments.ResultsA total of 44 patients with end-stage renal disease (mean age, 57.39 years ± 8.63) and 46 healthy controls (mean age, 56.15 years ± 6.40) were recruited. Patients receive hemodialysis three times a week, and 27 of them have been replaced hemodialysis for hemodiafiltration twice a month. The cognitive function of patients was worse than healthy controls (P &lt; 0.05). The patients showed higher plasma concentrations of amyloid-β40, amyloid-β42, Tau, and pTau181 than healthy controls (P &lt; 0.05). The group receiving both hemodialysis and hemodiafiltration had higher cerebral blood flow signal values in the left caudate nucleus (chuster-level P &lt; 0.05, voxel-level P &lt; 0.001). They also exhibited better verbal fluency function than the hemodialysis-only group (P &lt; 0.05).ConclusionPatients with the end-stage renal disease showed widespread cognitive declines. Cerebral blood flow generally decreased in the cerebral cortex and increased in subcortical regions. The hemodiafiltration may protect verbal function by increasing cerebral blood flow in the left caudate.
Construction and sustained release of konjac glucomannan/naringin composite gel spheres
Authors: Dao Liping , Chen Siyang , Sun Xiangyun , Pang Wenyuan , Zhang Hengzhe , Liao Jun , Yan Jiqiang , Pang Jie 
Published: January 2023

ObjectiveTo improve the bioavailability of active substances and reduce the toxic and side effects on the human body, natural biological macromolecules are used to load active substances and control their release speed in different environments of the human body. In this study, mesoporous silica (MSN) was combined with konjac glucomannan (KGM) and sodium alginate (AC) to prepare pH-sensitive konjac glucomannan/sodium alginate–mesoporous silica loaded naringin gel spheres (KS/MSN). On this basis, the structure, morphology, and release properties of the composite gel spheres were characterized. The results showed that the cumulative release rates of both simulated gastric fluid (SGF) and Simulated colonic fluid (SCF) were lower than that of simulated small intestinal fluid (SIF), which indicated that the prepared composite gel spheres were pH-sensitive to SIF and obtained the best release rate of about 70% under SIF environment.MethodsThe pH-sensitive konjac glucomannan/sodium alginate composite gel spheres (KGM/SA) were prepared by combining inorganic nano-materials mesoporous silica (MSN) with natural macromolecular polysaccharides konjac glucomannan (KGM) and sodium alginate (SA) and characterized.ResultsThe results showed that there was a process of ionic crosslinking and entanglement between konjac glucomannan (KGM) and sodium alginate (SA). Naringin (NG) and mesoporous silica (MSN) were successfully compounded and had good compatibility. The gel microstructure diagram showed that the addition of MSN improved the gel properties of KGM, and KGM and SA gel spheres (KGM/SA) had good compatibility with mesoporous silica/naringenin nanoparticles (NG/MSN). The study of the simulated digestive environment of the gastrointestinal release medium showed that Konjac glucomannan/sodium alginate-mesoporous silica loaded naringin gel spheres (KS/NM) composite gel spheres had the best slow-release effect and the highest final-release completion degree in SIF. The release of NG from KS/NM composite gel spheres showed a slow upward trend. The results showed that KS/NM composite gel spheres were pH-sensitive.ConclusionThe KS/NM composite gel spheres showed obvious pH sensitivity to the release of NG, and the gel spheres had a good sustained release effect on NG.
Association between daily eating frequency and mortality in people with diabetes: Findings from NHANES 1999–2014
Authors: Xie Jing , Wang Zhenwei , Zhang Xin , Wang Junjie , Feng Wei , Hu Yifang , Liu Naifeng , Liu Yun 
Published: January 2023

BackgroundPrevious studies have shown that increasing the frequency of eating is beneficial in terms of cardiovascular metabolic risk factors; however, limited evidence is available for the association between daily eating frequency and mortality, especially in people with diabetes. Therefore, we aimed to explore the association between eating frequency and long-term mortality in populations with diabetes.MethodsWe selected 4,924 individuals suffering from diabetes (mean age: 57.77 years; 51.3% men) from the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2014. Daily eating frequency was used as the exposure factor in this study. We extracted the mortality data from the National Death Index records and matched them with the population of NHANES. All participants were followed up from the date of getting enrolled in NHANES to 31 December 2015. Multivariate Cox proportional hazards regression, Kaplan–Meier survival curves, and restricted cubic spline were used to assess the associations between eating frequency and all-cause and cause-specific mortality among people with diabetes.ResultsDuring 34,950 person–years of follow-up, 1,121 deaths were documented, including 272 cardiovascular disease (CVD)-related deaths and 156 cancer-related deaths. After adjusting for confounding factors, the daily eating frequency was linearly inversely associated with all-cause and CVD-related mortality, and the HR (95% CIs) for per one-time increment of eating frequency was 0.88 (0.80–0.98) and 0.77 (0.63–0.93), respectively. Sensitivity analyses showed that the main results and statistical significance were still stable.ConclusionHigher eating frequency was independently related to lower all-cause and CVD-related mortality in people with diabetes, which can be used as a potential strategy for daily-diet management among populations suffering from diabetes.
Emerging patterns and trends in global cancer burden attributable to metabolic factors, based on the Global Burden of Disease Study 2019
Authors: Zhang Yan , Ding Yuwei , Zhu Ning , Mi Mi , Lu Yier , Zheng Jia , Weng Shanshan , Yuan Ying 
Published: January 2023

BackgroundThe exponential growth of the cancer burden attributable to metabolic factors deserves global attention. We investigated the trends of cancer mortality attributable to metabolic factors in 204 countries and regions between 1990 and 2019.MethodsWe extracted data from the Global Burden of Disease Study (GBD) 2019 and assessed the mortality, age-standardized death rate (ASDR), and population attributable fractions (PAFs) of cancers attributable to metabolic factors. Average annual percentage changes (AAPCs) were calculated to assess the changes in the ASDR. The cancer mortality burden was evaluated according to geographic location, SDI quintiles, age, sex, and changes over time.ResultsCancer attributable to metabolic factors contributed 865,440 (95% UI, 447,970-140,590) deaths in 2019, a 167.45% increase over 1990. In the past 30 years, the increase in the number of deaths and ASDR in lower SDI regions have been significantly higher than in higher SDI regions (from high to low SDIs: the changes in death numbers were 108.72%, 135.7%, 288.26%, 375.34%, and 288.26%, and the AAPCs were 0.42%, 0.58%, 1.51%, 2.36%, and 1.96%). Equatorial Guinea (AAPC= 5.71%), Cabo Verde (AAPC=4.54%), and Lesotho (AAPC=4.42%) had the largest increase in ASDR. Large differences were observed in the ASDRs by sex across different SDIs, and the male-to-female ratios of ASDR were 1.42, 1.50, 1.32, 0.93, and 0.86 in 2019. The core population of death in higher SDI regions is the age group of 70 years and above, and the lower SDI regions are concentrated in the age group of 50-69 years. The proportion of premature deaths in lower SDI regions is significantly higher than that in higher SDI regions (from high to low SDIs: 2%, 4%, 7%, 7%, and 9%). Gastrointestinal cancers were the core burden, accounting for 50.11% of cancer deaths attributable to metabolic factors, among which the top three cancers were tracheal, bronchus, and lung cancer, followed by colon and rectum cancer and breast cancer.ConclusionsThe cancer mortality burden attributable to metabolic factors is shifting from higher SDI regions to lower SDI regions. Sex differences show regional heterogeneity, with men having a significantly higher burden than women in higher SDI regions but the opposite is observed in lower SDI regions. Lower SDI regions have a heavier premature death burden. Gastrointestinal cancers are the core of the burden of cancer attributable to metabolic factors.
Glutamine synthetase expression rescues human dendritic cell survival in a glutamine-deprived environment
Authors: Schoeppe Robert , Babl Nathalie , Decking Sonja-Maria , Schönhammer Gabriele , Siegmund Andreas , Bruss Christina , Dettmer Katja , Oefner Peter J. , Frick Linus , Weigert Anna , Jantsch Jonathan , Herr Wolfgang , Rehli Michael , Renner Kathrin , Kreutz Marina 
Published: January 2023

IntroductionGlutamine deficiency is a well-known feature of the tumor environment. Here we analyzed the impact of glutamine deprivation on human myeloid cell survival and function.MethodsDifferent types of myeloid cells were cultured in the absence or presence of glutamine and/or with L-methionine-S-sulfoximine (MSO), an irreversible glutamine synthetase (GS) inhibitor. GS expression was analyzed on mRNA and protein level. GS activity and the conversion of glutamate to glutamine by myeloid cells was followed by 13C tracing analyses.ResultsThe absence of extracellular glutamine only slightly affected postmitotic human monocyte to dendritic cell (DC) differentiation, function and survival. Similar results were obtained for monocyte-derived macrophages. In contrast, proliferation of the monocytic leukemia cell line THP-1 was significantly suppressed. While macrophages exhibited high constitutive GS expression, glutamine deprivation induced GS in DC and THP-1. Accordingly, proliferation of THP-1 was rescued by addition of the GS substrate glutamate and 13C tracing analyses revealed conversion of glutamate to glutamine. Supplementation with the GS inhibitor MSO reduced the survival of DC and macrophages and counteracted the proliferation rescue of THP-1 by glutamate.DiscussionOur results show that GS supports myeloid cell survival in a glutamine poor environment. Notably, in addition to suppressing proliferation and survival of tumor cells, the blockade of GS also targets immune cells such as DCs and macrophages.
Huashi baidu granule in the treatment of pediatric patients with mild coronavirus disease 2019: A single-center, open-label, parallel-group randomized controlled clinical trial
Authors: Chen Jiande , Tang Qiuyu , Zhang Baoqin , Yuan Shuhua , Chen Jia , Shen Shiyu , Wang Dong , Lin Jilei , Dong Hongliang , Yin Yong , Gao Jian 
Published: January 2023

Background: Since late February 2022, a wave of coronavirus disease 2019 (COVID-19) mainly caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant rapidly appeared in Shanghai, China. Traditional Chinese medicine treatment is recommended for pediatric patients; however, the safety and efficacy remain to be confirmed. We conducted a single-center, open-label, parallel-group randomized controlled trial to assess the efficacy and safety of a Chinese herb compound, Huashi Baidu granule (HSBDG) in pediatric patients with laboratory-confirmed mild COVID-19.Methods: 108 recruited children (aged 3–18 years) with laboratory-confirmed mild COVID-19 were randomly allocated 2:1 to receive oral HSBDG for five consecutive days (intervention group) and to receive compound pholcodine oral solution for five consecutive days (control group). The negative conversion time of SARS-CoV-2 nucleic acid and symptom scores were recorded.Results: The median negative conversion time of SARS-CoV-2 nucleic acid was significantly shorter in the intervention group than in the control group (median days [interquartile range (IQR)]: 3 [3–5] vs. 5 [3–6]; p = 0.047). The median total symptom score on day 3 was significantly lower in the intervention group than in the control group (median total symptom score [IQR]: 1 [0–2] vs. 2 [0–3]; p = 0.036). There was no significant differences in the frequency of antibiotic use and side effects between the two groups.Conclusion: HSBDG is a safe, effective oral Chinese herbal compound granule, which shows a good performance within the Omicron wave among pediatric patients.