bluuebunny/crossref_metadata_2025_split huggingface dataset:
Network meta-analysis and cost-effectiveness analysis of infliximab, cyclosporine and tacrolimus for ulcerative colitis
Authors: Wang Xueqi , Li Qiubo , Sun Shijiang , Liang Xi , Li Huijing , Huang Jing , Zhao Tianhe , Hu Jingnan , Liu Jianxin , Hu Zhenbiao , Duan Yangyang , He Jianming 
Published: December 2022

Background:
Assess the efficiency and cost-effectiveness of infliximab, cyclosporine and tacrolimus for the treatment of ulcerative colitis (UC).

Methods:
A literature search identified studies that investigated infliximab, cyclosporine or tacrolimus compared with placebo in UC patients. Short-term, long-term remission rates and response rates were employed to assess efficacy. Odds ratios with 95% confidence intervals were analyzed. A Markov model was constructed to simulate the progression in a cohort of patients with UC, with an over 10 years of time horizon, with a discount rate of 3%, and established threshold of €30,000/quality-adjusted life-year (QALY) or ¥82442/QALY.

Results:
Results of network meta-analysis showed that the order was cyclosporine, tacrolimus, infliximab and placebo from high rate to low with regard to short-term clinical response. The comparison between infliximab versus cyclosporine achieved an incremental cost effectiveness ratio (ICER) of €184435/QALY and ¥531607/QALY, with a 0.34893 QALYs difference of efficacy, and an incremental cost of €64355 and ¥185494. Tacrolimus versus cyclosporine reached an ICER of €44236/QALY and ¥57494/QALY, with a difference of 0.40963 QALYs in efficacy, and a raising cost to €18120 and ¥23551. The probabilistic sensitivity analysis shows that cyclosporine would be cost-effective in the 75.8% of the simulations, tacrolimus in the 24.2%, and infliximab for the 0%.

Conclusion:
Infliximab, cyclosporine and tacrolimus as salvage therapies are efficacious. For long-term of clinical remission, the order of pharmacological agents was tacrolimus, infliximab and cyclosporine from high efficacy to low while no significant difference is seen. In cost-effectiveness analysis, the cyclosporine versus infliximab or tacrolimus is expected to be at best.
Clinical value of thyroid related hormones combined with neutrophil to lymphocyte ratio in patients with nonalcoholic fatty liver disease
Authors: Li Ping , Liu Liang , Niu Bin , Mi YuQiang , Liu YongGang , Feng Jing , Zhang Peng , Wu Xue , Chu WeiKe 
Published: December 2022

Background:
In sufferers with nonalcoholic fatty liver disease (NAFLD), the differences of thyroid associated hormones and neutrophil to lymphocyte ratio (NLR) in different liver pathological groups have been compared.

Methods:
Patients with NAFLD diagnosed by liver biopsy in our hospital from July 2012 to February 2019 were selected. All subjects were divided into nonalcoholic steatohepatitis (NASH) team and non-NASH group, no/mild fibrosis group (F0-1) and significant fibrosis group (F2-4). The differences of thyroid related hormones and NLR in these groups were in contrast, respectively. For the TSH, we conducted further evaluation based on gender.

Results:
The TSH and NLR in NASH patients were significantly higher than non-NASH patients, but there was no considerable difference in free triiodothyronine (FT3) and free thyroxine (FT4) between the 2 groups. In the gender-based subgroup analysis, the variations of TSH between the 2 groups were nonetheless statistically significant (P < .05). The TSH and NLR in the significant fibrosis group were higher than these in the non/mild liver fibrosis group, and the differences were statistically significant (P < .05), but there was no large difference in FT3 and FT4 between the 2 groups (P > .05). In addition, in the gender-based subgroup analysis and further multivariable analysis, the variations of TSH between the 2 groups were still statistically significant (P < .05).

Conclusions:
In this study, we found that serum thyroid stimulating hormone (TSH) and neutrophil to lymphocyte ratio (NLR) were closely associated to the severity of NAFLD, suggesting that this simple available laboratory index may additionally be incorporated into the future noninvasive diagnostic scoring model to predict the incidence of NASH and the degree of fibrosis.
Impact of iron overload on poor graft function after allo-HSCT in a patient with transfusion-dependent low-risk MDS: A case report and literature review
Authors: Wang Cong , Zhao Munan , Nie Yuanyuan , Yang Yan , Tan Yehui , Du Zhonghua , Gao Sujun , Li Wei 
Published: December 2022

Rationale:
Poor graft function (PGF) occurs in 5% to 27% of allogeneic hematopoietic stem cell transplantation (allo-HSCT) and is associated with high life-threatening complications. The etiology of PGF is complex and multifactorial, and iron overload (IOL) is considered as a predictive factor.

Patient concern:
A 45-years-old woman who was diagnosed as low-risk myelodysplastic syndrome in 2012 has been transfusion dependent and developed severe IOL.

Diagnoses:
Due to transfusion dependency and also ineffective erythropoiesis, this patient was diagnosed as IOL and developed PGF after allo-HSCT.

Interventions:
Deferasirox (20mg/kg/d) was administered regularly after allo-HSCT for 2 years.

Outcomes:
Hematopoiesis was gradually recovered during iron chelation therapy treatment after allo-HSCT and PGF was reverted.

Lessons:
IOL, as a prognostic factor for PGF, is a common problem in Transfusion dependent myelodysplastic syndrome patients undergoing HSCT. IOL issues should be considered at the time of diagnosis and throughout the treatment course for patients who are potential candidates for HSCT.
The role of vitamin A and zinc supplementation in pediatric pneumonia: A protocol for systematic review and network meta-analysis
Authors: Shi Yu , Lei Qihong , Liu Hongxia , Han Qing 
Published: December 2022

Background:There is still controversy regarding the role of zinc and vitamin A supplementation in pediatric pneumonia. Therefore, we designed a systematic review and network meta-analysis to incorporate the available evidence to determine the role of vitamin A and zinc in pediatric pneumonia.Methods:From the inception to December 31, 2022, the Web of Science, EMBASE, Medicine, the Cochrane Central Register of Controlled Trials and Cochrane Library electronic databases were searched using the key phrases “pneumonia,” “pediatric,” “zinc,” “vitamin A,” and “cohort” for all relevant studies. Cohort studies assessing the efficacy and safety of zinc and/or vitamin A supplementation in children with pneumonia will be included for quantitative or qualitative analysis. Non-cohort studies and studies that do not meet the inclusion criteria will be excluded. Outcome measures include reduction in duration of pneumonia, adverse drug events, length of hospital stay, amount of antibiotics used, and radiological parameters. The primary outcome is the degree of reduction in the duration of pneumonia.Results:This Bayesian network meta-analysis will be conducted in accordance with the PRISMA extension statement, which is used to report systematic reviews that incorporated a meta-analysis of medical intervention networks.
Rupture-mediated large uterine defect at 30th gestational week with protruded amniotic sac and fetal head without fetal compromise after laparoscopic electromyolysis: Case report and literature review
Authors: Yang Seung-Woo , Yoon Sang-Hee , Yuk Jin-Sung , Chun Kyoung-Chul , Jeong Myeong Ja , Kim Myounghwan 
Published: December 2022

Background:
We describe a case of a rupture–mediated large uterine defect, which occurred on the 30th gestation week presenting a protruding amniotic sac sac without fetal compromise after a laparoscopic electromyolysis.

Case presentation:
A 28-year-old woman in her 30th week of gestation (gravida 2, para 0) presented with whole abdominal and right lower quadrant pain at Sanggye Paik Hospital. Ultrasound examination showed normal amniotic fluid and placentation but with breech presentation. She had undergone laparoscopic right ovarian cystectomy due to endometriosis 5 years earlier. Cardiotocography revealed an intermittent variable deceleration and no uterine contraction. Magnetic resonance imaging ruled out acute appendicitis. Four hours later, we observed a protrusion of the amniotic sac with the fetal head through a large uterine defect on magnetic resonance imaging, and performed emergency cesarean section. A boy was delivered without fetal compromise. During the cesarean section, multiple myometric wall defects and thinning were identified. After reconstruction of the uterine wall, the flaccid uterus bled persistently; thus, a cesarean hysterectomy was performed. Packed red cells and frozen plasma were transfused. The mother and neonate had uneventful puerperal and neonatal courses, respectively. After cesarean hysterectomy, we were informed that the mother had undergone a combined laparoscopic electromyolysis during the laparoscopic right ovarian cystectomy. Three years later, the child showed normal neural development.

Conclusions:
Before myomectomy or electromyolysis, patients should be informed of the possibility of uterine rupture during subsequent pregnancies. If a pregnant woman has abdominal pain, clinicians should take a detailed history of uterine surgery and consider uterine rupture. Although, fortunately, the outcomes in this case were uneventful, urgent delivery is required when uterine rupture is diagnosed.
Advanced stage cutaneous T-cell lymphoma treated with high-dose external beam radiation therapy: A case report
Authors: Youn Sang Hee , Lee Sun Young 
Published: December 2022

Introduction:
The treatment for advanced-stage or refractory cutaneous T-cell lymphoma (CTCL) is largely palliative. Due to the rarity of the disease, there are few randomized controlled trials and large-scale prospective studies. Therefore, the treatment of advanced-stage CTCL remains challenging.

Patient concerns and diagnosis:
A 64-years-old man who had received narrowband UVB phototherapy for several years presented with a generalized rash with widespread polycyclic erosions and painful ulcers on his hands and feet. We restaged him as stage III CTCL.

Interventions and outcomes:
He was treated with high-dose radiation for curative purposes and 3-dimensional conformal radiation therapy to both hands and feet. At the 2-year follow-up after the end of radiotherapy, the irradiated skin had recovered to normal soft, smooth skin with localized fibrosis and hypopigmented skin. He reported an excellent quality of life, and his hands and feet were free to move.

Conclusion:
CTCL at an advanced stage could require dose escalation with local radiotherapy for curative purposes. High-dose 3-dementional conformal radiation therapy could be effective and has tolerable toxicities.
A randomized controlled study of a combination of internal and external treatments for albumin paclitaxel-related peripheral neurotoxicity: A randomized controlled: A study protocol
Authors: Li Xiaoli , Sun Qimeng , Ding Hao , Hao Shulan , Lan Yonglin , Liu Likun , Wang Ruimin 
Published: December 2022

Introduction:
Albumin-bound paclitaxel (nab-PTX), a novel paclitaxel preparation, has been found to successfully blocks tumor progression in breast and lung cancer. However, at the same time of as clinical application, neurotoxicity caused by nab-PTX has become the main factor limiting the clinical application of nab-PTX, which seriously affects the quality of life of patients and increases their psychological or financial burden. In clinical applications, JHGWD combined with bloodletting therapy at the end of the extremities has a positive effect on neurotoxic symptoms such as numbness, pain, and weakness of the hands and feet caused by nab-PTX. In a single-arm experiment, it was also found that the immediate effective rate of exsanguination therapy was as high as 70%, and when combined with oral Chinese medicine treatment, it further improved the efficacy. Therefore, a randomized controlled trial (RCT) was designed to further evaluate the efficacy and safety of this treatment.

Methods:
This RCT will be conducted at the Shanxi Provincial Hospital of Traditional Chinese Medicine. A total of 120 patients with Nab-PTX chemotherapy-induced neurotoxicity will be recruited. Treatment groups will be categorized into herbs alone group, bloodletting treatment alone group, and herbs combined with bloodletting group. Blank control was used. The primary outcome will be the EORTC QLQ-CIPN20 scale of the included patients, and the secondary outcomes will include EMG, peripheral neurotoxicity symptom score, NCI-CTCAE5.0 peripheral neurotoxicity grade, and WHO anti-tumor drug peripheral neurotoxicity grade. Adverse reactions will be recorded throughout the process. All data in this RCT will be analyzed by SPSS 26.0 software.

Discussion:
The results of this RCT will contribute to treating PIPN, relieving the neurotoxic symptoms, and improving the quality of life of patients. Finally, the RCT results will be published in a relevant academic journal on completion of the trial.

Trial registration:
ChiCTR2200060217(May22,2022)
Electrocautery ablation therapy for anal intraepithelial carcinoma: A study protocol
Authors: Ando Naokatsu , Mizushima Daisuke , Takano Misao , Kitamura Hiroshi , Shiojiri Daisuke , Nakamoto Takato , Aoki Takahiro , Watanabe Koji , Uemura Haruka , Gatanaga Hiroyuki , Oka Shinichi 
Published: December 2022

Background:
Anal cancer is a human papillomavirus-related cancer. Screening with high-resolution anoscopy (HRA) and subsequent therapeutic intervention are increasingly recognized as the standard procedure for anal cancer. Generally, lesions suspected as being high-grade squamous intraepithelial lesions are biopsied and treated if they are grade 2 or 3 anal intraepithelial neoplasia (AIN). According to several studies, electrocautery ablation for grade 2 or 3 AIN is highly effective. However, relapse within and outside the targeted areas after the intervention is a clinical problem. In Japan, electrocautery ablation is not available at most facilities. Therefore, this study aims to investigate the efficacy and safety of electrocautery ablation.

Methods:
This single-arm, open-label, pilot intervention study will investigate the efficacy and safety of electrocautery ablative therapy using high-frequency medical devices. Patients diagnosed with grade 2 or 3 AIN will be included and will receive ablation treatment. Then, they will be followed up at 3 and 6 months after the procedure for HRA-guided sextant biopsy. To reduce the possibility of missed lesions before and after the intervention, we will perform HRA-guided sextant biopsy routinely. In this study, a sextant biopsy is defined as at least 6 biopsies in all directions, regardless of abnormal findings under HRA. The primary outcome is the recurrence rate at 6 months, and the secondary outcomes are the adverse event and recurrence rates at 3 months.

Conclusion:
This pilot study will provide data on the effectiveness and safety of electrocautery ablation as a treatment for grade 2 or 3 AIN.
Effectiveness and safety of ear acupuncture for ankylosing spondylitis: A protocol for systematic review and meta-analysis
Authors: Zhang Zheng , Jiang Yin , Fang Yaqi , Lou Fei 
Published: December 2022

Introduction:
Ankylosing spondylitis (AS) is a type of autoimmune disease commonly characterized by joint pain and stiffness. This disease progression can exhibit common deformities and other activities with limited symptoms and significantly impacts people’s work and life. Ear acupuncture as a traditional Chinese therapy, showing several advantages (e.g., safety, economy, and less side effects), has been extensively used to treat AS. However, its curative effect is supported by limited evidence. Accordingly, the present study aims to comprehensively assess the reliability of ear acupuncture in AS treatment.

Methods and analysis:
The study will conduct a systematic review and meta-analysis. Seven databases, including the Embase, Cochrane Library, PubMed, SinoMed, China National Knowledge Infrastructure, Chongqing VIP Database for Chinese Technical Periodicals, and Wanfang Data, will be searched using predefined search terms to identify relevant studies. The primary outcomes will be the clinical efficiency, the Bath Ankylosing Spondylitis Disease Activity Index, and the visual analog scale. Eligible studies should report at least 1 of these primary outcomes. Eligible studies designed as randomized controlled trials will be included for meta-analysis, while other related clinical studies will be reviewed. The methodological quality of the included studies will be assessed with a previously established checklist. The Cochrane Collaboration’s bias risk tool will be used for assessing the bias of included randomized controlled trials. Stata 17.0 software is used for meta-analysis.

Results:
The protocol will be used to assess the efficacy and safety of ear acupuncture in AS treatment.

Conclusion:
This review reliably evidences whether ear is a reliable method for the intervention of AS.
Effectiveness of self-management of dry and wet cupping therapy for low back pain: A systematic review and meta-analysis
Authors: Shen Wei-Cheng , Jan Yih-Kuen , Liau Ben-Yi , Lin Quanxin , Wang Song , Tai Chien-Cheng , Lung Chi-Wen 
Published: December 2022

Background:
Low back pain (LBP) can significantly affect a person’s quality of life. Cupping has been used to treat LBP. However, various cupping methods are typically included in evaluating the efficacy of cupping therapy. Therefore, the objectives of this study were to evaluate the evidence from the literature regarding the effects of dry and wet cupping therapy on LBP in adults. Dry and wet cupping therapy are analyzed categorically in this study.

Methods:
We searched for randomized clinical trials with cupping in LBP published between 2008 and 2022. In dry or wet cupping clinical studies, pain intensity was assessed using the Visual Analogue Scale and present pain intensity, and the quality of life intensity was measured using the Oswestry disability index.

Results:
The 656 studies were identified, of which 10 studies for 690 patients with LBP were included in the meta-analysis. There was a significant reduction in the pain intensity score with present pain intensity using wet cupping therapy (P < .01). In addition, both cupping therapy groups displayed significant Oswestry disability index score reduction compared to the control group (both P < .01). The patients with LBP have a substantial reduction by using wet cupping but have not shown a considerable decrease by using dry cupping (P = .19). In addition, only wet cupping therapy groups displayed a significantly improved quality of life compared to the control group. The study had a very high heterogeneity (I
2 > 50%). It means there is no standardization in the treatment protocol in randomized clinical trials. In the meta-regression, there was statistically significant evidence that the number of treatment times and intercepts were related (P < .01).

Conclusion:
The present meta-analysis shows that wet cupping therapy effectively reduces the pain intensity of LBP. Furthermore, both dry wet cupping therapy improved patients with LBP quality of life.
Predictors of COVID-19 outcomes: Interplay of frailty, comorbidity, and age in COVID-19 prognosis
Authors: Lee Yoon Kyung , Motwani Yash , Brook Jenny , Martin Emily , Seligman Benjamin , Schaenman Joanna 
Published: December 2022

Prior research has identified frailty, comorbidity, and age as predictors of outcomes for patients with coronavirus disease 2019 (COVID-19), including mortality. However, it remains unclear how these factors play different roles in COVID-19 prognosis. This study focused on correlations between frailty, comorbidity and age, and their correlations to discharge outcome and length-of-stay in hospitalized patients with COVID-19.
Clinical data was collected from 56 patients who were ≥50 years old and admitted from March 2020 to June 2020 primarily for COVID-19. Frailty Risk Score (FRS) and the Charlson Comorbidity Index (CCI) were used for assessment of frailty and comorbidity burden, respectively.
Age had significant positive correlation with FRS and CCI (P < .001, P < .001, respectively). There was also significant positive correlation between FRS and CCI (P < .001). For mortality, patients who died during their hospitalization had significantly higher FRS and CCI (P = .01 and P < .001, respectively) but were not significantly older than patients who did not. FRS, CCI, and age were all significantly associated when looking at overall adverse discharge outcome (transfer to other facility or death) (P < .001, P = .005, and P = .009, respectively). However, none of the 3 variables were significantly correlated with length-of-stay. Multivariate analysis showed FRS (P = .007) but not patient age (P = .967) was significantly associated with death.
We find that frailty is associated with adverse outcomes from COVID-19 and supplants age in multivariable analysis. Frailty should be part of risk assessment of older adults with COVID-19.
Efficacy and safety of external therapy of TCM for diabetic peripheral vascular disease: A protocol for systematic review and meta-analysis
Authors: Ding Tingwei , Sheng Lei , Zhu Haiyu , Guan Hongyi , Wang Ying , Guo Haoze , Bi Yunpeng , Song Bailin 
Published: December 2022

Background:
In modern society, the incidence of diabetes is increasing yearly, and poor glycemic control can accelerate the progression and severity of diabetic peripheral vascular disease. External treatment with traditional Chinese medicine (TCM) has been widely used in the treatment of diabetes, but there is no systematic review on the external treatment of TCM for diabetic peripheral vascular disease; therefore, this study aimed to conduct a meta-analysis on the clinical efficacy and safety of external treatment of TCM in the treatment of diabetic peripheral vascular diseases.

Methods:
We searched The Cochrane Library, PubMed, Web of Science, EMBASE, China Science and Technology Journal, China National Knowledge Infrastructure, Wanfang, Chinese Biomedical Literature Database, and other sources from their respective inception dates to October 20, 2022, to identify potentially eligible studies. We will use Review Manager 5.4 software provided by the Cochrane Collaborative Network for statistical analysis. We then assessed the quality and risk of the included studies and observed their outcome measures.

Results:
Changes in the bilateral femoral artery, popliteal artery, dorsal artery diameter, blood flow, ankle/brachial index, and dorsal foot temperature: An overall reduction in symptoms (a reduction in diabetes-related symptoms that occur only during the intervention or as a result of the intervention, including peripheral vascular disease).

Conclusion:
The objective of this meta-analysis was to investigate the influence of external treatment of traditional Chinese medicine on diabetic peripheral vascular disease and to provide more methods for the clinical prevention and treatment of diabetic peripheral vascular disease.