bluuebunny/crossref_metadata_2025_split huggingface dataset:
An asymptomatic double-chambered left ventricle diagnosed by contrast-enhanced ultrasound imaging: A case report
Authors: Tian Jie , Jin Dan , Zhu Ying , Liu Yani 
Published: April 2023

Rationale:
The double-chambered left ventricle (DCLV) is a rare congenital heart disease and is separated into 2 chambers by abnormally hypertrophied bundles of muscle or fibrous strips. Differential diagnoses, especially diverticulum, aneurysms and large ventricular septal defect are sometimes difficult.

Patient concerns:
A 33-year-old woman was admitted to the hospital to undergo abortion without any discomfort such as palpitation, chest tightness, shortness of breath and etc. The electrocardiogram reported a suspicious left anterior branch block and extensive anterior wall R-wave incremental dysplasia. The transthoracic echocardiography showed a bilayer structure of the ventricular septum with a continuity interruption visible on the left ventricular surface, and the color doppler flow imaging showed a low velocity bidirectional flow at this continuity interruption, communicated with the left ventricular cavity.

Diagnoses:
Final diagnosis of DCLV was confirmed by contrast-enhance ultrasound imaging.

Interventions:
The patient was discharged without any special treatment of the heart after the abortion.

Outcomes:
The patient did not complain of any special discomfort after the 3, 6, and 9 months of outpatient follow-ups.

Lessons:
This case highlights the necessity of contrast-enhance ultrasound imaging, which plays an important role in improving the accuracy of DCLV diagnosis and in differentiating it from other diseases.
Flail arm syndrome due to duplication mutations in the SMN1 gene: A case report
Authors: Luo Han , Li Shanshan , Liu Bo 
Published: April 2023

Rationale:
Flail arm syndrome (FAS) only involves the upper limbs early stage and manifests as proximal weakness and atrophy of both upper limbs and decreased tendon reflexes. As a benign variant type of amyotrophic lateral sclerosis, FAS progresses slowly, with no lower motor neuron signs in the lower limbs or bulbar muscles within 12 months after onset.

Patient concerns:
A 49-year-old male patient was admitted to the hospital with a 15-month history of proximal weakness and muscle atrophy in both upper limbs. His other symptoms and signs were not obvious.

Diagnoses:
Gene test results indicated that there were duplication mutations in the exon 7 to 8 region of the SMN1 gene.

Lessons:
The abnormal duplication of exons 7 and 8 of the SMN1 gene in this patient may increase the risk of FAS. Further studies are needed to identify the dominant genes and genetic factors causing males to be susceptible to FAS.
Transcutaneous electronic acupoint stimulation improves bone marrow suppression in lung cancer patients following chemotherapy: A systematic review and meta-analysis of randomized controlled trials
Authors: Wei Yi , Zheng Yun 
Published: April 2023

Background:
This systematic review and meta-analysis aimed to evaluate the efficacy of transcutaneous electronic acupoint stimulation (TEAS) on bone marrow suppression in patients with lung cancer after chemotherapy.

Methods:
We conducted a comprehensive search of 6 databases until November 2022 and included 6 randomized controlled trials comprising 534 patients in our analysis. Eligible randomized controlled trials were included based on predefined inclusion criteria. The weighted mean difference (WMD) was calculated with all of the continuous outcomes. Heterogeneity among the included studies was evaluated using Cochran I
2 and Q statistics. When the value of I
2 was over 50%, a random-effects model was used. Egger test was used to assess publication bias, and trim and fill analysis was conducted if bias was detected.

Results:
Our analysis found that TEAS significantly increased white blood cell counts (WMD: 0.79, 95% confidence interval (CI): 0.40–1.18, P < .001), platelet counts (WMD: 45.45, 95% CI: 30.47–60.43, P < .001), and comfort score (WMD: 6.89, 95% CI: 5.12–8.66, P < .001) compared to the conventional group. However, no significant difference was observed in red blood cell counts (WMD: 0.00, 95% CI: −0.10 to 0.10, P = .97) and hemoglobin level (WMD: −0.01, 95% CI: −2.49 to 2.46, P = .99) between the 2 groups.

Conclusions:
We tentatively conclude that TEAS can reduce bone marrow suppression risk and improve comfort in lung cancer patients undergoing chemotherapy. However, larger randomized controlled trials with more diverse patient populations and blood routine indexes are urgently needed to confirm these findings.
Efficacy analysis of virtual reality-based training for activities of daily living and functional task training in stroke patients: A single-subject study
Authors: Lee Lan-Ju , Choi Seong-Youl , Lee Hye-Sun , Han Sang-Woo 
Published: April 2023

Introduction:
Virtual reality (VR)-based training for functions such as cognition, upper extremities, balancing, and activities of daily living (ADL) has been used on stroke patients, and its efficacy has been reported. However, no comparison has been made between the efficacy of VR-based training for daily activities that exactly reproduces ADL and functional training. Therefore, this study sought to analyze the difference in independency enhancement of VR-based training for daily activities compared to cognitive and motor functional training.

Patient concerns and diagnosis:
This study was conducted on 4 patients who have been diagnosed with stroke and are currently receiving rehabilitation therapy in G hospital located in the city of Gwangju, using A-B-A’-B’ design from single-subject experimental designs.

Interventions:
Intervention was performed in 2 ways: application of VR-based training for daily activities after the application of cognitive and motor function training; and application of cognitive and motor function training after the application of VR-based training for daily activities. The Assessment of Motor and Process Skills, Computer Cognitive Screening Assessment System, Box and Block Test, and Grip and Pinch Strength Test were used to measure the changes in the performance of daily activities, cognitive function, and upper extremities function.

Outcomes:
The results confirmed that the performance of daily activities, cognitive function, and upper extremities function was improved after the application of VR-based intervention. In addition, the efficacy of independency enhancement was maximized by the early approach of training for daily activities at the time of VR-based intervention in stroke patients.

Conclusions:
VR-based intervention of training for daily activities and functional training can be considered to benefit the improvement of the performance of daily activities, cognitive function, and upper extremities function in stroke patients. In addition, although functional training was also effective in enhancing independency and functional improvement in stroke patients, an early approach to training for ADL based on tasks with objectives was deemed to be more effective.
Family health therapy for treating anxiety symptoms in flood victims
Authors: Ugwuoke Cajethan U. , Ede Kelechi Ruth , Ede Moses Onyemaechi , Oneli Joy Obiageli 
Published: April 2023

Background:
Flood cases in so many parts of Nigeria, especially in Anambra state and the accruing psychological and health related problems, affecting members of families and society necessitated this study. In view to assist and help affected individuals who specialized in farming therapeutically, this study investigated the effect of rational emotive family health therapy (REFHT) on flood-induced anxiety disorders among farmers in Anambra state Nigeria. This study was guided with 3 null hypotheses.

Methods:
This is a group randomized control study, conducted in Anambra state Nigeria. The sample size was 120 registered cassava farmers in Anambra State Nigeria. A measure of anxiety disorders was used to assess the baseline data of the condition before the treatment, immediately after treatment, and after 3 weeks. The treatment was a self-developed REFHT manual that lasted for 12 sessions, 60 minutes per session with aim of reducing anxiety disorders among farmers who are victims of flood. The manual was delivered by counseling psychologists with orientation in rational emotive behavior and family therapies. Data collected were analyzed using descriptive (mean, standard deviation, chi-square, and percentage) and inferential (Partial Eta Squared, and Analysis of Covariance) statistical tools.

Results:
The result revealed no significant gender difference was observed among the study participants’ socioeconomic, working status, and loan status. REFHT was significantly effective in reducing flood-induced anxiety disorders among farmers. There was no significant moderating effect of gender on flood-induced anxiety disorders among farmers. There was no significant interaction effect of gender and REFHT treatment on anxiety disorders among farmers.

Conclusion:
REFHT was significantly effective in reducing flood-induced anxiety disorders among farmers. Based on the findings, this study recommended among others that rational-emotive therapists and family health professionals should liaise with community leaders to provide career counseling services to farmers and establishment of community-based rational emotive institute for each state in Nigeria.
Association of IL-27 gene rs153109 and rs17855750 polymorphisms with preeclampsia susceptibility and severity: Meta-analysis and trial sequential analysis
Authors: Wang Fengzhen , Wen Ersheng , Huang Yuyang , Wen Zhenyin , Liu Ziyou 
Published: April 2023

Background:
The aim of this meta-analysis is to evaluate the association of interleukin-27 gene rs153109 and rs17855750 polymorphisms with preeclampsia susceptibility and severity.

Methods:
Web of Science, PubMed, Embase, CBM, WanFang Data, CNKI, and VIP database were used for retrieving. After screening with our inclusion and exclusion criteria, data extraction and quantity evaluation were performed by 2 independent authors. Included case-control studies were used for meta-analysis by RevMan 5.4, and sensitivity analysis was carried out through 1-by-1 exclusion procedure. If heterogeneity exists, then random effects model was used; otherwise, fixed effect model was used. Publication bias analysis was performed using Begg test and Egger test. Trial sequential analysis was performed using trial sequential analysis 0.9.5.10 Beta.

Results:
A total of 5 articles were included. The heterogeneity was high across most models during the meta-analysis. Meta-analysis results related to preeclampsia susceptibility showed that P values of all the models were higher than .05, while for meta-analysis results related to preeclampsia severity showed that P values of all the models were higher than .05 except for TT versus TG + GG and TT versus TG models of rs17855750 group. The sensitivity of the meta-analysis was high, and trial sequential analysis showed the possibility of false negative results. No obvious publication bias was found.

Conclusions:
There is no obvious association between interleukin-27 gene rs153109 and rs17855750 polymorphisms and preeclampsia susceptibility or severity. However, more multi-center and large sample case-control studies are expected to be carried out to verify our conclusion in the future.
Effects of monitoring exercise rehabilitation with target intensity on the patient with twice PCI: A case report
Authors: Liu Xiangyang , Chen Yunxian , Chen Jinfeng , Li Aihua , Zhong Ming , Zhou Wanming , Tang Liangqiu 
Published: April 2023

Rationale:
As the core of cardiac rehabilitation (CR), early exercise rehabilitation is beneficial for patients with coronary heart disease (CHD), and center-based CR with target intensity is superior to home-based CR. However, there was no research to observe the effects of exercise rehabilitation on cardiopulmonary exercise capacity, oxygen uptake efficiency slope, endothelial function evaluated as flow-mediated vasodilation (FMD), and blood plasma lipoprotein-associated phospholipase A2 (Lp-PLA2) in CHD patients undergone percutaneous coronary intervention (PCI) for 3 months.

Patient concerns:
A 57-year-old woman had been identified with triple vessel disease and undergone twice PCI for complete revascularization, however, there was no improvement in Lp-PLA2, FMD, and related indicators of cardiopulmonary exercise testing.

Diagnosis:
Coronary angiography showed an 85% stenosis in the middle left anterior descending artery, an 85% stenosis in the proximity of a thick first-diagonal branch, a long 75 to 85% stenosis in the middle left circumflex artery, and a 90 to 95% stenosis in the proximal. The case was diagnosed as CHD.

Interventions:
The patient obtained optimal medical therapy comprising therapeutic lifestyle changes, and began monitoring exercise rehabilitation with target intensity 3 months after the second PCI in the CR center.

Outcomes:
There were changes in cardiopulmonary exercise capacity, oxygen uptake efficiency slope, FMD, and Lp-PLA2 in the patient with 3 apparent stenotic coronary arteries who was done PCI twice, without or with postoperative exercise rehabilitation, respectively.

Lessons:
We proved that monitoring exercise rehabilitation training with target intensity could improve the prognosis of chronic coronary syndrome patients, and it was never too late to do regular exercise rehabilitation.
Sufentanil, dexmedetomidine combined with surface anesthesia for awake fiberoptic nasotracheal intubation in the patient with severe mouth opening difficulty undergoing wedge resection of the right upper lung: A case report and literature review
Authors: Zhang Yanwei , Lv Xiang , Sun Pingping , Yin Dekun 
Published: April 2023

Background:
Severe mouth opening difficulty may increase the risk of airway management during anesthesia induction, and awake fiberoptic nasotracheal intubation (AFNI) is the first option for patients with orofacial anatomical changes.

Case summary:
A 54-year-old man was scheduled to undergo wedge resection of the right upper lung in August 2021. The patient had a history of enlarged right maxillary lesion resection and partial right maxillary resection surgery in April 2020, which led to orofacial anatomical changes and severe mouth opening difficulty. To avoid difficult airway-related emergency scenarios, the AFNI was successfully performed through intravenous injection of sufentanil and dexmedetomidine combined with lidocaine topical anesthesia under a conscious state without any uncomfortable feeling or complications.

Conclusions:
Intravenous injection of sufentanil and dexmedetomidine combined with lidocaine topical anesthesia can be used as an alternative medication scheme to relieve uncomfortable suffering for AFNI in patients with severe mouth opening difficulty.
Treatment of large gastric trichobezoar in children: Two case reports and literature review
Authors: Kwon Hyung Jun , Park Jinyoung 
Published: April 2023

Rationale:
Gastric trichobezoars are a rare form of bezoar formed from swallowed human hair as well as hair from dolls or animals, blankets, and carpets. They usually develop in young women who are emotionally disturbed, depressed, or mentally retarded, with trichotillomania and trichophagia. They can lead to abdominal pain, gastric ulceration, bleeding, obstruction, and perforation.

Patient concerns:
A 13-year-old girl was admitted to our institution with complaints of nausea, vomiting, and epigastric pain for 2 days. She underwent laparoscopic removal of a large gastric trichobezoar at our institution 5 years ago. A 12-year-old girl presented at our institution due to epigastric pain, dizziness, and melena for 2 days.

Diagnosis:
They were diagnosed with gastric trichobezoar by abdominal computed tomography scan and upper gastrointestinal endoscopy.

Interventions:
Large gastric trichobezoars were removed via a mini-laparotomy.

Outcomes:
They recovered well postoperatively without complication.

Lessons:
Although the recurrence of gastric trichobezoar after surgery is rare, few recurrent cases were reported in the literature. Therefore, psychiatric consultation and regular follow-up after treatment should be considered in the children and their parents to prevent the recurrence of gastric trichobezoar.
Combined Tui na and Western medicine treatment improves pulmonary function and quality of life in patients with amyotrophic lateral sclerosis: A case report
Authors: Li Bei , Liu Haijing , Li Cuiling , Yang Meidi , Zhang Tingting 
Published: April 2023

Rationale:
Amyotrophic lateral sclerosis is a rare disease that cannot be cured. We report a case of a patient with amyotrophic lateral sclerosis whose pulmonary function and quality of life were improved by a combined tui na treatment and Western medicine.

Patient concerns:
A 48-year-old male was diagnosed with ALS 1 year ago and was treated with western medicine and herbal medicine with no significant effect. This time, he was admitted to our department because of slurred speech, coughing and choking, and weakness of the left upper limb for more than 1 year.

Intervention and outcome:
After 1 month of treatment with tui na and traditional western medicine, the patient’s lung function and quality of life improved and he was discharged from the hospital.

Diagnoses:
Motor neuron disease. Amyotrophic lateral sclerosis.

Lessons:
The physiological function of ALS patients can be improved through the intervention of tui na.
Exploring the molecular mechanism of Nux Vomica in treating ischemic stroke using network pharmacology and molecular docking methods
Authors: Zhang Chengdong , Gai Jialin , Fan Xiaohua , Lei Junfang , Tang Jiqin 
Published: April 2023

Background:
Nux Vomica (NV) has the effects of dredging collaterals, relieving pain, dispersing knots, and detumescence, and has a verified effect in treating ischemic stroke (IS), but its molecular mechanism for treating IS remains unclear. In this study, network pharmacology and molecular docking methods were adopted to explore the pharmacological mechanism of NV in treating IS.

Methods:
The Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) and the HERB database were searched to screen the active components and targets of NV. IS disease targets were retrieved from the DisGeNET, DrugBank, GeneCards, and Therapeutic Target Database. Venn diagram and intersection targets were obtained from the Venny website. Subsequently, the STRING database was employed to analyze the interrelationship of the intersection targets. Metascape database was used for Gene Ontology (GO) functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis of intersection targets. Furthermore, Cytoscape was employed to plot a drug-component-target network, and other networks, and molecular docking method was adopted to predict the effective components and targets of NV for treating IS.

Results:
A total of 14 active compounds and 59 targets of NV were screened, of which 35 targets were related to IS. Stigmasterol, brucine, isobrucine, isostrychnine N-oxide (I), (S)-stylopine, icaride A, and (2R)-5,7-dihydroxy-2-(4-hydroxyphenyl)chroman-4-one were the main active ingredients, and SLC6A4, NR3C1, SLC6A3, HTR3A, CHRNA7, MAOA, PTGS2, ESR1, catalase (CAT), ADRB2, and AR were the core targets. Molecular docking shows that these compounds bind well to the core targets. In addition, the treatment of IS by NV may mainly involve salivary secretion, serotonergic synapse, calcium signaling pathway, cGMP-PKG signaling pathway, and neuroactive ligand-receptor interaction.

Conclusions:
This study revealed that NV exerts its therapeutic effect on IS through multi-component, multi-target, and multi-pathway, which provides a basis for clinical treatment of IS.
The Characteristics of Isolated Bulb Celiac Disease in Children
Authors: Behl Supriya , Khan Muhammad Rehan , Ismail Yasmine , Swantek Courtney , Chen Zong-Ming (Eric) , Murray Joseph A. , Absah Imad 
Published: April 2023

Objectives:
Mucosal injury in celiac disease (CD) patients can be patchy, and up to 12% of CD patients can have mucosal changes limited to the duodenal bulb. Hence, recent guidelines recommend obtaining bulb biopsies in addition to distal duodenum. This study aimed to describe a cohort of children with isolated bulb CD and assess the benefit of separating bulb biopsies.

Methods:
A retrospective chart review between January 2011 and January 2022 at 2 medical centers was conducted. We included children with CD who underwent endoscopy with separated biopsies from the bulb and distal duodenum. A blinded pathologist performed Marsh-Oberhuber grading on selected cases.

Results:
We identified 224 CD patients, of which 33 (15%) had histologically confirmed isolated bulb CD. Patients with isolated bulb CD were older at diagnosis (10 vs 8 years; P = 0.03). Median anti-tissue transglutaminase immunoglobulin A (TTG IgA) level was lower in isolate bulb CD (2.8 vs 16.7 times the upper limit of normal [ULN], P < 0.001). Almost 88% (29/33) of isolated bulb CD patients had an anti-TTG IgA value of less than 10 times the ULN. Time to anti-TTG IgA normalization (mean 14 months) was similar between the 2 groups. A pathologist review of diagnostic biopsies could not distinguish between the bulb and distal duodenum biopsies in approximately one-third of the reviewed samples.

Conclusions:
Separating bulb from distal duodenum biopsies can be considered during CD diagnosis, particularly in children with anti-TTG IgA levels less than 10 times the ULN. Larger prospective cohorts are needed to decide whether isolated bulb CD is a unique cohort or an early stage of the conventional CD.
Characterization of Eosinophilic Esophagitis in Infants and Toddlers
Authors: Hirsch Suzanna , Cohen Alexandra , Rahbar Reza , Rubinstein Eitan , Rosen Rachel 
Published: April 2023

Objectives:
The objective of this study is to determine demographic and clinical characteristics of infants and toddlers <2 years with eosinophilic esophagitis (EoE) and to assess treatment response in this rarely studied pediatric age group.

Methods:
Retrospective study of children <2 years diagnosed with EoE at a single center from 2016 to 2018. EoE was defined by ≥15 eosinophils per high power field (eos/hpf) on at least 1 esophageal biopsy. Demographics, symptoms, and endoscopic findings were collected via chart review. EoE treatment [proton pump inhibitor (PPI), swallowed steroids, dietary restriction, or a combination] and treatment responses on all follow-up endoscopies were reviewed, with remission defined as <15 eos/hpf.

Results:
Forty-two children ages 1.3 ± 0.4 years underwent 3.8 ± 2.3 endoscopies over 3.6 ± 1.7 years of follow-up. Thirty-six children (86%) were male, and comorbidities included atopy (86%), reflux (74%), and a history of cow’s milk protein allergy (40%). Common symptoms were feeding difficulties in 67% of patients (with gagging or coughing with feeding in 60% and difficulty with progression to pureed or solid foods in 43%), vomiting (57%), and coughing/wheezing (52%). Of the 37 patients with follow-up endoscopies, 25 (68%) had histologic remission. There was an effect of therapy type on histologic response (P = 0.004) with the best responses seen on combinations of diet/steroids or diet/PPI and the worst response seen on PPIs alone. All patients showed improvement in ≥1 symptom at the time of first follow-up endoscopy.

Conclusions:
EoE should be considered in young children with feeding difficulties, vomiting, or respiratory symptoms. All patients improved clinically with standard medical or dietary interventions, however there is dissociation between clinical and histologic response with only 2 of 3 patients achieving histologic remission.