bluuebunny/crossref_metadata_2025_split huggingface dataset:
The treatment of continuous double-level lumbar degenerated disease with PE-TLIF: A case report
Authors: Chen Yufeng , Jiang Weiwei , Ma Xiaoming 
Published: January 2025

Rationale:
Percutaneous endoscopic transforaminal lumbar interbody fusion (PE-TLIF) is a minimally invasive surgical approach for the treatment of lumbar degenerative diseases, Due to the high incidence of surgical complications and long operative time, the cases reported in previous literature were focused on single segment lumbar degenerative diseases. In our study, we present 2 patients who had continuous double-level lumbar degenerated disease.

Patient concerns:
A 71-year-old man with severe low back pain and right leg pain for 3 months, a 57-year-old woman with severe low back pain and bilateral leg pain for 6 months. Conservative treatment is ineffective for both of them.

Diagnoses:
Magnetic resonance imaging and physical examination show that the patients had 2 consecutive segments lumbar degenerated disease that required surgical treatment.

Interventions:
Considering the poor efficacy of conservative treatment, We performed PE-TLIF on 2 patients.

Outcomes:
Finally, both of 2 patients obtained a satisfactory short-term clinical efficacy, without any complications.What’s more, the most crucial thing is that average operative time is only 205 minutes.

Lessons:
The patients of continuous double-level lumbar degenerated disease treated with PE-TLIF may provide significant support in selecting the appropriate treatments for similar cases and increase the surgical indications for PE-TLIF.
Fatal complications of aortoesophageal fistula caused by pseudoaneurysm following esophageal stent placement: A case report
Authors: Liao Yiran , Yu Shishi , Shen Neng , Liao Zhongli , Wang Jiong 
Published: January 2025

Rationale:
Aortoesophageal fistula (AEF) is an exceedingly rare yet critically life-threatening condition, with mortality rates nearing 100% if not addressed promptly. AEF often develops in the context of thoracic aortic aneurysms, esophageal malignancies, or as a complication of foreign body ingestion and prior thoracic aortic surgeries. This study reports an exceptionally severe and clinically rare case of AEF associated with a pseudaneurysm induced by esophageal stenting. By disseminating this case, we aim to heighten awareness of AEF and emphasize the necessity for meticulous decision-making during esophageal stent placement, along with the importance of vigilant postoperative monitoring to enable early intervention.

Patient concerns:
A 70-year-old male presented with “food obstruction” and was subsequently diagnosed with esophageal malignancy. To alleviate the obstruction, he underwent esophageal stenting. Fifty-five days postprocedure, he experienced a sudden onset of “chest pain, vomiting of dark red blood, and melena,” prompting hospitalization for “gastrointestinal bleeding.”

Diagnoses:
Urgent computed tomography angiography revealed the emergence of a new pseudaneurysm at the lateral aspect of the esophageal stent, with direct communication between the aneurysm and the adjacent esophagus, raising the suspicion of AEF.

Interventions:
An urgent multidisciplinary emergency team was convened to execute critical interventions, including endoluminal stenting of the esophagus and thoracic endovascular aortic repair.

Outcomes:
The patient suffered a sudden and massive hematemesis, estimated at approximately 3000 mL, leading to his subsequent demise.

Lessons:
AEF is a rare cause of upper gastrointestinal bleeding. For patients suspected of AEF, it is imperative to conduct prompt and thorough computed tomography angiography while initiating an emergency surgical alert. The proximity of esophageal stents to the aorta may significantly elevate the risk of AEF; thus, a comprehensive risk assessment should precede stent placement in cases involving tumors adjacent to the aorta. Furthermore, postoperative surveillance is crucial to monitor potential aortic invasion by the tumor or the development of an aneurysm near the esophagus, facilitating timely intervention.
Cardiac papillary fibroelastoma involving the mitral valve: A case report
Authors: An Yuqiong , Nie Fang 
Published: January 2025

Rationale:
Cardiac papillary fibroelastoma (CPF) is a rare cardiac tumor that can lead to severe and potentially fatal complications such as stroke, myocardial infarction, and sudden cardiac death. The rarity of CPF makes it challenging for clinicians to diagnose and treat, highlighting the importance of timely and accurate diagnosis to prevent catastrophic outcomes. This case report aims to contribute to the clinical understanding of CPF involving the mitral valve (MV), providing insights into diagnosis and treatment strategies.

Patient concerns:
We present a case of CPF attached to the MV in a 69-year-old male patient with a 3-year history of syncope.

Diagnoses:
Echocardiography and computed tomography (CT) imaging confirmed a floating, round-shaped mass on the anterior leaflet MV, with pathological analysis supporting the diagnosis of CPF.

Interventions:
The patient underwent the tumor resection and valve repair operation.

Outcomes:
Postoperative recovery was favorable, with no evidence of recurrence or valve dysfunction at 1-year follow-up.

Lessons:
Echocardiography is a valuable diagnostic tool for identifying CPF and guide treatment decisions. This case emphasizes the importance of recognizing this rare valve tumor for timely clinical intervention.
Sub-coronary ROSS operation in a young man with quadricuspid aortic valve and anomalous aortic origin of the left coronary artery: A case report
Authors: Xu Li , Su Yueqiu , Leng Zhou 
Published: January 2025

Rationale:
Quadricuspid aortic valve (QAV) is a rare condition with a very low incidence. Anomalous aortic origin of a coronary artery (AAOCA) is the most prevalent form of coronary anomaly. One variant of AAOCA is the anomalous aortic origin of the left coronary artery from the right coronary sinus (L-AAOCA). It is even rarer for QAV to occur in combination with AAOCA.

Patient concerns:
In this case report, we present a patient who was diagnosed with QAV and L-AAOCA using preoperative transesophageal echocardiography and 3-dimensional computed tomography (3D-CT).

Diagnoses:
Cardiac-enhanced CT showed an anomalous aortic origin of the left coronary artery from the right coronary sinus with an intramural course.

Interventions:
The patient underwent sub-coronary ROSS procedure along with the unroofing procedure.

Outcomes:
The timely diagnosis of this incorporated cardiac anomaly, or rather its accidental discovery, led to successful surgical correction, eliminating the future risk of cardiac ischemia or SCD.

Lessons:
The timely diagnosis of this incorporated cardiac anomaly, or rather its accidental discovery, led to successful surgical correction, eliminating the future risk of cardiac ischemia or SCD.
Effects of Shenmai Injection on proliferation, migration, invasion and angiogenesis of colorectal carcinoma vascular endothelial cells
Authors: Liu Xiangyu 
Published: January 2025

Background:
Colorectal cancer, being 1 of the most significant malignant tumors globally, poses a substantial risk to human health. Unfortunately, its 5-year survival rate stands at a mere 65%. There remains an urgent need for the development of novel treatments to combat this detrimental malignancy effectively. The Shenmai Injection (SMI) is a Chinese medicine that has been proven to have significant clinical efficacy in the treatment of cardiovascular diseases. This study aimed to examine the impact of SMI on the proliferation, migration, invasion, and angiogenesis of tumor-derived endothelial cells (Td-EC).

Methods:
Human umbilical vein endothelial cells (HUVEC) induced Td-EC, and HUVEC were treated with conditioned media from the human colorectal carcinoma cells (HCT116). The effects of HCT116 on the proliferation, migration, and invasion of hepatocellular carcinoma cells after treatment of SMI were observed by MTS assay and Transwell techniques. Additionally, an angiogenesis experiment was used to investigate Td-EC tube formation capacity.

Results:
SMI had a significant inhibiting effect on the proliferation, migration, and invasion of HCT116. SMI was also able to inhibit the angiogenesis of Td-EC. Notably, SMI did not have any effect on the normal endothelium.

Conclusion:
SMI has obvious antiproliferation, migration, infiltration, and neogenesis effects on HCT116.
Prenatal diagnosis and treatment of fetal intestinal volvulus: A case report
Authors: Zeng Xiaoyan , Li Xiang , Mo Weinong , Zhu Xuefen 
Published: January 2025

Rationale:
Fetal intestinal volvulus, a rare and severe disorder, poses significant diagnostic challenges prenatally and can lead to intrauterine death or adverse neonatal outcomes if untreated in a timely manner. This study reports a case of fetal intestinal volvulus confirmed postoperatively, providing insights into its clinical manifestations, diagnostic methods, and treatment outcomes, thereby enhancing understanding of this rare condition.

Patient concerns:
A Chinese gravida 2, para 1 female presented at 32 weeks and 5 days of gestation with decreased fetal movements. Fetal ultrasound and MRI revealed small intestinal torsion and obstruction. Due to fetal distress, an emergency cesarean section was performed, followed by an urgent laparotomy on the neonate to untwist the intestinal volvulus and resect the necrotic bowel segment.

Diagnosis:
Fetal intestinal volvulus

Interventions:
Following an emergency cesarean section, the neonate was promptly transferred to the surgical department for immediate surgical intervention. The procedure encompassed detorsion of the intestinal volvulus and resection of the necrotic bowel segment.

Outcomes:
The infant exhibited a satisfactory postoperative recovery, successfully transitioned to complete oral and gastrointestinal nutrition, and demonstrated normal physical growth and cognitive development during the ensuing follow-up period.

Lessons:
Fetal intestinal volvulus requires multidisciplinary collaboration for diagnosis and treatment. Early recognition, prompt delivery, and urgent surgical intervention are crucial for optimizing neonatal outcomes. By sharing this case, we hope to enhance the diagnostic and therapeutic capabilities of healthcare providers in managing this rare but severe condition.
Dexmedetomidine-associated hypothermia in critical trauma: A case report and literature analysis
Authors: Kim Se Heon , Sul Younghoon , Ye Jin Bong , Lee Jin Young , Lee Jin Suk 
Published: January 2025

Rationale:
Hypothermia, defined as a core body temperature below 35°C, is a common and serious complication in severe trauma patients, often worsened by hemorrhage and medical interventions. Dexmedetomidine, an α2-adrenergic agonist used for sedation in intensive care units, has known thermoregulatory effects; however, its association with hypothermia in trauma patients remains insufficiently explored.

Patient concerns:
A 40-year-old male with severe polytrauma from a motor vehicle accident presented in distress, with hypotension, tachycardia, and a baseline temperature of 35.8°C. Despite effective management, he developed profound hypothermia, with a recorded temperature dropping below 34.0°C after switching from midazolam to dexmedetomidine for sedation.

Diagnoses:
The patient had multiple bilateral rib fractures, a right-sided pneumothorax, and grade 3 liver and grade 5 splenic injuries, along with orthopedic fractures. His Injury Severity Score signified critical trauma, increasing the risk of complications like hypothermia.

Interventions:
Following stabilization, dexmedetomidine was administered for sedation. Continuous warming interventions were initiated to address hypothermia; however, the temperature continued to decline. Suspecting dexmedetomidine’s contribution, its administration was discontinued.

Outcomes:
After stopping dexmedetomidine, the patient’s temperature gradually recovered to 36.8°C within 5 hours. He demonstrated improved consciousness and stable vital signs, subsequently undergoing 2 successful orthopedic surgeries and discharging without further hypothermia-related issues.

Lessons:
This case highlights dexmedetomidine’s potential to induce hypothermia in critically ill trauma patients. It stresses the importance of careful temperature monitoring and proactive thermoregulation during sedative administration in intensive care. Further research is needed to explore the prevalence and mechanisms of dexmedetomidine-associated hypothermia in trauma populations.
Lupus Nephritis Renal Response in a Real-World Setting in Argentina
Authors: Reyes Torres Alvaro Andres , Scaglioni Valeria , Soriano Enrique R. , Rosa Javier Eduardo , Scolnik Marina 
Published: January 2025

Objective
To identify the percentage of patients with incident lupus nephritis who achieved primary efficacy renal response (PERR) and complete renal response (CRR) after 2 years of treatment at a university hospital.

Methods
An observational study including patients with lupus with a first renal biopsy with nephritis class III, IV, or V, or combined, performed between years 2000 and 2018 and follow-up for over 2 years at a university hospital in Argentina. The proportion of patients with PERR and CRR at 1 and 2 years and the proportion of patients requiring rescue therapy were calculated. Comparison with clinical trials and observational studies was done through literature search.

Results
Seventy-five patients were included; 85.3% were female and 36.5 years in average at the time of biopsy, with lupus nephritis class III (n = 7), class IV (n = 59), combination of IV + V (n = 4), and pure V (n = 5). At 1 and 2 years, PERR was achieved in 57 patients (76.0%; 95% confidence interval [CI], 64.8%–84.5%), whereas CRR was achieved in 44 patients (58.7%; 95% CI, 46.9%–69.4%). A proteinuria level <0.7 g/24 hours was observed in 80.0% (95% CI, 69.2%–87.7%) of patients at 2 years and <0.5 g/24 hours in 76.0% (95% CI, 64.8%–84.5%). Fifteen patients (20.0%; 95% CI, 12.3%–30.8%) needed rescue therapy during the first 2 years after biopsy.

Conclusion
We found higher PERR (76.0%) and CRR (58.7%) at 2 years after the first renal biopsy than those reported in many randomized trials, similar to those reported in observational studies.
NAT10 promotes pyroptosis and pancreatic injury of severe acute pancreatitis through ac4C modification of NLRP3
Authors: Gao Ke , Yang Xuejiao , Zhao Wei , Lin Yipeng , Hu Bin , Wang Dadong 
Published: January 2025

Abstract
Severe acute pancreatitis (SAP) is a highly morbid acute digestive disorder linked to pyroptosis. N-acetyltransferase 10 (NAT10) facilitates the production of N4-acetylcytidine (ac4C) modifications in mRNA, thereby contributing to the progression of various diseases. However, the specific role of NAT10 in SAP remains to be elucidated. This study aimed to elucidate the mechanism through which NAT10 mediates pyroptosis in SAP. Sprague-Dawley rats and AR42J rat pancreatic exocrine cells were used to establish in vivo and in vitro models of SAP. The levels of ac4C and NAT10 expression were quantified using dot blot analysis and quantitative real-time PCR (qPCR). Assessment of cell viability, apoptosis, amylase content, and concentrations of lactate dehydrogenase (LDH), interleukin (IL)-1β, and IL-18 was conducted to evaluate the severity of SAP both in vivo and in vitro. Pyroptosis was assessed by measuring caspase-1 and gasdermin D (GSDMD)-N-terminal (GSDMD-N) expression. Further mechanistic insights were gained using methylated RNA immunoprecipitation (MeRIP), RNA immunoprecipitation (RIP), and dual-luciferase reporter assays. Our findings indicate that the levels of ac4C modification and NAT10 were elevated in both in vivo and in vitro SAP models. Knockdown of NAT10 inhibited cell death and reduced the levels of amylase, LDH, IL-1β, and IL-18 as well as the protein expression of caspase-1 and GSDMD-N, suggesting that NAT10 knockdown suppresses pyroptosis in SAP cell models. Mechanistically, NAT10 knockdown decreased the expression and stability of NOD-like receptor thermal protein domain-associated protein 3 (NLRP3) mRNA by inhibiting ac4C modification of NLRP3. Moreover, NAT10 knockdown alleviated pancreatic tissue pathology, mitigated SAP severity, and suppressed pyroptosis in an SAP rat model. Collectively, these results demonstrate that NAT10 exacerbates pancreatic injury in SAP by promoting pyroptosis through ac4C modification of NLRP3, thereby enhancing its expression. These findings suggest a potential novel therapeutic target for SAP.
Obstetric Anal Sphincter Injury: Vaginal Birth After Cesarean Versus First Vaginal Delivery
Authors: Mumford Brigid S. , Lemon Lara , Harris John , Giugale Lauren E. 
Published: January 2025

Importance
Modern data regarding the relationship between vaginal birth after cesarean (VBAC) and obstetric anal sphincter injury (OASI) are minimal with mixed results.

Objective
The aim of the study was to determine if VBAC is associated with an increased risk of OASIs.

Study Design
This was a retrospective cohort study of liveborn deliveries from 2018 to 2022 within a large, multihospital academic health system. The primary outcome was the proportion of OASIs compared between patients who underwent a first vaginal delivery (primiparous vaginal delivery group) versus patients who underwent a first VBAC (VBAC group).

Results
A total of 17,044 patients were included. A total of 16,208 had a primiparous vaginal delivery and 836 underwent VBAC. Vaginal birth after cesarean patients were older (29.9 vs 27.0 years, P < 0.01), more likely to self-identify as Black or Asian race (26.1% vs 18.0%, P < 0.01), and had lower maternal weight (182.7 vs 187.2 lbs, P < 0.01). The proportion of OASIs was significantly higher in the VBAC group (6.9% vs 5.1%, P = 0.02). Vacuum-assisted vaginal deliveries were more common in the VBAC group (7.7% vs 5.4%, P < 0.01).
On multivariable logistic regression, VBAC was not significantly associated with OASIS (odds ratio [OR] = 1.01, 95% confidence interval [CI] = 0.75–1.36, P = 0.95). Operative vaginal delivery (OR = 6.44, CI = 5.51–7.52, P < 0.01), older maternal age (OR = 1.05, CI = 1.03–1.07), and Asian race (OR 2.62, CI = 2.10–3.26) demonstrated increased odds of OASIs. Patients who identified as Black demonstrated lower odds of OASIs (OR = 0.68, CI = 0.50–0.93).

Conclusions
While there was a greater proportion of OASIs in the VBAC group compared to the primiparous vaginal delivery group, VBAC was not an independent risk factor.
The impact of physician handoffs on the outcomes of admitted emergency department patients: a medical administrative database retrospective cohort study
Authors: Mokhtari Akram , Simonyan David , Mallet Myriam , Blais S. , Moore L. , Berthelot Simon 
Published: January 2025

AbstractIntroductionA physician handoff is the process through which physicians transfer the primary responsibility of a care unit. The emergency department (ED) is a fast-paced and crowded environment where the risk of information loss between shifts is significant. Yet, the impact of handoffs between emergency physicians on patient outcomes remains understudied. We performed a retrospective cohort study in the ED to determine if handed-off patients, when compared to non-handed-off patients, were at higher risk of negative outcomes.MethodsWe included every adult patient first assessed by an emergency physician and subsequently admitted to hospital in one of the five sites of the CHU de Québec-Université Laval during fiscal year 2016-17. Primary outcome was mortality. Secondary outcomes were incidence of ICU admission and surgery and hospital length of stay. We conducted propensity score based analysis accounting for patient and hospital clusters and adjusting for demographics, multiple disease severity indicators and ED processes indicators, including crowding.Results21,136 ED visits and 17,150 unique individuals were included in the study. Median[Q1-Q3] age, Charlson score, door-to-emergency-physician time and ED length of stay were 71[55-83] years old, 3[1-4], 48 [24,90] minutes, 20.8[9.9,32.7] hours, respectively. In propensity score analysis (OR handoff/no handoff [CI95%] or GMR[Cl95%]), handoff status was not associated with mortality (1.08[0.93,1.26]), ICU admission (1.01[0.87,1.18]) or hospital length of stay (1.02[0.94-1.10]). Sensitivity and sub-group based analyses yielded no further information.ConclusionEmergency physicians’ handoffs were not associated with an increase in risk of severe in-hospital adverse events. Further studies are needed to explore the impact of ED handoffs on adverse events of low and moderate severity.What is already known on this subjectHandoffs are widely believed to affect patient outcomes in the ED, although data remains scarce.What did this study askWhat is the impact of handoffs between emergency physicians on patient outcomesWhat this study addsHanded off patients do not seem to do worse than non handed off patients concerning majors outcomes (mortality, ICU admission, LOS).Why does it matter to clinicians?In the ED, handoffs may not represent a risk to patient outcomes. QI efforts may be better invested in other care inefficiencies.
OsWRKY53 dictates wound responses in rice through fine-tuning cross-talk between PEP and PSK mediated signalling
Authors: Harshith Chitthavalli Y. , Dey Riju , Palchaudhuri Dipasmit , Shivaprasad Padubidri V. 
Published: January 2025

SummaryWounding and tissue damage are major events among the multitude of stresses that plants face in their natural environment. Wound response is a very dynamic event that involves the integration of various regulatory networks culminating in successful wound-induced downstream signalling. Plants depend on endogenously derived molecular signals to initiate wound responses. Transcriptional response is paramount in dictating successful transition of early defense to late growth responses. Here we show the involvement of a WRKY transcription factor (TF) named OsWRKY53, that is responsive to both wounding as well as wound-derived plant elicitor peptide (PEP), OsPep2 treatments. OsWRKY53 is involved in positive regulation of gene expression of OsPep2 responsive genes. OsWRKY53 displays altered DNA occupancy in response to OsPep2 treatment over time correlating with the altered gene expression. Further, OsWRKY53 is involved in simultaneous activation and suppression of OsPep2-responsive and phytosulfokine (PSK) responsive genes, respectively. In agreement with these, mis-expression of OsWRKY53 led to compromised wound responses. Collectively, we establish that OsWRKY53 acts at the intersection of PEP and PSK mediated transition of wound responses and positively regulates the early defense-related gene expression.