bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cross-sectional study of the association between triglyceride glucose-body mass index and obstructive sleep apnea risk
Authors: Gong Li , Su Ming , Xu Jing-Han , Peng Zhen-Fei , Du Lin , Chen Ze-Yao , Liu Yu-Zhou , Chan Lu-Cia , Huang Yin-Luan , Chen Yu-Tian , Huang Feng-Yi , Piao Chun-Li 
Published: January 2025

BACKGROUND
The triglyceride glucose-body mass index (TyG-BMI) is a novel indicator of insulin resistance (IR). Obstructive sleep apnea (OSA) is a prevalent disorder characterized by recurrent complete or partial collapse of the pharyngeal airway during sleep; however, the relationship between these two conditions remains unexplored. We hypothesized that a higher TyG-BMI is associated with the occurrence of OSA.
AIM
To assess the association between TyG-BMI and OSA in adults in the United States.
METHODS
A cross-sectional study was conducted utilizing data from the National Health and Nutrition Examination Surveys spanning from 2005-2008 to 2015-2018. TyG-BMI was calculated as Ln [triglyceride (mg/dL) × fasting blood glucose (mg/ dL)/2] × BMI. Restricted cubic splines were used to analyze the risk of TyG-BMI and OSA occurrence. To identify potential nonlinear relationships, we combined Cox proportional hazard regression with smooth curve fitting. We also conducted sensitivity and subgroup analyses to verify the robustness of our findings.
RESULTS
We included 16794 participants in the final analysis. Multivariate regression analysis showed that participants with a higher TyG-BMI had a higher OSA incidence. After adjusting for all covariates, TyG-BMI was positively correlated with the prevalence of OSA (odds ratio: 1.28; 95% confidence interval: 1.17, 1.40; P < 0.001); no significant nonlinear relationship was observed. Subgroup analysis showed no strong correlation between TyG-BMI and OSA in patients with diabetes. The correlation between TyG-BMI and OSA was influenced by age, sex, smoking status, marital status, hypertensive stratification, and obesity; these subgroups played a moderating role between TyG-BMI and OSA. Even after adjusting for all covariates, there was a positive association between TYG-BMI and OSA prevalence.
CONCLUSION
A higher TyG-BMI index is linked to higher chances of developing OSA. As TyG-BMI is an indicator of IR, managing IR may help reduce the risk of OSA.
Association between serum retinol-binding protein and lower limb atherosclerosis risk in type 2 diabetes mellitus
Authors: Zhang Yu-Ling , Peng Gui-Liang , Leng Wei-Ling , Lian Yu , Cheng Li-Qing , Li Xing , Wang Yu-Lin , Zhou Ling , Long Min 
Published: January 2025

BACKGROUND
Serum retinol-binding protein (RBP) is the primary transport protein of circulating vitamin A. RBP has a crucial role in maintaining nutrient metabolism and physiologic homeostasis. Several studies have indicated that serum RBP participates in the progression of diabetes and diabetes-related complications. However, the impact of serum RBP on lower limb atherosclerosis has not been determined in individuals with type 2 diabetes mellitus (T2DM).
AIM
To determine the association between serum RBP and lower limb atherosclerosis in individuals with T2DM.
METHODS
This retrospective study enrolled 4428 eligible T2DM patients and divided the patients into non-lower limb atherosclerosis (n = 1913) and lower limb atherosclerosis groups (n = 2515) based on lower limb arterial ultrasonography results. At hospital admission, baseline serum RBP levels were assessed, and all subjects were categorized into three groups (Q1-Q3) based on RBP tertiles. Logistic regression, restricted cubic spline regression, subgroup analysis, and machine learning were used to assess the association between RBP levels and lower limb atherosclerosis risk.
RESULTS
Among 4428 individuals with T2DM, 2515 (56.80%) had lower limb atherosclerosis. Logistic analysis showed that lower limb atherosclerosis risk increased by 1% for every 1 unit rise in serum RBP level (odds ratio = 1.01, 95% confidence interval: 1.00-1.02, P = 0.004). Patients in the highest tertile group (Q3) had a higher lower limb atherosclerosis risk compared to the lowest tertile group (Q1) (odds ratio = 1.36, 95% confidence interval: 1.12-1.67, P = 0.002). The lower limb atherosclerosis risk gradually increased with an increase in RBP tertile (P for trend = 0.005). Restricted cubic spline analysis indicated a linear correlation between serum RBP levels and lower limb atherosclerosis risk (non-linear P < 0.05). Machine learning demonstrated the significance and diagnostic value of serum RBP in predicting lower limb atherosclerosis risk.
CONCLUSION
Elevated serum RBP levels correlate with an increased lower limb atherosclerosis risk in individuals with T2DM.
Association between high-sensitivity troponin T levels below the ninety-ninth percentile and diabetic kidney disease: A cross-sectional study
Authors: Luo Xiao-Yan , Huang Li-Hua , Kang Kun-Peng 
Published: January 2025

BACKGROUND
Identification of myocardial injury has traditionally relied on high-sensitivity troponin T (hs-TnT) levels exceeding the 99th percentile threshold. However, patients with detectable hs-TnT levels below this threshold represent a heterogeneous group with an inadequately characterized risk profile.
AIM
To investigate the association between hs-TnT levels below the 99th percentile and the presence of diabetic kidney disease (DKD) in patients with diabetes mellitus.
METHODS
This study analyzed data from the National Health and Nutrition Examination Survey obtained between 1999 and 2004, focusing on adults with type 2 diabetes mellitus. Serum hs-TnT concentrations were evaluated. DKD was defined as impaired glomerular filtration rate (< 60 mL/minute/1.73 m²), proteinuria (urinary albumin-to-creatinine ratio of ≥ 30 mg/g), or both conditions in patients with diabetes mellitus. Weighted multivariable logistic regression analysis and restricted cubic spline analyses were employed to examine the independent association between hs-TnT and DKD, with the likelihood ratio test being used to evaluate nonlinearity.
RESULTS
The study included 2505 patients with a mean age of 55.02 (standard error: 0.72) years, of whom 44.87% were females. Among the participants, 909 (32.34%) were diagnosed with DKD. Multivariable logistic regression analysis indicated that, compared to the lowest tertile of hs-TnT (< 5.93 ng/L), tertile 2 (5.94-9.79 ng/L) had an odds ratio of 1.25 (95% confidence interval: 0.77-2.02, P = 0.350), while tertile 3 (9.80-21.88 ng/L) had an odds ratio of 2.07 (95% confidence interval: 1.13-3.80, P = 0.022), with a significant trend (P for trend = 0.022). Smoothed curve fitting demonstrated a linear association between hs-TnT levels and DKD in the overall population (P = 0.061 for nonlinearity) and in male (P = 0.136 for nonlinearity) and female (P = 0.067 for nonlinearity) subgroups. Further stratification and sensitivity analyses yielded consistent conclusions.
CONCLUSION
Our study findings suggest that in individuals with type 2 diabetes, detectable hs-TnT levels below the 99th percentile are associated with DKD.
Correlation between key indicators of continuous glucose monitoring and the risk of diabetic foot
Authors: Geng Xin-Qian , Chen Shun-Fang , Wang Fei-Ying , Yang Hui-Jun , Zhao Yun-Li , Xu Zhang-Rong , Yang Ying 
Published: January 2025

BACKGROUND
Continuous glucose monitoring (CGM) metrics, such as time in range (TIR) and glycemic risk index (GRI), have been linked to various diabetes-related complications, including diabetic foot (DF).
AIM
To investigate the association between CGM-derived indicators and the risk of DF in individuals with type 2 diabetes mellitus (T2DM).
METHODS
A total of 591 individuals with T2DM (297 with DF and 294 without DF) were enrolled. Relevant clinical data, complications, comorbidities, hematological parameters, and 72-hour CGM data were collected. Logistic regression analysis was employed to examine the relationship between these measurements and the risk of DF.
RESULTS
Individuals with DF exhibited higher mean blood glucose (MBG) levels and increased proportions of time above range (TAR), TAR level 1, and TAR level 2, but lower TIR (all P < 0.001). Patients with DF had significantly lower rates of achieving target ranges for TIR, TAR, and TAR level 2 than those without DF (all P < 0.05). Logistic regression analysis revealed that GRI, MBG, and TAR level 1 were positively associated with DF risk, while TIR was inversely correlated (all P < 0.05). Achieving TIR and TAR was inversely correlated with white blood cell count and glycated hemoglobin A1c levels (P < 0.05). Additionally, achieving TAR was influenced by fasting plasma glucose, body mass index, diabetes duration, and antidiabetic medication use.
CONCLUSION
CGM metrics, particularly TIR and GRI, are significantly associated with the risk of DF in T2DM, emphasizing the importance of improved glucose control.
Distant metastasis in the right inguinal area from gastric cancer: A case report
Authors: Hao Jia-Qi , Hu Shu-Yue , Zhuang Zi-Xuan , Zhang Yu-Jie , Zhang Jia-Wan , He Feng-Jun , Zhuang Wen , Wang Mo-Jin 
Published: January 2025

BACKGROUND
Gastric cancer is the fifth most common cancer and the fourth leading cause of death worldwide. Most cases of newly diagnosed gastric cancer involve not only locally advanced tumor growth and regional lymph node metastases but also distant metastases. We report a rare case finding of a mass in the right inguinal area which is derived from gastric cancer.
CASE SUMMARY
A 68-year-old male initially diagnosed with an inguinal hernia presented with a 2 cm mass in the right inguinal area. Gastrointestinal symptoms led to the discovery of a stomach tumor. Biopsy confirmed gastrointestinal adenocarcinoma. The diagnosis was advanced gastric cancer with peritoneal dissemination, and the inguinal mass was due to direct infiltration. Due to gastrointestinal bleeding, the patient underwent palliative gastrectomy and lymph node dissection. Postoperatively, the patient received hyperthermic intraperitoneal chemotherapy and localized radiation therapy.
CONCLUSION
This case indicates that a systematic evaluation should be conducted during the initial consultation to explore the potential connection between unrecognized distant masses and the primary tumor.
Prognostic value of preoperative fibrinogen to albumin ratio in predicting postoperative outcomes in patients with gallbladder cancer
Authors: Wang Peng-Fu , Duan Ya-Jian 
Published: January 2025

BACKGROUND
Gallbladder cancer (GBC) is known for its poor prognosis and challenging management. The preoperative fibrinogen to albumin ratio (FAR) has been proposed as a potential prognostic marker for predicting postoperative outcomes in GBC patients, but its efficacy and prognostic value remain underexplored.
AIM
To evaluate the prognostic value of preoperative FAR in GBC outcomes.
METHODS
This retrospective cohort study included 66 patients who underwent curative surgery for GBC at our institution from January 2018 to January 2022. Preoperative FAR values were obtained within one week prior to surgery. Patients were followed through outpatient visits or telephone interviews, with overall survival (OS) as the primary endpoint. Statistical analyses, including receiver operating characteristic curve analysis and Kaplan-Meier survival estimates, were performed using SPSS software (version 27.0).
RESULTS
The cohort consisted of 36 male and 30 female patients, with a mean age of 61.81 ± 8.58 years. The optimal FAR cut-off value was determined to be 0.088, with an area under the receiver operating characteristic curve of 0.7899, sensitivity of 68.96%, and specificity of 80.01%. Patients with FAR ≤ 0.088 showed significantly better survival rates (1-year: 60.5%, 2-year: 52.6%, 3-year: 25.9%) and a median OS of 25.6 months (95% confidence interval: 18.8-30.5 months), compared to those with FAR > 0.088 who had a median OS of 10.8 months (95% confidence interval: 6.3-12.9 months).
CONCLUSION
Lower preoperative FAR is associated with longer OS in GBC patients, confirming its potential as a valuable prognostic indicator for improving outcome predictions and guiding patient management strategies in gallbladder cancer.
Long-term survival outcomes of duodenal adenocarcinoma: A cohort study with 15-year single-center experience
Authors: Xie Qing-Feng , Long Lian-Sheng , Luo Yang-Yang , Lu Meng-Ting , Ming Wai-Kit , Zhao Li-Ying , Liu Hao 
Published: January 2025

BACKGROUND
Duodenal adenocarcinoma (DA), a rare gastrointestinal malignancy, lacks clear natural history and management strategies. This study aimed to investigate the long-term outcomes of patients with DA, focusing on long-term survival and the impact of tumor characteristics, surgery, and adjuvant therapy.
AIM
To bridge this knowledge gap, we conducted a hospital-based cohort study in our 15-year experience with DA aimed at investigating the long-term outcomes of the patients with DA, along with analyzing the impact of the tumor characteristics, operations and adjuvant therapy on survival outcomes.
METHODS
A retrospective analysis of 208 patients diagnosed with non-ampullary DA at a single institution between 2009 and 2023 was performed. This study used SPSS 26.0 software to make a comprehensive statistical analysis of demographic characteristics, clinical presentation, treatment modalities, and survival outcomes. The effectiveness of surgical resection and adjuvant therapy in 5-year oval survival (OS) and disease-free survival was evaluated using Kaplan-Meier survival curves, the Cox proportional hazards model, and statistical comparisons of survival distributions.
RESULTS
The median OS time for the cohort was 39 months, with 3- and 5-year OS rates of 51.2% and 43.6%, respectively. Radical resection was performed in 82.6% of cases, and was significantly associated with an improved 5-year OS, with a rate of 57.8%. Adjuvant therapy showed a survival benefit in the specific patient subsets, particularly in tumor stage II or III tumors, with an improved OS. Adjuvant therapy (hazard ratio= 2.71, 95% confidence interval: 1.30-5.62, P = 0.008), pancreatic invasion and advanced tumor stage were identified as significant predictors of OS in multivariate analyses.
CONCLUSION
Radical operation for DA is associated with a remarkable improvement in the 5-year OS. Importantly, postoperative adjuvant therapy can significantly prolong the OS time in patients with radical operation, especially in patients with stage III. It highlights the necessity for early diagnosis, tailored surgical approaches, and a nuanced understanding of the role of adjuvant therapy.
Value of brief hematological characteristics in differentiating carcinoembryonic-antigen-negative colorectal cancer from benign colorectal diseases
Authors: Yi Li-Ling , Lao Xian-Jun , Lu Liu-Yi , Zhu Chun-Ling , Zhou Dong-Yi , Li Si-Ting , Fan Meng-Li , Peng Qi-Liu 
Published: January 2025

BACKGROUND
Colorectal cancer (CRC) remains one of the most common malignancies worldwide, with a significant subset of patients exhibiting absence of carcinoembryonic-antigen (CEA) expression. The lack of effective diagnostic method for CEA-negative CRC prevents its early treatment.
AIM
To identify potentially valuable biomarkers for identifying CEA-negative CRC, the hematological characteristics of patients with CEA-negative CRC was investigated.
METHODS
In this retrospective analysis, 74 patients were included who had been pathologically confirmed to have CEA-negative CRC, along with 79 individuals diagnosed with benign colorectal conditions. The utility of various biomarkers was evaluated using analysis of the receiver operating characteristic (ROC) curve.
RESULTS
Compared with patients with benign colorectal diseases, those with CEA-negative CRC had lower hemoglobin-to-red blood cell distribution width ratio (HRR) and lymphocyte-to-red blood cell distribution width ratio (LRR), and higher platelet-to-lymphocyte ratio (PLR) (P < 0.05). Correlation analysis showed that HRR was negatively correlated with T stage (r = -0.237), LRR was negatively correlated with T stage (r = -0.265) and distant metastasis (r = -0.321), and PLR was positively correlated with T stage (r = 0.251) (all P < 0.05). ROC analysis indicated that HRR outperformed LRR and PLR in identifying CEA-negative CRC. Combining HRR and PLR provided the highest area under the curve (area under the curve = 0.808; sensitivity = 82.43%; specificity = 68.35%) for distinguishing CEA-negative CRC from benign colorectal diseases.
CONCLUSION
HRR, LRR, and PLR alone or in combination could be used to distinguish CEA-negative CRC from benign colorectal diseases.
Predictive value of magnetic resonance imaging parameters combined with tumor markers for rectal cancer recurrence risk after surgery
Authors: Wu Lei , Zhu Jing-Jie , Liang Xiao-Han , Tong He , Song Yan 
Published: January 2025

BACKGROUND
An increasing number of studies to date have found preoperative magnetic resonance imaging (MRI) features valuable in predicting the prognosis of rectal cancer (RC). However, research is still lacking on the correlation between preoperative MRI features and the risk of recurrence after radical resection of RC, urgently necessitating further in-depth exploration.
AIM
To investigate the correlation between preoperative MRI parameters and the risk of recurrence after radical resection of RC to provide an effective tool for predicting postoperative recurrence.
METHODS
The data of 90 patients who were diagnosed with RC by surgical pathology and underwent radical surgical resection at the Second Affiliated Hospital of Bengbu Medical University between May 2020 and December 2023 were collected through retrospective analysis. General demographic data, MRI data, and tumor markers levels were collected. According to the reviewed data of patients six months after surgery, the clinicians comprehensively assessed the recurrence risk and divided the patients into high recurrence risk (37 cases) and low recurrence risk (53 cases) groups. Independent sample t -test and χ 2 test were used to analyze differences between the two groups. A logistic regression model was used to explore the risk factors of the high recurrence risk group, and a clinical prediction model was constructed. The clinical prediction model is presented in the form of a nomogram. The receiver operating characteristic curve, Hosmer-Lemeshow goodness of fit test, calibration curve, and decision curve analysis were used to evaluate the efficacy of the clinical prediction model.
RESULTS
The detection of positive extramural vascular invasion through preoperative MRI [odds ratio (OR) = 4.29, P = 0.045], along with elevated carcinoembryonic antigen (OR = 1.08, P = 0.041), carbohydrate antigen 125 (OR = 1.19, P = 0.034), and carbohydrate antigen 199 (OR = 1.27, P < 0.001) levels, are independent risk factors for increased postoperative recurrence risk in patients with RC. Furthermore, there was a correlation between magnetic resonance based T staging, magnetic resonance based N staging, and circumferential resection margin results determined by MRI and the postoperative recurrence risk. Additionally, when extramural vascular invasion was integrated with tumor markers, the resulting clinical prediction model more effectively identified patients at high risk for postoperative recurrence, thereby providing robust support for clinical decision-making.
CONCLUSION
The results of this study indicate that preoperative MRI detection is of great importance for predicting the risk of postoperative recurrence in patients with RC. Monitoring these markers helps clinicians identify patients at high risk, allowing for more aggressive treatment and monitoring strategies to improve patient outcomes.
Common bile duct stump stones and recurrent acute pancreatitis after Roux-en-Y choledochojejunostomy in a child: A case report
Authors: Li Jian-Feng , Xie Min-Jian , Wei Jin-Xiu , Yang Cheng-Ning , Chen Guang-Wen , Li Li-Qun , Zhao Yi-Na , Liu Li-Jian , Xie Sheng 
Published: January 2025

BACKGROUND
Pancreaticobiliary maljunction (PBM) is a rare congenital abnormality in pancreaticobiliary duct development. PBM is commonly found in children, and it often leads to acute pancreatitis and other diseases as a result of pancreaticobiliary reflux. Roux-en-Y choledochojejunostomy is a common surgical method for the treatment of PBM, but there are several associated complications that may occur after this operation.
CASE SUMMARY
The patient, a 12-year-old female, was hospitalized nearly 20 times in 2021 for recurrent acute pancreatitis. In 2022, she was diagnosed with PBM and underwent laparoscopic common bile duct resection and Roux-en-Y choledochojejunostomy in a tertiary hospital. In the first year after surgery, the patient had more than 10 recurrent acute pancreatitis episodes. After undergoing abdominal computed tomography and other examinations, she was diagnosed with “residual bile duct stones and recurrent acute pancreatitis”. On January 30, 2024, the patient was admitted to our hospital due to recurrent upper abdominal pain and was cured through endoscopic retrograde cholangiopancreatography.
CONCLUSION
This article reports a case of a child with distal residual common bile duct stones and recurrent acute pancreatitis after Roux-en-Y choledochojejunostomy for PBM. The patient was cured through endoscopic retrograde cholangiopancreatography.
Proximal small intestinal bypass outperforms Roux-en-Y and jejunoileal bypass in glucose regulation in streptozotocin induced diabetic rats
Authors: Xu Chi-Ying , Tan Cai , Luo Xin , Yang Kun , Wu Ren-Ran , Lin Lei , Liu Guan-Lei , Duan Jin-Yuan 
Published: January 2025

BACKGROUND
The efficacy of various bariatric surgeries varies in reducing blood glucose levels. Given the distinct mechanisms and anatomical alterations associated with each procedure, it is crucial to compare their glycemic control outcomes. We hypothesize that proximal small intestinal bypass (PSIB) is superior in blood glucose reduction over Roux-en-Y gastric bypass (RYGB) and jejunoileal bypass (JIB).
AIM
To compare the effectiveness of PSIB, RYGB, and JIB in lowering blood glucose.
METHODS
Rats with streptozotocin-induced diabetes were randomly divided into PSIB, RYGB, JIB, and sham-operated groups. Body weight, food intake, fasting blood glucose level, oral glucose tolerance test, insulin tolerance test, liver enzymes, and blood lipids were measured.
RESULTS
Postoperatively, only the JIB group had a lower body weight compared to the sham group. The food intake of the rats in all three surgical groups was significantly less than that in the sham group. Fasting blood glucose was reduced in all surgical groups and was lower in the PSIB group than in the RYGB and JIB groups. Glucose tolerance and insulin sensitivity improved in all three surgical groups compared to the sham group, but the improvement appeared earliest in the PSIB group. At six weeks post-surgery, the PSIB group showed a reduction in alanine transaminase levels and maintained a normal lipid profile.
CONCLUSION
PSIB demonstrated excellent hypoglycemic effects in the early postoperative period, and had better efficacy than RYGB and JIB.