bluuebunny/crossref_metadata_2025_split huggingface dataset:
Robot-assisted thoracoscopic surgery vs. sternotomy for thymectomy: A systematic review and meta-analysis
Authors: Wang Cheng-qian , Wang Jie , Liu Fei-yu , Wang Wei 
Published: January 2023

IntroductionSurgeons have widely regarded sternotomy (ST) as the standard surgical method for thymectomy. Minimally invasive methods for thymectomy, including video-assisted and robot-assisted thoracoscopic surgery (RATS), have been explored. There are some studies have researched and compared the outcomes of patients after robotic and sternotomy procedure.MethodsWe searched the databases of Pubmed, the Cochrane Library, Embase and selected the studies on the efficacy and safety of RATS or ST for thymectomy. Meta-analysis was performed for operation time, operation blood loss, postoperative drainage time, operative complications and hospitalization time.ResultsA total of 16 cohort studies with 1,089 patients were included. Compared to ST, RATS is an appropriate alternative for thymectomy which reduced operation blood loss [standardized mean difference (SMD) = −1.82, 95% confidence interval (95% CI): (−2.64, −0.99), p = 0.000], postoperative drainage time [SMD = −2.47, 95% Cl: (−3.45, −1.48), p = 0.000], operative complications [odds ratio (OR) = 0.31, 95% Cl: (0.18, 0.51), p = 0.000] and hospitalization time [SMD = −1.62, 95% Cl: (−2.16, −1.07), p = 0.000].ConclusionsThis meta-analysis based on cohort studies shows that RATS has more advantages over ST. Therefore, RATS is a more advanced and suitable surgical method for thymectomy.
Machine learning algorithms to predict atypical metastasis of colorectal cancer patients after surgical resection
Authors: Yang Xiaoyan , Yu Wei , Yang Feimin , Cai Xiujun 
Published: January 2023

BackgroundThe prognosis of colorectal cancer with atypical metastasis is poor. However, atypical metastasis was less common and under-appreciated.MethodsIn this study we attempted to present the first machine learning models to predict the risk of atypical metastasis in colorectal cancer patients. We evaluated the differences between metastasis and non-metastasis groups, assessed factors associated with atypical metastasis using univariate and multivariate logistic regression analyses, and preliminarily developed the multiple machine learning models to predict atypical metastasis.Results168 patients were included. Prognostic Nutritional Index (PNI) [OR =  0.998; P = 0.030], Cancer antigen 19–9 (CA19-9) [OR = 1.011; P = 0.043] and MR-Distance [-mid OR = 0.289; P = 0.009] [-high OR = 0.248; P = 0.021] were shown to be independent risk factors for the atypical metastasis via multivariate analysis. Furthermore, the machine learning model based on AdaBoost algorithm (AUC: 0736) has better predictive performance comparing to Logistic Regression (AUC: 0.671) and KNeighbors Classifier (AUC: 0.618) by area under the curve (AUC) in the validation cohorts. The accuracy, sensitivity, and specificity of the model trained using the Adaboost method in the validation set are 0.786, 0.776 and 0.700, while 0.601, 0.933, 0.508 using Logistic Regression and 0.743, 0.390, 0.831 using KNeighbors Classifier.ConclusionMachine-learning approaches containing PNI, CA19-9 and MR-Distance show great potentials in atypical metastasis prediction.
Reliability and repeatability of a modified thoracolumbar spine injury classification scoring system
Authors: Lu Wen-jie , Zhang Jiaming , Deng Yuan-guo , Jiang Wei-yu 
Published: January 2023

PurposeOn the basis of the Thoracolumbar Injury Classification and Severity Score (TLICS), an modified TLICS classification system was presented, its reliability and repeatability were assessed, and the factors influencing classification consistency were examined.MethodsFive spinal surgeons were chosen at random. The clinical data of 120 patients with thoracolumbar fractures admitted to the Department of Spine Surgery, Ningbo Sixth Hospital from December 2019 to June 2021 were categorized using the modified TLICS system. After 6 weeks, disrupt the order of data again. Using unweighted Cohen's kappa coefficients, the consistency of the modified TLICS system was assessed in five aspects: neurofunctional status, disc injury status, fracture morphology, posterior ligament complex (PLC) integrity, and treatment plan.ResultsIn terms of reliability, the average kappa values for the subclasses of the modified TLICS system (neurofunctional status and disc injury status) were 0.920 and 0.815, respectively, reaching the category of complete confidence. Fracture morphology and treatment plan had average kappa values of 0.670 and 0.660, respectively, which were basically reliable. The average kappa value of PLC integrity was 0.453, which belonged to the category of moderate confidence. The average kappa coefficients of each subcategory (neurological status, disc injury status) had excellent consistency, and the kappa values were 0.936 and 0.879, respectively, which belonged to the completely credible category. The kappa values of fracture morphology and treatment plan repeatability were 0.772 and 0.749, respectively, reaching the basic credibility category. PLC integrity repeatability kappa value is low, 0.561, to moderate credibility category.ConclusionThe modified TLICS system is intuitive and straightforward to understand. The examination of thoracolumbar fracture injuries is more exhaustive and precise, with excellent reliability and repeatability. The examination of neurological status and disc injury status is quite reliable and consistent. The consistency of fracture morphology is slightly poor, which is basically credible; the PLC integrity consistency is poor, reaching a reliability level of moderate, which may be associated with the subjectivity of clinical evaluation of PLC.
The clinical efficacy of anterior cervical discectomy and fusion with ROI-C device vs. plate-cage in managing traumatic central cord syndrome
Authors: Song Dawei , Deng Zicheng , Feng Tao , Wang Jinning , Liu Yijie , Wang Heng , Yang Huilin , Niu Junjie 
Published: January 2023

PurposeTo assess the efficacy and complications of anterior cervical discectomy and fusion (ACDF) with ROI-C device vs. conventional anterior plate and cage system (APCS) in managing traumatic central cord syndrome (TCCS).MethodsA total of 37 patients diagnosed with TCCS who underwent ACDF with ROI-C implant and APCS were recruited in this retrospective study from June 2012 to February 2020. Radiological parameters and clinical results were recorded and compared through follow-up time. Characteristics of patients and complications were also recorded.ResultsAll patients tolerated the procedure well. The average follow-up time was 25.00 ± 7.99 months in the ROI-C group, and 21.29 ± 7.41 months in the APCS group. The blood loss and operation time were significantly lower in the ROI-C group than in the APCS group. Radiological parameters and clinical results were all improved postoperatively and maintained at the final follow-up. Fusion was achieved in all patients. ROI-C group had a lower incidence of postoperative dysphagia than the APCS group. Only 1 case of ALD was observed at the final follow-up in the APCS group.ConclusionsBoth ROI-C device and APCS demonstrated satisfactory clinical effects and safety in managing symptomatic single-level traumatic central cord syndrome with underlying instability. Both techniques could improve and maintain cervical lordosis and disc height. ROI-C device was related to a lower incidence of postoperative dysphagia, shorter operation time, and less blood loss.
Can oblique lateral interbody fusion (OLIF) create more lumbosacral lordosis in lumbar spine surgery than minimally invasive transforaminal interbody fusion (MIS-TLIF)?
Authors: Li Jie , Chen Yilei , Wu Hao , Gan Kaifeng , Bei Dikai , Fan Tengdi , Chen Jian , Zhao Fengdong , Chen Binhui 
Published: January 2023

ObjectiveTo compare the differences in the correction effect for lumbosacral lordosis and clinical outcomes between OLIF with/without posterior pedicle screw fixation (PSF) and MIS-TLIF through a retrospective cohort study.MethodThere were 98 consecutive patients originally enrolled for the study, but 15 patients were excluded due to intraoperative endplate injury or osteotomy performed for severe spinal deformity. Thus, 83 patients included in this study (36 males and 47 females, mean age 66.0 ± 10.8 years) underwent single to three-segment OLIF (including OLIF + PSF and OLIF Standalone) or MIS-TLIF surgery from 2016 to 2018. The operation time, bleeding and blood transfusion, fusion rate, complication, pre-and postoperative visual analogue scale (VAS), Oswestry Disability Index (ODI) were evaluated. In addition, radiological parameters including lumbosacral lordosis (LL), fused segment lordosis (FSL), anterior disc height (ADH) and posterior disc height (PDH) were measured. The clinical outcomes, LL, FSL, ADH and PDH restored and were compared between the OLIF group, OLIF subgroups and MIS-TLIF group.ResultsThe average operation time and intraoperative bleeding were significantly less in the OLIF group than in the MIS-TLIF group (189 ± 83 vs. 229 ± 80 min, 113 ± 138 vs. 421 ± 210 ml), P &lt; 0.001). There was no statistically significant difference between the OLIF group and the MIS-TLIF group in VAS and ODI improvements, fusion rate, complication, LL and FSL correction (P &gt; 0.05). The ADH and PDH increases in the OLIF group were more than that in MIS-TLIF group (P &lt; 0.001). The correction of LL was significantly more in the OLIF+PSF group than in the MIS-TLIF group (10.6 ± 8.7 vs. 4.0 ± 6.1 deg, P = 0.005).ConclusionOLIF and MIS-TLIF are both safe and effective procedures, capable of restoring lumbosacral lordosis and disc height partly. Combined with PSF, OLIF can achieve a better correction effect of lumbosacral lordosis than MIS-TLIF.
Lateral approach for insertional Achilles tendinitis with Haglund deformity
Authors: Jiang Jiantao , Wang Cheng , Fu Shaoling , Wang Jiazheng , Wu Chenglin , Yao Guangxiao , Song Guoxun , Gu Wenqi , Yang Kai , Xue Jianfeng , Shi Zhongmin 
Published: January 2023

ObjectiveThe study aims to investigate the functional outcome of the lateral approach for insertional Achilles tendinitis (IAT) with Haglund deformity.MethodsFrom January 2016 to September 2019, 14 cases of IAT with Haglund deformity that resisted conservative treatment received surgery in our department. A lateral approach was used to debride the bony and soft tissue and reattach the insertion of the Achilles tendon. The Visual Analog Scale (VAS), American Orthopedic Foot and Ankle Score (AOFAS), and Victorian Institute of Sport Tendon Study Group-Achilles Tendinopathy score (VISA-A) were used to evaluate clinical outcomes.ResultThe mean patient age was 39.57 years at the time of surgery. The mean follow-up was 14.74 months. The mean VAS score significantly decreased from 4.86 ± 0.86 preoperatively to 1.21 ± 1.58 postoperatively (P &lt; 0.001). The mean AOFAS score significantly improved from 66.64 ± 6.23 preoperatively to 90.21 ± 11.50 postoperatively (P &lt; 0.001). The mean preoperative and the last follow-up VISA-A were 66 (range 56.75–69.25) and 86 (range 75.75–97.00) points, respectively (P &lt; 0.05).ConclusionThe lateral approach was effective and safe for IAT with Haglund deformity. Moreover, the mid-term functional outcome was promising.Level of Clinical EvidenceIV
Total knee arthroplasty and femoral osteotomy with a patient-specific cutting guide to treat haemophilic arthritis with severe extra-articular deformity: A case report and review of literatures
Authors: Lv Shuai-Jie , Wang Zheng-Ming , Wang Rui , Jin Heng-Kai , Tong Pei-Jian , Liu Xun 
Published: January 2023

BackgroundTotal knee arthroplasty (TKA) is recommended for haemophilic patients with end-stage arthritis. TKA combined with a one-stage extraarticular osteotomy is uncommon in the treatment of haemophilic arthritis (HA) with severe extra-articular deformities (EADs) and a history of inhibitors under the guidance of a patient-specific cutting guide (PSI).Case presentationWe reported a 20-year-old male patient with severe haemophilia, limited knee functionality, a 30° sagittal deformity on the femoral side and a history of inhibitors. We adopted the Van Creveld protocol to decrease the inhibitors. TKA and extra-articular osteotomy (EAO) were performed simultaneously and sequentially under the guidance of PSI. An appropriate central alignment of the lower limb was restored by using cement prostheses with antibiotics and femur shaft locking compression plates. The last follow-up showed that the knee function was good, the VAS score was 0, the WOMAC score was 18 and the ROM was 0°–95°.ConclisionRegular haematology management can reduce the perioperative bleeding risk in haemophilic patients treated with inhibitors. PSI plays an important role in guiding the TKA and EAO of end-stage HA patients with severe EAD.
Trends of rhinoplasty research in the last decade with bibliometric analysis
Authors: Zhu Xuanru , Zhang Bin , Huang Yuesheng 
Published: January 2023

BackgroundAs rhinoplasty (RP) with different requirements is becoming more and more popular in the latest decade, this study aims to quantitatively and qualitatively explore the trends in RP research, depict research hotspots, and point out the future direction with a bibliometric analysis.MethodsAll RP literature studies in the last decade (from 2012 to 2021) were retrieved from the Web of Science Core database. Annual output, institutions, authors, journals, and most-cited literature studies were analyzed by bibliometric tools, including CiteSpace, bibliometric online platform, bibliometrix R language kit, BICOMB, and gCLUTO.ResultsA total of 2,590 RP research studies dated between 2012 and 2021 were included according to our criterion. As for the country, the United States, Turkey, and Korea maintained the top three in RP research. As for the institutions, the University of California, Irvine, Stanford University, and University of Ulsan ranked top three in RP research publications based on article counts. Professor Rhorich RJ, Most SP, and Jang YJ were the most contributed authors according to article counts and citation number. The top journals were The Plastic and Reconstructive Surgery, JAMA Facial Plastic Surgery, and Aesthetic Surgery Journal. The 10 most-cited literature studies were also listed explicitly in this study. Finally, biclustering analysis on the most frequent keywords were conducted which helped us to identify seven hotspot clusters in RP research.ConclusionsWe comprehensively summarized the publication information of RP literature studies in the past decade, highlighted the current status and trends over time, and provide guidance for in-depth research direction on RP for the future.
The treatment of a Morel-Lavallée lesion of the thigh with incision and drainage along with tissue debridement and a surgically placed drain: A case report and literature review
Authors: Hu Minhua , Chen Junbang , Ma Luyao , Huang Feng , Cai Qunbin 
Published: January 2023

BackgroundA Morel-Lavallée lesion (MLL) is a rare closed degloving injury that usually occurs around the hips and is associated with pelvic fractures after high-energy trauma, which is commonly overshadowed by other severe post-traumatic manifestations. An isolated MLL, mostly caused by low-energy violence, is even rarer. Thus, the rates of misdiagnosis and missed diagnosis are often high. In this case report and literature review, we review the pathophysiology, clinical manifestations, imaging data, and treatment of this lesion to increase awareness of this rare disease.Case reportWe report the case of an isolated MLL in the right thigh caused by trauma, which happened to be one of missed diagnosis both at the initial visit and at the return visit of the patient, with a significant sign of a mass on MRI. Given the size of the lesion, open debridement and irrigation were adopted to treat the lesion, and the patient recovered well post-operatively.ConclusionYoung surgeons should pay attention to the MLL with sufficient recognization to avoid missed diagnosis and misdiagnosis. Comprehensive physical examination and imaging data play important roles in the diagnosis of MLL. In the early stages of this injury, a detailed history review combined with physical examination and MRI, can reduce the rates of missed diagnosis and misdiagnosis. The choice of the therapeutic scheme depends on the size and severity of the lesion. For an isolated MLL, compared with conservative treatments, we suggest that incision and drainage, along with tissue debridement and a surgically placed drain, will reduce the rates of infection and recurrence.
Secondary tuberculosis of adjacent segments after anterior cervical discectomy and fusion: A case report
Authors: Liu Chengjiang , Liu Yidong , Ma Boyuan , Zhou Mengmeng , Zhao Xinyan , Fu Xuanhao , Kan Shunli , Hu Wei , Zhu Rusen 
Published: January 2023

IntroductionAnterior cervical discectomy and fusion (ACDF) is a common operation for spinal surgery to treat a variety of cervical diseases. The postoperative infection rate of this procedure is extremely low, and adjacent segments are rarely involved. Tuberculosis (TB) is a common infectious disease that affects the spine in less than 1% of cases and is more common in the thoracolumbar and rarely cervical spine. Herein, for the first time, we report tuberculosis infection in adjacent segments after ACDF.Case presentationWe report a 50-year-old patient with cervical spondylotic myelopathy (CSM) who was discharged from the hospital after receiving ACDF at the C3/4 level. Two months later, he was admitted to the hospital with neck pain and found to be infected with tuberculosis in C4/5. After 4 months of anti-tuberculosis treatment, the vertebral body was fused.ConclusionAfter ACDF, the adjacent cervical vertebrae were infected with TB but the infection was limited. We believe that the special vertebral blood supply and postoperative secondary blood-borne infection may lead to the occurrence of extrapulmonary tuberculosis.
Comprehensive analysis of global research on overactive bladder: A scientometric approach
Authors: Wang Lu , Deng Sheng , Meng Fanchao , Zhang Lun , Min Zhenxing , Li Jitao , Wang Jisheng 
Published: January 2023

BackgroundOveractive bladder, a syndrome marked by an urgent need to urinate, is a globally prevalent ailment. Human health and quality of life are seriously affected. Therefore, it is essential to investigate the current progress and trends in this field.ObjectiveNo bibliometric analysis of overactive bladder has been conducted. Through the use of bibliometrics and visualization, this study intends to examine the current progress and development trend of this field.MethodsGlobal publications on overactive bladder between January 2004 and August 2022 were extracted from the Web of Science core collection database. A bibliometric and visual analysis was carried out using VOSviewer software and CiteSpace.ResultsOver the last 20 years, publications have grown rapidly, but after 2019, they started to fall. According to the collaboration network, the United States, Univ Pittsburgh AND NEUROUROLOGY AND URODYNAMICS are the most active countries, institutes AND journals in the field, respectively. All keywords were categorized by the symbiosis analysis into four categories: experimental study, symptoms, clinical use, and quality of life. The most prevalent keyword across all clusters is “overactive bladder.”ConclusionYear after year, there have been more publications in the field of overactive bladder research in many countries, and there has been a deeper level of cooperation and exchange. Researchers will still be interested in overactive bladder in the future. Currently, the clinical application of the disease and the safety and effectiveness of medications are being investigated. However, radical innovation in relevant experimental technologies is a significant obstacle in this field.
A novel predictive model of hospital stay for Total Knee Arthroplasty patients
Authors: Liu Bo , Ma Yijiang , Zhou Chunxiao , Wang Zhijie , Zhang Qiang 
Published: January 2023

ObjectiveThis study aimed to explore the main risk factors affecting Total Knee Arthroplasty (TKA) patients and develop a predictive nomogram of hospital stay.MethodsIn total, 2,622 patients undergoing TKA in Singapore were included in this retrospective cohort study. Hospital extension was defined based on the 75% quartile (Q3) of hospital stay. We randomly divided all patients into two groups using a 7:3 ratio of training and validation groups. We performed univariate analyses of the training group, in which variables with P-values &lt; 0.05 were included and then subjected to multivariate analysis. The multivariable logistic regression analysis was applied to build a predicting nomogram, using variable P-values &lt; 0.01. To evaluate the prediction ability of the model, we calculated the C-index. The ROC, Calibration, and DCA curves were drawn to assess the model. Finally, we verified the accuracy of the model using the validation group and by also using the C-index. The ROC curve, Calibration curve, and DCA curve were then applied to evaluate the model in the validation group.ResultsThe final study included 2,266 patients. The 75% quartile (Q3) of hospital stay was six days. In total, 457 (20.17%) patients had hospital extensions. There were 1,588 patients in the training group and 678 patients in the validation group. Age, Hb, D.M., Operation Duration, Procedure Description, Day of Operation, Repeat Operation, and Blood Transfusion were used to build the prediction model. The C-index was 0.680 (95% CI: 0.734–0.626) in the training group and 0.710 (95% CI: 0.742–0.678) for the validation set. The calibration curve and DCA indicated that the hospital stay extension model showed good performance in the training and validation groups.ConclusionTo identify patients' risk factors early, medical teams need to plan a patient’s rehabilitation path as a whole. Its advantages lie in better resource allocation, maximizing medical resources, improving the functional recovery of patients, and reducing the overall cost of hospital stay and surgery, and will help clinicians in the future.
Total knee arthroplasty and physical therapy for arthropathy in alkaptonuria: A 4-year follow-up case report
Authors: Wu Linfeng , Hu Yu 
Published: January 2023

IntroductionAlkaptonuria is a rare autosomal recessive metabolic disorder which leads to accumulation of homogentisic acid in the body.Case PresentationWe report a rare case of an alkaptonuria-related knee arthritis who underwent left total knee arthroplasty and received postoperative systematic physical therapy in a 57-year-old male patient. The patient has suffered from bilateral knee pain for over 4 years. The patient developed melanin pigmentation on the skin of the whole body, especially on the face and auricle. He self-reported that fresh urine was normal color but after standing overnight, the color deepened to black or soy color. He underwent routine urine examination for many times, but no obvious abnormality was found. The patient has suffered from low back pain for more than 20 years. He had been considered for lumbar disc herniation and ankylosing spondylitis after many in-hospital visits. After symptomatic medication, there was no obvious relief. We followed the patient for 4 years after surgery.ResultThe patient presented with pain relief and enhanced range of motion at the 4-year follow-up. The improvements of daily living and the pain relief suggest that the surgery is appropriate for this rare disease.ConclusionIt is rare that the knee pain is diagnosed as alkaptonuria. After total knee arthroplasty and physical therapy, the patient had a good outcome. This case provides experience for the diagnosis and treatment of alkaptonuria-related knee arthritis.