bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combination of Chinese medicinal formulas and chemotherapy for triple-negative breast cancer strengthens body resistance to eliminate pathogenic factors
Authors: Zhang Yiyi , Mo Jing-Wen , Lu Hai-Zhen , Han Ling-Ling , Liu Chengjiang , Zhou Yi 
Published: December 2022

Background:
To evaluate the efficacy and safety of strengthening the body’s resistance to eliminate pathogenic factors in Chinese medicinal formulas combined with chemotherapy (hereafter referred to as combined therapy [CT]) in triple-negative breast cancer.

Methods:
By searching the 7 electronic databases, PubMed, EMBASE, Web of Science, Cochrane Library, Chinese Academic Journal, Wanfang Database, and Chinese Science and Technology Journal, from the beginning of the establishment to April 2022 to identify eligible randomized controlled trial studies.

Results:
The meta-analysis showed that compared with chemotherapy, CT can effectively improve the objective remission rate (risk ratio [RR]: 1.39; 95% confidence interval [CI]: 1.28, 1.52; P < .00001, I
2 = 3%), reduce the recurrence rate (RR: 0.33; 95% CI: 0.14, 0.78; P = .01, I
2 = 0%) metastasis rate (RR: 0.48; 95% CI: 0.31, 0.73; P = .0006, I
2 = 0%) and the incidence of toxic and side reactions, lower tumor marker levels, regulated T lymphocyte subset changes, and increased average progression-free survival (standardized mean difference: 2.78; 95% CI: 1.41, 4.14; P < .0001, I
2 = 97%), and improve the quality of life (RR: 1.55; 95% CI: 1.21, 1.99; P = .0005, I
2 = 52%).

Conclusion:
This study suggests that CT appears to be an effective and safe treatment approach. Although this conclusion requires further confirmation owing to insufficient quality of the included trials.
Efficacy and safety of traditional Chinese medicine retention enema in the treatment of anal sinusitis: A protocol for systematic review and meta-analysis
Authors: Jiang Chunlai , Lu Jinwu 
Published: December 2022

Background:
Anal sinusitis is an acute or chronic inflammation of the anal sinus, anal flap, and anal glands. There are many traditional Chinese medicine (TCM) therapies for anal sinusitis, and most of them can achieve satisfactory results. Retention enema is one effective treatment for anal sinusitis. Although a number of studies have shown the effectiveness of retention enema with TCM in treating anal sinusitis, the results are inconsistent. Therefore, a meta-analysis was carried out in this study to evaluate the efficacy and safety of retention enema with TCM in the treatment of anal sinusitis.

Methods:
Randomized controlled trials on TCM retention enema for treating anal sinusitis were retrieved from PubMed, EMBASE, The Cochrane Library, CNKI, WanFang databases and VIP databases. The search time limit was from the database establishment to November 15, 2022. Two researchers independently screened the literature, extracted the data, and evaluated the risk of bias in the included studies. Risk of bias was assessed using the Cochrane Risk of Bias Tool (RoB 2.0). The meta-analysis was conducted by RevMan 5.3.

Results:
The results of this study will be published in a peer-reviewed publication.

Conclusion:
This systematic review and meta-analysis will provide evidence for the efficacy and safety of TCM retention enema in the treatment of anal sinusitis.
Regional variation of medical expenditures attributable to hypertension in China’s middle-aged and elderly population
Authors: Sheng Huilin , Dong Weihua , He YunZhen , Sui Mengyun , Li Hongzheng , Liu Ziyan , Wang Huiying , Chen Zhi , Xue Long 
Published: December 2022

Background:
Hypertension is a prevalent and costly health condition in China. Little is known about variation of the inpatient and outpatient expenditures attributable to hypertension between prefecture-level administrative regions (PARs) and the drivers of such variation among China’s middle-aged and elderly population.

Methods:
We obtain data from China Health and Retirement Longitudinal Survey between 2011 and 2015, panel tobit models were used in our study to estimate differences across 122 PARs. Expenditure variation was explained by the characteristics of individuals and regions, including measures of healthcare supply.

Results:
The cost of treatment for patients with hypertension varies greatly geographically, with the highest outpatient and inpatient costs being 77 and 102 times the lowest, respectively. After adjustment for the individual and PAR character, there are associations between expenditure and region bed density.

Conclusion:
There were significant regional differences in the outpatient and inpatient costs of middle-aged and elderly patients with hypertension in China, the difference between individuals may be an important reason, which has little to do with regional economic development differences, but is related to regional bed density.
A preoperative parathyroid scan is important for the total removal of the transplanted parathyroid tissue in recurrent secondary hyperthyroidism: A case report and literature review
Authors: Guo Xin-Ling , Yin Wen-Yao 
Published: December 2022

Rationale:
Secondary hyperparathyroidism was one of mineral and bone disorders owing to chronic kidney disease. Patients who suffer from secondary hyperparathyroidism would receive medical treatment or parathyroidectomy with or without autotransplantation (AT). However, some patients receiving parathyroidectomy with AT have recurrent hyperparathyroidism, which impacts their lives. Patients with recurrent hyperparathyroidism may present persistent hypercalcemia and hyperphosphatemia, which would cause cardiovascular disease, like atherosclerosis.

Patient concerns:
A 63-year-old female of Asian descent with chronic kidney disease who suffered from recurrent hyperparathyroidism for twice. The patient underwent parathyroidectomy with AT in the left thigh when secondary hyperparathyroidism happened. After 3 months, recurrent hyperparathyroidism happened.

Diagnosis:
The patient was diagnosed with recurrent hyperparathyroidism due to chronic kidney disease with hyperparathyroidism status post parathyroidectomy with AT in the left thigh. Our patient also suffered from mineral and bone disorder.

Intervention:
Two parathyroid adenoma in the left thigh were found. However, one of them was too small to found in the operation. Therefore, autograftectomy of the large one was performed. However, hyperparathyroidism happened again. This time, the autograftectomy was performed under dual phase Tc-99m MIBI (99m Tc-methoxy isobutyl isonitrile) parathyroid scintigraphy and it succeeded.

Outcomes:
After secondary autograftectomy, the value of intact parathyroid hormone was surveyed immediately and dropped by two-third followed by gradual reduction in the following weeks. The calcemia and phosphatemia were back to normal gradually.

Lessons:
In our case, importance of scintigraphy in the parathyroidectomy was confirmed.
An unusual pseudolymphoma in the context of necrotizing fasciitis: A case report
Authors: Dislich Bastian , Hoch Dennis , Dirnhofer Stefan , Novak Urban , Banz Yara 
Published: December 2022

Rationale:
The diagnosis of lymphoma in routine diagnostics can be challenging due to clinical, morphological and immunphenotypical overlap with unusual reactive processes termed “pseudolymphomas.”

Patient concerns:
45-year-old male that underwent surgical debridement for a necrotizing fasciitis of the thigh with concomitant excision of a regional lymph node.

Diagnoses:
The lymph node demonstrated an architecture-effacing activation and proliferation of lymphoblasts and was initially misdiagnosed as an aggressive lymphoma. Only in consideration of the clinical context and with the help of additional immunohistochemical and molecular analyses the final diagnosis of a reactive lymphadenopathy could be made.

Interventions:
No further therapy was required after the final diagnosis of a reactive lymphadenopathy was made.

Outcomes:
The clinical follow-up was unremarkable, with no evidence of residual disease after 6 months.

Lessons:
This case report adds the parafollicular activation and proliferation of blasts and plasmablasts in the drainage area of an active infection to the spectrum of “pseudolymphomas” and reiterizes the importance of placing histopathological findings in the proper context.
C.487C>T mutation in PAX4 gene causes MODY9: A case report and literature review
Authors: Zhang Di , Chen Congli , Yang Wenli , Piao Yurong , Ren Li , Sang Yanmei 
Published: December 2022

Rationale:
Maturity-onset diabetes of the young (MODY) is a group of autosomal dominant monogenic diabetes mellitus with a wide range of clinical manifestations that require distinct treatment strategies. MODY9 (OMIM # 612225) is a rare type of MODY, caused by a mutation in the Paired box gene 4 (PAX4).

Patient concern:
A 19-months boy was admitted to the department of endocrinology at Beijing Children’s Hospital due to excessive water drinking, polyuria for over half a month, and wheezing for 3 days.

Diagnose:
The whole-exon sequencing analysis demonstrated that the child carried the heterozygous missense mutation of c.487>T in the 7th exon region of PAX4 gene and diagnosed MODY9.

Intervention:
The patient was treated with fluid therapy, ketosis correction, insulin, and anti-infection treatment.

Outcomes:
After 17 days in the hospital, the blood glucose levels remained stable and the patient was discharged.

Lessons:
In Chinese children, the heterozygous mutation of c.487C>T in the PAX4 gene can lead to the occurrence of MODY9.Gene sequencing analysis is of great significance in the diagnosis and classification of MODY.
Association of hormone replacement therapy and the risk of knee osteoarthritis: A meta-analysis
Authors: Hou Wen-Yuan , Zhu Cai-Yu , Gu Yi-Fan , Zhu Lei , Zhou Zheng-Xin 
Published: December 2022

Background:
The relationship between hormone replacement therapy (HRT) and osteoarthritis is controversial in epidemiological studies. With the aim of better understanding the effect of HRT use, this first meta-analysis was implemented to explore the association of HRT and knee OA.

Methods:
A series of data is retrieved from Web of Science, PubMed, and Embase databases to observe the association of HRT and knee osteoarthritis up to December 2021. Two separated reviewers chose the research, extracted the data, and evaluated the study quality. Pooled estimates of 95% CI and HRs were acquired through a random-effects model.

Results:
Finally, there existed 13 pieces of research, containing one case-control research, four cross-sectional pieces of research, as well as eight cohort pieces of research, involving 2573,164 participants. The overall results showed that the use of HRT was related to a raised risk of knee OA (HR = 1.24, 95% CI 1.07–1.45). And the pooled analysis showed a statistically significant raised risk of knee joint replacement (HR = 1.30, 95% CI 1.09–1.54) when using HRT. In addition, the outcome exhibits the raised knee OA risk for the present users of HRT (HR = 1.40, 95% CI 1.16–1.68) according to HRT status. In the past users of HRT, the augment of knee OA risk was not statistically evident (HR = 1.16, 95% CI 0.94–1.42).

Conclusion:
We observed that HRT use was related to a raised knee OA risk. Furthermore, future studies might focus on relevant mechanistic to verify our observed associations.
Extension of decompression to C2 doesn’t affect the spinal sagittal parameters compared with standard open-door laminoplasty
Authors: Wang Wenxuan , Xue Chenhui , Ma Xun , Feng Haoyu , Ma Zhuo , Guan Xiaoming , Chen Xu , Zhang Xin 
Published: December 2022

We modified and extended laminoplasty to the upper cervical spine on patients with canal stenosis associated with upper cervical spinal ossified lesions. However, whether the extended decompression range of laminoplasty can cause further effects on cervical stability is rarely studied at present.
A retrospective study to analyze the relationship between the surgical levels and cervical sagittal parameters effects was performed in patients with cervical spondylosis myelopathy who had undergone posterior cervical expansive open-door laminoplasty with/without extending to C2.
In total, 64 patients were divided into 2 groups according to the surgical levels. Radiologic outcomes of occipito-cervical angle (C0-2 Cobb angle), CL C27 Cobb angle, cervical sagittal vertical alignment, T1-Slope (T1S), T1S minus CL (T1S–CL), spino-cranial angle and center of the sella turcica–C7 SVA (St-SVA) were evaluated on lateral X-rays of the cervical spine at pre-operation, post-operation, and 2-year follow-up. The patient’s health-related quality of life was obtained including neck disability index, Japanese orthopaedic association scores, and visual analog scale.
Changes in sagittal parameters were observed in both groups after surgery. T1S, cervical sagittal vertical alignment, and T1S-CL significantly increased and CL decreased in 2 groups of patients postoperative. After a 2-year follow-up period, the C0-2 Cobb angle was found to increase compared to preoperative records. In addition, there were no significant differences in spino-cranial angle and st-SVA between preoperative and 2 years follow-up measurements. Health-related quality of life was improved in both groups and was not significantly different.
Herein, the parameters indicated a tilting forward of the lower cervical spine and a more lordotic upper cervical spine to maintain a horizontal gaze in patients. However, C2 to 7 laminoplasty was performed to achieve satisfactory clinical results without significantly changing the spinal sagittal parameters.
Association of hypernatremia with outcomes of COVID-19 patients: A systematic review and meta-analysis
Authors: Shrestha Abhigan Babu , Sapkota Unnat Hamal , Shrestha Sajina , Aryal Manjil , Chand Swati , Thapa Sangharsha , Chowdhury Faisal , Salman Abdullah , Shrestha Shumneva , Shah Sangam , Jaiswal Vikash 
Published: December 2022

Background:
This systematic review and meta-analysis aimed to assess the association of hypernatremia with the outcomes of COVID-19 patients.

Methods:
We performed a systematic literature search on PubMed, Google Scholar, and Science Direct until October 2021 and found a total of 131 papers. With meticulous screening finally, 17 papers met the inclusion criteria. COVID-19 patients with sodium levels greater than the reference level were the study population and the outcome of interest was the poor outcome; such as mortality, mechanical ventilation, intensive care unit (ICU) admission, and prolonged hospital stay. The pooled estimate was calculated as the odds ratio (OR).

Results:
There were 19,032 patients with hypernatremia in the 17 studies included. An overall random effect meta-analysis showed that hypernatremia was associated with mortality (OR: 3.18 [1.61, 6.28], P < .0001, I
2 = 91.99%), prolong hospitalization (OR: 1.97 [1.37, 2.83], P < .001, I
2 = 0.00%) and Ventilation (OR: 5.40 [1.89, 15.42], P < .001, I
2 = 77.35%), ICU admission (OR: 3.99 [0.89, 17.78], P = .07, I
2 = 86.79%). Meta-regression analysis showed the association of age with the ICU outcome of hypernatremia patients. Whereas, other parameters like male, hypertension, chronic kidney disease, and diabetes mellitus did not significantly influence the odds ratio.

Conclusion:
Hypernatremia was markedly associated with poor outcomes in patients with COVID-19. Hence, a blood ionogram is warranted and special attention must be given to hypernatremia COVID-19 patients.
HFA-PEFF score as an independent predictor of 2-year mortality in liver cirrhosis patients
Authors: Dimitroglou Yannis , Tsartsalis Dimitrios , Vasilieva Larisa , Patsourakos Dimitrios , Kalompatsou Argyro , Alexopoulou Alexandra , Tousoulis Dimitris , Tsioufis Konstantinos , Aggeli Constantina 
Published: December 2022

Background and aims
Cardiovascular complications of liver cirrhosis include high cardiac output heart failure with reduced afterload and diastolic dysfunction. Heart Failure Association Pre-test assessment, Echocardiography and natriuretic peptide, Functional testing, Final etiology (HFA-PEFF) (values 0–6) is a diagnostic tool for heart failure. It is a cluster of echocardiographic and biochemical parameters. The purpose of this prospective study was to assess if HFA-PEFF score is associated with the severity of liver disease and to determine its prognostic significance in patients with cirrhosis.

Methods
Patients with cirrhosis without an acute event were enrolled. A comprehensive echocardiography study was conducted, brain natriuretic peptide and N-terminal-pro-B-type Natriuretic Peptide levels were measured and HFA-PEFF score was calculated. All patients were prospectively followed up after enrollment. The study end-point was defined as the composite of all-cause death.

Results
Seventy-two consecutive patients [median age 59 years (inter-quartile range: 52–65), 72.2% males, Model for End-stage Liver Disease (MELD) 12.9 (8.5–16.3)] were included. The 52.8% had a high HFA-PEFF score (5 or 6) and the 47.2% intermediate/low score (0–4). HFA-PEFF score was correlated with MELD score (rho = 0.566, P < 0.001), but not with age, SBP and heart rate. The median follow-up was 24.2 (9.5–38.8) months. The 1- and 2-year cumulative mortality was higher in patients with high HFA-PEFF compared to those with intermediate/low (log-rank P < 0.001 for both). The predicted 2-year probability of survival in high vs intermediate/low HFA-PEFF was found to be a prognostic factor of death even when adjusted for age, gender and MELD score [hazard ratio = 3.539 (1.134–11.046), P = 0.029].

Conclusion
HFA-PEFF score is high among patients with liver cirrhosis, especially those with advanced liver disease. HFA-PEFF score is associated with survival even when adjusting for cirrhosis severity.
Fib-4 index predicts prognosis after achievement of sustained virologic response following direct-acting antiviral treatment in patients with hepatitis C virus infection
Authors: Ideno Naomi , Nozaki Akito , Chuma Makoto , Ogushi Katsuaki , Hara Koji , Moriya Satoshi , Fukuda Hiroyuki , Numata Kazushi , Maeda Shin 
Published: December 2022

Objective(s)
Toinvestigate liver carcinogenesis and other causes of death by collecting clinical data, including the Fib-4 index, from patients with successfully eradicated hepatitis C virus (HCV) by direct-acting antivirals (DAA) treatment.

Methods
Patients (n = 690), who achieved a sustained virologic response (SVR) between 2014 and 2021, were identified and followed up for approximately 6.8 years; 71 incident hepatocellular carcinoma (HCC) cases were identified. The Fib-4 index was calculated at DAA-treatment initiation and HCV eradication, and its relationship with carcinogenesis and prognosis was analyzed.

Results
The Fib-4 index was initially calculated and divided into three groups: Fib-4<1.45, 1.45 ≤ Fib-4<3.25, and 3.25 ≤ Fib-4 to develop HCC over time. On analysis, no carcinogenic cases were observed at Fib-4<1.45. In patients with a Fib-4 index ≥3.25, the initial HCC carcinogenic rate was higher than that in patients with Fib-4=1.45–3.25, and a significant difference was obtained between the two groups [P = 0.0057 (<1.45 vs. >3.25); P = 0.0004 (<1.45–3.25 vs. >3.25)]. Regarding all 18 death and Fib-4 at treatment initiation, a significant difference was observed after stratification into two groups [Fib-4 < 3.25 and 3.25 ≤ Fib-4; P = 0.0136 (<3.25 vs. ≥3.25)]. Significant differences were obtained in another analysis of 13 deaths, not due to HCC.

Conclusions
The high Fib-4 index calculated at baseline and SVR12 significantly correlated not only with liver carcinogenesis but also with all mortality rates, including those due to causes other than liver cancer. Our findings suggest that improving liver fibrosis by eradicating HCV improves prognosis related to all etiologies.
Diagnosis of Metastatic Lymph Nodes in Patients With Hepatocellular Carcinoma Using Dual-Energy Computed Tomography
Authors: Mo Huiqiang , Huang Ruisui , Wei Xue , Huang Lifeng , Huang Jianning , Chen Jiong , Qin Mi , Lu Wei , Yu Xiaofang , Liu Manrong , Ding Ke 
Published: December 2022

Objective
Our study aimed to investigate the role of quantitative parameters derived from dual-energy computed tomography (DECT) in discriminating metastatic from nonmetastatic lymph nodes in hepatocellular carcinoma (HCC).

Methods
Forty-two patients (34 males; mean age, 53.7 years) with HCC underwent unenhanced computed tomography scans and triple-phase DECT scans of the upper abdomen. A total of 72 suspected lymph nodes were resected, including 43 nonmetastatic and 29 metastatic lymph nodes. The maximum short-axis diameter of the lymph nodes, iodine concentration, normalized iodine concentration (NIC), and slope of the spectral curve were analyzed for the HCC primary lesions and the suspected lymph nodes. Lymph node metastasis was confirmed by pathologic examination.

Results
A maximum short-axis diameter of >10 mm had a sensitivity and a specificity of 75.9% (22/29) and 53.5% (23/43) in diagnosing metastatic lymph nodes. The iodine concentration, NIC, and slope of the spectral curve of the nonmetastatic lymph nodes were significantly higher than those of the primary HCC lesions and the metastatic lymph nodes (all P < 0.05). Among all the analyzed spectral parameters, the NIC in the arterial phase had the highest sensitivity and specificity of 88.4% and 86.2% in diagnosing metastatic lymph nodes.

Conclusions
The arterial phase NIC of DECT has superior diagnostic performance than the traditional lymph node size in diagnosing metastatic lymph nodes in HCC.
Prior infection- and/or vaccine-induced protection against Omicron BA.1, BA.2 and BA.4/BA.5-related hospitalisations in older adults: a test-negative case-control study in Quebec, Canada
Authors: Carazo Sara , Skowronski Danuta M. , Brisson Marc , Sauvageau Chantal , Brousseau Nicholas , Fafard Judith , Gilca Rodica , Talbot Denis , Ouakki Manale , Febriani Yossi , Deceuninck Geneviève , De Wals Philippe , De Serres Gaston 
Published: December 2022

ABSTRACTBackgroundDue to severe outcomes, elderly adults 60 years or older are prioritized for COVID-19 vaccination but accumulated SARS-CoV-2 infection and vaccination likely modifies their risk. We estimated vaccine effectiveness against omicron-associated hospitalisation among elderly adults, by number of doses, prior infection history and time since last immunological event.MethodsWe conducted a test-negative case-control study among symptomatic elderly adults tested for SARS-CoV-2 in Quebec, Canada during BA.1-, BA.2- and BA.4/5-dominant periods. Relative to unvaccinated, infection-naïve participants, we compared COVID-19 hospitalisation risk by mRNA vaccine dose and/or prior infection (pre-omicron or omicron) history.FindingsDuring BA.1, BA.2 and BA.4/5 periods, two- vs. four-dose vaccine effectiveness alone against hospitalisation was: 78% (95%CI:75-80) vs. 96% (95%CI:93-98); 60% (95%CI:50-97) vs. 84% (95%CI:81-87); and 40% (95%CI:30-49) vs. 68% (95%CI:63-72), respectively, consistent with longer median time since second vs fourth dose. By respective period, effectiveness of pre-omicron vs. omicron infection alone against hospitalisation was: 93% (95%CI:80-97) vs. [not estimable]; 88% (95%CI:50-97) vs. 96% (95%CI:68-99); and 69% (95%CI:30-85) vs. 90% (95%CI:79-95). Regardless of doses (2-5) or prior infection type, hybrid protection was ≥90%, lasting at least 6-8 months during the BA.4/5 period. Prior omicron infection alone reduced BA.4/5 hospitalisation risk by >80% for at least 6-8 months.InterpretationElderly adults with history of both prior SARS-CoV-2 infection and ≥2 vaccine doses appear well-protected for a prolonged period against omicron hospitalisation, including BA.4/5. Ensuring infection-naïve older adults remain up-to-date with vaccination may further reduce COVID-19 hospitalisations most efficiently.FundingMinistère de la Santé et des Services sociaux du Québec.