bluuebunny/crossref_metadata_2025_split huggingface dataset:
Difference between the blood samples of patients with bone and joint tuberculosis and patients with tuberculosis studied using machine learning
Authors: Ye Zhen , Zhu Jichong , Liu Chong , Lu Qing , Wu Shaofeng , Zhou Chenxing , Liang Tuo , Jiang Jie , Li Hao , Chen Tianyou , Chen Jiarui , Deng Guobing , Yao Yuanlin , Liao Shian , Yu Chaojie , Sun Xuhua , Chen Liyi , Guo Hao , Chen Wuhua , Jiang Wenyong , Fan Binguang , Tao Xiang , Yang Zhenwei , Gu Wenfei , Wang Yihan , Zhan Xinli 
Published: January 2023

BackgroundTuberculosis (TB) is a chronic infectious disease. Bone and joint TB is a common type of extrapulmonary TB and often occurs secondary to TB infection. In this study, we aimed to find the difference in the blood examination results of patients with bone and joint TB and patients with TB by using machine learning (ML) and establish a diagnostic model to help clinicians better diagnose the disease and allow patients to receive timely treatment.MethodsA total of 1,667 patients were finally enrolled in the study. Patients were randomly assigned to the training and validation cohorts. The training cohort included 1,268 patients: 158 patients with bone and joint TB and 1,110 patients with TB. The validation cohort included 399 patients: 48 patients with bone and joint TB and 351 patients with TB. We used three ML methods, namely logistic regression, LASSO regression, and random forest, to screen the differential variables, obtained the most representative variables by intersection to construct the prediction model, and verified the performance of the proposed prediction model in the validation group.ResultsThe results revealed a great difference in the blood examination results of patients with bone and joint TB and those with TB. Infectious markers such as hs-CRP, ESR, WBC, and NEUT were increased in patients with bone and joint TB. Patients with bone and joint TB were found to have higher liver function burden and poorer nutritional status. The factors screened using ML were PDW, LYM, AST/ALT, BUN, and Na, and the nomogram diagnostic model was constructed using these five factors. In the training cohort, the area under the curve (AUC) value of the model was 0.71182, and the C value was 0.712. In the validation cohort, the AUC value of the model was 0.6435779, and the C value was 0.644.ConclusionWe used ML methods to screen out the blood-specific factors—PDW, LYM, AST/ALT, BUN, and Na+—of bone and joint TB and constructed a diagnostic model to help clinicians better diagnose the disease in the future.
Gastric infiltration of hepatic sarcomatoid carcinoma: A case report and literature review
Authors: Ma Shuoshuo , Zhang Dengyong , Zhao Guanru , Ding Sheng , Wu Qiong , Zhang Xueli , Lu Zheng 
Published: January 2023

BackgroundHepatic sarcomatoid carcinoma (HSC) is an extremely rare malignant tumor typically observed in clinical settings. HSC occurrence is predominantly noted in the right lobe and rarely in the left lobe of the liver. This report presents a case of sarcomatoid carcinoma that occurred in the left outer lobe of the liver, which was accompanied by gastrointestinal stromal tumors (GSTs) in the greater curvature of the stomach. In addition, the patient showed late-stage recurrence of HSC in gastric tissues.Case presentationA 63-year-old man was concomitantly diagnosed with HSC and GST. The main clinical manifestation was fever. Abdominal computer tomography (CT) and ultrasound-guided percutaneous liver biopsy at the local hospital revealed the presence of malignant hepatic tumors. The patient approached our hospital for further treatment. The subsequent electronic gastroscopy showed multiple submucosal tumors (SMT) in the stomach. Owing to the absence of multiple metastases in other regions of the body, we performed left hepatic lobe resection with gastric partial resection. The postoperative pathological analysis confirmed the presence of HSC and GST. The patient reported feeling well 1 month after the surgery, and no obvious space-occupying lesions in other areas were noted via imaging examinations. However, 3 months later, the patient presented with pain in the upper left abdomen, and examination revealed cancer recurrence in the stomach. The surgery was repeated, and the patient recovered favorably after the procedure. Unfortunately, the patient died owing to multiple metastatic diseases 4 months after the second surgical procedure.ConclusionHSC shows no characteristic clinical manifestations and is highly malignant. Surgical intervention is the first treatment of choice for patients with HSC. In cases of sarcomatoid cancer occurring in the left lobe of the liver, it is imperative to exercise strict vigilance against the tumor's invasion of the stomach tissue. This is particularly important when the tumor breaks through the capsule of the liver.
Treatment of obstructive jaundice induced by non-hodgkin lymphoma with EUS-guided transgastric anterograde common bile duct stenting: Technical case report and literature review
Authors: Yuan Lingzhi , Shi Xiao , Shan Hongbo , Xiao Dinghua , Wang Xiaoyan , Wang Fen 
Published: January 2023

BackgroundNon-Hodgkin lymphoma (NHL) is a rare cause of biliary obstruction. The optimum treatment for these patients is unclear. Lymphoma-associated obstructive jaundice is generally managed with open surgery, Endoscopic retrograde cholangiopancreatography (ERCP), or Percutaneous transhepatic biliary drainage. Here, we present the first description of EUS-guided anterograde common bile duct stenting via the stomach for obstructive jaundice associated with NHL.Patient and methodsA 58-year-old male patient who had been undergoing chemotherapy for NHL was admitted to our institution for severe obstructive jaundice. The patient's hepatic function indicators were: alanine aminotransferase 211 U/L, aspartate aminotransferase 301 U/L, total bilirubin 485.6 μmol/L, and direct bilirubin 340.2 μmol/L. Abdominal magnetic resonance imaging showed massive lymphomatous lesions filling the peritoneal cavity. Magnetic resonance cholangiopancreatography revealed an external compressive stricture in the superior middle common bile duct and dilation of the intrahepatic and extrahepatic ducts. ERCP was performed unsuccessfully, due to the stricture at the descending junction of the duodenal bulb caused by lymphoma infiltration. So, EUS-guided anterograde common bile duct stenting via the stomach was performed.ResultsThe patient's bilirubin level decreased significantly in the postoperative period, and no adverse reaction was observed. Computed tomography showed marked shrinking of the abdominal mass after targeted therapy.ConclusionsOur report suggests that early relief of biliary obstruction may be more beneficial to subsequent chemotherapy when symptoms of lymphoma-associated jaundice are persistently aggravating. Endoscopic ultrasound-guided biliary drainage is a safe, effective and timely alternative approach to treat biliary obstruction when ERCP fails, especially in cases of malignancy caused by extrahepatic bile duct space-occupying lesions.
The ultrasound-guided percutaneous release technique for De Quervain's disease using an acupotomy
Authors: Shen Yifeng , Zhou Qiaoyin , Sun Xiaojie , Qiu Zuyun , Jia Yan , Li Shiliang , Zhang Weiguang 
Published: January 2023

BackgroundThis study aimed to compare the effectiveness and safety of the percutaneous first extensor compartment performed by acupotomy procedure with or without ultrasonic (US) guidance.MethodsThe percutaneous release was performed with an acupotomy on 40 wrists of cadavers, which was divided into US guidance operation and blind operation. Each arm was dissected and assessed regarding the amount of release and the extent of neurovascular and tendon injury. An analysis of finite biomechanical elements based on wrists specimen data is analyzed to observe the stress of the first extensor tendon compartment. A prospective study observed the pain visual analogue score(VAS) and Patient-Rated Wrist Evaluation (PRWEB) changes after the ultrasound guidance or blind acupotomy treatment in 30 dQD patients.ResultsThe success rate in the ultrasound-guided technique was 85%, and the blind technique was 70% in the cadaver study, both techniques without neurovascular injury. There was no statistically significant difference between the two groups in measuring the distance from the incision marks to the blood vessels and nerves (P &gt; 0.05). According to the biomechanical analysis, the tendon friction rubs when the wrist is upright. When the wrist is flexed, the tendon and tendon sheath is stressed in the bone ridges. In this prospective study, both ultrasound guidance and blind acupotomy treatment achieved well improvements in pain and function (P &lt; 0.05), but the results with no statistically significant between groups (P &gt; 0.05).ConclusionBoth blind and US-guided percutaneous release by acupotomy of the first extensor tendon compartment can get a good result. US-guided techniques can improve the success rate during acupotomy operations, especially for beginners and followers.
Effect of visual endotracheal tube combined with bronchial occluder on pulmonary ventilation and arterial blood gas in patients undergoing thoracic surgery
Authors: Xin Jing , Fan Xiu-juan 
Published: January 2023

BackgroundTo investigate the effect of visual endotracheal tube combined with bronchial occluder on pulmonary ventilation and arterial blood gas in patients undergoing thoracic surgery.MethodsNinety patients who underwent thoracic surgery under anesthesia and required pulmonary ventilation at our hospital from May 2020 to December 2021 were collected. The patients were divided into three groups according to different intubation methods: visual double-lumen endotracheal tube group (VDLT group), bronchial occluder group (BO group), and VDLT + BO group. Clinical data and laboratory test data were collected from the three groups. Additionally, the three groups were compared in terms of peak airway pressure, time to correct positioning, pulmonary ventilation time, hemodynamics before and after intubation, intubation success rate, and postoperative recovery.ResultsThe VDLT + BO group was superior to the BO group or VDLT group in airway peak pressure, time to correct positioning, pulmonary ventilation time, intubation success rate, and hemodynamics after intubation (P &lt; 0.05). In the comparison of postoperative recovery, the postoperative pain score, white blood cell level, incidence rate of pneumonia, hospital stay and hospitalization costs in the VDLT + BO group were significantly lower than those in the BO group or VDLT group (P &lt; 0.05).ConclusionThe visual endotracheal tube combined with bronchial occluder is effective in pulmonary ventilation during thoracic surgery under anesthesia, and can improve arterial blood gas in patients.
Case report: Thoracolumbar spinal stenosis associated with alkaptonuria
Authors: Ding Hong , Wang Liang , Feng Gan-Jun , Song Yue-Ming , Liu Li-Min 
Published: January 2023

BackgroundAlkaptonuria is a rare autosomal genetic disorder with an incidence of about 1 in 1 million per year. Spinal involvement often manifests in the later stages of the disease. However, this is the first report of the presentation of thoracolumbar spinal stenosis.Case presentationWe report the case of a 61-year-old female patient with significant thoracolumbar stenosis symptoms. The patient had obvious kyphosis with preoperative lower extremity muscle strength grade 2/5. Symptoms and imaging signs initially suggested ankylosing spondylitis. This patient was classified into motor incomplete injury (ASIA C). However, the patient was found to have melanin deposits on the sclera and skin, and the urine was darkened at rest. CT and MRI both suggested no bone bridge connection between vertebrae, which was the key difference between ankylosing spondylitis and alkaptonuria in imaging. Most importantly, urine specimen testing and intraoperative pathology demonstrated alkaptonuria. The patient underwent spinal decompression and vertebral body fixation. Postoperative recovery was good: the patient had significantly relieved pain and could stand and walk.ConclusionThis case is the first report of thoracolumbar spinal stenosis associated with alkaptonuria involving the spine.
The role of laparoscopic surgery in the surgical management of recurrent liver malignancies: A systematic review and meta-analysis
Authors: Lv Tian-Run , Hu Hai-Jie , Ma Wen-Jie , Hu Ya-Fei , Dai Yu-Shi , Li Fu-Yu 
Published: January 2023

ObjectiveTo evaluate the efficiency of laparoscopic surgery in treating recurrent liver tumors vs. conventional open surgery.MethodsDatabase searching was conducted in PubMed, the Cochrane Library and EMBASE. Rev Man 5.3 software and Stata 13.0 software were applied in statistical analyses.ResultsA total of fourteen studies were finally included with 1,284 patients receiving LRH and 2,254 with ORH. LRH was associated with less intraoperative hemorrhage, a higher R0 resection rate, a lower incidence of Pringle Maneuver, a lower incidence of postoperative morbidities, a better overall survival and an enhanced postoperative recovery vs. ORH. Patients receiving LRH shared similar operative time, tumor number and disease-free survival as those with ORH. However, tumor size was relatively larger in patients receiving ORH and major hepatectomy, anatomic hepatectomy were rarely performed in patients with LRH. Additional analyses between LRH and laparoscopic primary hepatectomy revealed less intraoperative blood loss in patients with LRH.ConclusionLRH is safe and feasible with more favorable peri-operative outcomes and faster postoperative recovery. However, it is only applicable for some highly-selected cases not requiring complex surgical procedures. Future larger well-designed studies are expected for further validation.
Are the preoperative albumin levels and the albumin to fibrinogen ratio the risk factors for acute infection after primary total joint arthroplasty?
Authors: Jiang Boyi , Xu Hong , Xie Jinwei , Wang Duan , Gan Qiang , Zhou Zongke 
Published: January 2023

BackgroundAcute infection, such as periprosthetic joint infection and superficial surgical site infection, after primary total joint arthroplasty (TJA) is a serious complication, and its risk factors remain controversial. This study aimed to identify the risk factors for acute infection after primary TJA, especially the serological indicators that reflect preoperative nutritional statuses, such as albumin level and albumin to fibrinogen ratio (AFR).MethodsWe retrospectively reviewed patients who underwent elective primary hip or knee arthroplasty at our institution from 2009 to 2021. Potential risk factors of acute infection and demographic information were extracted from an electronic health record. Patients who suffered acute infection, such as PJI or SSI, after TJA were considered the study group. Non-infected patients were matched 1:2 with the study group according to sex, age, the involved joint (hip or knee), and year of surgery (control group). The variables of potential risk factors for acute postoperative infection (demographic characteristics, preoperative comorbidities and drug use, operative variables, and laboratory values) were collected and evaluated by regression analysis. Restrictive cubic spline regression analysis was also used to examine the relationship between preoperative serum albumin levels and acute postoperative infection.ResultsWe matched 162 non-infected patients with 81 patients who suffered from acute postoperative infection. Among the patients who suffered from acute infection within 90 days after TJA, 18 were diagnosed with periprosthetic joint infection and 63 with surgical site infection. Low albumin levels were strongly associated with acute postoperative infection (95% confidence interval, 0.822–0.980; P = 0.015). This risk increased as preoperative albumin levels decreased, with a negative dose-response relationship (Poverall = 0.002; Pnonlinear = 0.089). However, there was no significant association between the AFR and acute infection after primary TJA (P = 0.100).ConclusionThere is currently insufficient evidence to confirm the relationship between preoperative AFR and acute infection after elective primary TJA, while a lower preoperative albumin level is an independent risk factor for acute infection with a negative dose-response relationship. This suggests that optimal nutritional management may be benefited before elective primary TJA.
Risk factors for early local lymph node recurrence of thoracic ESCC after McKeown esophagectomy
Authors: Dai Liang , Yang Yong-Bo , Wu Ya-Ya , Fu Hao , Yan Wan-Pu , Lin Yao , Wang Zi-Ming , Chen Ke-Neng 
Published: January 2023

ObjectivesEven underwent radical resection, some patients of thoracic esophageal squamous cell carcinoma (ESCC) are still exposed to local recurrence in a short time. To this end, the present study sought to differentiate patient subgroups by assessing risk factors for postoperative early (within one year) local lymph node recurrence (PELLNR).MethodsESCC patients were selected from a prospective database, and divided into high- and low-risk groups according to the time of their local lymphatic recurrence (within one year or later). Survival analysis was conducted by the Cox regression model to evaluate the overall survival (OS) between the two groups. The hazard ratio (HR) and 95% confidence interval (CI) of different variables were also calculated. Logistic regression analysis was used to explore the high-risk factors for PELLNR with the odds ratio (OR) and 95% CI calculated.ResultsA total of 432 cases were included. The survival of patients in the high-risk group (n = 47) was significantly inferior to the low-risk group (n = 385) (HR = 11.331, 95% CI: 6.870–16.688, P &lt; 0.001). The 1-year, 3-year, and 5-year OS rate of the patients in high/low-risk groups were 74.5% vs. 100%, 17% vs. 88.8%, and 11.3% vs. 79.2%, respectively (P &lt; 0.001). Risk factors for local lymph node recurrence within one year included upper thoracic location (OR = 4.071, 95% CI: 1.499–11.055, P = 0.006), advanced T staging (pT3–4, OR = 3.258, 95% CI: 1.547–6.861, P = 0.002), advanced N staging (pN2–3, OR = 5.195, 95% CI: 2.269–11.894, P &lt; 0.001), and neoadjuvant treatment (OR = 3.609, 95% CI: 1.716–7.589, P = 0.001). In neoadjuvant therapy subgroup, high-risk group still had unfavorable survival (Log-rank P &lt; 0.001). Multivariate analysis demonstrated that upper thoracic location (OR = 5.064, 95% CI: 1.485–17.261, P = 0.010) and advanced N staging (pN2–3) (OR = 5.999, 95% CI: 1.986–18.115, P = 0.001) were independent risk factors for early local lymphatic recurrence. However, the cT downstaging (OR = 0.862, 95% CI: 0.241–3.086, P = 0.819) and cN downstaging (OR = 0.937, 95% CI: 0.372–2.360, P = 0.890) for patients in the neoadjuvant subgroup failed to lower PELLNR. The predominant recurrence field type was single-field.ConclusionsThoracic ESCC patients with lymph node recurrence within one year delivered poor outcomes, with advanced stages (pT3–4/pN2–3) and upper thoracic location considered risk factors for early recurrence.
Impact of frozen elephant trunk on the outcomes of thoracoabdominal aortic repair with normothermic iliac perfusion
Authors: Gao Haoyu , Wang Luchen , Liu Yanxiang , Liang Shenghua , Zhang Bowen , Ren Jie , Yu Cuntao , Sun Xiaogang 
Published: January 2023

BackgroundFrozen elephant trunk technique (FET) has been proven to provide an excellent landing zone for second-stage thoracoabdominal (TA) aortic repair. The aim of this study was to evaluate the impact of FET in TA aortic repair with normothermic iliac perfusion.MethodsFrom January 2008 to December 2019, 144 patients undergoing TA repair with normothermic iliac perfusion were enrolled in this study. Early and mid-term outcomes of patients with previous FET implantation (group A, n = 62) were compared with patients without previous FET implantation (group B, n = 82). The logistic regression analysis was performed to investigate the risk factors for adverse events, which were deﬁned as early death, permanent stroke, permanent paraplegia, or permanent renal failure necessitating dialysis.ResultsThe proximal aortic clamp time and operating time was 14.26 ± 5.57 min and 357.40 ± 94.51 respectively in group A, which were both significantly shorter than that in group B (18.67 ± 5.24 min and 18.67 ± 5.24 min). The incidence of adverse event was significantly lower in group A than that in group B (9.7% vs. 25.6%, P = 0.027). There was no significant difference between two groups with regard to other complications or late outcomes. In addition, age &gt;50 years, a Ccr &lt; 90 ml/min/1.73 m2 and the operating time were identified as significant risk factors through logistic regression analysis for adverse events of TA repair.ConclusionsThe FET technique simplifies the operative technique of proximal anastomosis, decreases the operating time and improves the early outcomes in TA repair, whereas does not provide a significant benefit with regard to late outcomes. Long-term follow-up and studies with larger sample sizes are necessary for further confirmation.
New insights into a microvascular invasion prediction model in hepatocellular carcinoma: A retrospective study from the SEER database and China
Authors: Wang Xingchang , Fu Yiling , Zhu Chengzhan , Hu Xiao , Zou Hao , Sun Chuandong 
Published: January 2023

Background and AimsThe prognosis of liver cancer is strongly influenced by microvascular infiltration (MVI). Accurate preoperative MVI prediction can aid clinicians in the selection of suitable treatment options. In this study, we constructed a novel, reliable, and adaptable nomogram for predicting MVI.MethodsUsing the Surveillance, Epidemiology, and End Results (SEER) database, we extracted the clinical data of 1,063 patients diagnosed with hepatocellular carcinoma (HCC) and divided it into either a training (n = 739) or an internal validation cohort (n = 326). Based on multivariate analysis, the training cohort data were analyzed and a nomogram was generated for MVI prediction. This was further verified using an internal validation cohort and an external validation cohort involving 293 Chinese patients. Furthermore, to evaluate the efficacy, accuracy, and clinical use of the nomogram, we used concordance index (C-index), calibration curve, and decision curve analysis (DCA) techniques.ResultsIn accordance with the multivariate analysis, tumor size, tumor number, alpha-fetoprotein (AFP), and histological grade were independently associated with MVI. The established model exhibited satisfactory performance in predicting MVI. The C-indices were 0.719, 0.704, and 0.718 in the training, internal validation, and external validation cohorts, respectively. The calibration curves showed an excellent consistency between the predictions and actual observations. Finally, DCA demonstrated that the newly developed nomogram had favorable clinical utility.ConclusionsWe established and verified a novel preoperative MVI prediction model in HCC patients. This model can be a beneficial tool for clinicians in selecting an optimal treatment plan for HCC patients.