bluuebunny/crossref_metadata_2025_split huggingface dataset:
Detection of the Disorders of Glycerophospholipids and Amino Acids Metabolism in Lung Tissue From Male COPD Patients
Authors: Huang Qian , Wu Xiaojie , Gu Yiya , Wang Ting , Zhan Yuan , Chen Jinkun , Zeng Zhilin , Lv Yongman , Zhao Jianping , Xie Jungang 
Published: March 2022

Background: At present, few studies have reported the metabolic profiles of lung tissue in patients with COPD. Our study attempted to analyze the lung metabolome in male COPD patients and to screen the overlapping biomarkers of the lung and plasma metabolomes.Methods: We performed untargeted metabolomic analysis of normal lung tissue from two independent sets (the discovery set: 20 male COPD patients and 20 controls and the replication set: 47 male COPD patients and 27 controls) and of plasma samples from 80 male subjects containing 40 COPD patients and 40 controls.Results: We found glycerophospholipids (GPs) and Amino acids were the primary classes of differential metabolites between male COPD patients and controls. The disorders of GPs metabolism and the valine, leucine and isoleucine biosynthesis metabolism pathways were identified in lung discovery set and then also validated in the lung replication set. Combining lung tissue and plasma metabolome, Phytosphingosine and l-tryptophan were two overlapping metabolites biomarkers. Binary logistic regression suggested that phytosphingosine together with l-tryptophan was closely associated with male COPD and showed strong diagnostic power with an AUC of 0.911 (95% CI: 0.8460-0.9765).Conclusion: Our study revealed the metabolic perturbations of lung tissues from male COPD patients. The detected disorders of GPs and amino acids may provide an insight into the pathological mechanism of COPD. Phytosphingosine and l-tryptophan were two novel metabolic biomarkers for differentiating COPD patients and controls.
A Clinical Assessment of a Magnetic Resonance Computer-Aided Diagnosis System in the Detection of Pathological Complete Response After Neoadjuvant Chemotherapy in Breast Cancer
Authors: Peng Haiyong , Yan Shaolei , Chen Xiaodan , Hu Jiahang , Chen Kaige , Wang Ping , Zhang Hongxia , Zhang Xiushi , Meng Wei 
Published: March 2022

PurposeThis study aimed to assess the diagnostic performance and the added value to radiologists of different levels of a computer-aided diagnosis (CAD) system for the detection of pathological complete response (pCR) after neoadjuvant chemotherapy (NAC) in patients with breast cancer. Besides, to investigate whether tumor molecular typing is associated with the efficiency of diagnosis of the CAD systems.Methods470 patients were identified with breast cancers who underwent NAC and post MR imaging between January 2016 and March 2019. The diagnostic performance of radiologists of different levels and the CAD system were compared. The added value of the CAD system was assessed and subgroup analyses were performed according to the tumor molecular typing.ResultsAmong 470 patients, 123 (26%) underwent pCR. The CAD system showed a comparable specificity as the senior radiologist (83.29% vs. 84.15%, p=0.488) and comparable area under the curve (AUC) (0.839 vs. 0.835, p =0.452). The performance of all radiologists significantly improved when aided by the CAD system (P&lt;0.05), And there were no statistical differences in terms of sensitivity, specificity and accuracy between the two groups with CAD assistance(p&gt;0.05).The AUC values for identifying pCR in TN patients were significant (0.883, 95%CI: 0.801-0.964, p &lt; 0.001).ConclusionThe CAD system assessed in this study improves the performance of all radiologists, regardless of experience. The molecular typing of breast cancer is potential influencer of CAD diagnostic performance.
Lenvatinib Beyond First-Line Therapy in Patients With Advanced Biliary Tract Carcinoma
Authors: Wang Yunchao , Yang Xiaobo , Wang Dongxu , Yang Xu , Wang Yanyu , Long Junyu , Zhou Jinxue , Lu Zhenhui , Mao Yilei , Sang Xinting , Guan Mei , Zhao Haitao 
Published: March 2022

IntroductionLenvatinib, a multiple receptor tyrosine kinase inhibitors that target vascular endothelial growth factor receptors and fibroblast growth factor receptors, recently demonstrated a treatment effect in various tumors. This study evaluated the efficacy and safety of lenvatinib for patients with biliary tract cancers (BTCs) who had received ≥1 line of prior systemic anti-BTC therapy.MethodsThis open-label, single-arm study included adult (≥18 years) patients with histologically confirmed BTC. Efficacy and safety were evaluated based on the Response Evaluation Criteria in Solid Tumors RECIST Version 1.1 (RECIST 1.1) and the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE version 4.0). Changes in tumor biomarkers throughout the treatment period were recorded.Results41 patients received lenvatinib treatment. The ORR was 12% (95% CI: 1.7–22.7), with a median PFS of 3.8 months (95% CI: 1.3–6.3) and an OS of 11.4 months (95% CI: 6.6–16.2). Thirty-nine (95.1%) patients experienced ≥1 treatment-related adverse event. Decreasing carbohydrate antigen 19-9 (CA19-9) level predicted tumor size reduction in intrahepatic cholangiocarcinoma with a sensitivity of 77.7% and a specificity of 73.9%.ConclusionsLenvatinib which was individualized based on the patient’s weight has promising clinical activity against advanced BTC and had an acceptable safety profile. Additionally, serum biomarkers and gene sequencing may hold the potential to guide our treatment.
The Value of Intravoxel Incoherent Motion Diffusion-Weighted Magnetic Resonance Imaging Combined With Texture Analysis of Evaluating the Extramural Vascular Invasion in Rectal Adenocarcinoma
Authors: Gao Fei , Shi Bin , Wang Peipei , Wang Chuanbin , Fang Xin , Dong Jiangning , Lin Tingting 
Published: March 2022

PurposeThis study aims to evaluate the value of 3.0T MRI Intravoxel Incoherent motion diffusion-weighted magnetic resonance imaging (IVIM-DWI) combined with texture analysis (TA) for evaluating extramural vascular invasion (EMVI) of rectal adenocarcinoma.MethodsNinety-six patients with pathologically confirmed rectal adenocarcinoma after surgical resections were collected. Patients were divided into the EMVI positive group (n=39) and the EMVI negative group (n=57). We measured the IVIM-DWI parameters and TA parameters of rectal adenocarcinoma. We compare the differences of the above parameters between the two groups and establish a prediction model through multivariate logistic regression analysis. the ROC curve was performed for parameters with each individual and in combination.ResultsADC, D, D* value between the two groups were statistically significant (P= 0.015,0.031,0). Six groups of texture parameters were statistically significant between the two groups (P=0.007,0.037,0.011,0.005,0.007,0.002). Logistic regression prediction model shows that GLCM entropy_ALL DIRECTION_offset7_SD and D* are important independent predictors, and the AUC of the regression prediction model was 0.821, the sensitivity was 92.98%, the specificity was 61.54%, and the Yoden index was 0.5452. The AUC was significantly higher than that of other single parameters.Conclusion3.0T MRI IVIM-DWI parameters combined with texture analysis can provide valuable information for EMVI evaluation of rectal adenocarcinoma before the operation.
Risk Factors for Survival in Patients With Medulloblastoma: A Systematic Review and Meta-Analysis
Authors: Liu Yu , Xiao Bo , Li Sen , Liu Jiangang 
Published: March 2022

BackgroundConventional parameters show limited and unreliable correlations with medulloblastoma prognosis.AimTo evaluate the factors influencing overall survival (OS), event-free survival (EFS), and progression-free survival (PFS) in patients with medulloblastoma.MethodsPubMed, EMBASE, the Cochrane Library, and Web of Science were searched for studies published up to May 2021. The associations between various clinical and treatment factors and survival parameters were assessed.ResultsTwenty-nine studies (8455 patients) were included. Desmoplastic medulloblastoma (HR=0.41, 95%CI: 0.31-0.56), M0 disease (HR=2.07, 95%CI: 1.48-2.89), WNT, SSH, group 4 (all P&lt;0.05 vs. group 3), GTR vs. STR (HR=1.37, 95%CI: 1.04-1.08), radiotherapy (HR=0.45, 95%CI: 0.20-0.80), craniospinal irradiation (HR=0.49, 95%CI: 0.38-0.64), and high 5hmC levels (HR=2.90, 95%CI: 1.85-4.55) were associated with a better OS. WNT, SSH, group 4 (all P&lt;0.05 vs. group 3), residual tumor ≤1.5 cm2 (HR=2.08, 95%CI: 1.18-3.68), GTR vs. STR (HR=1.31, 95%CI: 1.03-1.68), craniospinal irradiation (HR=0.46, 95%CI: 0.37-0.57), high 5hmC levels (HR=3.10, 95%CI: 2.01-4.76), and &lt;49 days between resection and radiotherapy (HR=2.54, 95%CI: 1.48-4.37) were associated with better PFS. Classic vs. desmoplastic medulloblastoma (HR=1.81, 95%CI: 1.04-3.16), SSH, WNT (both P&lt;0.05 vs, non-SSH/non-WNT), GTR vs. STR (HR=2.01, 95%CI: 1.42-2.85), and radiotherapy (HR=0.31, 95%CI: 0.15-0.64) were associated with a better EFS.ConclusionHistology, molecular subgroup, GTR, and radiotherapy are significantly associated with survival parameters in patients with medulloblastoma. Nevertheless, high-quality prospective cohort studies are necessary to improve the conclusions.
α-Hederin Inhibits the Proliferation of Hepatocellular Carcinoma Cells via Hippo-Yes-Associated Protein Signaling Pathway
Authors: Chen Tongqing , Sun Dongdong , Wang Qijuan , Zhou Tingting , Tan Jiani , Xu Changliang , Cheng Haibo , Shen Weixing 
Published: March 2022

AimsYes-associated protein (YAP), a downstream protein in the Hippo signaling pathway, plays an important role in tumor proliferation, including in hepatocellular carcinoma (HCC). α-hederin, a monodesmosidic triterpenoid saponin isolated from Fructus akebiae, displayed anti-cancer effects on several cancer cell lines but the precise mechanism has not been ascertained. In the present study, we explored the effects of α-hederin on cell proliferation and apoptosis in human HCC cell lines and the underlying mechanisms.Main MethodCell proliferation and apoptosis were assessed using 5-ethynyl-2’-deoxyuridine staining, colony formation, flow cytometry. The expression patterns of components of Hippo signaling pathway and apoptotic genes were further examined via RT-qPCR and immunoblotting. A xenograft tumor model in nude mice was used to evaluate the anti-HCC effects of α-hederin in vivo.Resultsα-hederin promoted the apoptosis and inhibited the proliferation of SMMC-7721 and HepG2 cells in vitro, and remarkably inhibited the tumor size and weight in the xenograft mouse model. Additionally, α-hederin increased the expression of pro-apoptosis proteins and suppressed the expression of anti-apoptosis proteins. Moreover, α-hederin treatment upregulated the expression of Hippo signaling pathway-related proteins and genes, while, effectively reduced the level of nuclear YAP, which resulted in the inhibition of proliferation and the induction of apoptosis of HCC cells. Finally, the effects of α-hederin on HCC cell proliferation and apoptosis were alleviated by XMU-MP-1, a Mst1/2 inhibitor in vitro.SignificanceWe identified α-hederin is a novel agonist of Hippo signaling pathway and possesses an anti-HCC efficacy through inhibiting YAP activity.
Bacillus Calmette–Guérin Treatment Changes the Tumor Microenvironment of Non-Muscle-Invasive Bladder Cancer
Authors: Su Fei , Liu Ming , Zhang Wei , Tang Min , Zhang Jinsong , Li Hexin , Zou Lihui , Zhang Rui , Liu Yudong , Li Lin , Ma Jie , Zhang Yaqun , Chen Meng , Xiao Fei 
Published: March 2022

BackgroundBacillus Calmette–Guérin (BCG) is currently the most effective intravesical therapy for non-muscle-invasive bladder cancer (NMIBC) as it can prevent disease recurrence and progression and lower mortality. However, the response rates to BCG vary widely and are dependent on a multitude of factors.MethodsWe performed a systematic discovery by analyzing the whole exome sequence, expression profile, and immune repertoire sequence of treatment-naive and 5-year time-serial relapsed tumors from 24 NMIBC patients.ResultsBCG therapy showed bidirectional effects on tumor evolution and immune checkpoint landscape, along with a significant reduction of the percentage of neoantigen burden. In addition, a remarkable proportion of subclonal mutations were unique to the matched pre- or post-treatment tumors, suggesting the presence of BCG-induced and/or spatial heterogeneity. In the relapsed tumors, we identified and validated a shift in the mutational signatures in which mutations associated with aristolochic acid (AA) exposure were enriched, implying AA may be associated with tumor recurrence. Enhanced expressions of immune checkpoint regulation genes were found in the relapsed tumors, suggesting that the combination of immune checkpoint with BCG treatment may be an effective strategy to treat NMIBC. TCR sequencing revealed treatment-associated changes in the T-cell repertoire in the primary and relapsed tumors.ConclusionOur results provide insight into the genomic and immune dynamics of tumor evolution with BCG treatment, suggest new mechanisms of BCG resistance, and inform the development of clinically relevant biomarkers and trials of potential immune checkpoint inhibitor combination therapies.
Classification of Gliomas and Germinomas of the Basal Ganglia by Transfer Learning
Authors: Ye Ningrong , Yang Qi , Chen Ziyan , Teng Chubei , Liu Peikun , Liu Xi , Xiong Yi , Lin Xuelei , Li Shouwei , Li Xuejun 
Published: March 2022

BackgroundGerm cell tumors (GCTs) are neoplasms derived from reproductive cells, mostly occurring in children and adolescents at 10 to 19 years of age. Intracranial GCTs are classified histologically into germinomas and non-germinomatous germ cell tumors. Germinomas of the basal ganglia are difficult to distinguish based on symptoms or routine MRI images from gliomas, even for experienced neurosurgeons or radiologists. Meanwhile, intracranial germinoma has a lower incidence rate than glioma in children and adults. Therefore, we established a model based on pre-trained ResNet18 with transfer learning to better identify germinomas of the basal ganglia.MethodsThis retrospective study enrolled 73 patients diagnosed with germinoma or glioma of the basal ganglia. Brain lesions were manually segmented based on both T1C and T2 FLAIR sequences. The T1C sequence was used to build the tumor classification model. A 2D convolutional architecture and transfer learning were implemented. ResNet18 from ImageNet was retrained on the MRI images of our cohort. Class activation mapping was applied for the model visualization.ResultsThe model was trained using five-fold cross-validation, achieving a mean AUC of 0.88. By analyzing the class activation map, we found that the model’s attention was focused on the peri-tumoral edema region of gliomas and tumor bulk for germinomas, indicating that differences in these regions may help discriminate these tumors.ConclusionsThis study showed that the T1C-based transfer learning model could accurately distinguish germinomas from gliomas of the basal ganglia preoperatively.
Effectiveness of Impregnated Central Venous Catheters on Catheter-Related Bloodstream Infection in Pediatrics
Authors: Deng Zhengrong , Qin Jiangwei , Sun Huanbin , Xv Furong , Ma Yimei 
Published: March 2022

BackgroundThe efficacy and safety of impregnated central venous catheters (CVCs) in pediatrics remain controversial. The purpose of this study was to evaluate the efficacy of impregnations for the prevention of catheter-related bloodstream infection (CRBSI).MethodsWe searched the following five electronic databases: Medline, PubMed, Cochrane, Embase, and the Web of Science for randomized controlled trials (RCTs) up to March 2021. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using a fixed-effects model. Assessment of publication biases was evaluated by Egger's test. Heterogeneity between studies was assessed based on the chi-square test and I2 statistics, and sensitivity analysis and subgroup analysis were also performed.ResultsA total of six RCTs with 3,091 patients were included. Impregnated CVCs provided significant benefits in reducing the risk of CRBSI (RR = 0.41, 95% CI: 0.26–0.66) in pediatric patients, especially in the pediatric group. No publication bias was observed in the Egger test for the risk of CRBSI. Drug type is a source of heterogeneity.ConclusionAntimicrobial-impregnated CVCs are beneficial to prevent CVC-related complications in pediatrics.
Use of Urethral Sound to Facilitate Locating Retrovesical Ureter for Politano-Leadbetter Pneumovesicoscopic Ureteral Reimplantation
Authors: Zhao Xiang , Tian Qingqing , Fang Erhu , Li Ning 
Published: March 2022

BackgroundPneumovesicoscopic ureteral reimplantation (PVUR) has gained popularity due to its minimal invasiveness. However, most of the reported PVUR procedures were based on the Cohen technique. Only few studies reported their experience of PVUR using the Politano-Leadbetter technique (PVUR-PL). Here, we reported our experience of PVUR-PL using a novel technique to facilitate locating the retrovesical ureter during the procedure.Materials and MethodsThe medical records of the patients who underwent PVUR-PL between January 2018 and December 2020 in our institution were retrospectively reviewed. The patients were classified into two groups: the modified group that accepted PVUR-PL using our novel technique (using urethral sound to facilitate identifying the retrovesical ureter) and the traditional group that accepted PVUR-PL not using the novel technique. Clinical data were collected retrospectively.ResultsThere were 22 patients who underwent PVUR-PL, with 13 in the traditional group and nine in the modified group. The mean operating time for unilateral cases in the modified group was significantly shorter than that in the traditional group (154.5 vs. 195.5 min, p &lt; 0.001). For bilateral cases, the mean operating time was also significantly reduced (from 263.0 to 221.3 min, p = 0.022) in the modified group. There were no severe complications in each of the two groups. The peritoneum was perforated in one case from the traditional group, while no peritoneum perforation occurred in the modified group.ConclusionThe use of urethral sound to help to identify the retrovesical ureter during PVUR-PL is a safe and effective technique. This simple but effective technique could shorten the operating time of PVUR-PL and reduce the risk of peritoneum perforation.
Case Report: Structural Changes in the Coronary Vessel Wall in a Patient With Incomplete Kawasaki Disease
Authors: Ishikawa Takamichi , Uchiyama Hiroki , Mogi Satoshi , Ohtani Hayato 
Published: March 2022

BackgroundKawasaki disease (KD) is an acute systemic vasculitis of infants and young children that affects medium-sized vessels. Conventional cardiac imaging techniques, such as cardiac catheterization, are useful for characterizing the coronary arterial lesion (CAL) size and luminal diameter of the diseased coronary artery segment in patients with KD, but there are limitations to the visualization of the detailed vascular anatomy. Optical coherence tomography (OCT) is a high-resolution intracoronary arterial imaging modality that can distinguish the three layers of the coronary arterial wall. Several studies have reported coronary artery wall abnormalities in KD patients with coronary arterial aneurysm or regressed aneurysm. However, there have been no reports on changes in the coronary artery wall in cases of incomplete KD without CAL.Case PresentationWe herein report an 11-year-old girl with a history of incomplete KD without coronary arterial aneurysms. She had been diagnosed with perimembranous ventricular septal defect (VSD) after birth and had experienced incomplete KD at 1 year old. During her hospitalization for KD, she did not receive intravenous immunoglobulin (IVIG), because she did not meet the Harada score or criteria for treatment in patients with incomplete KD established by the American Heart Association. No dilatation or coronary artery aneurysm were observed on transthoracic echocardiography in the acute or follow-up period. At 11 years old, she received cardiac catheterization and coronary angiography (CAG) for the evaluation of a VSD and follow-up of KD. CAG demonstrated no aneurysm, dilatation, or significant stenosis of the coronary arteries. We performed an OCT study, which revealed the presence of intimal thickening, disruption of the media, and neovascularization in the left anterior descending artery.ConclusionOCT demonstrates the structural changes of CA even in the patient with incomplete KD who have not been treated with IVIG.
One-Bed-One-Team—Does an Integrated General Hospital Inpatient Model Improve Care Outcomes and Productivity: An Observational Study
Authors: Lai Yi Feng , Lee Shi Qi , Tan Yi-Roe , Lau Zheng Yi , Phua Jason , Khoo See Meng , Gollamudi Satya Pavan Kumar , Lim Cher Wee , Lim Yee Wei 
Published: March 2022

IntroductionWith the increasing complexity of healthcare problems worldwide, the demand for better-coordinated care delivery is on the rise. However, current hospital-based practices remain largely disease-centric and specialist-driven, resulting in fragmented care. This study aimed to evaluate the effectiveness and feasibility of an integrated general hospital (IGH) inpatient care model.MethodsRetrospective analysis of medical records between June 2018 and August 2019 compared patients admitted under the IGH model and patients receiving usual care in public hospitals. The IGH model managed patients from one location with a multidisciplinary team, performing needs-based care transition utilizing acuity tagging to match the intensity of care to illness acuity.Results5,000 episodes of IGH care entered analysis. In the absence of care transition in intervention and control, IGH average length of stay (ALOS) was 0.7 days shorter than control. In the group with care transition in intervention but not in control, IGH acute ALOS was 2 days shorter, whereas subacute ALOS was 4.8 days longer. In the presence of care transition in intervention and control, IGH acute ALOS was 6.4 and 10.2 days shorter and subacute ALOS was 15.8 and 26.9 days shorter compared with patients under usual care at acute hospitals with and without co-located community hospitals, respectively. The 30- and 60-days readmission rates of IGH patients were marginally higher than usual care, though not clinically significant.DiscussionsThe IGH care model maybe associated with shorter ALOS of inpatients and optimize resource allocation and service utilization. Patients with dynamic acuity transition benefited from a seamless care transition process.