bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy and safety of Yinchenwuling Powder for nonalcoholic fatty liver disease: A protocol for systematic review and meta-analysis of randomized controlled trials
Authors: Wu Peishan , Zhang Jiaqi , Xiao Jingjing , Huang Guangwen , Li Jiahui , Zhou Zheng 
Published: December 2022

Background:
Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease worldwide. Owing to the complexity of NAFLD pathogenesis, there is still no specific medication for NAFLD that is safe and effective. Yinchenwuling Powder (YCWLP), a classic Chinese formula, has been widely applied to NAFLD and its efficacy has been proven in numerous studies. However, systematic evaluation of the efficacy and safety of YCWLP for NAFLD is still lacking.

Methods:
We will search 8 databases to collect randomized controlled trials of patients with NAFLD treated in the YCWLP from the database inception to September 30, 2022. Two researchers will independently perform the selection of studies, data extraction, and assessment of the risk of bias. The Cochrane Review Manager (RevMan5.4) software will be used for data synthesis and analysis.

Results:
Comprehensive evidence of YCWLP for the treatment of NAFLD will be provided in this study.

Conclusion:
The efficacy and safety of YCWLP in treating NAFLD will be proved, providing feasible and effective clinical recommendations for the treatment of NAFLD.
Positive response of a recurrent clear cell sarcoma to anlotinib combined with chemotherapy: A case report
Authors: Tao Junyue , Yang Hao , Hao Zongyao , Liang Chaozhao , Du Yingying , Zhang Chao , Yin Yu , Zhou Jun 
Published: December 2022

Rationale:
Renal clear cell sarcoma is a rare and highly invasive malignant renal tumor that easily relapses after treatment. Recurrent recurrent clear cell carcinoma (CCSK) responds poorly to chemotherapy and has no established standardized treatment, and need to be explored potentially useful treatments.

Patient concerns:
A 18-years-old patient with renal clear cell sarcoma recurrence after open radical nephrectomy.

Diagnosis:
Recurrent clear cell sarcoma.

Interventions:
After chemotherapy alone failed, the patient received 6 courses of anlotinib combined with chemotherapy. The tumor had significantly reduced in size and the recurrent tumor and part of the liver were resected.

Outcomes:
No tumor recurrence or metastasis was detected during the follow-up 8 months after the operation.

Lessons:
This is the first report describing the use of anlotinib in treating CCSK. We believe that anlotinib combined with chemotherapy may be a useful treatment option for patients with recurrent CCSK.
Gastrointestinal bleeding caused by rupture of a posterior inferior pancreaticoduodenal artery pseudoaneurysm: A case report
Authors: Cui JinHua , Liu YaMan , Li Jian 
Published: December 2022

Background:
Gastrointestinal bleeding caused by a ruptured pancreatic pseudoaneurysm is rare, and a pseudoaneurysm of the posterior inferior pancreaticoduodenal artery is especially rare. A 68-year-old man was hospitalized after presenting intermittent black stools and dyspnea accompanied by severe anemia. Angiographic examination revealed that Pseudoaneurysm of the posterior inferior pancreaticoduodenal artery.

Methods:
Angiography was performed and revealed a pseudoaneurysm of the posterior inferior pancreaticoduodenal artery. Subsequently, a blood transfusion and endovascular embolization were performed.

Results:
The patient’s gastrointestinal bleeding stopped, and the hemoglobin level remained stable. During 1 year of follow-up, the patient remained in a generally good condition.

Conclusion:
posterior inferior pancreaticoduodenal artery pseudoaneurysmIt is rare and difficult to diagnose, gastrointestinal bleeding is a serious complication, vascular interventional embolization is effective.
Analysis of clinical characteristics of centrally mediated abdominal pain syndrome, exploration of diagnostic markers and its relationship with the efficacy of duloxetine treatment
Authors: Tang Yuming , Song Jiani , Zhu Ying , Chen Hefeng , Yao Weiyan , Zou Duowu 
Published: December 2022

Introduction:
Centrally mediated abdominal pain syndrome (CAPS) is characterized by severe abdominal pain. Diagnosis of CAPS is still an exclusionary diagnosis, there remain no effective diagnostic biomarkers so far. Duloxetine is the major pharmacotherapy of CAPS, while some CAPS patients do not respond to duloxetine treatment. However, there is a lack of molecular markers to predict the efficacy of duloxetine. In our pilot study, we have found differential expression profiles of serum miRNAs between CAPS patients and healthy controls. Our study aims to explore the clinical characteristics, specific miRNAs in serum as diagnostic biomarkers of CAPS and predictive biomarkers of the efficacy of duloxetine.

Methods/design:
In this prospective cohort study, we plan to enroll 430 participants including 215 CAPS patients and 215 healthy controls. The CAPS group takes duloxetine 30 mg per day as an initial dose. Patients will have 24-week medication period and follow up at week 0, 4, 12, 24 and 36. Blood samples will be obtained from patients at every visits and health controls at the initial visit and a series of questionnaires will be completed by the participants. The primary end points are: The differential expression of miRNAs between CAPS groups and healthy control groups at baseline. The changes in abdominal pain scores before and after duloxetine treatment in patients with CAPS and their relationship with the changes in miRNAs. The secondary end point is the changes in scores of depression, anxiety, sleep quality and quality of life before and after duloxetine treatment in patients with CAPS and their relationship with changes in miRNAs.

Discussion:
Findings of study will provide the reliable basis for diagnosis and the predictor of duloxetine efficacy of CAPS. Importantly, findings grant patients a chance to benefit from treatment.
Reactive perforating collagenosis and systemic lupus erythematosus: A rare case report
Authors: Alenzi Fahidah 
Published: December 2022

Background:
Transepidermal clearance of altered collagen and excessive excretion of keratin are characteristics of a rare cutaneous disorder known as reactive perforating collagenosis (RPC). There are different forms of RPC; however, the acquired form is the most prevalent and inherited. Reactive perforating collagenosis is rarely described in autoimmune rheumatic diseases; instead, it is typically linked to systemic conditions such as renal failure or hepatic disease.

Methods:
A 31-year-old Saudi female patient who was initially diagnosed with undifferentiated connective tissue disease. She developed RPC with a severe diffuse itchy skin rash with numerous papules and nodules with central hyperkeratotic plugs over the lower limb, upper limb, and face.

Results:
The patient tested positive for antinuclear antibody; however, a year later, patient developed Raynaud’s phenomenon, oral and nasal ulcers, malar rash, fatigue, and lupus rash around her eyes, and systemic lupus erythematosus was diagnosed clinically. The patient was treated for reactive perforating collagenosis with systemic antihistamines (diphenhydramine 50 mg orally twice daily), topical steroid cream (betamethasone dipropionate cream), and oral isotretinoin (20 mg daily). The patient was advised to undergo phototherapy. A year later, she presented with symptoms of systemic lupus erythematosus and started taking oral hydroxychloroquine 200 mg twice daily for systemic lupus erythematosus. The patient is listed on follow-up.

Conclusion:
Variable skin rash can mimic systemic lupus erythematosus and vasculitis. Therefore, reactive perforating collagenosis is a skin condition that requires high clinical suspension for diagnosis, and it might be challenging to determine whether it is an association or a complication. Furthermore, the timing of the skin biopsy may be crucial for the diagnosis of reactive perforating collagenosis.
Two possible etiologies of Guillain-Barré syndrome: mRNA-1273 (Moderna) vaccination and scrub typhus: A case report
Authors: Hwang Byoung Wook , Bong Jeong Bin 
Published: December 2022

Rationale:
Guillain-Barré syndrome (GBS) is an acute inflammatory polyneuropathy related to infection with bacteria or virus and vaccination. Cases of GBS after coronavirus infection-19 (COVID-19) vaccination have been reported. However, cases of GBS after inoculation with mRNA-based COVID-19 vaccines, especially mRNA-1273, have rarely been reported compared to after inoculation with adenovirus vector-based COVID-19 vaccines. On 1 hand, GBS occurring after scrub typhus is often reported, but the exact pathological mechanism has not been elucidated. We report the case of a patient with GBS after inoculation with mRNA-1273 COVID-19 vaccine and scrub typhus.

Patient concerns:
A 47-year-old man received COVID-19 vaccination 4 weeks before admission. He had a fever, rash and general weakness 1 day after vaccination. After 3 weeks, the muscle strength of the extremities deteriorated to the extent that walking was impossible.

Diagnosis, interventions, and outcomes:
The patient developed quadriplegia with areflexia, axonal-type sensorimotor polyneuropathy was confirmed by nerve conduction study. The patient was diagnosed as GBS. Scrub typhus was also diagnosed as eschar was observed in the chest area and the serologic test of anti-R-tsutsugamushi antibody showed a strongly positive result. The patient received treatment with intravenous immunoglobulin at 0.4 g/kg daily for 5 days. Mechanical ventilation was applied during the intensive care unit. He was treated for scrub typhus simultaneously. Six months after the onset of the disease, the patient showed improvement to the point where he could work and exercise alone.

Lessons:
When GBS is suspected, early evaluation and treatment can lead to favorable outcomes. Considering that cases of GBS after COVID-19 vaccination have been reported, it is important to conduct early evaluation and management of patients with muscle weakness after COVID-19 vaccination to ensure early detection of GBS. And even if fever and rash are side effects that can occur frequently after vaccination, it is necessary to consider other diseases in addition to the side effects of the vaccine. This is to prevent delay in diagnosis and treatment of other diseases.
Buccal carcinoma associated with adult congenital pulmonary hypoplasia: A case report and literature review
Authors: Qiu Miao , Lin De-Rong 
Published: December 2022

Rationale:
Congenital pulmonary hypoplasia is a relatively rare lung malformation. The disease is usually identified in the neonatal period or early childhood. Most affected patients die of respiratory insufficiency after birth. Mild congenital dysplasia is asymptomatic, while moderate congenital dysplasia manifests as respiratory distress or does not become evident until adulthood. Cases of congenital pulmonary hypoplasia in adults are rare, especially in combination with malignant tumors.

Patient concerns:
We report the case of a 64-year-old man with buccal carcinoma who was accidentally found to have hypoplasia of the left lung during treatment.

Diagnoses:
After chest computed tomography and chest radiograph, the diagnosis of adult congenital pulmonary hypoplasia was confirmed.

Interventions:
Since the patient had a history of bronchiectasis for more than 30 years and only had 1 healthy lung, the cardiopulmonary compensatory function was poor and the patient could not tolerate surgery, he was given radiotherapy and chemotherapy.

Outcomes:
Radiotherapy and chemotherapy were successfully completed, and within the patient’s tolerance, there was no serious adverse reaction of respiratory system.

Conclusion:
Congenital pulmonary hypoplasia’s diagnosis is challenging in adults because the condition can easily be mistaken for a more common disease. However, early diagnosis is very important to enable prompt therapy and ensure proper follow-up to detect and treat complications such as pulmonary infection and pulmonary hypertension in a timely manner.
Efficacy and safety of blood-activating herbs combined with edaravone in the treatment of acute ischemic stroke: A protocol for systematic review and meta-analysis
Authors: Su Zhuoyi , Zhang Shuai , Yu Ziqiao , Jin Hong , Sun Weichen , Yang Ziqi , Zhao Dexi 
Published: December 2022

Background:
Although the combination of blood-activating herbs and western drugs has shown advantages in the treatment of ischemic stroke, there is no consensus on the safety and efficacy. This study aimed to systematically evaluate the safety and efficacy of the combination of blood-activating herbs with edaravone (EDA) in the treatment of acute ischemic stroke (AIS).

Methods:
We will implement the search strategy in 8 English and Chinese databases: Cochrane Central Register of Controlled Trials, Web of Science, PubMed, China National Knowledge Infrastructure, China Science and Technology Journal Database, Wanfang Database, EMBASE and MEDLINE. The search included relevant clinical randomized controlled trials and quasi-randomized controlled trials that had been registered for publication by November 2022. Literature screening, data extraction and quality assessment will be performed by 2 authors. We will assess the risk of bias according to the Cochrane Handbook for Systematic Reviews of Interventions. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) method classification will be used to assess the quality of the literature. Meta-analysis was performed using RevMan V.5.4 and STATA 16 software.

Results:
This study will provide a comprehensive analysis of the current clinical evidence on the application of blood-activating herbs combined with EDA in the treatment of AIS.

Conclusion:
This study will clarify the safety and efficacy of the combination of blood-activating herbs with EDA in the treatment of AIS.
Efficacy and safety of icotinib in the treatment of advanced EGFR mutation-positive nonsmall cell lung cancer: A meta-analysis of randomized controlled trials
Authors: Li Dailong , Yao Ling , Xu Lu , Li Wanqiang , Che Yuan 
Published: December 2022

Background:
Icotinib is the first generation of epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) independently developed in China, which has been widely used in the treatment of advanced EGFR mutation-positive nonsmall cell lung cancer (NSCLC). The purpose of this study was to systematically evaluate the efficacy and safety of icotinib in the treatment of advanced EGFR mutation-positive NSCLC and to provide evidence-based evidence for clinical rational drug use.

Methods:
Up to September 30, 2022, the databases of PubMed, EMBASE, Cochrane Library, ClinicalTrials.gov, China National Knowledge Infrastructure, and Wanfang were searched, and the randomized controlled trials (RCTs) of icotinib (experimental group) versus gefitinib or erlotinib (control group) in the treatment of EGFR-positive advanced NSCLC were included. Two researchers independently screened the literature, extracted data, and evaluated the quality of the included literature. Revman5.4 software was used for meta-analysis.

Results:
A total of 957 patients were included in 12 studies. The results of meta-analysis showed that the objective response rate (ORR) and disease control rate (DCR) of the experimental group were better than those of the control group (relative risk (RR) = 1.29, 95% confidence interval (CI): 1.10–1.50, P = .001; RR = 1.10, 95%CI: 1.02–1.18, P = .01). There was no significant difference in progression-free survival (PFS) and overall survival between the 2 groups (P > .05). The results of stratified analysis showed that icotinib significantly improved the ORR of EGFR-positive advanced NSCLC patients compared with gefitinib (RR = 1.20, 95%CI: 1.01–1.43, P = .03), but had no significant improvement in DCR (RR = 1.08, 95%CI: 0.99–1.16, P = .07). Compared with erlotinib, icotinib significantly improved ORR and DCR (RR = 1.69, 95%CI: 1.17–2.45, P = .005; RR = 1.21, 95%CI: 1.01–1.44, P = .04). In terms of adverse events of drugs, the incidence of nausea and vomiting in the experimental group was significantly lower than that in the control group (P < .05).

Conclusion:
Icotinib is safer than gefitinib or erlotinib in the treatment of advanced EGFR-positive NSCLC and seems to bring more clinical benefits to patients. However, there is no obvious advantage in improving the survival rate of patients, and long-term follow-up clinical studies are needed to verify its efficacy.
Prolonged electrocardiography registration does not lead to increased diagnosis of atrial fibrillation in pulmonary embolism patients, but sex affects generic health-related quality of life: Findings from a randomized clinical trial
Authors: Westerlund Eli , Fili Awat , Svennberg Emma 
Published: December 2022

Background:
Pulmonary embolism (PE) is the third most common cause of cardiovascular death. Atrial fibrillation (AF) is the most common arrhythmia and is commonly detected in patients after embolic stroke. In this study, we set out to study if undiagnosed AF could be detected in patients with PE. In survivors of PE, persisting symptoms and exercise limitations are common. The disease burden of PE on quality of life (QoL) has received scarce attention. The primary aim was to study the prevalence of AF in patients with newly diagnosed PE. The secondary aim was to study QoL in PE patients.

Methods:
Patients with newly diagnosed acute PE were randomized 1:1 to long-term electrocardiogram (ECG) screening for AF (handheld ECG or ECG patch) or standard-of-care. The study participants were asked to complete RAND-36 questionnaires upon inclusion.

Results:
In total 89 PE patients (mean age 74.6 years) were included, and 40 out of these patients were randomized to AF screening. The study was terminated early due to futility when analysis 1 year after inclusion did not find any patients with newly detected AF.
RAND-36 showed that QoL was affected in PE patients. Interestingly, sex differences were found; women had a significantly lower QoL in the dimensions of vitality (P = .006), general health (P = .039), and mental health (P = .041).

Conclusion:
Screening for AF in PE patients did not yield a significant proportion of new cases. QoL is more affected in female patients with PE, and increased awareness of this is suggested.
How to improve the diagnosis of neoplastic transformation of gastric hyperplastic polyps in the context of autoimmune gastritis?: A case report and lierature review
Authors: Xing Yunqi , Han Haixiao , Wang Yuxuan , Sun Zhongmei , Wang Linheng , Peng Dan , Guo Xiaoyuan , Yao Na , Yuan Yali , Zhang Wenji , Mao Tangyou , Liu Yuyue 
Published: December 2022

Rationale:
Gastric hyperplastic polyp (GHP) commonly arises in the abnormal background mucosa, which makes it easy to be misdiagnosed and missed, and has a potential risk of malignant transformation over time. Here, we present a case of neoplastic transformation of GHP in a context of autoimmune gastritis (AIG).

Patient concerns:
In 2020, a 67-year-old woman was admitted for endoscopic review 6 years after gastric polyp resection, the histological diagnosis of gastric polyp was neoplastic transformation of GHP as before. The patient had undergone multiple polypectomies at the same part. Then histological examination revealed that partial epithelial hyperplasia and dysplasia, and the neoplastic areas were interlaced with normal mucosa.

Diagnoses and interventions:
We further found that the background diagnosis was AIG. These results supported the diagnosis of neoplastic transformation of GHP in a context of AIG. With the doubt of missed diagnose, we retrospectively analyzed the medical history in 2014, 2015 and 2016, confirmed the presence of AIG. Unfortunately, serological tests and special treatment were not performed.

Outcomes:
The correct diagnosis was eventually confirmed in 2020, which enables patients to receive normal treatment and monitoring, and avoids further deterioration of the disease.

Lessons:
The purpose of this case report is to increase clinical awareness of neoplastic transformation of GHP in a context of AIG, and hope promise for early diagnosis and treatment.
Targeting inflammation in hypertension
Authors: Deussen Andreas , Kopaliani Irakli 
Published: December 2022

Purpose of review
Hypertension remains a global health and socioeconomic burden. Immune mechanisms are now recognized as integral part of the multifactorial etiology of hypertension and related organ damage. The present review addresses inflammatory pathways and immune targets in hypertension, which may be important for an immunomodulatory treatment of hypertension aside from lowering arterial pressure.

Recent findings
Anti-inflammatory interventions targeting single interleukins or almost the entire immune system show different beneficial effects. While immunomodulation (targeting specific portion of immune system) shows beneficial outcomes in certain groups of hypertensives, this does not pertain to immunosuppression (targeting entire immune system). Immunomodulatory interventions improve outcomes of hypertension independent of arterial pressure. The studies reveal interleukins, such as interleukin (IL)-1β and IL-17 as targets of immunomodulation. Besides interleukins, targeting αvβ-3 integrin and matrix metalloproteinase-2 or using experimental cell-therapy demonstrate beneficial effects in hypertensive organ damage. The NLR family pyrin domain containing 3 (NLRP3) inflammasome/IL-1β/endothelial cell/T-cell axis seems to be an important mediator in sustained inflammation during hypertension.

Summary
Although immunomodulation may be advantageous as a causal therapy in hypertension, targeting immune networks rather than single interleukins appears of major importance. Further research is required to better identify these networks and their links to human hypertension.
The Experience of Uncertainty in Individuals With High Risk for Pancreatic Cancer
Authors: Underhill-Blazey Meghan L. , Zhang Yingzi , Stanek Susan , Norton Sally 
Published: December 2022

Background
Individuals with a strong family history of pancreatic cancer or a known hereditary cancer syndrome that is associated with pancreatic cancer are considered at high risk for developing pancreatic cancer. Living with a high risk for often fatal cancer is accompanied by high levels of uncertainty. Uncertainty is also independently associated with negative health outcomes. By understanding issues, sources, and responses to uncertainty, targeted supportive care strategies can be provided.

Objectives
This study aimed to examine how uncertainty manifests in the experience of being at high risk to develop pancreatic cancer and to describe issues, sources of, and responses to uncertainty.

Methods
In this secondary qualitative descriptive study, we analyzed 19 interviews with persons living with inherited pancreatic cancer risk. Analysis was guided by a conceptual framework of uncertainty and responses to uncertainty.

Results
Participants described multiple personal, practical, and scientific issues of uncertainty, centering on what to expect for their future health. Participants also expressed positive and negative cognitive, emotional, and behavioral responses to uncertainty, including engaging in surveillance. Uncertainty sources were both individual experiences as well as perceptions of healthcare provider uncertainty with managing pancreatic cancer risk.

Conclusion
Pancreatic cancer risk includes issues of uncertainty related to personal mortality, defining and managing risk, and experiencing surveillance. Positive and negative responses to this uncertainty could be targeted through interventions.

Implication for Practice
The oncology nurse should assess for sources of and responses to uncertainty in persons at risk for pancreatic cancer and offer psychosocial and educational support.