bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acupuncture treatment of hypertension with insomnia
Authors: Zhu Xun , Yan Luda , Dou Xuejiao , Zheng Yanping , He Guanglin , Liao Meiyan , Fu Wenbin 
Published: January 2022

Abstract

Introduction:
Hypertension patients often suffered from insomnia problems which lowered the quality of life. Studies have shown that acupuncture is effective to treat perimenopausal and cancer-related insomnia. However, there is a lack of randomized controlled trials to support the effectiveness of acupuncture on insomnia of hypertension patients.

Methods and analysis:
This study is a randomized, double-blind (patients and evaluators), and placebo-controlled clinical trial to investigate the effect of acupuncture in hypertension patients’ insomnia management. We will recruit 158 hypertension patients suffering from insomnia in Bao’an People's Hospital, Shenzhen and randomly assign them into treatment group (antihypertensive drugs + acupuncture) and control group (antihypertensive drugs + sham acupuncture) in a 1:1 ratio. The patients will receive acupuncture 3 times a week for 12 weeks, and then a 6-months follow-up will be conducted after the treatment. The primary outcome is the Pittsburgh Sleep Quality Index. The secondary outcomes include sleep parameters, blood pressure dropping, sleeping pill dosage, Rating Depression Scale score, and Self-Rating Anxiety Scale score. The primary outcome will be evaluated at baseline, 4, 8, and 12 weeks, and 1, 3, and 6 months following the end of treatment. The secondary outcomes will be assessed at baseline and 12 weeks of the treatment period.
Clinicopathological characteristics and treatment of patients with high-grade endometrial stromal sarcoma
Authors: Bai Huimin , Yuan Fang , Liang Bing , Sun Hengzi , Gao Yutao , Jin Mulan , Xing Xiaoming 
Published: January 2022

Abstract
To investigate the clinicopathological characteristics of patients with high-grade endometrial stromal sarcoma (HG-ESS).
The clinicopathological characteristics, treatments, and prognostic information of consecutive HG-ESS patients were collected from medical records and then evaluated.
A total of 40 women were included in the analysis. The immunohistochemical profiles indicated that HG-ESS tumors tend to be locally or weakly positive for vimentin (100%) and CD10 (72.0%) but mostly negative for desmin (7.7%) and AE1/AE3 (9.1%). The progression-free survival intervals and the clinical benefit rates of patients receiving radiotherapy and/or chemotherapy were slightly longer and higher than those receiving simple observation (progression-free survival: 6 and 5 months vs 2 months; clinical benefit rate: 83.3% and 75.0% vs 28.6%). The 1-year disease-specific survival (DSS) rate was 62.7%. Tumor size, myometrial invasion, lymphovascular space invasion, cervical involvement, Federation International of Gynecology and Obstetrics (FIGO) stage, and residual disease all significantly affected the DSS rate (P < .001, =.002, <.001, =.004, <.001, and <.001, respectively). For patients with stage I disease, the 1-year DSS rate was as high as 91.7%, in contrast to 66.7%, 26.7%, and 0% for those with stage II, III, and IV disease, respectively.
HG-ESS is associated with an adverse prognosis. FIGO stage could effectively predict the prognosis of patients with this lethal disease. Immunohistochemical markers, vimentin+/CD10+ (local or very weak), in combination with desmin-/AE1/AE3-, may be helpful for improving the diagnostic accuracy of this lethal condition. The therapeutic roles of adjuvant chemotherapy and radiotherapy warrant further investigation.
Programmed death 1 monoclonal antibody helped to treat mixed chimeric and reactivation of Epstein-Barr virus in a patient with adult-onset chronic active Epstein-Barr virus infection after allogeneic hematopoietic stem cell transplantation
Authors: You Yahong , Wang Jingshi , Wang Zhao 
Published: January 2022

Abstract

Rationale:
Systemic forms of chronic active Epstein-Barr virus infection (CAEBV) can predispose a patient to a protracted course of fulminant hemophagocytic lymphohistiocytosis, which has a poor prognosis. Epstein-Barr virus (EBV) infection may persist even after theoretically curative hematopoietic stem cell transplantation.

Patient concerns:
A female patient with CAEBV underwent chemotherapy followed by allogeneic hematopoietic stem cell transplantation from her human leukocyte antigen-matched sister. Neutrophil and platelet engraftment was observed on day +12 and +10. Full donor chimerism (DC) was achieved on Day +21.

Diagnoses:
From day +38, EBV-DNA in the blood was persistently positive, and DC declined. We attempted empirical interventions such as withdrawal of immune suppression, multiple donor lymphocyte infusion, stem cell boost, and interferon-α treatment. However, EBV-DNA copies continued to increase aggressively, whereas DC decreased rapidly and then reached a nadir of 63.27%.

Interventions:
Salvage programmed death 1 (PD-1) antibody treatment was administered as salvage therapy at +69 and +84.

Outcomes:
EBV-DNA was negative on day +97 and was ultimately undetectable. Equivalently, a full and stable DC was obtained at +97.

Lessons:
We summarize a case of PD-1 antibody used as salvage treatment in a post-transplant patient with CAEBV, which was eradicated and full DC was obtained. This case suggests that the PD-1 antibody appears to be a promising option for fighting EBV and mixed DCs.
Biliary atresia combined Wilson disease identified by whole exome sequencing in Vietnamese patient with severe liver failure
Authors: Hoa Nguyen Pham Anh , Lien Nguyen Thi Kim , Tung Nguyen Van , Lan Nguyen Ngoc , Mai Nguyen Thi Phuong , Huong Nguyen Thi Mai , Thach Hoang Ngoc , Hoang Nguyen Huy 
Published: January 2022

Abstract

Rationale:
Hepatobiliary diseases such as biliary atresia (BA), Wilson disease, and progressive familial intrahepatic cholestasis are common causes of morbidity and mortality in young children. Affected patients progress rapidly to end-stage cirrhosis and require liver transplantation or die. Mutations in many genes have been identified to play an important role in the pathogenesis of hepatobiliary diseases.

Patient concerns and diagnosis:
In this study, we identified mutations in an 8-year-old girl who had severe liver failure. The patient was first diagnosed with BA at 2.5 months of age and has undergone Kasai surgery to connect the umbilical cord and jejunum. After that, the patient suddenly had unusual developments with symptoms of jaundice, acute liver failure with hemolysis. She was tested and diagnosed with Wilson disease.

Interventions and outcomes:
She was treated according to the regimen for a patient with Wilson disease but had abnormal progress leading to severe liver failure. Genetic analysis was performed by whole exome sequencing and Sanger sequencing methods. The genetic analysis revealed that the patient had a homozygous mutation (p.Gly17Glyfs77∗) in the KRT18 gene, a double heterozygous mutation (p.Ser105∗ and p.Pro992Leu) in the ATP7B gene, and a homozygous variant (p.Val444Ala) in the ABCB11 gene. In silico prediction of mutations indicated that these mutations are the cause of the severe liver failure in the patient.

Lesson:
This is a rare clinical case of a BA patient combined with Wilson disease. Our results suggested that whole exome sequencing is an effective diagnostic tool and emphasizes the importance of early diagnosis and appropriate management to save lives and prevent serious complications in the patient.
Endovascular repair of an ilio-iliac arteriovenous fistula following rupture of common iliac artery aneurysm with an aortic extension cuff in common iliac vein
Authors: Yoo Young Sun 
Published: January 2022

Abstract

Rationale:
Common iliac artery aneurysm (CIAA) is complicated by ilio-iliac arteriovenous fistulas (IIAVF), which is rare but fatal and require prompt diagnosis and appropriate treatment. As open repair is associated with high morbidity and mortality, endovascular therapy is considered appropriate for treating an IIAVF.

Patient concerns:
A 76-year-old male patient who developed an IIAVF as a complication of ruptured CIAA, requiring immediate surgical repair presented to the hospital with hemodynamic instability.

Diagnosis:
Computed tomography angiography and conventional angiography revealed an IIAVF.

Intervention:
Endovascular therapy was selected to reduce the risk of morbidity and mortality. As the angiogram after the first endovascular aneurysm repair with stent-grafting showed contrast medium filling in the aneurysm sac, right common iliac vein, and the inferior vena cava, an aortic extension cuff was inserted into the right common iliac vein to close the orifice on the venous side.

Outcomes:
The right lower leg edema and discomfort were resolved immediately after the procedure, with the vital signs remaining stable. Computed tomography performed 6 months postoperatively showed patent stent-grafts of the artery and vein, with no evidence of IIAVF and endoleak.

Lessons:
IIAVF following CIAA rupture can be repaired successfully by stenting of the common iliac vein with an aortic extension cuff. For successful endovascular repair, the vein side of the fistula tract should be excluded with a stent-graft to block the backflow into the aneurysm sac.
Gastric neuroendocrine neoplasms and precursor lesions
Authors: Boeriu Alina , Dobru Daniela , Fofiu Crina , Brusnic Olga , Onişor Danusia , Mocan Simona 
Published: January 2022

Abstract

Rationale:
Gastric neuroendocrine neoplasms (g-NENs) represent a distinctive group of gastric tumors, stratified into different prognostic categories according to different histological characteristics, put forth in the 2018 World Health Organization classification system. The clinical presentations, as well as pathological features, represent important data in establishing the type of the tumor, in estimating the tumor behavior, and in selecting the best therapeutic strategy. In our case series we presented different clinical scenarios that may be encountered in practice regarding gastric NENs. We performed a literature review and discussed diagnostic strategy, current classification system, precursor lesions, and therapeutic options in g-NENs.

Patient concerns:
The first patient was a 41-year-old female with weight loss, persistent dyspeptic complaints and a history of pernicious anemia. In the second clinical case a 61-year-old man was admitted with heartburn, abdominal pain, diarrhea and mild iron deficiency anemia. The third patient was a 56-year-old male with a history of neoplasia, admitted for weight loss, dyspeptic complaints, and liver metastases.

Diagnosis:
All the 3 patients underwent upper endoscopy with targeted biopsies. Histopathological and laboratory evaluation, together with imagistic evaluation (abdominal ultrasound, endoscopic ultrasound, and magnetic resonance imaging) allowed the distinction between 3 different types of gastric tumors: type 1 enterochromaffin-like-cell G1 NET, type 2 enterochromaffin-like-cell G2 NET, and type 3 G2 NET with liver metastases.

Interventions:
Endoscopic polypectomy of the largest lesion was performed in patient with type 1 g-NET and autoimmune chronic atrophic gastritis, followed by regular endoscopic surveillance with biopsies. In type 2 g-NET associated with pancreatic gastrinoma, pancreaticoduodenectomy with total gastrectomy were performed. In type 3 g-NET, detected in metastatic stage, oncologic therapy was performed.

Outcomes:
The patients follow-up was selected according to tumor behavior, from regular endoscopic surveillance to oncology follow-up. The prognosis was good in case 1, whilst poorer outcomes were associated with more aggressive tumors in case 2 and case 3.

Lessons:
g-NENs are rare tumors with distinct clinical and histological features. Our case series emphasized the role of close collaboration between clinician and pathologist, as well as the importance of a detailed pathology report.
Effect of different intensity exercises intervention on cardiovascular functions and quality of life on patients with chronic heart failure
Authors: Bai Yan , Hua Bin , Zhang Fan , Zhou Wenqin , Deng Bing 
Published: January 2022

Abstract

Background:
Exercise training can improve exercise capacity, quality of life, and reduce hospitalization time in chronic heart failure (CHF) patients. Various training protocols have been studied in CHF, but there is no consensus on the optimal exercise intensity for the rehabilitation of cardiac patients. Therefore, systematic evaluation of the effects of different exercise intensities on the efficacy of cardiac function and quality of life in patients with CHF was done.

Methods:
Computer searches of PubMed, Web of Science, The Cochrane Library, Embase, SinoMed, the China National Knowledge Infrastructure, Wanfang, and VIP databases were conducted to collect randomized controlled trials of different exercise intensities applied to patients with CHF. Study selection and data extraction will be performed simultaneously by two independent reviewers, using the PEDro scale for quality assessment of the included literature. Publication bias will be assessed by funnel plot, and Begg and Egger tests. The I
2 statistic and the chi-square (χ
2) test will be used to assess heterogeneity. In addition, subgroup analyses will be performed for different left ventricular ejection fraction populations and different intervention cycles. All meta-analyses will be performed using Revman5.3 software.

Results:
The present study is a systematic review and meta-analysis program with no results. Data analysis will be completed after the program has been completed.

Conclusion:
This meta-analysis may provide more reliable, evidence-based evidence for the choice of exercise intensity in patients with CHF.

Registration number:
CRD42021276529
Accuracy of ultrasound in distinguishing pathology of malignant thyroid diseases
Authors: Qin Ling , Liu Qiyu , Sun Lipeng , Wang Hui 
Published: January 2022

Abstract

Background:
In recent years, the incidence rate of thyroid cancer is increasing. Meanwhile, with the development of medical technology, the detection rate of thyroid cancer by ultrasound has been greatly improved. Normally doctors can initially distinguish pathology of malignant thyroid diseases by their abundant experience. And it will bring assistance to follow-up treatment. However, the results of these studies have been contradictory. Therefore, this meta-analysis tested the hypothesis that ultrasound is accurate in distinguishing pathology of malignant thyroid diseases.

Methods:
We will search PubMed, Web of Science, Cochrane Library, and Chinese biomedical databases from their inceptions to the December 14, 2021, without language restrictions. Two authors will independently carry out searching literature records, scanning titles and abstracts, full texts, collecting data, and assessing risk of bias. Review Manager 5.2 and Stata14.0 software will be used for data analysis.

Results:
This systematic review will determine the accuracy of ultrasound in distinguishing pathology of malignant thyroid diseases.

Conclusion:
It is findings will provide helpful evidence for the accuracy of ultrasound in distinguishing pathology of malignant thyroid diseases.

Systematic review registration:
INPLASY2021120072.
Initial experience with intensity distribution analysis of hemodynamic parameters in the thoracic aorta using four-dimensional magnetic resonance imaging
Authors: Nishimura Takamasa , Sueyoshi Eijun , Koike Hirofumi , Uetani Masataka 
Published: January 2022

Abstract
The purpose of this study was to investigate whether there were significant differences in the intensity distributions of thoracic aorta hemodynamic parameters between groups with different ejection fractions (EF) using four-dimensional flow magnetic resonance imaging and to investigate the relationships between each parameter.
A total of 26 patients, 13 each with EF of >60% and <30%, underwent cardiac four-dimensional flow magnetic resonance imaging (EF >60%: mean age: 54 ± 11.6 years, EF <30%: mean age: 49.2 ± 17.2 years). The thoracic aorta was divided into the proximal and distal ascending aorta (AAo), aortic arch, and the proximal and distal descending aorta, and each section was further divided into the anterior wall, posterior wall, lesser curvature, and greater curvature. The intensity distributions of wall shear stress (WSS), energy loss (EL), and vorticity (Vort) (hemodynamic parameters) and the concordance rates between these distributions were analyzed.
The concordance rate between the intensity distributions of EL and Vort was high. Only the intensity distributions of EL and Vort in the distal AAo differed significantly between the groups (P < .001). In the EF >60% group, these intensity distributions showed higher values in the greater curvature of the AAo, whereas in the EF <30% group higher values were seen in the lesser curvature of the AAo.
Although there was no significant intergroup difference in the WSS intensity distribution, in the EF <30% group the WSS intensity distribution tended to exhibit higher values in the lesser curvature of the distal AAo, and the WSS intensity distribution values for the greater curvature tended to gradually increase from the arch to the proximal descending aorta.
The only significant differences between the EF groups were found in the intensity distributions of EL and Vort in the distal AAo. This suggests that the distributions of atherosclerosis may be EF-dependent.
Association of blood cobalt concentrations with dyslipidemia, hypertension, and diabetes in a US population
Authors: Wang Hongxin , Li Feng , Xue Jianghua , Li Yanshuang , Li Jiyu 
Published: January 2022

Abstract
Various heavy metal elements in the human body have been reported to be associated with dyslipidemia, hypertension, and diabetes. The role of cobalt in these conditions is unclear. The current study aimed to investigate the association of blood cobalt concentrations with dyslipidemia, hypertension, and diabetes.
Using the data collected from the National Health and Nutrition Examination Survey (2015-2018), we performed logistic regression to explore the association of blood cobalt concentrations with total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides, hypertension, and diabetes.
A total of 6866 adults were included in this study. Participants with higher blood cobalt levels appeared to be older and have a lower body mass index and, were more likely to be female (P for trend < .05). After fully adjusting for demographic characteristics (Model 2), compared with the lowest quartile, the highest quartile of blood cobalt concentrations had lower odds ratios (ORs) for elevated TC [OR: 0.62, 95% confidential interval (CI): 0.53 to 0.72, P < .001], elevated LDL-C (OR: 0.65, 95% CI: 0.53-0.80, P < .001) and low HDL-C (OR: 0.81, 95% CI: 0.69-0.96, P = .013). The adjusted ORs for elevated TC, elevated LDL-C and low HDL-C were negatively correlated with increased blood cobalt concentrations (P for trend < .05). The adjusted ORs for hypertension and diabetes were not associated with blood cobalt concentrations (P > .05 and P for trend > .05).
In conclusion, higher blood cobalt concentrations were associated with a lower risk of dyslipidemia. However, blood cobalt concentrations were not associated with the risk of hypertension or diabetes.
The effects of swimming sports on the prevention and restoration of COVID-19 and its variant strains
Authors: Zeng Jing , Liu Qing , Wang Yang , Lei Zhengfang , Shang Yao , Yang Qunru 
Published: January 2022

Abstract

Introduction:
Since 2019, corona virus disease 2019 (COVID-19) has become a new round of “epidemic,” which has brought about a major crisis to the world from national development, to people's life safety and mental health. Faced with the constant variation of viruses, from COVID-19 to Delta to Omicron. How to curb its further deterioration and enhance human defense against viruses is the focus of scientific researchers. From previous studies, we found that in addition to basic medical treatment, swimming with a certain amount of load and intensity can promote the ventilator of the human body, thereby playing an auxiliary and preventive role in the treatment of COVID-19 and its variant strains.

Methods:
This study searched China knowledge network, Web of science, Google scholar, PubMed database to search for the relevant research on swimming prevention and treatment for COVID-19, and the deadline for searching was December 2021. Two researchers independently screened and extracted the literature, and evaluated the bias risk of the included studies. The methodological quality of the included literature was evaluated by the Chochrane bias risk assessment tool.

Result:
This study will provide new evidence for the prevention and recovery of COVID-19 and its variant strains by swimming.

Conclusion:
To provide a method to help the prevention and restoration of COVID-19 and its variant strains by swimming.

INPLASY registration number:
INPLASY2021120075.
Multiple evanescent white dot syndrome following vaccination for COVID-19
Authors: Inagawa Sayako , Onda Masahiro , Miyase Taishi , Murase Shiho , Murase Hiroki , Mochizuki Kiyofumi , Sakaguchi Hirokazu 
Published: January 2022

Abstract

Rationale:
Multiple evanescent white dot syndrome (MEWDS) is an acute, usually unilateral, retinal disorder of unknown etiology that predominantly occurs in healthy young women. We report a case of bilateral asymmetric MEWDS that developed following the first vaccination for coronavirus-19 and worsened after a second vaccination.

Patient concerns:
A 30-year-old Japanese woman was examined in an eye clinic for blurred vision in her left eye for 1 week duration. Thirteen days before her examination, she had received her first BNT162b2 mRNA SARS-CoV-2 vaccination. Her best-corrected visual acuity was 20/20 in both eyes. Fundus examination revealed multiple yellowish-white spots in the perifoveal area of both eyes. Visibility of the spots gradually decreased during the following week. She was then vaccinated with a second dose, and 3 days later, her vision worsened in her left eye. She was then referred to our hospital because of worsened vision and the appearance of white spots on other parts of the retina. Ophthalmological examination revealed a best-corrected visual acuity of 30/20 both eyes.

Diagnosis:
The flare value in the anterior chamber was elevated in both the eyes. Fundus examination showed multiple white spots in the perifoveal area of both eyes, but they were more prominent in the left eye. Fundus fluorescein angiography revealed early hyperfluorescent spots located circumferentially around the fovea in both eyes. We concluded that the patient had MEWDS, which was most likely due to mRNA COVID-19 immunization.

Interventions:
The patient was treated with topical betamethasone sodium phosphate/fradiomycin sulfate 0.1% thrice daily for 2 months.

Outcomes:
Two months after treatment, her blurry vision resolved with the disappearance of the fundus lesions.

Lesson:
Clinicians should be aware of potential adverse ocular events following similar vaccinations.