bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of myasthenia gravis with the method of tonifying spleen and replenishing qi in traditional Chinese medicine
Authors: Jiang Li , Xu Peng , Zhang Dongmei , Lu Jing , Chang Tianying , Zhang Yinbin , Wang Jian 
Published: January 2022

Abstract

Background:
Myasthenia gravis (MG) is an autoimmune disease that is associated with the production of autoantibodies. The symptoms of MG are mainly mediated by pathogenic antibodies directed against nicotinic acetylcholine receptors, resulting in a decrease in the number of acetylcholine receptors molecules on the postsynaptic membrane of the neuromuscular junction endplate, leading to clinical symptoms of muscle fatigue and weakness. At present, traditional Chinese medicine (TCM) treatment of MG has a better effect by tonifying spleen and replenishing qi. The purpose of this study was to systematically evaluate the efficacy and safety of TCM therapy for tonifying spleen and replenishing qi in the treatment of myasthenia gravis.

Methods:
We searched the following databases from their establishment until December 2021: PubMed, Cochrane Library, EMBASE, Web of Science, Springer, CNKI, Wanfang, China Biomedical Database, China Science and Technology Journal Database, Chinese Knowledge Infrastructure, China Clinical Trial Registry, and Baidu Scholars. The literature search language was limited to Chinese and English, and publication time and status were not limited. Randomized controlled trials (RCTs) were included. Two researchers independently searched and screened the articles, assessed their quality, and used the RevMan 5.4.1 software to perform a meta-analysis of the included literature.

Results:
This study compared the main outcome indicators: efficacy rate, recurrence rate, quality of life, and quantitative myasthenia gravis (QMG). Secondary outcome indicators were the clinical absolute score, TCM syndrome score, serum acetylcholine receptor antibody level, and electromyogram low-frequency repetitive nerve stimulation.

Conclusion:
This study aimed to evaluate whether the TCM method of tonifying spleen and replenishing qi is effective in the treatment of MG and to provide evidence-based data.

Ethics and dissemination:
The protocol of the systematic review did not require ethical approval because it did not involve human subjects. This article will be published in peer-reviewed journals and will be presented at conferences.
Characteristics and survival outcomes of primary splenic cancers
Authors: Lei Yanna , Huang Qian , Li Xiaoying , Zheng Xiufeng , Liu Ming 
Published: January 2022

Abstract
Primary splenic cancers represent a small number of cancer cases and studies on its clinicopathological features and outcomes are limited. Splenic lymphomas and primary splenic angiosarcoma (PSA) are the 2 most common histological types of splenic cancers. This population-based study aimed to investigate the clinical characteristics and survival outcomes of patients with splenic lymphomas or PSA.
Patients diagnosed with splenic lymphomas or PSA between 2000 and 2015 were identified from the Surveillance Epidemiology and End Results database of the National Cancer Institutes. Overall survival (OS) and cancer-specific survival (CSS) rates were calculated using the Kaplan–Meier method. A Cox proportional hazard models were used to identify independent predictors of cancer-specific mortality.
A total of 700 patients with splenic lymphoma and 48 patients with PSA were included in this study. The median age of patients with splenic lymphoma was 65 years and 57 years for patients with PSA. For patients with splenic lymphoma, the most prevalent histological subtypes were splenic marginal zone lymphoma and diffuse large B-cell lymphoma. A total of 52.6% of the cases had stage IV disease based on the Ann Arbor staging system. Five-year OS and CSS were 76.9% and 83.4%, respectively. Multivariate analysis revealed that independent predictors of splenic lymphoma CSS included race, stage, chemotherapy, and histological subtype. However, a much shorter OS time was seen in the PSA cohort which had a 5-year OS of 11.8%, a median OS of 10.0 months and the 5-year CSS of 12.4%. Chemotherapy was correlated with better outcomes in patients with PSA. However, the survival benefits of surgery for splenic cancer were not statistically significant in our study.
The current study is the largest cohort of primary splenic cancer presented in literature based on the Surveillance Epidemiology and End Results database and our large series describe the characteristics and survival outcomes of such rare diseases which may provide reliable information for further studies and clinicians.
High expression of HOXB7 is an unfavorable prognostic factor for solid malignancies
Authors: Zhou Ting , Feng Zonghao , Yang Fan , Zhu Weipeng , Cao Jiashun , Hou Xianming , Zhao Yue , Chen Donghong 
Published: January 2022

Abstract

Background:
HOXB7 is abnormally expressed in a variety of tumors, but its prognostic value remains unclear due to sample size limitation and outcome inconsistency in previous studies. This meta-analysis was performed to explore the effect of HOXB7 expression on prognoses and clinicopathological factors in range of the whole solid tumors.

Methods:
PubMed, EMBASE, and Web of Science databases were searched to identify included studies. Hazard ratios (HR) with its 95% confidence interval (CI) and clinicopathological factors were extracted. Subgroup analyses were performed according to histopathological type, tumor occurrence systems, and HOXB7 detection methods.

Results:
A total of 3430 solid tumors patients from 20 studies (21 cohorts) were included in the meta-analysis. The results showed that high HOXB7 expression was significantly associated with worse survival (overall survival: HR = 1.98, 95%CI: 1.74–2.26, P < .001 and disease-free survival: HR = 1.59, 95%CI: 1.21–2.09, P = .001), more advanced tumor-node-metastasis (TNM) stage (odds ratio [OR] = 2.14, 95%CI: 1.68–2.73, P < .001), positive lymph node metastasis (OR = 2.16, 95%CI: 1.74–2.70, P < .001), more distant metastasis (OR = 1.63, 95%CI: 1.01–2.63, P = .048), poorer differentiation (OR = 1.48, 95%CI: 1.14–1.91, P = .003), and higher Ki-67 expression (OR = 2.53, 95%CI: 1.68–3.84, P < .001). Subgroup analysis showed that survival of patients with HOXB7 high expression was worse in either squamous cell carcinomas or non-squamous cell carcinomas, digestive tumors or non-digestive tumors, and protein level or mRNA level.

Conclusion:
High HOXB7 expression might be a valuable biomarker of poor prognosis for solid tumors. HOXB7 promotes tumor proliferation and metastasis, and is associated with poorer differentiation, more advanced stage, even the chemotherapy resistance, suggesting that HOXB7 is a potential therapeutic target for solid tumors.
Application of fecal microbial transplantation in hepatic encephalopathy after transjugular intrahepatic portosystemic shunt
Authors: Li Jun , Wang Dan , Sun Jingping 
Published: January 2022

Abstract

Rationale:
Transjugular intrahepatic portosystemic shunt (TIPS) is mainly used to treat acute and chronic esophageal, gastric, and intestinal variceal bleeding and refractory ascites caused by portal hypertension. The most common complication of TIPS is the development of hepatic encephalopathy (HE). Fecal microbiota transplantation (FMT) is an emerging method for treating diseases by altering the intestinal flora. We present 2 cases of FMT that ameliorated liver function and HE after TIPS.

Patient concerns:
In this report, 2 patients with liver cirrhosis secondary to hepatitis B had recurrent Grade 2-3 HE after TIPS.

Diagnosis:
Two patients were diagnosed as having HE.

Interventions:
The 2 patients separately received 3 times of FMT.

Outcomes:
The liver function of both patients improved, the clinical symptoms were relieved, and the number of HE attacks decreased significantly after FMT.

Lessons:
FMT may be another effective way to treat HE, and is worthy of further research.
Severe vaginal bleeding due to vaginal metastasis from renal cell carcinoma with inferior vena cava tumor thrombus
Authors: Geng Zhihai , Zhang Qinghua , Jia Peng , Miao Jia , Lin Qian 
Published: January 2022

Abstract

Rationale:
Renal cell carcinoma (RCC) is the most common type of kidney cancer and is the second most common urologic neoplasm. Vaginal metastasis from RCC is extremely rare clinically.

Patient concerns:
A 56-year-old woman presented with intermittent vaginal bleeding that had persisted for 1 month. Enhanced computed tomography examination suggested a vaginal mass (3 × 2 × 2 cm), right kidney tumor (15 × 12 × 10 cm), and an inferior vena cava tumor thrombus. During gynecologic examination, the mass was necrotic and caused uncontrollable vaginal bleeding.

Diagnoses:
Based on clinical and imaging examinations and the pathology, she was diagnosed as vaginal metastasis from RCC.

Interventions:
The patient received percutaneous transcatheter arterial embolization to stop uncontrollable vaginal bleeding, and then treated with targeted therapy.

Outcomes:
Vaginal bleeding disappeared after interventional embotherapy. However, disease progressed, and the patient died 9 months later.

Lessons:
In cases of vaginal bleeding, the possibility of metastatic renal cell carcinoma should be considered. Percutaneous transcatheter arterial embolization is an effective and novel treatment for uncontrollable vaginal bleeding caused by vaginal metastasis of RCC.
Effects of neuroplasticity in people with knee osteoarthritis
Authors: Iuamoto Leandro Ryuchi , Ito Fábio Luis Kenji , Tomé Thales Augusto , Hsing Wu Tu , Meyer Alberto , Imamura Marta , Battistella Linamara Rizzo 
Published: January 2022

Abstract

Background:
Knee osteoarthritis (OA) is associated with chronic inflammation in somatic structures, which alters sensory afferents and leads to plastic changes in the nervous system.

Methods:
A systematic literature review was carried out, without language restrictions, period, or status of publication. The database used were Medline, EMBASE, Cochrane Library and clinicaltrials.gov. Extra bibliographic references were extracted through the discussion with specialists, and through scientific researches in conference papers.

Results:
The electronic search found 938 articles. When excluding duplicates and applying the inclusion/exclusion criteria, 5 studies were considered: 2 using EEG and 3 using TMS. Significant reduction of EEG activity in the cingulate medium cortex, reduction of conditioned pain modulation (CPM) in studies with EEG, as well as the occurrence of an association between pain and motor response threshold/intracortical pain facilitation in studies with TMS were observed.

Conclusions:
The study contributes to a better understanding of the neurophysiological changes seen in the cingulate medium cortex, decrease in CPM and motor response threshold/intracortical pain facilitation. Advances in neuroplasticity studies may aid in the screening for early diagnosis of knee OA in the future. However, more studies are necessary.
Ultrasonographic morphological characteristics determined using a deep learning-based computer-aided diagnostic system of breast cancer
Authors: Kim Young Seon , Lee Seung Eun , Chang Jung Min , Kim Soo-Yeon , Bae Young Kyung 
Published: January 2022

Abstract
To investigate the correlations between ultrasonographic morphological characteristics quantitatively assessed using a deep learning-based computer-aided diagnostic system (DL-CAD) and histopathologic features of breast cancer.
This retrospective study included 282 women with invasive breast cancer (<5 cm; mean age, 54.4 [range, 29–85] years) who underwent surgery between February 2016 and April 2017. The morphological characteristics of breast cancer on B-mode ultrasonography were analyzed using DL-CAD, and quantitative scores (0–1) were obtained. Associations between quantitative scores and tumor histologic type, grade, size, subtype, and lymph node status were compared.
Two-hundred and thirty-six (83.7%) tumors were invasive ductal carcinoma, 18 (6.4%) invasive lobular carcinoma, and 28 (9.9%) micropapillary, apocrine, and mucinous. The mean size was 1.8 ± 1.0 (standard deviation) cm, and 108 (38.3%) cases were node positive. Irregular shape score was associated with tumor size (P < .001), lymph nodes status (P = .001), and estrogen receptor status (P = .016). Not-circumscribed margin (P < .001) and hypoechogenicity (P = .003) scores correlated with tumor size, and non-parallel orientation score correlated with histologic grade (P = .024). Luminal A tumors exhibited more irregular features (P = .048) with no parallel orientation (P = .002), whereas triple-negative breast cancer showed a rounder/more oval and parallel orientation.
Quantitative morphological characteristics of breast cancers determined using DL-CAD correlated with histopathologic features and could provide useful information about breast cancer phenotypes.
Prediction of loss of correction after hemiepiphysiodesis for the alignment of lower limb angular deformities
Authors: Schagemann Jan , Kudernatsch Nils , Russlies Martin , Mittelstädt Hagen , Götze Melanie , Horter Melanie , Paech Andreas , Behnke Barbara 
Published: January 2022

Abstract
Guided growth by temporary hemiepiphysiodesis (HEPD) is established for the alignment of lower limb angular deformities. This retrospective cohort study was designed to assess the effect of HEPD in idiopathic coronal plane deformities around the knee and on the frontal knee joint line orientation, and to test the frontal knee joint line as predictive means for recurrence.
Fourty-four patients (78 deformities: valgus n = 64, varus n = 14) were enrolled in the retrospective observational study. Mechanical axis deviation, mechanical lateral distal femoral angle, and mechanical medial proximal tibial angle were assessed prior to surgery and during follow-up. The facultative frontal knee joint line angle (FKJLA) was used as predictive tool. Cases of remaining growth potential (n = 45/78) after implant removal were followed to assess rebound deformity.
Pre-operative angles of the mechanical axis were corrected average 9.0 months after HEPD. Pre-operative assessment of the frontal knee joint line revealed a mean of 3.9° in valgus, and –1.0° in varus deformities. At time of complete deformity correction, mean FKJLA was –0.2° in valgus, and –0.8° in varus deformities. Mean shift of FKJLA was significantly higher after singleHEPD compared to combiHEPD (P < .001). Patients having an unphysiological FKJLA (>/<0°–3°) after correction of mechanical axis had a significantly higher risk of rebound deformity (P = .01). Regression analysis showed a 60.5% higher risk of rebound deformity per each degree deviating from the FKJLA physiological range. Age, gender, or body mass index had no impact.
Temporary HEPD offers great potential for the correction of the mechanical axis and the frontal knee joint line. An unphysiological change of the frontal knee joint line is associated with a high risk of recurrent angular deformities. CombiHEPD instead of singleHEPD seems to be safer to prevent detrimental frontal knee joint line shift.

Level of Evidence: Retrospective comparative therapeutic study, Level III.
Prevention of postoperative adhesions after flexor tendon repair with acellular dermal matrix in Zones III, IV, and V of the hand
Authors: Lee Yeon Ji , Ryoo Hyun Jung , Shim Hyung-Sup 
Published: January 2022

Abstract

Background:
Various techniques have been attempted for preventing postoperative flexor tendon adhesion, such as modification of suture technique, pharmacological agents, and mechanical barriers. However, there is no evidence of the efficacy of these methods in clinical settings. In this study, we present the long-term outcomes of a randomized prospective study in which acellular dermal matrix (ADM) was used to prevent postoperative adhesions after tendon injury in the hand.

Methods:
From January 2017 to January 2020, all patients with an acute single flexor tendon injury in hand Zones III, IV, or V were candidates. A single-digit, total tendon rupture repaired within 48 hours, from the index finger to the little finger, was included in the study. Patients were randomly allocated to either a control or ADM group. Complications and the range of movements were recorded. Functional outcomes and a patient satisfaction questionnaire were evaluated after 12 months following the tendon repair surgery. The present study is adhered to the CONSORT guidelines.

Results:
A total of 25 patients was enrolled in the study: 13 patients in the ADM group and 12 in the control group. According to Buck-Gramcko II criteria, the postoperative functional outcome score was 14.38 ± 1.71 in the ADM group and 13.08 ± 1.82 in the control group (P value = .0485). Patient satisfaction was recorded at 8.38 ± 1.44 in the ADM group and 7.08 ± 1.58 in the control group (P value = .0309), a significant difference. There were no differences in complications between the 2 groups.

Conclusion:
The beneficial effects of ADM after tendon repair were confirmed by improved postoperative functional outcome at flexor Zones III, IV, and V, preventing peritendinous adhesions and acting effectively as an anti-adhesive barrier.
Chinese herbal medicine Xianling Gubao capsule for knee osteoarthritis
Authors: Liu Wang , Xu Daoqing , Qi Qi , Li Jingjing , Ou Liang 
Published: January 2022

Abstract

Background:
Knee osteoarthritis (KOA) is the most prevalent degenerative joint disease among populations over 60 years old, and is the most common cause of musculoskeletal pain and disability worldwide. Xianling Gubao capsule (XLGBC), a Chinese patent medicine, is widely used for treatment of osteoporosis. Meanwhile, according to the theory of homotherapy for heteropathy, XLGBC is increasingly applied in the clinical practice of KOA. However, no systematic review has found that XLGBC is as effective in treatment of KOA as it is in treatment of osteoporosis. Therefore, we will conduct a systematic review of XLGBC in KOA treatments.

Methods:
All randomized controlled trials assessing the validity of XLGBC therapy for KOA will be retrieved from the following seven databases, including the Cochrane Library, PubMed, EMBASE, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Wan Fang Database, and Chinese Scientific Journal Database. The primary outcome measures are the visual analogue scale pain score, and a comprehensive evaluation including the Western Ontario and McMaster Universities Arthritis Index scores, Lysholm scores, and Bristol scores. And the secondary outcome measures include cure rate and adverse events. The procedure such as retrieval and selection of literature, data extraction, evaluation of risk of bias, and assessment of reporting bias will be executed by 2 reviewers independently. The data synthesis for meta-analysis will be conducted by Review Manager 5.4 software.

Results:
A high-quality evidence of XLGBC for the treatment of KOA will be generated from the aspects of safety and efficacy.

Conclusion:
This systematic review will provide evidence to help us confirm the clinical efficacy of XLGBC in the treatment of KOA.

OSF Registration number:
Registration DOI 10.17605/OSF.IO/QD5SY.
Unilateral pachydermodactyly misdiagnosed as juvenile idiopathic arthritis
Authors: Aljohani Roaa 
Published: January 2022

Abstract

Rationale:
Pachydermodactyly is a rare, benign disease that can manifest in healthy adolescent boys as painless, spindle-shaped, soft-tissue swelling of the proximal interphalangeal joints in the hand. It is usually bilateral, with symmetrical joint enlargement. There are relatively few documented cases of pachydermodactyly worldwide, signifying either a low incidence or lack of recognition by physicians; therefore, its diagnosis is challenging.

Patient concerns:
A 16-year-old boy with a 3-year history of painless unilateral swelling of the proximal interphalangeal joints of his left hand was misdiagnosed with juvenile idiopathic arthritis and was treated with oral methotrexate for 1 year. He had a history of frequent finger cracking.

Diagnosis:
He had normal levels of inflammatory markers, including erythrocyte sedimentation rate and C-reactive protein. His autoantibody profile results were normal, and radiography of his hands showed soft tissue swelling with no bone abnormalities. Therefore, the patient was diagnosed with Parkinson disease.

Interventions:
Methotrexate was discontinued, and a skin biopsy was performed, which revealed hyperkeratosis in the epidermis with thick collagenous fibers in the dermis. Therefore, the patient was informed of the benign nature of the disease and was advised to stop cracking his fingers.

Outcomes:
After regular follow-up, there was no progression of the patient's symptoms, and repeated blood tests revealed normal results.

Lessons:
Pachydermodactyly should be considered in the differential diagnosis of painless swelling in adolescent men with normal blood testing. Early recognition of this rare benign condition helps physicians appropriately reassure the patient and his parents without exposing them to unnecessary therapy.
Conservative management of orbital involvement in malignant tumors: is the paradigm evolving? A critical review
Authors: Dallan Iacopo , Picariello Miriana , Fiacchini Giacomo 
Published: January 2022

Purpose of review
Review the recent literature regarding conservative management of orbital invasion in sinonasal cancers.

Recent findings
Recent data seem to confirm the possibility to preserve the orbital content in a significant number of patients. MRI is the best available imaging tool for evaluating orbital invasion. Limited periorbital and extraconal fat invasion should not be considered an indication for orbital cleaning. Histology-driven neoadjuvant chemotherapy should be attempted whenever possible, and could act as a prognosticator.

Summary
Orbital preservation strategy can be attempted even in case of limited extraconal fat invasion. When extraocular muscles, massive extraconal fat, lateral wall of the lacrimal sac, eyelids or even optic nerve/globe are invaded, a conservative procedure cannot be offered. Induction chemotherapy and postoperative radiotherapy are invaluable tools for maintaining oncological outcome while preserving ocular function. Frozen section should be used for guiding surgical procedures in borderline situations.