bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sclerosing mesenteritis due to Mycobacterium genavense infection: A case report
Authors: Artigues Serra Francisca , García-Gasalla Mercedes , Campins Antoni , González de Cabo Miguel , Morales Rafael , Peña Rebecca Rowena , Gallegos María Carmen , Riera Melchor 
Published: September 2022

Rationale:
Since its first identification in the early 1990s, Mycobacterium genavense has been considered and opportunistic pathogen. It mainly causes gastrointestinal symptoms, but also disseminated infections in severely immunosuppressed patients. Sclerosing mesenteritis is a long-term complication with high morbidity and mortality. As it is a rare condition, there are no specific guidelines for its management. We report a challenging case of persistent M. genavense infection, and propose surgery as an alternative treatment strategy.

Patient concerns:
A 38-year-old Caucasian man presented to the emergency room with fever, abdominal pain, and night sweats for 3 months. HIV screening revealed a previously unknown HIV-1 infection, with a CD4 cell count of 216 cell/µL and viral load of 361.000 copies/mL at diagnosis. A body CT-scan showed mild splenomegaly as well as mesenteric and retroperitoneal enlarged lymph nodes. Fine needle aspiration revealed the presence of acid-fast bacilli, but mycobacterial cultures were negative. In the second sample, 16S RNA sequencing yielded a diagnosis of M. genavense infection. Despite 2 years of corticosteroids and antimycobacterial treatment excluding rifampicin due to a severe cutaneous reaction, there was no clinical improvement and an increase in the mesenteric lymph node size was observed, with a sclerosing transformation of the mesentery. A surgical approach was proposed to release small bowel loops and to remove fibrin. A second surgery was required due to an acute peritonitis ought to yeyunal segmental isquemia and perforation. Finally, the patient evolved favorably, and antimycobacterial drugs were suspended without relapse.

Lessons.
Despite a prolonged multidrug strategy, some patients develop persistent M. genavense infection. Once sclerosing mesenteritis is established, clinicians have few treatment options. Surgery should be considered in patients with sclerosing mesenteritis or bowel obstruction. The combination of medical and surgical treatment could be a potential cure for these patients.
Efficacy and safety of Chinese medicine combined with acupuncture in the treatment of chronic urticaria: A meta-analysis
Authors: Lu Zhenxiong , Zhou Qiujun , Chai Shiqian , Yang Huifeng , Wang Jinhui , Luo Hongbin , Cao Yi , Tao Maocan 
Published: September 2022

Background:
Increasing studies have shown that Chinese medicine combined with acupuncture has a significant effect on chronic urticaria, which can treat both symptoms and root causes. This meta-analysis aims to compare the efficacy and safety differences between acupuncture combined with conventional Western medicine, so as to provide guidance for the clinical treatment of chronic urticaria.

Methods:
We searched Pubmed, Embase, Cochrane Library, CNKI, Wanfang, CQVIP, and CBM from the establishment of the database to August 2021. We included randomized controlled trial study that the experimental group was acupuncture combined with traditional Chinese medicine, while the control group was treated with conventional Western medicine. We excluded repeated publication, researches without full text, incomplete information, or inability to conduct data extraction and animal experiments, reviews, and systematic reviews. STATA 15.1 was used to analyze the data.

Results:
The pooled results show that total effective rate of acupuncture combined with traditional Chinese medicine group was significantly higher than that in the conventional Western medicine group (ratio rate [RR] = 1.29, 95% confidence interval [CI]: 1.2–1.38). Additionally, the pooled results show that Urticaria Activity Score (standardized mean difference = –1.51, 95% CI: –2.24 to –0.78) and pruritus score (standardized mean difference = –1.09, 95% CI: –1.71 to –0.47) of acupuncture combined with traditional Chinese medicine group was significantly lower than that in conventional Western medicine group, while there is no significant difference in wheal score between acupuncture combined with traditional Chinese medicine group and conventional Western medicine group. Importantly, the pooled results show that recurrence rate (RR = 0.35, 95% CI: 0.19–0.64) and the incidence of adverse events (RR = 0.27, 95% CI: 0.10–0.75) of acupuncture combined with traditional Chinese medicine group were all significantly lower than that in conventional Western medicine group.

Conclusion:
Our research results found that traditional Chinese medicine combined with acupuncture has a more significant effect than conventional Western medicine and can significantly reduce the recurrence rate and the incidence of adverse reactions. The application of traditional Chinese medicine combined with acupuncture in the treatment of chronic urticaria should be further promoted.
Safety of Vitamin K in mechanical heart valve patients with supratherapeutic INR: A systematic review and meta-analysis
Authors: Sapapsap Bannawich , Srisawat Chansinee , Suthumpoung Pornsinee , luengrungkiat Onjira , Leelakanok Nattawut , Saokaew Surasak , Kanchanasurakit Sukrit 
Published: September 2022

Background:
Patients who had mechanical heart valves and an international normalized ratio (INR) of >5.0 should be managed by temporary cessation of vitamin K antagonist. This study aimed to investigate the safety of low-dose vitamin K1 in patients with mechanical heart valves who have supratherapeutic INR.

Methods:
CINAHL, Cochran Library, Clinical trial.gov, OpenGrey, PubMed, ScienceDirect, and Scopus were systematically searched from the inception up to October 2021 without language restriction. Studies comparing the safety of low-dose vitamin K1 treatment in patients with placebo or other anticoagulant reversal agents were included. We used a random-effect model for the meta-analysis. Publication bias was determined by a funnel plot with subsequent Begg’s test and Egger’s test.

Results:
From 7529 retrieved studies, 3 randomized control trials were included in the meta-analysis. Pooled data demonstrated that low-dose vitamin K was not associated with thromboembolism rate (risk ratio [RR] = 0.94; 95% CI: 0.19–4.55) major bleeding rate (RR = 0.58; 95% CI: 0.07–4.82), and minor bleeding rate (RR = 0.60; 95% CI: 0.07–5.09). Subgroup and sensitivity analysis demonstrated the nonsignificant effect of low-dose vitamin K on the risk of thromboembolism. Publication bias was not apparent, according to Begg’s test and Egger’s test (P = .090 and 0.134, respectively).

Conclusion:
The current evidence does not support the role of low-dose vitamin K as a trigger of thromboembolism in supratherapeutic INR patients with mechanical heart valves. Nevertheless, more well-designed studies with larger sample sizes are required to justify this research question.
Comparison of rectus sheath block and local anesthetic for analgesia in pediatric umbilical hernia repair: A systematic review and meta-analysis
Authors: Zhen Lun-Hui , Wang Hong-Bing , Zhou Yun 
Published: September 2022

Background:
Pediatric umbilical hernia repair could cause considerable postoperative discomfort. This study aimed to compare the analgesia between rectus sheath block and local anesthetic infiltration in child pediatric umbilical hernia repair.

Methods:
The relevant randomized controlled trials were searched from PubMed, Embase, Web of Science, EBSCO, and Cochrane library databases from its inception to October 2020. The random-effects model was used for meta-analysis.

Results:
Four randomized controlled trials were included in the meta-analysis. The 4 studies were published between 2006 and 2017, with sample sizes ranging from 13 to 52 and a total of 143 individuals across the 4 studies. The Jadad scores of the 4 included studies ranged from 4 to 5, and all 4 studies were considered high quality based on quality assessment. There was no difference in analgesic effect at 10 minutes (standardized mean difference [SMD] = −0.19; 95% confidence interval [CI] = −1.52 to 1.16; P = .78), 30 minutes (SMD = −0.37; 95% CI = −1.53 to 0.78; P = .52), 1 hour (SMD = −0.73; 95% CI = −2.00 to 0.53; P = .26) after surgery. Besides, there was no significant difference in postoperative nausea (risk ratio = 0.95; 95% CI = 0.18 to 5.02; P = .95) and postoperative morphine use in morphine equivalents (mean difference = −0.95; 95% CI = −0.06 to 0.01; P = .12).

Conclusion:
Rectus sheath block and local anesthetic are effective methods for analgesia in pediatric umbilical hernia repair.
Association between use of antacid medications (proton pump inhibitors and histamine-2 receptor antagonists) and the incidence of lung cancer: A population-based cohort analysis
Authors: Go Subin , Lee Dong Yoon , Choi Won-Il , Jeong Jihyeon 
Published: September 2022

This study investigated the association between antacid administration and lung cancer incidence in a real-world setting.
This was a nationwide, retrospective cohort study. The cohort comprised random samples (n = 1,031,392) from the entire South Korean population in 2002. The duration of antacid administration between January 2006 and December 2010 was recorded for each participant. Newly developed lung cancers were counted during the 5-year observation period (January 1, 2006 to December 31, 2010). A total of 437,370 participants aged ≥ 40 years were included, of whom 301,201 (68.9%) had antacid exposure before the diagnosis of lung cancer. A total of 1230 (0.28%) antacid-exposed patients developed lung cancer. Among patients with no antacid exposure or underexposure (n = 136,171), 597 (0.44%) developed lung cancer. In the multivariable analysis, antacid exposure before the diagnosis of lung cancer was independently associated with a reduced incidence of lung cancer (hazard ratio: 0.64; 95% confidence interval: 0.55–0.74; P < .001). Antacid use might be independently associated with a decreased risk of lung cancer development in this cohort study.
Network pharmacological analysis and molecular docking of Huangqin-Baizhu herb pair in the treatment of threatened abortion
Authors: Dang Chun-xiao , Wang Ding , Liu Peng-fei , Liu Jin-xing , Yu Xiao 
Published: September 2022

Background:
The incidence of threatened abortion (TA) is increasing due to poor diet and living habits, which brings great pressure to pregnant women and their families. Huangqin-Baizhu herb pair recorded in ancient books of traditional Chinese medicine has been widely used in the treatment of TA with remarkable effect. In this study, we will use the network pharmacology method to predict the target and mechanism of Huangqin-Baizhu herb pair.

Methods:
Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform database was used to screen the active components of Huangqin-Baizhu herb pair. Pubchem and Swiss Target Prediction databases were used to predict the action targets. Genecards, OMIM, and Drugbank databases were used to predict the related targets of TA. The intersection of drug target and disease target was selected and the intersection genes were uploaded to STRING database to construct protein–protein interaction network and conduct module analysis. Metascape database was used for Gene Ontology and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis, which was imported into Cytoscape software to construct component-pathway-gene network and finally verified by molecular docking. Ethical approval and informed consent of patients are not required because the data used in this study is publicly available and does not involve individual patient data or privacy.

Results:
The main active components of the herb pair are baicalein, flavanone, and norwogonin, etc. The main targets are AKT1, VEGFA, STAT3, MAPK1, SRC, etc. Cluster module analysis shows that the targets are related to cell metabolism, immune regulation and hormone level regulation. There were 2073, 3169, and 161 KEGG pathways involved in the biological processes, cell components, and molecular functions of Gene Ontology analysis, respectively. The main KEGG pathways involved in the intervention were HIF1 signaling pathway, PI3K-Akt signaling pathway, and Rap1 signaling pathway. Molecular docking showed that the main active components of the herb pair were well combined with the key targets.

Conclusions:
In this study, 42 active components, 152 potential targets and 11 key targets of Huangqin-Baizhu herb pair for the treatment of TA were revealed, participating in multiple signaling pathways such as PI3K-Akt, providing a theoretical basis for further experimental research.
Biomechanical characteristics of 2 different posterior fixation methods of bilateral pedicle screws: A finite element analysis
Authors: Ji Yulei , Zhang Qiaolin , Song Yang , Hu Qiuli , Fekete Gusztáv , Baker Julien S. , Gu Yaodong 
Published: September 2022

Background:
To explore the biomechanical characteristics of 2 posterior bilateral pedicle screw fixation methods using finite element analysis.

Methods:
A normal L3-5 finite element model was established. Based on the verification of its effectiveness, 2 different posterior internal fixation methods were simulated: bilateral pedicle screws (model A) were placed in the L3 and L5 vertebral bodies, and bilateral pedicle screws (model B) were placed in the L3, L4, and L5 vertebral bodies. The stability and stress differences of intervertebral discs, endplates, screws, and rods between models were compared.

Results:
Compared with the normal model, the maximum stress of the range of motion, intervertebral disc, and endplate of the 2 models decreased significantly. Under the 6 working conditions, the 2 internal fixation methods have similar effects on the stress of the endplate and intervertebral disc, but the maximum stress of the screws and rods of model B is smaller than that of model A.

Conclusions:
Based on these results, it was found that bilateral pedicle screw fixation in 2 vertebrae L3 and L5 can achieve similar stability as bilateral pedicle screw fixation in 3 vertebrae L3, L4, and L5. However, the maximum stress of the screw and rod in model B is less than that in model A, so this internal fixation method can effectively reduce the risk of fracture. The 3-dimensional finite element model established in this study is in line with the biomechanical characteristics of the spine and can be used for further studies on spinal column biomechanics. This information can serve as a reference for clinicians for surgical selection.
Paralytic ileus as first symptom of Miller Fisher syndrome: A case report
Authors: Liu Xiubin , Chen Xiqi , Zhou Yongkun , Zhang Xiaoxia 
Published: September 2022

Introduction:
Miller Fisher syndrome (MFS), regarded by many scholars as a variant of Guillain Barre syndrome (GBS), accounts for approximately 5% to 10% of GBS cases. The typical clinical manifestations of MFS are extraocular muscle paralysis, ataxia, and tendon reflex loss or disappearance. To date, intestinal obstruction has rarely been reported as the initial symptom.

Patient concerns:
A 48-year-old woman presenting with abdominal pain and distention was diagnosed with paralytic ileus. There was no significant improvement in symptoms after symptomatic treatment. After that, the patient developed visual rotation, with limited binocular abduction and adduction, and ataxia. Anti-ganglioside testing revealed positive anti-ganglioside antibodies.

Diagnosis:
The patient was diagnosed as MFS.

Interventions:
The early stage is mainly symptomatic treatment of paralytic ileus. After MFS was diagnosed, the patient was given large amounts of immunoglobulin and hormone shock therapy.

Outcomes:
After 1 week, the symptoms of intestinal obstruction and MFS gradually improved. The patient was later discharged automatically for financial reasons. Six months after discharge, the patient was interviewed by telephone, and she had recovered.

Conclusion:
To date, intestinal obstruction has rarely been reported as the initial symptom. In case of inconsistencies between the imaging examinations and clinical symptoms, neuroelectrophysiology and cerebrospinal fluid puncture should be performed, striving for timely detection and treatment.
Comparison of 2 effect-site concentrations of remifentanil with midazolam during transrectal ultrasound-guided prostate biopsy under procedural analgesia and sedation: A randomized controlled study
Authors: Lai Hou-Chuan , Chen Chin-Li , Huang Yi-Hsuan , Wu Ke-Li , Huang Ren-Chih , Lin Bo-Feng , Chan Shun-Ming , Wu Zhi-Fu 
Published: September 2022

Background:
Until now, target-controlled infusion of remifentanil with midazolam for transrectal ultrasound-guided prostate biopsy has not been described. Here, we investigate 2 effect-site concentrations of remifentanil with intermittent bolus midazolam for transrectal ultrasound-guided prostate biopsy under procedural analgesia and sedation.

Methods:
A prospective, randomized controlled trial including patients who received a transrectal ultrasound-guided prostate biopsy between February 2019 and January 2021 was conducted. Group 1 and Group 2 were respectively administered an initial effect-site concentration of remifentanil of 1.0 ng/mL and 2.0 ng/mL by a target-controlled infusion pump with Minto model. In both groups, maintenance of the effect-site concentration of remifentanil was adjusted upward and downward by 0.5 ng/mL to keep patient comfort with acceptable pain (remaining moveless), and mean arterial pressure and heart rate within baseline levels ± 30%, and using intermittent bolus midazolam to keep the Observer’s Assessment of Alertness/Sedation scale between 2 and 4. The primary outcome was to determine which effect-site concentration of remifentanil provide adequate patient comfort with acceptable pain (remaining moveless) during the procedure.

Results:
A total of 40 patients in Group 1 and 40 patients in Group 2 were eligible for analysis. Most parameters were insignificantly different between Group 1 and Group 2, except Group 1 having higher peripheral oxygen saturation while probe insertion compared with Group 2. Group 2 patients had less intraoperative movements affecting the procedure (2 vs 18; P < .001), and less total times of target-controlled infusion pump adjustment (0 [0–1] vs 1 [0–3], P < .001) compared with group 1. However, group 1 patients had less apnea with desaturation (peripheral oxygen saturation < 90%; 0 vs 9, P = .002) and less remifentanil consumption (94.9 ± 25.5 μg vs 106.2 ± 21.2 μg, P = .034) compared to Group 2.

Conclusion:
In transrectal ultrasound-guided prostate biopsy, target-controlled infusion with remifentanil Minto model target 2.0 ng/mL with 3 to 4 mg midazolam use provided sufficient analgesia and sedation, and appropriate hemodynamic and respiratory conditions.
Occupational acute argon gas poisoning: A case report
Authors: Li Yongkai , Yang Jianzhong 
Published: September 2022

Rationale:
Intentional or unintentional exposure to asphyxiating gases is a significant public health concern worldwide. Argon poisoning is fatal, and its onset is primarily due to neurological damage.

Patient concerns:
A 22-year-old man was admitted to the hospital for argon gas poisoning. While working in a plant containing argon gas, he suddenly lost consciousness, recovered consciousness slightly after on-site treatment, answered questions, and had impaired memory, sensory dullness, normal cognition, and symptoms of dizziness and headache.

Diagnosis:
Asphyxiating gas poisoning (argon gas poisoning), metabolic encephalopathy, and hepatic insufficiency.

Interventions:
Immediately after admission, the patient was treated with nasal cannula oxygen 3 L/min and hyperbaric oxygen therapy once a day. Mecobalamin tablets 500 μg were given orally 3 times a day. Oral Ginkgo biloba extract tablets 40 mg 3 times a day.

Outcome:
The patient was discharged after treatment with hyperbaric oxygen therapy and nerve-nourishing drugs, with no discomfort, clear consciousness, and good memory, and was followed up by telephone for 2 consecutive months, and the patient is now in good condition with no discomfort.

Lesson:
This case describes the pathogenesis, neurological damage, and rescue process of argon gas poisoning. Argon poisoning was found to damage bilateral cerebellar hemispheres and bilateral hippocampal regions, affecting the patient’s consciousness and memory, and was found to cause abnormal liver function and heart rate disorders.
Plasma cell-rich related acute rejection in kidney transplant: A case report and review of the literature
Authors: Tsai Yao-Yu , Lim Lee-Moay , Kuo Hung-Tien , Tsai Yi-Chun 
Published: September 2022

Rationale:
Plasma cell-rich acute rejection (PCAR), a subtype of T cell-mediated rejection, is a relatively rare type of acute allograft rejection, that is usually associated with a higher rate of graft failure. However, it is difficult to diagnose PCAR precisely.

Patient concerns:
A 45-year-old woman who had received a kidney transplant presented with acute kidney injury and uremic symptoms approximately 1 year after transplantation.

Diagnosis:
A renal biopsy was performed and pathological examination revealed marked inflammation with abundant plasma cells in areas within interstitial fibrosis and tubular atrophy. The patient was diagnosed with PCAR and chronic active T cell-mediated rejection (CA-TCMR) grade IA.

Interventions:
Immunosuppressants were administered as tacrolimus (2 mg twice daily), mycophenolate mofetil (250 mg twice daily), and prednisolone (15 mg/day) for suspected PCAR.

Outcomes:
The patients showed rapid deterioration in kidney function and reached impending graft failure.

Lessons:
PCAR is often associated with poor graft outcome. The high variability in tacrolimus levels could contribute to poor patient outcomes, leaving aggressive immunosuppressive therapy as the remaining choice for PCAR treatment.
Effect of proton pump inhibitors on the clinical outcomes of PD-1/PD-L1 inhibitor in solid cancer patients
Authors: Wu Bing , Sun Congcong , Sun Xiaoqin , Li Xue 
Published: September 2022

Background:
Some concomitant drugs may affect the efficacy of programmed death protein-1/ ligand-1 (PD-1/L1) inhibitors. Among the various concomitant drugs, proton–pump inhibitors (PPI) have attracted some attention but have not reached a conclusion. We conducted a meta-analysis to evaluate the impact of PPIs on the survival of cancer patients treated with PD-1/L1 inhibitors.

Material/methods:
Related databases and conferences reports were searched. Studies that reported the relationship between PPI use and clinical outcomes of PD-1/L1 inhibitors were included. Meta-analysis was conducted to obtain pooled hazard ratios (HR)s with 95% confidence interval (CI).

Results:
Eight studies involving 4869 cancer patients were included. Meta-analysis showed that PPI use was associated with worse overall survival (OS) (HR = 1.43, 95% CI 1.32–1.56), worse progression free survival (PFS) (HR = 1.30, 95% CI 1.20–1.40), and decreased objective response (odds ratio = 0.71, 95% CI 0.58–0.87) in cancer patients receiving PD-1/L1 inhibitors. Neither cancer type nor therapy type affected the effect of concomitant PPIs on the OS and PFS. In the subgroup of studies with a population size <500, PPIs did not reduce the OS, but the PFS. Only 1 single-center study was conducted, showing that PPI use did not affect the OS and PFS. There was no evidence of publication bias among included studies.

Conclusion:
Concomitant PPI use was correlated with worse clinical outcomes in cancer patients treated by PD-1/L1 inhibitors. Further prospective clinical and experimental studies are needed to confirm the effect and mechanism of PPI in worsening the clinical outcome of PD-1/L1 inhibitors.