Data items will be extracted using a predefined data extraction sheet. Moreover, the risk of bias and the quality of evidence were independently assessed using the quality in prognostic studies tool (QUIPS). The I2 and chi squared statistical tests will be used to analyze statistical heterogeneity across studies. An I2 values of > 50% will be considered substantial. All data analysis will be performed using STATA 16.0 (StataCorp LP, TX, USA). The outcomes examined will be progression-free and overall survival.

No ethical approval will be required and the findings of this meta-analysis will be published in a peer-reviewed journal.

International prospective Register of Systematic Reviews (PROSERO) number CRD42021218997.

International prospective Register of Systematic Reviews (PROSERO) number CRD42021218997.

Strephenopodia is a common complication after stroke, which is easily neglected in the early stage of the disease and seriously affects the rehabilitation process of patients’ limbs, and brings huge security risks and family burden. A large number of studies have confirmed that acupuncture combined with rehabilitation (ACR) has a significant effect on strephenopodia after stroke (SAS), but there is still a lack of systematic scientific evidence to support this argument. In this systematic review, we aimed to evaluate the efficacy and safety of ACR in the treatment of SAS, to provide evidence-based medical evidence for the clinical treatment of the disease.

We will search the following databases of 8 electronic databases from inception to January 2022 PubMed, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, China National Knowledge infrastructure (CNKI), Technology Periodical Database (VIP), WanFang Data, and China Biology Medicine (CBM). All relevant randomized controlACR is effective and safe in treating SAS.

CRD42021290960.

CRD42021290960.

In case of injuries to the subaxial cervical spine, especially in osteoporotic bone, the question of the most stable operative technique arises. There are several techniques of screw fixation available regarding dorsal stabilization. This study investigates 2 techniques (lateral mass screws (LMS) vs cervical pedicle screws (CPS)) in the subaxial cervical spine regarding primary stability in a biomechanical testing using a translational injury model.

A total of 10 human formalin fixed and 10 human fresh-frozen specimens (C 4 – T 1) were investigated. Specimens were randomized in 2 groups. Fracture generation of a luxation injury between C 5 and C 6 was created by a transection of all ligamentous structures as well as the intervertebral disc and a resection of the facet joints.Dorsal stabilization of C 4/C 5 to C 6/C 7 was performed in group A by lateral mass screws, in group B by pedicle screws. In the biomechanical testing, the specimens were loaded at 2 N/s in translation direction until implant failure.

Formalin fixed specimen Mean load failure was 513.8 (±86.74) Newton (N) for group A (LMS) and 570.4 (±156.5) N for group B (CPS). There was no significant difference (P = .6905).Fresh frozen specimen Mean load failure was 402.3 (±96.4) N for group A (LMS) and 500.7 (±190.3) N for group B (CPS). There was no significant difference (P = .4206).

In our loading model respecting the translational injury pattern and a flexion movement we could not verify statistically significant differences between lateral mass screws and cervical pedicle screws. Mean loading failure was slightly higher in the CPS group though.

In our loading model respecting the translational injury pattern and a flexion movement we could not verify statistically significant differences between lateral mass screws and cervical pedicle screws. Mean loading failure was slightly higher in the CPS group though.

Expanded dengue syndrome (EDS) is the phenomenon coined by the World Health Organization for cases of dengue fever (DF) with rare but dangerous consequences. EDS mainly leads to complications involving the vital organs, thus is also associated with a higher mortality rate. This case report presents the first-ever case where a patient developed EDS with both rhabdomyolysis-induced acute kidney injury and compartment syndrome of the limbs.

Our patient, an 18-year-old Pakistani male, presented with fever, colicky abdominal pain, vomiting, diarrhea, dark-colored urine, and oliguria.

Dengue rapid NS-1 test came back positive. Along with myoglobinuria both serum creatine phosphokinase and creatine levels were abnormal. Hence, the patient was diagnosed with rhabdomyolysis-induced acute kidney injury. On physical examination, his right arm was painful and tender with restricted movement at the elbow. A Doppler ultrasound of the arm revealed thickening of the skin and underlying muscles, as well as edematous abn lookout for any indications pointing to these complications in DF. A prompt diagnosis can prevent further complications and fatality.

U.S. Veterans Affairs (VA) patients’ multi-system use can create challenges for VA clinicians who are responsible for coordinating Veterans’ use of non-VA care, including VA-purchased care (“Community Care”) and Medicare.To examine the relationship between drive distance and time-key eligibility criteria for Community Care-and VA reliance (proportion of care received in VA versus Medicare and Community Care) among Veterans at high risk for hospitalization. We used prepolicy data to anticipate the impact of the 2014 Choice Act and 2018 Maintaining Internal Systems and Strengthening Integrated Outside Networks Act (MISSION Act), which expanded access to Community Care.Cross-sectional analysis using fractional logistic regressions to examine the relationship between a Veteran’s reliance on VA for outpatient primary, mental health, and other specialty care and their drive distance/time to a VA facility.Thirteen thousand seven hundred three Veterans over the age of 65 years enrolled in VA and fee-for-service Medr hospitalization may continue to rely on VA for outpatient primary care and mental health care despite access to outside services, but may increase use of outpatient specialty care in the community in the MISSION era, increasing demand for multi-system care coordination.

Surgeons generally perform Hickman catheter insertion in children under general anesthesia. At times, it is difficult to perform procedures with an anesthesiologist for an interventional radiologist. Several diagnostic and therapeutic procedures are efficiently and safely conducted using intravenous (IV) sedation in children with a pediatrician. This study aims to evaluate the efficacy and safety of radiologically placed Hickman catheters using IV sedation in children under 20 kg.Fifty-nine catheters were inserted in 45 children under IV sedation. With continuous monitoring of vital signs, IV midazolam and ketamine were slowly infused by a pediatrician. Sapogenins Glycosides molecular weight Mean age and body weights were 3.2 years and 15.2 kg, respectively. Acute leukemia was the most common disease for the procedure (72.9%). The location of the catheter tip was evaluated by measuring the height of the thoracic vertebra.Technical success rate was 100%, and IV sedation-related complications did not occur. The right internal jugular vein was acceections were suspected in 4 patients (6.8%), with 1 positive result.Radiological Hickman catheter placement in children under 20 kg using IV sedation by pediatricians is effective and safe, with minimal complications. The carina is a landmark to estimate the cavoatrial junction in pediatric patients.

Coronavirus disease 2019 (COVID-19) was first detected in China in December 2019, and declared as a pandemic by the World Health Organization (WHO) on March 11, 2020.To study the clinical features of patients with COVID-19, we analyzed the correlation between some inflammation-related indicators in patients’ serum and the severity of the disease, especially PV (pneumonia volume under CT scan) and pneumonia volume ratio (PVR).Sixty-six COVID-19 patients in Huai’an, China were selected as the research subjects. We collected the clinical data, including general characteristics, clinical symptoms, serum test results and CT performance, explored the relationship between inflammation-related indexes, oxygenation index, PV, PVR, while indicators of mild to moderate patients and severe patients were compared.The most prominent manifestations of COVID-19 patients were fever (47, 71.2%); cough (41, 62.1%), with or without respiratory and other systemic symptoms; There was no difference in gender (P = .567) and age (Pe in assessing the severity of COVID-19.

Pemphigus is a rare, devastating, bullous autoimmune disease that damages the skin and mucous membranes, and has high morbidity and mortality. Studies have shown associations of pemphigus vulgaris (PV) and pemphigus foliaceus (PF) with human leukocyte antigen (HLA) class II polymorphisms.This study examined the frequency of Major Histocompatibility Complex, Class II, DR Beta 1, a Protein Coding gene (HLA-DRB1) and Major Histocompatibility Complex, Class II, DQ Beta 1 (HLA-DQB1) alleles in Vietnamese PV and PF patients, and the association of these polymorphisms with pemphigus subtypes and disease severity.The study enrolled 31 unrelated Vietnamese who underwent HLA typing using Sanger sequencing.HLA-DRB1∗1454 was the most frequent allele in both PV (20.5%) and PF (33.3%) patients. The percentage of HLA-DQB1∗0302 was significantly higher in PF than PV patients, while the percentage of HLA-DQB1∗0503 was approximately 10 times higher in PV patients. Pemphigus patients who have the HLA-DRB1∗04 alleles are more ent allele in both PV (20.5%) and PF (33.3%) patients. The percentage of HLA-DQB1∗0302 was significantly higher in PF than PV patients, while the percentage of HLA-DQB1∗0503 was approximately 10 times higher in PV patients. Pemphigus patients who have the HLA-DRB1∗04 alleles are more likely to have mild or moderate disease.The HLA-DRB1 and DQB1 alleles may influence susceptibility to pemphigus subtypes, with DQB1∗0503 being specific for PV and DQB1∗0302 for PF. Our findings suggest that the DRB1∗04 alleles are likely to be associated with mild and moderate disease.

The aim of the study was to investigate the influence of intrarenal RAS on the decrease of renal function in patients undergoing cardiac surgery with cardiopulmonary bypass. This observational study investigated the activation of intrarenal RAS in 24 patients with AKI after cardiac surgery with cardiopulmonary bypass. The activation of intrarenal RAS was determined by urinary angiotensinogen (uAGT), which was measured at 12 hours before surgery, 0 and12 hours after surgery. The results were compared with those of 21 patients without AKI after cardiac surgery with cardiopulmonary bypass. Clinical and laboratory data were collected. Compared with baseline, all patients with cardiac surgery had activation of intrarenal RAS at 0 and 12 hours after surgery. The activation of intrarenal RAS was found significantly higher at both 0 and 12 hours after surgery in AKI group versus non AKI group (6.18 ± 1.93 ng/mL vs 3.49 ± 1.71 ng/mL, 16.38 ± 7.50 ng/mL vs 6.04 ± 2.59 ng/mL, respectively). There was a positive correlation between the activation of RAS at 0 hour after surgery and the decrease of renal function at 48 hours after surgery (r = 0.