Analysis of postpartum reversible cerebral vasoconstriction syndrome in China: A case report and literature review Reversible cerebral vasoconstriction syndrome (RCVS) is a rare clinical syndrome accompanying with severe headache as its main symptom. Postpartum reversible cerebral vasoconstriction syndrome (PPRCVS) refers to RCVS occurring in the puerperium, in which it has a low incidence, and that is easily missed diagnosed and misdiagnosed in clinical practice. By searching in CNKI and Wanfang databases, 9 published articles reported PPRCVS were found, totally including 12 cases with PPRCVS. The clinical data of these 12 cases were accordingly analyzed and summarized. The characteristics of these cases were compared with those reported in other countries, and eventually the clinical characteristics of Chinese PPRCVS patients were summarized. The clinical characteristics of Chinese PPRCVS patients were basically as same as those found in other countries, while the onset age was earlier, PPRCVS often occurred earlier after delivery, with higher proportions of concomitant symptoms and abnormal laboratory and imaging examinations; moreover, and fewer patients were diagnosed by digital subtraction angiography (DSA).

Efficacy of microsurgery for dural arteriovenous fistula: A systematic review protocol Background: Microsurgery is a treatment option for dural arteriovenous fistula (DAF), but its efficacy is still unclear. This study aims to assess the efficacy and safety of microsurgery for the treatment of patients with DAF. Methods: We will carry out this study assessing the use of microsurgery in patients with DAF from the following electronic databases: PUBMED, EMBASE, Cochrane Library, CINAHL, PsycINFO, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure. All those databases will be searched from inception to the present without language limitations. Two independent authors will perform study selection, data extraction, and methodological quality assessment. RevMan 5.3 Software will be applied for statistical analysis. Results: This study will assess the efficacy and safety of microsurgery for the treatment of patients with DAF through measuring initial treatment failure, late recurrence, neurological improvement, quality of life, and complications. Conclusion: This study will provide most recent evidence of microsurgery for the treatment of patients with DAF. Dissemination and ethics: The findings of this systematic review will be published in peer-reviewed journals. This systematic review dose not needs ethic approval, because it just analyzes the published data without individual information involvement. Systematic review registration: PROSPERO CRD42019144851.

Prognostic significance of neutrophil–lymphocyte ratio (NLR) in patients with ovarian cancer: A systematic review and meta-analysis The prognostic role of neutrophil to lymphocyte ratio (NLR) in patients with ovarian cancer remains inconsistent. This meta-analysis was conducted to evaluate the predictive value of this biomarker for prognoses in ovarian cancer patients. We systematically searched PubMed, Web of Science, and Embase for eligible studies embracing multivariate results. The Newcastle-Ottawa Scale were used to assess the study quality. Pooled hazard ratios (HRs), and 95% confidence intervals (CIs) were calculated. Ten studies involving 2919 patients were included in this meta-analysis. In multivariate analysis, the group with higher NLR had worse overall survival (OS) (HR = 1.34, 95% CI = 1.16–1.54) and shorter PFS (HR = 1.36, 95% CI = 1.17–1.57) than the control group. Furthermore, PLR values higher than the cut-off were associated with not only poorer OS (HR = 1.97, 95% CI = 1.61–2.40) but also more unfavorable PFS (HR = 1.79, 95% CI = 1.46–2.20). Univariate analysis also indicated the same results. Additionally, subgroup analysis showed that when the cut-off values for NLR and PLR were higher, their predictive effects became stronger. This comprehensive meta-analysis suggested that the values of inflammatory marker of NLR was associated with ovarian cancer survival. Therefore, inflammatory markers can potentially serve as prognostic biomarkers.

Effects of epinephrine for out-of-hospital cardiac arrest: A systematic review and meta-analysis of randomized controlled trials Aim: Our objective is to assess the effects of epinephrine for out of hospital cardiac arrest. Background: Cardiac arrest was the most serious medical incidents with an estimated incidence in the United States of 95.7 per 100,000 person years. Though epinephrine improved coronary and cerebral perfusion, improving a return of spontaneous circulation, potentially harmful effects on the heart lead to greater myocardial oxygen demand. Concerns about the effect of epinephrine for out-of-hospital cardiac arrest were controversial and called for a higher argument to determine whether the effects of epinephrine is safe and effective for shor and long terms outcomes. Method: Searching databases consist of all kinds of searching tools, such as Medline, the Cochrane Library, Embase, PubMed, etc. All the included studies should meet our demand of this meta-analysis. In the all interest outcomes blow we take the full advantage of STATA to assess, the main measure is Risk Ratio (RR) with 95% confidence, the publication bias are assessed by Egger Test. Result: In current systematic review and meta-analysis of randomized trials investigating epinephrine for out of hospital cardiac arrest, we found that epinephrine was associated with a significantly higher likelihood of ROSC (RR = 3.05, I2 = 23.1%, P = .0001) and survival to hospital discharge (RR = 1.40, I2 = 36.3%, P = .008) compared with non-adrenaline administration. Conversely, epinephrine did not increase CPC 1 or 2 (RR = 1.15, I2 = 40.5%, P = .340) and hospital admission (RR = 2.07, I2 = 88.2%, P = .0001). Conclusion: In conclusion, in this systematic review and meta-analysis involving studies, the use of epinephrine resulted in a significantly higher likelihood of survival to hospital discharge and ROSC than the non-epinephrine administration, but, there was no significant between group difference in the rate of a favorable neurologic outcome.

Measurement of proximal tibial morphology in northeast Chinese population based on three-dimensional reconstruction computer tomography Tibial component of total knee arthroplasty (TKA) is designed according to morphology of proximal tibia to a large extent. Owing to racial difference, current design of tibial component based on Caucasian may not be suitable for Chinese patients. Meanwhile, data of proximal tibial morphology in Chinese population is lacking. The objective of this research was to investigate proximal tibial morphology of northeast Chinese population. Computer tomography (CT) image of 164 northeast Chinese participants was collected. After three-dimensional (3D) reconstruction, size of tibia plateau and TKA resected surface were gauged to guide the design of TKA tibia prothesis in northeast Chinese population. Measurement of tibial size mainly includes tibial mediolateral length (tML), tibial medial/lateral anteroposterior length (tMAP and tLAP). Afterwards, tML/tAP ratio of tibia plateau and TKA resected surface were calculated as feature point of tibia prothesis. tMAP/tLAP ratio of TKA resected surface was calculated to represent tibial asymmetry degree. Medial and lateral posterior tibial slope (MPTS and LPTS) were also measured to give reference to posterior angle of tibia prothesis and angle of tibia osteotomy in TKA. Independent sample t test was performed to conduct statistical analysis, P < .05 was regarded as statistically significance. Northeast Chinese male has larger knee size than female. Significant difference of tML/tAP ratio was also observed between male and female on tibia plateau (1.71 ± 0.07 vs 1.77 ± 0.09) but not on TKA resected surface (1.60 ± 0.05 versus 1.61 ± 0.06). Significant difference of tMAP/tLAP ratio between male and female was also found and they were 1.31 ± 1.03 and 1.11 ± 0.05 respectively. Northeast Chinese female has higher PTS than male (MPTS: 9.56 ± 2.96° vs 8.81 ± 2.87° and LPTS: 8.57 ± 3.19° vs 8.44 ± 2.76°). Significant gender-difference of tibial size and asymmetry degree of tibial resected surface were found between northeast Chinese male and female. Meanwhile, northeast Chinese population has smaller knee size, larger PTS and tML/tAP ratio than that of Caucasian population. Therefore, Chinese-specific and gender-specific tibial prostheses were strongly recommended to be designed.

Tiam1 high expression is associated with poor prognosis in solid cancers: A meta-analysis Background : A number of studies have attempted to determine the prognostic value of T-cell lymphoma invasion and metastasis-inducing factor 1 (Tiam1) in patients with solid cancers, but the reported results were of inconsistency. Thus, we performed a systematic review and meta-analysis to exhaustively evaluate the prognostic role of Tiam1 expression in patients with solid cancers. Methods : We retrieved literature published in between 1994 and April 22th, 2019 through searching PubMed, Web of Science and China national knowledge infrastructure (CNKI). Hazard ratios (HRs) coupled with 95% confidence intervals (95% CIs) were used to assess the relationship of Tiam1 expression and overall survival (OS), and disease-free survival (DFS). Results : A total of 2647 patients with solid cancers in 20 studies were enrolled in our meta-analysis eventually. The pooled results showed that Tiam1 high expression was closely correlated with poor OS (HR = 2.17, 95% CI: 1.80–2.61, P = .000) and DFS (pooled HR = 1.95, 95% CI = 1.58–2.40, P = .000). Moreover, our subgroup analysis and sensitivity analysis demonstrated the reliability and stability of our pooled results. Conclusion : In conclusion, this meta-analysis confirmed that Tiam1 higher expression positively correlated with OS and DFS, suggesting that Tiam1 may act as a valuable prognostic predictor and therapeutic target for patients with solid cancers. Nevertheless, in future more homogeneous and prospective studies should be performed to further support our findings.

Tai Chi exercise for sleep problems in older adults: A protocol of systematic review and meta-analysis Background: Sleep plays a crucial role in the general health of the human body. However, sleep problems become increasingly severe with age, and its incidence is on the rise. Notably, Tai Chi exercise may be an efficacious means to ameliorate sleep problems among older adults. This is especially since Tai Chi has been widely used to manage sleep problems in China for many years, but there is limited evidence regarding its effectiveness. We will conduct this study aiming to investigate the efficacy of Tai Chi as a complementary and alternative therapy for sleep problems in older adults. Methods: We will systematically search Scopus, Embase, PubMed, Cochrane Library, China National Knowledge Infrastructure, and Wanfang database from their inceptions to August 2019. Only randomized controlled trials of Tai Chi for sleep problems among older adults will be considered for inclusion and the Pittsburgh sleep quality index will be the primary outcome measurement. Moreover, study selection, data extraction, and the evaluation of the methodological quality of trials will each be independently completed by at least 2 researchers. We will employ the software Stata version 12.0 to implement the statistical analysis. Results: The current systematic review and meta-analysis will provide synthesized results of the effectiveness and safety of Tai Chi exercise for sleep problems among older adults. Conclusion: This systematic review and meta-analysis will provide high-quality evidence on the effectiveness and safety of Tai Chi exercise for sleep problems in older adults. Registration: PEROSPERO CRD42019129782.

Prediction of relapse and prognosis by expression levels of long noncoding RNA PEG10 in glioma patients Background: Long noncoding RNA paternally expressed 10 (lncRNA PEG10) is highly expressed in a variety of human cancers and related to the clinical prognosis of patients. However, to date there has been no previous study evaluating the prognostic significance of lncRNA PEG10 in gliomas. In the present study, we investigated the expression levels of lncRNA PEG10 to determine the prognostic value of this oncogene in human gliomas. Methods: Expression levels of lncRNA PEG10 were detected by real-time polymerase chain reaction in a hospital-based study cohort of 147 glioma patients and 23 cases of patients with craniocerebral trauma tissues. Associations of lncRNA PEG10 expression with clinicopathological variables and clinical outcome of glioma patients were investigated. Results: The results indicated that expression levels of lncRNA PEG10 were significantly increased in human gliomas compared to normal control brain tissues. In addition, lncRNA PEG10 expression was progressively increased from pathologic grade I to IV (P = .009) and correlated with the Karnofsky performance status (P = .018) in glioma patients. Furthermore, we also found that glioma patients with increased expression of lncRNA PEG10 had a higher risk to relapse and a statistically significant shorter overall survival (OS) than patients with reduced expression of lncRNA PEG10. In multivariate analysis, expression level of lncRNA PEG10 was found to be an independent prognostic factor for both progression-free survival and OS in glioma patients. Conclusions: LncRNA PEG10 served as an oncogene and played crucial roles in the progression of glioma. Molecular therapy targeted on lncRNA PEG10 might bring significant benefits to the clinical outcome of malignant glioma.

Changing trends in lymphoid neoplasm distribution in South Korea: analysis of 8615 cases from a single institute, 1997–2016: An observational study The purpose of this study was to evaluate changes in the proportion of lymphoid neoplasm subtypes in South Korea. A total of 8615 cases of lymphoid neoplasms diagnosed in 1997–2016 at Samsung Medical Center in South Korea were classified according to the 2008 World Health Organization system. The total number and proportion of lymphoid neoplasms were compared between these two decades, with data from nationwide studies, and with other countries. To evaluate changes in the proportion of subtypes, crude rate of each subtype per 100 lymphoma patients during each decade and age adjusted rate were calculated. There were 3024 patients with lymphoid neoplasm in 1997–2006, and 5591 in 2007–2016, which represents an average increase of 1.85 times over the 20-year study period. Crude rate and age adjusted rate were increased in Hodgkin's lymphoma and mature B cell lymphoma while precursor lymphoid neoplasms and mature T cell lymphoma were decreased. Among B cell neoplasms, age adjusted rate of plasma cell neoplasm, follicular lymphoma, mantle cell lymphoma increased while there was no significant change in extranodal marginal zone lymphoma and Burkitt lymphoma. The increase in follicular lymphoma was due to the increases in nodal follicular lymphoma of low grade and duodenal-type follicular lymphoma. These results are consistent with the dynamics of causative factors, including socioeconomic factors, in Korea.

APRISMA-compliant systematic review and meta-analysis determining the association of miRNA polymorphisms and risk of congenital heart disease Purpose: Recent genetic association studies showed conflicting results on the relationship of miRNA single-nucleotide polymorphisms (SNPs) and congenital heart disease (CHD) risk. The purpose of the present systematic review was to collect the current available evidences to evaluate the association between miRNA polymorphisms and CHD risk. Methods: Four electronic databases including PubMed, EMBASE, ISI Web of Science, and CENTRAL were extensively searched for relevant studies published before February, 2019. Observational studies determining the association between miRNA polymorphisms and risk of CHD were included. Risk of bias was evaluated using the Newcastle-Ottawa Scale by 2 independent researchers. Major characteristics of each study and estimation of effect size of individual locus polymorphism were summarized. In addition, meta-analysis was performed to quantify the associations between miRNA polymorphisms and CHD risk. Results: Nine studies containing 6502 CHD patients and 6969 healthy controls were included in this systematic review. Ten loci in 9 miRNAs were reported. Only rs11614913 in miR-196a2 was determined to have significant associations with CHD susceptibility, which was supported by meta-analysis (CC vs CT+TT: odds ratio 1.54, 95% confidence interval 1.30, 1.82; P < .00001). A strong evidence indicated lack of association between rs2910164 in miR-146a and CHD. Limited or conflicting evidences were found for the associations of the other variants (rs11134527, rs139365823, rs76987351, rs3746444, rs4938723, rs2292832, rs41291957, rs895819) and risk of CHD. Conclusions: Locus polymorphisms in miRNAs are not generally associated with CHD. Only rs11614913 was found to have significant associations with CHD. Further studies will be needed, using larger populations of different ethnicities, to obtain a better understanding of these associations.