Streptococcus suis meningoencephalitis diagnosed with metagenomic next-generation sequencing: A case report with literature review.

Streptococcus suis is a pathogen of emerging zoonotic diseases and meningoencephalitis is the most frequent clinical symptom of S. suis infection in humans. Rapid diagnosis of S. suis meningoencephalitis is critical for the treatment of the disease. While the current routine microbiological tests including bacterial culture and gram staining are poorly sensitive, diagnosis of S. suis meningoencephalitis by metagenomic next-generation sequencing (mNGS) has been rarely reported. Here, we report a 52-year-old female pork food producer with a broken finger developed S. suis meningoencephalitis. After her admission, no pathogenic bacteria were detected through bacterial culture and Gram staining microscopy in the cerebrospinal fluid obtained via lumbar puncture. However, mNGS identified the presence of S. suis in the sample. mNGS is a promising diagnostic tool for rapid diagnosis of rare infectious diseases in the central nervous system.

High-sensitivity C-reactive protein as a predictive factor of acute kidney injury following aneurysmal subarachnoid hemorrhage: a prospective observational study.

BACKGROUND: High-sensitivity C-reactive protein (hs-CRP) is a well-recognized biomarker of neurologic complications and clinical outcome of stroke patients. However, whether hs-CRP can predict the occurrence of acute kidney injury (AKI) in aneurysmal subarachnoid hemorrhage (aSAH) patients is still unclear. The objective of this study was to assess the feasibility of using serum hs-CRP level to predict the occurrence of AKI in aSAH patients. METHODS: One hundred sixty-four aSAH patients were enrolled into a prospective observational study. AKI was diagnosed using the modified Kidney Disease Improving Global Outcomes (KDIGO) standard. The relationship between serum hs-CRP level at admission and occurrence of AKI was analyzed. RESULTS: AKI occurred in 17 patients (10.4%) in this cohort. Patients with AKI had significantly higher hs-CRP levels than those without. The mortality of the AKI group tends to be higher than that of the non-AKI group, but the difference was not statistically significant (4/17 (23.5%) vs. 13/147 (8.8%), P = 0.081). After adjusting for possible confounding factors including World Federation of Neurosurgical Societies grade, diabetes, and serum creatinine, multivariate analysis revealed that serum hs-CRP level and antibiotic therapy were both significant factors independently associated with AKI following aSAH (serum hs-CRP: OR = 1.2, 95% confidence interval (CI) = 1.1-1.3, P = 0.003; antibiotic therapy: OR = 5.8, 95%CI = 1.6-20.7, P = 0.007). Receiver operating characteristic curve analysis showed that hs-CRP had a sensitivity of 76.5% and a specificity of 64.6% for predicting the development of AKI on the basis of the best thresholds. The post hoc log-rank test revealed that patients having serum hs-CRP level > 6.6 mg/L had a significantly higher AKI rate than patients having serum hs-CRP level ≤ 6.6 mg/L (P = 0.001). CONCLUSIONS: Serum hs-CRP level might be helpful as a predictor for the development of AKI in aSAH patients. Delayed cerebral ischemia occurrence rate and mortality of patients with AKI tend to be higher than those of patients without in this cohort; however, they were not significantly different.

Efficacy of methotrexate, doxorubicin, and cisplatin for osteosarcoma: Study protocol for a systematic review of randomized controlled trial.

BACKGROUND: This systematic review will address the efficacy and safety of methotrexate, doxorubicin, and cisplatin (MAP) for the treatment of patients with osteosarcoma. METHODS: We will retrieve the studies from the following 9 electronic databases: Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE, the Cumulative Index to Nursing and Allied Health Literature, the Allied and Complementary Medicine Database, and Chinese Biomedical Literature Database, China National Knowledge Infrastructure, VIP Information, and Wanfang Data. Two independent researchers will screen and select the relevant papers for eligibility after the search strategies have been conducted. All articles up to the present in any language, region will be considered in this study. A systematic review and data synthesis will be performed of randomized controlled trials of MAP for the treatment of patients with osteosarcoma. The primary outcome includes event-free survival. The secondary outcomes consist of overall survival, quality of life, and toxicity. In addition, 2 independent researchers will extract data, and will assess the quality of included studies by using Cochrane risk of bias tool. Results data will be pooled and meta-analysis will be conducted if >2 eligible studies will be included. RESULTS: This systematic review will evaluate the efficacy and safety of MAP for the treatment of patients with osteosarcoma. CONCLUSION: The findings of this study will summarize the up-to-date evidence of MAP for osteosarcoma, and may provide the guidance for the clinical practice, as well as the health policy maker. PROSPERO REGISTRATION NUMBER: PROSPERO CRD42018120004.

Effectiveness of electroacupuncture for pain after osteosarcoma post surgery: A study protocol of systematic review of randomized controlled trial.

BACKGROUND: This study will assess the effectiveness of electroacupuncture (EA) for pain in patients with osteosarcoma post surgery (OSPS). METHODS: In this study, we will comprehensively search the following electronic databases from inception to the present without language restrictions: Cochrane Library, EMBASE, MEDLINE, the Cumulative Index to Nursing and Allied Health Literature, the Allied and Complementary Medicine Database, and Chinese Biomedical Literature Database. Two authors will independently carry out study selection, data extraction, and methodological assessments. RevMan 5.3 software will be used for statistical analysis. RESULTS: The primary outcome is pain intensity. The secondary outcomes consist of event-free survival, overall survival, quality of life, and adverse events. CONCLUSION: The findings of this study will provide helpful evidence of EA treatment for patients with OSPS. PROSPERO REGISTRATION NUMBER: PROSPERO CRD42019146696.

Therapeutic efficacy of extracorporeal shock wave combined with hyaluronic acid on knee osteoarthritis.

This retrospective study investigated the efficacy and safety of extracorporeal shock wave (EPSW) combined with hyaluronic acid (HA) for patients with knee osteoarthritis (KOA).This retrospective study included 70 patients with KOA. Of those subjects, 35 of them received EPSW combined HA, and were allocated to a treatment group, while the other 35 participants received HA alone and were allocated to a control group. Patients in both groups were treated for a total of 8 weeks. The primary outcome was measured by visual analog scale (VAS). The secondary outcomes were measured by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and knee injury and osteoarthritis outcome score (KOOS). In addition, adverse events (AEs) were also evaluated. All outcomes were measured before and after the treatment.After the treatment, patients in the treatment group exhibited better efficacy in VAS (P < .01), WOMAC scale (pain, P < .01; function, P < .01; and stiffness, P < .01), and KOOS scores (pain, P < .01; function in daily living, P < .01; symptoms, P < .01; sport and recreation, P < .01; and quality of life, P < .01), than patients in the control group. In addition, no significant differences regarding the AEs were found between 2 groups.The findings of this study demonstrated that the efficacy of EPSW combined with HA is superior to the HA alone for patients with KOA.

A retrospective study of acupuncture as an adjunctive therapy to topical ibuprofen for chronic knee pain due to osteoarthritis.

This retrospective study investigated the effectiveness and safety of acupuncture as an adjunctive therapy to topical ibuprofen (TIP) for patients with chronic knee pain (CKP) due to osteoarthritis.This retrospective study analyzed medical records of 84 patients with CKP due to osteoarthritis. These patients were divided into a treatment group (n = 42) and a control group (n = 42). The patients in the treatment group were treated with acupuncture plus TIP, while the subjects in the control group received TIP monotherapy. The primary effectiveness endpoint was assessed by Western Ontario and McMaster Universities osteoarthritis index (WOMAC). The secondary effectiveness endpoints were evaluated by the numeric rating scale (NRS), 12-item Short FormHealth Survey (SF-12, mainly including mental component summary [MCS], and physical component summary [PCS]), and adverse events. All patients received an 8-week treatment. All endpoints were measured pre-treatment and posttreatment.The patients who received acupuncture plus TIP showed better effectiveness in both primary endpoint of WOMAC scale (pain, P < .01; function, P < .01; and stiffness, P < .01) and secondary endpoints of NRS (P < .01), and SF-12 (MCS, P < .01; and PCS, P < .01), than patients who received TIP monotherapy. In addition, both groups had similar safety profile.The results of this study showed that the effectiveness of acupuncture plus TIP may be better than TIP monotherapy for patients with CKP due to osteoarthritis.

Effect of knee joint function training on joint functional rehabilitation after knee replacement.

This retrospective study investigated the effect of knee joint function training (KJFT) on joint functional rehabilitation after knee replacement in Chinese patients with severe knee osteoarthritis (KOA).Eighty-six eligible patients with severe KOA were included. Of those, 43 patients in the intervention group received KJFT and educational program, while the other 43 patients received educational program only. Primary outcome was measured by the Western Ontario and McMaster Universities Arthritis Index (WOMAC). Secondary outcomes were measured by the visual analogue scale (VAS), and Knee Injury and Osteoarthritis Outcome Score (KOOS). All outcomes were assessed at baseline, 1 week before and 3 months after the surgery.Patients in the intervention group showed encouraging benefit neither at 1 week before nor 3 months after the surgery in all outcome measurements, including WOMAC, VAS, and KOOS, when compared with the patients in the control group.The results of this study did not show promising effect of KJFT for joint functional rehabilitation in Chinese patients with KOA after KJR.