Clinics最新文献 - Book学术

Prognostic impact of sarcomatous component in patients with localized and locally advanced uterine carcinosarcoma: a retrospective study in Latin America 局部和局部晚期子宫癌肉瘤患者的肉瘤成分对预后的影响：拉丁美洲的一项回顾性研究

IF 2.4 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Clinics

Pub Date : 2026-01-01 Epub Date: 2025-12-25 DOI: 10.1016/j.clinsp.2025.100854

Daniel Santos Rocha Sobral Filho , Giulia Mazaro de Oliveira , Letícia Vecchi Leis , Mariana de Paiva Batista , Vanessa da Costa Miranda , Renata Colombo Bonadio , Maria del Pilar Estevez Diz , Samantha Cabral Severino da Costa

Objective

Evaluate the prognostic of the sarcomatous component (homologous vs heterologous).

Methods

This retrospective study evaluated patients with FIGO I‒IVA Uterine Carcinosarcoma (UCS) treated at a single cancer center. The endpoints were Overall Survival (OS) and Disease-Free Survival (DFS) according to the sarcomatous component. The Kaplan-Meier was used for survival analyses. Hazard Ratio (HR) and 95% Confidence Interval (95% CI) were calculated using Cox regression.

Results

61 patients with localized/locally advanced disease (34 homologous vs. 27 heterologous) were included. The most common pathological subtype was Rhabdomyosarcoma (60%) in the heterologous and endometrial stromal sarcoma (95%) in the homologous group. All patients underwent surgery. Adjuvant Chemotherapy (CT) was indicated for approximately 70%. A difference was observed between patients who did not complete adjuvant CT: 32.0% vs. 57.9% in homologous and heterologous groups, respectively (p = 0.03). The main reason for this was recurrence during treatment. Comparing homologous vs. heterologous group, median DFS was 143.2 months vs. 18.0 months (HR = 3.72, 95% CI 1.73‒8.02; p = 0.001) and median OS was 143.2 months vs. 34.4 months (HR = 2.79, 95% CI 1.27‒6.13; p = 0.001), respectively. Heterologous subtype (HR = 4.34, 95% CI 1.59‒11.85, p = 0.004) and FIGO stage III (HR = 3.33, 95% CI 1.18–9.39, p = 0.023) were associated with inferior DFS and OS, while completing adjuvant CT (HR = 0.22, 95% CI 0.07‒0.69, p = 0.009) was associated with superior outcomes.

Conclusions

The sarcomatous component has a relevant prognostic impact in localized/locally advanced UCS. The heterologous component was associated with a worse DFS and OS. Other negative prognostic factors were FIGO stage III and not completing adjuvant CT.

目的评价同种异体肉瘤的预后。方法回顾性研究在单一癌症中心治疗的FIGO I-IVA子宫癌肉瘤（UCS）患者。终点是根据肉瘤成分的总生存期（OS）和无病生存期（DFS）。Kaplan-Meier法用于生存分析。采用Cox回归计算风险比（HR）和95%置信区间（95% CI）。结果纳入61例局部/局部晚期疾病患者（34例同源对照27例异源）。异体组中最常见的病理亚型为横纹肌肉瘤（60%），同源组中最常见的病理亚型为子宫内膜间质肉瘤（95%）。所有患者均接受手术治疗。辅助化疗（CT）约占70%。未完成辅助CT的患者在同源组和异体组的差异分别为32.0%和57.9% （p = 0.03）。主要原因是治疗期间复发。同源组和异源组比较，中位DFS分别为143.2个月和18.0个月（HR = 3.72, 95% CI 1.73-8.02, p = 0.001），中位OS分别为143.2个月和34.4个月（HR = 2.79, 95% CI 1.27-6.13, p = 0.001）。异源亚型（HR = 4.34, 95% CI 1.59-11.85, p = 0.004）和FIGO III期（HR = 3.33, 95% CI 1.18-9.39, p = 0.023）与较差的DFS和OS相关，而完成辅助CT （HR = 0.22, 95% CI 0.07-0.69, p = 0.009）与较好的结果相关。结论肉瘤成分对局部/局部晚期UCS的预后有一定影响。异种成分与较差的DFS和OS相关。其他不良预后因素为FIGO III期和未完成辅助CT。

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引用次数: 0

Limb remote ischemic preconditioning attenuates biomarkers of acute lung injury and inflammation during thoracoscopic lobectomy: a randomized controlled trial 肢体远端缺血预处理可减弱胸腔镜肺叶切除术期间急性肺损伤和炎症的生物标志物：一项随机对照试验。

IF 2.4 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Clinics

Pub Date : 2026-01-01 Epub Date: 2026-02-17 DOI: 10.1016/j.clinsp.2026.100883

Wenfu Zhang , Mingwang Zeng , Chao Yang , Lijun Yang , Juan Yang , Yi Wang , Haiyu Xie , Lifeng Wang , Maolin Zhong , Fuzhou Hua , Weidong Liang

Background

One-Lung Ventilation (OLV), though essential for thoracic surgery, triggers inflammation and oxidative stress that may lead to Acute Lung Injury (ALI). Remote Ischemic Preconditioning (RIPC) is a simple, non-invasive intervention that may activate protective pathways and reduce ischemia-reperfusion injury. This randomized controlled trial assessed whether limb RIPC attenuates OLV-induced lung injury during thoracoscopic lobectomy.

Methods

Fifty-four patients undergoing thoracoscopic lobectomy with OLV were randomized to the RIPC (n = 27) or Control (NC, n = 27) group. RIPC consisted of five cycles of 5-min ischemia and 5-min reperfusion using a lower limb tourniquet before OLV. Blood samples were collected at T0 (post-induction), T1 (30-min after OLV), T2 (90-min after OLV), and T3 (30-min after resumption two-lung ventilation). The primary endpoint was plasma CC16. Secondary endpoints included IL-6, MDA, arterial blood gases, Intraoperative Oxygenation Indices (OI, RI, A-aDO₂, a/A), and hospital stay.

Results

Plasma CC16, IL-6, and MDA levels were significantly lower in the RIPC group from T1 to T3 (all p < 0.001). In contrast, oxygenation indices, blood gas parameters, and hospital stay did not differ significantly between groups (all p > 0.05).

Conclusions

Limb RIPC effectively reduced systemic markers of lung injury (CC16), inflammation and oxidative stress during OLV but not in short-term improvements in oxygenation or clinical recovery. These findings suggest that RIPC confers molecular protection, with potential functional benefits requiring longer follow-up or evaluation in high-risk populations. Larger multicenter trials are warranted.

背景：单肺通气（OLV）虽然在胸外科手术中必不可少，但会引发炎症和氧化应激，可能导致急性肺损伤（ALI）。远端缺血预处理（Remote Ischemic Preconditioning， RIPC）是一种简单、无创的干预手段，可激活保护性通路，减少缺血再灌注损伤。这项随机对照试验评估了胸腔镜肺叶切除术中肢体RIPC是否减轻olv诱导的肺损伤。方法：54例胸腔镜肺叶切除术合并OLV患者随机分为RIPC组（n = 27）和Control组（n = 27）。RIPC包括5个周期，在OLV前使用下肢止血带进行5分钟缺血和5分钟再灌注。在T0（诱导后）、T1 （OLV后30分钟）、T2 （OLV后90分钟）和T3（恢复双肺通气后30分钟）采集血样。主要终点是血浆CC16。次要终点包括IL-6、MDA、动脉血气、术中氧合指数（OI、RI、a - ado2、a/ a）和住院时间。结果：血浆CC16、IL-6、MDA水平在RIPC组T1 ~ T3显著降低（p < 0.001）。组间氧合指数、血气参数、住院时间差异无统计学意义（p < 0.05）。结论：肢体RIPC有效降低了OLV期间肺损伤（CC16）、炎症和氧化应激的全身标志物，但在氧合或临床恢复方面没有短期改善。这些发现表明RIPC具有分子保护作用，其潜在的功能益处需要在高危人群中进行更长时间的随访或评估。更大规模的多中心试验是必要的。

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引用次数: 0

Resveratrol protects against isoflurane-induced testicular injury: a stereological and molecular study in mice 白藜芦醇对异氟醚致小鼠睾丸损伤的保护作用：一项体视学和分子研究。

IF 2.4 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Clinics

Pub Date : 2026-01-01 Epub Date: 2026-02-19 DOI: 10.1016/j.clinsp.2026.100878

Zahra Mohammadi , Sanaz Alaee , Majid Kamali-Dolat Abadi , Somayyeh Karami-Mohajeri , Zahra Khodabandeh , Saeed Shokri , Sulagna Dutta , Pallav Sengupta , Hesam Kamyab

Background

This study examines the therapeutic effects of resveratrol, known for its antioxidant and anti-inflammatory properties, in mitigating the harmful effects of isoflurane, an inhalation anesthetic, on testicular tissues in mice.

Methods

Sixty adult male C57BL/6 mice were grouped into six categories: control (normal saline), isoflurane only (1.5% for 1-hour/day), low-dose Resveratrol (RSV, 50 mg/kg/day), high-dose RSV (100 mg/kg/day), isoflurane combined with low-dose RSV, and isoflurane combined with high-dose RSV. After 35-days, the mice were euthanized, and their testes were harvested for stereological analysis and the assessment of antioxidant and apoptotic markers.

Results

Exposure to isoflurane resulted in decreased seminiferous tubule volume and length, along with increased interstitial tissue volume of the testis. Co-treatment with resveratrol, especially at higher doses, mitigated these changes. Additionally, resveratrol modulated the expression of the apoptotic genes Bcl2l1, Bax, and Caspase-3, and enhanced the expression of antioxidant genes GPX1, Sod1, and catalase in mice that received isoflurane.

Conclusions

The findings suggest that resveratrol effectively counters isoflurane-induced damage in testicular structures and gene expression, enhancing tubular integrity and antioxidant defense. This indicates a potential therapeutic approach to protect against isoflurane-induced testicular toxicity.

背景：本研究考察了白藜芦醇的治疗作用，白藜芦醇以其抗氧化和抗炎特性而闻名，减轻了吸入麻醉剂异氟醚对小鼠睾丸组织的有害影响。方法：将60只成年雄性C57BL/6小鼠分为对照组（生理盐水）、单剂量异氟醚（1.5%给药1小时/d）、低剂量白藜芦醇（RSV, 50 mg/kg/d）、高剂量RSV （100 mg/kg/d）、异氟醚联用低剂量RSV、异氟醚联用高剂量RSV 6组。35 d后，将小鼠安乐死，取睾丸进行体视学分析，并评估抗氧化和凋亡标志物。结果：异氟醚暴露导致精管体积和长度减少，睾丸间质组织体积增加。与白藜芦醇联合治疗，特别是在较高剂量时，可减轻这些变化。此外，白藜芦醇可调节异氟醚小鼠的凋亡基因Bcl2l1、Bax和Caspase-3的表达，并增强抗氧化基因GPX1、Sod1和过氧化氢酶的表达。结论：白藜芦醇能有效对抗异氟醚引起的睾丸结构和基因表达损伤，增强睾丸小管完整性和抗氧化防御能力。这表明了一种潜在的治疗方法来防止异氟醚引起的睾丸毒性。

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引用次数: 0

Short-term outcome of totally laparoscopic gastrectomy for gastric cancer: a comparative study 全腹腔镜胃癌切除术短期疗效的比较研究。

IF 2.4 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Clinics

Pub Date : 2026-01-01 Epub Date: 2026-02-19 DOI: 10.1016/j.clinsp.2026.100887

Liu Liu , Shijie Feng , Haiyan Wang , Lin Liu

Objective

Whether Totally Laparoscopic Gastrectomy (TLG) is beneficial for patients with gastric cancer remains not fully understood. This study was to evaluate the advantages of Totally Laparoscopic Gastrectomy (TLG) for treating Gastric Cancer (GC).

Methods

From January 2019 to December 2021, 380 patients with gastric cancer were included into this study (190 per group). The outcomes of interest, including postoperative recovery, inflammation, and oncological results, were compared between the two groups.

Results

The patient baselines between the two groups were comparable. The TLG group had lower risks of wound infection (p = 0.02) and total complications (p = 0.03) compared to LAG. The TLG group exhibited significantly shorter operative time (median: 215 vs. 240 min, p < 0.001), less intraoperative blood loss (median: 50 vs. 100 mL, p < 0.001), shorter time to first flatus (median: 3 vs. 4 days, p < 0.001), and reduced length of postoperative hospital stay (p < 0.001). Furthermore, patients in the TLG group exhibited lower White Blood Cell (WBC) counts on POD 1 compared to patients in the LAG group (mean 11.74 vs. 12.75 × 10^9/L; p = 0.003). Multivariate logistic regression analysis revealed that TLG was an independent predictor of shorter postoperative hospitalization (OR (95% CI): 0.54 (0.30‒0.95), p = 0.03). Interestingly, the TLG group had more lymph nodes harvested than the LAG group (median (range): 23 (2‒88) vs. 23 (2‒88), p < 0.001).

Conclusions

This study demonstrates that TLG has a lower risk of complications and faster postoperative recovery, thus TLG is superior to LAG for the treatment of gastric cancer.

目的：完全腹腔镜胃切除术（TLG）对胃癌患者是否有益尚不完全清楚。本研究旨在评价全腹腔镜胃切除术（TLG）治疗胃癌的优越性。方法：2019年1月至2021年12月，380例胃癌患者纳入研究，每组190例。对两组患者的术后恢复、炎症和肿瘤结果进行比较。结果：两组患者基线具有可比性。与LAG组相比，TLG组伤口感染风险（p = 0.02）和总并发症（p = 0.03）较低。TLG组的手术时间明显缩短（中位数：215 vs. 240 min, p < 0.001），术中出血量减少（中位数：50 vs. 100 mL, p < 0.001），首次放屁时间缩短（中位数：3 vs. 4天，p < 0.001），术后住院时间缩短（p < 0.001）。此外，与LAG组相比，TLG组患者的POD 1白细胞计数（WBC）较低（平均11.74比12.75 × 10^9/L; p = 0.003）。多因素logistic回归分析显示，TLG是术后住院时间缩短的独立预测因子(OR （95% CI): 0.54 (0.30-0.95), p = 0.03）。有趣的是，TLG组比LAG组有更多的淋巴结收获（中位数（范围）：23（2-88）比23 (2-88),p < 0.001）。结论：本研究表明TLG术后并发症发生率低，恢复快，TLG治疗胃癌优于LAG。

{"title":"Short-term outcome of totally laparoscopic gastrectomy for gastric cancer: a comparative study","authors":"Liu Liu , Shijie Feng , Haiyan Wang , Lin Liu","doi":"10.1016/j.clinsp.2026.100887","DOIUrl":"10.1016/j.clinsp.2026.100887","url":null,"abstract":"<div><h3>Objective</h3><div>Whether Totally Laparoscopic Gastrectomy (TLG) is beneficial for patients with gastric cancer remains not fully understood. This study was to evaluate the advantages of Totally Laparoscopic Gastrectomy (TLG) for treating Gastric Cancer (GC).</div></div><div><h3>Methods</h3><div>From January 2019 to December 2021, 380 patients with gastric cancer were included into this study (190 per group). The outcomes of interest, including postoperative recovery, inflammation, and oncological results, were compared between the two groups.</div></div><div><h3>Results</h3><div>The patient baselines between the two groups were comparable. The TLG group had lower risks of wound infection (<em>p</em> = 0.02) and total complications (<em>p</em> = 0.03) compared to LAG. The TLG group exhibited significantly shorter operative time (median: 215 vs. 240 min, <em>p</em> < 0.001), less intraoperative blood loss (median: 50 vs. 100 mL, <em>p</em> < 0.001), shorter time to first flatus (median: 3 vs. 4 days, <em>p</em> < 0.001), and reduced length of postoperative hospital stay (<em>p</em> < 0.001). Furthermore, patients in the TLG group exhibited lower White Blood Cell (WBC) counts on POD 1 compared to patients in the LAG group (mean 11.74 vs. 12.75 × 10^9/L; <em>p</em> = 0.003). Multivariate logistic regression analysis revealed that TLG was an independent predictor of shorter postoperative hospitalization (OR (95% CI): 0.54 (0.30‒0.95), <em>p</em> = 0.03). Interestingly, the TLG group had more lymph nodes harvested than the LAG group (median (range): 23 (2‒88) vs. 23 (2‒88), <em>p</em> < 0.001).</div></div><div><h3>Conclusions</h3><div>This study demonstrates that TLG has a lower risk of complications and faster postoperative recovery, thus TLG is superior to LAG for the treatment of gastric cancer.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100887"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146260638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Short-term effects of a 12-week Zumba program on thyroid and cardiometabolic markers in overweight/obese postmenopausal women: A randomized pilot study 12周尊巴项目对超重/肥胖绝经后妇女甲状腺和心脏代谢指标的短期影响：一项随机试点研究

IF 2.4 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Clinics

Pub Date : 2026-01-01 Epub Date: 2026-02-19 DOI: 10.1016/j.clinsp.2026.100880

Hanen Saadouni , Okba Selmi , Nejmeddine Ouerghi , Hamza Marzouki , Soukaina Hattabi , Lamia Attig , Katja Weiss , Thomas Rosemann , Beat Knechtle , Anissa Bouassida

Objective

This pilot study aimed to investigate the effects of a 12-week Zumba training program on Thyroid-Stimulating Hormone (TSH), Free Thyroxine (FT4), lipid profile, and anthropometric parameters in overweight and obese postmenopausal women.

Methods

Twenty-two women (aged 44‒60 years) were randomly assigned to a Zumba training group (ZG; n = 11) or a control group (CG; n = 11). The ZG participated in 60-min Zumba sessions three times per week for 12-weeks, while the CG maintained their usual lifestyle. Before and after the intervention, participants underwent assessments of body composition, blood pressure, and circulating levels of TSH, FT4, Total Cholesterol (TC), and Triglycerides (TG).

Results

Following the intervention, the ZG showed significant reductions in TSH (p = 0.001; Cohen’s d (d) = 0.90), TG levels (p = 0.043; d = 0.75), body fat percentage, body mass index, waist and hip circumference, and both systolic and diastolic blood pressure (all p < 0.05). No significant changes were observed for FT4 and TC levels. No notable changes were recorded in the CG.

Conclusions

The 12-week Zumba program can serve as a feasible and enjoyable strategy for promoting physical activity in overweight and obese postmenopausal women, leading to improvements in thyroid function, TG levels, body composition, and blood pressure. These preliminary findings support the potential of Zumba for enhancing cardiometabolic health during menopause, though larger, long-term trials are needed to confirm these effects and investigate their durability.

目的：本初步研究旨在探讨为期12周的尊巴训练计划对超重和肥胖绝经后妇女促甲状腺激素（TSH）、游离甲状腺素（FT4）、血脂和人体测量参数的影响。方法：22名女性（44-60岁）随机分为尊巴训练组（ZG, n = 11）和对照组（CG, n = 11）。ZG组每周参加三次60分钟的尊巴舞，持续12周，而CG组则保持他们平常的生活方式。在干预前后，参与者接受了身体成分、血压、TSH、FT4、总胆固醇（TC）和甘油三酯（TG）循环水平的评估。结果：干预后，ZG组TSH （p = 0.001; Cohen’s d (d) = 0.90）、TG水平（p = 0.043; d = 0.75）、体脂率、体重指数、腰臀围、收缩压和舒张压均显著降低（p < 0.05）。FT4和TC水平未见明显变化。CG未见明显变化。结论：为期12周的尊巴课程可以作为一种可行且愉快的策略，促进超重和肥胖绝经后妇女的身体活动，导致甲状腺功能，TG水平，身体成分和血压的改善。这些初步发现支持了尊巴在绝经期增强心脏代谢健康的潜力，尽管需要更大规模的长期试验来证实这些效果并调查其持久性。

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引用次数: 0

POEM for Zenker’s diverticulum (Z-POEM): Technical advances, challenges and complications – a narrative review Zenker憩室（Z-POEM）：技术进步，挑战和并发症-叙述性回顾。

IF 2.4 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Clinics

Pub Date : 2026-01-01 Epub Date: 2026-03-03 DOI: 10.1016/j.clinsp.2026.100897

Ygor Rocha Fernandes , Mateus Pereira Funari , Christiano Makoto Sakai , Fauze Maluf-Filho

Background/Aims

Zenker's Diverticulum (ZD) is a pharyngoesophageal pulsion diverticulum traditionally managed with open surgical or endoscopic (rigid and flexible) techniques. Zenker’s Peroral Endoscopic Myotomy (Z-POEM) has recently emerged as a minimally invasive alternative demonstrating promising efficacy and safety. This narrative review aims to synthesize current evidence regarding the technical evolution of Z-POEM, its indications, procedural nuances, long-term outcomes, cost-effectiveness, and future directions.

Methods

A structured narrative review was conducted in accordance with SANRA guidelines to assess the technical modifications, clinical outcomes, and complications of Zenker’s Per-Oral Endoscopic Myotomy (Z-POEM). Relevant literature published between January 2016 and September 2025 was systematically searched across PubMed, Scopus, and EMBASE, supplemented by manual citation tracing. Eligible studies included clinical trials, cohorts, observational reports, and technical notes focusing on Z-POEM or its variants. Data extraction and synthesis were performed independently by two reviewers, with findings organized into thematic domains comprising procedural techniques, efficacy, safety, adverse events, recurrence, and follow-up.

Results

Proper patient selection is critical for technical success. Factors such as diverticulum size, symptom severity, and anatomical features guide the optimal technique. Long-term studies report sustained clinical success exceeding 85% over 30‒40 months. Repeat Z-POEM procedures have shown high efficacy in managing recurrence. Comparative data indicate Z-POEM achieves superior clinical outcomes compared with flexible endoscopic septotomy, with comparable safety and procedure times.

Conclusions

Z-POEM demonstrates high safety and efficacy, though long-term durability may favor Z-POEM in larger or fibrotic diverticula. Further research should focus on cost-effectiveness, technique standardization, and long-term comparative outcomes to refine patient selection criteria and consolidate Z-POEM as a first-line therapy for ZD.

背景/目的：Zenker氏憩室（ZD）是一种咽-食管排异憩室，传统上采用开放手术或内镜（刚性和柔性）技术进行治疗。Zenker的经口内窥镜肌切开术（Z-POEM）最近作为一种微创替代方法出现，显示出良好的疗效和安全性。这篇叙述性综述旨在综合目前关于Z-POEM技术演变的证据，其适应症，程序上的细微差别，长期结果，成本效益和未来方向。方法：根据SANRA指南进行结构化的叙述性回顾，以评估Zenker经口内窥镜肌切开术（Z-POEM）的技术改进、临床结果和并发症。系统检索2016年1月至2025年9月期间发表的相关文献，检索PubMed、Scopus和EMBASE，并辅以人工引文追踪。符合条件的研究包括临床试验、队列、观察性报告和关注Z-POEM或其变体的技术笔记。数据提取和合成由两名审稿人独立完成，研究结果按主题领域组织，包括程序技术、疗效、安全性、不良事件、复发和随访。结果：正确的患者选择是技术成功的关键。憩室大小、症状严重程度和解剖特征等因素指导最佳技术。长期研究报告在30-40个月内持续的临床成功率超过85%。重复Z-POEM手术对治疗复发有很高的疗效。对比数据表明，与柔性内窥镜鼻中隔切开术相比，Z-POEM取得了更好的临床效果，具有相当的安全性和手术时间。结论：Z-POEM具有较高的安全性和有效性，但对于较大的憩室或纤维化憩室，Z-POEM的长期耐受性可能更有利。进一步的研究应侧重于成本效益、技术标准化和长期比较结果，以完善患者选择标准，巩固Z-POEM作为ZD的一线治疗方法。

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引用次数: 0

Six IL-8 gene polymorphisms and the entire cancer susceptibility according to a comprehensive analysis especially in prostate cancer 6种IL-8基因多态性与整体癌症易感性的综合分析，特别是前列腺癌。

IF 2.4 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Clinics

Pub Date : 2026-01-01 Epub Date: 2026-02-02 DOI: 10.1016/j.clinsp.2026.100862

Xiao Zhang , Jian Sun , Xiqi Ding

Objectives

Interleukin-8 (IL-8) is a key cytokine regulating immunity and inflammation, and its genetic polymorphisms have been increasingly linked to cancer susceptibility. However, findings on the role of specific IL-8 polymorphisms across different cancers remain inconsistent, necessitating a comprehensive meta-analysis.

Methods

The authors systematically searched Embase, PubMed, Chinese databases, Google Scholar, and Web of Science up to June 25, 2023. A total of 104 case-control studies (26,029 cases and 31,577 controls) were included in a high-powered meta-analysis. Summary Odds Ratios (ORs) with 95% Confidence Intervals (95% CIs) were calculated using Stata. Additionally, the authors performed an ELISA-based validation study to measure serum IL-8 levels in Prostate Cancer (PCa) patients grouped by genotype.

Results

The +2767 polymorphism was associated with a significant reduction in overall cancer risk. The +781 polymorphism increased cancer risk specifically in Caucasian populations. In contrast, the -251 polymorphism demonstrated a strong pan-cancer risk association, particularly in Mixed/Asian ethnicities, gastric cancer, lung cancer, and hospital-based studies. Mechanistically, patients with the -251 AA/AC genotypes had elevated serum IL-8 levels, which were linked to more aggressive PCa pathogenesis.

Conclusion

This pioneering meta-analysis identifies the IL-8 -251 polymorphism as a high-risk biomarker and +2767 as a protective variant. By functionally validating that the -251 risk allele promotes PCa progression via IL-8 overexpression, the present study establishes IL-8 genotyping as a potential tool for ethnic-specific risk stratification and prognostic prediction, with broad implications for precision oncology.

目的：白细胞介素-8 （IL-8）是调节免疫和炎症的关键细胞因子，其遗传多态性与癌症易感性的关系日益密切。然而，关于特定IL-8多态性在不同癌症中的作用的发现仍然不一致，需要进行全面的荟萃分析。方法：系统检索Embase、PubMed、中文数据库、谷歌Scholar、Web of Science，检索截止日期为2023年6月25日。一项高强度荟萃分析共纳入104项病例对照研究（26,029例和31,577例对照）。使用Stata计算具有95%置信区间（95% ci）的总体优势比（ORs）。此外，作者进行了一项基于elisa的验证研究，以测定按基因型分组的前列腺癌（PCa）患者血清IL-8水平。结果：+2767多态性与总体癌症风险的显著降低相关。+781多态性增加了癌症风险，特别是在高加索人群中。相比之下，-251多态性显示出强烈的泛癌症风险关联，特别是在混合/亚洲种族、胃癌、肺癌和基于医院的研究中。机制上，具有-251 AA/AC基因型的患者血清IL-8水平升高，这与更具侵袭性的PCa发病机制有关。结论：这项开创性的荟萃分析确定IL-8 -251多态性是一种高风险生物标志物，而+2767是一种保护性变异。通过功能性验证-251风险等位基因通过IL-8过表达促进前列腺癌进展，本研究建立了IL-8基因分型作为种族特异性风险分层和预后预测的潜在工具，对精确肿瘤学具有广泛意义。

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引用次数: 0

Electrophysiological evaluation of the auditory pathway in newborns and infants with peri-intraventricular hemorrhage and/or periventricular leukomalacia 新生儿和伴有脑室周围出血和/或脑室周围白质软化的婴儿的听觉通路的电生理评价

IF 2.4 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Clinics

Pub Date : 2026-01-01 Epub Date: 2025-12-18 DOI: 10.1016/j.clinsp.2025.100853

Rosanna Giaffredo Angrisani , Natalia Olival Balzarini , Carla Regina Tragante , Valdenise Martins Laurindo Tuma Calil , Werther Brunow de Carvalho , Carla Gentile Matas

Objective

To evaluate and monitor, through electrophysiological assessment of hearing, the integrity of the peripheral and central auditory pathways in infants with Peri-intraventricular hemorrhage and/or Periventricular Leukomalacia (PIVH/PVL) who stayed in a Neonatal Intensive Care Unit (NICU), aiming to verify the occurrence of possible neural dysfunctions in this system.

Material and methods

This prospective longitudinal study evaluated preterm Newborns (NBs) and infants at the time of hospital discharge and after 3- and 6-months. The Study Group (SG) had 12 females and 11 males, with gestational age between 25- and 33-weeks, and a mean gestational age of 29.82-weeks at birth. The Control Group (CG) had 26 healthy NBs, distributed in 13 females and 13 males, with gestational age between 27- and 33-weeks and a mean of 30.67-weeks of gestational age at birth. All participants underwent Auditory Brainstem Response (ABR) and Cortical Auditory Evoked Potentials (CAEP) P1, N1, P2, at the time of hospital discharge, and 3- and 6-months after discharge. Each group’s results were compared using statistical tests.

Results

Evolutionary study of mean ABR and CAEP latencies in infants in the study and control group showed a similar pattern over the six months after hospital discharge.

Conclusion

The comparison of brainstem and cortical potentials showed that auditory function is symmetrical in the peripheral and central portions of the auditory pathway in both groups. The maturation of the ABR and CAEP waves in both groups developed in a very similar way over the six months after hospital discharge.

目的通过听力电生理评估和监测新生儿重症监护病房（NICU）新生儿脑室周围出血和/或脑室周围白质acia （PIVH/PVL）患儿外周和中枢性听觉通路的完整性，以验证该系统可能存在的神经功能障碍。材料和方法本前瞻性纵向研究评估了早产新生儿（NBs）和婴儿出院时、3个月和6个月后的情况。研究组（SG）有12名女性和11名男性，胎龄在25至33周之间，出生时平均胎龄为29.82周。对照组（CG）有26名健康新生儿，分布在13名女性和13名男性中，胎龄在27至33周之间，平均出生时胎龄为30.67周。所有参与者在出院时以及出院后3个月和6个月分别进行了听觉脑干反应（ABR）和皮层听觉诱发电位（CAEP） P1、N1、P2测试。采用统计学检验对各组结果进行比较。结果研究组和对照组婴儿平均ABR和CAEP潜伏期在出院后6个月内的演化研究显示出相似的模式。结论脑干电位和皮层电位的比较表明，两组大鼠听觉通路外周和中枢部分的听觉功能是对称的。两组患者在出院后6个月内ABR和CAEP波的成熟发展非常相似。

{"title":"Electrophysiological evaluation of the auditory pathway in newborns and infants with peri-intraventricular hemorrhage and/or periventricular leukomalacia","authors":"Rosanna Giaffredo Angrisani , Natalia Olival Balzarini , Carla Regina Tragante , Valdenise Martins Laurindo Tuma Calil , Werther Brunow de Carvalho , Carla Gentile Matas","doi":"10.1016/j.clinsp.2025.100853","DOIUrl":"10.1016/j.clinsp.2025.100853","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate and monitor, through electrophysiological assessment of hearing, the integrity of the peripheral and central auditory pathways in infants with Peri-intraventricular hemorrhage and/or Periventricular Leukomalacia (PIVH/PVL) who stayed in a Neonatal Intensive Care Unit (NICU), aiming to verify the occurrence of possible neural dysfunctions in this system.</div></div><div><h3>Material and methods</h3><div>This prospective longitudinal study evaluated preterm Newborns (NBs) and infants at the time of hospital discharge and after 3- and 6-months. The Study Group (SG) had 12 females and 11 males, with gestational age between 25- and 33-weeks, and a mean gestational age of 29.82-weeks at birth. The Control Group (CG) had 26 healthy NBs, distributed in 13 females and 13 males, with gestational age between 27- and 33-weeks and a mean of 30.67-weeks of gestational age at birth. All participants underwent Auditory Brainstem Response (ABR) and Cortical Auditory Evoked Potentials (CAEP) P1, N1, P2, at the time of hospital discharge, and 3- and 6-months after discharge. Each group’s results were compared using statistical tests.</div></div><div><h3>Results</h3><div>Evolutionary study of mean ABR and CAEP latencies in infants in the study and control group showed a similar pattern over the six months after hospital discharge.</div></div><div><h3>Conclusion</h3><div>The comparison of brainstem and cortical potentials showed that auditory function is symmetrical in the peripheral and central portions of the auditory pathway in both groups. The maturation of the ABR and CAEP waves in both groups developed in a very similar way over the six months after hospital discharge.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100853"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145766000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

From diagnosis to daily life: A comparative pilot study on healthcare access and challenges for neurofibromatosis type 1 in public systems of Brazil and Portugal 从诊断到日常生活：巴西和葡萄牙公共系统中1型神经纤维瘤病的医疗保健可及性和挑战的比较试点研究

IF 2.4 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Clinics

Pub Date : 2026-01-01 Epub Date: 2026-02-12 DOI: 10.1016/j.clinsp.2026.100875

Déborah Domeneghetti de Francisco , Isabela Mayá Wayhs Silva , Jorge M. Saraiva , Carlos Eduardo Steiner , Vera Lúcia Gil-da-Silva-Lopes

Background

Neurofibromatosis type 1 is a systemic genetic disease with manifestations that include neurocognitive alterations. The disease's characteristics influence various areas of the lives of affected individuals, regardless of their place of residence.

Objectives

This study compares the experiences of a small group of patients with type 1 neurofibromatosis in two public hospitals in Brazil and Portugal.

Methods

This is an exploratory, cross-sectional, and descriptive study. Patients of legal age or those responsible for underage patients were included in a health service in the Clinical Hospital of the State University of Campinas in Brazil and the Clinical Academic Center of Coimbra in Portugal. They answered an online form about quality of life and access to health.

Results

18 participants were included, 13 Brazilians and 5 Portuguese. Most were female and had a mean age at diagnosis of 8.2-years. The mean age of Brazilians was 9.1-years for the first consultation with a geneticist and 15.5-years among Portuguese. The average number of professionals accessed was 4.5 among Brazilians and 3.8 among Portuguese.

Limitations

Small sample size, restricted temporal aspect, convenience bias of participants with internet access, and self-declaration of data by participants.

Conclusions

Both Brazilians and Portuguese participants with neurofibromatosis type 1 presented similar difficulties regarding access to health. The differences found between the participants from both countries focus on access to medical geneticists and their health literacy. Expanding studies would help identify care priorities related to the specificities of NF1 that could improve the quality of life of affected individuals.

1型神经纤维瘤病是一种全身性遗传疾病，其表现包括神经认知改变。该病的特点影响到患者生活的各个方面，无论其居住地点如何。目的：本研究比较了巴西和葡萄牙两家公立医院一小群1型神经纤维瘤病患者的经历。方法探索性、横断面、描述性研究。法定年龄的病人或对未成年病人负责的人被纳入巴西坎皮纳斯州立大学临床医院和葡萄牙科英布拉临床学术中心的保健服务。他们回答了一份关于生活质量和获得健康的在线表格。结果18名参与者，13名巴西人，5名葡萄牙人。大多数是女性，诊断时的平均年龄为8.2岁。第一次咨询遗传学家时，巴西人的平均年龄为9.1岁，葡萄牙人的平均年龄为15.5岁。巴西人平均有4.5位专业人士，葡萄牙人平均有3.8位。局限性：样本量小，时间方面受限，上网参与者的便利性偏差，以及参与者对数据的自我声明。结论巴西和葡萄牙的1型神经纤维瘤病患者在获得健康方面都有类似的困难。两国参与者之间的差异集中在获得医学遗传学家和他们的健康素养方面。扩大研究将有助于确定与NF1特异性相关的护理重点，从而改善受影响个体的生活质量。

{"title":"From diagnosis to daily life: A comparative pilot study on healthcare access and challenges for neurofibromatosis type 1 in public systems of Brazil and Portugal","authors":"Déborah Domeneghetti de Francisco , Isabela Mayá Wayhs Silva , Jorge M. Saraiva , Carlos Eduardo Steiner , Vera Lúcia Gil-da-Silva-Lopes","doi":"10.1016/j.clinsp.2026.100875","DOIUrl":"10.1016/j.clinsp.2026.100875","url":null,"abstract":"<div><h3>Background</h3><div>Neurofibromatosis type 1 is a systemic genetic disease with manifestations that include neurocognitive alterations. The disease's characteristics influence various areas of the lives of affected individuals, regardless of their place of residence.</div></div><div><h3>Objectives</h3><div>This study compares the experiences of a small group of patients with type 1 neurofibromatosis in two public hospitals in Brazil and Portugal.</div></div><div><h3>Methods</h3><div>This is an exploratory, cross-sectional, and descriptive study. Patients of legal age or those responsible for underage patients were included in a health service in the Clinical Hospital of the State University of Campinas in Brazil and the Clinical Academic Center of Coimbra in Portugal. They answered an online form about quality of life and access to health.</div></div><div><h3>Results</h3><div>18 participants were included, 13 Brazilians and 5 Portuguese. Most were female and had a mean age at diagnosis of 8.2-years. The mean age of Brazilians was 9.1-years for the first consultation with a geneticist and 15.5-years among Portuguese. The average number of professionals accessed was 4.5 among Brazilians and 3.8 among Portuguese.</div></div><div><h3>Limitations</h3><div>Small sample size, restricted temporal aspect, convenience bias of participants with internet access, and self-declaration of data by participants.</div></div><div><h3>Conclusions</h3><div>Both Brazilians and Portuguese participants with neurofibromatosis type 1 presented similar difficulties regarding access to health. The differences found between the participants from both countries focus on access to medical geneticists and their health literacy. Expanding studies would help identify care priorities related to the specificities of NF1 that could improve the quality of life of affected individuals.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100875"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146185175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical significance and mechanistic role of Hsa_circ_0005075 in recurrent spontaneous abortion: Regulation of trophoblast proliferation and invasion through the Wnt/β-catenin pathway Hsa_circ_0005075在复发性自然流产中的临床意义及机制作用：通过Wnt/β-catenin通路调节滋养细胞增殖和侵袭

IF 2.4 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Clinics

Pub Date : 2026-01-01 Epub Date: 2026-02-13 DOI: 10.1016/j.clinsp.2025.100816

Meng Li , Shuyuan Liu , Xuan Du

Objective

Given the current lack of diagnostic markers with high sensitivity and specificity, the diagnosis and treatment of Recurrent Spontaneous Abortion (RSA) have always presented significant difficulties. To analyze the relationship between hsa_circ_0005075 and RSA and conduct a preliminary exploration of its mechanism.

Methods

Fifty-eight RSA patients admitted to the studied hospital from March 2022 to January 2024 (research group) and 52 normal pregnant women (control group) were selected as the research subjects. Peripheral blood hsa_circ_0005075 expression was detected to determine the difference between the two groups. In addition, the evaluation value of hsa_circ_0005075 for RSA, miscarriage, and adverse pregnancy outcomes was analyzed through Receiver Operating Characteristic (ROC) curves. Furthermore, human placental Trophoblast Cells (TBCs) HTR8/SVneowere purchased and transfected with abnormal hsa_circ_0005075 expression sequences to identify changes in HTR8/SVneoproliferation, invasion, and apoptosis, and alterations in Wnt/β-catenin pathway expression.

Results

hsa_circ_0005075 was higher in the research group than in the control group (4.00 ± 0.93 vs. 2.78 ± 0.94, p < 0.05). ROC curves indicated the excellent diagnostic effect of hsa_circ_0005075 on the occurrence of RSA (Area Under Curve [AUC = 0.820]), miscarriage (AUC = 0.744), and adverse pregnancy outcomes (AUC = 0.726). In vitro, increasing hsa_circ_0005075 inhibited HTR8/SVneogrowth, decreased cell clones and cell invasion number, increased apoptosis, shortened the G0/G1 phase, and activated the Wnt/β-catenin pathway; the opposite results were observed after silencing hsa_circ_0005075 expression. Mechanistically, gain and loss-of-function experiments revealed that hsa_circ_0005075 acts as a negative regulator of trophoblast proliferation, invasion, and cell cycle progression, and induces apoptosis by suppressing the Wnt/β-catenin signaling pathway.

Conclusions

The present findings identify hsa_circ_0005075 as a promising circulating biomarker for RSA and demonstrate that it contributes to RSA pathogenesis by impairing trophoblast function through inhibition of the Wnt/β-catenin pathway, suggesting its potential as a therapeutic target.

目的由于目前缺乏高敏感性和特异性的诊断标志物，复发性自然流产（RSA）的诊断和治疗一直存在很大的困难。分析hsa_circ_0005075与RSA之间的关系，并对其作用机制进行初步探讨。方法选择2022年3月至2024年1月在该院住院的58例RSA患者（研究组）和52例正常孕妇（对照组）作为研究对象。检测外周血hsa_circ_0005075的表达，确定两组之间的差异。此外，通过受试者工作特征（Receiver Operating Characteristic， ROC）曲线分析hsa_circ_0005075对RSA、流产和不良妊娠结局的评价价值。此外，我们购买人胎盘滋养细胞（tbc） HTR8/ svneoth，转染异常hsa_circ_0005075表达序列，以鉴定HTR8/ svneoth增殖、侵袭和凋亡的变化以及Wnt/β-catenin通路表达的变化。结果研究组的shsa_circ_0005075高于对照组（4.00±0.93比2.78±0.94,p < 0.05）。ROC曲线显示hsa_circ_0005075对RSA（曲线下面积[AUC = 0.820]）、流产（AUC = 0.744）、不良妊娠结局（AUC = 0.726）的发生具有良好的诊断效果。在体外，增加hsa_circ_0005075抑制HTR8/ svneog生长，减少细胞克隆和细胞侵袭数量，增加凋亡，缩短G0/G1期，激活Wnt/β-catenin通路；沉默hsa_circ_0005075表达后观察到相反的结果。机制上，功能增益和功能损失实验表明，hsa_circ_0005075作为滋养细胞增殖、侵袭和细胞周期进程的负调节因子，并通过抑制Wnt/β-catenin信号通路诱导细胞凋亡。结论hsa_circ_0005075是一种很有前景的RSA循环生物标志物，它通过抑制Wnt/β-catenin通路损害滋养细胞功能，参与RSA发病机制，提示其作为治疗靶点的潜力。

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引用次数: 0