The present study is a retrospective analysis of the activities of a tertiary stroke center (SC) operating on the basis of Akzhan Clinic in Karaganda Region during the year 2024. The primary objective of this study was to examine the epidemiological features, the structure of stroke morbidity, and the efficacy of thrombolytic therapy (TLT) in patients with ischemic stroke (IS). The study included data from a total of 585 patients, out of which 437 had been hospitalized with acute cerebrovascular disorders, and 104 of these patients had received TLT for IS. The analysis revealed a high level of utilization of TLT (23.8%), which was significantly higher than the average regional and national figures, owing to the efficient organization of prehospital and in-hospital stages, availability of skilled personnel, and a state-of-the-art technical infrastructure. Additionally, mechanical thrombectomy (MT) was performed in 100 instances, further confirming the high level of adoption of advanced treatment modalities. The proportion of hemorrhagic transformations (7.69%) and mortality (6.7%) was comparable to or lower than international benchmarks. The results demonstrate the high effectiveness of the performance of the SC “Akzhan” and the need for the further expansion of similar facilities in order to improve the accessibility and quality of stroke treatment in Kazakhstan.
{"title":"Evaluation of Stroke Care Delivery: 12-Month Experience of a Tertiary Stroke Center in Central Asia","authors":"Marina Grigolashvili, Dmitriy Klyuyev, Dmitry Kasatkin, Sharbanu Battakova, Yelena Shayakhmetova, Mira Beisembayeva, Shynar Muratbekova, Alina Koshelyuk, Yessenbay Baituyak, Ivan Turkevich, Alexey Dey","doi":"10.1155/ijcp/8109173","DOIUrl":"https://doi.org/10.1155/ijcp/8109173","url":null,"abstract":"<p>The present study is a retrospective analysis of the activities of a tertiary stroke center (SC) operating on the basis of Akzhan Clinic in Karaganda Region during the year 2024. The primary objective of this study was to examine the epidemiological features, the structure of stroke morbidity, and the efficacy of thrombolytic therapy (TLT) in patients with ischemic stroke (IS). The study included data from a total of 585 patients, out of which 437 had been hospitalized with acute cerebrovascular disorders, and 104 of these patients had received TLT for IS. The analysis revealed a high level of utilization of TLT (23.8%), which was significantly higher than the average regional and national figures, owing to the efficient organization of prehospital and in-hospital stages, availability of skilled personnel, and a state-of-the-art technical infrastructure. Additionally, mechanical thrombectomy (MT) was performed in 100 instances, further confirming the high level of adoption of advanced treatment modalities. The proportion of hemorrhagic transformations (7.69%) and mortality (6.7%) was comparable to or lower than international benchmarks. The results demonstrate the high effectiveness of the performance of the SC “Akzhan” and the need for the further expansion of similar facilities in order to improve the accessibility and quality of stroke treatment in Kazakhstan.</p>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/8109173","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145317609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Binali Firinci, Cetin Aydin, Dilek Yunluel, Ozgur Caglar, Mehmet Dumlu Aydin, Ali Ahiskalioglu
Objectives
Circumcision has been used for thousands of years with the belief that it is beneficial for sexual health and on religious grounds. The histopathological results regarding the neurobiological damage of this procedure have been rarely investigated. This study aimed to examine the potential adverse effects of circumcision, particularly the use of monopolar electrocautery, on pudendal nerve ganglia, Onuf’s nucleus, and the myenteric plexus (Auerbach’s ganglia) of the colon in rabbits.
Methods
Eighteen male rabbits were allocated to a control group (Group I, n = 5), and groups where circumcisions were performed without (Group II, n = 5) and with (Group III, n = 8) using monopolar electrocautery. The rabbits were followed up for 3 weeks and then sacrificed under general anesthesia. Penile tissues, Onuf’s nucleus and pudendal fiber origin complexes, dorsal root ganglion at sacral 3 level, and neurons in the myenteric plexus of Auerbach in rectum were examined using stereological methods. Degenerated neuron densities (n/mm3) of S3 ganglia, ganglia of Auerbach’s plexus, and Onuf’s nuclei of male rabbits were compared.
Results
Degenerated neuron intensities (n/mm3) in pudendal ganglia, Onuf’s nucleus, and myenteric ganglia were 9 ± 3, 3 ± 1, and 7 ± 2 in GI; 17 ± 5, 7 ± 2, and 11 ± 3 in GII; and 89 ± 13, 24 ± 5, and 45 ± 8 in GIII. There were no statistically significant differences between the control group (GI) and the sham surgical circumcision group (GII) (p > 0.05). However, both GI and GII showed significantly lower levels of neuronal degeneration when compared to the electrocautery group (GIII) (p < 0.005 for GII vs. GIII; p < 0.00001 for GI vs. GIII).
Conclusions
Denervation of the pudendal nerve ganglia and Onuf’s nucleus caused by surgical removal of the foreskin may also lead to neurodegeneration in the ganglia of Auerbach’s plexus in the rectum innervated by this denervated network.
{"title":"Neurodegenerative Effects of Monopolar Electrocautery on Myenteric Ganglia During Penile Surgery: A Preliminary Experimental Rabbit Study","authors":"Binali Firinci, Cetin Aydin, Dilek Yunluel, Ozgur Caglar, Mehmet Dumlu Aydin, Ali Ahiskalioglu","doi":"10.1155/ijcp/8849240","DOIUrl":"https://doi.org/10.1155/ijcp/8849240","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Circumcision has been used for thousands of years with the belief that it is beneficial for sexual health and on religious grounds. The histopathological results regarding the neurobiological damage of this procedure have been rarely investigated. This study aimed to examine the potential adverse effects of circumcision, particularly the use of monopolar electrocautery, on pudendal nerve ganglia, Onuf’s nucleus, and the myenteric plexus (Auerbach’s ganglia) of the colon in rabbits.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Eighteen male rabbits were allocated to a control group (Group I, <i>n</i> = 5), and groups where circumcisions were performed without (Group II, <i>n</i> = 5) and with (Group III, <i>n</i> = 8) using monopolar electrocautery. The rabbits were followed up for 3 weeks and then sacrificed under general anesthesia. Penile tissues, Onuf’s nucleus and pudendal fiber origin complexes, dorsal root ganglion at sacral 3 level, and <i>neurons</i> in the myenteric plexus of <i>Auerbach</i> in rectum were examined using stereological methods. Degenerated neuron densities (n/mm<sup>3</sup>) of S3 ganglia, ganglia of Auerbach’s plexus, and Onuf’s nuclei of male rabbits were compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Degenerated neuron intensities (n/mm<sup>3</sup>) in pudendal ganglia, Onuf’s nucleus, and myenteric ganglia were 9 ± 3, 3 ± 1, and 7 ± 2 in GI; 17 ± 5, 7 ± 2, and 11 ± 3 in GII; and 89 ± 13, 24 ± 5, and 45 ± 8 in GIII. There were no statistically significant differences between the control group (GI) and the sham surgical circumcision group (GII) (<i>p</i> > 0.05). However, both GI and GII showed significantly lower levels of neuronal degeneration when compared to the electrocautery group (GIII) (<i>p</i> < 0.005 for GII vs. GIII; <i>p</i> < 0.00001 for GI vs. GIII).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Denervation of the pudendal nerve ganglia and Onuf’s nucleus caused by surgical removal of the foreskin may also lead to neurodegeneration in the ganglia of Auerbach’s plexus in the rectum innervated by this denervated network.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/8849240","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145317124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To investigate the effects of dark chocolate consumption on anxiety and pain levels in patients undergoing thyroid fine needle aspiration biopsy (FNAB).
Materials and Methods
This was a single-center, randomized controlled study conducted between June 2024 and October 2024; local ethical approval was obtained. Patients who met the inclusion criteria were randomly divided into two groups: Group 1 received two squares of dark chocolate around 30 min before the procedure, while Group 2 did not. Anxiety levels were assessed using the State-Trait Anxiety Inventory (STAI), and pain levels were measured using the Visual Analog Scale (VAS) method. Anxiety levels were assessed before and after the procedure using the STAI, while pain levels were measured only after the procedure using the VAS.
Results
Of the 99 patients included, 82 (82.8%) were female, with a mean age of 47.61 ± 11.32 years. There were no demographic differences between Groups 1 and 2. Significant differences were found between the groups, with Group 1 reporting lower scores for both postprocedural anxiety adjusted for baseline Group STAI score and VAS scores (p < 0.05).
Conclusion
Dark chocolate consumption prior to thyroid FNAB may be an effective intervention for reducing both anxiety and pain in patients. Further studies with larger samples are recommended to confirm these findings.
{"title":"Dark Chocolate as a Preprocedure Intervention for Anxiety and Pain Reduction in Thyroid FNAB: A Prospective Randomized Controlled Study","authors":"Servan Yaşar","doi":"10.1155/ijcp/5687455","DOIUrl":"https://doi.org/10.1155/ijcp/5687455","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the effects of dark chocolate consumption on anxiety and pain levels in patients undergoing thyroid fine needle aspiration biopsy (FNAB).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This was a single-center, randomized controlled study conducted between June 2024 and October 2024; local ethical approval was obtained. Patients who met the inclusion criteria were randomly divided into two groups: Group 1 received two squares of dark chocolate around 30 min before the procedure, while Group 2 did not. Anxiety levels were assessed using the State-Trait Anxiety Inventory (STAI), and pain levels were measured using the Visual Analog Scale (VAS) method. Anxiety levels were assessed before and after the procedure using the STAI, while pain levels were measured only after the procedure using the VAS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 99 patients included, 82 (82.8%) were female, with a mean age of 47.61 ± 11.32 years. There were no demographic differences between Groups 1 and 2. Significant differences were found between the groups, with Group 1 reporting lower scores for both postprocedural anxiety adjusted for baseline Group STAI score and VAS scores (<i>p</i> < 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Dark chocolate consumption prior to thyroid FNAB may be an effective intervention for reducing both anxiety and pain in patients. Further studies with larger samples are recommended to confirm these findings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/5687455","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145317125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Increasing evidence has demonstrated a causal relationship between cerebrovascular disease (CVD) and cardiovascular events. This study investigated the effects of previous CVD on the in-hospital characteristics and prognosis of patients with first-ever acute myocardial infarction (AMI).
Methods
This study recruited 2993 consecutive patients diagnosed with AMI between January 2017 and December 2022. Baseline characteristics, general evaluations, and cardiac tests were compared between patients with AMI with and without a history of CVD (CVD group and nCVD group, respectively). The primary outcome was major adverse cardiovascular events (MACEs). The secondary outcome was extended length of stay (LOSE). Baseline characteristics were balanced using 1:1 propensity score matching (PSM).
Results
This study enrolled 536 patients with first-ever AMI after PAM. Compared with patients in the nCVD group, those in the CVD group had higher high-sensitivity C-reactive protein (p = 0.04) and N-terminal pro-B-type natriuretic peptide (p = 0.002) levels, as well as a lower left ventricular ejection fraction (p = 0.004). The CVD group also showed a lower percentage of moderate risk (p = 0.03) and a higher percentage of high risk (p = 0.03) GRACE scores on admission, in addition to a higher overall GRACE score before discharge (p = 0.04) compared with patients in the nCVD group. However, the risk of MACE or LOSE did not differ significantly between patients in the CVD and nCVD groups.
Conclusion
Patients with AMI and a history of CVD may experience severe damage to cardiac structure and function. However, a history of CVD was not associated with in-hospital outcomes in patients with AMI.
{"title":"Clinical Characteristics and In-Hospital Prognosis of Patients With First-Ever Acute Myocardial Infarction With a History of Cerebrovascular Disease","authors":"Yue Hu, Jinhuan Gao, Yayun Liu, Yumin Luo, Jinggang Xia","doi":"10.1155/ijcp/7908155","DOIUrl":"https://doi.org/10.1155/ijcp/7908155","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Increasing evidence has demonstrated a causal relationship between cerebrovascular disease (CVD) and cardiovascular events. This study investigated the effects of previous CVD on the in-hospital characteristics and prognosis of patients with first-ever acute myocardial infarction (AMI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study recruited 2993 consecutive patients diagnosed with AMI between January 2017 and December 2022. Baseline characteristics, general evaluations, and cardiac tests were compared between patients with AMI with and without a history of CVD (CVD group and nCVD group, respectively). The primary outcome was major adverse cardiovascular events (MACEs). The secondary outcome was extended length of stay (LOSE). Baseline characteristics were balanced using 1:1 propensity score matching (PSM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study enrolled 536 patients with first-ever AMI after PAM. Compared with patients in the nCVD group, those in the CVD group had higher high-sensitivity C-reactive protein (<i>p</i> = 0.04) and N-terminal pro-B-type natriuretic peptide (<i>p</i> = 0.002) levels, as well as a lower left ventricular ejection fraction (<i>p</i> = 0.004). The CVD group also showed a lower percentage of moderate risk (<i>p</i> = 0.03) and a higher percentage of high risk (<i>p</i> = 0.03) GRACE scores on admission, in addition to a higher overall GRACE score before discharge (<i>p</i> = 0.04) compared with patients in the nCVD group. However, the risk of MACE or LOSE did not differ significantly between patients in the CVD and nCVD groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Patients with AMI and a history of CVD may experience severe damage to cardiac structure and function. However, a history of CVD was not associated with in-hospital outcomes in patients with AMI.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/7908155","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145317123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abdullah Orhan Demirtas, Abdullah Yildirim, Samet Ayna, Halil Coskun, Hazar Harbalioglu, Mukremin Coskun, Sheldon M. Singh
Background
Increased rates of cardiac events at the time of natural disasters have been reported. However, the relationship between myocardial infarctions and earthquakes is less clear. We report on the rate of myocardial infarction with no obstructive coronary artery (MINOCA) disease during the 2023 Turkiye earthquakes.
Methods
All patients with a positive troponin undergoing a coronary angiogram at the Adana City Training and Research Hospital 2 months prior and 2 months subsequent to the February 6th, 2023, Turkiye earthquakes were included. Patients with MINOCA were identified. Multivariate logistic regression analysis was performed to determine variables associated with a diagnosis of MINOCA.
Results
619 patients underwent angiography during the study period—479 prior and 140 subsequent to the earthquake. The median age was 61 years and 73% male. MINOCA was diagnosed in 7.8% of the cohort. MINOCA was higher in the postearthquake period (pre: 3.8% vs. post: 21.4%; p < 0.001). The time period after the earthquake had the highest odds of a diagnosis of MINOCA (odds ratio: 5.76; 95% confidence interval: 2.90–11.44). Survival to hospital discharge was higher in the postearthquake period (pre: 89.4% vs. post: 97.9%; p < 0.001).
Conclusion
The rate of MINOCA increased after the Turkiye earthquakes on February 6th, 2023. This knowledge provides new insight into the spectrum of myocardial infarction after natural disasters. Our work also highlights a potential survivorship bias, which may confound studies reporting on cardiac events after natural disasters. Future work to assess the potential long-term adverse consequences of MINOCA in this population is suggested.
{"title":"Myocardial Infarction With No Obstructive Coronary Artery Disease and the 2023 Turkiye Earthquakes","authors":"Abdullah Orhan Demirtas, Abdullah Yildirim, Samet Ayna, Halil Coskun, Hazar Harbalioglu, Mukremin Coskun, Sheldon M. Singh","doi":"10.1155/ijcp/5969719","DOIUrl":"https://doi.org/10.1155/ijcp/5969719","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Increased rates of cardiac events at the time of natural disasters have been reported. However, the relationship between myocardial infarctions and earthquakes is less clear. We report on the rate of myocardial infarction with no obstructive coronary artery (MINOCA) disease during the 2023 Turkiye earthquakes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>All patients with a positive troponin undergoing a coronary angiogram at the Adana City Training and Research Hospital 2 months prior and 2 months subsequent to the February 6<sup>th</sup>, 2023, Turkiye earthquakes were included. Patients with MINOCA were identified. Multivariate logistic regression analysis was performed to determine variables associated with a diagnosis of MINOCA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>619 patients underwent angiography during the study period—479 prior and 140 subsequent to the earthquake. The median age was 61 years and 73% male. MINOCA was diagnosed in 7.8% of the cohort. MINOCA was higher in the postearthquake period (pre: 3.8% vs. post: 21.4%; <i>p</i> < 0.001). The time period after the earthquake had the highest odds of a diagnosis of MINOCA (odds ratio: 5.76; 95% confidence interval: 2.90–11.44). Survival to hospital discharge was higher in the postearthquake period (pre: 89.4% vs. post: 97.9%; <i>p</i> < 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The rate of MINOCA increased after the Turkiye earthquakes on February 6<sup>th</sup>, 2023. This knowledge provides new insight into the spectrum of myocardial infarction after natural disasters. Our work also highlights a potential survivorship bias, which may confound studies reporting on cardiac events after natural disasters. Future work to assess the potential long-term adverse consequences of MINOCA in this population is suggested.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/5969719","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145317126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To evaluate the effectiveness of the “3L Training + Experiential” teaching model in developing clinical research nurse teams in cases of urinary surgery.
Methods
The “3L Training + Experiential” teaching model was constructed, and teaching plans and training content were developed. The practical training for the clinical research nurse team employed the 3L approach (hospital–professional group–project simulation) combined with precepting and experiential learning. Thirty clinical research nurses from the urinary surgery unit were selected as the intervention group, and 30 clinical research nurses working at the hospital in 2022 were randomly selected as the control group. The intervention group received training under the “3L Training + Experiential” teaching model, while the control group underwent traditional clinical research nurse training within the hospital. Training assessment results were statistically analyzed using SPSS software.
Results
Compared to the control group, clinical research nurses who underwent “3L Training + Experiential” training achieved higher scores in both theoretical and practical assessments.
Conclusion
After validating the teaching effectiveness through the overall research quality of the projects, the “3L Training + Experiential” teaching model was ultimately constructed and applied to the training of urinary surgery clinical research nurse teams, improving the professionalism and motivation of researchers and achieving positive outcomes in team building for the professional group.
{"title":"Advantages of the “3L Training + Experiential” Teaching Model in Developing Urinary Surgery Research Nurse Teams","authors":"Jie’an Ding, Xiaofeng Wu, Liru Chen, Xin Cheng, Jie Cao, Jianping Xiu, Shouyan Tang","doi":"10.1155/ijcp/2871990","DOIUrl":"https://doi.org/10.1155/ijcp/2871990","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the effectiveness of the “3L Training + Experiential” teaching model in developing clinical research nurse teams in cases of urinary surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The “3L Training + Experiential” teaching model was constructed, and teaching plans and training content were developed. The practical training for the clinical research nurse team employed the 3L approach (hospital–professional group–project simulation) combined with precepting and experiential learning. Thirty clinical research nurses from the urinary surgery unit were selected as the intervention group, and 30 clinical research nurses working at the hospital in 2022 were randomly selected as the control group. The intervention group received training under the “3L Training + Experiential” teaching model, while the control group underwent traditional clinical research nurse training within the hospital. Training assessment results were statistically analyzed using SPSS software.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared to the control group, clinical research nurses who underwent “3L Training + Experiential” training achieved higher scores in both theoretical and practical assessments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>After validating the teaching effectiveness through the overall research quality of the projects, the “3L Training + Experiential” teaching model was ultimately constructed and applied to the training of urinary surgery clinical research nurse teams, improving the professionalism and motivation of researchers and achieving positive outcomes in team building for the professional group.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/2871990","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145316878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yan Du, Kaisen Huang, Jingjia Yang, Guojun Xiong, Xiaojian Deng, Yu Lei, Qing Peng
Background
Atrial fibrillation (AF) and major depressive disorder (MDD) are prevalent chronic diseases with unclear bidirectional causal relationships and shared mechanisms. This study aimed to explore their associations and underlying pathways.
Methods
We used two-sample Mendelian randomization (MR) with Genomewide Association Studies (GWAS) data to assess causal links between AF and MDD. Transcriptomic analyses identified differentially expressed genes (DEGs) and hub genes in AF (GSE41177) and MDD (GSE38206) datasets, followed by functional enrichment (GO/KEGG), immune cell infiltration analysis, and gene set enrichment analysis (GSEA) for the key gene HCK. A competing endogenous RNA (ceRNA) network was predicted for upstream/downstream gene regulation.
Results
MR revealed a bidirectional causal relationship: AF increased MDD risk (OR = 1.002, p = 0.019) and MDD elevated AF risk (OR = 4.547, p = 0.035). Through transcriptome gene analysis of AF and MDD, 17 key overlapping genes with dual diseases were identified. Functional enrichment and immune cell infiltration analyses both demonstrated that the key overlapping genes were correlated with immune regulation and inflammatory responses in two diseases. Eight hub genes were identified by Cytoscape software, with HCK as the central gene, upregulated in both diseases and correlated with immune cell infiltration (e.g., monocytes, M1 macrophages in MDD; negative correlation with Tregs in AF). GSEA highlighted toll-like receptor and cytokine–cytokine receptor pathways. The predicted HCK-centered ceRNA network (1 mRNA, 1 miRNA, and 7 lncRNAs) suggested joint regulation of disease pathogenesis.
Conclusion
We demonstrated that AF and MDD exhibit a bidirectional causal association and identified 17 key overlapping genes that may be involved in the shared immune-inflammatory mechanisms between AF and MDD. HCK emerges as a potential biomarker, linking immune cell dynamics and inflammation. These findings offer novel targets for integrated management of AF and MDD.
背景房颤（AF）和重度抑郁症（MDD）是常见的慢性疾病，双向因果关系尚不清楚，但存在共同的发病机制。本研究旨在探讨它们之间的联系和潜在的途径。方法采用两样本孟德尔随机化（MR）和全基因组关联研究（GWAS）数据来评估房颤和重度抑郁症之间的因果关系。转录组学分析鉴定了AF （GSE41177）和MDD （GSE38206）数据集中的差异表达基因（DEGs）和枢纽基因，随后进行了关键基因HCK的功能富集（GO/KEGG）、免疫细胞浸润分析和基因集富集分析（GSEA）。预测了一个竞争的内源RNA （ceRNA）网络用于上游/下游基因调控。结果MR显示双向因果关系：AF增加MDD风险（OR = 1.002, p = 0.019）， MDD增加AF风险（OR = 4.547, p = 0.035）。通过对AF和MDD的转录组基因分析，鉴定出17个与双重疾病相关的关键重叠基因。功能富集和免疫细胞浸润分析均表明，关键重叠基因与两种疾病的免疫调节和炎症反应相关。通过Cytoscape软件鉴定出8个枢纽基因，以HCK为中心基因，在两种疾病中均表达上调，并与免疫细胞浸润相关（如MDD中单核细胞、M1巨噬细胞；AF中与Tregs负相关）。GSEA强调toll样受体和细胞因子-细胞因子受体途径。预测的以hck为中心的ceRNA网络（1个mRNA、1个miRNA和7个lncrna）提示疾病发病机制的共同调控。结论AF和MDD表现出双向的因果关系，并鉴定出17个关键的重叠基因，这些基因可能参与AF和MDD之间共享的免疫炎症机制。HCK作为一种潜在的生物标志物，将免疫细胞动力学和炎症联系起来。这些发现为房颤和重度抑郁症的综合治疗提供了新的靶点。
{"title":"Integrated Analysis of Bidirectional Causality and Immune-Inflammatory Mechanism Between Atrial Fibrillation and Major Depression","authors":"Yan Du, Kaisen Huang, Jingjia Yang, Guojun Xiong, Xiaojian Deng, Yu Lei, Qing Peng","doi":"10.1155/ijcp/3653798","DOIUrl":"https://doi.org/10.1155/ijcp/3653798","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Atrial fibrillation (AF) and major depressive disorder (MDD) are prevalent chronic diseases with unclear bidirectional causal relationships and shared mechanisms. This study aimed to explore their associations and underlying pathways.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used two-sample Mendelian randomization (MR) with Genomewide Association Studies (GWAS) data to assess causal links between AF and MDD. Transcriptomic analyses identified differentially expressed genes (DEGs) and hub genes in AF (GSE41177) and MDD (GSE38206) datasets, followed by functional enrichment (GO/KEGG), immune cell infiltration analysis, and gene set enrichment analysis (GSEA) for the key gene HCK. A competing endogenous RNA (ceRNA) network was predicted for upstream/downstream gene regulation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>MR revealed a bidirectional causal relationship: AF increased MDD risk (OR = 1.002, <i>p</i> = 0.019) and MDD elevated AF risk (OR = 4.547, <i>p</i> = 0.035). Through transcriptome gene analysis of AF and MDD, 17 key overlapping genes with dual diseases were identified. Functional enrichment and immune cell infiltration analyses both demonstrated that the key overlapping genes were correlated with immune regulation and inflammatory responses in two diseases. Eight hub genes were identified by Cytoscape software, with HCK as the central gene, upregulated in both diseases and correlated with immune cell infiltration (e.g., monocytes, M1 macrophages in MDD; negative correlation with Tregs in AF). GSEA highlighted toll-like receptor and cytokine–cytokine receptor pathways. The predicted HCK-centered ceRNA network (1 mRNA, 1 miRNA, and 7 lncRNAs) suggested joint regulation of disease pathogenesis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We demonstrated that AF and MDD exhibit a bidirectional causal association and identified 17 key overlapping genes that may be involved in the shared immune-inflammatory mechanisms between AF and MDD. HCK emerges as a potential biomarker, linking immune cell dynamics and inflammation. These findings offer novel targets for integrated management of AF and MDD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/3653798","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145316682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ye Ma, Mengxuan Yuan, Wanjun Lu, Lu Jiang, Jian Peng
Objective
To develop a diagnostic model for uremic sarcopenia by combining radiomic features of the erector spinae muscle from chest CT images with clinical data.
Methods
A total of 195 patients with uremia were collected, including 84 diagnosed with uremic sarcopenia based on the gold standard, and 111 without sarcopenia. A nomogram model was developed by integrating radiomic and clinical features. The diagnostic performance of the nomogram model, radiomics signature, and clinical signature was individually compared to validate their effectiveness. Receiver operating characteristic (ROC) curves were generated to assess diagnostic accuracy.
Results
A nomogram combining radiomic and clinical features was developed using a logistic regression machine learning algorithm. The predictive performance of the nomogram was evaluated using the area under the ROC curve (AUC) and calibration curves. In the test set, the nomogram demonstrated superior predictive performance, with an AUC of 0.951 (95% CI: 0.886–1.000). Decision curve analysis (DCA) was used to assess the clinical benefits of the model, and the nomogram showed a higher clinical benefit in diagnosing uremic sarcopenia.
Conclusion
The nomogram developed by combining CT radiomic features of the erector spinae muscle with clinical features demonstrates excellent diagnostic performance for uremic sarcopenia, achieving perfect specificity and eliminating false positives compared to individual models.
{"title":"A Nomogram Model Based on Radiomic and Clinical Features of Erector Spinae Muscle CT Images for Diagnosing Uremic Sarcopenia","authors":"Ye Ma, Mengxuan Yuan, Wanjun Lu, Lu Jiang, Jian Peng","doi":"10.1155/ijcp/8872776","DOIUrl":"https://doi.org/10.1155/ijcp/8872776","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To develop a diagnostic model for uremic sarcopenia by combining radiomic features of the erector spinae muscle from chest CT images with clinical data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 195 patients with uremia were collected, including 84 diagnosed with uremic sarcopenia based on the gold standard, and 111 without sarcopenia. A nomogram model was developed by integrating radiomic and clinical features. The diagnostic performance of the nomogram model, radiomics signature, and clinical signature was individually compared to validate their effectiveness. Receiver operating characteristic (ROC) curves were generated to assess diagnostic accuracy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A nomogram combining radiomic and clinical features was developed using a logistic regression machine learning algorithm. The predictive performance of the nomogram was evaluated using the area under the ROC curve (AUC) and calibration curves. In the test set, the nomogram demonstrated superior predictive performance, with an AUC of 0.951 (95% CI: 0.886–1.000). Decision curve analysis (DCA) was used to assess the clinical benefits of the model, and the nomogram showed a higher clinical benefit in diagnosing uremic sarcopenia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The nomogram developed by combining CT radiomic features of the erector spinae muscle with clinical features demonstrates excellent diagnostic performance for uremic sarcopenia, achieving perfect specificity and eliminating false positives compared to individual models.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/8872776","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145272266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To compare femoral cartilage thickness between patients with psoriasis (PsO) and psoriatic arthritis (PsA), and to investigate whether knee joint pain in PsO patients could be an early risk factor for PsA.
Methods
Fifty-nine patients (28 PsO and 31 PsA) were included in this cross-sectional study. Demographic data were collected, and clinical assessments were performed using the Psoriasis Area and Severity Index (PASI) and the Disease Activity Score 28 (DAS28). PsO patients were evaluated for knee arthralgia symptoms within the past month. Femoral cartilage thickness was measured bilaterally at the medial femoral condyle, lateral femoral condyle, and intercondylar area using ultrasonography.
Results
Femoral cartilage thickness was significantly lower in PsA patients compared to those with PsO (p < 0.05). Among patients with PsO, those reporting arthralgia (n = 14) had significantly reduced lateral femoral condyle cartilage thickness in both knees compared to those without arthralgia (p < 0.05). Spearman correlation analysis revealed a negative correlation between age and lateral cartilage thickness (e.g., right LFC: ρ = −0.338, p = 0.009, 95% CI –0.55 to −0.09). PASI scores showed a consistent positive correlation with femoral cartilage thickness across regions; for example, the correlation with the left LFC was significant (ρ = 0.504, p < 0.01, 95% CI 0.29–0.67). These associations indicate that both demographic and disease-related factors may influence cartilage status in PsO and PsA, although the confidence intervals indicate some degree of uncertainty and call for validation in larger cohorts.
Conclusions
Femoral cartilage thinning is evident in PsA patients and may begin even in the subclinical phase. In PsO patients, the presence of arthralgia, especially in the lateral femoral condyle, may reflect early structural changes and could serve as a predictor for PsA development. Ultrasonographic assessment offers a noninvasive, accessible method for early detection and follow-up.
背景比较银屑病（PsO）和银屑病关节炎（PsA）患者股骨软骨厚度，探讨PsO患者膝关节疼痛是否可能是PsA的早期危险因素。方法59例患者（PsO 28例，PsA 31例）进行横断面研究。收集人口统计数据，并使用银屑病面积和严重程度指数（PASI）和疾病活动评分28 （DAS28）进行临床评估。评估PsO患者在过去一个月内的膝关节疼痛症状。在双侧股骨内侧髁、股骨外侧髁和髁间区采用超声测量股骨软骨厚度。结果PsA患者股骨软骨厚度明显低于PsO患者（p < 0.05）。在PsO患者中，报告关节痛的患者（n = 14）与无关节痛的患者相比，双膝股骨外侧髁软骨厚度明显减少（p < 0.05）。Spearman相关分析显示年龄与外侧软骨厚度呈负相关（例如，右侧LFC: ρ = - 0.338, p = 0.009, 95% CI为-0.55至- 0.09）。PASI评分与各区域股骨软骨厚度呈一致的正相关；例如，与左LFC的相关性显著（ρ = 0.504, p < 0.01, 95% CI 0.29-0.67）。这些关联表明，人口统计学和疾病相关因素都可能影响PsO和PsA的软骨状态，尽管置信区间表明存在一定程度的不确定性，需要在更大的队列中进行验证。结论股骨软骨变薄在PsA患者中是明显的，甚至可能在亚临床期就开始了。在PsO患者中，关节痛的存在，特别是在股骨外侧髁，可能反映了早期的结构变化，可以作为PsA发展的预测指标。超声检查为早期发现和随访提供了一种无创、方便的方法。
{"title":"Knee Arthralgia and Cartilage Thinning in Psoriasis: Clues to Early Psoriatic Arthritis?","authors":"Semra Akturk, Raikan Buyukavci, Sezgin Zontul, Zekiye Kanat, Nihal Altunisik, Belda Altun, Emrah Simsek, Dursun Turkmen, Ummuhan Akturk","doi":"10.1155/ijcp/6096621","DOIUrl":"https://doi.org/10.1155/ijcp/6096621","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>To compare femoral cartilage thickness between patients with psoriasis (PsO) and psoriatic arthritis (PsA), and to investigate whether knee joint pain in PsO patients could be an early risk factor for PsA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Fifty-nine patients (28 PsO and 31 PsA) were included in this cross-sectional study. Demographic data were collected, and clinical assessments were performed using the Psoriasis Area and Severity Index (PASI) and the Disease Activity Score 28 (DAS28). PsO patients were evaluated for knee arthralgia symptoms within the past month. Femoral cartilage thickness was measured bilaterally at the medial femoral condyle, lateral femoral condyle, and intercondylar area using ultrasonography.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Femoral cartilage thickness was significantly lower in PsA patients compared to those with PsO (<i>p</i> < 0.05). Among patients with PsO, those reporting arthralgia (<i>n</i> = 14) had significantly reduced lateral femoral condyle cartilage thickness in both knees compared to those without arthralgia (<i>p</i> < 0.05). Spearman correlation analysis revealed a negative correlation between age and lateral cartilage thickness (e.g., right LFC: <i>ρ</i> = −0.338, <i>p</i> = 0.009, 95% CI –0.55 to −0.09). PASI scores showed a consistent positive correlation with femoral cartilage thickness across regions; for example, the correlation with the left LFC was significant (<i>ρ</i> = 0.504, <i>p</i> < 0.01, 95% CI 0.29–0.67). These associations indicate that both demographic and disease-related factors may influence cartilage status in PsO and PsA, although the confidence intervals indicate some degree of uncertainty and call for validation in larger cohorts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Femoral cartilage thinning is evident in PsA patients and may begin even in the subclinical phase. In PsO patients, the presence of arthralgia, especially in the lateral femoral condyle, may reflect early structural changes and could serve as a predictor for PsA development. Ultrasonographic assessment offers a noninvasive, accessible method for early detection and follow-up.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/6096621","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145272134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tianyang Chen, Jia Yan, Tong Xu, Jiaping Zheng, Binghua Zhu, Chunlei Jiang, Dan Han, Yangyang Ou, Rong Fang, Qian Wang
<div> <section> <h3> Background</h3> <p>Septic shock is a critical condition with high mortality and limited treatment options. The optimized Yantiao formula, a traditional Chinese herbal compound, may offer immunomodulatory benefits, but clinical evidence is limited.</p> </section> <section> <h3> Methods</h3> <p>This randomized controlled trial enrolled 124 patients with septic shock, who were randomly assigned to receive either standard Western therapy alone (<i>n</i> = 62) or a combination of standard Western therapy and the optimized Yantiao formula (<i>n</i> = 62). By Day 14, 2 patients in the treatment group and 3 in the control group had died; 119 patients completed the trial (treatment group: <i>n</i> = 60; control group: <i>n</i> = 59). The primary outcome was 28-day survival. Secondary outcomes included white blood cell (WBC) count, neutrophil percentage (N%), C-reactive protein (CRP), lactate (LAC), procalcitonin (PCT), heparin-binding protein (HBP), Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and Sequential Organ Failure Assessment (SOFA) score. Network pharmacology and bioinformatics analyses were performed to explore potential mechanisms.</p> </section> <section> <h3> Results</h3> <p>The 28-day survival rate was significantly higher in the treatment group (78.3%, 47/60) compared with the control group (42.8%, 25/59; <i>p</i> value = 0.001). After treatment, the treatment group showed greater reductions in WBC (13.82 ± 3.46 vs. 10.56 ± 2.34 × 10<sup>9</sup>/L, <i>p</i> value < 0.001), N% (89.15 ± 6.29% vs. 80.42 ± 5.87%, <i>p</i> value < 0.001), and CRP (56.34 ± 14.22 vs. 34.23 ± 10.12 mg/L, <i>p</i> value < 0.001). Additionally, APACHE II (17.3 ± 2.1 vs. 13.1 ± 1.9, <i>p</i> value < 0.001) and SOFA scores (9.4 ± 1.6 vs. 6.2 ± 1.4, <i>p</i> value < 0.001) were significantly lower. Levels of TNF-α (<i>p</i> value = 0.012), IL-6 (<i>p</i> value < 0.001), PCT (<i>p</i> value < 0.001), and HBP (<i>p</i> value < 0.001) also showed significant reductions in the treatment group. Network analysis identified 78 overlapping targets enriched in pathways, including AGE-RAGE signaling and interleukin pathways.</p> </section> <section> <h3> Conclusions</h3> <p>The optimized Yantiao formula significantly improved survival and reduced inflammation in patients with septic shock, possibly through multitarget immune modulation. These findings support its potential as an adjunctive treatment for septic shock.</p> </section> <section> <h3> Trial Regis
{"title":"Evaluation of Optimized Yantiao Formula in Septic Shock Management: A Randomized Controlled Trial","authors":"Tianyang Chen, Jia Yan, Tong Xu, Jiaping Zheng, Binghua Zhu, Chunlei Jiang, Dan Han, Yangyang Ou, Rong Fang, Qian Wang","doi":"10.1155/ijcp/1414752","DOIUrl":"https://doi.org/10.1155/ijcp/1414752","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Septic shock is a critical condition with high mortality and limited treatment options. The optimized Yantiao formula, a traditional Chinese herbal compound, may offer immunomodulatory benefits, but clinical evidence is limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This randomized controlled trial enrolled 124 patients with septic shock, who were randomly assigned to receive either standard Western therapy alone (<i>n</i> = 62) or a combination of standard Western therapy and the optimized Yantiao formula (<i>n</i> = 62). By Day 14, 2 patients in the treatment group and 3 in the control group had died; 119 patients completed the trial (treatment group: <i>n</i> = 60; control group: <i>n</i> = 59). The primary outcome was 28-day survival. Secondary outcomes included white blood cell (WBC) count, neutrophil percentage (N%), C-reactive protein (CRP), lactate (LAC), procalcitonin (PCT), heparin-binding protein (HBP), Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and Sequential Organ Failure Assessment (SOFA) score. Network pharmacology and bioinformatics analyses were performed to explore potential mechanisms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The 28-day survival rate was significantly higher in the treatment group (78.3%, 47/60) compared with the control group (42.8%, 25/59; <i>p</i> value = 0.001). After treatment, the treatment group showed greater reductions in WBC (13.82 ± 3.46 vs. 10.56 ± 2.34 × 10<sup>9</sup>/L, <i>p</i> value < 0.001), N% (89.15 ± 6.29% vs. 80.42 ± 5.87%, <i>p</i> value < 0.001), and CRP (56.34 ± 14.22 vs. 34.23 ± 10.12 mg/L, <i>p</i> value < 0.001). Additionally, APACHE II (17.3 ± 2.1 vs. 13.1 ± 1.9, <i>p</i> value < 0.001) and SOFA scores (9.4 ± 1.6 vs. 6.2 ± 1.4, <i>p</i> value < 0.001) were significantly lower. Levels of TNF-α (<i>p</i> value = 0.012), IL-6 (<i>p</i> value < 0.001), PCT (<i>p</i> value < 0.001), and HBP (<i>p</i> value < 0.001) also showed significant reductions in the treatment group. Network analysis identified 78 overlapping targets enriched in pathways, including AGE-RAGE signaling and interleukin pathways.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The optimized Yantiao formula significantly improved survival and reduced inflammation in patients with septic shock, possibly through multitarget immune modulation. These findings support its potential as an adjunctive treatment for septic shock.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Regis","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/1414752","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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