International Journal of Clinical Practice最新文献_第4页

Prevalence and Impact of Depression Among Patients Hospitalized With COPD From 2016 to 2023: A Population-Based Study in Spain 2016 - 2023年慢性阻塞性肺病住院患者抑郁患病率及影响：西班牙一项基于人群的研究

IF 2.4 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

International Journal of Clinical Practice

Pub Date : 2025-12-08 DOI: 10.1155/ijcp/5057728

Teresa Gómez-Garcia, Javier de Miguel-Diez, Valentín Hernández-Barrera, Ana López-de-Andrés, David Carabantes-Alarcon, Ana Jiménez-Sierra, Elena Labajo-González, Andrés Bodas-Pinedo, Rodrigo Jiménez-Garcia

Purpose

Depression is a frequent comorbidity in individuals with chronic obstructive pulmonary disease (COPD) and is associated with adverse clinical outcomes, including an increased risk of exacerbations and death. This study aimed to describe national trends in the prevalence of depression among COPD hospitalizations in Spain, from 2016 to 2023, to assess sex-related differences, to evaluate its impact on hospital outcomes, and to determine how the COVID-19 pandemic modified these associations.

Patients and Methods

We carried out a population-based cohort study using data from the Spanish National Hospital Discharge Database (RAE-CMBD). All admissions of patients aged 40 years or older with a diagnosis of COPD were included. Depression was identified through International Classification of Diseases, Tenth Revision (ICD-10) codes. We analyzed temporal changes and sex-stratified patterns and factors independently associated with in-hospital mortality (IHM).

Results

During the study period, 2,545,151 hospitalizations with COPD were recorded nationwide, of which 106,337 (4.17%) included a diagnosis of depression. The prevalence rose progressively, remaining consistently higher in women. Female patients exhibited greater frequencies of anxiety, obesity, and personality disorders, whereas men showed higher rates of alcohol (17.9% vs. 6.1%; p < 0.001) and tobacco use (58.5% vs. 43.4%; p < 0.001) and a greater proportion of suicide attempts (0.11% vs. 0.06%; p < 0.001). Men were also older (74.1 vs. 73.3 years; p < 0.001) and had higher Charlson Comorbidity Index (CCI) values (1.31 vs. 1.01; p < 0.001). ICU admissions (5.0% vs. 4.6%; p < 0.001) and IHM (7.8% vs. 5.6%; p < 0.001) were more common in men. In multivariable models, older age and greater comorbidity burden were the strongest predictors of IHM in both sexes. COVID-19 infection and dementia increased the odds of death, whereas anxiety and obesity were inversely associated with mortality.

Conclusion

Between 2016 and 2023, depression among COPD hospitalizations in Spain increased steadily, with clear sex-based differences in prevalence, clinical profile, and hospital outcomes. The results emphasize the need to integrate mental health screening and management into routine COPD care.

抑郁症是慢性阻塞性肺疾病（COPD）患者常见的合并症，并与不良临床结果相关，包括加重和死亡风险增加。本研究旨在描述2016年至2023年西班牙COPD住院患者中抑郁症患病率的全国趋势，以评估性别相关差异，评估其对医院预后的影响，并确定COVID-19大流行如何改变这些关联。患者和方法我们使用来自西班牙国家医院出院数据库（RAE-CMBD）的数据进行了一项基于人群的队列研究。所有入院的40岁或以上诊断为慢性阻塞性肺病的患者被纳入研究。抑郁症是通过《国际疾病分类第十版》（ICD-10）代码确定的。我们分析了与住院死亡率（IHM）独立相关的时间变化、性别分层模式和因素。结果在研究期间，全国共有2,545,151例COPD住院记录，其中106,337例（4.17%）包括抑郁症诊断。患病率逐渐上升，在妇女中一直较高。女性患者表现出更频繁的焦虑、肥胖和人格障碍，而男性患者则表现出更高的酒精（17.9%对6.1%;p < 0.001）和烟草使用（58.5%对43.4%;p < 0.001）和更高比例的自杀企图（0.11%对0.06%;p < 0.001）。男性的年龄也较大（74.1岁对73.3岁；p < 0.001）， Charlson合并症指数（CCI）值也较高（1.31比1.01;p < 0.001）。ICU住院（5.0%比4.6%;p < 0.001）和IHM（7.8%比5.6%;p < 0.001）在男性中更为常见。在多变量模型中，年龄较大和更大的合并症负担是两性中IHM的最强预测因子。COVID-19感染和痴呆增加了死亡几率，而焦虑和肥胖与死亡率呈负相关。结论：2016年至2023年间，西班牙COPD住院患者的抑郁症稳步上升，在患病率、临床概况和医院结局方面存在明显的性别差异。结果强调了将心理健康筛查和管理纳入常规COPD护理的必要性。

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引用次数: 0

The Effect of Landiolol in Patients With Critical Illness: A Systematic Review and Meta-Analysis 兰地洛尔对危重患者的影响：系统回顾和荟萃分析

IF 2.4 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

International Journal of Clinical Practice

Pub Date : 2025-12-08 DOI: 10.1155/ijcp/8739008

Huanming Kuang, Jian Qiu Zhu, Ying Qiu Xie, Youfeng Zhu, Xing Luo

Background

Patients with critical illnesses frequently experience tachyarrhythmias as a result of excessive sympathetic hyperactivity and high levels of inflammatory cytokines. Ultrashort-acting β-blockers like landiolol are commonly utilized in intensive care units (ICUs) because of their unique features.

Methods

Electronic databases (Cochrane Library, PubMed, Web of Science, and Embase) were searched for randomized controlled trials (RCTs) from inception to September 1, 2025 assessing the efficacy of landiolol in critically ill patients. The primary outcome was new-onset arrhythmias. All-cause mortality, heart rate (HR), length of ICU and hospital stay, and need for norepinephrine following landiolol therapy were the secondary outcomes. Trial sequential analysis (TSA) was performed to further evaluate the robustness of findings. The quality of evidence was evaluated through the Grading of Recommendations Assessment, Development and Evaluation (GRADE) method.

Results

Nine studies totaling 836 patients were included. Overall, our meta-analysis exhibited that landiolol might considerably lower the incidence of new-onset arrhythmias when compared to the control treatment (9 studies [836 patients]; odds ratio [OR], 0.44; 95% confidence interval [CI] 0.23 to 0.82; p = 0.01), and TSA agreed with this finding. We also observed that landiolol could reduce HR (mean difference [MD], −6.41, 95% CI, −8.63 to −4.18, p < 0.001). However, there was no considerable decrease in requirement of norepinephrine dose (MD, 0.04, 95% CI, −0.01 to 0.09, p = 0.11), length of hospital stay (MD, −0.87, 95% CI, −7.40 to 5.65, p = 0.79), or all-cause mortality (OR, 1.10, 95% CI, 0.62 to 1.96, p = 0.75). Additionally, the length of ICU stay in the landiolol group was longer than that in the control group (MD, 0.19; 95% CI 0.01 to 0.37; p = 0.03).

Conclusion

New-onset arrhythmias and HR were significantly reduced in critical illness patients receiving landiolol.

背景：由于过度的交感神经过度活跃和高水平的炎症细胞因子，重症患者经常经历心律失常。超短效β受体阻滞剂，如兰地洛尔，由于其独特的特性，通常用于重症监护病房（icu）。方法检索电子数据库（Cochrane Library、PubMed、Web of Science和Embase），检索自成立至2025年9月1日评估兰地洛尔对危重患者疗效的随机对照试验（RCTs）。主要结局为新发心律失常。兰地洛尔治疗后的全因死亡率、心率（HR）、ICU和住院时间以及去甲肾上腺素需求是次要结局。采用试验序列分析（TSA）进一步评价研究结果的稳健性。通过分级建议评估、发展和评价（GRADE）方法评价证据质量。结果纳入9项研究，共836例患者。总的来说，我们的荟萃分析显示，与对照治疗相比，兰地洛尔可能显著降低新发心律失常的发生率（9项研究[836例患者]；优势比[OR] 0.44； 95%可信区间[CI] 0.23至0.82;p = 0.01）， TSA同意这一发现。我们还观察到兰地洛尔可以降低HR（平均差异[MD]， - 6.41, 95% CI, - 8.63至- 4.18,p < 0.001）。然而，对去甲肾上腺素剂量的需求（MD, 0.04, 95% CI, - 0.01至0.09,p = 0.11）、住院时间（MD, - 0.87, 95% CI, - 7.40至5.65,p = 0.79）或全因死亡率（or, 1.10, 95% CI， 0.62至1.96,p = 0.75）没有显著降低。兰地洛尔组患者在ICU的住院时间明显长于对照组（MD = 0.19; 95% CI = 0.01 ~ 0.37; p = 0.03）。结论重症患者服用兰地洛尔可明显降低新发心律失常和HR。

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引用次数: 0

Comparative Evaluation of the Efficacy and Safety of Endoscopic Ligation and Endoscopic Injection Sclerotherapy for Internal Hemorrhoids 内痔内窥镜结扎与内窥镜注射硬化治疗的疗效及安全性比较

IF 2.4 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

International Journal of Clinical Practice

Pub Date : 2025-12-08 DOI: 10.1155/ijcp/8868241

Shanshan Cai, Bowen Cheng, Hangcheng Zhang, Yongjie Lin, Miaomiao Zhou, Bushan Xie

<div> <section> <h3> Background</h3> <p>Endoscopic treatment has gradually become the main method for internal hemorrhoids because of its advantages of less trauma, shorter treatment time, less adverse reactions, and obvious improvement of symptoms.</p> </section> <section> <h3> Objective</h3> <p>To evaluate the efficacy and safety of endoscopic ligation and endoscopic injection sclerotherapy for internal hemorrhoids.</p> </section> <section> <h3> Patients</h3> <p>This is a retrospective cohort study that included 123 patients diagnosed with internal hemorrhoids and treated with endoscopic ligation or endoscopic injection sclerotherapy at the First Affiliated Hospital of Nanchang University between January 2019 and December 2021.</p> </section> <section> <h3> Method</h3> <p>In this retrospective cohort study, 123 patients with internal hemorrhoids were divided into endoscopic ligation (<i>n</i> = 55) or endoscopic injection sclerotherapy (<i>n</i> = 68) groups according to the treatment received. The treatment effect was evaluated at baseline and at least one year after operation. The evaluation criteria were based on the “Diagnostic Efficacy Criteria of Anorectal Department of Traditional Chinese Medicine” issued by the State Administration of Traditional Chinese Medicine. The efficacy was divided into cure, improvement, ineffective, and recurrence. The safety of treatment was evaluated using postoperative adverse reactions and VAS scores.</p> </section> <section> <h3> Results</h3> <p>In this study, the effective rates of endoscopic ligation and endoscopic injection sclerotherapy were 87.3% and 86.8% respectively, and there was no significant difference between the two groups. However, the incidence of postoperative hematochezia, perianal pain, and the degree of perianal pain in endoscopic ligation group were significantly higher than those in endoscopic injection sclerotherapy group (<i>p</i> < 0.05). In addition, the hospitalization cost and duration of endoscopic ligation group were significantly higher than those of endoscopic injection sclerotherapy group (<i>p</i> < 0.05). The median follow-up time was 596 days. During the follow-up period, the recurrence rates of endoscopic ligation group and endoscopic injection sclerotherapy group were 25.0% and 16.9%, respectively. The median recurrence time after operation was 6 months and 5.5 months, respectively. There was no significant difference in recurrence rates between the two groups (<i>p</i> > 0.

内镜治疗因其创伤小、治疗时间短、不良反应少、症状改善明显等优点，逐渐成为内痔治疗的主要方法。目的评价内痔内窥镜结扎联合内窥镜注射硬化治疗内痔的疗效和安全性。这是一项回顾性队列研究，纳入了2019年1月至2021年12月在南昌大学第一附属医院诊断为内痔并接受内窥镜结扎或内窥镜注射硬化治疗的123例患者。方法回顾性队列研究123例内痔患者，根据所接受的治疗情况分为内镜结扎组（55例）和内镜注射硬化治疗组（68例）。在基线和术后至少一年评估治疗效果。评价标准参照国家中医药管理局发布的《中医肛肠科诊断疗效标准》。疗效分为治愈、改善、无效、复发。采用术后不良反应和VAS评分评价治疗的安全性。结果本研究中，内镜下结扎和内镜下注射硬化治疗的有效率分别为87.3%和86.8%，两组间差异无统计学意义。但内镜结扎组术后便血发生率、肛周疼痛发生率、肛周疼痛程度均显著高于内镜注射硬化治疗组（p < 0.05）。此外，内镜结扎组住院费用和住院时间均显著高于内镜注射硬化治疗组（p < 0.05）。中位随访时间为596天。随访期间，内镜结扎组复发率为25.0%，内镜注射硬化治疗组复发率为16.9%。术后中位复发时间分别为6个月和5.5个月。两组复发率比较，差异无统计学意义（p > 0.05）。多因素logistic回归分析显示，术前高氏评分和术前出血评分是术后复发的独立危险因素（p < 0.05）。结论两种内镜治疗方法的有效率和复发率无显著差异。然而，考虑到内镜结扎术后较高的不良反应发生率和严重程度、较长的住院时间和较高的住院费用，内镜硬化疗法可能是内痔患者更有利的选择。

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引用次数: 0

Cardiovascular–Renal–Metabolic Syndrome: Hit Two Birds With One Stone?—Mini-Review and Complementary on “Cardiovascular-Kidney-Metabolic Health: A Presidential Advisory From the American Heart Association” 心血管-肾脏-代谢综合征：一箭双雕？-“心血管-肾脏-代谢健康：美国心脏协会主席咨询”的迷你评论和补充

IF 2.4 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

International Journal of Clinical Practice

Pub Date : 2025-12-05 DOI: 10.1155/ijcp/9112371

May Thu Kyaw

Cardiovascular–renal–metabolic syndrome (CRMS), often referred to as the “two birds with one stone” condition, is a complex disorder characterized by the intricate interplay between cardiovascular, renal, and metabolic dysfunctions. This mini-review aims to provide an in-depth examination of the pathophysiological mechanisms, clinical implications, and potential therapeutic interventions for CRMS, focusing on the critical role of addressing social determinants of health (SDOH). Drawing upon the recent Presidential Advisory from the American Heart Association (AHA) on Cardiovascular-Renal-Metabolic Health, this mini-review seeks to elucidate the multifaceted relationships between these three major systems and their far-reaching impact on overall health. The synergistic interactions between cardiovascular, renal, and metabolic health underline the importance of adopting a comprehensive approach for healthcare providers and policymakers in managing patients with CRMS.

心血管肾代谢综合征（CRMS）通常被称为“一石二鸟”，是一种复杂的疾病，其特征是心血管、肾脏和代谢功能障碍之间复杂的相互作用。这篇小型综述旨在深入研究CRMS的病理生理机制、临床意义和潜在的治疗干预措施，重点是解决健康的社会决定因素（SDOH）的关键作用。根据最近美国心脏协会（AHA）关于心血管-肾脏-代谢健康的总统咨询，这篇小型综述试图阐明这三个主要系统之间的多方面关系及其对整体健康的深远影响。心血管、肾脏和代谢健康之间的协同作用强调了医疗保健提供者和政策制定者在管理CRMS患者时采用综合方法的重要性。

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引用次数: 0

Changes in the Epidemiological Characteristics of Inpatients in the Nephrology Department in a Hospital in Anhui During 2007–2022 2007-2022年安徽省某医院肾内科住院患者流行病学特征变化分析

IF 2.4 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

International Journal of Clinical Practice

Pub Date : 2025-12-05 DOI: 10.1155/ijcp/1885064

Jing Zhang, Lijuan Tang, Jun Hu

Background

The incidence of chronic kidney disease (CKD) is on the rise globally. The aim of this study was to characterize the profile of inpatients in the nephrology department of a hospital in Southern Anhui Province, China, during 2007–2022.

Methods

We constructed a retrospective cohort of inpatients from the nephrology department of a hospital and retrieved basic information through the Medical Record Management System (MRMS), including sex, age, length of hospital stay, diagnosis, and outcome of treatment.

Results

This cross-sectional study involved 35,963 inpatients. Both the total number of hospitalized patients and the average age of inpatients from 2007 to 2022 presented a significant increasing trend (p < 0.001). The number of cases aged 40–60 years old is the largest, followed by the cases aged 60–80 years old. CKD is the main cause of hospitalization. Among the causes of CKD, the number of cases with diabetic kidney disease (DKD) had exceeded chronic glomerulonephritis (CGN) and become the main cause for the hospitalization of CKD patients starting from 2016. The average hospitalized day presented a downward trend (11.4 ± 0.5 vs. 9.6 ± 1.2 days, p = 0.002), and the improvement rate presented an upward trend (90.7 ± 4.7% vs. 96.6 ± 1.7%, p = 0.008) from 2007 to 2022.

Conclusion

The renal disease spectrum of hospitalization is changing with variations over time in the nephrology department of our hospital. Understanding the change of the CKD spectrum is crucial to develop effective public health strategies to control the burden of CKD and improve the average hospitalized day.

慢性肾脏疾病（CKD）的发病率在全球范围内呈上升趋势。本研究的目的是描述2007-2022年中国安徽省南部一家医院肾脏病科住院患者的概况。方法对某医院肾内科住院患者进行回顾性队列分析，通过病案管理系统（MRMS）检索患者的基本信息，包括性别、年龄、住院时间、诊断、治疗结果等。结果本横断面研究共纳入35,963例住院患者。2007 - 2022年住院总人数和住院平均年龄均呈现显著上升趋势（p < 0.001）。40 ~ 60岁发病最多，60 ~ 80岁次之。慢性肾病是住院治疗的主要原因。在CKD的病因中，糖尿病肾病（DKD）的病例数已超过慢性肾小球肾炎（CGN），成为2016年以来CKD患者住院的主要原因。2007 - 2022年，平均住院天数呈下降趋势（11.4±0.5天比9.6±1.2天，p = 0.002），改善率呈上升趋势（90.7±4.7%比96.6±1.7%,p = 0.008）。结论我院肾内科住院患者肾脏疾病谱随时间变化而变化。了解CKD频谱的变化对于制定有效的公共卫生策略以控制CKD负担和提高平均住院天数至关重要。

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引用次数: 0

Short-Term Mortality Rate and Predictors for Older Patients With Liver Cirrhosis–Associated Acute Upper Gastrointestinal Bleeding 老年肝硬化相关急性上消化道出血患者的短期死亡率及预测因素

IF 2.4 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

International Journal of Clinical Practice

Pub Date : 2025-12-03 DOI: 10.1155/ijcp/6615949

Qi Li, Qikun Zhang, Zhao Liu, Lingna Lyu, Chunlei Fan, Huiguo Ding

Acute upper gastrointestinal bleeding (AUGIB) is a life-threatening complication of liver cirrhosis. Clinical characteristics and predictors for short-term mortality in older patients with liver cirrhosis–associated AUGIB remain little known. Consecutive cirrhotic patients with AUGIB admitted in the Department of Emergency from April 1st, 2021, to Dec 31st, 2022, were analyzed. Clinical characteristics of older cirrhotic patients with AUGIB and predictors for short-term mortality were analyzed. A total of 628 patients aged ≥ 60 years constituted the older group. Compared with the control group (age < 60 years), all-cause in-hospital mortality and 6-week mortality were higher (16.7% vs. 9.25%, p < 0.001; 24.0% vs. 15.6%, p < 0.001), respectively, in older patients. Female gender and melena were independent predictors for both in-hospital mortality and 6-week mortality. Esophageal sclerotherapy, moderate–severe encephalopathy, hyperlipoidemia, and coexisting portal vein thrombosis (PVT)/diabetes mellitus (DM) were independent predictors for in-hospital mortality, whereas an unknown source of AUGIB and hepatocellular carcinoma (HCC) were independent predictors for 6-week mortality. In older cirrhotic patients with AUGIB, female gender and melena contribute to lower in-hospital mortality and 6-week mortality. Esophageal sclerotherapy, control of DM, treatment of encephalopathy, and PVT are beneficial in reducing in-hospital mortality. An unknown source of AUGIB and HCC enhance 6-week mortality.

急性上消化道出血（AUGIB）是肝硬化的一种危及生命的并发症。老年肝硬化相关AUGIB患者的临床特征和短期死亡率预测因素仍知之甚少。分析2021年4月1日至2022年12月31日急诊科收治的连续肝硬化AUGIB患者。分析老年肝硬化合并AUGIB患者的临床特征和短期死亡率的预测因素。年龄≥60岁的患者共628例构成老年组。与对照组（年龄60岁）相比，老年患者的全因住院死亡率和6周死亡率分别高于对照组（16.7%对9.25%,p < 0.001； 24.0%对15.6%,p < 0.001）。女性性别和黑黑是院内死亡率和6周死亡率的独立预测因子。食道硬化治疗、中重度脑病、高脂血症和并存的门静脉血栓(PVT)/糖尿病（DM）是住院死亡率的独立预测因素，而来源不明的AUGIB和肝细胞癌（HCC）是6周死亡率的独立预测因素。在老年肝硬化合并AUGIB患者中，女性和黑黑有助于降低住院死亡率和6周死亡率。食道硬化治疗、控制糖尿病、治疗脑病和PVT有利于降低住院死亡率。不明来源的AUGIB和HCC增加了6周死亡率。

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引用次数: 0

A Novel PCD-Driven Risk Model Predicts Prognosis and Chemoresistance in Gastric Cancer Through Tumor Microenvironment Deregulation 一个新的pcd驱动的风险模型通过肿瘤微环境调节预测胃癌预后和化疗耐药

IF 2.4 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

International Journal of Clinical Practice

Pub Date : 2025-12-01 DOI: 10.1155/ijcp/6204187

Xueying Wu, Qingsheng Zheng, Shuai Peng, Sicong Jiang, Ning Hu

Background

Gastric cancer (GC) displays profound molecular heterogeneity, leading to divergent therapeutic responses and prognoses. Programmed cell death (PCD) pathways and the tumor microenvironment (TME) are critical determinants of GC progression, yet their interplay and clinical significance remain insufficiently understood.

Methods

We conducted integrative multiomics analyses using bulk RNA-seq data from TCGA-STAD (426 tumors, 35 normals) and single-cell RNA-seq (GSE167297; 4 tumor/normal pairs). PCD-based molecular subtypes were identified through consensus clustering. Drug sensitivity (pRRophetic), immune infiltration (ESTIMATE/CIBERSORT), and functional enrichment (GSVA/clusterProfiler) were systematically evaluated. A prognostic risk model was established via LASSO-Cox regression and externally validated in GSE26901.

Results

Two distinct PCD-associated subtypes were identified. Cluster 1, characterized by elevated PCD activity, enriched KRAS signaling and interferon response, showed a poorer prognosis; whereas Cluster 2 exhibited favorable survival with activation of E2F and mTORC1 pathways. Cluster 1 demonstrated higher immune and stromal scores but lower tumor purity, along with upregulation of immune checkpoints (PDCD1, CD40LG). Drug sensitivity profiling revealed subtype-specific vulnerabilities, including heightened sensitivity of Cluster 1 to cJQ1_2172. A nine-gene prognostic model (5 year AUC = 0.73) robustly predicted survival, with NRP1 identified as an independent risk factor (HR = 1.91, p < 0.05).

Conclusions

This study delineates the PCD–TME crosstalk underlying GC heterogeneity and proposes a clinically relevant molecular classification and prognostic tool. Our findings highlight subtype-specific therapeutic vulnerabilities and underscore the potential of targeting PCD pathways to advance precision oncology in GC.

胃癌（GC）表现出深刻的分子异质性，导致不同的治疗反应和预后。程序性细胞死亡（PCD）途径和肿瘤微环境（TME）是胃癌进展的关键决定因素，但它们的相互作用和临床意义尚不清楚。方法采用TCGA-STAD（426例肿瘤，35例正常）和单细胞RNA-seq （GSE167297, 4对肿瘤/正常）的大量RNA-seq数据进行综合多组学分析。通过一致聚类确定了基于pcd的分子亚型。系统评价药物敏感性（prophytic）、免疫浸润（ESTIMATE/CIBERSORT）和功能富集（GSVA/clusterProfiler）。通过LASSO-Cox回归建立预后风险模型，并在GSE26901中进行外部验证。结果鉴定出两种不同的pcd相关亚型。以PCD活性升高、KRAS信号和干扰素反应富集为特征的第1组预后较差；而簇2在激活E2F和mTORC1通路时表现出良好的存活。簇1免疫和间质评分较高，但肿瘤纯度较低，免疫检查点（PDCD1, CD40LG）上调。药物敏感性分析揭示了亚型特异性漏洞，包括集群1对cJQ1_2172的敏感性增高。九基因预后模型（5年AUC = 0.73）可靠预测生存，NRP1被确定为独立危险因素（HR = 1.91, p < 0.05）。结论本研究描述了GC异质性背后的PCD-TME串扰，并提出了一种临床相关的分子分类和预后工具。我们的研究结果强调了亚型特异性治疗脆弱性，并强调了靶向PCD途径在胃癌中推进精确肿瘤学的潜力。

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引用次数: 0

Serum Neuron-Specific Enolase Levels in Patients With Diabetic Peripheral Neuropathy 糖尿病周围神经病变患者血清神经元特异性烯醇化酶水平

IF 2.4 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

International Journal of Clinical Practice

Pub Date : 2025-12-01 DOI: 10.1155/ijcp/5569034

Selcen Duran, Asuman Celikbilek, Aysu Yetis, Bilal Ilanbey, Burc Esra Sahin, Aydan Koysuren, Himmet Durmaz

Background

Based on previous reports that elevated NSE levels may predict diabetic neuropathy, we aimed to validate this association in a well-characterized cohort. Using strict exclusion criteria, standardized clinical scales, and nerve conduction studies, we aimed to evaluate the clinical utility of NSE levels in diabetic patients with and without neuropathic pain.

Methods

A total of 144 Type 2 diabetic patients were included in this prospective cross-sectional study. Neuropathic pain symptoms were assessed using the Douleur Neuropathique 4 questionnaire (DN4) and the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS). The diagnosis of diabetic peripheral neuropathy (DPNP) was established based on electrophysiological findings. Patients were divided into three groups as follows: those having neuropathic pain with DPNP (Group 1, n = 60) and without DPNP (Group 2, n = 56). The patients without neuropathic pain (n = 28) were defined as Group 3. Serum NSE levels were derived via electrochemiluminescence immunoassay.

Results

There was no significant between-group difference in age or gender (both p > 0.05). The disease duration was significantly longer in patients having neuropathic pain, compared to those without neuropathic pain (p = 0.004). The serum levels of NSE (p < 0.001) and the scores on the DN4 (p = 0.001) and LANSS (p = 0.016) instruments were higher in Group 1 than in Group 2. The NSE level was positively correlated with the LANSS score (r = 0.260, p = 0.005) and independently associated with the presence of DPNP in a multivariate model (OR 1.33, 95% confidence interval 1.12–1.58, p = 0.001). On the ROC analysis, an NSE cutoff of 9.51 ng/mL predicted the presence of DPNP.

Conclusion

Elevated serum NSE levels were significantly associated with DPNP in diabetic patients, indicating that NSE may serve as a potential biomarker for large-fiber involvement. However, this finding warrants confirmation in larger, multicenter studies.

背景：基于先前的报道，NSE水平升高可能预测糖尿病神经病变，我们的目的是在一个特征明确的队列中验证这种关联。通过严格的排除标准、标准化的临床量表和神经传导研究，我们旨在评估NSE水平在伴有和不伴有神经性疼痛的糖尿病患者中的临床应用。方法对144例2型糖尿病患者进行前瞻性横断面研究。采用双神经性疼痛问卷（DN4）和利兹神经性症状和体征评估（LANSS）评估神经性疼痛症状。糖尿病周围神经病变（DPNP）的诊断是基于电生理结果。将患者分为三组：神经性疼痛伴DPNP组（组1，n = 60）和无DPNP组（组2，n = 56）。无神经性疼痛患者（n = 28）为第三组。通过电化学发光免疫分析法测定血清NSE水平。结果两组患者年龄、性别差异无统计学意义（p > 0.05）。与没有神经性疼痛的患者相比，神经性疼痛患者的病程明显更长（p = 0.004）。组1血清NSE水平（p < 0.001）、DN4评分（p = 0.001）和LANSS评分（p = 0.016）均高于组2。在多变量模型中，NSE水平与LANSS评分呈正相关（r = 0.260, p = 0.005），并与DPNP的存在独立相关（OR为1.33,95%置信区间为1.12-1.58,p = 0.001）。在ROC分析中，NSE截止值为9.51 ng/mL预测DPNP的存在。结论糖尿病患者血清NSE水平升高与DPNP显著相关，提示NSE可能是大纤维病变的潜在生物标志物。然而，这一发现需要在更大的、多中心的研究中得到证实。

{"title":"Serum Neuron-Specific Enolase Levels in Patients With Diabetic Peripheral Neuropathy","authors":"Selcen Duran, Asuman Celikbilek, Aysu Yetis, Bilal Ilanbey, Burc Esra Sahin, Aydan Koysuren, Himmet Durmaz","doi":"10.1155/ijcp/5569034","DOIUrl":"https://doi.org/10.1155/ijcp/5569034","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Based on previous reports that elevated NSE levels may predict diabetic neuropathy, we aimed to validate this association in a well-characterized cohort. Using strict exclusion criteria, standardized clinical scales, and nerve conduction studies, we aimed to evaluate the clinical utility of NSE levels in diabetic patients with and without neuropathic pain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 144 Type 2 diabetic patients were included in this prospective cross-sectional study. Neuropathic pain symptoms were assessed using the Douleur Neuropathique 4 questionnaire (DN4) and the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS). The diagnosis of diabetic peripheral neuropathy (DPNP) was established based on electrophysiological findings. Patients were divided into three groups as follows: those having neuropathic pain with DPNP (Group 1, <i>n</i> = 60) and without DPNP (Group 2, <i>n</i> = 56). The patients without neuropathic pain (<i>n</i> = 28) were defined as Group 3. Serum NSE levels were derived via electrochemiluminescence immunoassay.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There was no significant between-group difference in age or gender (both <i>p</i> > 0.05). The disease duration was significantly longer in patients having neuropathic pain, compared to those without neuropathic pain (<i>p</i> = 0.004). The serum levels of NSE (<i>p</i> < 0.001) and the scores on the DN4 (<i>p</i> = 0.001) and LANSS (<i>p</i> = 0.016) instruments were higher in Group 1 than in Group 2. The NSE level was positively correlated with the LANSS score (<i>r</i> = 0.260, <i>p</i> = 0.005) and independently associated with the presence of DPNP in a multivariate model (OR 1.33, 95% confidence interval 1.12–1.58, <i>p</i> = 0.001). On the ROC analysis, an NSE cutoff of 9.51 ng/mL predicted the presence of DPNP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Elevated serum NSE levels were significantly associated with DPNP in diabetic patients, indicating that NSE may serve as a potential biomarker for large-fiber involvement. However, this finding warrants confirmation in larger, multicenter studies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/5569034","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145695029","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}

引用次数: 0

Analysis of Risk Factors for Ureteral Stent–Related Symptoms in Patients Undergoing Short-Term Ureteral Stent Placement due to Ureteroscopy and Urinary Stones 输尿管镜检查和尿路结石导致短期输尿管支架置入术患者输尿管支架相关症状的危险因素分析

IF 2.4 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

International Journal of Clinical Practice

Pub Date : 2025-11-30 DOI: 10.1155/ijcp/8677297

Yirixiatijiang Amier, Jiabo Li, Dongfeng Yuan, Xianmiao Li, Wenlong Wan, Junyi Yang, Yisheng Huang, Wenke Ji, Yang Xun, Xiao Yu

Objective

To evaluate the risk factors associated with ureteral stent–related symptoms in patients undergoing short-term ureteral stent placement using a validated questionnaire.

Methods

A total of 263 patients who underwent short-term stent placement following upper urinary tract stone surgery or ureteroscopy were included in this prospective study. The linguistically validated Chinese version of the Ureteral Stent Symptom Questionnaire was administered to all patients on Days 7 and 28 after stent placement to assess stent-related symptoms. Univariate and multivariate linear regression analyses were performed to identify risk factors, and a two-tailed p < 0.05 was considered statistically significant.

Results

Compared to Day 7, scores for urinary symptoms, body pain, general health, work performance, sexual matters, and additional problems significantly decreased by Day 28 (p < 0.05). Multivariate linear regression revealed that stent placement due to urinary tract stone surgery, stent positioning beyond the midline, and a lower distal length ratio (positioned closer to the bladder neck) were common risk factors for both early and late stent-related symptoms. Stent positioning beyond the midline was associated with at least three symptom domains. In addition, a higher body mass index and no history of previous stent placement were risk factors for worse body pain and more additional problems in the early phase, respectively. The presence of recurrent urinary tract infections was a risk factor for more severe urinary symptoms and poorer general health in the late phase.

Conclusions

The stent-related symptoms are most pronounced in the early period, with a noticeable reduction in these effects over time. The distal position characteristics of the stent have the greatest impact on patient discomfort. Stent placement due to urinary tract stone surgery, presence of recurrent urinary tract infections, and higher BMI are also risks for experiencing severe stent-related symptoms.

目的通过一份有效的问卷调查，评估短期输尿管支架置入术患者输尿管支架相关症状的相关危险因素。方法本前瞻性研究共纳入263例在上尿路结石手术或输尿管镜检查后接受短期支架置入的患者。在输尿管支架放置后第7天和第28天，对所有患者使用经语言验证的中文版输尿管支架症状问卷，以评估支架相关症状。采用单因素和多因素线性回归分析确定危险因素，双尾p <； 0.05认为有统计学意义。结果与第7天相比，第28天泌尿系统症状、身体疼痛、一般健康状况、工作表现、性问题和其他问题的得分显著下降（p < 0.05）。多元线性回归显示，由于尿路结石手术而放置支架、支架放置在中线以外、远端长度比较低（放置在更靠近膀胱颈的位置）是早期和晚期支架相关症状的常见危险因素。超过中线的支架定位与至少三个症状域相关。此外，较高的身体质量指数和没有支架植入史分别是早期更严重的身体疼痛和更多其他问题的危险因素。复发性尿路感染的存在是后期更严重的泌尿系统症状和较差的一般健康状况的危险因素。结论：支架相关症状在早期最为明显，随着时间的推移，这些症状明显减轻。支架的远端位置特性对患者的不适影响最大。由于尿路结石手术而放置支架、尿路感染复发和较高的BMI也是发生严重支架相关症状的风险。

{"title":"Analysis of Risk Factors for Ureteral Stent–Related Symptoms in Patients Undergoing Short-Term Ureteral Stent Placement due to Ureteroscopy and Urinary Stones","authors":"Yirixiatijiang Amier, Jiabo Li, Dongfeng Yuan, Xianmiao Li, Wenlong Wan, Junyi Yang, Yisheng Huang, Wenke Ji, Yang Xun, Xiao Yu","doi":"10.1155/ijcp/8677297","DOIUrl":"https://doi.org/10.1155/ijcp/8677297","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the risk factors associated with ureteral stent–related symptoms in patients undergoing short-term ureteral stent placement using a validated questionnaire.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 263 patients who underwent short-term stent placement following upper urinary tract stone surgery or ureteroscopy were included in this prospective study. The linguistically validated Chinese version of the Ureteral Stent Symptom Questionnaire was administered to all patients on Days 7 and 28 after stent placement to assess stent-related symptoms. Univariate and multivariate linear regression analyses were performed to identify risk factors, and a two-tailed <i>p</i> < 0.05 was considered statistically significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared to Day 7, scores for urinary symptoms, body pain, general health, work performance, sexual matters, and additional problems significantly decreased by Day 28 (<i>p</i> < 0.05). Multivariate linear regression revealed that stent placement due to urinary tract stone surgery, stent positioning beyond the midline, and a lower distal length ratio (positioned closer to the bladder neck) were common risk factors for both early and late stent-related symptoms. Stent positioning beyond the midline was associated with at least three symptom domains. In addition, a higher body mass index and no history of previous stent placement were risk factors for worse body pain and more additional problems in the early phase, respectively. The presence of recurrent urinary tract infections was a risk factor for more severe urinary symptoms and poorer general health in the late phase.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The stent-related symptoms are most pronounced in the early period, with a noticeable reduction in these effects over time. The distal position characteristics of the stent have the greatest impact on patient discomfort. Stent placement due to urinary tract stone surgery, presence of recurrent urinary tract infections, and higher BMI are also risks for experiencing severe stent-related symptoms.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/8677297","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145686496","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}

引用次数: 0

Sinapic Acid Attenuates Hypertrophic Scarring by Modulating the TGF-β1/Smad Pathway: An In Vivo and In Vitro Investigation 辛酸通过调节TGF-β1/Smad通路减轻增生性瘢痕：体内和体外研究

IF 2.4 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

International Journal of Clinical Practice

Pub Date : 2025-11-29 DOI: 10.1155/ijcp/3671828

Zhe Jin, Libo Yin, Zhiguang Huang

Rationale

Hypertrophic scars are formed as a result of excess collagen and fibroblast activity during the tissue healing process and can result in loss of function. Sinapic acid (SA) is a naturally occurring phenolic compound with antifibrotic, anti-inflammatory, and antioxidant properties.

Aims and Objectives

This study aims to evaluate the ability of SA to inhibit hypertrophic scar generation and explain the mechanisms through which this happens by performing both in vivo and in vitro experiments.

Methods

A rat tail wound model in vivo was employed to assess the impact of SA on the pathological scar area, biomolecule deposition, and fibroblast multiplication. Histopathological, immunohistochemistry, and molecular tests were also performed. Fibroblast cell culture of hypertrophic scar fibroblast cells was used in addition to SA treatment to measure cell growth, movement activity, cell division phases, and fibrotic-related proteins.

Results

In vivo results showed that SA reduced the area of scarring in skin tissues and enhanced the organization of collagen, with the high-concentration group showing the most improvement. The reduction in TGF-β1 and P-SMAD2 was established through immunohistochemistry assays. In vitro findings indicated SA to decrease cell proliferation and movement capabilities of fibroblasts, as well as blocking the G1 phase and resulting in apoptosis. SA also downregulated key fibrosis markers including COL1A1, COL3A1, and α-SMA.

Conclusions

Modulation of the TGF-β1/Smad pathway, reduction of fibroblast proliferation, and the improvement of collagen organization are effects of SA, which aid in attenuation of hypertrophic scar formation. Our findings support the suggestion for further studies in this regard in order to test the safety and efficacy of SA, which can have great potentials for use in antiscarring therapies. These findings provide a mechanistic rationale for the translational development of SA as a topical antiscarring therapy.

在组织愈合过程中，增生性疤痕是由于胶原蛋白和成纤维细胞活性过剩而形成的，可导致功能丧失。辛酸（SA）是一种天然存在的酚类化合物，具有抗纤维化、抗炎和抗氧化特性。目的和目的本研究旨在通过体内和体外实验来评估SA抑制增生性瘢痕生成的能力，并解释其发生的机制。方法采用活体大鼠尾外伤模型，观察SA对病理性瘢痕面积、生物分子沉积及成纤维细胞增殖的影响。同时进行组织病理学、免疫组织化学和分子检测。增生性瘢痕成纤维细胞培养除SA处理外，还使用成纤维细胞来测量细胞生长、运动活性、细胞分裂期和纤维相关蛋白。结果体内实验结果显示，SA减少皮肤组织瘢痕面积，增强胶原组织，其中高浓度组改善效果最大。免疫组化检测发现TGF-β1和P-SMAD2均明显降低。体外实验结果表明，SA可降低成纤维细胞的增殖和运动能力，阻断成纤维细胞G1期，导致成纤维细胞凋亡。SA还下调关键纤维化标志物，包括COL1A1、COL3A1和α-SMA。结论SA可调节TGF-β1/Smad通路，减少成纤维细胞增殖，改善胶原组织，减轻增生性瘢痕的形成。我们的研究结果支持在这方面进一步研究的建议，以测试SA的安全性和有效性，它在抗疤痕治疗中具有很大的潜力。这些发现为SA作为局部抗疤痕疗法的转化发展提供了机制基础。

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引用次数: 0