International Journal of General Medicine最新文献

Objective: This study aimed to examine the effects and the efficacy of a combination of interventional embolization and endocrine hormone therapy for Pelvic congestion syndrome (PCS).

Methods: We retrospectively analyzed 132 patients diagnosed with PCS, and divided them into three groups based on their therapeutic schedule. The visual analog scale (VAS), pelvic venous blood flow parameters, and serum hormone levels of the three groups were compared before and after treatment. Moreover, the clinical efficacy and long-term changes in ovarian reserve functions were analyzed. For the comparison of measurement data before and after treatment within the group, paired - sample t - test was used for analysis. For the comparison between groups, one - way analysis of variance was applied. A P - value less than 0.05 indicated a statistically significant difference.

Results: Patients in the study group had significantly lower pain degrees than in the control group I and the control group II at 24 h and the first month after the operation (p < 0.05). The degree of pain in patients in the study group was significantly lower than that in the control group I at the third and 6 months following the treatment (p < 0.05). The parameters of venous blood flow and ovarian reserve in patients treated with the combined endocrine hormone therapy were significantly better than those in patients not treated with endocrine hormone therapy (p < 0.05). The total effective rate of the study group was significantly higher than that of the control groups (p < 0.05).

Conclusion: A combination of precise interventional embolization and endocrine hormone therapy can rapidly and effectively relieve pain in patients with PCS. Compared with free coil embolization, this combination can effectively increase vascular tension, reduce congestion, inhibit ovarian function, reduce pelvic congestion, and relieve symptoms.

Introduction: Idiopathic Intracranial Hypertension (IIH) is a disorder characterized by elevated intracranial pressure without an identifiable cause, commonly affecting young obese women. Current treatment strategies, including weight loss, acetazolamide, and surgical interventions, have limitations due to side effects, adherence challenges, and potential complications. Bromocriptine, a dopamine D2 receptor agonist, has emerged as a potential novel therapy due to its metabolic effects. This study aims to evaluate the safety and efficacy of bromocriptine in IIH management through a retrospective cohort analysis.

Methods: A retrospective analysis was conducted, focusing on patients with IIH. Propensity score matching was applied to balance baseline characteristics, including age, sex, race, and BMI, between the bromocriptine and control groups. Key outcome measures, papilledema, headache severity, refractory IIH status, and acetazolamide dose dependency, were assessed at multiple follow-up intervals.

Results: The bromocriptine group demonstrated significant improvement in papilledema and headache severity over 24 months, with early effects observed at one month. There was a marked reduction in refractory IIH (30.66% lower incidence at 24 months, p<0.0001) and reduced dependency on acetazolamide from three months onward (p=0.0246). The safety profile was favorable, with comparable adverse event rates to controls, although allergic skin reactions were noted in the bromocriptine group.

Conclusion: Bromocriptine shows promise as an effective and safe therapeutic option for IIH, with sustained improvement in clinical parameters and reduced reliance on conventional treatment. Future randomized controlled trials are needed to confirm these findings and explore optimal dosing strategies.

Purpose: This study aimed to investigate the effects of σ-1R on autophagy in sepsis-AKI and its potential involvement in the AMPK/mTOR signaling pathway.

Methods: The serum samples from patients were used to diagnose sepsis and sepsis-AKI using double-blind and randomized method and to quantify σ-1R and inflammatory cytokines using enzyme-linked immunosorbent assays. HK-2 cells induced by lipopolysaccharide (LPS) were employed as an in vitro model of sepsis-AKI. To evaluate the function of σ-1R in sepsis-AKI, siRNA and an overexpression plasmid targeting σ-1R were used. σ-1R and autophagy marker expressions were analyzed using quantitative real-time polymerase chain reaction and Western blot assays. Cell proliferation was evaluated using CCK-8 and EdU assays, and cell apoptosis was detected using flow cytometry and TUNEL staining assays. Phosphorylated proteins were detected in the AMPK/mTOR signaling pathway.

Results: In sepsis and sepsis-AKI, σ-1R levels were reduced, whereas the levels of interleukin-1β (IL-1β), IL-6, and tumor necrosis factor-α (TNF-α) increased. σ-1R promoted the proliferation of LPS-induced HK-2 cells while inhibiting apoptosis. Moreover, σ-1R enhanced autophagy, as evidenced by the upregulation of autophagy biomarkers LC3-II/LC3-I and Beclin 1. Furthermore, σ-1R promoted the phosphorylation of AMPK and ULK1 while inhibiting mTOR.

Conclusion: σ-1R utilizes the AMPK/mTOR signaling pathway to enhance autophagy in sepsis-AKI, indicating that σ-1R may serve as a promising target for sepsis-AKI diagnosis and therapy.

Background: Diabetes mellitus is a serious global health issue with increasing incidence at all income levels. Insulin injections are frequently administered improperly. Proper disposal of sharps is commonly overlooked when using an injection technique.

Aim: This study explores the knowledge and factors associated with insulin injection techniques among patients with diabetes. A study was also conducted to analyze the knowledge and practices of patients with diabetes regarding the disposal of medical waste.

Materials and methods: A cross-sectional study employing a questionnaire-based survey was conducted at two sites within Al-Ahsa, Saudi Arabia. Eligibility criteria comprised men and non-pregnant women aged 18 years or older diagnosed with either type 1 or type 2 diabetes who administered insulin via insulin pens or syringes. The descriptives were presented and a chi-square test was used to study the association. All the data were analyzed using Jamovi software.

Results: A significant association of knowledge was found with the duration of diabetes mellitus (p=0.031) and the source of insulin injection training (p=0.014). A positive correlation between participants' knowledge and practice (r = 0.221, p < 0.05) was observed. Participants' insulin injection practices reveal that 66.2% (n = 235) demonstrated good or safe practices, 33.8% (n = 117) exhibited average or potentially needing improvement practices, and 0.8% (n = 3) displayed poor injection practices. A mixed picture of medical waste disposal practices among the participants has been observed, with 30% (n = 106) exhibiting good or safe practices, 64% (n = 228) moderate practices, and nearly 6% (n = 21) of participants reported employing poor disposal practices.

Conclusion: This study showed that insulin injection and medical waste disposal practices need to be improved. Most of the patients come under the average medical waste disposal practice category. More awareness campaigns and counselling sessions are crucial to improve the practices.

Objective: We aimed to utilize network pharmacological analysis and molecular docking to elucidate the potential mechanisms of Banxia Decoction (BD) action in the treatment of Hashimoto's thyroiditis (HT).

Materials and methods: Active compounds and HT-related targets were predicted using databases and the intersection of the results was taken. STRING and DAVID 6.8 tools were used to obtain the protein-protein interaction (PPI) network and perform GO and KEGG evaluations, respectively. Discovery Studio 2017 R2 was utilized to perform molecular docking and RT-qPCR was conducted to confirm hub gene expressions in clinical samples.

Results: A total of 136 active compounds in BD were screened, and 74 potential targets related to HT were identified in BD. Further, 17 key targets in the PPI network were identified and HIF1A, EP300, PRKCA, and TERT were included for subnet analysis. Next, a network of "Chinese medicine-active compound-potential target-signal pathway" was obtained and the HIF-1 signaling pathway was identified as the key pathway. Finally, 8 active compounds and their stable binding to target proteins were confirmed by molecular docking; MAPK3, SRC, TERT, and HIF1A were upregulated in HT relative to the goiter samples.

Conclusion: The integration of network pharmacology and molecular docking provides a systematic framework for exploring the multi-component and multi-target characteristics of BD in HT, underscores the therapeutic potential of BD in HT by targeting genes and pathways involved in immune regulation and oxidative stress. These findings not only enhance our understanding of BD's pharmacological mechanisms but also lay the groundwork for the development of novel therapeutic strategies for HT.

Purpose: The purpose of this study was to investigate the relationship between sleep quality and dry eye syndrome, with a specific focus on identifying the sleep-related factors that increase the risk of developing dry eye syndrome.

Patients and methods: We utilized the PSQI-K (Korean version of the Pittsburgh Sleep Quality Index) and MQ (McMonnies Dry Eye Questionnaire) to assess sleep quality and dry eye syndrome in 221 participants. The seven subfactors of sleep measured were subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbance, use of sleep medication, and daytime dysfunction.

Results: There was a significant correlation between poor sleep quality and higher scores of dry eye syndrome. Factors such as lower subjective sleep quality, longer sleep latency, shorter sleep duration, frequent sleep interruptions, and increased daytime dysfunction were associated with worse dry eye scores. The primary disruptors of sleep included sleep fragmentation and unsuitable thermal environments during sleep.

Conclusion: Sleep disruptions, particularly those caused by modern lifestyle factors such as excessive use of digital devices and mental health issues like depression, anxiety, and stress, significantly contribute to the likelihood of developing dry eye syndrome. Addressing these sleep-disrupting factors through comprehensive management of sleep habits and mental health is crucial for preventing dry eye syndrome. Even in individuals not currently classified with dry eye syndrome, preemptive management of identified risk factors is recommended to mitigate potential future onset.

Purpose: Cancer-associated fibroblasts (CAFs) could promote the progression and migration of tumors. However, the roles of CAFs infiltration related genes in glioblastoma (GBM) were still unclear.

Methods: GBM-related transcriptome data and clinical information were downloaded from the UCSC Xena and CGGA databases. In this study, the abundance of fibroblasts were calculated by "MCPcounter", and the CAFs infiltration related genes were identified by "WGCNA". Then, the biomarkers of GBM were screened out, and based on it, the survival risk model (risk score) and the prognostic model (nomogram) were constructed to clinical predict the survival of GBM. Moreover, the function and mutation analyses were performed to further study the mechanisms of GBM. Furthermore, the competitive endogenous RNAs (ceRNA) regulatory network were used to reveal the potential regulation of biomarkers.

Results: Totals of 46 CAFs infiltration related genes were associated with focal adhesion. Four biomarkers, including STC1, BDKRB2, SOCS3 and FURIN were identified, and all of them were negative factors. Nomogram constructed based on risk scores and clinical indicators had good predictive performance (AUC > 0.68). Noticeable, COL5A1 might be the key gene, which were extremely positively associated with all these four biomarkers. Besides, the genes in high-risk groups were associated with the functions of epithelial mesenchymal transition (EMT) and angiogenesis. In addition, hsa-miR-107 could regulate STC1 through the TGF-β signaling pathway and further regulating the migration and invasion of tumour.

Conclusion: This study identified four CAFs infiltration related biomarkers associated with the prognosis of GBM. This finding might help to deepen the understanding the roles of CAFs in development of GBM.

Objective: To evaluate the effects of Banxia Gualou Xiebai Tang combined with Qishen Yiqi Dropping Pills on Qi deficiency, phlegm, and blood stasis syndrome in post-percutaneous coronary intervention (PCI) coronary heart disease (CHD) patients.

Methods: A retrospective analysis was conducted on 100 post-PCI CHD patients with Qi deficiency, phlegm, and blood stasis syndrome treated from October 2022 to April 2024. Patients were divided into a control group (n=50, receiving standard secondary prevention) and an observation group (n=50, receiving additional Banxia Gualou Xiebai Tang and Qishen Yiqi Dropping Pills). Treatment efficacy, TCM syndrome scores, cardiac function (LVEF, LVEDD, LVESD, CO), blood lipids (TC, TG, HDL-C, LDL-C), hemorheological parameters (PV, Hct, HSBV, LSBV), and adverse events were compared.

Results: ① The total effective rate in the observation group (92.0%) was significantly higher than in the control group (76.0%) (P<0.05). ② TCM syndrome scores significantly improved in both groups, with greater improvement in the observation group at 3 and 6 months (P<0.05). ③ Cardiac function: LVEF and CO increased, while LVEDD and LVESD decreased in both groups, with more significant changes in the observation group (P<0.05). ④ Blood lipids: TC, TG, and LDL-C decreased, and HDL-C increased in both groups, with greater changes in the observation group (P<0.05). ⑤ Hemorheology: PV, Hct, HSBV, and LSBV decreased more in the observation group (P<0.05). ⑥ Adverse events: The observation group had a higher incidence of adverse events (22.0% vs 14.0%, P<0.05).

Conclusion: Banxia Gualou Xiebai Tang combined with Qishen Yiqi Dropping Pills, alongside standard treatment, significantly improves efficacy, cardiac function, hemorheology, and blood lipids in post-PCI CHD patients without increasing adverse events.

Objective: Tetanus remains a public health problem in developing countries. Patients with severe tetanus require long-term access to emergency medical resources. Here, we identified the risk factors for a prolonged length of stay (LOS) in the emergency intensive care unit (EICU) in adult tetanus patients.

Methods: We conducted a retrospective study using data from adult tetanus patients admitted to the EICU in our hospitals. K‒M analysis was used for LOS analysis in the EICU, and the Log rank test was used for comparisons between groups. Cox proportional hazards regression model analyses were used to assess significant factors associated with LOS in the EICU.

Results: A total of 81 tetanus patients were included in the study. The patients had an average age of 59.39 ± 10.90 years (SD). The mean LOS was 18.1 days (median, 16.0 days; range, 0.6 days to 50.0 days). From 15 related factors, we identified two independent factors for prolonging the LOS of tetanus patients in the EICU: tracheotomy and mechanical ventilation. The risk of EICU retention in patients with mechanical ventilation was 55.3% greater than that in patients without mechanical ventilation (HR=0.447, 95% CI: 0.227-0.880, P=0.020); the risk of EICU retention was 86.2% greater in patients with tracheotomy than in those without tracheotomy (HR=0.138, 95% CI: 0.058-0.328, P<0.001).

Conclusion: Tracheotomy and mechanical ventilation support were associated with increased LOS in the EICU in adult tetanus patients, independent of the tetanus antitoxin dose. Clinicians must focus on spasm control and optimize airway management in tetanus patients in the EICU.