International Journal of General Medicine最新文献

Objective: This study aimed to investigate the association between the polymorphisms of the FUT2 gene (rs1047781, rs601338) and the FUT3 gene (rs3745635, rs28362459) with susceptibility to inflammatory bowel disease (IBD) in the Zhuang population of Guangxi.

Methods: Intestinal mucosal tissues were collected from 113 Zhuang patients (41 with Crohn's disease [CD] and 72 with ulcerative colitis [UC]) and 120 han patients (42 with CD and 78 with UC), all of whom were unrelated and diagnosed with IBD, as well as from 106 Zhuang and 119 han unrelated healthy controls, from January 2021 to December 2023. DNA was extracted from intestinal mucosal samples in each group. FUT2 gene polymorphisms (rs1047781, rs601338) and FUT3 gene polymorphisms (rs3745635, rs28362459) were amplified using polymerase chain reaction (PCR). PCR product fragments were analyzed by DNA sequencing, and sequence analysis was conducted using the GenBank database.

Results: The genotype and allele frequencies of the FUT2 rs1047781 polymorphism in the Zhuang UC patient group were significantly different from those in the control group (P < 0.05). Similarly, significant differences were observed in the genotype and allele frequencies of the FUT3 rs3745635 polymorphism in the Zhuang UC and CD patient groups compared to controls (P < 0.05). No statistically significant differences were found in the genotype and allele frequencies of FUT2 rs1047781 between the Zhuang CD patients and controls (P > 0.05). Additionally, no significant differences were observed in the genotype and allele frequencies of FUT2 rs601338 and FUT3 rs28362459 polymorphisms between the Zhuang UC and CD patient groups and the controls (P > 0.05).

Conclusion: The FUT2 rs1047781 and FUT3 rs3745635 polymorphisms may be associated with IBD in the Guangxi Zhuang population, while FUT2 rs601338 and FUT3 rs28362459 polymorphisms may not show such an association.

Purpose: This study aims to evaluate the performance of a deep learning-based artificial intelligence (AI) diagnostic system in the analysis of retinal diseases, assessing its consistency with expert diagnoses and its overall utility in screening applications.

Methods: A total of 3076 patients attending our hospital underwent comprehensive ophthalmic examinations. Initial assessments were performed using the AI, the Comprehensive AI Retinal Expert (CARE) system, followed by thorough manual reviews to establish final diagnoses. A comparative analysis was conducted between the AI-generated results and the evaluations by senior ophthalmologists to assess the diagnostic reliability and feasibility of the AI system in the context of ophthalmic screening.

Results: : The AI diagnostic system demonstrated a sensitivity of 94.12% and specificity of 98.60% for diabetic retinopathy (DR); 89.50% sensitivity and 98.33% specificity for age-related macular degeneration (AMD); 91.55% sensitivity and 97.40% specificity for suspected glaucoma; 90.77% sensitivity and 99.10% specificity for pathological myopia; 81.58% sensitivity and 99.49% specificity for retinal vein occlusion (RVO); 88.64% sensitivity and 99.18% specificity for retinal detachment; 83.33% sensitivity and 99.80% specificity for macular hole; 82.26% sensitivity and 99.23% specificity for epiretinal membrane; 94.55% sensitivity and 97.82% specificity for hypertensive retinopathy; 83.33% sensitivity and 99.74% specificity for myelinated fibers; and 75.00% sensitivity and 99.95% specificity for retinitis pigmentosa. Additionally, the system exhibited notable performance in screening for other prevalent conditions, including DR, suspected glaucoma, suspected glaucoma, pathological myopia, and hypertensive retinopathy.

Conclusions: : The AI-assisted screening system exhibits high sensitivity and specificity for a majority of retinal diseases, suggesting its potential as a valuable tool for screening practices. Its implementation is particularly beneficial for grassroots and community healthcare settings, facilitating initial diagnostic efforts and enhancing the efficacy of tiered ophthalmic care, with important implications for broader clinical adoption.

Background: Understanding the dynamic changes in immune indicators during sepsis and their predictive value for Acute respiratory distress syndrome (ARDS) is crucial for improving patient outcomes.

Methods: This single-center, observational retrospective study was conducted at Lishui Central Hospital, Zhejiang Province. Patients diagnosed with Sepsis-3 were categorized into non-ARDS and ARDS groups based on ARDS development. Data collection included demographics, clinical data, and immune parameters. Immune parameters were collected on days 1, 3, and 7 post-admission. Multivariate logistic regression analysis identified independent risk factors for ARDS, and a nomogram model was constructed. The predictive ability of the model was evaluated using ROC curves.

Results: Multivariate analysis identified key factors for the nomogram, including CD4, CD8, Treg, lymphocyte, IgG, and IgA levels on Days 3 and 7. On Day 3, CD8 (P < 0.001), Tregs (P = 0.021), IgG (P < 0.001), and IgA (P < 0.001) showed significant negative correlations with ARDS development. On Day 7, CD4 (P < 0.001), CD8 (P < 0.001), lymphocyte count (P < 0.001), and IgA (P < 0.001) similarly demonstrated significant negative correlations with ARDS risk. The nomogram model had an AUC of 0.998 (95% CI: 0.997-0.999), indicating high predictive ability.

Conclusion: Early dynamic changes in immune indicators, including CD8, CD4, Treg, IgA, IgG, and Lymphocyte, predict ARDS development in ICU sepsis patients.

Background: To investigate the effects of aerosol size and concentration in pigeon lofts on the lung function of pigeon feeders.

Methods: From January 2022 to February 2022, 135 pigeon-feeders randomly selected from four villages in Turpan City, Xinjiang Uygur Autonomous Region were included in the exposure group, and 135 healthy medical check-ups from the same villages who had not been exposed to pigeons were included in the control group, and were questioned in detail to record the relevant information about the study subjects, to complete the pulmonary function examination, and to examine the concentration and size of aerosols in the surroundings, to analyze the effects of different concentrations and sizes of pigeon house aerosols on the lung function of the pigeon-feeders. The effects of different concentrations and sizes of pigeon loft aerosols on the lung function (FEV1, FVC, FEV1%, FVC%, FEV1/FVC) of the pigeon breeders were analyzed, and the correlation between the lung function and the number of years of keeping pigeons, the number of pigeons kept, and the time of daily exposure were analyzed.

Results: The aerosol concentration in the pigeon lofts of the exposed group was higher than that of the control group. Comparing the lung function of the exposed group with that of the control group, it was found that the lung function indexes of FVC, FEV1% and FVC% were lower than those of the control group, the aerosol concentration was negatively correlated with the lung function indexes of FEV1, FVC, FEV1%, FVC%, FEV1/FVC, the daily contact time with pigeons was negatively correlated with lung function indices, the number of years of keeping pigeons was negatively correlated with FEV1, and the difference was statistically significant.

Conclusion: The higher the aerosol concentration in the pigeon lofts, the longer the years of keeping, the longer the daily contact time with pigeons, the more pronounced is the decrease of the lung function indices in pigeon feeders.

Background: The objective of this study was to examine how miR-145-5p contributes to inhibiting the growth and movement of breast cancer cells by targeting and modulating the ADP-ribosylation factor 6 gene, as well as to clarify the mechanisms involved.

Methods: Bioinformatics analysis was used to study miR-145-5p expression in breast cancer samples from the TCGA database. RT-qPCR was performed on 25 pairs of HER2-positive breast cancer tissues and adjacent normal tissues, as well as in SK-BR3 and MCF10A cell lines. The effects of miR-145-5p overexpression on cell viability, migration, and invasion were assessed using CCK-8, scratch, and Transwell assays in SK-BR3 cells. A dual luciferase reporter assay was used to confirm miR-145-5p binding to the 3'-UTR of ARF6 mRNA. Additionally, the combined effects of miR-145-5p and ARF6 overexpression on SK-BR3 cell proliferation, migration, and invasion were evaluated.

Results: The examination of the TCGA database indicated that the expression levels of miR-145-5p were reduced in both paired and unpaired breast cancer tissues in comparison to normal control breast tissues. Notably, miR-145-5p showed a remarkably lower expression in HER2-positive breast cancer tissues versus paraneoplastic tissues. When the cells were transfected with a miR-145-5p mimic, there was a significant reduction in SK-BR3 cell proliferation, migration, and invasion in vitro. Conversely, the transfection of the cells with a miR-145-5p inhibitor led to a notable increase in SK-BR3 cell proliferation, migration, and invasion. Furthermore, miR-145-5p was found to suppress the expression of ARF6 mRNA by directly interacting with its 3'-untranslated region.

Conclusion: Overall, this study reveals that miR-145-5p suppresses the proliferation, migration, and invasion of breast cancer cells by interacting with ARF6 mRNA. Consequently, this miRNA might serve as a new target for accurate diagnosis and treatment of breast cancer.

Objective: The measles outbreak has recently recurred across the world despite the actions taken, and Yemen is among the worst-hit nations. There has been a lack of information regarding the status of the measles outbreak in Yemen. Therefore, this retrospective analysis aimed to determine the trend of the measles outbreak in Yemen from January 2020 to August 2024.

Methods: This retrospective analysis relied on the secondary data recorded between January 2020 and August 2024. The Ministry of Health and Population provided the necessary data in a soft copy format (Excel file), which was statistically analyzed.

Results:  A total of 41135 suspected measles cases were reported between January 2020 and August 2024. A higher proportion was observed among males (54.72%), age groups of 0-4 years (69.34%), in 2023 (50.5%), Aden governorate (20.54%), and in the spring (32.25%). The overall incidence rate was 18.82 per 10,000 population, with a higher rate among males (19.8 cases), age groups of 0-4 years (93.87 cases), in 2023 (9.5 cases), and Abyan governorate (89.06 cases). The overall fatality rate cases were 424 (4.92%), with the highest rate among females (1.06%), aged 0-4 years (1.26%), in 2023 (1.32%), and the Al Hudaydah governorate (2.97%). Furthermore, 82.4% of suspected cases were among unvaccinated individuals and 10.2% among individuals vaccinated with one dose.

Conclusion: According to current findings, the alarming rise in measles cases in recent years poses a serious threat to Yemenis' lives if not addressed. Therefore, vaccination efforts should be strengthened, healthcare infrastructure needs to be improved, vaccine hesitancy must be addressed, and international collaboration must be cultivated to control and eliminate measles.

Objective: To explore the clinical application value of neurophysiological monitoring combined with ultrasound guidance in Acute spinal cord injury.

Methods: Ten patients with acute spinal cord injury underwent intramedullary decompression surgery under neurophysiological monitoring and intraoperative ultrasound guidance. ASIA (American Spinal Injury Association) classification and JOA (Japan Orthopaedic Association) scoring were performed preoperatively and postoperatively.

Results: The preoperative, 1-week postoperative, and 1-year postoperative JOA scores for the ten patients were (6.2 ± 1.55), (7 ± 1.58), and (11.8 ± 1.60), respectively. The JOA improvement rates at 1 week and 1 year postoperation were 7.4% and 51.9%, respectively. Among the patients, one patient had severe thoracic spinal cord injury upon admission, and their ASIA classification remained at Grade A after 1 year postoperation, while the remaining nine patients showed varying degrees of neurological function improvement.

Conclusion: Intraoperative neurophysiological monitoring combined with intraoperative ultrasound not only allows for timely monitoring of spinal cord function but also enables observation of whether decompression is adequate during surgery. It represents a very good surgical option for patients with spinal cord injuries.

Background: Entecavir (ETV), tenofovir disoproxil fumarate (TDF), and tenofovir alafenamide(TAF) are first-line nucleos(t)ide analogs (NUCs) with chronic hepatitis B (CHB). This study aimed to assess the renal safety profile in NUC-experienced CHB patients who received ETV, TDF or TAF therapy.

Methods: This retrospective observational cohort study investigated factors related to renal function in 154 patients with NUC-experienced CHB who received ETV, TDF, and TAF therapy for 48 weeks. Changes in UREA, uric acid (UA), creatinine (Cr), and estimated glomerular filtration rate (eGFR) were analyzed using a one-way analysis of variance. A linear mixed-effects model for repeated measures was used to evaluate the correlation between baseline information and eGFR changes 48 weeks following treatment initiation. The model considered sex, baseline age, viral load, aminotransferases, renal function, and treatment group as fixed effects, and incorporated random effects for individual subjects.

Results: There were no significant differences in UA or Cr levels during therapy over time. The eGFR level was elevated in ETV-treated patients (117.5 ± 16.65 mL/min/1.7m² vs 109.8 ± 15.69 mL/min/1.7m², P=0.027), whereas it did not change significantly in TDF- (123.6 ± 28.54 mL/min/1.7m² vs 115.5 ± 20.44 mL/min/1.7m², P=0.070) and TAF-treated (121.6 ± 23.44 mL/min/1.7m² vs 113.4 ± 16.90 mL/min/1.7m², P=0.053) patients. Younger patients (<30 years) and those with higher HBV DNA (> 7 log₁₀IU/mL) and lower alanine aminotransferase levels (<5 × upper limit of normal) showed a significant improvement in eGFR elevation during NUCs therapy. The linear mixed-effects model showed that the baseline HBV DNA level was an important positive predictor of eGFR elevation at 48 weeks following treatment initiation (estimate was 1.437 and 2.449, P<0.001).

Conclusion: In real-life experience, ETV, TDF, and TAF therapy may not be associated with eGFR changes in NUC-experienced CHB patients without baseline renal impairment.

Objective: Glioma-associated epilepsy (GAE) is a common neurological symptom in glioma patients, which can worsen the condition and increase the risk of death on the basis of primary injury. Given this, accurate prediction of GAE is crucial, and this study aims to develop and validate a GAE warning recognition prediction model.

Methods: We retrospectively collected MRI scan imaging data and urine samples from 566 glioma patients at the Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science from August 2016 to December 2023. Least Absolute Shrinkage and Selection Operator (LASSO) regression and multivariate logistic regression analysis are used to determine independent risk factors for GAE. The nomogram and decision tree GAE visualization prediction model were constructed based on independent risk factors. The discrimination, calibration, and clinical usefulness of GAE prediction models were evaluated through receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA), respectively.

Results: In the training and validation datasets, the incidence of GAE was 34.50% and 33.00%, respectively. Nomogram and decision tree were composed of five independent radiomic predictors and three differential protein molecules derived from urine. The discrimination rate of area under the curve (AUC) was 0.897 (95% CI: 0.840-0.954), slightly decreased in the validation data set, reaching 0.874 (95% CI: 8.817-0.931). The calibration curve showed a high degree of consistency between the predicted GAE probability and the actual probability. In addition, DCA analysis showed that in machine learning prediction models, decision trees have higher overall net returns within the threshold probability range.

Conclusion: We have introduced a machine learning prediction model for GAE detection in glioma patients based on multiomics data. This model can improve the prognosis of GAE by providing early warnings and actionable feedback and prevent or reduce pathological damage and neurobiochemical changes by implementing early interventions.