International Journal of General Medicine最新文献

The 2024 Nobel Prize in Physiology or Medicine, awarded for the discovery of microRNAs (miRNAs) as essential regulators of gene expression, has spotlighted their pivotal roles in disease processes, including autoimmune conditions such as Sjögren's disease (SD). SD is a chronic autoimmune disease marked by lymphocytic infiltration of exocrine glands, resulting in significant glandular dysfunction and diverse systemic effects. Recent research has revealed that miRNAs play crucial roles in SD pathogenesis, orchestrating immune cell activity, epithelial cell integrity, and the regulation of inflammatory pathways. Dysregulation of specific miRNAs is associated with exacerbated immune responses, glandular damage, epithelial cell dysfunction, and sustained inflammation, positioning these small RNA molecules as central players in disease progression. This review synthesizes current findings on the roles of miRNAs in SD, highlighting how certain miRNAs contribute to immune dysregulation, epithelial dysfunction, and disease chronicity. Additionally, we explore the potential of miRNAs as biomarkers for disease activity, reflecting both immune and epithelial health, and as novel therapeutic targets. By consolidating recent advancements, we aim to offer a comprehensive perspective on the involvement of miRNAs in SD and to underscore the potential for miRNA-based strategies to transform the diagnosis, management, and treatment of SD.

Objective: To explore the clinical effect of Traditional Chinese Medicine (TCM) plus azithromycin in the treatment of Mycoplasma pneumonia (MP).

Methods: This was a retrospective study including the clinical data of 119 patients with MP treated at Taihe County Hospital of Traditional Chinese Medicine from April 2021 to November 2023. According to treatment records, 58 cases were treated with conventional therapy and azithromycin (azithromycin group), and 61 cases were treated with conventional therapy, azithromycin, and Xiaoxianxiong decoction and Weijing decoction and acupoint application (TCM + azithromycin group). The treatment outcomes, levels of inflammatory status indicators before and after treatment, respiratory function status, and incidence of adverse reactions were analyzed between the two groups.

Results: The overall effective rate of TCM + azithromycin group was significantly higher than that of azithromycin group (P<0.05). After treatment, the serum C-reactive protein (CRP), procalcitonin (PCT), and white blood cell count (WBC) levels in both groups significantly decreased compared to before treatment, and the TCM + azithromycin group was significantly lower than the azithromycin group (P<0.05). After treatment, partial pressure of carbon dioxide (PaCO₂) in both groups significantly decreased compared to before treatment, while oxygen partial pressure (PaO₂) and oxygenation index (OI) significantly increased compared to before treatment; Moreover, the TCM + azithromycin group had significantly lower PaCO₂ and higher PaO₂ and OI than the azithromycin group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).

Conclusion: Compared with treatment with azithromycin alone, intervention with TCM + azithromycin can significantly improve the respiratory function of patients with MP, reduce the degree of inflammatory response, and enhance the overall treatment effect without increasing the incidence of adverse reactions.

Core tip: This study indicates that intervention with traditional Chinese medicine and azithromycin can significantly improve the respiratory function of MP patients, reduce the degree of inflammatory response, improve overall treatment efficacy, and is safe.

Background: Patient satisfaction emerges as an indicator for enhancing the quality of health organizations, facilitating the evaluation and identification of the most significant characteristics of patient experience and their corresponding satisfaction levels. This can guide decisions to improve healthcare services and develop policies for better care. This study seeks to assess the level of patient satisfaction with primary healthcare (PHC) services in a large military hospital in Riyadh, Saudi Arabia, and to determine the extent of association between the level of satisfaction and patients' social and demographic factors.

Methods: A cross-sectional study was carried out on a convenient sample who received primary health care at the Security Forces Hospital in Riyadh, Saudi Arabia, between January and June 2023. Comparisons between qualitative variables were made using the chi-square to test significance and the One-Way ANOVA test was used to compare the means of total patient satisfaction scores, p < 0.05 was considered significant.

Results: Among the 379 participants, 268 (70.7%) were males, 271 (71.2%) were married, 222 (58.6%) were military personnel, and 207 (54.6%) were between the ages of 31 and 49. The average satisfaction with PHC clinics was 52.1 (SD=4.9, highest score=60) while the average satisfaction with general evaluation was 27.6 (SD=3.4, highest score=35). Male participants exhibited greater satisfaction levels (M= 117.8, SD=12.8) than their female counterparts (M= 115.7, SD=15.3, p-value = 0.01). Patients aged 18-30 had greater satisfaction levels (M= 117.5, SD=16.8, p-value = 0.02). Individuals who were single reported higher levels of satisfaction (M= 118.3, SD=16.2, p-value = 0.001). Participants with lower earnings (less than 5000 SR) had greater satisfaction levels compared to individuals having a greater income (p-value = 0.002).

Conclusion: Patients attending a PHC center in a large military hospital in Riyadh generally reported high levels of satisfaction, particularly among male, single, younger, and low-income individuals. Despite these favorable results, several aspects of healthcare need enhancement to fulfill patient expectations and guarantee optimal healthcare provision. Therefore, healthcare practitioners must persist in determining and addressing these areas to guarantee that patients obtain optimal care and experience in primary healthcare clinics.

Objective: The osteoprotegerin (OPG)/receptor activator of nuclear factor-κB (RANK)/receptor activator of nuclear factor-κB ligand (RANKL) system plays a pivotal role in the balance between osteoblasts and osteoclasts and is closely related to the pathogenesis of rheumatoid arthritis (RA). The present study aimed to clarify the associations of OPG/RANK/RANKL gene single-nucleotide polymorphisms (SNPs) with disease susceptibility, bone mineral density (BMD), and clinical manifestations in RA patients.

Methods: A case-control study including 319 RA patients and 330 healthy controls was conducted. All subjects were genotyped for rs4355801 and rs1023968 in OPG, rs10805033 in RANK, and rs9533155 and rs875625 in RANKL. BMD and clinical manifestations were recorded.

Results: An association was found between OPG rs4355801 and risk of RA. In recessive models, the GG genotype of rs4355801 was associated with an increased risk of RA compared with the AA/AG genotypes (OR=1.679, 95% CI: 1.062-2.655, p=0.025). A correlation between RANKL rs9533155 and BMD was found in RA patients. Patients with the GG genotype (n=108) in RANKL rs9533155 had the more decreased BMD values at lumbar level 2 (t=3.424, p=0.009), lumbar level 3 (t=3.171, p=0.019), lumbar level 4 (t=4.187, p=0.001), and total lumbar levels 2-4 (t=2.989, p=0.021) compared with CC+GC genotypes. No associations were found between the OPG, RANK, and RANKL SNPs and clinical manifestations of RA (all p>0.05). Logistic regression analysis indicated that older age (OR=1.057, 95% CI: 1.017-1.099, p=0.005), higher HAQ (OR=2.786, 95% CI: 1.329-5.841, p=0.007), and GG genotype of rs9533155 (OR=3.242, 95% CI: 1.254-8.376, p=0.015) were risk factors of lumbar osteoporosis onset in RA patients.

Conclusion: In summary, OPG rs4355801 is associated with susceptibility to RA and RANKL rs9533155 GG genotype potentially contributes to decreased BMD in RA. Studies with larger sample sizes are needed to confirm the present findings.

Objective: Osteoporosis, a prevalent degenerative bone disorder, and its associated complications can have a substantial impact on patients. To enhance osteoporosis prevention, it is imperative to explore the public's awareness of this condition.

Methods: In this paper, literature related to osteoporosis awareness, which was published from October 2020 to October 2023, was searched in the CNKI, Wanfang, and PubMed databases. After the establishment of volume exclusion criteria, 16 articles were ultimately included in the analysis. Two reviewers independently extracted the study methods, tools, and results.

Results: Currently, most international research tools are questionnaires that have undergone rigorous reliability and validity testing and are extensively applied in clinical research. In contrast, in China, there is a paucity of research tools and cases, with most relying on translations of international questionnaires. The findings indicate that the awareness of osteoporosis among the general population in China and other countries is relatively low, and the awareness level in China is generally lower than that in developed countries. Currently, there are diverse measures to enhance awareness, including traditional media and online education via the Internet. All results suggest that active education can significantly boost awareness.

Conclusion: The area of osteoporosis awareness research remains relatively under - explored, and research tools need to be tailored to the characteristics of populations in different regions. Currently, there are few relevant studies, and their results consistently show that the public's awareness of osteoporosis is relatively low. Existing evidence demonstrates that health education can improve awareness, so healthcare professionals should place greater emphasis on bone health education.

Objective: This observational study aimed to investigate the prevalence and influencing factors of demoralization syndrome (DS) in elderly maintenance hemodialysis (MHD) patients, with a focus on improving their psychological distress levels.

Methods: Convenient sampling was used to select 350 MHD patients aged 60 or older from three tertiary hospitals in China. Data was collected using questionnaires, including the Chinese version of the DS Scale. Statistical analysis was conducted using SPSS 26.0 software.

Results: Single factor analysis revealed that sex, average monthly household income, living alone, dialysis duration, complications, and self-care abilities were significant influencers of DS levels. The average DS score was moderately high, with 59.4% of patients scoring in the high range. Multivariable linear regression identified average monthly household income, dialysis duration, complications, and self-management abilities as independent factors impacting DS.

Conclusion: The study highlighted the importance of addressing complications, enhancing social support, improving self-management skills, and tailoring individualized hemodialysis plans to reduce DS levels and alleviate psychological distress in elderly MHD patients. These findings provide valuable insights for healthcare providers aiming to enhance patient well-being in this population.

Background: Chronic disorders of consciousness (cDoC) resulting from severe traumatic brain injury (sTBI) are associated with significant challenges in treatment and recovery. This review explores multimodal interventions aimed at improving patient outcomes.

Methods: A systematic review was conducted on peer-reviewed studies from PubMed and Google Scholar published between 2000 and 2023. The review included clinical trials, observational studies, and case series that assessed interventions for improving consciousness and cognitive function in patients with cDoC following sTBI. Interventions considered included pharmacological treatments, non-invasive neuromodulation, rehabilitation therapies, and traditional medicine approaches.

Results: The review identifies several promising interventions. Hyperbaric oxygen therapy (HBOT), when combined with physical rehabilitation and non-invasive brain stimulation techniques like transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), has shown positive effects on consciousness and cognitive recovery. Non-invasive neuromodulation techniques have been linked to improvements in cortical activity and consciousness, with taVNS emerging as a novel approach. Additionally, traditional Chinese medicine, particularly herbal therapies, has demonstrated complementary benefits when integrated with modern rehabilitation methods. Personalized treatment strategies based on clinical characteristics, biomarkers, and genetic data were found to enhance recovery. Notably, integrating these modalities into personalized care protocols has shown enhanced efficacy, suggesting that individualized approaches are critical for improving outcomes.

Conclusion: Multimodal therapies show promise in enhancing recovery in cDoC patients after sTBI, but further research is needed to optimize treatment protocols and standardize clinical practices. The integration of traditional and modern therapies represents a potentially effective strategy for improving patient outcomes.

Purpose: Coronary artery disease (CAD), clinically manifested as coronary syndrome (CS), is the leading cause of death and a significant contributor to morbidity worldwide. Elevated serum homocysteine levels have been associated with an increased risk of cardiovascular diseases, including CAD. Despite extensive research, the relationship between serum homocysteine and coronary syndromes with related short-term mortality is still under-studied. The main objective of this study is to evaluate the correlation between serum homocysteine levels and various types of CS, as well as in-hospital mortality in these patients.

Patients and methods: This multicenter study included 381 CS patients from Afghanistan, Egypt, and Pakistan tertiary care hospitals. The relation of serum homocysteine levels with different types of CS as well as with in-hospital mortality was measured and analyzed using inferential statistics (ANOVA, Kruskal-Wallis test, Tukey's post-hoc, Pearson correlation, etc.) and regression analysis (Binary regression).

Results: Among 381 patients from both genders, 160 were from Pakistan, 130 from Egypt, and 91 from Afghanistan. There was no significant difference in baseline characteristics, like age, gender, homocysteine level, CS type, and mortality, among the three countries (p > 0.05). The one-way ANOVA, the Kruskal Wallis Test, and Tukey's post hoc test showed a significant difference among different CS groups based on serum homocysteine levels, and Pearson correlation showed a strong correlation between serum homocysteine and CS (r = 0.4). Binary regression analysis showed a 10.5% increase in in-hospital mortality for each 1 µmol/L increase in homocysteine levels.

Conclusion: Serum homocysteine could serve as a valuable biomarker and mortality predictor in CS patients.

Purpose: This study aimed to investigate the prevalence of common respiratory viruses among children with acute respiratory infections in Fuzhou from 2017 to 2023, considering the varying Corona Virus Disease 2019 (COVID-19) epidemic control measures in place.

Patients and methods: This study retrospectively analyzed the detection of respiratory viruses in children diagnosed with acute respiratory infections at a tertiary hospital in Fuzhou during the study period. The analysis covers three distinct phases: Phase I (2017-2019), Phase II (2020-2022), and Phase III (2023). The subjects of this study included adenovirus (ADV), influenza A virus (Flu A), influenza B virus (Flu B), parainfluenza virus types 1, 2, and 3 (PIV-1, PIV-2, PIV-3), and respiratory syncytial virus (RSV).

Results: A total of 24,838 throat swab samples were collected, resulting in an overall positive detection rate of 17.87% (4439/24,838). The positive detection rates of respiratory viruses among hospitalized children in Phases I, II, and III were 18.51%, 18.27%, and 15.90%, respectively, demonstrating a statistically significant decreasing trend over the years (P < 0.001). Among the detected viruses, RSV, PIV-3, and Flu A were the most prevalent. RSV infections was most common in children under six years of age. Seasonal trends for Flu A, PIV-3, and RSV varied throughout the outbreak; specifically, the detection rate of Flu A increased during March and April in 2023, while RSV detection rebounded sharply from April to June. The incidence of mixed respiratory virus infections was 0.40% (100/24,838), the most common being PIV-3 and RSV.

Conclusion: Using COVID-19 safety rules has helped stop the spread of some viruses in kids. But these rules have not made much difference in how often RSV and PIV-3 viruses show up.