International Journal of General Medicine最新文献

Background: The polymorphisms of the Toll-like receptor 4 (TLR4) gene are associated with lipid levels, such as serum total cholesterol, low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG). The aim of this study was to detect the association of the six polymorphisms in TLR4 gene and serum lipid levels and the risk of ischemic stroke (IS) in a Southern Chinese Han population.

Methods: Genotypes of six polymorphisms in TLR4 gene in 372 subjects (IS, 186 and healthy controls, 186) were determined by the Snapshot Technology. The relationship between TLR4 polymorphisms and serum lipid levels, risk of IS were analyzed.

Results: The levels of fasting blood glucose and triglyceride were higher, and the high-density lipoprotein cholesterol (HDL-C) level was lower in IS cases than those in controls. The allelic frequencies of TLR4 gene rs11536889 SNP (p=0.037) and rs1927914 SNP (p=0.036) were different between the IS and control groups. The rs11536889 C allele carriers had an increased risk of IS (odds ratio (OR)=1.278, 95% confidence interval (CI) =1.013-1.784, p=0.037 for C vs G alleles), and the G allele carriers of rs1927914 had a decreased risk of IS (OR=0.695, 95% CI=0.534-0.949, p=0.036 for G vs A allele) in the southern Chinese Han population.

Conclusion: The TLR4 rs11536889 and rs1927914 SNPs may be associated with decreased risk of IS in the Chinese population.

Insomnia is a common clinical disorder characterized by difficulty falling asleep or maintaining sleep with daytime irritability or fatigue. The annual prevalence of insomnia symptoms in the global adult population is 35-50% and the prevalence of insomnia disorders is 12-20%. Most patients with insomnia cost a lot but fail to receive effective treatment. First-line treatments for insomnia include cognitive-behavioral therapy (CBT-I) and medication, but they both have limitations such as expensive and serious side effects. Traditional Chinese herbal remedies, such as the Guipi capsule, are selected as an alternative strategy of treatment because of more convenient, affordable, and fewer side-effects. Here, we review the potential pathogenesis of insomnia, the pharmacological ingredients of the Guipi capsule, and its effects and mechanisms in treating insomnia.

Objective: To analyze the level of systemic immune-inflammatory index (SII) in patients with ulcerative colitis (UC) and assess its relationship with disease activity.

Methods: This study included 616 UC patients and 211 healthy controls. Disease activity was assessed using the modified Mayo score, categorizing patients into remission (n=115) and active (n=501) groups, with the latter further stratified into mild, moderate, and severe activity. We compared multiple inflammatory indices-including SII, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), neutrophil percentage-albumin ratio (NPAR), and others-between groups. Spearman correlation and ROC curve analyses were used to evaluate their associations with disease activity and predictive value for active and severe UC.

Results: SII, NLR, PLR, NPAR, and several other indices were significantly higher in the UC group than controls, while lymphocyte-to-monocyte ratio (LMR) and LHR were lower (all P<0.05). Most indices were also elevated in active versus remission UC (P<0.05), and showed significant differences across severity subgroups (P<0.05), with SII, NLR, NPAR, NHR, and MHR increasing with severity. Spearman analysis revealed positive correlations between these markers and disease activity/severity (P<0.001). ROC analysis demonstrated significant predictive value for active and severe UC (AUC>0.60, P<0.001), with NPAR exhibiting the highest efficacy (AUC=0.854).

Conclusion: SII, NLR, PLR, NPAR, and other inflammatory indices are useful non-invasive biomarkers for assessing UC disease activity and severity, with NPAR showing the strongest predictive performance.

Background: Zinc-finger and homeobox (ZHX) family members have been identified as valuable predictors of survival outcomes in several types of cancers. Nevertheless, the prognostic implications of ZHX factors in esophageal carcinoma (EC) remain unclear.

Materials and methods: Bioinformatic analyses were conducted to evaluate the transcription levels of ZHX factors and their corresponding prognostic significance in EC. Immunohistochemistry was further utilized to assess the association between ZHX3 protein expression and clinicopathologic variables as well as survival outcomes in patient with esophageal squamous cell carcinoma (ESCC).

Results: Data from online databases showed no association between ZHX mRNA expression levels and overall survival (OS) in EC patients. However, subgroup analyses revealed significant associations between the expression of ZHX factors and survival outcomes in selected patient cohorts. Immunohistochemical analysis supported that high ZHX3 protein expression was associated with advanced histological grade and unfavorable OS in ESCC patients. Multivariate analysis revealed that ZHX3 expression was an independent prognostic predictor for patient survival.

Conclusion: These observations by means of combining bioinformatics and immunohistochemical analyses suggest that ZHX factors is involved in disease progression and may be potential biomarkers for predicting more accurate prognosis for EC patients.

Background: Heart failure (HF) remains a global health burden characterized by frequent hospitalizations and high mortality. The Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score has emerged as a composite marker reflecting nutritional and inflammatory status, but its prognostic utility in acute HF settings remains underexplored.

Objective: To investigate the association between the HALP score and prolonged hospital stay and in-hospital mortality among patients admitted with acute heart failure.

Methods: This retrospective study included 222 patients hospitalized with acute heart failure at a tertiary care center in Somalia between January 2024 and April 2025. Patients were stratified by hospital stay duration: short (≤7 days) vs long (>7 days). The HALP score was calculated using routine laboratory values, and a previously validated cut-off was used for stratification. Logistic regression analysis was used to identify predictors of long hospital stay. Model performance was assessed using Hosmer-Lemeshow test, Nagelkerke R², classification statistics, and ROC curve analysis.

Results: A total of 222 patients were analyzed; 86 (38.7%) had prolonged hospitalization. Patients with the HALP score above the prognostic threshold were significantly more likely to experience long hospital stay (p = 0.002). In multivariable analysis, The HALP score ≥ cut-off (OR: 10.19, 95% CI: 2.49-41.63, p = 0.002) and prior stroke (OR: 8.44, 95% CI: 1.15-61.88, p = 0.035) independently predicted prolonged hospital stay. Model fit was adequate (Hosmer-Lemeshow p = 0.105), and explanatory power was moderate (Nagelkerke R² = 0.31). However, the HALP score's standalone discriminative ability was poor (AUC = 0.511).

Conclusion: The HALP score is an independent predictor of prolonged hospitalization in acute heart failure patients. While its individual discriminative power is limited, its role within multivariable risk stratification models appears promising. Further prospective validation is warranted.

As technology continues to progress, innovations in research and applications within the medical field are steadily emerging. Magnesium and its alloys, as emerging materials, exhibit characteristics such as low density, favorable biocompatibility, and biodegradable properties, rendering them highly promising for broad applications in the medical field.This article reviews the research and development of magnesium and its alloys in medical fields such as orthopedics, oncology, and neurology, as well as their use as biomedical materials. It summarizes how treatments including purification, alloying, and surface modification of magnesium can fully unlock the potential of magnesium and its alloys in targeted therapy, tissue repair, antibacterial applications, and fixation of medical implants. However, to achieve widespread clinical adoption of magnesium-based biomaterials, further breakthroughs remain necessary in areas such as biocompatibility, mechanical properties, and large-scale clinical validation.

Background: Diabetic nephropathy (DN) is the leading cause of end-stage renal disease worldwide, whose pathogenesis involves immune dysregulation and inflammatory response. Glycosylation plays key roles in numerous biological processes. This study aims to interrogate the role of glycosylation-related genes in tubulointerstitial immunoinflammatory injury in DN.

Methods: We utilized two tubulointerstitial transcriptome datasets from DN patients and normal individuals. Glycosylation-related hub genes were identified by integrating differential expression analysis, glycosylation-related gene sets, and machine learning. Immune cell infiltration was assessed using single-sample GSEA (ssGSEA), and functional enrichment analysis was performed via GO and KEGG. The expression levels of hub genes were validated in STZ-induced diabetic mouse model (n=5/group) followed by the evaluation of diagnostic efficiency and clinical significance.

Results: Six glycosylation-related hub genes (HEXB, B4GALT5, GALNT7, GCNT3, CGA, and VCAN) were identified, all closely associated with immune cell infiltration in DN. Enrichment analysis indicated their involvement in immune and inflammatory processes. CGA was significantly downregulated, while the other genes were upregulated in DN, which was experimentally validated in diabetic mice. ROC curve analysis revealed high diagnostic accuracy for all genes: HEXB (AUC = 0.892), B4GALT5 (AUC = 0.909), GALNT7 (AUC = 0.931), GCNT3 (AUC = 0.929), CGA (AUC = 0.898), and VCAN (AUC = 0.967). Elevated VCAN, GCNT3, and GALNT7 exhibited a positive association with renal function decline or proteinuria, providing valuable prognostic insights.

Conclusion: This study highlights the significant role of glycosylation-related genes in DN pathogenesis, likely mediated through immune and inflammatory mechanisms. VCAN, GCNT3, and GALNT7 show particular promise as novel biomarkers for clinical diagnosis and immunotherapeutic targets, supporting their future clinical translation for DN management.

Background and purpose: Research is still underway to determine the effect of blood pressure variability (BPV) on the prognosis of acute ischaemic stroke (AIS). The posterior circulation is vulnerable to BPV due to its unique anatomy. Our study systematically evaluated the effects of daily BPV and cerebral perfusion on 90-day prognosis of patients with acute posterior circulation cerebral infarction (PCCI) and further investigated their association.

Methods: The study included 462 patients diagnosed with PCCI. Cerebral perfusion was assessed by F.MTT (focus mean transit time), rCBV (relative cerebral blood volume) and rCBF (relative cerebral blood flow). Blood pressure (BP) was recorded twice daily and the daily BPV was calculated with standard deviation (SD) and coefficient of variation (CV). Subsequently, the correlation between daily BPV, cerebral perfusion and 90-day prognosis was examined using logistic regression modelling. Potential non-linear relationships were assessed through the use of smooth curve fitting. Assessment to explore the relationship between cerebral perfusion levels and daily BPV using stepwise logistic regression analysis. Finally, mediation analysis was performed to test the relationship between CT perfusion (CTP) mediated BPV and 90-day adverse prognosis.

Results: The study included 363 participants. Multivariate logistic regression analysis revealed that higher daily BPV and poorer cerebral perfusion were negatively associated with 90-day adverse prognosis in patients with PCCI (P < 0.05). In addition, poor cerebral perfusion was associated with higher daily BPV (MAP-SD: OR 1.15, 95% CI [1.03-1.27], P = 0.011; MAP-CV: OR 1.17, 95% CI [1.05 ~ 1.3], P = 0.004). Meanwhile, mediation analysis showed that rCBF mediated the association between daily BPV and 90-day adverse prognosis (indirect effect estimate = 0.918, direct effect estimate = 0.0621).

Conclusion: Our study demonstrated that daily BPV and cerebral perfusion were positively associated with 90-day adverse prognosis in patients with PCCI, which was partly mediated by rCBF.

Objective: To analyse the correlation between real-time cerebral state index (CSI) and postoperative emergence agitation (EA) in children undergoing surgery for decayed teeth during recovery from general anaesthesia, and to explore the feasibility of CSI in predicting EA during perioperative care.

Methods: A retrospective case-control study was performed for paediatric patients who underwent radical surgery for decayed teeth under general anaesthesia at the Stomatology Outpatient Department of the Children's Hospital of Shanxi from January 2022 to December 2022. According to the presence or absence of EA in children during recovery from general anaesthesia, the enrolled patients were divided into two groups: the agitation group (Group A) and the non-agitation group (Group NA). All paediatric patients were monitored for CSI using a combined-type multifunctional monitor of HXD-I Multi-parameter Monitor after the induction of tracheal intubation under intravenous anaesthesia.

Results: There were 16 cases (40%) of EA among the affected children. At post-extubation (T6), the subcortical excitability index (SCEi) (95[71-99] vs 46[15-78]), cortical excitability index (CEi) (45[34-77] vs 32[10-49]) and anxiety index (ANXi) (49[41-58] vs 41[30-49]) of Group A were significantly higher than those of Group NA, while memory index (Mi) (10[8-14] vs 12[9-14]) was smaller than in the latter group, with statistically significant differences between groups (P<0.05). Additionally, as shown in the receiver operating characteristic curve, at T6, the area under the curve of SCEi, CEi, ANXi and Mi in predicting EA separately was 0.762, 0.771, 0.709 and 0.711, with sensitivity of 82.9%, 87.0%, 84.3% and 63.6%, and specificity of 70.4%, 43.5%, 46.8% and 77.2%, respectively.

Conclusion: Post-extubation SCEi, CEi, ANXi and Mi were significantly associated with EA occurrence in children undergoing decayed tooth surgery under general anaesthesia, with SCEi and ANXi showing relatively better predictive performance.