International Journal of General Medicine最新文献

Purpose: To investigate the synergistic effect of Acupuncture combined with Chinese Herbal Medicine (CHM) in treating cerebral infarction (CI) rats, focusing on its impact on gut short-chain fatty acids (SCFAs) and serum interleukin-17 (IL-17) expression.

Methods: 36 male SD rats were divided into 6 groups (n=6): Sham, Model, Acupuncture, CHM, Combined Therapy, and Western Medicine (positive control). The CI model was established by middle cerebral artery occlusion (MCAO). The Combined group received both acupuncture (at bilateral "Hegu" (LI4), "Taichong" (LR3), "Zusanli" (ST36), and "Fenglong" (ST40)) and CHM (oral Banxia Baizhu Tianma Decoction combined with Taoren Honghua Decoction). Treatment lasted 14 days. Neurological deficit scores (Longa and horizontal wooden stick tests) were assessed. SCFA content in colonic contents was analyzed by gas chromatography, and serum IL-17 levels by ELISA. Subsequently, the correlation between SCFAs and IL-17 levels was analyzed.

Results: The combined therapy group showed significantly better improvements in neurological function compared to all single-therapy groups (P < 0.05). Compared to the model group, the total content of SCFAs (including acetic acid, propionic acid, and butyric acid) was significantly lower in the model group, while IL-17 levels were significantly elevated. All treatment groups showed increased SCFA content and decreased IL-17 levels, with the combined group demonstrating superior effects compared to single therapies (P < 0.05). A significant negative correlation was found between total SCFAs, acetic acid, propionic acid, and butyric acid, and serum IL-17 (R² = 0.601-0.711, P < 0.05).

Conclusion: The combination of acupuncture and CHM significantly improved neurological deficits in CI rats. This synergistic effect is likely associated with the regulation of gut microbiota-derived SCFAs and the suppression of IL-17-mediated neuroinflammation.

Background: Inflammatory bowel disease (IBD) encompasses Crohn's disease (CD) and ulcerative colitis (UC) and represents a heterogeneous spectrum of chronic intestinal inflammation with no exclusive etiology. Emerging evidence underscores that IBD arises from complex interactions between host factors and microbial communities. The disruption of microbial homeostasis facilitates the colonization and invasion of opportunistic pathogens within the gut, precipitating an exaggerated host immune response and driving disease progression. While extensive research has elucidated the role of the gut microbiota in IBD pathogenesis, the contribution of the oral microbiota to this process is garnering increasing attention. Oral microbes can translocate to the intestine via the swallowing of saliva, and harmful oral bacteria and proinflammatory immune cells from the oral mucosa may migrate to the gut, eliciting immune activation. This review explores the emerging role of the oral microbiota in IBD pathogenesis and synthesizes recent advancements in understanding the intricate relationship between oral microbial communities and IBD.

Purpose: Failure to wean from mechanical ventilation can lead to prolonged hospital stays, increased incidence of ventilator-associated pneumonia, and higher mortality rates. This study aimed to explore the effectiveness of the diaphragm contraction pressure index (DCPI) in predicting weaning outcomes in patients undergoing mechanical ventilation, providing a scientific basis for successful weaning in clinical practice.

Patients and methods: This prospective observational study included 286 individuals in the derivation cohort and 104 patients in the validation cohort, all of whom completed the spontaneous breathing trial (SBT). During SBT, ultrasound was used to quantify the right hemidiaphragm excursion (DE), diaphragm thickness (DTF) after inspiration and expiration, and DCPI. MIP values were gathered from the mechanical ventilator when the patients breathed peacefully. The derivation cohort determined the cut-off value of DCPI and compared these ultrasound diaphragm parameters. The validation cohort contributes to verifying the accuracy of DCPI.

Results: The weaning success group's DCPI in the derivation cohort was significantly higher than that of the weaning failure group (36.67% ± 7.02% vs 24.03% ± 5.78%, P < 0.001). While the area under the receiver operating characteristic curve (ROC) (AUC) of DE, DTF, and MIP was 0.698 (95% CI, 0.615-0.771, P < 0.001), 0.770 (95% CI, 0.693-0.837, P < 0.01), and 0.811 (95% CI, 0.737-0.872, P < 0.001), the ROC of DCPI was 0.954 (95% CI, 0.905-0.982, P < 0.001), indicating good predictive performance for weaning success. The DCPI had a sensitivity of 94.1% and a specificity of 90.8%, with the ideal cut-off value set at ≥30.0%. Similarly, in the validation cohort, the AUC of DCPI for the predicted value is 0.952 (95% CI, 0.854-0.992, P < 0.001).

Conclusion: Compared with DTF, DE, and MIP, DCPI dramatically improves the accuracy of predicting successful weaning.

Trial registration: No. ChiCTR2100052470, Registered 28 October 2021.

Background: Residing at high altitude is associated with increased red blood cell volume (RBCV) and reduced plasma volume (PV), changes that complicate interpretation of hemoglobin (Hb) and hematocrit (Hct). Here, we assess blood volume (BV), RBCV, PV, and hemoglobin mass (Hbmass) in individuals living at moderate altitude with the aim of deriving reference range for use in clinical practice.

Methods: One hundred and fifty-eight moderate-altitude residents (ALT; 51 women) from Abha, Saudi Arabia (2250 m above sea level) were recruited and compared to 40 control subjects (CON; 0 women). Blood volumes and Hbmass were determined by carbon monoxide rebreathing. Lean body mass (LBM) was quantified by dual-energy X-ray absorptiometry and adjusted for.

Results: When normalized to LBM, ALT men displayed an 8% increase in BV (109 vs 101 mL, p = 0.003), 14.8% increase in RBCV (54 vs 47 mL, p < 0.001), and 16.2% increase in Hbmass (18 vs 15 g, p < 0.001) compared to CON. ALT women exhibited lower BV (3928 vs 5476 mL), RBCV (1684 vs 2690 mL), PV (2276 vs 2767 mL), and Hbmass (558 vs 886 g), than ALT men, (p < 0.001 for all). When expressed per body weight, ALT men have higher RBCV (33 vs 30 g), lower PV (34 vs 40 mL) and no different BV (68 vs 69 mL, p = 0.443). When expressed per LBM, gender differences in RBCV and Hbmass disappeared (RBCV: 54 vs 51 mL/kg^LBM, p = 0.164; Hbmass: 18 vs 17 g/kg^LBM, p = 0.201). Women have significantly higher BV (120 vs 109 mL/kg^LBM) owing to higher PV (72 vs 55 mL/kg^LBM).

Conclusion: Moderate altitude is associated with a higher BV owing to a higher RBCV, which also explains the elevated Hb. A reference range based on the 5% and 97.5% percentiles of blood volumes and Hbmass adjusted for LBM is suggested for use in clinical practice.

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.