International Journal of General Medicine最新文献

Objective: Delirium is a common complication of acute pancreatitis. Receptor-interacting protein kinase 3 (RIP3) is an activator of programmed cell necrosis. This study aimed to determine its ability to predict delirium after acute pancreatitis.

Methods: In total, 297 patients with acute pancreatitis were prospectively enrolled in this study. Patients were divided into two subgroups (study and validation groups: 197 and 100 cases, respectively). Serum RIP3 levels were measured in all patients and in 100 healthy controls. Acute Physiology and Chronic Health Evaluation (APACHE) II, Ranson, and sequential organ failure assessment (SOFA) scores were used for the severity assessment. In-hospital delirium was observed as an outcome variable. Multifactorial analyses were performed to discern severity correlations and outcome associations.

Results: Serum RIP3 levels were significantly higher in the patients than in the controls. Serum RIP3 levels had linear relationships under the restricted cubic spline and were independently correlated with APACHE II, Ranson, and SOFA scores. Serum RIP3 levels were linearly correlated with the likelihood of developing in-hospital delirium and exhibited a strong discrimination efficiency under the receiver operating characteristic curve. Serum RIP3 levels, coupled with APACHE II scores, Ranson scores, and SOFA scores, were the four independent predictors of in-hospital delirium. No interactions were revealed regarding its relevance to sex, age, or body mass index in subgroup analysis. These were integrated to form a model graphically represented by a nomogram that showed effective stability, clinical fit, and predictive ability for in-hospital delirium. The model was verified in the validation group.

Conclusion: An incremental trend in serum RIP3 levels was notable after acute pancreatitis. Serum RIP3 levels are independently related to illness severity and occurrence of in-hospital delirium, indicating that serum RIP3 may be a potential biomarker of acute pancreatitis.

Objective: The present study aimed to investigate the potential association between the treatment with Xinfeng Capsule (XFC) and the risk of readmission among patients with rheumatoid arthritis (RA).

Methods: Through a retrospective approach, data were collected from all hospitalized patients diagnosed with RA at the First Affiliated Hospital of Anhui University of Chinese Medicine between 2013 and 2021. To mitigate selection bias and confounding factors, patients were stratified into an XFC group and a Non-XFC (Non-XFC) group based on their treatment status using propensity score matching with a 1:2 ratio. Variables such as age, gender, and baseline medications were adjusted. Subsequently, the Cox proportional hazards model was employed to calculate the hazard ratio (HR) for readmission among RA patients, while Kaplan-Meier curves were utilized to depict the incidence of readmission.

Results: A total of 9987 RA patients were included in this study. Following rigorous inclusion/exclusion criteria and propensity score matching, the XFC group comprised 2036 patients, while the Non-XFC group contained 4072 patients. The Cox proportional hazards model analysis revealed that XFC acted as a protective factor, significantly reducing the risk of readmission among RA patients. Further examination of Kaplan-Meier curves demonstrated that XFC use not only effectively lowered the frequency of readmissions but also exhibited a more pronounced effect in diminishing the risk of readmission with extended usage durations (beyond 12 months). Additionally, association rule analysis underscored the strong link between XFC and freedom from readmission, as well as the robust correlation between XFC usage and significant improvements in multiple laboratory indicators, including C3, C4, CRP, ESR, and others.

Conclusion: This study underscores a robust and long-term association between XFC usage and lower readmission rates among RA patients. As a protective factor against readmission risk in these patients, the clinical value of XFC merits further promotion and investigation.

Objective: This study aimed to examine the correlation and prognostic value of serum irisin levels in acute ischaemic stroke (AIS) and the subsequent development of hemiplegia.

Methods: This study recruited participants from the Department of Neurology and Rehabilitation Medicine at Shunde Hospital, Southern Medical University. The Fugl-Meyer Assessment was used to assess functional impairment. Serum irisin levels were measured using the enzyme-linked immunosorbent assay method. Multivariate logistic regression was employed to explore the factors related to serum irisin levels and AIS.

Results: Serum irisin levels in the AIS group were significantly lower than those in the control group. However, no significant association was observed between serum irisin and stroke severity within the AIS cohort. Multivariate logistic regression analysis revealed an inverse correlation between serum irisin levels and AIS risk, indicating that it serves as a protective factor against AIS. The increase in serum irisin levels (adjusted odds ratio (OR) 0.938, 95% confidence interval [CI]: 0.899-0.977 per 100 pg/mL increment) was associated with a decreased risk of AIS. Analysis of the receiver operating characteristic curve confirmed the diagnostic value of serum irisin for AIS, with the area under the curve being 0.591 (95% CI: 0.522-0.659, p = 0.012).

Conclusion: Serum irisin levels were significantly lower in AIS and were identified as a protective factor, suggesting that serum irisin may have diagnostic value for AIS.

Objective: To investigate the diagnostic value of serum fibrinogen domain-containing lectin-3 (Ficolin-3) and galectin-3 (Gal-3) in sepsis-associated acute kidney injury (SA-AKI).

Methods: This study retrospectively analyzed 126 SA-AKI patients with SA-AKI and 103 septic patients without AKI as controls. Based on the severity of renal injury, the SA-AKI patients were divided into three groups: mild (41 cases), moderate (53 cases), and severe (32 cases). Serum levels of Ficolin-3 and Gal-3 were measured using ELISA, and their correlation was determined through Pearson analysis. Multivariate logistic regression was used to identify factors associated with the occurrence of SA-AKI.

Results: The serum creatinine (SCr), blood urea nitrogen (BUN), as well as the expression levels of serum Ficolin-3 and Gal-3 in the SA-AKI group were higher than those in the non SA-AKI group (P<0.05). The expression levels of Ficolin-3 and Gal-3 in the serum of the SA-AKI group were also higher than those of the non SA-AKI group (P<0.05). The expression levels of Ficolin-3 and Gal-3 in serum gradually increased with the severity of renal injury in SA-AKI patients (P<0.05). The expression levels of Ficolin-3 and Gal-3 in serum were greatly positively correlated (P<0.001). Elevated levels of BUN, Ficolin-3, and Gal-3 were risk factors affecting the occurrence of SA-AKI (P<0.05). The area under the curve (AUC) of serum Ficolin-3 and Gal-3 for individual diagnosis of SA-AKI was 0.877 and 0.867, respectively, the AUC of their combined diagnosis was 0.953, and the diagnostic sensitivity was higher than that of their individual diagnosis (P<0.001).

Conclusion: The expression levels of serum Ficolin-3 and Gal-3 are closely related to associated with the onset and progression of SA-AKI and hold diagnostic value for its detection. Furthermore, the combined use of both markers provides a more accurate diagnosis than either marker alone.

Background: Interstitial lung disease (ILD) is one of the significant complications of dermatomyositis (DM), but the mechanisms by which it occurs remain incompletely elucidated. This study aimed to explore further the possible genetic mechanisms by which this complication occurs.

Methods: Gene expression profiles for DM (GSE39454, GSE46239, GSE143323) and ILD (GSE32537, GSE110147, GSE150910) were downloaded from the Gene Expression Omnibus (GEO) database. After identifying common differentially expressed genes (DEGs) to DM and ILD using the "limma" R package and the "VennDiagram" R package, functional annotation, relationship to immune cell infiltration, identification of transcription factors (TFs), we also collected clinical cases of DM-associated ILD (DM-ILD), including 3 cases of rapidly progressive ILD (RP-ILD) and 3 cases of none-RP-ILD, and explored whether there were differences in serum lymphocyte subpopulations.

Results: A total of 4 common DEGs (SLAMF7, SPP1, TDO2, and VCAM1) were screened and Gene Ontology (GO) enrichment analysis showed that these genes were mainly enriched in T cell activation, regulation of lymphocyte activation, lymphocyte differentiation, leukocyte proliferation and regulation of T cell activation. In terms of Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways, the three significantly enriched pathways were the PI3K-Akt signaling pathway, MAPK signaling pathway, and Cytokine-cytokine receptor interaction. In lung and muscle tissues, 21 and 3 TFs may regulate the expression of these genes, respectively. Finally, by analysing the serum lymphocyte subpopulations, we also found a decrease in the absolute number of CD8+ T cells and an increase in the CD4+ /CD8+ T cell ratio in DM combined with RP-ILD.

Conclusion: These common pathways and key genes may provide new ideas for further research into DM-ILD.

Objective: To assess the safety and efficiency of in vitro fertilization/ intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET) on maternal and neonatal perinatal outcomes in women (≥40y) with singleton pregnancies.

Methods: This multi-center retrospective cohort study, carried out from January 2018 to June 2023, enrolled 1762 women (≥40y) with singleton pregnancies of at least 28 weeks. Participants were divided into two groups: the IVF/ICSI-ET group (204 cases) and the spontaneous conception (SC) group (1558 cases). After 1:2 propensity score matching (PSM), the two groups were compared for maternal and neonatal outcomes. The SC group (1558 cases) was further divided by age into the <43 years group (1195 cases) and the ≥43 years group (363 cases) for subgroup analysis.

Results: Adverse maternal and neonatal outcomes were comparable between the IVF/ICSI-ET group and the SC group, with a higher cesarean section rate (78% vs 67.5%, P =0.013), an increased maternal ICU admissions rate (5.5% vs 1.3%, P =0.008), and a lower birth defects rate (1.1% vs 4.6%, P =0.037) in the IVF/ICSI-ET group. Subgroup analysis showed that women aged ≥43 years had higher incidences of gestational diabetes, gestational hypertension, cesarean section, and neonatal asphyxia compared to women aged <43 years.

Conclusion: This study indicated IVF/ICSI-ET is relatively safe for women ≥40 years with singleton pregnancies. However, advanced maternal age deteriorated maternal and neonatal outcomes, and IVF/ICSI-ET further heightened the risk of cesarean section and maternal ICU admissions. Therefore, enhanced care and vigilance are crucial for women over 40 undergoing IVF/ICSI-ET.

Long COVID refers to symptoms that appear 3 months after initial infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative virus of Coronavirus disease 2019 (COVID-19), and last for at least 2 months, not attributable to other diagnoses. This health issue significantly burdens patients' quality of life, the economy, and society. Improving the af-termath of COVID-19 is a crucial global health issue in the post-pandemic era. According to current results, it is evident that developing a simple, low-cost respiratory training method that can be easily used at home by themselves with long Coronavirus disease 2019 symptoms (long COVID) is an important and urgent issue. The incentive spirometer is widely used in physical, speech, and respiratory therapy, as well as in preventing postoperative pulmonary infections and improving sputum clearance. However, to date, the role of incentive spirometer respiratory training in long COVID symptoms is still limited. In this literature review is presented to explore the effectiveness of incentive spirometer respiratory training in alleviating symptoms among individuals recovering from long COVID. We also compile non-invasive assessment methods, with the aim to enable individuals to undergo training and assessments conveniently at home or in the community. In this review, a literature review approach was utilized to explore the effectiveness of incentive spirometer intervention in alleviating long-term COVID symptoms. This study is to synthesize the findings of articles published during January 2019 and December 2023 retrieved from PubMed/CINAHL/MEDLINE/ Google Scholar without re-strictions on study type. We ultimately identified seven articles and have summarized similar past studies. This review could contribute to improving symptoms related to long COVID by incentive spirometer respiratory training and serve as practical reference material for clinical medical staff and provide insights for healthcare policymakers in de-veloping guidelines for future research directions, clinical guidance, and educational strategies in the context of nursing care.

Gout is a metabolic disease characterized by inflammatory arthritis caused by abnormal uric acid metabolism. It is often complicated with cardio-renal damage and vascular lesions. In recent years, the relationship between lipid metabolism and gout has attracted increasing attention. Changes in blood lipids in gout patients are often clinically detectable and closely related to uric acid metabolism and inflammatory response in gout. With the development of lipidomics, the changes in small lipid molecules and their metabolic pathways have been gradually discovered, yielding a greater understanding of the lipid metabolism changes in gout patients and their potential role in gout development. Through searching the literature on lipid metabolism in gout since 2000 in PubMed and Web of Science, this article reviewed lipid metabolism changes in gout patients and their role in the risk of gout, uric acid metabolism, inflammatory response, and comorbidities. Additionally, the strategies to regulate the abnormal lipid metabolism in gout have also been summarized from the aspects of drugs, diet, and exercise. These will provide a new perspective for understanding gout pathogenesis and its treatment and management.

Background: Neonatal respiratory distress syndrome (NRDS) is common in preterm infants. Prognostic nutritional index (PNI)((albumin (g/L)+(5×total lymphocyte count (10⁹/L)) is a comprehensive indicator of nutritional and immune levels, and associated with several diseases. The relationship between PNI and the risk of NRDS in newborns of different gestational ages remains unclear.

Methods: A total of 2722 preterm infants were included in this retrospective study. PNI level and clinical records of these neonates (adverse pregnancy and birth history, amniotic fluid contamination, nuchal cord, placental abnormality, mode of delivery, gender and birth weight of neonates, Apgar scores) were collected. The clinical features of the infants with and without NRDS were compared. Logistic regression analysis was used to evaluate the relationship between PNI and NRDS in newborns with different gestational ages.

Results: There were 1226 neonates with NRDS and 1496 without NRDS. The differences in the proportions of placenta abnormality, cesarean section, and small for gestational age (SGA) among infants with 34-37 weeks, 28⁺¹-33⁺⁶ weeks, and ≤28 weeks gestational age were statistically significant. Logistic analysis showed that cesarean section (odds ratio (OR): 1.550, 95% confidence interval (CI): 1.197-2.007, p=0.001), and low PNI (OR: 1.417, 95% CI: 1.110-1.808, p=0.005) were associated with NRDS in infants born at 34-37 weeks gestational. Adverse pregnancy and birth history (OR: 1.507, 95% CI: 1.124-2.019, p=0.006), SGA (OR: 1.994, 95% CI: 1.455-2.733, p<0.001), and low PNI (OR: 1.626, 95% CI: 1.230-2.149, p=0.001) were associated with NRDS in infants with 28⁺¹-33⁺⁶ weeks gestational age. Low PNI (OR: 5.512, 95% CI: 1.555-19.536, p=0.008) was associated with NRDS in infants with ≤28 weeks gestational age.

Conclusion: The risk factors for NRDS in preterm infants with different gestational ages were different. But the low PNI level is associated with an increased risk of NRDS in preterm infants with all different gestational ages.