Journal of International Medical Research最新文献

ObjectivePrevious studies have reported inconsistent findings regarding alterations in lipid profiles among patients with acne vulgaris (acne). This meta-analysis aimed to resolve these inconsistencies.MethodsA systematic search was conducted in Web of Science, Scopus, and PubMed. Lipid profile levels were compared between patients with acne and healthy controls. Mean values and standard deviations for total cholesterol, triglycerides, low-density lipoprotein, and high-density lipoprotein were used to calculate standardized mean differences with 95% confidence intervals.ResultsA total of 916 articles were initially identified, of which 38 studies comprising 2485 patients met the eligibility criteria. The pooled analysis demonstrated that patients with acne had significantly higher levels of total cholesterol (pooled standardized mean difference = 0.92, 95% confidence interval: 0.55-1.28), triglycerides (pooled standardized mean difference = 0.82, 95% confidence interval: 0.51-1.14), and low-density lipoprotein (pooled standardized mean difference = 1.52, 95% confidence interval: 1.11-1.92) as well as significantly lower high-density lipoprotein levels (pooled standardized mean difference = -0.45, 95% confidence interval: -0.69 to -0.21). Subgroup and meta-regression analyses were performed to identify the sources of significant heterogeneity. Subgroup analyses further revealed significant alterations in lipid profiles among female patients and in studies conducted in Egypt and Saudi Arabia.ConclusionAlterations in lipid profiles were observed in patients with acne.

Hepatectomy is an effective and widely adopted surgical technique for treating various liver diseases. However, owing to the liver's unique anatomical structure and rich blood supply, hepatectomy poses considerable challenges. The most critical challenge is intraoperative bleeding, which is closely associated with postoperative complications and patient mortality. This has driven the pursuit of effective and safe strategies to minimize bleeding during hepatectomy. Managing a low central venous pressure of <5 cm H₂O or 3 mmHg has been shown to significantly reduce hepatic vein bleeding and provide optimal surgical visibility during hepatectomy. Before the routine application of low central venous pressure management, bleeding during hepatectomy was often associated with unacceptably high morbidity and mortality rates. Although this technique has been demonstrated to be safe and effective in multiple studies of hepatectomy and transplantation, its widespread adoption remains limited. Concerns have been raised regarding morbidity related to insufficient perfusion to vital organs during the low central venous pressure phase of hepatectomy. This review has discussed recent developments concerning the effects of low central venous pressure management during hepatectomy on the function of critical organs.

ObjectiveThis study aimed to investigate the association between the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and nonalcoholic fatty liver disease in non-obese individuals, using data from the National Health and Nutrition Examination Survey.MethodsThis cross-sectional study analyzed data from the National Health and Nutrition Examination Survey (2017-2023), including 6265 eligible participants. The ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol was calculated, and nonalcoholic fatty liver disease was diagnosed using liver ultrasound transient elastography. The association between the ratio and nonalcoholic fatty liver disease was assessed using multivariable logistic regression and restricted cubic spline models. Threshold effect analysis was conducted to evaluate potential nonlinear relationships, while subgroup analyses and interaction tests were performed to assess consistency across demographic groups. Sensitivity analyses were also conducted using alternative controlled attenuation parameter thresholds to ensure the robustness of the findings.ResultsAmong the 6265 participants (mean age, 44.32 years), 1355 (21.62%) had nonalcoholic fatty liver disease. Restricted cubic spline analysis revealed a nonlinear dose-response relationship between the ratio and nonalcoholic fatty liver disease risk (P for nonlinearity <0.0001). When the ratio was below 3.4, the odds ratio was 2.17 (95% confidence interval, 1.51-3.12, P < 0.0001), indicating a strong positive association. However, when the ratio exceeded 3.4, the relationship plateaued (odds ratio, 1.40; 95% confidence interval, 1.11-1.75; P = 0.003). Subgroup analyses showed that the association was more pronounced among non-Hispanic White females aged over 60 years, although further validation is needed. Sensitivity analyses using controlled attenuation parameter thresholds of 248 and 288 dB/m showed similar patterns, supporting the stability of the observed associations.ConclusionsIn non-obese adults, higher levels of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio are associated with a greater prevalence of nonalcoholic fatty liver disease, with the strongest association observed when the ratio was below 3.4. As this study is cross-sectional, causal relationships cannot be inferred. This ratio may serve as a simple indicator for identifying individuals at higher risk of nonalcoholic fatty liver disease, but further longitudinal studies are needed to confirm these findings.

BackgroundHelicobacter pylori infection has been associated with diverse extraintestinal morbidities, including cardiometabolic diseases. Insulin resistance is a key pathogenic factor involved in the development of various metabolic diseases. This study aimed to investigate the association between Helicobacter pylori infection and insulin resistance.MethodsThis cross-sectional study analyzed two independent cohorts: 2918 participants from the US National Health and Nutrition Examination Survey (1999-2000) and 912 inpatients from Southern China. Helicobacter pylori infection was determined using serum antibodies (National Health and Nutrition Examination Survey), ¹³C-urea breath test, or rapid urease test (China cohort). Insulin resistance was assessed using the triglyceride-glucose index or homeostasis model assessment of insulin resistance. Multivariate linear regression models were used to analyze the associations.ResultsIn the National Health and Nutrition Examination Survey cohort, Helicobacter pylori positivity was initially associated with a higher triglyceride-glucose index (coefficient = 1.17, p = 0.001); however, this association lost statistical significance after full adjustment, and no significant association was observed with the homeostasis model assessment of insulin resistance index (coefficient = 0.03, p = 0.900). Similarly, in the Southern China cohort, no significant relationship was found between Helicobacter pylori infection status and the triglyceride-glucose index (coefficient = 0.06, p = 0.689).ConclusionsHelicobacter pylori infection is not consistently associated with insulin resistance. Further studies are needed to clarify its role in metabolic diseases.

ObjectiveThis study aimed to systematically elucidate the role of gut microbial metabolites in the development and progression of ovarian cancer.MethodsPublic databases, including GutMgene, were used to screen and integrate gut microbial metabolite-target genes with ovarian cancer-related genes, ultimately identifying 59 key intersection genes. A gut microbiota-metabolite-gene regulatory network was constructed, and Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses, protein-protein interaction network analysis, and evaluations of the drug-likeness and toxicity of key metabolites were performed.ResultsA total of 72 key genes associated with immune regulation were identified. Enrichment analyses demonstrated that these genes were significantly involved in immune-related processes, including T cell activation and the Toll-like receptor signaling pathway. Protein-protein interaction network analysis identified five core genes: STAT3, IL6, TNF, AKT1, and TP53. Drug-likeness analysis suggested that metabolites such as butyric acid and indole-3-propionic acid exhibit potential drug-like properties.ConclusionGut microbiota-derived metabolites may influence ovarian cancer progression and the immune microenvironment by regulating core genes such as TP53 and AKT1 and pathways including Toll-like receptor signaling. These findings provide a potential basis for microbiota-targeted interventions in ovarian cancer.

Horticultural therapy is a plant-based therapeutic intervention that has shown promise in alleviating depressive symptoms and supporting clinical rehabilitation. This scoping review synthesizes current evidence on the use of horticultural therapy for individuals diagnosed with depression. A systematic search across eight Chinese and international databases identified 1044 studies, of which 18 met the inclusion criteria. These studies were conducted in diverse settings, including hospitals, nursing homes, schools, and community centers. Interventions ranged from active participation (e.g. planting and floral arrangement) to passive engagement (e.g. nature walks). Outcomes included psychological indicators such as depression and anxiety levels and physiological markers such as salivary cortisol and cardiovascular response. Most studies reported positive effects on mood and quality of life. However, variations in intervention design, duration, frequency, and facilitator qualifications limited comparability. This review highlights horticultural therapy as a promising complementary approach for depression rehabilitation while emphasizing the need for standardized protocols and culturally adapted applications in future research.

BackgroundOlder adults with hypertension have a high incidence of heart failure and poor prognosis, often accompanied with nutritional, inflammatory, and immune dysregulation. The C-reactive protein-albumin-lymphocyte (CALLY) index provides an integrated measure of these conditions. However, its association with the prevalence and prognosis of heart failure in older hypertensive populations remains unclear.ObjectiveThe core objective of this study was to explore the correlation between the CALLY index and the prevalence of heart failure as well as mortality risk in the older hypertensive population.MethodsWe included data from 5876 hypertensive individuals aged ≥60 years who participated in the National Health and Nutrition Examination Survey from 2003 to 2016. Complex sampling weights were applied for all analyses. The natural logarithmic transformation of the CALLY index (Ln CALLY) was used as the primary exposure variable to reduce skewness and meet model assumptions. The association between Ln CALLY and heart failure prevalence was assessed using a multivariable logistic regression model, while the analysis of mortality was conducted using a Cox proportional hazards model. Further analyses included restricted cubic spline modeling, stratified analyses with interaction tests, and sensitivity analyses.ResultsParticipants in the highest quartile of Ln CALLY had a 44% lower likelihood of heart failure compared with those in the lowest quartile (odds ratio = 0.56, 95% confidence interval: 0.40-0.78). Among individuals with heart failure, those in the highest quartile of Ln CALLY exhibited 54% lower all-cause mortality (hazard ratio = 0.46, 95% confidence interval: 0.31-0.68) and 64% lower cardiovascular mortality (hazard ratio = 0.36, 95% confidence interval: 0.19-0.71) than those in the lowest quartile. Restricted cubic spline modeling demonstrated a linear inverse association between Ln CALLY and heart failure prevalence, all-cause mortality, and cardiovascular mortality (all p for nonlinearity >0.05). The results of the subgroup analysis were consistent with the overall conclusions, and no significant interaction effects were observed (all p-interaction >0.05).ConclusionLn CALLY was significantly and inversely associated with both heart failure prevalence and mortality among older adults with hypertension. As a readily obtainable composite index derived from routine laboratory tests, Ln CALLY may serve as a practical tool for precision management in this high-risk population.

This article reports the case of a male patient in his 70s with middle aortic syndrome (MAS). The patient was admitted with abdominal pain, abdominal distension, vomiting, and cessation of defecation for 2 days as chief complaints and was diagnosed with intestinal obstruction. Enhanced computed tomography and vascular reconstruction revealed distal occlusion of the abdominal aorta. The celiac trunk, superior mesenteric artery, and inferior mesenteric artery were not visualized, whereas bilateral renal arteries maintained blood flow. Given the patient's history of intermittent claudication and uncontrolled hypertension, the condition was ultimately diagnosed as MAS secondary to Takayasu's arteritis, with bowel obstruction identified as a secondary manifestation of MAS. After insertion of a nasointestinal obstruction catheter, the patient's symptoms of intestinal obstruction were relieved. However, the obstruction recurred, and the patient subsequently improved following vascular reconstruction. During postoperative follow-up to date, intestinal obstruction has recurred only once due to improper diet and resolved after dietary modifications. MAS is relatively rare in clinical practice, particularly among older patients. We hope that this case study provides clinicians with an opportunity for learning and knowledge exchange, thereby contributing to improved diagnostic and therapeutic approaches for patients with similar conditions.

This report describes the case of a patient in her early 40s with a history of laparoscopic myomectomy who presented to the Beijing Shunyi District Maternal and Child Health Hospital (Beijing, China) in December 2024 with menstrual disturbances and a pelvic mass. The patient had disseminated peritoneal leiomyomatosis, a rare benign neoplastic condition characterized by multifocal smooth muscle nodules on the peritoneal surface. Its nonspecific clinical and radiological features often lead to misdiagnosis as malignant peritoneal carcinomatosis. Pelvic magnetic resonance imaging revealed a 9.5-cm cervical mass, an 11.4-cm right pelvic mass, and multiple T2-hypointense uterine lesions, with the largest lesion measuring 14.9 cm. The patient underwent a total laparoscopic hysterectomy with bilateral salpingectomy and resection of multiple mesenteric tumors, with an aggregate specimen weight of 4600 g. Histopathological examination confirmed benign leiomyomatosis, thereby establishing the diagnosis of disseminated peritoneal leiomyomatosis. This case demonstrates a causal link between uncontained morcellation and disseminated peritoneal leiomyomatosis, underscores the role of magnetic resonance imaging T2 hypointensity in differentiating this benign condition from malignancies such as leiomyosarcoma, and confirms surgery as the cornerstone of management when fertility is not a concern. Long-term surveillance remains imperative due to risks of recurrence and rare sarcomatous transformation. Written informed consent was obtained from the patient for treatment and publication, and all patients details have been deidentified to protect anonymity.

Tuberous sclerosis complex is a rare, autosomal dominant disorder caused by pathogenic variants in the tuberous sclerosis complex 1 or tuberous sclerosis complex 2 genes, leading to constitutive activation of the mammalian target of rapamycin pathway and abnormal cell growth. Tuberous sclerosis complex is characterized by benign hamartomas affecting multiple organs, most commonly the brain, skin, kidneys, heart, and lungs. Clinical manifestations vary depending on the organs involved and disease severity. We report the case of a Chinese woman in her mid-30s who presented with progressive dyspnea. Her medical history included hypertension, intellectual disability, seizures, left nephron-sparing enucleation for renal angiomyolipoma, and hysterectomy for uterine smooth muscle tumors. Physical examination revealed classic features of tuberous sclerosis complex, including facial angiofibromas and periungual fibromas. Imaging demonstrated a right-sided pleural effusion. Thoracoabdominal imaging showed pulmonary lymphangioleiomyomatosis and bilateral renal angiomyolipomas with hemorrhage. Genetic testing identified three pathogenic variants in the tuberous sclerosis complex 2 gene. A multidisciplinary team confirmed the diagnosis of tuberous sclerosis complex with multisystem involvement. This case highlights the multisystem heterogeneity of tuberous sclerosis complex and underscores the importance of an interdisciplinary approach to diagnosis and management.