Journal of International Medical Research最新文献

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.

BackgroundHypopharyngeal cancer is increasingly emerging as a disease that threatens global health, with poor prognosis and survival rates. However, clinical strategies and effective therapies remain limited.MethodsThe inhibitory effect of liensinine on tumor cells was detected through cell cycle, colony formation, and apoptosis assays. Changes in the expression levels of relevant proteins were detected and enrichment analysis of signaling pathways was performed through in vitro and RNA sequencing experiments. The transcription levels of relevant genes were further verified using reverse transcription polymerase chain reaction.ResultsWe previously discovered that the natural compound, liensinine, is effective in treating hypopharyngeal cancer. In this study, we found through in vitro and RNA sequencing experiments that liensinine can activate the Ras homolog family member B protein, thereby inhibiting the mitogen-activated protein kinase signaling pathway. Additionally, liensinine activates the nuclear factor kappa B signaling pathway and releases downstream inflammatory factors, effectively exerting its antitumor effects.ConclusionLiensinine induces cell death and inhibits hypopharyngeal cancer cell growth through multiple pathways, indicating that it is a potential chemotherapeutic agent for the treatment of hypopharyngeal cancer.

Fabry disease is a rare X-linked lysosomal storage disorder caused by a defect in glycosphingolipid metabolism, which leads to the accumulation of globotriaosylceramide (Gb3) in various cell types. It has diverse clinical manifestations, often making diagnosis challenging. This report presents the case of a male patient in his mid-20s with Fabry disease who presented with recurrent lower limb edema and proteinuria. He was ultimately diagnosed and treated with enzyme replacement therapy in combination with a nonsteroidal mineralocorticoid receptor antagonist. Since 2018, the patient's serum creatinine level and 24-h urinary protein excretion had progressively increased, while his estimated glomerular filtration rate and hemoglobin levels had decreased. Following the addition of the nonsteroidal mineralocorticoid receptor antagonist to the treatment regimen, these parameters gradually improved and stabilized. Long-term follow-up of the patient is ongoing. This case suggests that combining enzyme replacement therapy with a nonsteroidal mineralocorticoid receptor antagonist aids in arresting disease progression and improving prognosis in patients with Fabry disease.

Ventilator-associated pneumonia substantially increases mortality and imposes a heavy burden on healthcare resources. Patients undergoing endotracheal intubation and mechanical ventilation in emergency departments face a particularly high risk of ventilator-associated pneumonia. Compared with healthcare providers in intensive care units, those in emergency departments often lack sufficient awareness of timely and systematic ventilator-associated pneumonia prevention strategies, and existing intensive care unit-based care bundles are rarely tailored to emergency department-specific constraints. This gap leads to suboptimal implementation of ventilator-associated pneumonia preventive measures and increases the risk of ventilator-associated pneumonia. In this narrative review, we synthesize the current evidence on ventilator-associated pneumonia prevention and assess the feasibility of care bundles in resource-constrained emergency department settings. We propose the use of position, hand hygiene, airway, sedation, and equipment-a structured, multicomponent ventilator-associated pneumonia prevention strategy-in emergency departments with limited resources, supported by enabling strategies such as electronic checklists, multidisciplinary collaboration, and training to ensure adherence. Moving forward, efforts should focus on establishing consensus on emergency department-specific ventilator-associated pneumonia prevention protocols and optimizing nursing resource allocation to support implementation.

BackgroundCoronavirus disease 2019 (COVID-19) is a serious global health threat, and some patients with COVID-19 develop post-COVID-19 symptoms, which are characterized by symptoms following acute infection. In December 2022, China relaxed its strict COVID-19 policies, which was followed by outbreaks. Therefore, it is important to investigate post-COVID-19 symptoms in China to understand their prevalence and risk factors. This multicenter study examined post-COVID-19 symptoms among Chinese healthcare workers to better understand their epidemiology.MethodsHealthcare workers from seven hospitals who met specific COVID-19 and work criteria participated in an anonymous online survey conducted from 17 July to 19 August 2023. The collected data were analyzed using various statistical methods to identify factors associated with self-reported post-COVID-19 symptoms.ResultsOf the 5213 healthcare workers who were included in the study, 17.0% reported post-COVID-19 symptoms. Binary logistic regression confirmed male sex (odds ratio = 1.418, 95% confidence interval: 1.151-1.747), doctor/nurse position (doctor: odds ratio = 1.406, 95% confidence interval: 1.074-1.840; nurse: odds ratio = 1.516, 95% confidence interval: 1.176-1.954), chronic respiratory disease (odds ratio = 1.576, 95% confidence interval: 1.035-2.399), moderate/severe COVID-19 (odds ratio = 1.583, 95% confidence interval: 1.323-1.894), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfection (odds ratio = 1.420, 95% confidence interval: 1.219-1.655), and high self-reported COVID-19 severity (odds ratio = 1.707, 95% confidence interval: 1.456-2.001) as post-COVID-19-associated factors.ConclusionOur real-world multicenter study showed that 17% of healthcare workers developed post-COVID-19 symptoms following SARS-CoV-2 infection. Therefore, targeted interventions are required for healthcare workers. This study provides important insights into the prevention and management of COVID-19 in healthcare workers and the general population.

ObjectiveThis study aimed to evaluate the potential of hepatocyte-derived fibrinogen-related protein 1 (HFREP1) as a biomarker for community-acquired pneumonia and community-acquired pneumonia secondary to sepsis.MethodThis cross-sectional observational study included 124 patients with community-acquired pneumonia, 52 patients with community-acquired pneumonia-sepsis, and 123 healthy controls. Clinical data were collected, including procalcitonin and C-reactive protein levels. Serum HFREP1 concentrations were measured, and statistical analyses were performed.ResultHFREP1 levels differed significantly among the healthy control, community-acquired pneumonia, and community-acquired pneumonia-sepsis groups (37.2 vs. 211.6 vs. 696.8 ng/mL). Binary logistic regression analysis identified procalcitonin and HFREP1 as independent predictors of community-acquired pneumonia-sepsis, while C-reactive protein was not an independent predictor. The area under the curve for HFREP1 in distinguishing community-acquired pneumonia patients from healthy controls was 0.8810. For differentiating community-acquired pneumonia-sepsis from community-acquired pneumonia, the area under the curves were 0.8814 for HFREP1, 0.8167 for C-reactive protein, and 0.8902 for procalcitonin.ConclusionHFREP1 may serve as a biomarker for community-acquired pneumonia and community-acquired pneumonia-sepsis. In community-acquired pneumonia-sepsis, HFREP1 was strongly correlated with C-reactive protein and procalcitonin, and its diagnostic performance was comparable to that of procalcitonin.

BackgroundSepsis remains a leading cause of mortality in critically ill patients, necessitating the identification of reliable prognostic markers. The triglyceride glucose-body mass index, which combines lipid and glucose metabolism, may serve as a valuable predictor of long-term outcomes in this population.MethodsThis study employed a retrospective observational cohort design and analyzed data from the MIMIC-IV database encompassing 2424 septic patients admitted between 2008 and 2019. Patients were categorized into quartiles based on triglyceride glucose-body mass index values. The primary outcomes assessed were all-cause mortality rates at 30, 90, and 180 days as well as 1-year post-admission, and analysis was performed using multivariable Cox proportional hazards models.ResultsIn total, 2424 septic patients meeting the inclusion criteria were finally included in the analyses. Lower triglyceride glucose-body mass index values have been associated with higher long-term mortality outcomes in critically ill septic patients. However, higher triglyceride glucose-body mass index quartiles were associated with a significant reduction in mortality risk at 180 days and 1 year after admission, even after adjustment for potential confounding variables. Patients in the third (hazard ratio: 0.81, 95% confidence interval: 0.67-0.98, p = 0.028) and fourth (hazard ratio: 0.73, 95% confidence interval: 0.56-0.96, p = 0.026) quartiles exhibited significantly lower hazard ratios for mortality than those in the lowest quartile. Notably, no significant associations were observed with 30-day mortality, suggesting that triglyceride glucose-body mass index values are more strongly associated with long-term outcomes.ConclusionIn this retrospective cohort study, lower triglyceride glucose-body mass index values were associated with higher long-term mortality in critically ill septic patients. Our findings suggest that the triglyceride glucose-body mass index serves as a useful prognostic marker and can help identify patients at increased risk of mortality. These results highlight a potential association that warrants further investigation in prospective studies to clarify the role of triglyceride glucose-body mass index in sepsis management.

ObjectivesThis study aimed to investigate the effect of postoperative dexmedetomidine infusion on the recovery of gastrointestinal function in patients undergoing laparoscopic colorectal surgery.MethodsA total of 128 participants were randomized into dexmedetomidine and control groups. In the dexmedetomidine group, patients received a loading dose of 0.5 μg/kg dexmedetomidine over 15 min before skin incision followed by continuous infusion of 0.05 μg/kg/h starting at the end of surgery and maintained for 48 h. The control group received the same loading dose of dexmedetomidine without the postoperative infusion.ResultsNo statistically significant differences were observed between the dexmedetomidine and control groups in time to first flatus, time to first defecation, or time to first oral feeding. The incidences of postoperative gastrointestinal function and delirium were comparable between the two groups. However, patients in the dexmedetomidine group experienced better sleep quality and had lower C-reactive protein levels than those in the control group.ConclusionsAlthough postoperative continuous infusion of dexmedetomidine was associated with improved sleep quality in patients undergoing laparoscopic colorectal surgery, it did not accelerate the recovery of gastrointestinal function.

BackgroundThe role of the C-reactive protein-albumin-lymphocyte (CALLY) index in predicting cardiovascular disease prognosis, particularly in the broader population, remains inadequately studied.MethodsData from 22,848 adults, collected between 1999 and 2010, were analyzed in this study. The association between the CALLY index and cardiovascular disease prevalence and mortality was examined using multivariate logistic regression and Cox proportional hazards models. Restricted cubic spline, Kaplan-Meier survival curves, time-dependent receiver operating characteristic curves, and subgroup and interaction tests were employed.ResultsFollowing adjustment for all covariates, a 1-unit rise in the ln CALLY index was correlated with an 11% reduction in cardiovascular disease prevalence (odds ratio = 0.89, 95% confidence interval: 0.85, 0.93) and a 15% decrease in the risk of cardiovascular disease mortality (hazard ratio = 0.85, 95% confidence interval: 0.81, 0.89). Compared with the lowest quartile, patients in the highest quartile of the ln CALLY index exhibited a 33% lower prevalence of cardiovascular disease (odds ratio = 0.67, 95% confidence interval: 0.57, 0.79) and a 39% reduced risk of cardiovascular disease mortality (hazard ratio = 0.61, 95% confidence interval: 0.50, 0.74). The time-dependent receiver operating characteristic curve showed that the ln CALLY index predicted the 1-year cardiovascular disease mortality with an area under the curve of 0.819 (95% confidence interval: 0.753, 0.885).ConclusionsThe CALLY index was significantly inversely associated with cardiovascular disease prevalence and mortality and provided reliable discriminatory capacity in predicting early mortality attributable to cardiovascular disease.