Medicine最新文献

This study explores the relationship between serum uric acid to high-density lipoprotein-cholesterol ratio (UHR) and all-cause mortality among US cancer patients. Data from the 2005 to 2018 National Health and Nutrition Examination Survey, linked to National Death Index records until December 31, 2019, are analyzed. To investigate the relationship between UHR and mortality, multivariate Cox proportional hazards models are utilized. Kaplan-Meier curves compare survival across UHR quartiles, while the restricted cubic spline approach evaluates dose-response relationships. Subgroup analyses consider age, gender, diabetes, hypertension, body mass index, and income-to-poverty ratio, with stratified analyses by cancer type. Two sensitivity analyses exclude participants under 65 and those with multiple cancers. During the 81.0-month follow-up period, the all-cause mortality rate is 15.6%. Cancer patients in the top quartile group have a significantly increased mortality risk (hazard ratio: 1.43, 95% confidence interval: 1.07-1.93). Kaplan-Meier survival analysis links higher UHR to reduced survival. This association is nonlinear and more pronounced in those aged ≥ 65, males, and individuals with diabetes or hypertension. Stratified analyses reveal a significant link in breast, colorectal, and prostate cancers. UHR may serve as a valuable predictor of all-cause mortality among individuals with cancer.

Background: The sliding cupping therapy represents a traditional Chinese medicine therapy and receives much appreciation for treating plaque psoriasis. This study was designed to test the hypothesis that sliding cupping therapy is non-inferior to narrowband ultraviolet B (NBUVB) therapy in improving disease severity in patients with plaque psoriasis.

Methods: This prospective study recruited 60 patients with plaque psoriasis who were randomized to receive either sliding cupping intervention or NBUVB treatment. The cup was moved 30 times for each skin lesion until the target skin area turned purple. The initial dose (mJ/cm2) of ultraviolet radiation b (UVB) was determined based on sun-reactive skin types I through VI, which ranged from 300 mJ/cm2 to 800 mJ/cm2. Both treatments were performed 3 times per week for 8 weeks. The primary endpoint was the percentage reduction in Psoriasis Area and Severity Index (PASI) score at week 8, with secondary endpoints, including Physician's Global Assessment (PGA), body surface area, visual analogue scale scores, and quality of life measures.

Results: The total response rates were 69.23% (18/26) and 79.17% (19/24) for patients receiving sliding cupping intervention and those receiving NBUVB treatment, respectively, which showed no significant difference (P = .526). The PASI scores, body surface area, and PGA were reduced in patients with plaque psoriasis at W0, W4 and W8 after either sliding cupping intervention or NBUVB treatment (P <.001), and these reductions were not significantly different between the patients receiving sliding cupping intervention and those receiving NBUVB treatment at W0, W4, W8, and W12. At W8, the mean percentage reduction in PASI was 62.4% (95% CI, 54.9-69.8) in the sliding cupping group and 66.9% (95% CI, 59.6-74.2) in the NBUVB group, with no significant difference between groups. The total response rates were 69.23% (18/26) and 79.17% (19/24), respectively (P = .526). Patients receiving sliding cupping intervention and those receiving NBUVB treatment did not show statistically significant differences in these outcomes at W0, W4, W8, and W12 (P >.05).

Conclusion: The overall results suggest that sliding cupping therapy exhibits statistically similar efficacy and safety profiles as NBUVB treatment, especially at 8 weeks after treatment.

Alzheimer's disease (AD) is a major cause of dementia, and this paper explores the unclear roles of mitochondrial dysfunction and programmed cell death in AD. Differentially expressed genes (DEGs) were identified using AD datasets GSE63061 and GSE63060 from the Gene Expression Omnibus. DEGs were intersected with mitochondria-related genes and programmed cell death-related genes to obtain DEGs (in AD) intersected with mitochondrial-related genes and DEGs (in AD) intersected with programmed cell death-related genes. Correlation analysis of these DEGs was used to identify candidate genes. Machine learning algorithms were applied to key genes, followed by functional enrichment, network construction, immune infiltration analysis, drug prediction, and expression validation. Two key genes, superoxide dismutase 1 (SOD1) and translocase of the outer mitochondrial membrane 7 (TOMM7), were identified and linked to pathways like ribosome and chemokine signaling. A strong positive correlation (0.76, P < .001) was found between them. Immune analysis showed differences in 11 immune cells between AD and controls, with TOMM7 positively linked to activated CD8 T cells and negatively to myeloid-derived suppressor cells. SOD1 and TOMM7 are regulated by 4 miRNAs and 71 long noncoding RNAs (lncRNAs). Seventeen potential AD drugs, including urea and nitric oxide, were predicted. Two key genes, SOD1 and TOMM7, related to mitochondria and PCD, were identified as potential targets for understanding AD's etiology, detection, and therapeutic approaches.

Arthroscopic meniscal surgery remains controversial regarding optimal tissue management strategies. While partial meniscectomy provides immediate symptom relief, concerns persist about accelerated joint degeneration. Meniscal repair preserves tissue but requires technical expertise and prolonged rehabilitation. This study aims to comprehensively compare mid-term outcomes between arthroscopic meniscal repair and partial meniscectomy through multidimensional assessment of biochemical, functional, biomechanical, and structural parameters. Arthroscopic meniscal repair demonstrates superior mid-term efficacy compared to partial meniscectomy across all assessed domains. The comprehensive benefits reduced inflammatory burden, enhanced functional recovery, improved biomechanics, and better structural outcomes strongly support tissue preservation strategies. This retrospective comparative study analyzed 108 patients with meniscal injuries (October 2022-October 2024) who underwent either arthroscopic repair (n = 56) or partial meniscectomy (n = 52). Outcomes assessed at 6-month follow-up included serum pain mediators (5-HT, prostaglandin E2, bradykinin) via enzyme-linked immunosorbent assay, functional status using Oxford knee score and Lysholm scale, gait parameters through instrumented analysis, and clinical/magnetic resonance imaging evaluation. Statistical analysis employed Mann-Whitney U test for continuous variables and chi-square tests for categorical variables, with Wilcoxon signed-rank test for paired comparisons (P < .05). Both groups showed comparable baseline characteristics. At 6-month follow-up, the repair group demonstrated significantly lower pain mediator concentrations compared to resection: 5-HT (438.67, interquartile range [IQR] 398.52-485.43 vs 516.51, IQR 465.38-572.84 μg/L, P < .001), prostaglandin E2 (152.79, IQR 131.45-175.38 vs 206.46, IQR 182.74-235.67 pg/mL, P < .001), and bradykinin (8.43, IQR 6.82-10.15 vs 12.51, IQR 9.45-15.83 ng/mL, P < .001). Functional scores favored repair with superior Oxford knee score (14.24, IQR 11.95-16.82 vs 16.32, IQR 13.58-19.24, P = .002) and Lysholm scores (80.39, IQR 74.52-86.94 vs 69.38, IQR 63.48-75.82, P < .001). Effect sizes ranged from 0.65 to 0.92, indicating large clinical differences. Clinical examination positivity rates were markedly lower after repair, with magnetic resonance imaging abnormalities persisting in 17.86% versus 36.54% (P = .029).

This study aimed to evaluate the effectiveness and safety of combined medication therapy and ultrasound-guided stellate ganglion block treatment for primary tinnitus. This retrospective cohort study reviewed the clinical data of 113 patients with primary tinnitus, with 46 patients receiving stellate ganglion block treatment as the control group and 67 patients receiving the combined medication therapy combined with ultrasound-guided stellate ganglion block treatment as the observation group. Baseline characteristics, tinnitus severity scores, quality of life, psychological health, adverse events, and patient satisfaction were assessed and compared between the 2 treatment groups. Baseline demographics and tinnitus characteristics were similar between groups (P > .05). Posttreatment, the observation group showed significantly greater improvements in tinnitus severity (all metrics, P < .05), quality of life (physical, emotional, role, cognitive, social domains, P < .005), and psychological health (anxiety, depression, stress, sleep, social support, P < .05). Adverse events (headache, dizziness, nausea) were comparable (P > .05). Patient satisfaction favored the observation group (P = .034), though fewer reported "very satisfied". The combined intervention demonstrates superior efficacy across clinical and psychosocial outcomes with comparable safety. Medication therapy combined with ultrasound-guided stellate ganglion block treatment significantly reduces tinnitus severity. However, due to the retrospective observational nature of this study, the findings demonstrate an association rather than a causal relationship.

Benign prostatic hyperplasia-related lower urinary tract symptoms are highly prevalent in middle-aged and older men. Compared to traditional transurethral resection of the prostate (TURP), minimally invasive surgical therapies (MISTs) aim to provide meaningful symptom relief. This review evaluated the efficacy, safety, and procedural characteristics of 5 representative MISTs: water vapor thermal therapy (WVTT), prostatic urethral lift (PUL), prostatic artery embolization (PAE), temporary implantable nitinol device (iTIND), and Aquablation. A systematic literature search was conducted in PubMed (2018-2023), supplemented by backward citation tracking. Clinical studies reporting International prostate symptom score (IPSS), quality of life (QoL), and/or maximum flow rate (Qmax) were included, with higher-level evidence prioritized. Long-term data show that WVTT and PUL provide durable symptom improvement, achieving 48% IPSS reduction and 35% IPSS improvement, respectively, at 5 years. Aquablation has a lower rate of retrograde ejaculation than TURP. Importantly, no new sexual dysfunction has been reported after WVTT or PUL. The long-term retrograde ejaculation rate with iTIND is 4%. Most MISTs can be performed in an outpatient setting under local anesthesia. For prostates >80 cm3, PAE achieved >44% volume reduction. In summary, MISTs offer personalized treatment options for benign prostatic hyperplasia, though evidence strength varies. Aquablation has the strongest evidence for larger prostates, while WVTT and PUL are guideline-recommended for medium-sized glands. PAE is suitable for older/high-risk patients, and iTIND shows promise but requires more long-term data. Future research should focus on comparative trials to optimize patient selection.

Sleep problems and psychological distress are frequently reported by patients with primary glaucoma, yet the contribution of day‑to‑day ocular symptom burden has not been quantified with standard sleep and mental‑health metrics. We performed a single‑center cross‑sectional study of consecutive adults with primary glaucoma. Patients completed the study questionnaire, chart data provided visual acuity, visual field index, intraocular pressure. Ocular symptom burden (OSB) was derived from 20 bilateral ocular‑symptom items. Sleep quality was summarized by the Pittsburgh Sleep Quality Index (PSQI) constructed from S1 to S9 (global score 0-21; poor sleep PSQI > 5). Psychological distress was assessed with Kessler-10 psychological distress scale (K10) (10-50). Vision and visual‑field severities were recomputed as textbook‑concordant vision grade (1-5) and modified Glaucoma Symptom Scale grade from visual field index (1-5). Associations were tested with Spearman correlation (Benjamini-Hochberg false discovery rate), and multivariable linear/logistic regression (heteroskedasticity-consistent 3robust standard errors) adjusting for age, sex, glaucoma subtype, disease course, vision grade and visual‑field grade. We analyzed 208 patients (mean age 59.3 ± 15.0 years; 52.9% female; primary open-angle glaucoma 55.3%, primary angle-closure glaucoma 44.7%). Mean OSB severity was 34.9 ± 17.4 (0-80). PSQI global score averaged 5.81 ± 2.64; 51.9% met PSQI > 5 (108/208; 95% confidence interval (CI) 45.2%-58.6%), with sleep efficiency 90.6 ± 11.0%. K10 averaged 15.2 ± 4.9; 16.3% had mild‑to‑severe distress (≥20). OSB correlated with PSQI (OSB count r = 0.16, P = .022; OSB severity r = 0.14, P = .038) and more strongly with K10 (r = 0.23, P = .0007). The ocular‑surface/irritation symptom and pain domain correlated with PSQI (r = 0.16, P = .019), whereas visual‑function/glare domains did not (P > .20). In adjusted models, standardized OSB severity had a positive point estimate for PSOI (β = 0.31, 95% CI -0.04 to 0.66; P = .080) and was not independently associated with poor sleep (PSQI > 5; OR = 1.22, 95% CI 0.92-1.62; P = .165). Standardized OSB severity was also not independently associated with K10 total (β = 0.56, 95% CI -0.12 to 1.24; P = .109) or distress (K10 ≥ 20; OR = 1.03, 95% CI 0.72-1.48; P = .868). In this cross‑sectional study, OSB showed small bivariate correlations with sleep quality and psychological distress. However, covariate-adjusted associations were imprecise and not statistically significant. Given that approximately half of participants screened positive for poor sleep, brief screening for sleep quality and psychological distress may be considered in glaucoma care.

To examine the association of early central venous pressure (ECVP) measurement with 28-day mortality in critically ill elderly patients. We used the Medical Information Mart for Intensive Care database to identify critically ill elderly patients. Multivariable logistic regression was used to control confounding effects and characterize the association between ECVP measurement and 28-day mortality. Propensity score matching and propensity score-based inverse probability of treatment weighting were employed to assess the robustness of our findings. 21,781 patients were included in our study, of which 2860 underwent central venous pressure measurement within 24 hours of intensive care unit admission (ECVP group). ECVP measurement was associated with lower 28-day mortality (odds ratio = 0.73, 95% Confidence Interval 0.634-0.84, P < .001). The ECVP group's in-hospital mortality and 1-year mortality were also significantly lower than those of the non-ECVP group. The ECVP patients had significantly shorter duration of intensive care unit stay and hospital stay. The ECVP patients received more intravenous fluid. The duration of mechanical ventilation and vasopressor use among ECVP patients was also shorter. The ECVP group lactate increase was significantly lower than the non-ECVP group. The mediating effect of lactate change was significant (P = .014 for the average causal mediation effect). ECVP measurement is associated with a decreased risk of 28-day mortality, and serum lactate change may proportionally mediate this beneficial effect.

Background: Alopecia areata (AA) is characterized by hair loss triggered by an autoimmune response that leads to emotional distress and a poor quality of life. However, conventional treatments may also have potential side effects. Therefore, traditional medicine methods such as acupuncture are emerging as alternative treatments for AA, with recent evidence suggesting their effectiveness and prompting further research to assess their safety and efficacy.

Methods: This systematic review aimed to evaluate the current evidence regarding AA treatment using acupuncture. We searched 13 databases until December 2024 for studies that compared the efficacy of acupuncture and Western medicine in treating AA. The present review solely targeted randomized controlled trials (RCTs). The risk of bias was assessed using the Risk of Bias tool (ROB), whereas the quality of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation approach.

Results: Eleven RCTs with 1144 participants were included in this review. The included studies had an unclear risk of bias in most domains. Among these, 7 RCTs tested the total treatment effects of combining plum-blossom needling with western medicine compared with western medicine alone. The results revealed that combining plum-blossom needling with western medicine resulted in a higher rate of improved symptoms than using western medicine alone (RR 1.09, 95% CI 1.03-1.16, I2 = 50%, P = .005, 7 RCTs, 756 participants, low certainty of evidence).

Conclusion: This review provides evidence for the benefits of acupuncture in AA treatment. However, the quality of the evidence was low, and the sample size was small. Therefore, future large-scale studies should be conducted using more rigorous methodologies.

Vitiligo, known as "Bai Bo Feng" in traditional Chinese medicine (TCM), is a prevalent skin disorder characterized by the loss of pigment, manifesting as white patches on the skin and the mucous membranes. While the diagnosis is straightforward, effective treatment remains elusive due to frequent recurrences. This study investigated the therapeutic mechanisms of TCM for vitiligo. A literature review was conducted to evaluate the association between T cell-related cytokines and vitiligo, and to examine the active ingredients in TCM and traditional Chinese medicine formulas (TCMFs) that show promise in the treatment of vitiligo. Various Chinese herbal extracts have been identified, including Salvia miltiorrhiza, Artemisia annua, and Tribulus terrestris, which exhibit effects on T-cell modulation. Traditional Chinese medicine formulas have also demonstrated clinical efficacy, showing reduction in cytokine secretion, thus mitigating autoimmune responses against melanocytes. This review provides evidence for the role of TCM and TCMFs in managing vitiligo through multi-target and multi-pathway interventions. Traditional Chinese medicine could present a promising avenue for treatment by affecting T-cell and cytokine profiles. Further research is essential to elucidate the complex mechanisms of action of TCM and TCMFs, which could lead to more effective treatment strategies for vitiligo.