Medicine最新文献

This study investigates the efficacy and safety of transurethral prostate laser resection (HoLEP) with preservation of the urethral mucosa from the bladder neck to the tip of the prostate for the treatment of benign prostatic hyperplasia (BPH). A retrospective study was conducted on 208 patients with BPH treated at our hospital. In the control group, the urethral mucosa from the bladder neck to the tip of the prostate was not retained during surgery to ensure maximum removal of possible diseased tissue. The urethral mucosa was preserved in the observation group, which was finely separated to avoid injury, in order to protect urinary control function to the greatest extent and reduce postoperative complications. The surgical-related indicators, urinary function, sexual function, quality of life (QOL), and occurrence of postoperative complications were compared between the 2 groups of patients. After the procedure, both groups of patients experienced an increase in maximum flow rate and a decrease in residual urine volume (P < .05). The observation group showed a higher immediate postoperative urinary continence rate of 98.23% compared to 85.26% in the control group (P < .05). After the procedure, both groups of patients exhibited a significant increase in International index of erectile function-5 scores (P < .05). The retrograde ejaculation rates were compared between the 2 groups of patients before the procedure (P > .05). After the procedure, the occurrence rate of retrograde ejaculation decreased in both groups of patients, with the observation group being lower than the control group (P < .05). The International prostate symptom score (IPSS) scores and QOL scores were compared between the 2 groups of patients before and after the procedure (P > .05). After the procedure, both groups of patients showed a decrease in IPSS scores and QOL scores compared to before the procedure (P < .05). The occurrence of complications such as urethral injury, urinary incontinence, urinary retention, and postoperative bleeding was compared between the 2 groups of patients (P > .05). The efficacy and safety of performing HoLEP treatment for BPH patients with preservation of the urethral mucosa from the bladder neck to the tip of the prostate are comparable to those without preservation. However, it can improve immediate urinary continence rate and reduce retrograde ejaculation rate.

A recent randomized controlled clinical trial expanded the time window of intravenous thrombolysis (IVT) in patients with acute ischemic stroke (AIS) beyond 4.5 hours by applying neuroimaging standards, enabling more patients to benefit from IVT. However, hemorrhagic transformation (HT) after IVT is still a major concern. We aimed to develop a nomogram to predict HT in AIS patients receiving IVT with extended time window. We aimed to develop a nomogram to predict HT in AIS patients receiving IVT with extended time window. Patients with AIS receiving IVT with extended time window from March 2017 to April 2023 were retrospectively reviewed. They were divided into the HT group and the non-HT group based on computed tomography. Logistic regression analysis was used to screen the predictive factors for HT. A nomogram was developed based on the predictive factors. The predictive accuracy of the nomogram was assessed by the area under the curve (AUC) of the receiver operating characteristic curve (ROC). A calibration plot was used to evaluate the calibration of the nomogram. A decision curve analysis (DCA) was used to test the clinical value. A total of 210 patients were enrolled, and 44 patients (21.0%) had HT. Onset to needle time (ONT) (OR = 1.002, 95% CI: 1.000-1.004, P = .016), atrial fibrillation (OR = 2.853, 95% CI: 1.072-7.594, P = .036), and baseline NIHSS (OR = 1.273, 95% CI: 1.159-1.399, P = .000) were predictive factors of HT. The AUC of the nomogram was 0.833 (95% CI: 0.7623-0.9041), with a sensitivity of 78.9% and specificity of 77.3%. The calibration curve indicates that predicted results of the nomogram were in good agreement with the actual observation results. The DCA showed the nomogram had good clinical applicability in predicting HT. We developed an easy-to-use nomogram to predict HT in AIS patients receiving IVT with extended time window. It could be a potential tool to stratify the risk of HT for patients beyond 4.5 hours of onset who may undergo IVT.

The present study aims to investigate the clinical efficacy of recombinant human growth hormone (r-hGH) in the treatment of school-age pediatric patients with idiopathic short stature (ISS). Pediatric patients who were diagnosed with ISS and treated with r-hGH at our hospital were enrolled as research subjects. The main outcome indicators included the serum level of insulin-like growth factor-1, insulin-like growth factor binding protein-3, baseline height standard deviation scores, and posttreatment height standard deviation scores and retrospective analysis was performed. This study complies with the Strengthening the Reporting of Observational Studies in Epidemiology guidelines. A total of 42 pediatric patients with a diagnosis of ISS were enrolled in the present study (24 males and 18 females). Following treatment, the levels of insulin-like growth factor-1 and insulin-like growth factor binding protein-3 were significantly higher than the baseline level and the difference was statistically significant. The posttreatment height standard deviation scores was significantly higher than the baseline height standard deviation scores and the difference was statistically significant. There were no significant differences between male and female participants in height standard deviation scores, either before or following treatment. This study found that r-hGH therapy may increase height in school-age pediatric patients with ISS and is therefore worthy of clinical application.

Background: To explore distributed characteristics and identify research focus and emerging trends related to cancer-related fatigue (CRF) in the nursing field.

Methods: Data were collected from the Web of Science Core Collection database between January 2012 and December 2021 using an advanced search strategy. Data were extracted and analyzed using CiteSpace and Microsoft Excel.

Results: A total of 967 articles were included in this study. The number of published nursing studies on CRF has increased with slight fluctuations. Keyword co-occurrence analysis and timeline view indicated that CRF is closely related to quality of life, and there is a correlation between CRF and other symptoms. Moreover, increasing attention has been paid to CRF nursing interventions. The assessment tools and their different language versions, risk factors and reviews of CRF were the research frontiers in recent years with citation bursts.

Conclusions: In the field of nursing, the focus of CRF research is still on risk factors, adverse outcomes and nursing management. Assessment tools will continue to be developed and additional risk factors will be studied in the future.

Helicobacter pylori (H pylori) eradication is expected to effectively prevent gastric cancer (GC). However, GC cases may occur even longer than 10 years after H pylori eradication (L10AE). Moreover, the associated factors and characteristics are unknown. In this retrospective, single-center study conducted between 2017 and 2022, patients with GC diagnosed after H pylori eradication were enrolled and categorized into groups according to whether they were shorter than 10 years after H pylori eradication (S10AE) or L10AE. Patients were also categorized according to the depth of cancer invasion. Clinical data, pathological data, and risk factors were analyzed using logistic regression. Clinicopathological characteristics of GC diagnosed at L10AE and those invading the submucosal tissue or deeper (SMD) were investigated. In total, 202 cases of GC occurring after H pylori eradication were identified. Comparison of 158 S10AE and 44 L10AE GC cases revealed a significantly longer surveillance interval (SI) in L10AE cases (median: 2.0 vs 1.0 years, P = .01). Comparison of 150 intramucosal and 52 SMD GC cases revealed that L10AE GC cases were significantly more frequent amongst the SMD cases (18.0% vs 32.7%, P = .03). Pathologically, undifferentiated and mixed types were significantly more frequent in GC cases with SMD invasion (P < .001). Multivariate analysis revealed that L10AE was significantly related to GC cases with SMD invasion (odds ratio, 2.45; 95% confidence interval, 1.15-5.11; P = .019). SI was significantly longer in GC that developed at L10AE than at S10AE. In addition, GC with SMD invasion was more frequently detected in L10AE than in S10AE. Our data indicated that SI should not be groundlessly extended in patients at L10AE.

Background: Gouty arthritis is a metabolic condition caused by disordered purine metabolism and elevated uric acid levels. This study adopts a bibliometric approach to analyze current research on pain in gouty arthritis and forecast future research trends.

Methods: Retrieve relevant research on gouty arthritis pain in the Web of Science core collection database, screen literature, and use visualization software such as CiteSpace, Vosviewers, and R package "Bibliometrix" for analysis.

Results: The total number of documents included was 1133, with 909 articles and 224 reviews. Between 2014 and 2024, there was an overall upward trend in the number of publications about pain in gouty arthritis, with the United States of America and China ranking first and second, respectively, in terms of publication volume. The UNIVERSITY OF ALABAMA BIRMINGHAM had the most publications, and Professor DALBETH N played a key role in this field. According to the keyword analysis, disease management and treatment, particularly methods for enhancing patients' quality of life and reducing symptoms, are research hotspots. For a deeper understanding, attention is also being paid to the epidemiology and pathological mechanisms of the disease. Emerging keywords such as "gut microbiota" and "urate-lowering therapies" indicate growing interest in the interrelationship between gut microbiota and gout, and the development of new treatment methods.

Conclusion: This bibliometric study reveals that research on gouty arthritis pain is actively developing. Current hot topics reflect investigations into the deeper pathological mechanisms of gouty arthritis and the development of new treatment methods, including urate-lowering therapies. There is also increasing attention on the role of gut microbiota in the disease. Despite limitations such as the preliminary nature of research methods and insufficient interdisciplinary collaboration, future research directions aim to improve the rigor of research design, strengthen international cooperation, promote unified treatment guidelines, and optimize the diagnosis and treatment of gouty arthritis with new technologies like artificial intelligence, precision medicine, and nanomedicine. This will drive the field towards a deeper scientific understanding, more effective treatment methods, and more comprehensive disease management, ultimately improving patients' prognosis and quality of life.

Background: Osteoarthritis (OA) is a prevalent joint disease affecting the spine, hands, hips, knees, and feet. However, definitive drugs for OA are lacking, and current treatments are limited owing to inconvenient administration, inadequate functional improvement, and long-term side effects including gastrointestinal and cardiovascular adverse events. Therefore, in this study, we aimed to assess the pharmacokinetics and safety profiles of PK101, a fixed-dose combination (FDC) comprising PG201, a 12-herb extract used in OA treatment in traditional East Asian medicine, and celecoxib, a selective cyclooxygenase-2 inhibitor, by comparing its administration as an FDC and the corresponding individual formulations in healthy subjects.

Patients and methods: A randomized, open-label, single-dose, 2 × 2 crossover design with a cohort of healthy participants. All subjects received a single FDC tablet (405.4 mg PG201 and 100 mg celecoxib) or the individual formulations, with 7-day washout period between administrations. The estimation of maximum plasma concentration and area under the plasma concentration-time curve from time zero to the time of the last quantifiable concentration of celecoxib involved determining the geometric mean ratios and 90% confidence intervals of the FDC compared to its individual formulations.

Results: Forty-six participants were enrolled; however, only 44 completed the study. The geometric mean ratios (90% confidence intervals) for the area under the plasma concentration-time curve from time zero to the time of the last quantifiable concentration and maximum plasma concentration of celecoxib were 1.1124 (1.0601-1.1672) and 1.2788 (1.1708-1.3969), respectively. The time of maximum plasma concentration range was 1.0 to 4.0 hours and 1.0 to 6.0 hours (minimum-maximum) for the FDC and individual formulations, respectively. Seven adverse events occurred in 6 subjects.

Conclusion: The systemic exposure and safety profiles of the individual and FDC formulations were similar, supporting their potential as an innovative and effective therapeutic approach for OA treatment. All relevant data are within the paper and its Supporting Information files.

Esophageal subepithelial lesions (ESELs) encompass a variety of diseases, including leiomyoma, granular cell tumors, hemangioma, lipoma, stromal tumors, leiomyosarcoma, schwannoma, neuroendocrine tumors and more. These lesions often present asymptomatically, leading to a generally low clinical diagnosis rate. Common imaging techniques for diagnosing ESELs include conventional endoscopy, spiral computed tomography, and endoscopic ultrasound (EUS). Among these, EUS is currently regarded as one of the most accurate methods for diagnosing ESELs. In recent years, EUS has increasingly been combined with advanced technologies such as artificial intelligence, submucosal saline injection, high-frequency impedance measurement, and enhanced imaging to improve diagnostic accuracy and reduce missed diagnoses. This article reviews the application and recent advancements of EUS in diagnosing esophageal submucosal lesions.

Background: Adhesive capsulitis (AC) is often accompanied by pain and restriction in range of movement, which long lasting symptoms often have negative impact on patients' work and lives. Since diabetes mellitus (DM) is an independent risk factor for developing AC, and AC with DM have more limitations of joint motion than general people.

Aims: The aim of the present study is to evaluate the difference of clinical efficacy between diabetes and non-diabetes, and to explore whether AC with diabetes need special intervention compared to non-diabetes.

Methods: Pubmed NCBI and Embase were searched for studies published in the last 30 years. We conducted a literature search for terms regarding AC and DM on Pubmed NCBI and Embase.

Results: A total of 9 studies eligible for inclusion. The affected shoulders in these studies ranged from 26 to 135, 460 shoulders (551 participants) in total, including 166 shoulders in diabetic group and 394 shoulders in non-diabetic/idiopathic group. Interventions included shock wave therapy, hydrodilatation, arthroscopic capsular release, manipulation under cervical nerve root block. Evaluation indicators included pain, certain shoulder questionnaires, range of motion. Positive clinical efficacy were emerged after interventions between the 2 groups. The studies that better improvement of pain in non-diabetic/idiopathic group were 2 of 6, that of certain shoulder questionnaires were 4 of 8, that of range of motion were 3 of 6.

Conclusions: Whether AC combined with DM or not, the current treatment could achieve positive clinical effectiveness and there is some statistical evidence show that the curative effect of AC combined with DM is worse than non-diabetic. In other words, the available evidence suggests that patients with DM might require additional rehabilitation measures with routine glycemic control.

Population aging generated changes in the epidemiological profile and culminated in a high frequency of diseases. The objective of this study was estimating the prevalence of multimorbidity and the associated variables in the elderly of an educational program in the Federal District of Brazil. This is a cross-sectional study with data collection carried out during the period from December 2022 to April 2023 by means of telephone calls. Multimorbidity was defined as a concomitant presence of 2 or more noncommunicable chronic diseases. One-hundred fifty individuals aged between 60 and 82 years old participated in the study. The median number of self-reported diseases was 2, ranging from 0 to 9. The estimated prevalence of multimorbidity was 69.3%, being higher among elderly individuals self-reporting their health as regular or bad/or very bad, having systemic arterial hypertension, diabetes mellitus, dyslipidaemia, hypothyroidism, overweight/obesity, and depression, including polypharmacy (P < .05). The high rate of multimorbidity and associated variables shows the importance of an integrated approach on health services focused on promoting health and preventing health impairment to favor the quality of life during aging.