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Objectives: Deep vein thrombosis (DVT) demonstrated significant health risk in elderly populations, with numerous comorbidities and biomarkers affecting its incidence. This study evaluated the prevalence, potential allied risk factors for DVT in elderly.

Methods: A literature search was conducted across PubMed, Science Direct, Cochrane Library, and Google Scholar. After excluding studies, 26 studies were comprised in the study. Data were collected for DVT prevalence and associated risk factors.

Results: A total of 11,651 participants comprised from China, Japan, Germany, Saudi Arabia, and Thailand. The overall DVT prevalence was 17.10 %, with higher prevalence in females (67.08 %) than males (32.92 %). Age was significantly associated with increased DVT risk (OR=1.54, 95 % CI: 0.34-2.73, p<0.01). While DVT incidence was insignificantly higher among hypertensive and diabetic patients. Significant associations identified between DVT occurrence and malignancy (OR=1.36, 95 % CI: 1.02-1.83, p<0.04), as well as recent surgical history (OR=1.34, 95 % CI: 1.01-1.77, p<0.04). Elevated D-dimer were strongly linked to DVT risk (OR=1.13, 95 % CI: 1.08-1.17, p<0.001).

Conclusions: This review suggested the significant impact of aging, malignancy, recent surgery, and elevated D-dimer levels on DVT risk in elderly and recommends the assessment of clinical signs, risk factors, and biomarkers in elderly individuals.

Objectives: High altitude poses extreme living environment for humans, impacting human physiology and leading to physiological adaptations, including higher hemoglobin levels in highlanders. However, further understanding is required regarding the medical reference ranges at very high altitudes (>4,500 m). Therefore, we conducted a study involving 1,656 healthy individuals from the "Health Improvement at Very High Altitude (HI-VHA)" population to establish a reference range for 25 biochemical analyses in this population residing at very high altitudes.

Methods: The HI-VHA project sampled 3,564 individuals from Tibet Autonomous Region above 4,500 m. After strict exclusion criteria, 1,656 healthy individuals were included to establish age and sex stratified reference intervals (RIs) for 25 biochemical analytes using serum samples.

Results: RIs were generated following the statistical guidelines outlined in CLSI C28-A3. Among the 25 biochemical analytes studied, the levels of ALT, GLB, CREA, UA, HDLC, and HCY showed significant variations by gender, while ALB, AG, CHOL, and DBIL were influenced by age. LDLC was the only analyte affected by both gender and age. AST, TP, TBIL, IBIL, Glu, TG, LDLC, CRP, K, Na, Cl, Ca, Mg, and P, comprising 14 analytes, were not influenced by gender or age.

Conclusions: We established the RIs for 25 biochemical analytes in the very high-altitude population. These RIs are crucial for disease diagnosis and health management of individuals living at very high altitudes. Moreover, an accurate identification of diseases commonly observed at very high altitudes provides insights into the biological adaptation mechanisms of humans residing in such environments.

Objectives: Coronary artery anomalies are rare both in coronary angiogram and computed tomography angiography. Hypertrophic cardiomyopathy (HCM) is the most frequent inherited cardiac disease. The phenotype of HCM associated with anomalous coronary origin is not commonly seen especially in children.

Case presentation: We describe a case series of two children with HCM combined right coronary artery (RCA) originated from left coronary sinus. Case 1 was a 9-month-old female with TTN gene heterozygous mutation (p.R16724L) who exhibited cardiac insufficiency. Case 2 was a 12-year-old male with MYBPC3 gene heterozygous mutation (p.R820Q) who only exhibited intermittent chest pain. A total of 7 HCM cases with RCA originated from left coronary sinus have been reported with our literature review. Case 1 is the youngest child patient in our report until now. Moreover, the echocardiogram of case 1 is similar with restrictive cardiomyopathy (RCM) and it demonstrates the progression of HCM to heart failure. So, HCM with TTN gene mutation may exhibit cardiac insufficiency more early. And the gene mutation site of TTN has never been reported in previous HCM cases.

Conclusions: HCM coexisted with anomalous origin of RCA has different clinical presentation, and it maybe due to different gene mutation.

Objectives: Stroke is a major cause of long-term disability and cognitive impairment, substantially affecting patients' quality of life and functional independence. Effective strategies for post-stroke cognitive recovery remain limited. To evaluate the effects of transcranial magnetic stimulation (TMS) combined with reminiscence therapy on cognitive function and functional independence in stroke patients.

Methods: A retrospective cohort study was conducted at a rehabilitation hospital from March 2017 to October 2024, including patients with ischemic stroke and cognitive impairment who received either routine treatment (n=68) or TMS combined with reminiscence therapy (n=66). Cognitive and functional outcomes were assessed using the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Trail Making Test (TMT), and Functional Independence Measure (FIM).

Results: Post-treatment, the TMS plus reminiscence therapy group showed significantly higher MMSE (27.42 ± 3.08 vs. 25.18 ± 3.41, p=0.0001) and MoCA scores (20.05 ± 3.99 vs. 18.44 ± 4.05, p=0.0020), and shorter TMT times (65.28 ± 9.75 vs. 72.45 ± 10.32, p<0.001). FIM scores were also higher (92.18 ± 7.06 vs. 88.35 ± 7.15, p=0.0024). No significant differences in adverse events were observed.

Conclusions: TMS combined with reminiscence therapy may effectively enhance cognitive function and functional independence in patients with post-stroke cognitive impairment.

Objectives: To explore the optimal initiation time of hyperbaric oxygen therapy (HBOT) for moderate-to-severe acute carbon monoxide poisoning (ACOP) and to assess the prognostic value of lactate clearance and early MRI findings.

Methods: This single-center retrospective study included 12 ACOP patients (2020-2023) treated with HBOT within 6 h after admission. Patients were categorized by HBOT initiation time: early (≤3 h, n=8) and delayed (>3 h, n=4). Clinical, biochemical, and imaging data were analyzed. Primary outcomes were time to regain consciousness and Barthel Index at 6 months.

Results: Median HBOT initiation was 112 min. Early treatment was associated with faster organ function recovery (greater SOFA score reduction, p<0.05). Lactate normalized within a median of 17.5 h, and clearance >50 % in 24 h correlated with better neurological outcomes (p=0.002). MRI detected early globus pallidus injury more sensitively than CT. At 6 months, 83.3 % recovered functionally; one developed delayed encephalopathy.

Conclusions: Early HBOT initiation (≤3 h) may facilitate metabolic and neurological recovery in ACOP. Early lactate clearance and MRI findings may serve as prognostic markers. Given the small sample size and absence of a non-HBOT control group, these results are exploratory and require confirmation in larger studies.

Objectives: To explore the effects of curcumol on ferroptosis and angiogenesis of hepatic sinusoidal endothelial cells, further elucidate the molecular mechanism of curcumol against liver fibrosis, and provide new ideas for the prevention and treatment of chronic liver disease.

Methods: We used VEGF to construct pathological model group, and divided hepatic sinusoidal endothelial cells into blank group, model group, high, middle and low curcumol group. Ferroptosis and angiogenesis were detected by various cell molecular biology experiments.

Results: Curcumol significantly inhibited the proliferation and migration of hepatic sinusoidal endothelial cells, significantly increased the expression of P53 and TFR1 protein, significantly decreased the expression of FTH1 protein, significantly promoted the occurrence of iron death, and significantly inhibited angiogenesis. When we knocked out p53, the effect of curcumol contributing to the onset of ferroptosis was rescued, while curcumol's role in inhibiting angiogenesis was saved, which was the same effect as when we used Ferrostatin-1.

Conclusions: Curcumol targets the P53-TFR1-FTH1 signalling axis and induces massive deposition of iron ions in hepatic sinusoidal endothelial cells, leading to the onset of ferroptosis inhibiting hepatic angiogenesis, which may be one of the molecular mechanisms of its anti-hepatic fibrosis.

Objectives: To identify causal genes for benign prostatic hyperplasia (BPH) based on single-cell RNA sequencing (scRNA-seq) and genome-wide association studies.

Methods: We explored scRNA-seq datasets to identify the differentially expressed genes (DEGs) in BPH patients vs. healthy controls. Mendelian randomization (MR) was conducted to investigate the causal relationships between the identified DEGs and BPH. Bayesian colocalization and reverse MR were performed to consolidate the MR findings. Potential therapeutic drugs targeting causal genes were explored via molecular docking. The results of bioinformatics analyses were validated through experiments including flow cytometry, quantitative reverse transcription polymerase chain reaction, western blotting, immunohistochemistry, and immunofluorescence staining.

Results: BPH patients showed an increased proportion of myeloid cells in the prostate transition zone, with 85 classical monocyte-specific DEGs. Among these, SLC25A37 was causally associated with BPH based on MR, Bayesian colocalization, and reverse MR analyses. Functional analyses indicated its involvement in proliferation-related signaling pathways in classical monocytes. Ferriheme chloride and catechol were identified as potential drugs targeting SLC25A37. In vitro study confirmed increased expression levels of SLC25A37 and myeloid cells in BPH tissues.

Conclusions: Our integrative analyses revealed SLC25A37 as a novel causal gene in BPH pathogenesis, unveiling potential therapeutic strategies for BPH treatment.

Objectives: The present study focused on exploring the role of orosomucoid 1 (ORM1) in rheumatoid arthritis (RA).

Methods: Differentially expressed genes in GSE15573 dataset were analyzed by bioinformatics. Fibroblast-like synoviocytes (FLS) from RA patients were stimulated with collagen-II, followed by quantification of ORM1 and C-C chemokine receptor 5 (CCR5) expressions. The interaction between ORM1 and CCR5 in FLS was examined by Co-immunoprecipitation. After ORM1 intervention or maraviroc treatment, the effect of ORM1 or CCR5 as well as their interplay in the stimulated cells was investigated using molecular experiments, methylthiazolyldiphenyl-tetrazolium bromide assay and transwell assay. Rats underwent collagen-induced arthritis (CIA) modeling. Arthritis index scoring, western blot assay and histopathological evaluation were performed in CIA rats with ORM1 or CCR5 knockdown.

Results: ORM1 and CCR5 were highly expressed in collagen type II (CII)-stimulated FLS and synovial tissues of CIA rats. The expression of CCR5 was positively regulated by ORM1, and the interaction of ORM1 and CCR5 was confirmed. CII stimulation enhanced viability, migration and invasion of FLS, but these effects were antagonized in the absence of ORM1 or CCR5. Knockdown of ORM1 or CCR5 in CIA rats reduced arthritis index, while alleviating cartilage erosion, inflammatory infiltration and synovial hyperplasia of ankle joints.

Conclusions: ORM1 deficiency suppresses the aggressive phenotype of FLS to reduce RA progression by downregulating CCR5.

Objectives: Acute lymphoblastic leukemia (ALL) is generally thought to be widely distributed in the bone marrow (BM). Localized involvement of BM from particular bones is extremely rare, especially in newly diagnosed cases. Here, we described a newly diagnosed case of B-cell ALL localized to the lower extremities in a five-year-old boy.

Case presentation: The patient presented with pain in both knees for over one month. Imaging findings indicated pathological fracture of the right distal femur and bilateral proximal tibiae. An open biopsy of the right distal femur lesion was performed, and BM cytology and histopathological analysis confirmed the diagnosis of B-cell ALL. However, his whole blood and BM findings on usual biopsy sites (the sternum and iliac bone) were normal. He received standard treatments for ALL, and achieved complete remission. He has been on maintenance therapy till now without evidence of relapse for two and a half years.

Conclusions: The present case highlights the fact that, in exceptionally rare circumstances, ALL may initially manifest as localized infiltration within BM of specific bones, rather than exhibit diffuse BM involvement, which renders BM aspiration and biopsy only from the usual sites insufficient for the diagnosis of leukemia. Therefore, clinicians should maintain a high index of suspicion for acute leukemia when facing any child with unexplained persistent skeletal pain and radiographic abnormalities even in the absence of abnormal hematologic findings, and strongly consider performing targeted BM biopsies of radiologically abnormal bone lesions alongside conventional BM sampling sites.

Objectives: Pediatric trigger thumb (PTT) is characterized by flexion deformity and interphalangeal joint locking caused by A1 pulley constriction. Open A1 pulley release is the standard surgical method, whereas percutaneous release under local anesthesia offers a minimally invasive outpatient alternative. This study compared the outcomes of these two techniques.

Methods: A retrospective cohort of children aged 2-10 years undergoing A1 pulley release between 2012 and 2024 was analyzed. Patients were assigned to open release under general anesthesia or percutaneous release under local anesthesia. Demographics, operative details, complications, and outcomes were compared using appropriate statistical tests, with significance set at p<0.05.

Results: Ninety-nine patients (107 thumbs) were included: 53 (58 thumbs) in the open group and 46 (49 thumbs) in the percutaneous group. Mean age at surgery was similar (4.33 ± 1.53 vs. 4.29 ± 1.70 years; p=0.781). Satisfactory results were achieved in 100 % of open and 85.7 % of percutaneous cases (p=0.003). Recurrence was 3.4 % and 8.2 %, respectively (p=0.409). No neurovascular or tendon injuries occurred; superficial infections were minor and limited to the open group.

Conclusions: Both techniques are effective and safe. Open release remains the gold standard, while percutaneous release is a practical minimally invasive option in selected patients.

Level of evidence: III, retrospective comparative study.