{"title":"Neuroangiostrongyliasis after consumption of the Monitor Lizard.","authors":"Nitin Gupta, Anjely Sebastian, Muralidhar Varma, Sachin David, Anil Kumar, Tirlangi Praveen Kumar","doi":"10.1093/qjmed/hcag042","DOIUrl":"https://doi.org/10.1093/qjmed/hcag042","url":null,"abstract":"","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146150518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Methods: This trial was conducted across 23 hospitals in China between August 4, 2020, and April 25, 2023. A total of 300 participants diagnosed with PSD following acute ischemic stroke and presenting with Functional Oral Intake Scale levels 2 to 4 were enrolled. They were randomly assigned to receive either verum acupuncture (VA) or sham acupuncture (SA), delivered in 10 sessions over 14 days. The primary outcome was the response rate at day 14, defined as the percentage of participants achieving a Functional Oral Intake Scale level ≥6. Ten Secondary outcomes included swallowing function, quality of life, patient-reported outcome, nutrition, and pneumonia.
Results: Of 300 eligible participants, 149 were randomly assigned to SA and 151 were randomly assigned to VA (1 did not diagnose ischemic stroke). At day 14, the VA group exhibited a higher response rate compared to the SA group (117 [78.0%] vs. 85 [57.0%], relative risk, 1.37 [95% CI, 1.16 to 1.61], P < 0.001). Four cases of treatment-related adverse events were reported in the VA group, and 3 were reported in the SA group. All events were mild and transient.
Conclusions: Two weeks of VA demonstrated superior recovery of swallowing function compared to SA in patients with dysphagia after acute ischemic stroke.
{"title":"Acupuncture for Dysphagia among Patients with Acute Ischemic Stroke: A Randomized Clinical Trial.","authors":"Wei Liu, Hongbo Jia, Wenyi Ge, Yibing Li, Li Li, Zhimiao Murong, Kangchen Lei, Songjiao Li, Menglong Zhang, Weiwei Zhang, Tongtao Fan, Shuwen Shi, Yutong Dong, Qiang Liu, Shu Wang, Jian Liu, Yan Shen, Sha Yang, Chen Li, Lili Zhang, Ying Hai, Chang She, Dan Li, Peng Zhang, Jiangwei Shi, Yuzheng Du, Guiping Li, Shiyan Yan, Baoyan Liu, Xiaonong Fan","doi":"10.1093/qjmed/hcag040","DOIUrl":"https://doi.org/10.1093/qjmed/hcag040","url":null,"abstract":"<p><strong>Background: </strong>Acupuncture may be effective for post-stroke dysphagia (PSD) after acute ischemic stroke, but the evidence is limited.</p><p><strong>Objective: </strong>To assess the effect of acupuncture for PSD after acute ischemic stroke.</p><p><strong>Design: </strong>A multicentre, randomised, sham-controlled trial. (Chinese Clinical Trial Registry, ChiCTR1900028061).</p><p><strong>Methods: </strong>This trial was conducted across 23 hospitals in China between August 4, 2020, and April 25, 2023. A total of 300 participants diagnosed with PSD following acute ischemic stroke and presenting with Functional Oral Intake Scale levels 2 to 4 were enrolled. They were randomly assigned to receive either verum acupuncture (VA) or sham acupuncture (SA), delivered in 10 sessions over 14 days. The primary outcome was the response rate at day 14, defined as the percentage of participants achieving a Functional Oral Intake Scale level ≥6. Ten Secondary outcomes included swallowing function, quality of life, patient-reported outcome, nutrition, and pneumonia.</p><p><strong>Results: </strong>Of 300 eligible participants, 149 were randomly assigned to SA and 151 were randomly assigned to VA (1 did not diagnose ischemic stroke). At day 14, the VA group exhibited a higher response rate compared to the SA group (117 [78.0%] vs. 85 [57.0%], relative risk, 1.37 [95% CI, 1.16 to 1.61], P < 0.001). Four cases of treatment-related adverse events were reported in the VA group, and 3 were reported in the SA group. All events were mild and transient.</p><p><strong>Conclusions: </strong>Two weeks of VA demonstrated superior recovery of swallowing function compared to SA in patients with dysphagia after acute ischemic stroke.</p>","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146126213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yunfeng Jia, Lu Fan, Lei Wei, Yiming Zuo, Dejun Han, Jingya Li, Rui Wang, Fan Qu, Xuezheng Liu, Junping Zhang, Xiaoling Wang, Li Yanyang, Shichao Lv
<p><strong>Background: </strong>Chronic heart failure (CHF) has become a significant global disease burden due to its high prevalence, re-hospitalization rate, and mortality rate. Decreased exercise tolerance is a typical manifestation of CHF patients, which severely impairs their quality of life. Yiqi Fumai injection (YQFM), an injectable drug, is a representative medication recommended by Chinese guidelines for the treatment of CHF. It has significant advantages in improving the clinical symptoms and quality of life of CHF patients. However, there is still a lack of high-quality evidence-based evidence to support clinical decisions in improving exercise tolerance.</p><p><strong>Purpose: </strong>The aim of this study was to evaluate the clinical effect of YQFM in improving the exercise tolerance of patients with CHF, and to promote the overall prevention and treatment level of CHF.</p><p><strong>Study design and methods: </strong>This was a single-center, prospective, open-label, randomized, controlled clinical trial that included patients with heart failure (CHF) who had a brain natriuretic peptide (BNP) level > 35 ng/L, NYHA cardiac function classification of grades II to IV, and were aged 18 to 90 years, and were recruited at the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from January 2024 to February 2025. The random allocation sequence was generated using the block randomization method to randomly assign the subjects to the control group (conventional Western medicine treatment) or the YQFM group (conventional Western medicine treatment + injection of Yiqi Fumai). The intervention period was 10 days, and the follow-up period was 60 days. The primary outcome measure was the metabolic equivalent (METs) predicted by the Veterans Specific Activity Questionnaire (VSAQ). Secondary outcome measures included 6-minute walk distance (6MWD), NYHA cardiac function classification, BNP level, cardiac ultrasound indicators, and the Kansas City Cardiomyopathy Patient Quality of Life Scale (KCCQ) score. Safety assessments of adverse events and laboratory indicators were conducted throughout the trial period. The outcome indicators were analyzed using the complete analysis set, following the intention-to-treat (ITT) principle.</p><p><strong>Results: </strong>A total of 204 CHF patients completed this study. The intention-to-treat analysis showed that compared with the control group, the YQFM group had significantly higher METs at 10 days of treatment, 30 days of follow-up, and 60 days of follow-up (P < 0.05), and the improvement in METs at 60 days of follow-up was more significant [4.91 ± 1.02 vs 4.53 ± 0.96; Mean difference: 0.38; 95% CI: 0.11-0.65; P = 0.006]. The YQFM group also had significantly higher 6MWD at 10 days of treatment, 30 days of follow-up, and 60 days of follow-up compared with the control group (P < 0.05), and the improvement in 6MWD at 60 days of follow-up was more significant [347.0 (288.5, 403.3) vs
{"title":"Effect of Yiqi Fumai injection improves exercise tolerance in patients with chronic heart failure: A prospective, open-label, randomized, controlled clinical trial.","authors":"Yunfeng Jia, Lu Fan, Lei Wei, Yiming Zuo, Dejun Han, Jingya Li, Rui Wang, Fan Qu, Xuezheng Liu, Junping Zhang, Xiaoling Wang, Li Yanyang, Shichao Lv","doi":"10.1093/qjmed/hcag041","DOIUrl":"https://doi.org/10.1093/qjmed/hcag041","url":null,"abstract":"<p><strong>Background: </strong>Chronic heart failure (CHF) has become a significant global disease burden due to its high prevalence, re-hospitalization rate, and mortality rate. Decreased exercise tolerance is a typical manifestation of CHF patients, which severely impairs their quality of life. Yiqi Fumai injection (YQFM), an injectable drug, is a representative medication recommended by Chinese guidelines for the treatment of CHF. It has significant advantages in improving the clinical symptoms and quality of life of CHF patients. However, there is still a lack of high-quality evidence-based evidence to support clinical decisions in improving exercise tolerance.</p><p><strong>Purpose: </strong>The aim of this study was to evaluate the clinical effect of YQFM in improving the exercise tolerance of patients with CHF, and to promote the overall prevention and treatment level of CHF.</p><p><strong>Study design and methods: </strong>This was a single-center, prospective, open-label, randomized, controlled clinical trial that included patients with heart failure (CHF) who had a brain natriuretic peptide (BNP) level > 35 ng/L, NYHA cardiac function classification of grades II to IV, and were aged 18 to 90 years, and were recruited at the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from January 2024 to February 2025. The random allocation sequence was generated using the block randomization method to randomly assign the subjects to the control group (conventional Western medicine treatment) or the YQFM group (conventional Western medicine treatment + injection of Yiqi Fumai). The intervention period was 10 days, and the follow-up period was 60 days. The primary outcome measure was the metabolic equivalent (METs) predicted by the Veterans Specific Activity Questionnaire (VSAQ). Secondary outcome measures included 6-minute walk distance (6MWD), NYHA cardiac function classification, BNP level, cardiac ultrasound indicators, and the Kansas City Cardiomyopathy Patient Quality of Life Scale (KCCQ) score. Safety assessments of adverse events and laboratory indicators were conducted throughout the trial period. The outcome indicators were analyzed using the complete analysis set, following the intention-to-treat (ITT) principle.</p><p><strong>Results: </strong>A total of 204 CHF patients completed this study. The intention-to-treat analysis showed that compared with the control group, the YQFM group had significantly higher METs at 10 days of treatment, 30 days of follow-up, and 60 days of follow-up (P < 0.05), and the improvement in METs at 60 days of follow-up was more significant [4.91 ± 1.02 vs 4.53 ± 0.96; Mean difference: 0.38; 95% CI: 0.11-0.65; P = 0.006]. The YQFM group also had significantly higher 6MWD at 10 days of treatment, 30 days of follow-up, and 60 days of follow-up compared with the control group (P < 0.05), and the improvement in 6MWD at 60 days of follow-up was more significant [347.0 (288.5, 403.3) vs","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146126183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Herpes Zoster After COVID-19 as a Marker Of Long-Term Neuro-Ophthalmic Risk.","authors":"Chien-Feng Li, Yuan-Ti Lee","doi":"10.1093/qjmed/hcag034","DOIUrl":"https://doi.org/10.1093/qjmed/hcag034","url":null,"abstract":"","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Timing and Sex Bias in Prehospital Prediction of Trauma Transfusion Requirements.","authors":"Bi-Yu Gao, Chun-Chieh Chen","doi":"10.1093/qjmed/hcag038","DOIUrl":"https://doi.org/10.1093/qjmed/hcag038","url":null,"abstract":"","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rubén Pérez-García, Raúl López-Izquierdo, Michael Eichinger, Carlos Del Pozo Vegas, Juan F Delgado Benito, Irene Sánchez Soberón, Begoña Polonio-López, José Luis Martín-Conty, Ancor Sanz-García, Francisco Martín-Rodríguez
{"title":"Reply to Letter: Timing and Sex Bias in Prehospital Prediction of Trauma Transfusion Requirements.","authors":"Rubén Pérez-García, Raúl López-Izquierdo, Michael Eichinger, Carlos Del Pozo Vegas, Juan F Delgado Benito, Irene Sánchez Soberón, Begoña Polonio-López, José Luis Martín-Conty, Ancor Sanz-García, Francisco Martín-Rodríguez","doi":"10.1093/qjmed/hcag039","DOIUrl":"https://doi.org/10.1093/qjmed/hcag039","url":null,"abstract":"","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Response to 'Letter to Editor': 'Herpes Zoster After COVID-19 as a Marker of Long-Term Neuro-Ophthalmic Risk'.","authors":"Kuo-Cheng Lu, Yu-Chen Cheng","doi":"10.1093/qjmed/hcag035","DOIUrl":"https://doi.org/10.1093/qjmed/hcag035","url":null,"abstract":"","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pseudoprogression after CAR T-cell therapy mimicking orbital lymphoma relapse.","authors":"Takashi Miyachi, Akihiro Kitadate, Naoto Takahashi","doi":"10.1093/qjmed/hcag037","DOIUrl":"https://doi.org/10.1093/qjmed/hcag037","url":null,"abstract":"","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146107076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jixiang Pei, Chao Huang, Cuicui Liang, Luxin Feng, Chao Xuan, Hongwei Ji, Kuo Wang, Χueying Wang, Zhexun Lian, Junjie Guo
Background: Polycystic ovary syndrome (PCOS) and ischemic cardiomyopathy (ICM) share metabolic and cardiovascular risk factors, including insulin resistance and chronic inflammation, but the molecular links remain unclear.
Aim: To identify shared diagnostic biomarkers between PCOS and ICM and clarify their biological basis.
Methods: Transcriptomic datasets from multiple PCOS and ICM GEO cohorts were integrated. Differential expression analysis, WGCNA, and 105 machine-learning model combinations were applied to identify robust cross-disease biomarkers. The top-performing Elastic Net (Enet) model was used to screen candidate genes. Immune infiltration, single-cell RNA sequencing (scRNA-seq), and spatial transcriptomics defined cell-type specificity and tissue localization. Drug-target interactions were explored by molecular docking.
Results: Eleven candidate genes were identified, and COL14A1 was the only gene consistently validated across all independent datasets. scRNA-seq identified COL14A1 enrichment in TPM2+ activated fibroblasts, and cell-cell communication analysis highlighted a macrophage-fibroblast crosstalk axis. Spatial transcriptomics confirmed that COL14A1 is tightly linked to fibroblast activation, supporting its role as a mediator of immune-fibrotic responses during postischemic cardiac remodelling. Molecular docking revealed that rofecoxib is a high-affinity potential therapeutic agent targeting COL14A1.
Conclusions: COL14A1 may represent a shared molecular link between PCOS and increased susceptibility to ischemic cardiac injury, potentially acting through macrophage-associated immune activation and fibroblast-mediated ECM remodelling. Rofecoxib may serve as a potential repurposed therapeutic candidate pending further validation. These findings provide mechanistic insights into the ovario-cardiac axis and highlight COL14A1 as a promising target for future risk stratification and intervention studies in women with PCOS.
{"title":"COL14A1 drives ischemic cardiac injury in PCOS: an artificial intelligence-identified biomarker.","authors":"Jixiang Pei, Chao Huang, Cuicui Liang, Luxin Feng, Chao Xuan, Hongwei Ji, Kuo Wang, Χueying Wang, Zhexun Lian, Junjie Guo","doi":"10.1093/qjmed/hcag033","DOIUrl":"https://doi.org/10.1093/qjmed/hcag033","url":null,"abstract":"<p><strong>Background: </strong>Polycystic ovary syndrome (PCOS) and ischemic cardiomyopathy (ICM) share metabolic and cardiovascular risk factors, including insulin resistance and chronic inflammation, but the molecular links remain unclear.</p><p><strong>Aim: </strong>To identify shared diagnostic biomarkers between PCOS and ICM and clarify their biological basis.</p><p><strong>Methods: </strong>Transcriptomic datasets from multiple PCOS and ICM GEO cohorts were integrated. Differential expression analysis, WGCNA, and 105 machine-learning model combinations were applied to identify robust cross-disease biomarkers. The top-performing Elastic Net (Enet) model was used to screen candidate genes. Immune infiltration, single-cell RNA sequencing (scRNA-seq), and spatial transcriptomics defined cell-type specificity and tissue localization. Drug-target interactions were explored by molecular docking.</p><p><strong>Results: </strong>Eleven candidate genes were identified, and COL14A1 was the only gene consistently validated across all independent datasets. scRNA-seq identified COL14A1 enrichment in TPM2+ activated fibroblasts, and cell-cell communication analysis highlighted a macrophage-fibroblast crosstalk axis. Spatial transcriptomics confirmed that COL14A1 is tightly linked to fibroblast activation, supporting its role as a mediator of immune-fibrotic responses during postischemic cardiac remodelling. Molecular docking revealed that rofecoxib is a high-affinity potential therapeutic agent targeting COL14A1.</p><p><strong>Conclusions: </strong>COL14A1 may represent a shared molecular link between PCOS and increased susceptibility to ischemic cardiac injury, potentially acting through macrophage-associated immune activation and fibroblast-mediated ECM remodelling. Rofecoxib may serve as a potential repurposed therapeutic candidate pending further validation. These findings provide mechanistic insights into the ovario-cardiac axis and highlight COL14A1 as a promising target for future risk stratification and intervention studies in women with PCOS.</p>","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2026-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146097151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Raccoon eyes and macroglossia in AL amyloidosis.","authors":"Ankur Jain","doi":"10.1093/qjmed/hcag036","DOIUrl":"https://doi.org/10.1093/qjmed/hcag036","url":null,"abstract":"","PeriodicalId":20806,"journal":{"name":"QJM: An International Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146092850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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