Pub Date : 2026-12-01Epub Date: 2026-01-16DOI: 10.1080/07853890.2026.2615509
Sreenath N, Pallavi L C, Baskaran Chandrasekaran, Lavya Shetty, Lavina M Manu, Shivaprakash Gangachannaiah
Background: Rapid autonomic recovery after physical stress is a hallmark of cardiovascular health. While both yoga and conventional exercise modulate autonomic function, direct comparisons of their effect on post-exercise recovery are scarce. This study compared autonomic recovery in yoga practitioners versus those in aerobic or resistance training.
Methods: We conducted a cross-sectional study of 51 healthy adults (18-35 years) in three long-term training groups: Yoga (n = 17), Aerobic (n = 17), and Resistance (n = 17). Participants performed a 5-minute submaximal Harvard step test. Heart rate variability (HRV) was analyzed from electrocardiograms recorded at baseline and during a 10-minute post-exercise recovery.
Results: After adjusting for baseline differences, the Yoga group showed a more efficient autonomic recovery profile. ANCOVA revealed a significant group effect on vagal reactivation, as measured by High-Frequency (HF) power (p = 0.001). Post-hoc tests confirmed that the Yoga group's recovery was significantly greater than that of the Aerobic and Resistance groups. Similar significant effects favouring Yoga were found for pNN50, SDNN, LF power, and total power (all p < 0.05). No significant group differences were observed for pulse rate, blood pressure, or RMSSD recovery.
Conclusion: Regular yoga practice is associated with more efficient parasympathetic reactivation after physical exertion. This suggests yoga's integrative nature is associated with unique advantages for autonomic strength compared to conventional aerobic and strength training.
{"title":"Autonomic recovery following submaximal exercise in yoga practitioners versus aerobic and strength-trained individuals.","authors":"Sreenath N, Pallavi L C, Baskaran Chandrasekaran, Lavya Shetty, Lavina M Manu, Shivaprakash Gangachannaiah","doi":"10.1080/07853890.2026.2615509","DOIUrl":"10.1080/07853890.2026.2615509","url":null,"abstract":"<p><strong>Background: </strong>Rapid autonomic recovery after physical stress is a hallmark of cardiovascular health. While both yoga and conventional exercise modulate autonomic function, direct comparisons of their effect on post-exercise recovery are scarce. This study compared autonomic recovery in yoga practitioners versus those in aerobic or resistance training.</p><p><strong>Methods: </strong>We conducted a cross-sectional study of 51 healthy adults (18-35 years) in three long-term training groups: Yoga (<i>n</i> = 17), Aerobic (<i>n</i> = 17), and Resistance (<i>n</i> = 17). Participants performed a 5-minute submaximal Harvard step test. Heart rate variability (HRV) was analyzed from electrocardiograms recorded at baseline and during a 10-minute post-exercise recovery.</p><p><strong>Results: </strong>After adjusting for baseline differences, the Yoga group showed a more efficient autonomic recovery profile. ANCOVA revealed a significant group effect on vagal reactivation, as measured by High-Frequency (HF) power (<i>p</i> = 0.001). Post-hoc tests confirmed that the Yoga group's recovery was significantly greater than that of the Aerobic and Resistance groups. Similar significant effects favouring Yoga were found for pNN50, SDNN, LF power, and total power (all <i>p</i> < 0.05). No significant group differences were observed for pulse rate, blood pressure, or RMSSD recovery.</p><p><strong>Conclusion: </strong>Regular yoga practice is associated with more efficient parasympathetic reactivation after physical exertion. This suggests yoga's integrative nature is associated with unique advantages for autonomic strength compared to conventional aerobic and strength training.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"58 1","pages":"2615509"},"PeriodicalIF":4.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12818321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145991635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Early spontaneous abortion (ESA) is recognized as the most common complication during pregnancy and is often linked to dysfunction in the trophoblast and placenta. Studies suggest that downregulation of trophoblast oestrogen-related receptor gamma (ESRRG) may play a significant role in the impairment of placental function. In light of these findings, we evaluated the impact of ESRRG on trophoblast and placental function in ESAs, aiming to uncover new targets for diagnosis and treatment.
Patients/materials and methods: Bioinformatics methods were used to analyse differentially expressed genes in the trophoblast of ESA patients and normal controls. ESA Patients and controls were recruited and the villus tissues were collected. Protein and mRNA levels were determined by western blot and qRT-PCR, respectively. Mitochondrial morphological changes in trophoblasts were observed via transmission electron microscopy. CCK8 and Transwell assays were conducted with ESRRG-knockdown HTR-8/SVneo cells. MitoSOX staining, JC-1 assays and ATP quantification were used to assess mitochondrial function in vitro. In addition, Esrrg was overexpressed in ICR female mice, and the number of embryos in the uterus was determined.
Results: The expression of ESRRG was significantly decreased in the placental villous tissue of ESA patients, accompanied by abnormal mitochondrial morphology and decreased ATP levels in trophoblast cells. Impaired proliferation, invasion, migration and tube formation abilities were observed in ESRRG-downregulated HTR-8/SVneo cells, as well as impaired mitochondrial function. ESRRG overexpression was associated with improved trophoblast functionality in a lipopolysaccharide-induced abortion model in ICR mice, leading to an increased number of retained embryos in the uterus.
Conclusion: In summary, this study revealed that ESRRG downregulation plays an important role in ESA, providing new targets for diagnosis and treatment.
{"title":"ESRRG downregulation in early spontaneous abortion induces mitochondrial damage, leading to impaired trophoblast function.","authors":"Sha Lv, Lieyang Li, Xiaoxiao Xu, Zhengwei Liang, Rongrui Zhang, Zunlun Zhou, Deqin Lu","doi":"10.1080/07853890.2026.2622749","DOIUrl":"10.1080/07853890.2026.2622749","url":null,"abstract":"<p><strong>Background: </strong>Early spontaneous abortion (ESA) is recognized as the most common complication during pregnancy and is often linked to dysfunction in the trophoblast and placenta. Studies suggest that downregulation of trophoblast oestrogen-related receptor gamma (ESRRG) may play a significant role in the impairment of placental function. In light of these findings, we evaluated the impact of ESRRG on trophoblast and placental function in ESAs, aiming to uncover new targets for diagnosis and treatment.</p><p><strong>Patients/materials and methods: </strong>Bioinformatics methods were used to analyse differentially expressed genes in the trophoblast of ESA patients and normal controls. ESA Patients and controls were recruited and the villus tissues were collected. Protein and mRNA levels were determined by western blot and qRT-PCR, respectively. Mitochondrial morphological changes in trophoblasts were observed <i>via</i> transmission electron microscopy. CCK8 and Transwell assays were conducted with ESRRG-knockdown HTR-8/SVneo cells. MitoSOX staining, JC-1 assays and ATP quantification were used to assess mitochondrial function <i>in vitro</i>. In addition, Esrrg was overexpressed in ICR female mice, and the number of embryos in the uterus was determined.</p><p><strong>Results: </strong>The expression of ESRRG was significantly decreased in the placental villous tissue of ESA patients, accompanied by abnormal mitochondrial morphology and decreased ATP levels in trophoblast cells. Impaired proliferation, invasion, migration and tube formation abilities were observed in ESRRG-downregulated HTR-8/SVneo cells, as well as impaired mitochondrial function. ESRRG overexpression was associated with improved trophoblast functionality in a lipopolysaccharide-induced abortion model in ICR mice, leading to an increased number of retained embryos in the uterus.</p><p><strong>Conclusion: </strong>In summary, this study revealed that ESRRG downregulation plays an important role in ESA, providing new targets for diagnosis and treatment.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"58 1","pages":"2622749"},"PeriodicalIF":4.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12865851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146101123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-12-01Epub Date: 2026-01-28DOI: 10.1080/07853890.2026.2622179
Min-Yuan Zhuang, Li-Na Xu, Jun Lv, Lin-Lin Liu, Yong-da Lu, Fu-Hai Ji, Nazneen Sudhan, Lei Huang, Ke Peng
Introduction: Endoscopic retrograde cholangiopancreatography (ERCP) is associated with significant discomfort and necessitates adequate sedation. This study aims to determine the effect of dexmedetomidine nasal spray adjunct to propofol sedation for patients undergoing ERCP procedures.
Patients and methods: This randomized, double-blind, placebo-controlled trial will be conducted at a tertiary teaching hospital in eastern China. Approximately 15 min before sedation, 160 adult patients will be randomly assigned (1:1) to either the dexmedetomidine group (dexmedetomidine nasal spray; n = 80) or the control group (normal saline nasal spray; n = 80). Sedation will be achieved with a target-controlled infusion of propofol, titrated to Modified Observer's Assessment of Alertness/Sedation scores of 1 and 2. The primary endpoint is the total propofol consumption during sedation. Secondary endpoints include the composite incidence of hypotension and hypoxemia during the procedures and recovery; and fatigue scores 15 min after emergence from sedation. An independent Data and Safety Monitoring Committee will conduct an ongoing review of study implementation.
Discussion: We anticipate that preoperative dexmedetomidine nasal spray will decrease total propofol requirements, reduce sedation-related adverse events, and enhance recovery for patients undergoing ERCP.
Trial registration: Chinese Clinical Trial Registry (ChiCTR2400093656) on December 10, 2024.
{"title":"Dexmedetomidine nasal spray for patients undergoing endoscopic retrograde cholangiopancreatography: protocol for a randomized controlled trial.","authors":"Min-Yuan Zhuang, Li-Na Xu, Jun Lv, Lin-Lin Liu, Yong-da Lu, Fu-Hai Ji, Nazneen Sudhan, Lei Huang, Ke Peng","doi":"10.1080/07853890.2026.2622179","DOIUrl":"https://doi.org/10.1080/07853890.2026.2622179","url":null,"abstract":"<p><strong>Introduction: </strong>Endoscopic retrograde cholangiopancreatography (ERCP) is associated with significant discomfort and necessitates adequate sedation. This study aims to determine the effect of dexmedetomidine nasal spray adjunct to propofol sedation for patients undergoing ERCP procedures.</p><p><strong>Patients and methods: </strong>This randomized, double-blind, placebo-controlled trial will be conducted at a tertiary teaching hospital in eastern China. Approximately 15 min before sedation, 160 adult patients will be randomly assigned (1:1) to either the dexmedetomidine group (dexmedetomidine nasal spray; <i>n</i> = 80) or the control group (normal saline nasal spray; <i>n</i> = 80). Sedation will be achieved with a target-controlled infusion of propofol, titrated to Modified Observer's Assessment of Alertness/Sedation scores of 1 and 2. The primary endpoint is the total propofol consumption during sedation. Secondary endpoints include the composite incidence of hypotension and hypoxemia during the procedures and recovery; and fatigue scores 15 min after emergence from sedation. An independent Data and Safety Monitoring Committee will conduct an ongoing review of study implementation.</p><p><strong>Discussion: </strong>We anticipate that preoperative dexmedetomidine nasal spray will decrease total propofol requirements, reduce sedation-related adverse events, and enhance recovery for patients undergoing ERCP.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Registry (ChiCTR2400093656) on December 10, 2024.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"58 1","pages":"2622179"},"PeriodicalIF":4.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12863067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146115119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-12-01Epub Date: 2026-02-04DOI: 10.1080/07853890.2026.2624183
Jun Gao, Lixue Wang, Wanjun Li, Wei Liu
Background: The testis is a male-specific organ that plays a central role in spermatogenesis and androgen secretion. Testicular ageing is a hallmark of male senescence. However, the underlying mechanisms, as well as strategies to prevent, delay, or reverse this process, remain incompletely understood.
Discussion: As a critical component of male ageing, testicular ageing has attracted broad scientific attention, with ongoing efforts to identify effective strategies to delay or prevent its onset, though therapeutic efficacy remains limited. In this review, we summarise the biological and clinical features of testicular ageing, discuss its underlying molecular and cellular mechanisms, and highlight emerging strategies aimed at mitigating age-related testicular dysfunction, with the goal of advancing understanding and improving therapeutic outcomes.
Conclusions: Testicular ageing is a defining feature of male senescence, marked by progressive structural deterioration and declining steroidogenic and spermatogenic capacity. Although lifestyle, pharmacological, and stem-cell-based interventions show promise, their clinical applicability remains limited. A deeper mechanistic understanding and well-designed, large-scale prospective studies are essential to establish effective strategies for delaying or preventing testicular ageing.
{"title":"Testicular ageing as a central hallmark of male senescence: characteristics, molecular mechanisms and emerging therapeutic strategies.","authors":"Jun Gao, Lixue Wang, Wanjun Li, Wei Liu","doi":"10.1080/07853890.2026.2624183","DOIUrl":"10.1080/07853890.2026.2624183","url":null,"abstract":"<p><strong>Background: </strong>The testis is a male-specific organ that plays a central role in spermatogenesis and androgen secretion. Testicular ageing is a hallmark of male senescence. However, the underlying mechanisms, as well as strategies to prevent, delay, or reverse this process, remain incompletely understood.</p><p><strong>Discussion: </strong>As a critical component of male ageing, testicular ageing has attracted broad scientific attention, with ongoing efforts to identify effective strategies to delay or prevent its onset, though therapeutic efficacy remains limited. In this review, we summarise the biological and clinical features of testicular ageing, discuss its underlying molecular and cellular mechanisms, and highlight emerging strategies aimed at mitigating age-related testicular dysfunction, with the goal of advancing understanding and improving therapeutic outcomes.</p><p><strong>Conclusions: </strong>Testicular ageing is a defining feature of male senescence, marked by progressive structural deterioration and declining steroidogenic and spermatogenic capacity. Although lifestyle, pharmacological, and stem-cell-based interventions show promise, their clinical applicability remains limited. A deeper mechanistic understanding and well-designed, large-scale prospective studies are essential to establish effective strategies for delaying or preventing testicular ageing.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"58 1","pages":"2624183"},"PeriodicalIF":4.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12875105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146115160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-12-01Epub Date: 2026-02-17DOI: 10.1080/07853890.2026.2625545
Qi Yu, Jisong Yan, Jianping Song, Fan Yu, Nanchuan Jiang, Yaya Zhou, Xinliang He, Fengyun Gong, Xiaorong Wang
Background: Tuberculosis infection (TBI) is a significant cause of bronchiectasis (BE). Identifying risk factors for radiological BE (RBE) could enhance the early detection of high-risk individuals following TB infection. This study aimed to develop and validate a novel Inflammation-Nutrition Risk Score (INRS) and a corresponding nomogram model to predict the risk of RBE after TBI.
Patients and methods: We enrolled 2,210 post-TBI patients from two medical centres. Data from 1,825 patients at Wuhan Jinyintan Hospital were used to develop the INRS and the RBE nomogram. An independent cohort of 385 patients from Wuhan Union Hospital served as an external validation set.
Results: The INRS was derived from four parameters: PNI, HALP score, Lg(SII) and CAR. Multivariate analysis identified the following independent risk factors for RBE: age ≥60 years (OR = 1.19, p = 0.030), current smoking (OR = 1.71, p = 0.009), COPD (OR = 3.13, p < 0.001), RDW-CV ≥12.8% (OR = 1.09, p = 0.005), ALB <35.5 g/L (OR = 1.04, p = 0.003) and INRS ≥1.86 (OR = 5.04, p < 0.001). The RBE nomogram model demonstrated strong discriminatory power, accuracy and clinical utility across the development, internal validation and external validation cohorts.
Conclusion: In post-TBI patients, the INRS represents a novel predictive biomarker for RBE. The INRS-based nomogram is a clinically applicable and efficient tool for risk stratification and guiding follow-up management to prevent RBE progression.
背景:结核感染(TBI)是支气管扩张(BE)的重要病因。确定放射性BE (RBE)的危险因素可以提高结核病感染后高危个体的早期发现。本研究旨在开发和验证一种新的炎症-营养风险评分(INRS)和相应的nomogram模型来预测TBI后RBE的风险。患者和方法:我们从两个医疗中心招募了2210名脑外伤后患者。来自武汉金银潭医院1825名患者的数据用于编制INRS和RBE图。来自武汉协和医院的385例独立队列作为外部验证集。结果:INRS由PNI、HALP评分、Lg(SII)和CAR 4个参数得出。多因素分析确定了以下RBE的独立危险因素:年龄≥60岁(OR = 1.19, p = 0.030),吸烟(OR = 1.71, p = 0.009), COPD (OR = 3.13, p = 0.005), ALB p = 0.003)和INRS≥1.86 (OR = 5.04, p)。结论:在脑外伤后患者中,INRS是一种新的RBE预测生物标志物。基于inrs的nomographic是一种临床适用的有效工具,用于风险分层和指导后续管理,以防止RBE进展。
{"title":"A novel inflammation-nutrition risk score (INRS) and its related nomogram model to predict radiological bronchiectasis in patients after tuberculosis infection in Wuhan, China.","authors":"Qi Yu, Jisong Yan, Jianping Song, Fan Yu, Nanchuan Jiang, Yaya Zhou, Xinliang He, Fengyun Gong, Xiaorong Wang","doi":"10.1080/07853890.2026.2625545","DOIUrl":"10.1080/07853890.2026.2625545","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis infection (TBI) is a significant cause of bronchiectasis (BE). Identifying risk factors for radiological BE (RBE) could enhance the early detection of high-risk individuals following TB infection. This study aimed to develop and validate a novel Inflammation-Nutrition Risk Score (INRS) and a corresponding nomogram model to predict the risk of RBE after TBI.</p><p><strong>Patients and methods: </strong>We enrolled 2,210 post-TBI patients from two medical centres. Data from 1,825 patients at Wuhan Jinyintan Hospital were used to develop the INRS and the RBE nomogram. An independent cohort of 385 patients from Wuhan Union Hospital served as an external validation set.</p><p><strong>Results: </strong>The INRS was derived from four parameters: PNI, HALP score, Lg(SII) and CAR. Multivariate analysis identified the following independent risk factors for RBE: age ≥60 years (OR = 1.19, <i>p</i> = 0.030), current smoking (OR = 1.71, <i>p</i> = 0.009), COPD (OR = 3.13, <i>p</i> < 0.001), RDW-CV ≥12.8% (OR = 1.09, <i>p</i> = 0.005), ALB <35.5 g/L (OR = 1.04, <i>p</i> = 0.003) and INRS ≥1.86 (OR = 5.04, <i>p</i> < 0.001). The RBE nomogram model demonstrated strong discriminatory power, accuracy and clinical utility across the development, internal validation and external validation cohorts.</p><p><strong>Conclusion: </strong>In post-TBI patients, the INRS represents a novel predictive biomarker for RBE. The INRS-based nomogram is a clinically applicable and efficient tool for risk stratification and guiding follow-up management to prevent RBE progression.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"58 1","pages":"2625545"},"PeriodicalIF":4.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12918364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146215397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-12-01Epub Date: 2026-02-12DOI: 10.1080/07853890.2026.2625547
Liang Fang, Haolin Zhang, Jia Nie, Yiyong Wei, Huanhuan Ma, Peng Lu, Yu Zhang, Wei Chen, Haiying Wang
Background: While dexamethasone is proven to enhance single-shot erector spinae plane block (ESPB), its role as an adjuvant in continuous ESPB catheters is unclear. This randomised controlled trial evaluated whether adding dexamethasone to ropivacaine improves analgesia after video-assisted thoracoscopic surgery (VATS).
Methods: 85 patients undergoing VATS with continuous ESPB were randomised to receive postoperative infusion of either 0.2% ropivacaine(C-ESPB group) or ropivacaine with 10 mg dexamethasone(D + C-ESPB group). The primary outcome was resting pain visual analog scale (VAS)at 12 h postoperatively, while secondary outcomes included QoR-15 scores, tramadol consumption, time to first analgesic requirement, postoperative adverse events, 3-month incidence of chronic pain, catheter-related complications, pain intensity at other times, and hospital stay.
Results: The D + C-ESPB group had significantly lower resting pain at 12 h [2.56 (1.03) vs 3.24 (1.21), mean difference -0.680, p = 0.006]; and lower coughing pain at 12 h [4.60 (1.48) vs 5.69 (1.35), mean difference 1.086, p < 0.001], with analgesic superiority sustained through 72 h. Quality of Recovery-15 scores were higher at 12 h [124.70 (12.48) vs 117.26 (12.24); mean difference -7.436, p = 0.007] and 48 h [141.60 (5.51) vs 138.98 (6.64); mean difference -2.628, p = 0.050]; Total tramadol consumption over 72 h was markedly reduce [0 (0,100) vs 100 (75,100), z = -3.807, p < 0.001], and hospital stay was shorter [Mean (SD) 6.09 (1.34) d vs 6.93 (1.55)d, p < 0.001]. The intervention did not, however, alter the 3-month incidence of chronic postsurgical pain (31% vs 34%, p = 0.756).
Conclusion: Dexamethasone significantly enhances the analgesic efficacy of continuous ESPB, improving early pain control, recovery quality, and opioid-sparing after VATS, but does not reduce the incidence of chronic persistent surgical pain.
背景:虽然地塞米松已被证实可增强单针直立脊柱平面阻滞(ESPB),但其作为连续ESPB导管辅助剂的作用尚不清楚。这项随机对照试验评估在罗哌卡因中加入地塞米松是否能改善视频胸腔镜手术(VATS)后的镇痛效果。方法:85例持续ESPB的VATS患者随机分组,术后输注0.2%罗哌卡因(C-ESPB组)或罗哌卡因加10 mg地塞米松(D + C-ESPB组)。主要终点是术后12小时静息疼痛视觉模拟评分(VAS),次要终点包括QoR-15评分、曲马多用量、到首次镇痛需要的时间、术后不良事件、3个月慢性疼痛发生率、导管相关并发症、其他时间疼痛强度和住院时间。结果:D + C-ESPB组12 h静息疼痛明显降低[2.56 (1.03)vs 3.24(1.21),平均差异-0.680,p = 0.006];12 h咳嗽疼痛减轻[4.60(1.48)比5.69(1.35),平均差1.086,p = 0.007]和48 h[141.60(5.51)比138.98 (6.64)];平均差-2.628,p = 0.050];72 h曲马多总消耗量显著降低[0 (0,100)vs 100 (75,100), z = -3.807, p p p = 0.756)。结论:地塞米松可显著提高持续ESPB的镇痛效果,改善VATS术后早期疼痛控制、恢复质量和阿片类药物节约,但不能降低慢性持续性手术疼痛的发生率。
{"title":"Dexamethasone as an adjuvant to continuous erector spinae plane block for postoperative analgesia after video-assisted thoracoscopic surgery for pulmonary nodule surgery: a randomized controlled trial.","authors":"Liang Fang, Haolin Zhang, Jia Nie, Yiyong Wei, Huanhuan Ma, Peng Lu, Yu Zhang, Wei Chen, Haiying Wang","doi":"10.1080/07853890.2026.2625547","DOIUrl":"10.1080/07853890.2026.2625547","url":null,"abstract":"<p><strong>Background: </strong>While dexamethasone is proven to enhance single-shot erector spinae plane block (ESPB), its role as an adjuvant in continuous ESPB catheters is unclear. This randomised controlled trial evaluated whether adding dexamethasone to ropivacaine improves analgesia after video-assisted thoracoscopic surgery (VATS).</p><p><strong>Methods: </strong>85 patients undergoing VATS with continuous ESPB were randomised to receive postoperative infusion of either 0.2% ropivacaine(C-ESPB group) or ropivacaine with 10 mg dexamethasone(D + C-ESPB group). The primary outcome was resting pain visual analog scale (VAS)at 12 h postoperatively, while secondary outcomes included QoR-15 scores, tramadol consumption, time to first analgesic requirement, postoperative adverse events, 3-month incidence of chronic pain, catheter-related complications, pain intensity at other times, and hospital stay.</p><p><strong>Results: </strong>The D + C-ESPB group had significantly lower resting pain at 12 h [2.56 (1.03) vs 3.24 (1.21), mean difference -0.680, <i>p</i> = 0.006]; and lower coughing pain at 12 h [4.60 (1.48) vs 5.69 (1.35), mean difference 1.086, <i>p</i> < 0.001], with analgesic superiority sustained through 72 h. Quality of Recovery-15 scores were higher at 12 h [124.70 (12.48) vs 117.26 (12.24); mean difference -7.436, <i>p</i> = 0.007] and 48 h [141.60 (5.51) vs 138.98 (6.64); mean difference -2.628, <i>p</i> = 0.050]; Total tramadol consumption over 72 h was markedly reduce [0 (0,100) vs 100 (75,100), <i>z</i> = -3.807, <i>p</i> < 0.001], and hospital stay was shorter [Mean (SD) 6.09 (1.34) d vs 6.93 (1.55)d, <i>p</i> < 0.001]. The intervention did not, however, alter the 3-month incidence of chronic postsurgical pain (31% vs 34%, <i>p</i> = 0.756).</p><p><strong>Conclusion: </strong>Dexamethasone significantly enhances the analgesic efficacy of continuous ESPB, improving early pain control, recovery quality, and opioid-sparing after VATS, but does not reduce the incidence of chronic persistent surgical pain.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"58 1","pages":"2625547"},"PeriodicalIF":4.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12912211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146183874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-12-01Epub Date: 2026-02-16DOI: 10.1080/07853890.2026.2627063
Zhang Jianjun, Su Peng, Feng Tianhang, Zhu Zexuan, Lei Qian, Xu Guangmin
Background: Many factors can influence the occurrence of postoperative pulmonary complications (PPCs) in the perioperative period, but it is unclear whether chronic high-altitude exposure (CHAE) affects the occurrence of PPCs.
Methods: This retrospective study included 235,128 surgical patients aged 18 years and older from January 2013 to December 2022. The occurrence of PPCs, such as pneumonia, atelectasis, and respiratory failure, was determined based on the admission and discharge diagnoses. To reduce the confounding effects caused by imbalances in demographic and clinical characteristics at baseline, we employed a 1:1 propensity score matching (PSM) to match the CHAE and non chronically high-altitude exposed (NCHAE) patients. Statistical analyses were conducted from January 1, 2025, to March 1, 2025.
Results: A total of 235,128 cases were included, with 11,075 (4.7%) patients experiencing PPCs. There were 8,565 patients with CHAE, of whom 484 (5.7%) developed PPCs. In contrast, there were 226,562 patients NCHAE, with 10,591 (4.7%) experiencing PPCs. After 1:1 PSM, 8,564 CHAE were matched with 8,564 NCHAE. In the CHAE group, 484 (5.7%) experienced PPCs, while 394 (4.6%) in the NCHAE group shoewd a statistically significant difference (p = 0.002). Adjusted multivariable conditional logistic regression analysis indicated that CHAE increased the incidence of PPCs (odds ratio [OR], 1.25; 95% CI, 1.02-1.53). Furthermore, the length of hospitalization and postoperative hospitalization duration of patients in the CHAE group were longer than those in the NCHAE group.
Conclusions: This retrospective study suggests an association between CHAE and PPCs within 30 days after surgery. However, the undefined exposure duration highlight the need for prospective studies to definitively establish causality.
{"title":"Effect of chronic high-altitude exposure on postoperative pulmonary complications: a retrospective cohort study.","authors":"Zhang Jianjun, Su Peng, Feng Tianhang, Zhu Zexuan, Lei Qian, Xu Guangmin","doi":"10.1080/07853890.2026.2627063","DOIUrl":"10.1080/07853890.2026.2627063","url":null,"abstract":"<p><strong>Background: </strong>Many factors can influence the occurrence of postoperative pulmonary complications (PPCs) in the perioperative period, but it is unclear whether chronic high-altitude exposure (CHAE) affects the occurrence of PPCs.</p><p><strong>Methods: </strong>This retrospective study included 235,128 surgical patients aged 18 years and older from January 2013 to December 2022. The occurrence of PPCs, such as pneumonia, atelectasis, and respiratory failure, was determined based on the admission and discharge diagnoses. To reduce the confounding effects caused by imbalances in demographic and clinical characteristics at baseline, we employed a 1:1 propensity score matching (PSM) to match the CHAE and non chronically high-altitude exposed (NCHAE) patients. Statistical analyses were conducted from January 1, 2025, to March 1, 2025.</p><p><strong>Results: </strong>A total of 235,128 cases were included, with 11,075 (4.7%) patients experiencing PPCs. There were 8,565 patients with CHAE, of whom 484 (5.7%) developed PPCs. In contrast, there were 226,562 patients NCHAE, with 10,591 (4.7%) experiencing PPCs. After 1:1 PSM, 8,564 CHAE were matched with 8,564 NCHAE. In the CHAE group, 484 (5.7%) experienced PPCs, while 394 (4.6%) in the NCHAE group shoewd a statistically significant difference (<i>p</i> = 0.002). Adjusted multivariable conditional logistic regression analysis indicated that CHAE increased the incidence of PPCs (odds ratio [OR], 1.25; 95% CI, 1.02-1.53). Furthermore, the length of hospitalization and postoperative hospitalization duration of patients in the CHAE group were longer than those in the NCHAE group.</p><p><strong>Conclusions: </strong>This retrospective study suggests an association between CHAE and PPCs within 30 days after surgery. However, the undefined exposure duration highlight the need for prospective studies to definitively establish causality.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"58 1","pages":"2627063"},"PeriodicalIF":4.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12912214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146208452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-12-01Epub Date: 2026-02-24DOI: 10.1080/07853890.2026.2634447
Jiyeong Kim, Jun Ho Lee, Sung Hwan Hwang, Jung Hye Choi, Young-Woong Won, Joon Young Hur
Background: The treatment strategy for intestinal non-Hodgkin lymphoma (NHL) and the role of surgery warrant reevaluation.
Methods: This study analyzed clinical data from a cohort of 12,047 patients diagnosed with intestinal NHL, extracted from the Korean National Health Insurance System database between 2002 and 2021.
Results: Among these patients, 3,566 (29.6%) were categorized into the surgery group, while 8,481 (70.4%) were included in the nonsurgery group. Surgery was independently associated with both prolonged overall survival (OS) and a favorable prognosis in multivariate analysis (Hazard Ratio [HR] = 0.645, 95% Confidence Interval [CI] = 0.598-0.695, p <.001). The median OS was longer in patients who underwent lymph node dissection during surgery than in patients who did not undergo lymph node dissection (10-year OS with lymph node dissection 63.17% vs. surgery without lymph node dissection 54.78%, p < .001).
Conclusions: To our knowledge, this is the first Korean population-based nationwide study to describe the clinical impact of surgery on the OS of patients with intestinal NHL. A prospective randomized study evaluating strategies to improve the survival of intestinal NHL patients is needed.
背景:肠道非霍奇金淋巴瘤(NHL)的治疗策略和手术的作用值得重新评估。方法:本研究分析了2002年至2021年间从韩国国民健康保险系统数据库中提取的12047例诊断为肠道NHL患者的临床数据。结果:其中手术组3566例(29.6%),非手术组8481例(70.4%)。在多变量分析中,手术与延长总生存期(OS)和良好预后独立相关(风险比[HR] = 0.645, 95%可信区间[CI] = 0.598-0.695, p p)。结论:据我们所知,这是韩国第一个以人群为基础的全国性研究,描述了手术对肠道NHL患者OS的临床影响。需要一项前瞻性随机研究来评估提高肠道NHL患者生存率的策略。
{"title":"The surgery for the patients with intestinal non‑Hodgkin lymphomas: a nationwide study.","authors":"Jiyeong Kim, Jun Ho Lee, Sung Hwan Hwang, Jung Hye Choi, Young-Woong Won, Joon Young Hur","doi":"10.1080/07853890.2026.2634447","DOIUrl":"10.1080/07853890.2026.2634447","url":null,"abstract":"<p><strong>Background: </strong>The treatment strategy for intestinal non-Hodgkin lymphoma (NHL) and the role of surgery warrant reevaluation.</p><p><strong>Methods: </strong>This study analyzed clinical data from a cohort of 12,047 patients diagnosed with intestinal NHL, extracted from the Korean National Health Insurance System database between 2002 and 2021.</p><p><strong>Results: </strong>Among these patients, 3,566 (29.6%) were categorized into the surgery group, while 8,481 (70.4%) were included in the nonsurgery group. Surgery was independently associated with both prolonged overall survival (OS) and a favorable prognosis in multivariate analysis (Hazard Ratio [HR] = 0.645, 95% Confidence Interval [CI] = 0.598-0.695, <i>p</i> <.001). The median OS was longer in patients who underwent lymph node dissection during surgery than in patients who did not undergo lymph node dissection (10-year OS with lymph node dissection 63.17% vs. surgery without lymph node dissection 54.78%, <i>p</i> < .001).</p><p><strong>Conclusions: </strong>To our knowledge, this is the first Korean population-based nationwide study to describe the clinical impact of surgery on the OS of patients with intestinal NHL. A prospective randomized study evaluating strategies to improve the survival of intestinal NHL patients is needed.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"58 1","pages":"2634447"},"PeriodicalIF":4.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12934337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147277644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: There remains a lack of epidemiological data and evidence regarding risk factors for intracranial arterial dissection (IAD) worldwide, making it difficult to make a more timely and accurate clinical diagnosis. We aimed to identify risk factors, clinical and imaging features of spontaneous IAD (sIAD) using a case-control design.
Methods: We collected data on sIAD patients admitted to Tongji Hospital in Wuhan, China from June 2017 to June 2024. Non-IAD ischemic stroke (IS) and non-IAD intracerebral hemorrhage (ICH) patients served as control groups. Logistic regression models analyzed the three data sets, with results expressed as odds ratio (OR) and 95% confidence interval (CI).
Results: After screening, 71 patients with sIAD, 84 patients with non-IAD IS and 102 patients with non-IAD ICH were included in this study. The findings showed that the participants with diabetes had a lower likelihood of sIAD than non-IAD IS (OR = 0.145, 95%CI = 0.030-0.702). Compared with non-IAD ICH patients, individuals with sIAD had lower systolic blood pressure on admission (OR = 0.941, 95%CI = 0.900-0.983) and less likely to be young (OR = 0.911, 95%CI = 0.855-0.970). Serological data showed that compared with non-IAD ICH patients, elevated triglyceride (OR = 0.326, 95%CI = 0.179-0.594) were associated with the reduced likelihood of sIAD, whereas the opposite was true for uric acid levels (OR = 1.007, 95%CI = 1.000-1.014). In imaging, sIAD patients showed the largest number of arterial lumen dilatation, followed by stenosis with dilatation.
Conclusions: Diabetes may be associated with a reduced likelihood of sIAD. Differences in serologic markers may help in the differential diagnosis of sIAD from other cerebrovascular events.
{"title":"Spontaneous intracranial artery dissection: risk factors, clinical features and imaging features.","authors":"Yidi Wang, Qingqing Jiang, Xiang Chen, Qiming Liang, Shiyi Cao, Furong Wang","doi":"10.1080/07853890.2026.2634573","DOIUrl":"10.1080/07853890.2026.2634573","url":null,"abstract":"<p><strong>Purpose: </strong>There remains a lack of epidemiological data and evidence regarding risk factors for intracranial arterial dissection (IAD) worldwide, making it difficult to make a more timely and accurate clinical diagnosis. We aimed to identify risk factors, clinical and imaging features of spontaneous IAD (sIAD) using a case-control design.</p><p><strong>Methods: </strong>We collected data on sIAD patients admitted to Tongji Hospital in Wuhan, China from June 2017 to June 2024. Non-IAD ischemic stroke (IS) and non-IAD intracerebral hemorrhage (ICH) patients served as control groups. Logistic regression models analyzed the three data sets, with results expressed as odds ratio (OR) and 95% confidence interval (CI).</p><p><strong>Results: </strong>After screening, 71 patients with sIAD, 84 patients with non-IAD IS and 102 patients with non-IAD ICH were included in this study. The findings showed that the participants with diabetes had a lower likelihood of sIAD than non-IAD IS (OR = 0.145, 95%CI = 0.030-0.702). Compared with non-IAD ICH patients, individuals with sIAD had lower systolic blood pressure on admission (OR = 0.941, 95%CI = 0.900-0.983) and less likely to be young (OR = 0.911, 95%CI = 0.855-0.970). Serological data showed that compared with non-IAD ICH patients, elevated triglyceride (OR = 0.326, 95%CI = 0.179-0.594) were associated with the reduced likelihood of sIAD, whereas the opposite was true for uric acid levels (OR = 1.007, 95%CI = 1.000-1.014). In imaging, sIAD patients showed the largest number of arterial lumen dilatation, followed by stenosis with dilatation.</p><p><strong>Conclusions: </strong>Diabetes may be associated with a reduced likelihood of sIAD. Differences in serologic markers may help in the differential diagnosis of sIAD from other cerebrovascular events.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"58 1","pages":"2634573"},"PeriodicalIF":4.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12934335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147286547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-12-01Epub Date: 2026-02-17DOI: 10.1080/07853890.2026.2624175
Fangda Fu, Yuying Chen, Huan Luo, Hongfeng Ruan
Background: Micro/nanoplastics (MNP) have emerged as ubiquitous environmental contaminants with demonstrated bioaccumulation potential in organisms through multiple exposure pathways, posing substantial health risks globally. While mounting evidence indicates that MNP exposure adversely affects various organ systems including the nervous, reproductive, and digestive systems, the specific mechanisms underlying MNP-induced thyrotoxicity remain enigmatic.
Methods: 4-week-old male C57BL/6 mice were administered microplastics (MP, 5 μm) or nanoplastics (NP, 50 nm) via intragastric gavage at 30 mg/kg for 4 and 8 weeks. The thyroid architecture and endocrine function were evaluated by histological staining and thyroid hormones ELISA kit. The expression of apoptosis indicators (BCL2, BAX, CASPASE3), inflammatory factors (IL-1β, IL-18, TNF-α) and pyroptosis related-proteins (NLRP3, CASPASE1 and GSDMD), as well as the activity of NF-κB signaling were determined by immunofluorescence.
Results: We found that MNP exposure induces significant thyrotoxicity characterized by disrupted thyroid follicular architecture, comprised endocrine function, heightened apoptosis, and excessive inflammatory cytokines production, with NP exhibiting a more pronounced effect than MP. Mechanistically, MNP exposure stimulated thyroid follicular cell pyroptosis by upregulation of key pyroptotic mediators including NLRP3, CASPASE1, and GSDMD, driven by NF-κB signaling pathway activation.
Conclusion: Collectively, these findings provide novel mechanistic insights into MNP-induced thyroid toxicity and highlight the critical role of follicular cell pyroptosis, contributing to our understanding of the adverse health consequences associated with environmental plastic pollution.
{"title":"Micro/nanoplastics induce thyroid follicular cell pyroptosis to trigger thyrotoxicity by activating NF-κB signaling.","authors":"Fangda Fu, Yuying Chen, Huan Luo, Hongfeng Ruan","doi":"10.1080/07853890.2026.2624175","DOIUrl":"10.1080/07853890.2026.2624175","url":null,"abstract":"<p><strong>Background: </strong>Micro/nanoplastics (MNP) have emerged as ubiquitous environmental contaminants with demonstrated bioaccumulation potential in organisms through multiple exposure pathways, posing substantial health risks globally. While mounting evidence indicates that MNP exposure adversely affects various organ systems including the nervous, reproductive, and digestive systems, the specific mechanisms underlying MNP-induced thyrotoxicity remain enigmatic.</p><p><strong>Methods: </strong>4-week-old male C57BL/6 mice were administered microplastics (MP, 5 μm) or nanoplastics (NP, 50 nm) <i>via</i> intragastric gavage at 30 mg/kg for 4 and 8 weeks. The thyroid architecture and endocrine function were evaluated by histological staining and thyroid hormones ELISA kit. The expression of apoptosis indicators (BCL2, BAX, CASPASE3), inflammatory factors (IL-1β, IL-18, TNF-α) and pyroptosis related-proteins (NLRP3, CASPASE1 and GSDMD), as well as the activity of NF-κB signaling were determined by immunofluorescence.</p><p><strong>Results: </strong>We found that MNP exposure induces significant thyrotoxicity characterized by disrupted thyroid follicular architecture, comprised endocrine function, heightened apoptosis, and excessive inflammatory cytokines production, with NP exhibiting a more pronounced effect than MP. Mechanistically, MNP exposure stimulated thyroid follicular cell pyroptosis by upregulation of key pyroptotic mediators including NLRP3, CASPASE1, and GSDMD, driven by NF-κB signaling pathway activation.</p><p><strong>Conclusion: </strong>Collectively, these findings provide novel mechanistic insights into MNP-induced thyroid toxicity and highlight the critical role of follicular cell pyroptosis, contributing to our understanding of the adverse health consequences associated with environmental plastic pollution.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"58 1","pages":"2624175"},"PeriodicalIF":4.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12915396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146208414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}