European Journal of Medical Research最新文献

{"title":"Association between the Zhejiang University index and chronic diarrhea: a cross-sectional study.","authors":"Dongzhi Hong, Bin Xi, Nannan Li, Xiaoxiao Shao, Beilei Fu, Xinyu He, Tingting Yan, Chenxing Wang, Hao Wu","doi":"10.1186/s40001-025-03287-8","DOIUrl":"10.1186/s40001-025-03287-8","url":null,"abstract":"<p><strong>Background: </strong>Chronic diarrhea is a widespread digestive symptom with unclear etiology. The association between metabolic disorders and chronic diarrhea remains unclear. This study aimed to investigate the association between the Zhejiang University (ZJU) index, a recently developed metabolic index that provides a more comprehensive assessment of metabolic disorders, and chronic diarrhea.</p><p><strong>Methods: </strong>The study included 6,224 participants who completed the chronic diarrhea questionnaire in the 2005-2010 cycles of the National Health and Nutrition Examination Survey. The ZJU index was sex-specific and was calculated based on fasting plasma glucose, triglycerides, body mass index, alanine aminotransferase, and aspartate transaminase. Chronic diarrhea was assessed based on the Bristol Stool Form Scale. We used multivariable weighted logistic regression to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for the association between the ZJU index and chronic diarrhea. Non-linear associations were evaluated using restricted cubic splines. Moreover, subgroup and sensitivity analyses were performed to evaluate the robustness of the findings.</p><p><strong>Results: </strong>The prevalence of chronic diarrhea was 6.72% (95% CI: 5.93%; 7.50%). Each 10-unit increase in the ZJU index was associated with higher odds of chronic diarrhea (OR: 1.37, 95% CI: 1.20; 1.55, P < 0.001). Participants in the highest quartile of the ZJU index had higher odds of chronic diarrhea than those in the lowest quartile of the ZJU index (OR: 2.02, 95% CI: 1.37; 2.96, P = 0.002). Subgroup analysis revealed a higher odds of chronic diarrhea among non-Hispanic whites.</p><p><strong>Conclusions: </strong>Higher ZJU index is associated with increased odds of chronic diarrhea, underscoring the importance of maintaining normal blood glucose, lipid levels, and body mass index to reduce the risk.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"997"},"PeriodicalIF":3.4,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12538803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145344431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of semilunar ganglion radiofrequency thermal coagulation in moderate and severe trigeminal postherpetic neuralgia and its impact on serum IL-1β and IL-6 levels.","authors":"Cong Wu, Yi Lv, Conghuan Wang, Changyang Zhong","doi":"10.1186/s40001-025-03257-0","DOIUrl":"10.1186/s40001-025-03257-0","url":null,"abstract":"<p><strong>Background: </strong>Trigeminal postherpetic neuralgia (TPHN) represents a severe neuropathic pain syndrome with challenging therapeutic management. While radiofrequency thermocoagulation (RF-TC), a minimally invasive neuromodulation technique, has demonstrated favorable outcomes in treating thoracoabdominal and lumbosacral PHN, its clinical application in trigeminal nerve distributions remains underexplored.</p><p><strong>Objective: </strong>To evaluate gasserian ganglion RF-TC efficacy in moderate-to-severe TPHN and its effects on serum IL-1β and IL-6 levels.</p><p><strong>Methods: </strong>This study enrolled 120 eligible patients diagnosed with TPHN at the Department of Cerebrovascular Diseases, Hangzhou Third People's Hospital, between January 2024 and December 2024. Patients were stratified into moderate (n = 60) and severe (n = 60) pain cohorts based on baseline pain severity. Severe PHN patients were randomly assigned to either the RF-TC group (Group A, n = 30) or the  control group (Group B, n = 30), while moderate PHN patients were randomized to the RF-TC group (Group C, n = 30) or the control group (Group D, n = 30). All RF-TC procedures were performed via a foramen ovale approach under digital subtraction angiography (DSA) guidance. Visual Analogue Scale (VAS) scores and serum cytokine levels (IL-1β, IL-6) were quantified pre-treatment and at 1-/4-week post-intervention using standardized ELISA protocols.</p><p><strong>Results: </strong>RF-TC groups (A/C) demonstrated significantly lower VAS scores and reduced serum IL-1β/IL-6 concentrations compared to controls (B/D) at both follow-ups (all p < 0.01), with enhanced therapeutic magnitude observed in severe cases. These findings indicate RF-TC's dual mechanism of pain alleviation and systemic anti-inflammatory modulation.</p><p><strong>Conclusion: </strong>Gasserian ganglion RF-TC is a safe, effective TPHN treatment, achieving significant pain reduction and proinflammatory cytokine suppression.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"1005"},"PeriodicalIF":3.4,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12542188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145343864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of a diagnostic prediction model for acute liver injury in sepsis based on serum ferritin level.","authors":"Yuxia Tao, Jianhao Wang, Jiyi Dong, Jinshuai Lu","doi":"10.1186/s40001-025-03242-7","DOIUrl":"10.1186/s40001-025-03242-7","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and objective: &lt;/strong&gt;The early diagnosis and treatment of acute liver injury in sepsis are crucial determinants of the prognosis for patients with sepsis. The study aimed to investigate the early predictive value of serum ferritin level for acute liver injury in sepsis, to construct and validate a predictive model for acute liver injury in patients with sepsis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;The training group data were selected from the Medical Information Mart for Intensive Care (MIMIC)-IV database. Least absolute shrinkage and selection operator (LASSO) regression, Boruta algorithm, univariate and multivariate logistic regression analyses were used to identify relevant independent risk factors, and these factors were incorporated into the predictive model. A sensitivity analysis was performed to validate the result. We constructed a nomogram prediction model based on ferritin level and evaluated its performance using the Receiver operating characteristic (ROC) curve, the area under the curve (AUC), calibration, and decision curve analysis (DCA). Collected patients in the intensive care unit (ICU) of the Xinjiang Uygur Autonomous Region People's Hospital who met the sepsis-3 diagnostic criteria as clinical validation group data, and clinical data were applied to the prediction model to validate its predictive performance.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;This study included 1109 sepsis patients from the MIMIC database and 122 sepsis patients from the Xinjiang Uygur Autonomous Region People's Hospital. Based on the outcome of total bilirubin (TBIL) and/or alanine aminotransferase (ALT) after ICU admission, patients were divided into two groups: the sepsis-associated liver injury (SALI) group and the non-sepsis-associated acute liver injury (non-SALI) group. Analysis of the two groups' data revealed the following: the Lasso regression and Boruta algorithm results for the SALI group and the non-SALI group intersected to identify 12 differential factors; after propensity score matching (PSM), ferritin level remained statistically different between the two groups. Logistic regression analysis showed that machine ventilation, continuous renal replacement therapy (CRRT), vasoactive agent, alkaline phosphatase (ALP), international normalized ratio (INR), and ferritin level were independent risk factors for secondary acute liver injury (P &lt; 0.05); ROC curve analysis showed that the AUC of the prediction models in the training and clinical validation groups were 0.765 and 0.773 respectively, with no statistically significant difference; Calibration curves were tightly aligned to the ideal line, indicating good agreement between predicted and actual outcomes; decision curve analysis provided evidence that the prediction model has high clinical utility with significant net benefit.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Higher serum ferritin level is an independent risk factor for acute liver injury in patients with sepsis. Based on the","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"998"},"PeriodicalIF":3.4,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12538882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145343870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation of lung ultrasound score with postoperative pulmonary complications in older adults undergoing thoracoscopic lobectomy: a prospective observational study.","authors":"Dongsheng Wang, Yang Zhang, Shasha Wang, Yanan Xue, Xiaoyi Hu, Jiaojiao Gao, Ru Yu, Qin Zhuang, Erdeng Cheng, Xiaohong Li","doi":"10.1186/s40001-025-03271-2","DOIUrl":"10.1186/s40001-025-03271-2","url":null,"abstract":"<p><strong>Background: </strong>It is unclear whether postoperative pulmonary complications (PPC) can be early predicted by lung ultrasound (LUS) score in older adults undergoing thoracoscopic lobectomy. This study aimed to evaluate the validity of lung ultrasound application.</p><p><strong>Methods: </strong>Two physicians performed lung ultrasonography on patients preoperatively, 30 min postoperatively and 72 h postoperatively to obtain LUS score. Pulmonary complications occurred within 10 days postoperatively were recorded. The correlation between lung ultrasound results and PPC was analyzed using logistic regression model. ROC curve were applied to assess the prediction accuracy.</p><p><strong>Results: </strong>PPC occurred in 115 of 292 patients (39.38%) in this study. Independent risk factors for PPC included higher age (OR 1.16, 95% CI 1.04-1.29, p = 0.007), COPD comorbidity (OR 5.03, 95% CI 1.29-19.59, p = 0.020), lower preoperative hemoglobin level (OR 0.96, 95% CI 0.93-1.00, p = 0.043), and higher postoperative 30 min LUS score (OR 1.32, 95% CI 1.22-1.43, p < 0.001). Postoperative 30 min lung ultrasound score (AUC: 0.811, cut-off: 14) shown in the ROC curve analysis was effective in predicting postoperative outcomes.</p><p><strong>Conclusions: </strong>Postoperative 30 min lung ultrasound score is a risk factor for PPC in older adults undergoing thoracoscopic lobectomy in this study. The value of lung ultrasound as a predictive tool for PPC is warranted.</p><p><strong>Trial registry: </strong>This study was registered in China Clinical Trial Registry (ChiCTR2100053449).</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"999"},"PeriodicalIF":3.4,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12539048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145344402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lumbar plexus combined with sacral plexus nerve block anesthesia in elderly patients undergoing hip surgery.","authors":"Zhongping Cao","doi":"10.1186/s40001-025-02917-5","DOIUrl":"10.1186/s40001-025-02917-5","url":null,"abstract":"<p><p>Fractures of hip-related areas are common orthopedic conditions among elderly individuals. Prolonged bed rest can easily lead to life-threatening pulmonary infections, pressure ulcers, lower limb thrombosis, and embolism complications. The most common treatment is hip joint surgery. However, the selection of anesthesia methods for hip surgery in elderly individuals is difficult, these patients often present with multiple comorbidities, including cardiovascular and cerebrovascular diseases. General anesthesia and neuraxial anesthesia often lead to hemodynamic fluctuations and hypotension, increasing the risk of cardiovascular and cerebrovascular diseases. With the advancement of ultrasound visualization technology in anesthesia, lumbar plexus combined with sacral plexus nerve block maintains stable intraoperative hemodynamics and is a good choice for hip joint surgery in elderly patients with various diseases. However, there are significant differences in the clinical application of this method.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"995"},"PeriodicalIF":3.4,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12538745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145336716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy and reliability of 3D cephalometric landmark detection with deep learning.","authors":"Boyan Liu, Chang Liu, Yutao Xiong, Hailin Zhu, Wei Zeng, Jinglong Chen, Jixiang Guo, Wei Liu, Wei Tang","doi":"10.1186/s40001-025-03198-8","DOIUrl":"10.1186/s40001-025-03198-8","url":null,"abstract":"<p><strong>Background: </strong>Three-dimensional (3D) landmark detection is essential for assessing craniofacial growth and planning surgeries, such as orthodontic, orthognathic, traumatic, and plastic procedures. This study aimed to develop an automatic 3D landmarking model for oral and maxillofacial regions and to validate its accuracy, robustness and generalizability in both spiral computed tomography (SCT, 41 landmarks) and cone-beam computed tomography (CBCT, 14 landmarks) scans.</p><p><strong>Methods: </strong>The model was implemented using an optimized lightweight 3D U-Net network architecture. Its accuracy, robustness and generalizability were thoroughly evaluated and validated through a multicenter retrospective diagnostic study. The model was trained and tested on a data set of 480 SCT and 240 CBCT cases. An additional inference on a different data set of 320 SCT and 150 CBCT cases was performed. Mean radial error (MRE) and success detection rate within 2-, 3-, and 4-mm error thresholds were measured as the primary evaluation metrics. Error analyses for landmark detection along each coordinate axis were performed. Consistency tests among observers were conducted.</p><p><strong>Results: </strong>The average MRE for both SCT and CBCT was consistently below 1.3 mm and, notably, below 1.4 mm in complex conditions, such as malocclusion, missing dental landmarks, and the presence of metal artifacts. No significant differences in MRE and SDR at 2-4 mm were observed between external and internal SCT and CBCT sets. SCT bone landmarks were more precise than dental ones, with no difference between bone/soft tissue and dental/soft tissue. CBCT dental landmarks exhibited greater precision compared to bone landmarks. A detailed error analysis across the coordinate axes showed that the coronal axis had the highest error rates. The implementation of this model significantly improved the landmarking proficiency of senior and junior specialists by 15.9% and 28.9%, respectively, while also achieving a 6-9.5-fold acceleration in GUI interaction time.</p><p><strong>Conclusions: </strong>This study shows that the AI-driven model delivers high-precision 3D localization of oral and maxillofacial landmarks, even in complex scenarios. The model demonstrates potential as a promising computer-aided tool to assist specialists in conducting accurate and efficient localization analyses; however, its robustness and generalizability require prospective clinical validation to ensure utility across varied experience levels.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"1000"},"PeriodicalIF":3.4,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12539169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145344356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanism of DKK3 protecting brain tissues in ischemic stroke by regulating LGI1 expression and activity.","authors":"DongLiang Zhou, Lei Miao, LinJuan Feng, HongWei Qin, Ying Xu, JianMin Wang","doi":"10.1186/s40001-025-03260-5","DOIUrl":"10.1186/s40001-025-03260-5","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the mechanism of Dickkopf-3 (DKK3) in protecting brain tissues in ischemic stroke (IS) by regulating LGI1 expression and activity.</p><p><strong>Methods: </strong>220 patients with acute ischemic stroke (AIS) were enrolled to measure the serum DKK3 levels and analyze the predictive ability of serum DKK3 for early neurological deterioration (END) in AIS patients. A murine model of permanent middle cerebral artery occlusion (pMCAO) was established. Neurological function recovery in mice was assessed using neurological function scores and behavioral experiments, and the volume of cerebral infarction in mice was measured. The histopathological morphology of the cortex in mice was observed by hematoxylin‒eosin staining; apoptotic neurons were evaluated by terminal deoxynucleotidyl transferase dUTP nick end labeling staining. DKK3 and leucine-rich glioma-inactivated protein 1 (LGI1) expression levels were measured by immunofluorescence, RT-qPCR, or Western blot, and their interaction was verified by bioinformatics analysis and Co-IP. A cellular model of oxygen-glucose deprivation (OGD) injury was established using HT22 murine neurons for in vitro investigation.</p><p><strong>Results: </strong>DKK3 was downregulated in IS and shows potential as a biomarker for predicting END in AIS patients. DKK3 overexpression contributed to neurological recovery and attenuated brain injury in pMCAO mice. DKK3 co-localized and interacted with LGI1. LGI1 downregulation weakened the protective effect of DKK3 against pMCAO-induced brain damage and OGD-induced neuronal injury.</p><p><strong>Conclusion: </strong>DKK3 protects against ischemic injury in permanent cerebral ischemia by regulating LGI1 expression and activity.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"996"},"PeriodicalIF":3.4,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12538828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145344290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammatory biomarkers in alcohol use disorder: neutrophil/lymphocyte and monocyte/HDL-C ratios as potential diagnostic indicators.","authors":"Omer Acat, Okan Imre","doi":"10.1186/s40001-025-03262-3","DOIUrl":"10.1186/s40001-025-03262-3","url":null,"abstract":"<p><strong>Background: </strong>Alcohol use disorder (AUD) constitutes a major global public health concern due to its widespread biological, psychological, and social consequences. Although several biochemical markers-such as gamma-glutamyl transferase (GGT), carbohydrate-deficient transferrin (CDT), and mean corpuscular volume (MCV)-have been proposed for AUD diagnosis, their limited specificity can lead to diagnostic inaccuracies. This study investigates the relationship between AUD and novel inflammatory markers, including the monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), neutrophil-to-HDL cholesterol ratio (NHR), and monocyte-to-HDL cholesterol ratio (MHR).</p><p><strong>Methods: </strong>This cross-sectional case-control study included 84 patients with clinically diagnosed AUD and 50 healthy controls (HC). The AUD group was subdivided into two categories: those with elevated liver enzyme levels (E-AUD) and those with normal liver function (NE-AUD). All participants underwent complete blood count and HDL-C measurement. Based on these values, NLR, MLR, NHR, and MHR were calculated. Statistical analysis was performed using one-way ANOVA and Kruskal-Wallis tests with SPSS version 25.0.</p><p><strong>Results: </strong>No significant differences were observed in neutrophil, monocyte, HDL-C, NLR, MHR, and NHR levels among the three groups (p > 0.05). However, HDL-C and NLR levels were significantly higher in the E-AUD group compared to controls. In the NE-AUD group, neutrophil, monocyte, and MHR levels were significantly elevated, despite normal liver enzyme profiles. These findings indicate early inflammatory activation in AUD patients without biochemical evidence of liver dysfunction.</p><p><strong>Conclusions: </strong>Neutrophil, monocyte, HDL-C, NLR, and MHR levels differ between individuals with AUD and healthy subjects. The elevated inflammatory markers in the NE-AUD group suggest their potential utility in early AUD detection. In contrast, increased HDL-C and NLR in the E-AUD group may reflect advanced disease. Further prospective studies are needed to validate these findings.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"1004"},"PeriodicalIF":3.4,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12541945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145344283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuromotor rehabilitation in Parkinsonian syndromes: outcomes and disability after hip fracture.","authors":"Pietro Giuseppe Scamarcia, Ferdinando Ambrosi, Alessandra Demontis, Emanuela Monica Huci, Sabrina Perego, Luca Sanavia, Laura Vulpio, Gianluca Concardi","doi":"10.1186/s40001-025-03294-9","DOIUrl":"10.1186/s40001-025-03294-9","url":null,"abstract":"<p><strong>Background: </strong>Patients with Parkinsonian syndromes, including Parkinson's disease (PD) and atypical parkinsonism (AP), are at increased risk of disability following hip fracture. Limited data are available on their functional recovery after inpatient rehabilitation. This study aimed to compare rehabilitation outcomes in patients with parkinsonism versus non-parkinsonian controls after hip fracture surgery and to identify clinical predictors of worse recovery within the parkinsonian group.</p><p><strong>Methods: </strong>A retrospective study was conducted on 60 patients with parkinsonism (45 PD, 15 AP) and 60 age- and sex-matched non-parkinsonian controls undergoing inpatient rehabilitation after hip fracture surgery. Functional status was assessed at admission and discharge using the Modified Barthel Index (MBI) and modified Rankin Scale (mRS). Linear mixed-effects models were applied to explore associations between clinical variables (including diagnosis, dementia, dysphagia, postural instability) and outcomes.</p><p><strong>Results: </strong>Patients with parkinsonism had significantly lower functional scores at both admission and discharge as compared to controls (p < 0.001), with AP patients performing worse than PD patients (p = 0.02). Among parkinsonian individuals, dementia, dysphagia, and postural instability were independently associated with worse outcomes (p < 0.001). Although MBI change scores (delta-MBI) did not differ significantly between groups, mRS change (delta-mRS) was greater in controls, suggesting that parkinsonian patients experienced a higher overall disability burden at both admission and discharge, despite a smaller relative improvement. These findings indicate that non-motor symptoms substantially influence rehabilitation trajectories and should be considered in planning care.</p><p><strong>Conclusions: </strong>Parkinsonian patients, particularly those with atypical parkinsonism, experience worse functional outcomes after hip fracture rehabilitation when compared with non-parkinsonian individuals. The presence of dementia, dysphagia, and postural instability further impairs recovery.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"1002"},"PeriodicalIF":3.4,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12538860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145344261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of platelet-rich plasma injections for the treatment of knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials.","authors":"Chengjing Wang, Bowen Yao","doi":"10.1186/s40001-025-03253-4","DOIUrl":"10.1186/s40001-025-03253-4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Knee osteoarthritis (KOA) is a prevalent degenerative joint disorder affecting a significant portion of the elderly population. Despite the availability of various non-surgical and pharmacological treatments, their effectiveness is often limited by temporary symptom relief and lack of disease-modifying properties. Platelet-rich plasma (PRP) has emerged as a promising biological therapy for KOA, with preclinical evidence suggesting its potential to promote cartilage repair and modulate inflammation. This systematic review and meta-analysis aims to comprehensively evaluate the efficacy and safety of PRP injections in the treatment of KOA.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A systematic literature search was conducted from January 1, 2021, to December 31, 2024, encompassing major medical databases, clinical trial registries, and grey literature sources. Randomized controlled trials (RCTs) comparing PRP with other treatments for KOA were included based on predefined eligibility criteria. Data extraction and analysis were performed using various statistical software packages and machine learning models. A neural network model was constructed to predict PRP treatment outcomes by integrating multidimensional clinical features. Study quality was assessed using the Cochrane Risk of Bias Tool, and publication bias was evaluated through funnel plot analysis and Egger's test.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The meta-analysis included 28 RCTs with a total of 3246 KOA patients. PRP demonstrated comparable pain relief to hyaluronic acid (HA) but superior functional improvement, especially when combined with HA. Compared to corticosteroids, PRP showed no significant difference in efficacy as monotherapy but enhanced outcomes when used in combination. PRP also outperformed physical therapy and exercise therapy in both pain control and functional improvement. The optimal PRP concentration range was identified as 600-900 × 10⁹/L, with 3-5 injections at 7-14-day intervals yielding the best results. Early intervention, particularly in KL grade I-II patients, was associated with superior outcomes. The neural network model accurately predicted treatment responses based on patient characteristics and disease factors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;The findings of this study have important implications for understanding the individualized regulatory mechanisms of PRP therapy. The nonlinear relationship between PRP concentration and treatment efficacy reflects the complex cytokine network dynamics and receptor saturation effects. The superiority of the 3-5 injection regimen may be attributed to its alignment with the time window of chondrocyte gene expression regulation, potentially mediated by epigenetic mechanisms. The synergistic effects of PRP with HA and the time-dependent treatment response patterns provide new insights for developing personalized, multi-target treatment strategies. The deep learning model demonstrated the potentia","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"992"},"PeriodicalIF":3.4,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12535052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}