European Journal of Medical Research最新文献

{"title":"The LINC01094 drives atherosclerosis endothelial injury and inflammation via the miR-218-5p/SP1 axis and servers as a clinical biomarker.","authors":"Shuxia Yao, Wenqi Yang","doi":"10.1186/s40001-026-04060-1","DOIUrl":"https://doi.org/10.1186/s40001-026-04060-1","url":null,"abstract":"<p><strong>Background: </strong>Atherosclerosis (AS) stems from endothelial injury and inflammation. This study clarified LINC01094's clinical implication and its role in endothelial damage and inflammation.</p><p><strong>Methods: </strong>GEO databases screened differential lncRNAs in tissue samples from ruptured, unstable, and advanced human carotid atherosclerotic plaques. 118 patients with AS and 100 controls was enrolled, with oxidized low-density lipoprotein (ox-LDL)-stimulated Human aortic endothelial cells (HAECs) were used. Real-time quantitative reverse transcription PCR detected LINC01094 levels in serum and HAECs. Receiver operating characteristic curve analysis LINC01094's predictive value for AS, and logistic regression identified AS risk factors. CCK-8 and flow cytometry assessed cell viability and apoptosis. Commercial kits and Enzyme-linked immunosorbent assay were used to quantify LDH adhesion molecules, chemokines, and inflammatory factors. DLR and RIP assays assessed miR-218-5p's binding to LINC01094 or SP1.</p><p><strong>Results: </strong>LINC01094 was upregulated in the GSE28829, GSE120521, and GSE21545 datasets, with notably higher expression observed in AS patients' serum and ox-LDL-stimulated HAECs. It predicted AS occurrence with 81.36% sensitivity and 90.00% specificity, and was identified as a risk factor (OR: 8.401, 95%CI 4.175-16.907). Silencing LINC01094 countered ox-LDL-induced suppression of HAECs viability, elevation of apoptosis, LDH levels, adhesion molecules, chemokines, and inflammation. However, low miR-218-5p expression partially mitigated these effects. Overexpression of SP1 hindered the ability of miR-218-5p to alleviate ox-LDL-triggered endothelial damage and inflammation. Notably, LINC01094 positively modulated SP1 expression by sponging miR-218-5p.</p><p><strong>Conclusions: </strong>LINC01094 is a promising biomarker for predicting AS. Moreover, silencing LINC01094 may decelerate AS progression via regulating the miR-218-5p/SP1 axis, thus alleviating endothelial injury and inflammation.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147372307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimodal brain tumor segmentation and classification based on optimized DeepLabV3 + and fused fire module with self-attention.","authors":"Muhammad Sami Ullah, Muhammad Attique Khan, Yunyoung Nam, Nouf Abdullah Almujally, Areej Alasiry, Mehrez Marzougui, Juan M Gorriz, Amir Hussain","doi":"10.1186/s40001-026-04161-x","DOIUrl":"https://doi.org/10.1186/s40001-026-04161-x","url":null,"abstract":"<p><p>In this work, we propose a novel deep learning architecture for brain tumor segmentation and classification, SMDeepNet, which is based on an optimized DeepLabV3 +  + and a Fused Fire Module with Self-Attention. The segmentation framework comprises down- and up-sampling based on a DeepLabV3 + neural network and is optimized by dynamically initializing hyperparameters for training the backbone ResNet-50 architecture. During the down-sampling or encoder stage, the Atrous Spatial Pyramid Pooling (ASPP) module extracted features using convolutional layers with various filter sizes and dilations. These features are then passed to the up-sampling or decoder section for final segmentation. The classification framework comprises two sub-frameworks: a fire-residual bottleneck (Fire-RB) and a Hybrid Efficient Attention (Hybrid-EA). The Fire-RB framework comprises several parallel blocks: one side implements squeeze-and-expand behavior in the fire mechanism, and the other implements residual bottlenecks. The two parallel blocks are concatenated, and features are extracted from Fire-RB. The Hybrid-EA model is a custom variant of the pre-trained EfficientNetB0 model that incorporates a self-attention mechanism. The self-attention mechanism enhanced the functionality of the EfficientNetB0 model. Features from Fire-RB and Hybrid-EA are concatenated channel-wise, and the final modality classification is performed. The BraTS 2023 dataset is used in this work to evaluate the proposed methodologies. Segmentation results indicate that accuracy, Dice Score, and Intersection over Union (IOU) are 0.9871, 0.9420, and 0.8951, respectively. Modality classification results indicate an accuracy of 0.9920, which is improved over the recent state-of-the-art techniques.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147369335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrative multi-omics and machine learning identify mitochondrial biomarkers for pathogen-specific sepsis stratification and translational prioritization.","authors":"Chaoyuan Jin, Ruijinlin Hao, Bate Gonggaoang, Qingxia Dai, Xingxing Ren, Jie Shen","doi":"10.1186/s40001-026-04065-w","DOIUrl":"https://doi.org/10.1186/s40001-026-04065-w","url":null,"abstract":"<p><strong>Background: </strong>Sepsis is a leading cause of critical illness and mortality, yet substantial heterogeneity limits risk stratification and biomarker translation. Mitochondrial dysfunction is widely implicated in sepsis, but genetically supported, multi-layer regulatory features and their clinical relevance remain incompletely characterized.</p><p><strong>Methods: </strong>We integrated publicly available sepsis GWAS summary statistics (general sepsis: 1634 cases/454,714 controls; gram-positive sepsis: 168/456,180; gram-negative sepsis: 383/455,965) with blood-based molecular QTL resources (including GTEx v8 whole blood, n = 670) to prioritize mitochondrial genes and infer regulatory cascades. Independent whole-blood transcriptomic cohorts (the GAinS cohort, GSE65682, n = 802; GSE54514, n = 163) were used for clinical and pathogen-specific expression characterization. We developed machine learning models using mitochondrial gene features and evaluated performance by internal tenfold cross-validation.</p><p><strong>Results: </strong>We identified mitochondrial genes with convergent genetic, epigenetic, and transcriptional regulatory evidence, showing stronger effects in inner membrane and matrix compartments. Transcriptomic analyses supported clinically relevant dysregulation and pathogen-associated patterns. In predictive modeling, aggregating mitochondrial gene features improved discrimination, with the best-performing random forest model achieving an AUC of 0.91 under internal cross-validation. These results require validation in independent external cohorts.</p><p><strong>Conclusions: </strong>This study provides a genetically supported, multi-omics framework linking compartment-specific mitochondrial dysregulation to sepsis heterogeneity and nominates candidate biomarkers for prioritization. The reported model performance reflects internal resampling and requires validation in independent clinical cohorts and future multi-omics profiling (including metabolomics) before translational implementation.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147369346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacotherapy in the acute phase of secondary spinal cord injury: an updated narrative review.","authors":"Filippo Migliorini, Luise Schäfer, Andreas Bell, Simeone Francesco, Federico Cocconi, Nicola Maffulli","doi":"10.1186/s40001-026-04005-8","DOIUrl":"https://doi.org/10.1186/s40001-026-04005-8","url":null,"abstract":"<p><p>Following primary spinal cord injury (SCI), spinal neuronal tissues and their surrounding tissues undergo pathological degeneration, known as secondary SCI. Secondary SCI is a complex process involving progressive neurodegeneration caused by ischemia, inflammation, and oxidative stress. Current strategies for managing secondary SCI are debated, and evidence remains limited. This narrative review discusses the latest evidence on pharmacological approaches to the treatment of the acute phase of secondary SCI. Erythropoietin (EPO) significantly enhances outcomes in secondary SCI, resulting in higher motor scores and a reduction in the American Spinal Cord Injury Association Impairment (ASIA) scale. Although methylprednisolone is one of the most commonly used drugs in secondary SCI, its effectiveness continues to be debated. Topical application of the rho-GTPases inhibitor VX-210 at the injury site showed no efficacy in secondary SCI. Similar results were observed with levetiracetam. Monosialotetrahexosylganglioside (GM1) has been linked to improvements in neurological and motor recovery. Riluzole demonstrated higher and better motor and sensory scores and improved impairment grading. The use of granulocyte colony-stimulating factor (G-CSF) enhanced motor and disability scores, promoted motor recovery, and was associated with fewer therapy-related complications. Hepatocyte growth factor (HGF) aids in motor function recovery, particularly in the lower limbs. Future progress in the pharmacological management of the acute phase of secondary spinal cord injury will depend on methodologically robust clinical trials with improved patient stratification, standardised therapeutic windows, and clinically meaningful outcome measures.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147364485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Roxadustat ameliorates renal interstitial fibrosis through regulating the CX43/ZO-1 signaling pathway.","authors":"Wanru Yin, Guoyu Wang, Hanlei Zhou, Xin Huang, Chao Zhu, Hui Zhou, Zhenhua Ji","doi":"10.1186/s40001-026-03942-8","DOIUrl":"https://doi.org/10.1186/s40001-026-03942-8","url":null,"abstract":"<p><p>Chronic kidney disease (CKD) is one of the most common kidney diseases, and the most common pathological type of its outcome is renal interstitial fibrosis (RIF), whose etiology is still unclear. Roxadustat (FG4592), a prolyl-hydroxylase inhibitor (HIF-PHI) that targets hypoxia-inducible factors (HIF), is showing promise as a potential method to minimize damage to kidneys in the treatment of anemia associated with CKD; however, the mechanisms involved are not yet completely understood. The current study explored the protective effect of FG4592 pretreatment on the development of renal fibrosis. Combining the bioinformatics analysis, we proposed a new mechanism in which FG4592 can stabilize Hif-1α expression, promote the levels of tight junction protein expression connexin43 (CX43), zonula occludens-1 (ZO-1), and adhesion junction molecule E-cadherin, thereby improving RIF and reducing inflammatory cytokine levels, restoring renal function. In addition, in vitro, FG4592 pretreatment can improve the transforming growth factor-β (TGF-β) induced human kidney-2 cells (HK-2) damage. In conclusion, the data from our investigation endorse the shielding influence of FG4592 on the folic acid (FA) induced renal dysfunction; Therefore, we consider FG4592 to be a promising therapeutic strategy for enhancing tubular epithelial cell repair and slowing the progression of renal fibrosis through the activation of the Gap Junction signaling pathway, which involves key proteins like CX43 and ZO-1.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147364549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of admission serum potassium levels with mortality according to renal function in coronary artery disease: a prospective cohort study.","authors":"Yufei Ma, Shengnan Liu, Zuming Liu, Jingyu Zhang, Dongli Song, Jiali Lv, Jiahao Chen, Guanghui Chen, Wen Zheng, Jingjing Ma, Jiaojiao Pang, Shuo Wu, Feng Xu, Juying Qian, Jiali Wang, Tao Zhang, Yuguo Chen","doi":"10.1186/s40001-026-04140-2","DOIUrl":"https://doi.org/10.1186/s40001-026-04140-2","url":null,"abstract":"<p><strong>Background: </strong>Serum potassium levels are regulated by renal function; however, the extent to which the association with mortality is affected by renal function remains unknown. We aimed to explore the association of admission serum potassium levels with mortality in patients with coronary artery disease (CAD), stratified by renal function.</p><p><strong>Methods and results: </strong>Renal function was categorized into normal (≥ 90 mL/min/1.73 m²), mildly decreased (60-89 mL/min/1.73 m²), and impaired (< 60 mL/min/1.73 m²) according to estimated glomerular filtration rate (eGFR). The outcome was all-cause mortality within 3 years after hospitalization. 7739 patients from a prospective multicenter registry were included. All-cause mortality occurred in 366 patients (4.7%). In normal renal function, restricted cubic spline analysis showed a U-shaped mortality curve. However, higher or lower potassium levels were not significantly associated with mortality risk compared with 4.0-4.5 mmol/L. In mildly decreased renal function, the slope of the U-shaped curve on the right side was steeper, and potassium levels of 4.6-5.0 mmol/L (hazard ratio (HR) 2.34, 95% confidence interval (CI) 1.48-3.70) and > 5.0 mmol/L (HR 5.76, 95% CI 2.54-13.12) were associated with higher mortality risk. In impaired renal function, the U-shaped curve flattened, and potassium levels > 5.0 mmol/L (HR 2.02, 95% CI 1.02-3.98) were linked to increased mortality risk. A significant interaction was observed between potassium levels and eGFR.</p><p><strong>Conclusions: </strong>Our findings highlighted the independent association of elevated potassium levels with increased mortality in the mildly decreased renal function, indicating that renal function should be considered when evaluating mortality risk related to serum potassium in CAD.</p><p><strong>Clinical trial registration information: </strong>https://clinicaltrials.gov/, NCT04044066.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147369364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protective effects of diosgenin against non-alcoholic fatty liver disease through inhibiting the STING-dependent inflammatory pathway.","authors":"Chaoyuan Song, Guoliang Yin, Ye Meng, Linya Wang, Fengxia Zhang","doi":"10.1186/s40001-026-04168-4","DOIUrl":"https://doi.org/10.1186/s40001-026-04168-4","url":null,"abstract":"<p><p>Growing evidence suggests that the stimulator of interferon genes (STING)-dependent inflammatory pathway is crucial in the progression of non-alcoholic fatty liver disease (NAFLD). Diosgenin (DG), a natural steroidal saponin, has demonstrated multi-pharmacological potential, such as anti-inflammatory and lipid-lowering capacities. Our previous study confirmed the protective role of DG in rat models of NAFLD. Our present study sought to further explore the protective effects of DG in NAFLD and to determine whether its mechanism involves the STING-dependent inflammatory pathway. In this research, we developed experimental models for both high-fat diet (HFD)-induced NAFLD in rats and steatosis induced by free fatty acids (FFAs) in HepG2 cells. The results revealed that DG treatment significantly reduced body weight, liver index, serum lipid levels, hepatic lipid accumulation, and liver injury in HFD-fed rats. Additionally, DG markedly alleviated mitochondrial dysfunction and suppressed the protein expression of the STING-dependent inflammatory pathway in both in vivo and in vitro NAFLD models. In contrast, administration of cGAMP, a STING agonist, upregulated the STING-dependent inflammatory pathway and exacerbated lipid accumulation and mitochondrial dysfunction in FFAs-induced HepG2 cells. In conclusion, our findings suggested that DG protects against NAFLD by mitigating lipid accumulation and mitochondrial dysfunction, with its mechanism related to the inhibition of the STING-dependent inflammatory pathway.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147369417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening, validation, and transcriptional regulation analysis of oxidative stress-related biomarkers in gestational diabetes mellitus: SH3BP5, ITGAM, PRRG1, and MIS12.","authors":"Haiyu He, Wen Wu","doi":"10.1186/s40001-026-03966-0","DOIUrl":"https://doi.org/10.1186/s40001-026-03966-0","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Gestational diabetes mellitus (GDM) is a common pregnancy complication linked to adverse outcomes, highlighting the need for new diagnostic markers. This study aimed to identify oxidative stress-related genes as potential biomarkers for GDM using integrated bioinformatics and experimental validation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The GSE70493 dataset was obtained from the Gene Expression Omnibus (GEO) database and analyzed using weighted gene co-expression network analysis (WGCNA), functional enrichment, and differential expression analysis. Reactive oxygen species (ROS) activity scores for each sample were calculated using single-sample gene set enrichment analysis (ssGSEA). ROS-associated differentially expressed genes (DEGs) were further screened using the least absolute shrinkage and selection operator (LASSO), support vector machine-recursive feature elimination (SVM-RFE), and RandomForest algorithms to identify pivotal genes. A diagnostic radial-kernel support vector machine (SVM) classifier was constructed and rigorously evaluated through a 5 × 5 nested cross-validation framework on the training set, followed by validation in an independent external cohort (GSE249311). A transcription factor (TF)-gene regulatory network was established via the JASPAR database on the NetworkAnalyst 3.0 platform. The biological role of PRRG1 in GDM was also explored using cellular experiments.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;WGCNA identified 7 co-expression modules, among which the green, pink, and black modules showed a strong positive correlation with ROS scores. Enrichment analysis showed that the module genes were mainly implicated in protein hydrolysis and processing, cell adhesion molecule binding, and various immune-related pathways. 765 DEGs, including 470 downregulated genes and 295 upregulated genes, were screened between GDM samples and control samples. Machine learning algorithm identified four hub genes (SH3BP5, ITGAM, PRRG1, and MIS12). When the four hub genes were combined, ROC curves showed that the hub genes exhibited strong diagnostic value for GDM. In GDM, SH3BP5, MIS12, and ITGAM were low-expressed, while PRRG1 was high-expressed. The TF-gene regulatory network showed that the hub genes could regulate multiple transcription factors separately. In vitro experiments demonstrated that PRRG1 knockdown significantly enhanced the viability, migration, and invasion of GDM cells.Table: Table [3, 4] was received; however, no citation was provided in the manuscript. Please provide the location of where to insert the citation in the main body of the text. Otherwise, kindly advise us on how to proceed. Please note that tables should be cited in ascending numerical order in the main body of the textDear editor, please consider removing the Tables 3 and 4 in the paper, since the data of molecular docking are absent in the current paper.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;We provided four novel biomarkers targeting oxid","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147364491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A mechanistic, imaging-based classification of complete retrograde ejaculation: insights from dynamic transrectal ultrasonography.","authors":"Cheng Cheng, Lei Zheng, Xingjun Bao, Letian Wei, Zhimin Wen, Wenrong Liu, Hui Jiang, Tao Jiang","doi":"10.1186/s40001-026-04159-5","DOIUrl":"https://doi.org/10.1186/s40001-026-04159-5","url":null,"abstract":"<p><strong>Background: </strong>Complete retrograde ejaculation (CRE), defined by total semen reflux into the bladder, currently lacks a standardized classification based on underlying pathophysiological mechanisms. Conventional diagnostic approaches are indirect and unable to visualize the dynamic, real-time dysfunction of the bladder neck (BN) and external urethral sphincter (EUS) during ejaculation.</p><p><strong>Objectives: </strong>To directly characterize the ejaculatory process in CRE using dynamic transrectal ultrasound (TRUS) and establish an etiology-specific, mechanism-driven classification system.</p><p><strong>Methods: </strong>In this single-center study, consecutive eligible patients with CRE (n = 20) underwent real-time TRUS during stimulated ejaculation to assess BN and EUS function. The cohort comprised two etiological subgroups: diabetes mellitus (n = 10) and urethral stricture (n = 10). Observations were complemented by a literature-based characterization of the spinal cord injury (SCI) subtype. Detailed dynamic video analysis was performed on selected representative cases from each subgroup for illustration, while quantitative analysis and statistical comparison were conducted across the entire cohort.</p><p><strong>Results: </strong>Systematic TRUS imaging revealed three distinct functional phenotypes of CRE, each linked to a specific etiology: Coordination dysfunction type (SCI-associated): Characterized by delayed BN closure coupled with failure of EUS relaxation, leading to post-ejaculatory reflux. Incomplete closure type (stricture-associated): Marked by partial BN incompetence under conditions of high outflow resistance, resulting in significantly delayed reflux concurrent with ejaculation. Complete bladder neck failure type (diabetes-associated): Defined by an absent BN contraction from the onset, causing immediate and total semen reflux into the bladder.</p><p><strong>Conclusions: </strong>Dynamic TRUS provides direct, real-time visualization of the ejaculatory mechanism in CRE, enabling quantification of dysfunction and revealing distinct pathophysiology across etiologies. This study proposes a novel three-type classification system-Coordination Dysfunction, Incomplete Closure, and Complete Bladder Neck Failure-which is grounded in both dynamic imaging and objective quantitative differences. This classification enhances diagnostic precision and lays the groundwork for personalized therapeutic strategies. However, this framework is derived from a single-center study with a limited cohort and incorporates a literature-based subtype (spinal cord injury); therefore, it requires validation in larger, prospective, and multicenter studies. Nevertheless, TRUS emerges as a valuable minimally invasive diagnostic tool for characterizing ejaculatory dysfunction.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147364450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prognostic value of serum albumin in cystectomy: a systematic review and meta-analysis.","authors":"Rui-Ping Su, Yi-Xuan Liu, Li-Li Peng, Fan He, Liang Liu","doi":"10.1186/s40001-026-04167-5","DOIUrl":"https://doi.org/10.1186/s40001-026-04167-5","url":null,"abstract":"<p><strong>Objective: </strong>To explore the risk stratification and perioperative optimization path of albumin in perioperative period, such as giving priority to eras + nutritional support for high-risk (low albumin) patients, giving priority to urinary diversion with lower risk of complications, and strengthening postoperative monitoring and rehabilitation resource allocation.</p><p><strong>Methods: </strong>The Cochrane Library, Embase, PubMed, Web of Science, Chinese National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodicals Database (VIP), Chinese Biomedical Literature Service System (SinoMed), and Wanfang databases were systematically searched from the inception to 20 June 2024. We conducted this meta-analysis about the prognostic indices of survival based on hazard ratio (HR), P-value or 95% confidence interval (95%CI) obtained from univariate or multivariate Cox regression analyses. Subgroup analysis, and sensitivity analysis were also conducted. Descriptive analyses were conducted when indicators could not be used for meta-analysis.</p><p><strong>Results: </strong>Five articles, including 2,631 patients undergoing cystectomy, met the inclusion criteria. The fixed effect model showed that lower serum albumin was significantly associated with worse overall survival (OS) (HR: 1.73, 95% CI 1.42-2.11, p < 0.001) and cancer-specific survival (CSS)/recurrence-free survival (RFS) (HR: 1.66, 95% CI 1.19-2.30, p = 0.003). Furthermore, subgroup analysis based on the country of study and sample size indicated that our findings were reliable.</p><p><strong>Conclusions: </strong>Our meta-analysis revealed that lower serum albumin level is associated with worse prognosis in patients undergoing cystectomy and may serve as an adjunctive marker within comprehensive prognostic models in patients with cystectomy.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147369338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}