European Journal of Medical Research最新文献

{"title":"The dual role of titanium particles in osteolysis: implications for gene therapy in prosthesis loosening.","authors":"Ping Chen, Hao-Hui Guo, Long Wu, Shuai Zhang, Qun-Hua Jin, Ke-Ning Sun","doi":"10.1186/s40001-025-02452-3","DOIUrl":"https://doi.org/10.1186/s40001-025-02452-3","url":null,"abstract":"<p><strong>Background: </strong>Aseptic prosthesis loosening caused by wear particles is a major complication in patients with osteoarthritis following total joint replacement. Despite advancements in treatment, the underlying mechanisms remain poorly understood, and effective therapies are still lacking.</p><p><strong>Methods: </strong>In this study, we investigated the effects of titanium particles on osteoclast and osteoblast differentiation through both in vitro and in vivo experiments.</p><p><strong>Results: </strong>Our findings revealed that titanium particles not only promote the differentiation of RAW264.7 cells into osteoclasts and enhance the secretion of inflammatory factors but also inhibit the differentiation of BMSCs into osteoblasts and reduce the expression of Wnt signaling pathway-related factors. Furthermore, using a mouse model of knee prosthesis loosening and AAV-mediated gene therapy, we demonstrated that the combination of TNF-α interference and Wnt3a overexpression was more effective than single-gene therapy in reducing inflammatory cell infiltration, promoting bone formation, and mitigating bone destruction.</p><p><strong>Conclusions: </strong>These results highlight the dual role of titanium particles in periprosthetic osteolysis and underscore the potential of a gene therapy strategy targeting both inflammatory factors and the Wnt signaling pathway to improve knee prosthesis loosening. This study provides a scientific foundation for developing novel therapeutic approaches.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"216"},"PeriodicalIF":2.8,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742721","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":"Glucocorticoids can reduce mortality in patients with severe community-acquired pneumonia: a systematic review and meta-analysis of randomized controlled trials.","authors":"Xue Gu, Penglei Yang, Lina Yu, Jun Yuan, Ying Zhang, Zhou Yuan, Lianxin Chen, Xiaoli Zhang, Qihong Chen","doi":"10.1186/s40001-025-02487-6","DOIUrl":"10.1186/s40001-025-02487-6","url":null,"abstract":"<p><strong>Background: </strong>Severe community-acquired pneumonia (sCAP) is associated with higher morbidity and mortality. The use of glucocorticoids to improve the prognosis of severe community-acquired pneumonia remains a topic of controversy.</p><p><strong>Methods: </strong>Following the guidelines given in the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA), we conducted a systematic review and meta-analysis to evaluate the effects of glucocorticoids on mortality and duration of mechanical ventilation in patients with sCAP. Randomized controlled studies investigating the use of glucocorticoids in the treatment of sCAP were extracted from PubMed, Embase, Cochrane Library, and Web of Science. Statistical analysis was performed to compare the differences in in-hospital mortality, mechanical ventilation duration, gastrointestinal bleeding, secondary infection, and other outcome measures between the glucocorticoid group and the control group.</p><p><strong>Results: </strong>A total of 8 studies involving 1769 patients were included in the analysis. The hospital mortality in the glucocorticoid group was significantly lower than that in the control group [8 studies, relative risk (RR) 0.59; 95% CI 0.47-0.76, p < 0.01. I² = 25%, low certainty]. The duration of mechanical ventilation in the glucocorticoid group was significantly shorter than that in the control group [Mean Difference (MD) -3.08; 95% CI -4.96 to -1.19, p < 0.01; I² = 0%, low certainty]. There was no significant difference in the incidence of gastrointestinal bleeding (RR 0.94; 95% CI 0.55-1.63, p = 0.84, I² = 0%, low certainty) or secondary infection (RR 0.85; 95% CI 0.58-1.25, p = 0.85, I² = 2%, moderate certainty) between the glucocorticoid group and the control group. In subgroup analysis, mortality was significantly lower in the hydrocortisone group compared to the control group (6.3% vs. 14.6%, RR 0.43; 95% CI 0.29-0.62, p < 0.01, I² = 0%, very low certainty). However, there was no significant difference in mortality between the methylprednisolone group and the control group (15.6% vs. 19.9%, RR 0.78; 95% CI 0.57-1.08, p = 0.14, I² = 0%, moderate certainty).</p><p><strong>Conclusion: </strong>Glucocorticoids can reduce mortality in patients with sCAP, and the effect may vary depending on the type and the dose of glucocorticoids used. Additionally, glucocorticoid treatment can lead to a shorter duration of mechanical ventilation, as well as the length of ICU stay, without increasing the risk of gastrointestinal bleeding or secondary infection in patients with sCAP. PROSPERO registration: CRD42023416525.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"215"},"PeriodicalIF":2.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729489","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 between thyroid hormone levels and the incidence and staging of bladder cancer.","authors":"Jia Wang, Lu Yang, Shigang Du, Yi Pan, Ling Zhao, Haihao Li, Zeping Zhou, Tingyu Ke","doi":"10.1186/s40001-025-02497-4","DOIUrl":"10.1186/s40001-025-02497-4","url":null,"abstract":"<p><strong>Objective: </strong>Given the role of thyroid hormones (THs) in metabolism, growth and development, their involvement in carcinogenesis and cancer progression in the context of bladder cancer (BC) warrants further investigation. This study aimed to investigate the associations between TH levels and the incidence and stage of BC.</p><p><strong>Methods: </strong>A cohort of 46 diagnosed BC patients with no history of thyroid disease, and 47 healthy controls were analysed. BC patients were classified into NMIBC and MIBC according to the 2017 TNM staging system (AJCC, 8th edition). Thyroid hormones and antibodies were measured. Statistical analysis was performed via SPSS software to evaluate differences in thyroid parameters between BC patients and healthy controls, and between non-muscle invasive bladder cancer (NMIBC) patients and muscle invasive bladder cancer (MIBC) patients.</p><p><strong>Results: </strong>Compared with healthy controls, BC patients had higher levels of thyrotropin (TSH), total triiodothyronine (TT3), total thyroxine (TT4) and thyroglobulin and lower levels of thyroid peroxidase antibody (TPOAb). Compared with controls, both NMIBC patients and MIBC patients had elevated TT3 and TT4 levels. The proportions of NMIBC and MIBC patients were significantly greater in the high TSH, TT3, and TT4 groups than in the low TSH, TT3 and TT4 groups.</p><p><strong>Conclusions: </strong>Elevated levels of TSH, TT3 and TT4 and low levels of TPOAb within the normal range appear to be associated with increased incidence and stage of BC. These findings suggest that TSH, TT3, TT4 and TPOAb levels may be useful for assessing BC prognosis and may provide new insights into therapeutic strategies.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"211"},"PeriodicalIF":2.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729469","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":"Impact of splenectomy on prognosis in lymphoma with splenic involvement.","authors":"Li Li, Mengqi Xiong, Lulu Wang, Lixia Zhu, Kui Zhao, Lijun Wang, Jingsong He, Xiujin Ye","doi":"10.1186/s40001-025-02465-y","DOIUrl":"10.1186/s40001-025-02465-y","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Lymphoma presenting splenic invasion as the primary manifestation poses unique diagnostic and therapeutic challenges. This study aims to systematically analyze the clinical features, prognostic factors, and outcomes of patients with splenic involvement as the initial presentation of lymphoma.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective analysis was conducted on lymphoma patients diagnosed with splenic involvement confirmed by histopathological examination at our hospital from March 2011 to February 2023. A total of 113 patients were included based on predefined inclusion and exclusion criteria. The collected data encompassed clinical presentations, diagnostic methods, histopathological features, treatment regimens, and outcomes. Kaplan-Meier survival analysis was performed to generate survival curves for overall survival (OS) and progression-free survival (PFS), with statistical significance assessed using the log-rank test. Additionally, univariate and multivariate analyses utilizing Cox regression analyses were conducted to identify potential prognostic factors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;According to the pathological results, there were 6 types of lymphoma: indolent lymphoma (n = 23.18 of splenic marginal zone lymphoma (SMZL), 4 of follicular lymphoma (FL), 1 of chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). Aggressive lymphoma (n = 90.74 of diffuse large B cell lymphoma (DLBCL), 10 of NK/T cell lymphoma, 4 of mantle cell lymphoma (MCL), 1 of T lymphoblastic lymphoma, 1 of EBV-positive T cell lymphoma). Diagnosis was confirmed by hollow needle biopsy in 42 patients and through diagnostic splenectomy in 71 patients. 12 patients underwent splenectomy alone while 59 received chemotherapy following splenectomy. The median follow-up time was 37.53 months (range 0 to 162.33 months). The overall 5 year survival (OS) rate for the entire cohort was 62.39% and the 5 year progression-free survival (PFS) rate was 53.98%. Among those who underwent splenectomy, the 5 year OS rate and 5 year PFS rate were 68.06 and 62.50%, which were superior to 52.44 and 37.80% for non-splenectomy patients (P = 0.009 and P &lt; 0.001, respectively). These differences were also observed in the aggressive lymphoma subgroup (n = 90), the 5 year OS rate and 5 year PFS rate were 62.96 and 57.41%, which were also superior to 48.61 and 37.50% for non-splenectomy patients (P = 0.042 and P = 0.017, respectively). In the whole group (n = 110), multivariate model shows prolonged APTT (P = 0.024), virous treatments (P = 0.016) and elevated ferritin (P = 0.017) were independent predicted OS parameters. In aggressive lymphoma subtype (n = 87), treatment (P = 0.021) and prolonged APTT (P = 0.016) emerged as independent risk factors. In indolent lymphomas, no significant differences were found.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;In this group of lymphoma patients presenting with splenic invasion as the first manifestation, the patho","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"213"},"PeriodicalIF":2.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729490","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":"No difference in the level of sports activity between single versus dual mobility total hip arthroplasty in adults: a clinical trial.","authors":"Riccardo D'Ambrosi, Filippo Maria Anghilieri, Federico Valli, Giovanni Palminteri, Guido Bandettini, Baldo Arcuri, Ilaria Mariani, Laura Mangiavini, Nicola Ursino, Filippo Migliorini","doi":"10.1186/s40001-025-02470-1","DOIUrl":"10.1186/s40001-025-02470-1","url":null,"abstract":"<p><p>Current evidence on the quality of sports activity in patients younger than 65 following dual mobility (DM) total hip arthroplasty (THA) is lacking, and whether this coupling allows better performance than single mobility (SM) still needs to be fully clarified. This clinical trial compared sport-related patient-reported outcome measures (PROMs) of the traditional SM versus DM implants in active patients younger than 65. All THAs were performed using a minimally invasive posterolateral approach, polyethylene liner and ceramic head. All implants were cementless. The University of California, Los Angeles (UCLA) activity scores, the High-Activity Arthroplasty Score (HAAS), the visual analogue scale for pain (VAS), and the Harris Hip Score (HHS) were administered to each patient. Patient assessment was conducted on admission, at 12, and at a minimum of 24 months postoperatively. A total of 403 patients were included in the study: 372 SM and 31 DM. The mean age was 56.3 ± 7.2 years. The mean length of the follow-up was 51.3 ± 21.0 months. The present clinical trial found no difference in UCLA, HHS, HAAS, and VAS. Patients returned at a similar level of sports activity in both groups.Level of evidence Level II, prospective group-controlled clinical trial.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"212"},"PeriodicalIF":2.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729493","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":"Integrative analysis of bulk and single-cell sequencing reveals TNFSF9 as a potential regulator in microsatellite instability stomach adenocarcinoma.","authors":"Jianlong Zhou, Yucheng Zhang, Yongfeng Liu, Jiehui Li, Wenxing Zhang, Junjiang Wang, Xueqing Yao, Huolun Feng, Jiabin Zheng, Yong Li","doi":"10.1186/s40001-025-02471-0","DOIUrl":"10.1186/s40001-025-02471-0","url":null,"abstract":"<p><strong>Background: </strong>Stomach adenocarcinoma (STAD) with microsatellite instability (MSI) is associated with a better prognosis compared to Non-MSI. This study aims to elucidate the differences in the tumor microenvironment (TME) of MSI and explore its underlying mechanisms in STAD.</p><p><strong>Methods: </strong>TME differences between MSI and Non-MSI were analyzed using single-cell RNA sequencing (MSI = 7, Non-MSI = 19) and bulk RNA sequencing (MSI = 39, Non-MSI = 198). Differentially expressed genes (DEGs) were used to identify enriched pathways and hub genes. TNFSF9 expression was validated by immunohistochemistry (IHC) on 23 STAD sections (MSI = 13, Non-MSI = 10) and confirmed in tumor epithelial cells using SNU-1 (MSI) and AGS (Non-MSI) cell lines through quantitative polymerase chain reaction (qPCR) and Western blot (WB).</p><p><strong>Results: </strong>The results showed MSI was significantly associated with a better prognosis (P < 0.05). Within the TME, MSI was associated with a higher abundance of antigen-presenting cells, including M1 macrophages (40.1% vs. 27.9%) and activated dendritic cells (22.1% vs. 10.5%), as well as pro-inflammatory Th1-like CD4⁺ T cells (15% vs. 11%). However, MSI also showed an increase in exhausted T cells, indicating a complex immune landscape. Signaling pathway and cell communication analyses revealed an enrichment of cytokine-related pathways in MSI. Hub gene analysis revealed that TNFSF9 was predominantly expressed in stromal cells and partially in tumor epithelial cells in MSI, with its upregulation further confirmed through IHC, qPCR, and WB. Correlation analysis demonstrated a positive relationship between TNFSF9 expression and the abundance of M1 macrophages.</p><p><strong>Conclusions: </strong>These findings provide new insights into the TME of MSI in STAD, emphasizing the significant role of TNFSF9 in shaping MSI-specific TME, enhancing immunotherapy efficacy, and improving patient survival.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"214"},"PeriodicalIF":2.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729492","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":"Detection of sperm DNA damage in male infertility patients and evaluation of Levocarnitine efficacy using sperm chromatin diffusion (SCD) and AI-DFI methods: a cross-sectional study.","authors":"Kangsheng Liu, Yajunchen, Xiangdong Wang, Mengjie Zhao, Shimin Wu, Ruifang An","doi":"10.1186/s40001-025-02480-z","DOIUrl":"10.1186/s40001-025-02480-z","url":null,"abstract":"<p><p>The objective of this study was to elucidate the relationship between sperm DNA damage and sperm parameters in male infertility patients and to assess the changes in sperm DNA fragmentation index before and after treatment with Levocarnitine in patients with asthenozoospermia and oligozoospermia. The results of 508 patients' semen samples tested between August 2021 and December 2022 in our Department of Urology and Reproductive Medicine were retrospectively analyzed. The 508 patients were divided into 3 groups: normal semen group (n = 181), asthenozoospermia group (n = 170), and oligozoospermia group (n = 157). Their sperm DNA integrity was evaluated using the sperm chromatin diffusion (SCD) method and an artificial Intelligence-based DNA fragmentation index (AI-DFI). The patients were divided into two groups based on the assessment of sperm DNA integrity: a sperm DNA damage group and a sperm DNA integrity group. The two groups were then compared in terms of sperm concentration, motility, viability, and the proportion of normal sperm morphology. Pearson's correlation coefficient analysis was employed to examine the relationship between sperm DNA damage and semen parameters. The results showed that sperm concentration, progressive motility, viability, and normal morphology rate were significantly lower in the DNA damaged group, and correlation analysis showed that the results of sperm DNA damage detection was negatively correlated with these semen parameters. And the DNA fragmentation index (DFI) was highest in the asthenozoospermia group, followed by the oligospermia group and the normal group, with significant differences between the groups (20.30 ± 2.85; 18.62 ± 2.42; 12.83 ± 2.13, P = 0.01). Treatment of patients in the group with sperm DNA damage with Levocarnitine oral solution was found to significantly improve sperm concentration, progressive motility, viability, normal morphology rate, and DFI results after its use (t = 7.265, 5.823, 7.750, 8.737, 8.355; P = 0.03, 0.02, 0.02, 0.03, 0.01). This study concludes that men with asthenozoospermia and oligozoospermia have a high DFI, and Levocarnitine is effective in reducing DNA damage and improving sperm quality, suggesting that Levocarnitine has potential for clinical use.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"210"},"PeriodicalIF":2.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729400","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":"Age at menarche is inversely related to the prevalence of uterine cancer.","authors":"Ning Chen, Xiaohui Pei, Hao Sun, Yaoyun Zhang, Mengmeng Wang, Ziqian Song, Jialin Wang, Yuantao Qi","doi":"10.1186/s40001-025-02472-z","DOIUrl":"10.1186/s40001-025-02472-z","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this study was to investigate the relationship between the age of menarche and the prevalence of malignancies of the uterus and ovaries.</p><p><strong>Methods: </strong>A total of 5540 women were screened from those who participated in the National Health And Nutrition Examination Survey (NHANES) questionnaire from 2007 to 2020, and their variable factors of age, race, education level, Poverty Impact Ratio (PIR), marital status, Body Mass Index (BMI), waist circumference, duration of moderate exercise, smoking habits, hypertension status, energy intake, diabetes and alcohol consumption habits were analysed statistically and by logistic regression.</p><p><strong>Results: </strong>Univariate and multivariate logistic regression analysis of the relationship between age at menarche and gynaecological cancer (uterus/cervix/ovary cancer, the following gynecologic cancers in the article refer to having at least one of these three cancers) prevalence showed a negative association between age at menarche and malignancies of the uterus and ovaries prevalence (OR: 0.82, 95% CI 0.69-0.97), with a statistically significant difference (p = 0.02). Regression results of the association between age at menarche and different types of malignancies of the uterus and ovaries found a negative association between age at menarche and prevalence in uterine cancers (P = 0.03) and no association between age at menarche and prevalence in cervical and ovarian cancers (P = 0.17, P = 0.29). Those with a younger age at menarche were more likely to develop uterine cancer (OR: 0.72, 95% CI 0.54-0.98).</p><p><strong>Conclusions: </strong>There was a correlation between age at menarche and malignancies of the uterus and ovaries, with those who had menarche at an earlier age being at a higher risk of uterine cancer.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"209"},"PeriodicalIF":2.8,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718248","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":"Open and arthroscopic debridement for lateral epicondylitis: a systematic review and meta-analysis based on comparative studies.","authors":"Bo Tang, Cheng Fan, Yuan He","doi":"10.1186/s40001-025-02460-3","DOIUrl":"10.1186/s40001-025-02460-3","url":null,"abstract":"<p><strong>Objective: </strong>To systematically compare and meta-analyse the clinical efficacy of open and arthroscopic debridement for patients with lateral epicondylitis.</p><p><strong>Methods: </strong>A retrieval and systematic review of comparative studies of lateral epicondylitis treated with open versus arthroscopic debridement was conducted, and further pooled analysis was performed to compare the overall differences in clinical outcomes, including pain and elbow function scores, surgical time, complications and revision surgery rate.</p><p><strong>Results: </strong>A total of 10 comparative studies involving 20,060 patients with lateral epicondylitis who were followed up for 12-93.6 months were included. Preliminary meta-analysis revealed that the visual analogue scale (VAS) score for pain was greater in the arthroscopic group than in the open group (MD: 0.01 [- 0.27-0.29], p = 0.93; I² = 0%, p = 0.98). Additionally, the Disabilities of the Arm, Shoulder and Hand (DASH) and quickDASH scores were worse in the arthroscopic group than in the open group (MD: 0.59[- 1.01-2.20], p = 0.47; I² = 68%, p = 0.02), and the surgical time was significantly longer in the arthroscopic group than in the open group (MD: 13.36[12.42-14.29], p < 0.00001; I² = 98%, p < 0.00001). There were not significant differences of complication rate, revision surgery rate between the arthroscopic group and the open group (RR: 0.82 [0.54-1.25], p = 0.36; I² = 0%, p = 0.80; RR: 1.30 [0.90-1.88], p = 0.16; I² = 0%, p = 0.76). Radial nerve injury represented the most prevalent complication within the arthroscopy group, and its incidence was slightly higher in the arthroscopic group compared to the open group [0.46% (12/2562) VS 0.33% (58/17409), X² = 1.169, p = 0.281].</p><p><strong>Conclusions: </strong>In this systematic review and meta-analysis, we did not observe any significant advantage of arthroscopic debridement over open debridement in the treatment of lateral epicondylitis, but the surgical duration was significantly longer in the arthroscopic group, and we could assume that arthroscopic debridement may be more expensive. It was important to highlight that radial nerve injury represented the most prevalent complication within the arthroscopy group, which suggested that arthroscopic procedures for lateral epicondylitis should be performed in experienced hands. Therefore, the decision between arthroscopic and open debridement should take into account various factors, including the advantages of minimally invasive techniques, cost-benefit analysis, potential complications, and the surgeon's level of expertise.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"204"},"PeriodicalIF":2.8,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709137","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":"Admission pulse pressure and in-hospital mortality in type A acute aortic dissection: result from a Chinese study in stable patients on admission.","authors":"Liyuan Wang, Yuxin Liu, Shijie Zhang, Jinzhang Li, Yuqi Cui, Yan Yun, Xiaochun Ma, Haizhou Zhang","doi":"10.1186/s40001-025-02475-w","DOIUrl":"10.1186/s40001-025-02475-w","url":null,"abstract":"<p><strong>Objectives: </strong>In recent years, several epidemiologic studies have shown that pulse pressure (PP) is a powerful predictor of mortality from many cardiovascular diseases. However, few studies have reported the association between PP and adverse events during hospitalization in patients with type A acute aortic dissection (TAAAD). The aim of this study was to evaluate the relationship between admission PP and in-hospital all-cause mortality, in patients with TAAAD of relatively stable patients.</p><p><strong>Methods: </strong>Patients with TAAAD of relatively stable patients admitted from January 2015 to December 2021 were included and divided into four groups according to the PP values measured at the time of admission: reduced group (PP ≤ 40 mmHg), normal group (40 < PP ≤ 56 mmHg), mildly elevated group (56 < PP ≤ 75 mmHg), and significantly elevated group (PP > 75 mmHg). A multivariate binary logistic regression model was constructed, plotted using nomogram and evaluated with ROC curve.</p><p><strong>Results: </strong>Admission PP and in-hospital all-cause mortality showed a \"J-curve\" correlation and in-hospital all-cause mortality was significantly higher in the significantly elevated group and reduced group (P = 0.002), respectively. Multivariate binary logistic regression analysis showed that significantly elevated PP (PP > 75 mmHg) (P < 0.001) and reduced PP (P = 0.043), D-dimer (P < 0.001), ascending aortic diameter (P = 0.037), Abdominal visceral vessels involved (P = 0.017), and coronary atherosclerosis (P = 0.003) and emergent surgery (P < 0.001) were independent predictive factors for in-hospital all-cause mortality. The AUC of ROC plotted was 0.827 (95% CI 0.774-0.880).</p><p><strong>Conclusions: </strong>Our findings demonstrated a \"J-curve\" association of admission PP with in-hospital all-cause mortality in TAAAD. Significantly elevated and reduced admission PP, D-dimer, ascending aortic diameter and coronary atherosclerosis were independent risk factors for in-hospital all-cause mortality in patients with TAAAD, and emergent surgery was a protective factor.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"203"},"PeriodicalIF":2.8,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709134","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}