European Journal of Medical Research最新文献

{"title":"Attention-enhanced deep learning model for automated classification of hemorrhagic and ischemic stroke on CT imaging.","authors":"Siyao Che, Siyu Che, Xiaofei Liu, Peipei Du, Zihan Wang, Yuanyuan Chen, Yue Hu, Lingbo Kong","doi":"10.1186/s40001-025-03784-w","DOIUrl":"https://doi.org/10.1186/s40001-025-03784-w","url":null,"abstract":"<p><strong>Background: </strong>Stroke is a disease with extremely high mortality and disability rates worldwide. Hemorrhagic stroke and ischemic stroke require completely different treatment plans, so rapid and accurate stroke classification is crucial for clinical decision-making. Based on deep learning technology, this study proposed a lightweight and efficient GCDCNet model for intelligent classification of stroke CT images to improve the accuracy and efficiency of diagnosis.</p><p><strong>Methods: </strong>This study used a public stroke CT dataset, including 964 hemorrhagic strokes and 1551 ischemic strokes. Based on the GhostNet lightweight architecture, GCDCNet combines SCSE attention mechanism, dilated convolution, and channel shuffling for feature optimization to enhance the model's attention to the lesion area and improve classification performance. The model uses a cross entropy loss function and Adam optimizer, and is compared with ConvNeXt, EfficientNet, GhostNet, HRNet, and ViT. Grad-CAM visualization analysis is used to evaluate the model's discriminant basis.</p><p><strong>Results: </strong>The experimental results show that GCDCNet has an accuracy of 99.26%, a recall rate of 99.33%, an F1 score of 99.13%, and a precision of 98.94% on the test set, with a parameter count of only 2.7 M, which is much lower than other mainstream deep learning models. The AUC-ROC curve analysis shows that GCDCNet has the best category discrimination ability (AUC = 0.9996), and the Grad-CAM visualization analysis shows that the model discrimination area is highly consistent with the clinician's focus area. In contrast, ConvNeXt and ViT performed poorly in this task.</p><p><strong>Conclusion: </strong>GCDCNet demonstrates superior accuracy, lightweight, and good generalization ability in the intelligent classification task of stroke CT images through lightweight design, feature optimization, and enhanced interpretability. This model can be used to assist clinicians in early stroke screening, emergency triage, and telemedicine applications, improve stroke diagnosis efficiency, and optimize medical resource allocation.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147347792","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 vitamin D deficiency and supplementation with clinical outcomes in multi-tendon chronic tendinopathy: a retrospective clinical study.","authors":"Volkan Kizilkaya, Sefa Erdem Karapinar, Namik Kemal Kilinccioglu, Mehmet Melih Asoglu, Mustafa Cukurlu, Fatih Enzin, Ali Levent","doi":"10.1186/s40001-026-04157-7","DOIUrl":"https://doi.org/10.1186/s40001-026-04157-7","url":null,"abstract":"<p><strong>Background: </strong>Tendinopathy is a common musculoskeletal condition associated with persistent pain and functional limitation. Although vitamin D deficiency has been widely implicated in musculoskeletal disorders, its association with clinical outcomes in tendinopathy remains incompletely understood. This study investigated the association between serum vitamin D levels, clinical severity of tendinopathy, and the effects of vitamin D supplementation.</p><p><strong>Methods: </strong>This retrospective observational study included 350 patients with tendinopathy treated at a tertiary referral center between 2023 and 2025. Patients were classified into a vitamin D supplementation group (n = 221), receiving 50,000 IU weekly for 4 weeks followed by 2000 IU daily for 8 weeks, and a nonsupplemented group (n = 129). Pain intensity (VAS), functional status (0-100 scale), disease duration, chronicity, and ultrasonographic inflammation severity were evaluated.</p><p><strong>Results: </strong>Patients with serum vitamin D levels below 20 ng/mL exhibited significantly higher pain scores (7.3 ± 1.2 vs. 5.7 ± 1.3, p < 0.001), longer disease duration (8.2 vs. 4.1 months, p < 0.001), and a higher prevalence of chronic tendinopathy (79.6% vs. 24.0%, p < 0.001). Following supplementation, serum vitamin D levels increased from 14.2 to 38.4 ng/mL (p < 0.001), accompanied by significant reductions in pain and improvements in functional status compared with the nonsupplemented group (p < 0.001). Severe vitamin D deficiency (< 10 ng/mL) was independently associated with a sevenfold increased likelihood of severe and chronic tendinopathy (OR: 7.2, p < 0.001).</p><p><strong>Conclusions: </strong>Vitamin D deficiency is strongly associated with greater clinical severity and chronicity of tendinopathy. Vitamin D supplementation is associated with meaningful improvements in pain and functional outcomes, suggesting that vitamin D status represents a clinically relevant and potentially modifiable factor in tendinopathy management. Clinical trial registration Clinical trial number: not applicable. This study was a retrospective observational study and was, therefore, not registered as a clinical trial.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147347821","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":"Predictive value of C-reactive protein-albumin-lymphocyte index for in-stent restenosis in acute coronary syndrome patients undergoing drug-eluting stenting.","authors":"Yan-Ge Wang, Guo-Liang Hao, Fan Yang, Gong-Xin Wang, Wen-Cai Zhang, Sen Guo, Shuai Zhou, Qiang-Wei Shi, Ya-Ge Jin, Li Jing, Gang Li, Xian-Fang Hao, Jia-Ning Cao, Zhan-Ying Han","doi":"10.1186/s40001-026-04116-2","DOIUrl":"https://doi.org/10.1186/s40001-026-04116-2","url":null,"abstract":"<p><strong>Background: </strong>The association between the C-reactive protein-albumin-lymphocyte (CALLY) index and in-stent restenosis (ISR) in patients with acute coronary syndrome (ACS) undergoing drug-eluting stent (DES) implantation remains unclear.</p><p><strong>Materials and methods: </strong>This retrospective study included 452 patients who underwent successful DES implantation in our department and repeat coronary angiography 6-48 months later between January 2020 and December 2024. Based on repeat coronary angiography findings, patients were categorized into ISR and non-ISR groups. First, baseline clinical characteristics were compared between the two groups. Subsequently, risk factors associated with the incidence of ISR after DES implantation were explored using logistic regression analysis. Finally, the predictive accuracies of the CALLY index and other predictors of ISR after DES implantation were evaluated using receiver operating characteristic curve analysis.</p><p><strong>Results: </strong>ISR was angiographically defined as ≥ 50% diameter stenosis within or within 5 mm of the stent edges. Patients in the ISR group had a lower CALLY index than those in the non-ISR group (P < 0.001). In addition, patients with a lower CALLY index were more likely to develop ISR (P < 0.001). After adjustment for confounding variables, the logistic regression analysis demonstrated that the CALLY index was an independent predictor of ISR (adjusted odds ratio OR = 0.321, P < 0.001). Receiver operating characteristic curve analysis further showed that the CALLY index had a larger area under the curve (AUC = 0.702, P < 0.001) than that of the other predictors.</p><p><strong>Conclusions: </strong>Our findings demonstrate a negative association between the CALLY index and ISR following DES implantation in patients with ACS. The CALLY index is a simple, cost-effective, and practical predictive indicator for risk stratification and prognosis assessment in patients with ACS. Trial registration This is a retrospective observational study.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147347317","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":"Predictive value of acute MRI-detected brain lesions for clinical outcome in patients with acute carbon monoxide poisoning.","authors":"Yangjuan Jia, Hui Guo, Xiaohui Liang, Ning Han, Yaxue Song, Jianguo Li, Quansheng Du","doi":"10.1186/s40001-026-04127-z","DOIUrl":"https://doi.org/10.1186/s40001-026-04127-z","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the predictive value of acute brain lesions (ABLs) for the clinical outcomes and delayed encephalopathy after acute carbon monoxide poisoning (DEACMP).</p><p><strong>Methods: </strong>This is a retrospective cohort study, patients with acute carbon monoxide (CO) poisoning were divided into the ABLs group and non-ABLs group. Outcome measures included clinical cure, favorable prognosis, and the incidence of DEACMP. Multivariate logistic regression analysis was used to identify independent predictors of clinical outcomes, and subgroup analyses were performed to clarify the impact of ABLs on clinical outcomes.</p><p><strong>Results: </strong>Multivariate analysis showed that ABLs (clinical cure: adjusted odds ratio [aOR] 0.35, 95% confidence interval [CI] 0.17-0.75; DEACMP [DEACMP: aOR 2.54, 95% CI 1.08-6.00) and time from onset to first hyperbaric oxygen therapy (HBOT) > 6 h (clinical cure: aOR 0.38, 95% CI 0.18-0.82; DEACMP: aOR 3.50, 95% CI 1.58-7.74) were associated with a lower clinical cure rate and a higher incidence of DEACMP. A Glasgow Coma Scale (GCS) score < 9 (aOR 7.50, 95% CI 3.33-16.89) was an independent predictor of DEACMP, but was not associated with clinical cure. Regarding ABLs in different locations, white matter lesions were significantly associated with lower clinical cure (adjusted OR = 0.23, 95% CI 0.10-0.55), lower favorable outcome (adjusted OR = 0.34, 95% CI 0.17-0.68), and higher DEACMP development (adjusted OR = 3.17, 95% CI 1.59-6.32). In contrast, basal ganglia lesions were only significantly correlated with lower clinical cure (adjusted OR = 0.45, 95% CI: 0.21-0.96), but not significant with favorable outcome or DEACMP occurrence.</p><p><strong>Conclusion: </strong>ABLs and time from onset to first HBOT were significant predictors of clinical cure and DEACMP in patients. A GCS score < 9 was significantly associated with DEACMP but showed no definitive correlation with clinical cure.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147347280","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 value of triglyceride-glucose-body shape index (TyG-ABSI) in evaluating stroke: a multi-centre cross-sectional study.","authors":"Hanlin Liu, Mingxiao Li, Ziyi Zhang, Yu Duan, Ke Yang, Jiang Liu","doi":"10.1186/s40001-026-04148-8","DOIUrl":"https://doi.org/10.1186/s40001-026-04148-8","url":null,"abstract":"<p><strong>Background: </strong>Stroke is the second leading cause of disability and mortality worldwide. A body shape index (ABSI) is calculated as waist circumference / (body mass index 2/3 × height 1/2). The TyG-ABSI is calculated as the product of the triglyceride-glucose index (TyG) and ABSI. To date, no studies have investigated the relationship between TyG-ABSI and stroke. Therefore, the purpose of this study is to fill this gap.</p><p><strong>Methods: </strong>This multi-centre cross-sectional study included 14,394 participants from the National Health and Nutrition Examination Survey (NHANES) cycles 2007-2018 and 10,869 participants from the China Health and Retirement Longitudinal Study (CHARLS) performed from 2015-2016. The potential association between TyG-ABSI and stroke was investigated using multivariable logistic regression, supplemented by subgroup analyses, restricted cubic spline (RCS) regression and threshold effect analyses. Pearson correlation analyses and Boruta's algorithm were applied to select features. Subsequently, the discriminative ability of TyG-ABSI for stroke was assessed using seven machine learning models and the SHAP algorithm.</p><p><strong>Results: </strong>After adjusting for sufficient covariates, the Odds Ratio (OR) for TyG-ABSI was 1.186 (95% CI: 1.027-1.370) in NHANES and 1.189 (95% CI: 1.058-1.336) in CHARLS. Subgroup analyses revealed that this association was more pronounced in non-elderly individuals without hypertension in NHANES. The RCS regression showed a linear relationship between TyG-ABSI and stroke, but no threshold effect was observed in two populations. Among the seven machine learning models, the Gradient Boosting Machine (GBM) performed the best, with an Area Under the Curve (AUC) of 0.784 (95%CI:0.751 - 0.817) in NHANES and 0.651(95%CI:0.604 - 0.699) in CHARLS.</p><p><strong>Conclusion: </strong>This study demonstrates a positive association between TyG-ABSI and stroke. The results suggest that TyG-ABSI is a relatively valuable indicator associated with stroke and can improve the development of public health policies.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147347296","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":"Bone marrow adipose tissue in obesity: a previously underappreciated but promising therapeutic target.","authors":"Hai Long Yu, Rui Chen, Suwen Sun, Ruixian Zhou","doi":"10.1186/s40001-026-04162-w","DOIUrl":"https://doi.org/10.1186/s40001-026-04162-w","url":null,"abstract":"<p><p>Bone marrow adipose tissue (BMAT) is an important modulator of metabolic and skeletal homeostasis in obesity. This review summarises current evidence supporting mechanistic links between BMAT and the development and progression of obesity. Accumulating data indicate that, beyond serving as a distinct adipose depot, BMAT functions as a dynamic and adaptive regulator within the bone marrow (BM) microenvironment under obese conditions. Therefore, limiting BM adipogenesis, regulating BMAT-derived adipokines, reversing metabolic dysfunction, and modulating systemic energy homeostasis have been proposed as potential therapeutic strategies for obesity. Collectively, BMAT is a previously underappreciated yet promising target for tailored, mechanism-based therapeutic strategies in obesity. Future research should prioritise mechanistic dissection and clinical validation of BMAT-targeted strategies, together with improved imaging and quantitative methodologies and Traditional Chinese Medicine (TCM)-informed system-level regulatory approaches, to facilitate their translation into effective therapies for obesity and related metabolic disorders.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147347914","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 analysis reveals metabolic dysfunction signatures as critical determinants of prostate cancer prognosis and immunosuppressive microenvironments.","authors":"Xiangqian Nie, Zhenlin He, Kun Wang, Decai Zhu, Wei Li, Lei Zhang, Ying Yu","doi":"10.1186/s40001-026-04049-w","DOIUrl":"https://doi.org/10.1186/s40001-026-04049-w","url":null,"abstract":"<p><strong>Background: </strong>Metabolic reprogramming is a hallmark of cancer. However, the precise mechanisms by which specific metabolic pathways drive prostate cancer (PCa) progression and shape the tumor microenvironment remain poorly defined.</p><p><strong>Methods: </strong>A machine learning-derived Metabolic Dysfunction Signature (MODS) was developed and validated as a prognostic model. Its clinical relevance was established through multidimensional assessment, demonstrating significant associations with: (1) adverse clinical outcomes, (2) genomic instability, and (3) distinct therapeutic response profiles. Pathway enrichment and transcriptomic deconvolution (via CIBERSORT and ssGSEA) of TCGA and GEO cohorts were performed to characterize MODS-associated remodeling of the tumor microenvironment. Single-cell resolution analysis, utilizing the AUCell algorithm and CellChat ligand-receptor networking, was conducted to elucidate MODS-mediated epithelial-immune crosstalk, highlighting its role in establishing an immunosuppressive niche. Validation of HPRT1 expression and function using human protein atlas database and in vitro models. Furthermore, molecular docking simulations were employed to evaluate the potential targeting of HPRT1 by prevalent environmental compounds.</p><p><strong>Results: </strong>The MODS prognostic model demonstrated robust predictive performance across three independent validation cohorts. MODS scores were positively correlated with adverse patient outcomes and advanced clinical stage. Notably, high-MODS tumors exhibited significantly greater genomic instability, reflected in a higher tumor mutational burden, and heightened resistance to conventional pharmacotherapies. Enrichment analysis revealed significant activation of proliferative signaling and oncogenic metabolic pathways in high-MODS tumors. Conversely, immune infiltration analysis indicated that high-MODS tumors were characterized by enhanced immunosuppressive features, including increased M2 macrophage infiltration. Single-cell analysis established that metabolically dysregulated epithelial cells, as defined by high MODS activity, functioned as central drivers of both poor prognosis and immunosuppressive microenvironment formation. Functional assays confirmed the oncogenic properties of HPRT1, promoting PCa cell proliferation and migration. Molecular docking simulations identified HPRT1 as a convergent molecular target for multiple environmental carcinogens implicated in PCa initiation.</p><p><strong>Conclusion: </strong>This study defines a prevalent metabolic dysfunction signature in PCa that is integrally linked to patient prognosis, genomic instability, therapeutic resistance, and the establishment of an immunosuppressive tumor microenvironment. Furthermore, HPRT1 is functionally validated as a promoter of PCa progression and is positioned as a novel potential biomarker and therapeutic target for both intervention and prognosis assessment.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147347924","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":"Integrating bulk and single cell RNA sequencing to predict the potential therapeutic efficacy of DLX5 in hypopharyngeal squamous cell carcinoma.","authors":"Yao Jiang, Lianhe Li, Hongmin Wang, Mingqiong Wang, Liangyu Zou","doi":"10.1186/s40001-026-03980-2","DOIUrl":"https://doi.org/10.1186/s40001-026-03980-2","url":null,"abstract":"<p><strong>Background: </strong>Biological targeted therapies show promise for personalized treatment of head and neck squamous cell carcinoma (HNSCC), but the intrinsic heterogeneity of hypopharyngeal squamous cell carcinoma (HPSCC) presents significant treatment challenges.</p><p><strong>Methods: </strong>CIBERSORT quantified immune cell composition, and weighted gene co-expression network analysis (WGCNA) identified gene modules linked to immune infiltration. Protein-protein interaction (PPI) networks were constructed using Search Tool for the Retrieval of Interacting Genes/Proteins (STRING), followed by the Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. InferCNV analyzed copy number variations (CNV) in malignant epithelial cells, and pySCENIC was used to build the DLX5 transcription factor network. The spatial localization of DLX5 in HPSCC and its correlation with the immune microenvironment were evaluated. In FaDu cells, DLX5 knockdown and overexpression were tested using CCK-8, wound healing, and Transwell assays. OncoPredict screened small molecules affecting DLX5 expression.</p><p><strong>Results: </strong>The transcription factor DLX5 is significantly upregulated in hypopharyngeal squamous cell carcinoma (HPSCC) and is closely associated with poor prognosis (log-rank p = 0.037). Tumor evolutionary tree analysis reveals a co-amplification of DLX5 with TP63, which is enriched in the MAPK signaling pathway. Functional experiments further confirm that DLX5 promotes the proliferation, migration, and invasion of HPSCC cells. Spatial transcriptomic analysis shows high expression of DLX5 in both tumor and immune regions. Immune cell composition analysis indicates a positive correlation with CD4+ T cells and M2 macrophages, and a negative correlation with CD8+ T cells. Additionally, three small molecule compounds targeting DLX5 (BI 2536, MN-64, and Ulistatin) were identified, which may serve as potential therapeutic agents.</p><p><strong>Conclusion: </strong>Through bioinformatics analysis, it was discovered that DLX5 exerts an oncogenic role in HPSCC through co-amplification with TP63 and activation of the MAPK signaling pathway, with functional assays further confirming its promotion of malignant phenotypes. High expression of DLX5 correlates positively with immunosuppressive cells, such as M2 macrophages, and negatively with antitumor CD8+ T cells, indicating an association with an immunosuppressive microenvironment. These findings highlight DLX5 as a key determinant of poor prognosis in HPSCC.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147347977","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":"Nanomedicine-based therapeutic strategies for cerebral ischemia-reperfusion injury: from blood-brain barrier penetration to precision targeting.","authors":"Xiaomeng Guo, Guohao Liu, Yong Liu, Meiling Jin, Zihao Yong, Fukai Li, Shicheng Tang, Liwei Xie, Chunming Huang, Qingchun Mu, He Bai","doi":"10.1186/s40001-026-04073-w","DOIUrl":"https://doi.org/10.1186/s40001-026-04073-w","url":null,"abstract":"<p><p>Cerebral ischemia-reperfusion injury (CIRI) represents a major contributing factor to adverse outcomes following ischemic stroke (IS), posing significant challenges to patient survival and long-term quality of life. Although various anti-inflammatory and antioxidant agents are currently employed clinically for CIRI treatment, their therapeutic efficacy remains constrained by blood-brain barrier (BBB) limitations and inherent drug limitations, including poor pharmacokinetics and limited in vivo stability. In recent years, nanotechnology has gained increasing prominence in the medical field, with rationally designed nanomedicines demonstrating enhanced BBB permeability and improved bioavailability, emerging as a promising therapeutic approach for CIRI. This review provides a concise overview of the pathological mechanisms underlying CIRI, highlights recent advances in various nanomedicines carrier systems, explores multiple delivery strategies ranging from passive diffusion to active targeting across the BBB, and discusses cutting-edge therapeutic approaches for precision targeting of specific organelles and cellular compartments, with the aim of providing novel insights for subsequent CIRI delivery strategies and therapeutic targets.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343883","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":"Elevated serum Interleukin-39 in Myasthenia gravis: a possible biomarker.","authors":"Kun Jia, Yingzhe Shao, Xuan Liu, Qiuxia Zhang, Li Yang","doi":"10.1186/s40001-026-04172-8","DOIUrl":"https://doi.org/10.1186/s40001-026-04172-8","url":null,"abstract":"<p><strong>Background: </strong>Interleukin-39 (IL-39) is a cytokine implicated in immune regulation and autoimmune diseases, but its role in myasthenia gravis (MG) is unknown. This study aimed to investigate serum IL-39 levels in MG patients.</p><p><strong>Methods: </strong>Serum IL-39 levels were measured by enzyme-linked immunosorbent assay (ELISA) in 51 acetylcholine receptor (AChR) antibody-positive MG patients without thymoma and 43 healthy controls (HCs). A subset of 20 patients who achieved sustained clinical remission after heterogeneous immunotherapy provided paired samples for longitudinal analysis.</p><p><strong>Results: </strong>Serum IL-39 levels were significantly higher in active MG patients compared to HCs [median: 5.09 pg/mL (IQR: 4.12-6.23) vs 1.83 pg/mL (IQR: 0.99-2.76); p < 0.001]. In the paired analysis, IL-39 levels were significantly lower during the remission phase than at the active disease baseline [median: 1.66 pg/mL (IQR: 0.94 ~ 3.31) vs 4.28 pg/mL (IQR: 3.69 ~ 5.33); p < 0.001]. IL-39 demonstrated high discriminatory capacity between active patients and HCs (AUC = 0.922). No correlation was found between baseline IL-39 levels and clinical severity scores (MG-ADL).</p><p><strong>Conclusion: </strong>Serum IL-39 levels are dynamically associated with disease activity states in AChR + MG, decreasing with clinical remission. Its lack of correlation with symptom severity and its likely non-specific nature suggest it may serve as a marker of general immune activation rather than a specific diagnostic or severity biomarker. Further studies are needed to validate its specificity and define its role in MG immunopathology.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147347917","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}