European Journal of Medical Research最新文献

{"title":"Novel multi-task learning for Alzheimer's stage classification using hippocampal MRI segmentation, feature fusion, and nomogram modeling.","authors":"Wenqi Hu, Qiaohui Du, Lisi Wei, Dawei Wang, Guang Zhang","doi":"10.1186/s40001-025-03204-z","DOIUrl":"10.1186/s40001-025-03204-z","url":null,"abstract":"<p><strong>Objective: </strong>To develop and validate a comprehensive and interpretable framework for multi-class classification of Alzheimer's disease (AD) progression stages based on hippocampal MRI, integrating radiomic, deep, and clinical features.</p><p><strong>Materials and methods: </strong>This retrospective multi-center study included 2956 patients across four AD stages (Non-Demented, Very Mild Demented, Mild Demented, Moderate Demented). T1-weighted MRI scans were processed through a standardized pipeline involving hippocampal segmentation using four models (U-Net, nnU-Net, Swin-UNet, MedT). Radiomic features (n = 215) were extracted using the SERA platform, and deep features (n = 256) were learned using an LSTM network with attention applied to hippocampal slices. Fused features were harmonized with ComBat and filtered by ICC (≥ 0.75), followed by LASSO-based feature selection. Classification was performed using five machine learning models, including Logistic Regression (LR), Support Vector Machine (SVM), Random Forest (RF), Multilayer Perceptron (MLP), and eXtreme Gradient Boosting (XGBoost). Model interpretability was addressed using SHAP, and a nomogram and decision curve analysis (DCA) were developed. Additionally, an end-to-end 3D CNN-LSTM model and two transformer-based benchmarks (Vision Transformer, Swin Transformer) were trained for comparative evaluation.</p><p><strong>Results: </strong>MedT achieved the best hippocampal segmentation (Dice = 92.03% external). Fused features yielded the highest classification performance with XGBoost (external accuracy = 92.8%, AUC = 94.2%). SHAP identified MMSE, hippocampal volume, and APOE ε4 as top contributors. The nomogram accurately predicted early-stage AD with clinical utility confirmed by DCA. The end-to-end model performed acceptably (AUC = 84.0%) but lagged behind the fused pipeline. Statistical tests confirmed significant performance advantages for feature fusion and MedT-based segmentation.</p><p><strong>Conclusions: </strong>This study demonstrates that integrating radiomics, deep learning, and clinical data from hippocampal MRI enables accurate and interpretable classification of AD stages. The proposed framework is robust, generalizable, and clinically actionable, representing a scalable solution for AD diagnostics.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"910"},"PeriodicalIF":3.4,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191132","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":"Psoriasis and phenotypic age acceleration in relation to all-cause and cardiovascular disease mortality risks in US adults.","authors":"Wen-Qi Zhao, Rui Gao, Jian-Yong Fan, Xiao-Lin Bu","doi":"10.1186/s40001-025-03176-0","DOIUrl":"10.1186/s40001-025-03176-0","url":null,"abstract":"<p><strong>Background: </strong>Psoriasis is a chronic, immune-mediated inflammatory dermatosis associated with an elevated risk of cardiovascular disease (CVD) due to systemic inflammation and metabolic dysregulation. Phenotypic age acceleration (PhenoAge-accel) quantifies accelerated biological aging by comparing an individual's predicted 'phenotypic age' (based on immune/inflammatory markers and chronological age) to their actual age. Notably, both the onset and progression of psoriasis exhibit strong associations with biological aging process. The aim of this study was to investigate their combined effect on the risk of all-cause and CVD mortality.</p><p><strong>Methods: </strong>This study included 11,443 participants from the National Health and Nutrition Examination Survey (NHANES) conducted during 2003-2006 and 2009-2010. Weighted multivariable logistic regression models were used to evaluate the association between PhenoAge-accel and psoriasis risk. PhenoAge-accel ≥ 0 was defined as PhenoAge-accel+. Furthermore, participants were stratified into four groups: psoriasis-/PhenoAge-accel-, psoriasis+/PhenoAge-accel-, psoriasis-/PhenoAge-accel+, and psoriasis+/PhenoAge-accel+. The Cox proportional hazards models were employed to investigate the joint effects of psoriasis and PhenoAge-accel on all-cause and CVD mortality risk.</p><p><strong>Results: </strong>At baseline, 312 participants were diagnosed with psoriasis. After adjusting for covariates, compared to those with PhenoAge-accel < 0, the odds ratios (95% CI) for psoriasis in the PhenoAge-accel ≥ 0 group was 1.83 (1.36-2.45). During a median follow-up of 10.91 years (interquartile range: 9.83-14.75), 1059 deaths event occurred, including 306 caused by CVD. In the multivariable-adjusted model, compared with the reference group, the hazard ratios and 95% CIs for all-cause mortality in the psoriasis-/PhenoAge-accel+, psoriasis+/PhenoAge-accel-, and psoriasis+/PhenoAge-accel+ groups were 1.80 (1.54-2.10), 0.96 (0.56-1.65), and 2.70 (1.66-4.39), respectively. A similar trend was observed for CVD mortality.</p><p><strong>Conclusions: </strong>PhenoAge-accel is positively associated with psoriasis risk. Furthermore, the coexistence of psoriasis and PhenoAge-accel are significantly associated with an increased risk of all-cause and CVD mortality.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"894"},"PeriodicalIF":3.4,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191386","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":"The protective effect of probiotic/prebiotic consumption against fatigue in the general population is modulated by BMI: an analysis of mediating and moderating effects based on NHANES.","authors":"Yan Wang, Zhimeng Yu, Huan Zhang, Zhusong Mei, Lei Wang, Chongxi Fan, Yan Wu, Minghao Yang, Yongquan Shi, Lei Shang, Zheyi Han","doi":"10.1186/s40001-025-03129-7","DOIUrl":"10.1186/s40001-025-03129-7","url":null,"abstract":"<p><strong>Objectives: </strong>Fatigue is closely linked to gut microbiota dysbiosis, making probiotics and prebiotics promising candidates for interventions related to fatigue. This study explores the relationship between probiotic/prebiotic consumption and fatigue in the general population, focusing on potential moderating and mediating factors, as most prior research has centered on clinical populations with secondary fatigue.</p><p><strong>Methods: </strong>This study is a cross-sectional analysis using data from the National Health and Nutrition Examination Survey (NHANES) from 2009 to 2018, and it included 3,791 US residents without underlying health conditions. Fatigue was assessed using the Patient Health Questionnaire-9 (PHQ-9), and probiotic/prebiotic consumption was evaluated via a 30-day dietary supplement questionnaire. Statistical analyses included weighted logistic regression to examine associations, and mediation/moderation models to assess the roles of BMI, sleep duration, depression scores, and exercise hours.</p><p><strong>Results: </strong>A total of 3,791 participants were included in the study, with 46.6% self-reporting fatigue. Probiotic/prebiotic consumers had a significantly lower fatigue risk (OR = 0.738, 95% CI 0.735-0.741, p < 0.001). Among the mediating and moderating factors analyzed, only BMI was found to weakly but significantly moderate the association between probiotic/prebiotic consumption and fatigue, with higher BMI strengthening the association of probiotics and/or prebiotics intake with reduced fatigue odds (p = 0.039).</p><p><strong>Conclusions: </strong>These findings indicate that the consumption of probiotics/prebiotics is correlated with a decreased risk of fatigue in the general population, and this association is further reinforced in individuals with a higher BMI.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"888"},"PeriodicalIF":3.4,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191406","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":"Assessing hemoglobin, albumin, lymphocyte, platelet (HALP) score in predicting strangulation and resection in hernia surgery.","authors":"Seyit Murat Aydın, İsmail Hakkı Şencan, Muhammed Kerem Deli, Ayşe Nur Kartal, Tayfun Bayraktar, Yunushan Furkan Aydoğdu, Aziz Mutlu Barlas","doi":"10.1186/s40001-025-03185-z","DOIUrl":"10.1186/s40001-025-03185-z","url":null,"abstract":"<p><strong>Background: </strong>Incarcerated hernias carry a risk of strangulation, which can lead to bowel ischemia, necrosis, and the need for organ resection. The Hemoglobin, Albumin, Lymphocyte, Platelet (HALP) score, a composite biomarker of nutritional and inflammatory status, has shown prognostic value in various malignant and inflammatory conditions. This study aimed to evaluate the role of HALP score in predicting strangulation and the need for bowel or tissue resection in patients undergoing surgery for incarcerated abdominal wall hernias.</p><p><strong>Methods: </strong>We retrospectively analyzed the data of 135 patients who underwent elective or emergency hernia surgery due to incarceration between 2015 and January 2025. Patients were divided into two groups: those requiring tissue or organ resection due to intraoperative signs of strangulation (n = 53) and those who underwent hernia repair without resection (n = 82). HALP scores were calculated using preoperative laboratory values. Statistical analyses were performed using non-parametric tests due to the non-normal distribution of variables. A p-value < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Of the 135 patients included, 53 (39.3%) underwent bowel or tissue resection due to intraoperative evidence of strangulation, while 82 (60.7%) underwent hernia repair without resection. Patients in the resection group tended to be older (median age: 72 vs. 64 years, p = 0.083). The median HALP score was notably lower in the strangulation group (2.55) compared to the non-resection group (4.55), though the difference did not reach statistical significance (p = 0.092). The most frequently resected tissues were small intestine (41.5%) and omentum (35.8%). Resection was significantly associated with the presence of ischemia (p < 0.001), whereas no significant associations were found with hernia type, side, or surgical approach.</p><p><strong>Conclusion: </strong>A decreasing trend was observed, the trend toward lower HALP scores in patients with strangulated hernias suggests a potential role for HALP as a supportive biomarker in preoperative risk assessment. Its low cost and accessibility make it a practical tool, especially in emergency settings. Larger, prospective studies with standardized preoperative protocols are warranted to validate the clinical utility of HALP in predicting ischemic complications in incarcerated hernias.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"895"},"PeriodicalIF":3.4,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191414","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":"Role of long non-coding RNAs in cartilage development and osteoarthritis pathogenesis.","authors":"Xuejiao Sun, Shan Wang, Jun Tian, Mingxing Li","doi":"10.1186/s40001-025-03173-3","DOIUrl":"10.1186/s40001-025-03173-3","url":null,"abstract":"<p><p>Osteoarthritis (OA) is a progressive joint disease characterized by the degradation of cartilage, remodeling of subchondral bone, and inflammation of synovial tissue, posing growing global health challenges. Long non-coding RNAs (lncRNAs) play crucial roles in various physiological and pathological processes associated with OA, including extracellular matrix (ECM) degradation, synovial inflammation, chondrocyte apoptosis, and angiogenesis. Chondrogenesis involves mesenchymal cell condensation followed by differentiation into chondrocytes, hypertrophy of chondrocytes, and subsequent maturation. This review aims to provide an updated overview of lncRNAs and their involvement in cartilage development as well as OA. Furthermore, we discuss the potential utility of lncRNAs as molecular biomarkers for early diagnosis and treatment of OA.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"900"},"PeriodicalIF":3.4,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191441","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":"Distribution effect of SOST on alveolar bone micro-bone formation in rats induced by Eldecalcitol.","authors":"Ying Guo, Hong Wang, Nu Mi, Qianmin Chen, RongRong Wang, Hui Ni","doi":"10.1186/s40001-025-03182-2","DOIUrl":"10.1186/s40001-025-03182-2","url":null,"abstract":"<p><strong>Objectives: </strong>This study controlled experimental and histological study based on an ovariectomized (OVX) rat model, and aimed to clarify the distribution changes of TRAP-positive osteoclasts and sclerostin-positive osteocytes in the alveolar septal area of rats after Eldecalcitol (ELD) treatment, and to explore their association with bone metabolism-related factors, thereby preliminarily elucidating the early pathological mechanism of alveolar osteoporosis.</p><p><strong>Methods: </strong>A total of 32 female Wistar rats (8 weeks) were randomly divided into three groups: sham-operated control (Sham, n = 10), ovariectomized (OVX, n = 11), and ovariectomized treated with Eldecalcitol (OVX + ELD, n = 11). Observations were Made at different timepoints, including 1 week and 2 weeks after surgery. OVX rat models were established by bilateral ovariectomy. Eldecalcitol (0.03 µg/kg/day) was administered orally for 2 weeks starting immediately after surgery. Mandibular samples were fixed, decalcified, and prepared into thin sections for histological analyses. Osteocyte distribution and characteristics were studied in detail using TRAP staining, ALP/TRAP staining, and sclerostin/TRAP/silver triple staining techniques. In addition, double staining of RANKL and TRAP was performed to further explore the expression of bone resorption-related molecules.</p><p><strong>Results: </strong>The experimental results showed that in the bone groove interval area, rats that underwent ovariectomy (OVX) had a small number of TRAP-positive osteoclasts in the early stage (1 week), but this number gradually increased over time. In the OVX group after 1 week of combined treatment with Eldecalcitol, the number of TRAP-positive osteoclasts was significantly reduced. In addition, the expression of sclerostin-positive osteocytes decreased over time, but this decrease was smaller in the combination treatment group.</p><p><strong>Conclusions: </strong>This study reveals the distribution of TRAP-positive osteoclasts and sclerostin-positive osteocytes in the alveolar septal area and their correlation with bone metabolism-related factors. Eldecalcitol treatment effectively inhibits osteoclast activity, reduces bone resorption, and significantly mitigates the reduction of sclerostin expression in osteocytes induced by ovariectomy. These findings suggest that Eldecalcitol may regulate alveolar bone metabolism partially by modulating sclerostin expression, making it a promising therapeutic strategy for osteoporosis.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"886"},"PeriodicalIF":3.4,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191066","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":"Dysphagia linked to clinical phenotype and disease progression in spinocerebellar ataxia type 3.","authors":"Cai-Ping Chen, Mao-Lin Cui, Wei Lin, Zhuo-Ying Huang, Bei-Ning Ye, Bin Cai, Shi-Rui Gan","doi":"10.1186/s40001-025-03154-6","DOIUrl":"10.1186/s40001-025-03154-6","url":null,"abstract":"<p><strong>Background: </strong>Spinocerebellar Ataxia type 3 (SCA3) is a widely recognized autosomal dominant disorder characterized by cerebellar ataxia, particularly prevalent in China. Dysphagia frequently arises in SCA3 and other neurological disorders, representing a significant threat to patient survival.</p><p><strong>Objective: </strong>Examining the Prevalence of Dysphagia among SCA3 Patients and Its correlation with Clinical phenotype and Disease Progression.</p><p><strong>Methods: </strong>We retrospectively analyzed 183 SCA3 patients, divided into dysphagia and non-dysphagia groups. Dysphagia, as an item within INAS, was assessed by ataxia specialists primarily based on patient-reported symptoms, supplemented by caregiver or family input when available. Spearman's rho tested factor associations with dysphagia, logistic regression identified dysphagia risk factors, and multivariable linear regression assessed dysphagia's effect on ataxia severity. Kaplan-Meier curves with first derivative fitting explored dysphagia progression over the disease duration.</p><p><strong>Results: </strong>The study found 77.0% of SCA3 patients had dysphagia, with disease duration most strongly linked to its onset (r = 0.456, p < 0.001). Sex (p = 0.001; OR = 4.69, 95% CI = 1.85 to 11.88), AAO (p = 0.031; OR = 0.93, 95% CI = 0.87 to 0.99), SARA scores (p = 0.034; OR = 1.12, 95% CI = 1.01 to 1.25), and disease duration (p < 0.001; OR = 1.34, 95% CI = 1.14 to 1.57) were independent dysphagia risk factors. Dysphagia also affected SARA scores (p = 0.048). Dysphagia progression rate peaks within the first decade of disease onset, reaching maximal velocity at 6.5 years, with a median time to dysphagia onset of 9 years.</p><p><strong>Conclusion: </strong>In China, dysphagia frequently occurs in SCA3 patients and can impact the severity of ataxia. The prevalence of dysphagia varies as the disease advances. These findings highlight the importance of timely intervention for dysphagia in SCA3 patients, particularly during the late stages of the first decade.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"901"},"PeriodicalIF":3.4,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190988","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":"Deferoxamine addresses metabolic dysregulation and urinary tract infections in weight-associated gestational diabetes mellitus.","authors":"Min Zhang, Na Wei, Rong Lin, Yue Xu, Qingfu Zhang, Lina Jia, Xiaotong Zhang, Xiaojing Yang","doi":"10.1186/s40001-025-03013-4","DOIUrl":"10.1186/s40001-025-03013-4","url":null,"abstract":"<p><strong>Background: </strong>The increasing prevalence of gestational diabetes mellitus (GDM), particularly among overweight or obese individuals, poses significant health risks. Excess iron contributes to oxidative stress, inflammation, and disruptions in immune and metabolic functions in GDM. Deferoxamine (DFO), an iron chelator, may offer a therapeutic solution by restoring immune and metabolic balance.</p><p><strong>Methods: </strong>We conducted a comprehensive multi-omics analysis using GEO transcriptomic data, applying Weighted Gene Co-expression Network Analysis (WGCNA) and gene set enrichment analysis to identify key immune-metabolic genes. Molecular docking experiments with DFO were performed using AutoDock Vina, and interactions were visualized in PyMOL. Various in vitro assays-CCK-8, qRT-PCR, Western blot, immunofluorescence, ELISA, and colony formation tests-were conducted under high glucose conditions to assess the effects of DFO, focusing on LAMA3 and the PI3K/AKT signaling pathway.</p><p><strong>Results: </strong>Key genes such as CDR2L, LIMCH1, LDLR, and LAMA3 were identified as being improperly regulated in cases of gestational diabetes mellitus (GDM). DFO demonstrated a significant affinity for these targets, especially LDLR. Functionally, DFO was found to improve cell survival during hyperglycemic stress, mitigate oxidative stress, and lower the concentrations of inflammatory cytokines like IL-6, IL-17, and IL-23. Notably, silencing or blocking LAMA3 reversed these effects, inhibiting the PI3K/AKT pathway, increasing apoptosis markers, and decreasing cell proliferation.</p><p><strong>Conclusions: </strong>DFO holds potential as a targeted treatment for GDM associated with obesity by addressing iron excess and immune-metabolic dysregulation. LAMA3 plays a crucial role in mediating DFO's anti-inflammatory and survival-promoting effects via the PI3K/AKT pathway. Further clinical studies are needed to explore DFO's therapeutic potential in GDM.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"897"},"PeriodicalIF":3.4,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191022","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":"Comprehensive analysis of intestinal barrier function and microbial diversity changes in L-arginine-induced acute pancreatitis mice.","authors":"Peng Zhang, Yufu Li, Zhenyu Chen, Xinxin Wang, Korotkova Irina Pavlovna","doi":"10.1186/s40001-025-03199-7","DOIUrl":"10.1186/s40001-025-03199-7","url":null,"abstract":"<p><strong>Introduction: </strong>While it has been established that intestinal health and microbial variations can influence pancreatic well-being, the extent of intestinal damage and the composition and diversity of the microbiota in animal models of L-arginine-induced acute pancreatitis (AP) remain unclear.</p><p><strong>Methods: </strong>This study aims to evaluate the extent of intestinal damage and microbial changes in AP mouse models. The male C57BL/6 mice were randomly divided into two groups: the AP group received an intraperitoneal injection of 10% L-arginine, while the control group received an equivalent volume of saline. Histological analysis was used to assess morphological changes and damage in the pancreas and the duodenum, ileum, and jejunum. Fluorescent immunohistochemistry and immunohistochemical techniques were employed to evaluate the expression of myeloperoxidase (MPO) in the pancreas and Zonula occludens-1 (ZO-1) and Occludin in the small intestine. High-throughput sequencing was utilized to analyze the composition and diversity of the intestinal microbiota.</p><p><strong>Results: </strong>L-arginine-induced AP in mice significantly increased serum lipase activity and decreased calcium levels, with an increase in pancreatic MPO expression. Additionally, we observed varying degrees of intestinal villi necrosis, edema, and inflammatory cell infiltration in the duodenum, jejunum, and ileum of the AP group mice. Notably, the expression of epithelial Occludin and ZO-1 was reduced in these regions. Compared to healthy mice, AP mice exhibited reduced bacterial richness and diversity, with changes in the intestinal microbiota including increased prevalence of Bacteroidetes and Proteobacteria, while the abundance of Firmicutes decreased.</p><p><strong>Discussion: </strong>L-arginine-induced acute pancreatitis in mice resulted in significant alterations in the intestinal barrier and microbiota.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"912"},"PeriodicalIF":3.4,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191073","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":"Prognostic value of the ARISCAT score for postoperative pneumonia in patients with esophageal squamous cell carcinoma: a retrospective cohort study.","authors":"Peng Zhang, Yunyun Chen, Zhiyun Xu, Tingting Qin, Yueqin Yang, Changying Liu, Jianqiang Zhao, Hui Xia","doi":"10.1186/s40001-025-03189-9","DOIUrl":"10.1186/s40001-025-03189-9","url":null,"abstract":"<p><strong>Background: </strong>Postoperative pneumonia remains one of the most common and serious complications after esophagectomy for esophageal squamous cell carcinoma, significantly impairing recovery and survival outcomes. Accurate preoperative risk stratification is critical, yet no widely validated scoring system currently exists for ESCC-specific surgical cohorts. The ARISCAT score, a preoperative risk index developed to estimate pulmonary complication risk in general surgery, has not been previously assessed in ESCC patients. This study aimed to evaluate the prognostic value of the ARISCAT score and its integration with other perioperative indicators for predicting postoperative pneumonia.</p><p><strong>Methods: </strong>This retrospective cohort study included 366 patients with histologically confirmed resectable ESCC who underwent curative thoraco-laparoscopic McKeown esophagectomy at a high-volume thoracic surgery center between January 2019 and December 2022. The ARISCAT score and other clinical parameters, including tumor length, length of hospital stay, PNI, and LMR, were collected preoperatively. Postoperative pneumonia was diagnosed based on radiologic, clinical, and laboratory criteria within 30 days after surgery. Univariate and multivariate logistic regression analyses were performed to identify independent predictors of pneumonia. Restricted cubic spline modeling was used to assess non-linear associations.</p><p><strong>Results: </strong>Postoperative pneumonia occurred in 99 of 366 patients (27.0%). Patients with pneumonia had significantly higher ARISCAT scores (59.6 ± 8.9 vs. 44.4 ± 7.6), longer tumor lengths (4.5 ± 0.7 cm vs. 3.8 ± 0.6 cm), and prolonged hospital stays (17.6 ± 2.8 vs. 13.6 ± 2.3 days), along with lower PNI and LMR values (all p < 0.001). In multivariate analysis, the ARISCAT score was independently associated with postoperative pneumonia (adjusted OR = 1.40, 95% CI 1.22-1.60, p < 0.001). Other independent predictors included tumor length (adjusted OR = 12.44), length of hospital stay (adjusted OR = 2.64), PNI (adjusted OR = 0.79), and LMR (adjusted OR = 0.18). RCS analysis revealed linear dose-response relationships for ARISCAT and tumor length, while LMR and hospital stay showed non-linear associations with pneumonia risk. No significant interaction effects were observed across subgroups.</p><p><strong>Conclusions: </strong>The ARISCAT score is an independent and robust predictor of postoperative pneumonia in ESCC patients undergoing McKeown esophagectomy. This study represents the first comprehensive evaluation of the ARISCAT score in an ESCC-specific surgical cohort, and uniquely demonstrates that its integration with inflammatory (LMR) and nutritional (PNI) markers significantly enhances preoperative risk stratification. These findings offer valuable clinical insights for personalized perioperative management.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"899"},"PeriodicalIF":3.4,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191438","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}