European Journal of Medical Research最新文献

{"title":"Association between volume of processed plasma and total bilirubin reduction during plasma adsorption for severe liver disease.","authors":"Yuanji Ma, Yan Xu, Lingyao Du, Lang Bai, Hong Tang","doi":"10.1186/s40001-025-02419-4","DOIUrl":"10.1186/s40001-025-02419-4","url":null,"abstract":"<p><strong>Background: </strong>The double plasma molecular adsorption system (DPMAS) is a crucial therapeutic modality for the management of severe liver disease. Current literature reports considerable variability in the volume of processed plasma (VPP) utilized during DPMAS treatment, and there is currently no consensus on the appropriate VPP. We aimed to investigate the relationship between VPP and changes in total bilirubin levels during DPMAS treatment.</p><p><strong>Methods: </strong>A prospective observational study with a repeated-measures design was conducted in patients with severe liver disease. The generalized estimation equations were used to evaluate the relationship between VPP and changes in total bilirubin levels during DPMAS treatment. The Bonferroni method was used for multiple comparisons. Tests for linear trends were performed by entering the median value of each category as a continuous variable. Total bilirubin level were detected repeatedly at four different times (four different VPP) (at 0.0 h (0 mL); at 2.0 h (3000 mL); at 2.5 h (3750 mL); at 3.0 h (4500 mL)).</p><p><strong>Results: </strong>Twenty-nine patients who underwent 75 sessions of DPMAS treatment were enrolled. The baseline total bilirubin levels and model for end-stage liver disease score were 426.1 (356.6-487.3) μmol/L and 21.9 (18.7-24.9). The total bilirubin levels and their reduction ratios in all patients (75 sessions) or patients with total bilirubin <425 μmol/L (39 sessions) or ≥425 μmol/L (36 sessions) decreased gradually and significantly at four different times (four different VPP) (all adjusted P for pairwise comparisons <0.001; adjusted P for trend <0.001). The reduction ratios of total bilirubin in patients with total bilirubin ≥425 μmol/L were similar to those with total bilirubin <425 μmol/L (adjusted OR (95% CI), 1.001 (0.966-1.036)). The positive relationship between the reduction ratios of total bilirubin and VPP was less remarkable in patients with higher height (adjusted P for interaction = 0.027) or lower albumin levels (adjusted P for interaction = 0.017).</p><p><strong>Conclusion: </strong>The VPP of DPMAS treatment could be more than 4500 mL. Patients with higher height or lower albumin levels might require a higher VPP to achieve sufficient therapeutic efficacy.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"175"},"PeriodicalIF":2.8,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633758","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":"CPA4 overexpression correlates with poor prognosis and tumor progression in endometrial cancer.","authors":"Kang He, Jingying Zheng, Tingyu Zhang, Hao Lv, Kai Wang, Zeyu Wang, Longyun Wang, Shan Wu, Lijing Zhao","doi":"10.1186/s40001-025-02293-0","DOIUrl":"10.1186/s40001-025-02293-0","url":null,"abstract":"<p><strong>Background: </strong>The rise in endometrial cancer rates globally calls for advanced diagnostic methods and new biomarkers. CPA4, known for its role in cancer development, has not yet been studied in relation to endometrial cancer, making it a promising research avenue.</p><p><strong>Methods: </strong>We analyzed CPA4's mRNA expression using data from TCGA and GEO databases and validated these findings with 116 clinical samples through immunohistochemical analysis. The Ishikawa and Hec-1-A cell lines were used to examine CPA4's functionality. In addition, we conducted correlation analysis, Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), Gene Set Enrichment Analysis (GSEA), and survival analysis to understand CPA4's role in endometrial cancer prognosis. A nomogram model was developed for clinical prognostic predictions.</p><p><strong>Results: </strong>CPA4 is significantly overexpressed in endometrial cancer, correlating with tumor progression and poor prognosis. Overexpression is linked to crucial functions, such as mitosis and cell cycle. Reducing CPA4 in cell lines inhibited tumor growth and spread. Kaplan-Meier plots and Cox regression analysis confirmed CPA4's significance in prognosis, with our predictive model showing high accuracy.</p><p><strong>Conclusions: </strong>CPA4 emerges as a vital biomarker for diagnosing and prognosing endometrial cancer, presenting a novel pathway for research and clinical application. The study highlights its potential as a clinical tool, paving the way for improved patient management and treatment strategies in endometrial cancer.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"174"},"PeriodicalIF":2.8,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633864","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":"Survival benefit of surgery vs radiotherapy alone to patients with stage IA lung adenocarcinoma: a propensity score-matched analysis.","authors":"Dejun Zeng, Zhencong Chen, Ming Li, Yanjun Yi, Zhengyang Hu, Besskaya Valeria, Guangyao Shan, Cheng Zhan, Junjie Xi, Qun Wang, Zongwu Lin","doi":"10.1186/s40001-025-02436-3","DOIUrl":"10.1186/s40001-025-02436-3","url":null,"abstract":"<p><strong>Objectives: </strong>We compared the overall survival (OS) and cancer-specific survival (CSS) of patients who received radiotherapy and surgery, respectively, in a large population.</p><p><strong>Methods: </strong>In this study, we counted the patients diagnosed with stage IA lung adenocarcinoma in the SEER database from 2015 to 2019. We compared the overall survival (OS) and cancer-specific survival (CSS) through Kaplan Meier analysis, balanced the differences of primary data through propensity score matching (PSM), screened independent prognostic factors through Cox regression analysis, and then compared the survival differences of different treatment methods through hierarchical analysis.</p><p><strong>Results: </strong>Among 11,159 patients with stage IA lung adenocarcinoma, 4254 patients chose radiotherapy alone (38.1%), and 6688 patients were finally included through the propensity score matching. The median survival time for patients with radiotherapy alone was 53 months, while the patients with surgery alone did not reach the median survival time (p < 0.001). Multivariate analysis showed that age, sex, tumor size, and household income affected the prognosis of patients. The results of the stratified analysis showed that, except in the subgroup of age ≤ 50 years, almost all subgroup analyses showed that surgical treatment achieved better results.</p><p><strong>Conclusions: </strong>Radiotherapy alone can be used as an option for patients with stage IA lung adenocarcinoma who cannot tolerate surgery, but the benefit to patients is limited, and surgical treatment may still be the best choice.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"173"},"PeriodicalIF":2.8,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633883","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":"Lower body mass index is associated with the achievement of target LDL in patients using PCSK9 inhibitors in Taiwan.","authors":"Kuan-Chieh Tu, Wei-Ting Chang, Hui-Wen Lin, Po-Lin Lin, Yen-Wen Wu, Chao-Feng Lin, Hung-I Yeh, Min-Ji Charng, Po-Hsun Huang, Tsung-Hsien Lin, Wei-Wen Lin, I-Chang Hsieh, Feng-Yu Kuo, Ching-Pei Chen, Sheng-Hsiang Lin, Yi-Heng Li","doi":"10.1186/s40001-025-02431-8","DOIUrl":"10.1186/s40001-025-02431-8","url":null,"abstract":"<p><strong>Objective: </strong>Proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors are a standard therapy for patients who respond poorly to or cannot tolerate statins. However, identifying responders to PCSK9 inhibitors remains unclear. This study investigates the characteristics of patients who achieve target LDL-C reduction (< 70 mg/dl) after PCSK9 inhibitor therapy.</p><p><strong>Methods: </strong>A multicenter, retrospective cohort study included patients initiating PCSK9 inhibitors at 11 teaching hospitals in Taiwan (2017-2021). Baseline characteristics, lipid-lowering therapies, and lipid profile changes were analyzed.</p><p><strong>Results: </strong>Among 211 patients (mean age 57.2 ± 13.1 years, 72.0% male), 73.5% used alirocumab and 26.5% used evolocumab. More than half had coronary artery disease and/or hypertension. Of these, 120 patients achieved the LDL-C target. Target achievers had a lower baseline BMI (25.8 ± 3.7 vs. 27.4 ± 4.5 kg/m², P = 0.028) and a higher incidence of myocardial infarction and anti-platelet use compared to non-achievers. Baseline cholesterol and LDL-C levels were similar, but target achievers experienced greater LDL-C reductions (- 71.5; IQR - 81.8, - 62.2 vs. - 29.4; IQR - 38, - 10.5 mg/dl, P < 0.001), as well as decreases in triglycerides and increases in HDL-C. Glucose levels and liver enzymes did not differ significantly. Logistic regression revealed BMI as the only independent predictor of LDL-C target achievement (odds ratio: 0.899, 95% CI 0.821-0.984, P = 0.021).</p><p><strong>Conclusions: </strong>Lower BMI at baseline was associated with a higher likelihood of achieving LDL-C < 70 mg/dl after 12 weeks of PCSK9 inhibitor therapy. These findings support personalized strategies for optimizing cholesterol management in statin-intolerant patients while further investigations are required.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"176"},"PeriodicalIF":2.8,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633869","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":"Anticancer efficacy of Spiruchostatin A: current insights into histone deacetylase inhibition and oncologic applications.","authors":"Saooda Ibrahim, Muhammad Umer Khan, Iqra Khurram, Muhammad Usman Ghani, Javad Sharifi-Rad, Daniela Calina","doi":"10.1186/s40001-025-02401-0","DOIUrl":"10.1186/s40001-025-02401-0","url":null,"abstract":"<p><p>Spiruchostatin A also referred to as YM753 and OBP801, a cyclic peptide-based natural product derived from Pseudomonas sp., is distinguished by its potent inhibition of Class I histone deacetylases (HDACs). The modulation of epigenetic mechanisms by HDAC inhibitors is fundamental for altering gene expression related to cell growth, apoptosis, and differentiation, highlighting their potential in oncologic therapies. This updated review assesses the antitumor efficacy of Spiruchostatin A across diverse cellular and animal models, scrutinizing its viability as a therapeutic agent against various cancers. A systematic literature review was executed by searching databases such as PubMed/MedLine, Scopus, and Web of Science from October 2022 to February 2023. The inclusion criteria focused on studies involving Spiruchostatin A in the context of cancer treatment, including in vitro and in vivo models. The review concentrated on the compound's mechanistic action, biological activity, and clinical applicability. Spiruchostatin A has demonstrated significant antitumor activities, including inducing apoptosis and inhibiting tumor growth effectively in multiple models. Its therapeutic potential is particularly noted in synergistic applications with other anticancer agents, enhancing its efficacy. Mechanistically, the compound facilitates chromatin relaxation and transcriptional activation of key tumor suppressor genes through increased histone acetylation. Spiruchostatin A exhibits substantial potential as an anticancer agent through effective HDAC inhibition and subsequent epigenetic modifications of cancer cell biology. However, comprehensive clinical trials are imperative to validate its efficacy and safety profiles comprehensively. Future research is warranted to elucidate detailed molecular mechanisms and to develop biomarkers for predicting treatment response. Comprehensive longitudinal clinical studies are also critical to establish Spiruchostatin A's role within the broader oncological therapeutic regimen, along with the exploration of its analogs for improved therapeutic outcomes.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"169"},"PeriodicalIF":2.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624049","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":"Transbronchial lung cryobiopsy for diagnosing interstitial lung disease: a cross-sectional, comparative study.","authors":"Min Yu, Xuefeng Xu, Xiaoyan Xin, Shangwen Yang, Yihua Wang, Yonglong Xiao, Shenyun Shi, Xuebing Feng","doi":"10.1186/s40001-025-02435-4","DOIUrl":"10.1186/s40001-025-02435-4","url":null,"abstract":"<p><strong>Objectives: </strong>Transbronchial lung cryobiopsy (TBLC) has been identified to be a new technique to diagnosis interstitial lung disease (ILD). The study was conducted to investigate the safety and the diagnostic accuracy of TBLC contrast with transbronchial lung biosy (TBLB) in patients with ILD.</p><p><strong>Methods: </strong>In a cross-sectional and comparative study, patients with suspected ILD who underwent TBLC or TBLB were evaluated from June 2018 to September 2022 in Nanjing drum tower hospital. TBLC and TBLB procedure details and clinical multidisciplinary discussion (MDD) diagnosis based on clinical, radiological, and histopathological information were retrospectively analyzed. Diagnostic yield and complications of TBLC and TBLB were evaluated.</p><p><strong>Results: </strong>187 patients who underwent TBLC and 176 patients who underwent TBLB following a standardized protocol were enrolled. The diagnostic yield of TBLC and TBLB in patients with ILD were 85.0% and 63.1%, respectively. In TBLC, 162 patients (86.6%) had no or mild bleeding and 25 patients (13.4%) had moderate bleeding. None of the patients had severe bleeding and the rate of pneumothorax was 14.4%. Comparatively, pooled incidences of complications were 91.5% for no or mild bleeding, 8.5% for moderate bleeding and 5.1% for pneumothorax after TBLB. There was no difference in the occurrence of bleeding among TBLC group and TBLB group.</p><p><strong>Conclusions: </strong>This study indicated that the clinical applicability of TBLC in ILD diagnostic algorithms, with a diagnostic yield of 85.0% and an acceptable safety profile.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"171"},"PeriodicalIF":2.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633890","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":"Comparison of ROX index with modified indices incorporating heart rate, flow rate, and PaO₂/FiO₂ ratio for early prediction of outcomes among patients initiated on post-extubation high-flow nasal cannula therapy.","authors":"Smitesh Gutta, Wei Jun Dan Ong, Shanaz Matthew Sajeed, Belinda Zer Hui Chern, Monika Gulati Kansal, Faheem Ahmed Khan, Amit Kansal","doi":"10.1186/s40001-025-02402-z","DOIUrl":"10.1186/s40001-025-02402-z","url":null,"abstract":"<p><strong>Background: </strong>Incorporation of heart rate, flow rate, and PaO₂/FIO₂ (PF) ratio to ROX index has been postulated to better predict high-flow nasal cannula (HFNC) usage outcomes in post-extubation setting. Therefore, we aimed to compare ROX index with new modified indices to predict HFNC outcomes in the post-extubation setting.</p><p><strong>Methods: </strong>This single-centre 6-year retrospective study included subjects initiated on HFNC post-extubation. The modified indices (ROX-HR, ROX-HR-Flow and POX-HR-Flow) incorporated HFNC flow rate, heart rate and substituted PF ratio for SF ratio. Evaluation was performed using AUROC and cut-offs assessed for prediction of HFNC outcomes.</p><p><strong>Results: </strong>Eighty-one subjects were initiated on HFNC post-extubation, of whom 67 patients (82.7%) had HFNC success. ROX-HR-Flow at 2 h post-HFNC initiation demonstrated the best prediction accuracy (AUROC 0.854, 95% CI 0.756-0.952). A ROX-HR-Flow > 12.25 at 2 h post-HFNC initiation was significantly associated with a lower risk of HFNC failure (Sensitivity 77.6% and Specificity 85.7%).</p><p><strong>Conclusions: </strong>Our proposed modified index at 2 h post-HFNC initiation (ROX-HR-Flow), may facilitate early and accurate prediction of HFNC outcomes compared to ROX index among subjects initiated on HFNC in the post-extubation setting.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"166"},"PeriodicalIF":2.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624057","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":"A comparative study of clinical outcomes and risk factors of tuberculosis in kidney transplant recipients from deceased donors.","authors":"Hedong Zhang, Mingda Zhong, Shanbiao Hu, Liang Tan, Longkai Peng, Xubiao Xie, Gongbin Lan","doi":"10.1186/s40001-025-02422-9","DOIUrl":"10.1186/s40001-025-02422-9","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the clinical characteristics, diagnosis and treatment of tuberculosis infection after deceased donor kidney transplantation and to analyze the risk factors and prognosis of tuberculosis infection through a paired case-control study.</p><p><strong>Methods: </strong>This study investigated 31 kidney transplant recipients who developed tuberculosis among 2185 total recipients during 2012-2021. We employed a 1:1 paired case-control design, utilizing 31 patients who received kidneys from the same donor as the controls. The study analyzed clinical presentation, diagnosis, treatment, risk factors, and prognosis.</p><p><strong>Results: </strong>This study identified a 1.4% incidence of tuberculosis (TB) infection (31/2185) in kidney transplant recipients. The median onset was 10.8 months post-transplant (range: 5-24 months), with 51.6% occurring within the first year. Anti-TB therapy achieved cure in 30 patients, but one died and three experienced kidney transplant dysfunctions. While overall patient survival was not statistically different between groups, kidney graft survival was significantly lower in the TB group (p = 0.042). While kidney function was initially similar, the TB group experienced significant declines in creatinine and GFR at 3, 6, and 12 months post-treatment (p < 0.05). Multivariate analysis identified diabetes mellitus (p = 0.005) and hepatitis (p = 0.027) as independent risk factors for post-transplant TB infection.</p><p><strong>Conclusion: </strong>Over half of the tuberculosis cases (51.6%) occurred within the first year post-transplant, highlighting the need for heightened vigilance during this early period. While standard anti-TB therapy achieved good overall patient survival, it takes a toll on kidney function which underscores the importance of close kidney function monitoring and delicate immunosuppressant management during TB treatment. Diabetes mellitus and hepatitis were identified as independent risk factors for post-transplant TB infection. Prophylaxis measures should be considered for these high-risk patients during early time post-transplant.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"167"},"PeriodicalIF":2.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624045","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 nomogram based on coagulation for individualized prediction after radical resection of hepatocellular carcinoma.","authors":"Ming Lu, Haibo Yuan, Mengjie Wu, Heng Li, Congyin Tu, Kongwang Hu","doi":"10.1186/s40001-025-02291-2","DOIUrl":"10.1186/s40001-025-02291-2","url":null,"abstract":"<p><strong>Background: </strong>The prognosis of patients with hepatocellular carcinoma (HCC) following radical resection remains suboptimal. This study aimed to create a nomogram integrating clinicopathological parameters and coagulation indices to predict the recurrence-free survival (RFS) of these individuals.</p><p><strong>Methods: </strong>A total of 863 patients with hepatocellular carcinoma after radical resection were included (504 patients in the training cohort, 216 patients in the internal verification cohort and 142 patients in the external verification cohort). Cox regression analysis was used to determine the independent risk factors in the training cohort, and it was used to construct a prognostic nomogram. Calibration curves, decision curve analysis (DCA), the C index and the time-dependent area under the curve (td-AUC) were used to evaluate the performance of the nomogram, and the internal and external validation cohorts were used for verification. We also calculated total risk points to divide patients into high-, medium- and low-risk groups. The Kaplan-Meier methodology was used to analyze RFS, and differences were compared using the log-rank test.</p><p><strong>Results: </strong>Age, tumor size, tumor differentiation, microvascular invasion, INR and FIB for RFS were integrated into the nomogram. The calibration curves revealed a strong correlation between the predicted and actual results, and the nomogram's C-index and DCA demonstrated superior predictive performance compared with TNM, BCLC, CNLC, and CLIP. Additionally, the td-AUC revealed that the nomogram effectively predicted recurrence-free survival (RFS) at 1, 3, and 5 years. Moreover, significant differences in RFS were observed between the high-, medium-, and low-risk groups (P < 0.0001) after the effective cutoff values of the risk points were identified using the nomogram.</p><p><strong>Conclusions: </strong>A nomogram model that is based on coagulation indices has high predictive efficacy for the recurrence of hepatocellular carcinoma in patients and significant clinical application value.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"172"},"PeriodicalIF":2.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11908055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633878","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":"Association of atrial cardiopathy and residual shunt after patent foramen ovale closure in patients experiencing migraine.","authors":"Xin Gao, Xinxin Zhang, Wei Song, Yan Liu, Ran Guo, Yinong Jiang","doi":"10.1186/s40001-025-02423-8","DOIUrl":"10.1186/s40001-025-02423-8","url":null,"abstract":"<p><strong>Aims: </strong>Migraine is a prevalent and incapacitating condition. The association between patent foramen ovale (PFO) and migraine-type headaches has been extensively documented. In clinical practice, patients may observe residual shunting after PFO closure. Nevertheless, the underlying mechanisms affecting residual shunting after PFO closure remain unclear. Recent studies have identified left atrial abnormalities, specifically atrial cardiopathy, as an independent risk factor for the development of atrial fibrillation (AF), left atrial thrombosis, and subsequent stroke. To that end, the present study aims to investigate the relationship between residual shunt occurrence after PFO closure and atrial cardiopathy.</p><p><strong>Methods: </strong>A retrospective analysis comparing postoperative residual shunts in patients with and without atrial cardiopathy was conducted. The study cohort consisted of 174 patients with severe migraine and confirmed right-to-left shunt (RLS) (grades II-IV) who voluntarily opted for PFO closure between April 1, 2021, and December 31, 2022. Enrolled patients were categorized into two groups: PFO with or without atrial cardiopathy.</p><p><strong>Results: </strong>A total of 174 migraineurs who underwent PFO closure (PFO with atrial cardiopathy group, n = 20; PFO without atrial cardiopathy group, n = 154) were included. Compared to patients without atrial cardiopathy, those with atrial cardiopathy were older (54.85 ± 11.86 vs. 43.03 ± 13.78 years, p = 0.0003), had a higher prevalence of hypertension (30.00% vs. 11.69%, p = 0.0255), and a higher prevalence of diabetes mellitus (10.00% vs. 1.30%, p = 0.0146). Following fully adjusted multivariate logistic analysis, atrial cardiopathy (OR = 0.119; P = 0.046), BMI (OR = 0.875; P = 0.025) and atrial septal aneurysm (OR = 5.465; P = 0.028) were identified as independent predictors for residual right-to-left shunt.</p><p><strong>Conclusions: </strong>The presence of atrial cardiopathy in patients with severe migraine and PFO was inversely associated with residual shunting following PFO closure.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"168"},"PeriodicalIF":2.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624054","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}