International Journal of Medical Sciences最新文献

{"title":"Effects of Remimazolam Anesthesia in Patients Undergoing Deep Inferior Epigastric Perforator Flap Reconstruction for Breast Cancer: A Retrospective Cohort Study.","authors":"Myoung Hwa Kim, Byongnam Jun, So Yeon Kim, Lin Lin, Hye Jung Shin, Dong Won Lee, Na Young Kim","doi":"10.7150/ijms.125732","DOIUrl":"https://doi.org/10.7150/ijms.125732","url":null,"abstract":"<p><p>In deep inferior epigastric perforator (DIEP) free flap surgery for breast reconstruction, vasopressors may cause vasoconstriction and impair flap perfusion, potentially increasing the risk of complications. In this study, we aimed to determine the effects of remimazolam anesthesia on intraoperative vasopressor requirements and postoperative outcomes in patients undergoing DIEP flap reconstruction compared with conventional anesthesia. We conducted a retrospective cohort study of DIEP flap procedures performed between March 2021 and March 2022 at a single institution. Patients were stratified according to the anesthetic regimen (sevoflurane, propofol, and remimazolam). The primary outcome was the total intraoperative norepinephrine requirement. Among 102 initially identified patients, 75 met the inclusion criteria. The remimazolam group required significantly less norepinephrine than the sevoflurane and propofol groups (202.1 µg vs. 1558.6 µg and 926.6 µg, respectively; <i>P <</i> 0.001), with comparable reductions in ephedrine use. Thus, remimazolam may serve as an effective alternative to sevoflurane and propofol anesthesia in terms of reducing intraoperative vasopressor requirements and is potentially better in maintaining hemodynamic stability during DIEP free flap reconstruction.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"23 5","pages":"1875-1883"},"PeriodicalIF":3.2,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814843","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":"Gallstone Disease Increases the Risk of Kidney Stone Disease: A Cross-Sectional and Longitudinal Cohort Study.","authors":"Yu-Ting Lin, Jia-In Lee, Szu-Chia Chen, Shu-Pin Huang, Jiun-Hung Geng","doi":"10.7150/ijms.128864","DOIUrl":"https://doi.org/10.7150/ijms.128864","url":null,"abstract":"<p><strong>Background: </strong>Gallstone disease (GSD) and kidney stone disease (KSD) may share metabolic pathways, however their association remains unclear. This study aimed to explore their relationship using cross-sectional and longitudinal analyses.</p><p><strong>Methods: </strong>The cross-sectional analysis included 121,550 participants in the Taiwan Biobank, and the association between self-reported GSD and KSD was examined using logistic regression. The longitudinal analysis included 25,208 participants without prior KSD, and the risk of incident KSD was assessed using Kaplan-Meier survival analysis and Cox proportional hazards models, adjusting for demographics, metabolic factors, lifestyle factors, and laboratory data.</p><p><strong>Results: </strong>In the cross-sectional cohort, the prevalence of KSD was higher in the participants with GSD (11% vs. 6%, p < 0.001). In adjusted analysis, GSD was associated with a 51% increased risk of KSD (odds ratio: 1.51, 95% CI: 1.38-1.65, p < 0.001). In the longitudinal analysis, the participants with GSD had a higher incidence of KSD (5% vs. 2%, p < 0.001), with an adjusted hazard ratio of 1.80 (95% CI: 1.36-2.38, p < 0.001). Subgroup analyses showed a significant interaction by sex but not by age, indicating a stronger association in women.</p><p><strong>Conclusion: </strong>Our results showed that GSD was an independent risk factor for KSD, suggesting shared metabolic mechanisms. Future studies should explore preventive strategies targeting the pathways underlying these mechanisms.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"23 5","pages":"1845-1853"},"PeriodicalIF":3.2,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814891","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":"Diabetes Status Modifies the Association Between Carotid Plaque Burden and Retinal Microvascular Parameters.","authors":"Ming Yang, Xueru Cheng, Jiaxin Guan, Zixuan Zhou, Jialin Wang","doi":"10.7150/ijms.130441","DOIUrl":"https://doi.org/10.7150/ijms.130441","url":null,"abstract":"<p><strong>Purpose: </strong>Carotid plaque burden (CPB) is a key indicator of atherosclerosis, yet its relationship with ocular microcirculation in the context of type 2 diabetes mellitus (T2DM) remains poorly understood. This study aimed to examine the association between CPB and ocular vascular parameters, and to evaluate whether this relationship is modified by diabetic status.</p><p><strong>Methods: </strong>This retrospective study included 237 eyes from 123 participants (47 with T2DM, 76 without diabetes). All participants underwent head and neck computed tomography angiography (CTA) to quantify CPB using plaque presence and maximum thickness scores. Retinal vascular calibers (central retinal arteriolar equivalent [CRAE], central retinal venular equivalent [CRVE], and arteriovenous ratio [AVR]) were assessed using fundus photography. Hemodynamic parameters (peak systolic velocity [PSV], end-diastolic velocity [EDV], resistance index [RI], and pulsatility index [PI]) of the ophthalmic artery (OA), central retinal artery (CRA), and posterior ciliary artery (PCA) were measured using color Doppler ultrasound. Linear mixed-effects models (LMM) with patient-level random intercepts were employed to account for inter-eye correlation, with adjustment for age, sex, hypertension, smoking history, ischemic heart disease, stroke history, and hyperlipidemia.</p><p><strong>Results: </strong>In the diabetic group, plaque thickness score was significantly associated with CRAE (beta = -2.223, P = 0.003), AVR (beta = -0.011, P < 0.001), and PCA RI (beta = 0.005, P = 0.021). Plaque presence score was significantly associated with AVR (beta = -0.022, P = 0.021) and PCA RI (beta = 0.016, P = 0.009). No such associations were observed in the non-diabetic group (all P > 0.05). Interaction analyses revealed that diabetic status significantly modified the relationship between plaque thickness and both CRAE (P for interaction = 0.014) and AVR (P for interaction = 0.002). For plaque presence score, diabetic status significantly modified the association with AVR (P for interaction = 0.013).</p><p><strong>Conclusion: </strong>Diabetic status significantly modifies the associations between CPB and retinal microvascular parameters (CRAE and AVR). These findings underscore the importance of metabolic status in ocular vascular pathology and suggest that diabetic patients may benefit from intensified ocular monitoring even with modest CPB. Further longitudinal studies are warranted to elucidate the underlying mechanisms.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"23 5","pages":"1854-1864"},"PeriodicalIF":3.2,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814901","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":"Mediation of Pre-Pregnancy Body Mass Index and Dietary Patterns with Relation to Vitamin D and Erythropoiesis-Related Micronutrients in Pregnant Women.","authors":"Nhi Thi Hong Nguyen, Chien-Yeh Hsu, Chyi-Huey Bai, Jung-Su Chang, Yi-Chun Chen, Ya-Li Huang, Fan-Fen Wang, Arpita Das, Jane C-J Chao","doi":"10.7150/ijms.131338","DOIUrl":"https://doi.org/10.7150/ijms.131338","url":null,"abstract":"<p><p>Pre-pregnancy body mass index (BMI) and dietary patterns (DPs) have been linked to serum erythropoiesis-related micronutrients (iron, folate, and vitamin B12). We studied the mediating effects of pre-pregnancy BMI and DPs on the association of serum vitamin D with the levels of erythropoiesis-related micronutrients. A cross-sectional research involving 1485 pregnant women was carried out in hospitals and clinics between 2017 and 2019 using the Nationwide Nutrition and Health Survey in Taiwan. Dietary intake was measured using food frequency questionnaire, and DPs were identified utilizing principal component analysis. Serum vitamin D and iron biomarker levels were examined. A mediation analysis was conducted to investigate the mediating effects of pre-pregnancy BMI and DPs on the association of serum vitamin D levels with erythropoiesis-related micronutrient levels. Serum 25(OH) vitamin D was positively linked to erythropoiesis-related micronutrient levels. Pre-pregnancy BMI partially mediated the association between serum 25(OH) vitamin D and serum iron (indirect effect: -0.004, 95% confidence interval (CI): -0.009, 0.000), folate (indirect effect: -0.009, 95% CI: -0.021, 0.000), and vitamin B12 levels (indirect effect: -0.137, 95% CI: 0.282, -0.02). Animal and staple-based DP and mushrooms, roots, and dairy DP mediated the association between serum 25(OH) vitamin D and serum iron levels (indirect effect: -0.004, 95% CI: -0.009, 0.000 and indirect effect: -0.004, 95% CI: 0.009, 0.000, respectively). Pre-pregnancy BMI mediates the association of serum vitamin D with erythropoiesis-related micronutrients. Animal and staple-based DP and mushrooms, roots, and dairy DP mediate the association between serum vitamin D and iron status.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"23 5","pages":"1865-1874"},"PeriodicalIF":3.2,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814360","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":"Effects of Initial Lactate Levels and 24-h Lactate Clearance on Mortality in Post-Cardiac Arrest Patients: Insights from the Multicenter TIMECARD Registry.","authors":"Hsin-Hui Hsu, Min-Shan Tsai, Li-Kuo Kuo, Chen-Hsu Wang, Chau-Chyun Sheu, Chun-Yu Wu, Shih-Ni Wu, Lung Chan, An-Yi Wang, Chew-Teng Kor","doi":"10.7150/ijms.129084","DOIUrl":"https://doi.org/10.7150/ijms.129084","url":null,"abstract":"<p><strong>Background: </strong>Lactate concentration and clearance are critical indicators of systemic hypoperfusion and can predict post-cardiac arrest outcomes. However, their combined prognostic value and factors influencing clearance achievement remain unexplored.</p><p><strong>Methods: </strong>This retrospective study analyzed 1,016 adults with cardiac arrest from the Taiwan TIMECARD registry (January 2017-July 2024) who achieved return of spontaneous circulation (ROSC). Patients were stratified into quartiles based on initial lactate levels and 24-hour lactate clearance, defined as the percentage reduction in serum lactate from ROSC to 24 hours. Cox proportional hazards models were used to assess associations with 3-day and 30-day all-cause mortality following ROSC.</p><p><strong>Results: </strong>Higher initial lactate levels (≥12.3 mmol/L) were associated with increased risks of 3-day (hazard ratio [HR]: 3.42, 95% confidence interval [CI]: 1.88-6.22) and 30-day mortality (HR: 1.88, 95% CI: 1.44-2.46). Poor lactate clearance (<16%) was associated with increased 3-day (HR: 21.05, 95% CI: 9.19-48.22) and 30-day mortality (HR: 2.74, 95% CI: 2.13-3.53). Patients achieving rapid clearance had better mortality outcomes despite moderately elevated initial levels, whereas those with both high initial lactate and poor clearance had a 6.9-fold higher 30-day mortality risk. Factors associated with low clearance included age ≥65 years, INR ≥1.15, Glasgow Coma Scale score ≤8, systolic blood pressure ≤125 mmHg, and repeat cardiopulmonary resuscitation within 1 h; conversely, targeted temperature management was protective.</p><p><strong>Conclusion: </strong>Routine measurement of lactate levels at ROSC, together with serial monitoring after cardiac arrest, provides clinically meaningful prognostic information. Although initial lactate levels reflect disease severity, their prognostic impact may be modifiable through adequate clearance, whereas poor clearance is associated with an increased risk of mortality. Early identification of patients with inadequate clearance may facilitate targeted interventions to improve survival.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"23 5","pages":"1884-1895"},"PeriodicalIF":3.2,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814821","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":"STATs Signaling Pathways in Acute Pancreatitis: Mechanisms and Regulation.","authors":"Yang Peng, An-Er Lin, Feng-Ning Yang, Yan-Min Tang, Jia-Qi Yao, Yong Tang, Yi-Fan Miao","doi":"10.7150/ijms.126174","DOIUrl":"https://doi.org/10.7150/ijms.126174","url":null,"abstract":"<p><p>Acute pancreatitis (AP) is a potentially life-threatening inflammatory disorder of the pancreas that can progress from local injury to systemic inflammatory response and multi-organ dysfunction. Despite improvements in supportive treatment, there is still no effective drug therapy for AP. This highlights the necessity of clarifying its molecular mechanisms and exploring novel therapeutic strategies. Among the diverse signaling pathways implicated in the pathogenesis of AP, the significance of the signal transducer and activator of transcription (STAT) family has become increasingly evident. Building on the increasing recognition of the STATs family in AP, this review provides a systematic synthesis in three domains. The first addresses mechanistic studies of STATs-related signaling, the second focuses on pharmacological regulation with an emphasis on natural products and chemical drugs, and the third explores clinical evidence connecting STATs activity to severity and outcomes of AP. By synthesizing mechanistic, pharmacological, and clinical evidence, this review highlights the central role of STATs family members in AP. It underscores the therapeutic potential of natural medicines in targeting STATs pathways and suggests directions for future translational studies to develop effective interventions for AP.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"23 5","pages":"1822-1844"},"PeriodicalIF":3.2,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814778","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":"Clinical effects of glucagon-like peptide-1 receptor agonist in type 2 diabetes with low body mass index: findings from large-scale emulated target trials.","authors":"Ming-Hsien Tsai, Yu-Wei Fang, Yu-Han Tsai, Meng-Ting Chen, Kuo-Cheng Lu, Chien-Lin Lu","doi":"10.7150/ijms.130295","DOIUrl":"https://doi.org/10.7150/ijms.130295","url":null,"abstract":"<p><strong>Aims: </strong>Chronic kidney disease (CKD) is a common and serious complication of type 2 diabetes, yet the effectiveness of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in non-obese or mildly overweight individuals remains uncertain. This study evaluated renal, cardiovascular, and systemic outcomes associated with GLP-1 RA therapy in adults with type 2 diabetes and body mass index (BMI) ≤ 30 kg/m².</p><p><strong>Materials and methods: </strong>We conducted a real-world, target trial emulation, retrospective cohort study using the TriNetX US Collaborative Network. Adults with type 2 diabetes and BMI ≤30 kg/m² initiating GLP-1 RAs or dipeptidyl peptidase-4 inhibitors (DPP-4i) between 2016 and 2023 were identified. After exclusions, 23,103 GLP-1 RA and 44,156 DPP-4i users remained; 1:1 propensity score matching yielded two balanced cohorts of 20,928 patients. Outcomes-including major adverse kidney events (MAKE), progression to dialysis, cardiovascular events, hospitalization, and sepsis-were assessed over up to four years. Cox regression and Kaplan-Meier analyses estimated hazard ratios.</p><p><strong>Results: </strong>GLP-1 RA initiation was associated with lower risks of MAKE (14.8% vs. 16.8%; HR 0.93, p = 0.005) and progression to dialysis (HR 0.78, p < 0.001). Cardiovascular outcomes and all-cause mortality were similar between groups. GLP-1 RAs significantly reduced hospitalization (HR 0.84, p < 0.001) and sepsis (HR 0.88, p = 0.001). Benefits were consistent across BMI strata and clinical subgroups, with no evidence of effect modification.</p><p><strong>Conclusions: </strong>In adults with type 2 diabetes and BMI ≤ 30 kg/m², GLP-1 RAs confer clinically meaningful kidney protection and reduce hospitalization and sepsis, despite neutral cardiovascular effects. These findings support the use of GLP-1 RAs in non-obese or mildly overweight diabetic populations.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"23 5","pages":"1748-1760"},"PeriodicalIF":3.2,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814857","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":"Identifying key bioprocess variables using explainable machine learning to enhance culture efficiency and viability of umbilical cord-derived mesenchymal stem cells.","authors":"Tse-Pu Huang, Hsin-Hui Huang, Bing-Tsiong Li, Pei-Hung Shen, Gracy Thomas, Juin-Yi Han, Chi-Ming Chu, Kun-Yi Lin","doi":"10.7150/ijms.127764","DOIUrl":"https://doi.org/10.7150/ijms.127764","url":null,"abstract":"<p><strong>Background: </strong>Human umbilical cord-derived mesenchymal stromal/stem cells (UC-MSCs) are promising for regenerative medicine, but consistent manufacturing quality is critical.</p><p><strong>Objective: </strong>To develop and interpret machine-learning models (Extreme gradient boosting (XGBoost), with Shapley Additive Explanations, SHAP) that identify facilitatory and inhibitory factors affecting UC-MSC culture duration and post-processing viability.</p><p><strong>Methods: </strong>We analyzed data from 203 UC-MSC manufacturing cases. Candidate predictors included neonatal characteristics (e.g., sex, delivery mode), processing timelines, medium composition, cell features, and operator-related factors. Performance was evaluated using accuracy, the area under the receiver operating characteristic curve (AUROC), the area under the precision-recall curve (AUPRC), log loss, and Brier score, with calibration assessed in cross-validation.</p><p><strong>Results: </strong>For predicting shorter culture duration (defined as a time interval between UC collection and the completion of cryopreservation of <600 h), the model achieved accuracy = 0.80, AUROC = 0.72, and log loss = 0.55; cross-validation yielded AUROC = 0.68, AUPRC = 0.81, and Brier score = 0.20 with good calibration. For predicting higher cell viability, the model achieved accuracy = 0.71, AUROC = 0.72, and log loss = 0.62; cross-validation yielded AUROC = 0.54, AUPRC = 0.58, and Brier score = 0.26. SHAP analysis indicated that shorter culture duration was most associated with medium composition, processing time, and delivery mode, whereas higher viability was linked to neonatal sex, operator identity, and processing time. Sensitivity analyses showed stable top-ranked features across decision-threshold shifts and after removing operator identity.</p><p><strong>Conclusions: </strong>An interpretable XGBoost+SHAP pipeline is effective for identifying process-critical drivers of UC-MSC culture duration. While current predictive precision for cell viability remains limited, the framework functions as a robust diagnostic tool for elucidating qualitative trends. By exploiting these insights, the model facilitates targeted optimization of media selection, timeline control, and standard operating procedures (SOPs), ultimately enhancing manufacturing quality.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"23 5","pages":"1808-1821"},"PeriodicalIF":3.2,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814047","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":"Unraveling Research Trends and Hotspots of Genetic Variants in Acute Leukemias: A Web of Science and Scopus-Based Bibliometric Study.","authors":"Ninie Nadia Zulkipli, Nur Shafawati Ab Rajab, Nurul Aain Ahmad Fauzi, Amin Abdurrahman Abdul Rashid, Sarina Sulong","doi":"10.7150/ijms.128446","DOIUrl":"https://doi.org/10.7150/ijms.128446","url":null,"abstract":"<p><strong>Background: </strong>Acute myeloid leukemia and acute lymphoblastic leukemia are acute leukemias frequently affecting adult and pediatric patients, respectively. Relapse and treatment resistance remain the primary limitations of standard treatments for acute leukemias. This study aimed to uncover the research trends and hotspots of acute leukemias in the past 10 years.</p><p><strong>Methods: </strong>The publications were retrieved from the Web of Science and Scopus databases, and the software tools, including Harzing's Publish or Perish, Microsoft Excel, and VOSviewer, were utilized for data analysis and visualization.</p><p><strong>Results: </strong>This study analysed 5,544 publications from 2015 to 2024, showing the fluctuating trends of publication over the years, peaking in 2021. The University of Texas System and St. Jude Children's Research Hospital were the most prolific and globally influential organizations, with 274 total publication (TP) and 1,065 total link strength (TLS), respectively. <i>Blood</i> is the top-ranked journal, featuring a total of 180 publications. Europe emerges as the top-contributor continent with robust international collaboration (TP = 3,629; TLS = 9,371). The United States becomes a top-performing country with TP, TLS, and citation values of 1,840, 1,655, and 83,210, respectively. The co-occurrence analysis of author keywords reveals gene mutations, genetic polymorphisms, and chemotherapy as the significant research hotspots.</p><p><strong>Conclusion: </strong>The research hotspots that have been identified in this study are transitioning from cytogenetic abnormalities to genomic technologies and targeted therapeutic strategies. The integration of these hotspots reflects a robust growth that emphasizes precision medicine. Further investigations that incorporate multidisciplinary approaches are necessary, as they might contribute to better management of acute leukemias.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"23 5","pages":"1782-1797"},"PeriodicalIF":3.2,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814719","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":"Comparative effects of remimazolam and propofol on intraoperative redistribution hypothermia in urologic surgery: a retrospective propensity-matched cohort study.","authors":"Ji-Yoon Jung, Woojin Kwon, Tae-Yun Sung","doi":"10.7150/ijms.126707","DOIUrl":"https://doi.org/10.7150/ijms.126707","url":null,"abstract":"<p><strong>Background: </strong>Redistribution hypothermia, characterized by rapid core-to-peripheral heat transfer after anesthetic induction, is a major cause of perioperative hypothermia and is linked to adverse outcomes. Propofol, widely used for induction, impairs thermoregulatory vasoconstriction. Remimazolam, a novel ultra-short-acting benzodiazepine, provides greater hemodynamic stability, but its thermoregulatory effects remain unclear. This study compared remimazolam and propofol on intraoperative hypothermia in patients undergoing urologic surgery.</p><p><strong>Methods: </strong>This retrospective observational study included adult patients (≥ 19 years) who underwent elective urologic surgery under general anesthesia between February 2024 and February 2025. Patients receiving remimazolam (0.2 mg/kg) or propofol (1.5-2.5 mg/kg) for induction were classified into respective groups. Propensity score matching (PSM) was performed (1:1 ratio) using demographic and perioperative covariates. The primary outcome was the incidence of redistribution hypothermia, defined as core temperature < 36.0°C within the first hour after induction. Secondary outcomes included severity of hypothermia, maximum temperature decrease, perioperative temperature trends, and predictors of hypothermia.</p><p><strong>Results: </strong>Among 181 patients analyzed, 71 per group were matched after PSM. Hypothermia incidence was significantly lower with remimazolam than propofol both before (16.5% vs. 50.0%, P < 0.001) and after matching (15.5% vs. 47.9%, P < 0.001). Propofol use was an independent risk factor (adjusted OR: 7.31; 95% CI: 2.81-21.58; P < 0.001). Female sex, higher BMI, and higher baseline temperature were protective factors.</p><p><strong>Conclusion: </strong>Compared with propofol, remimazolam was associated with lower incidence and severity of redistribution hypothermia in urologic surgery. These findings suggest thermoregulatory benefits of remimazolam, warranting confirmation in prospective trials.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"23 5","pages":"1798-1807"},"PeriodicalIF":3.2,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814816","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}