International Journal of Medical Sciences最新文献

{"title":"KMT5B in Cancerous and Noncancerous Diseases: Clinical and Mechanical Considerations.","authors":"Jiahui Liu, Xiaopeng Guo, Yu Wang, Wenbin Ma","doi":"10.7150/ijms.128796","DOIUrl":"https://doi.org/10.7150/ijms.128796","url":null,"abstract":"<p><p>KMT5B, also known as SUV4-20H1, is a lysine methyltransferase, catalyzing the generation of H4K20me2 through methylation at the histone H4K20 site, and is increasingly recognized as a pivotal driver of various tumor and non-tumor diseases. Under physiological conditions, KMT5B and its catalytic product, H4K20me2, regulate several essential cellular processes, including DNA replication site selection, G1/S phase transition, DNA double-strand break repair, and stem cell homeostasis in neural and muscle tissues. Furthermore, they support the development of the cytoskeleton, cilia, heart, and lungs. Beyond its catalytic activity, the non-catalytic functions of KMT5B also contribute to genomic stability. Conversely, KMT5B dysregulation is associated with diverse pathologies: deficiency is linked to glioblastoma, sarcoma, and neurodevelopmental disorders, whereas overexpression correlates with hepatocellular carcinoma and chronic myelogenous leukemia. This review summarizes the biological functions and pathological roles of KMT5B identified over the past decades, highlighting its potential as a therapeutic target for both cancer and non-cancer diseases.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"23 5","pages":"1720-1737"},"PeriodicalIF":3.2,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814327","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":"Potential influence of carbonic anhydrase 9 genetic variants and expression levels on the progression of diabetic retinopathy.","authors":"I-Chia Liang, Hsiang-Wen Chien, Kai Wang, Chia-Yi Lee, Ying-Erh Chou, Shun-Fa Yang","doi":"10.7150/ijms.131188","DOIUrl":"https://doi.org/10.7150/ijms.131188","url":null,"abstract":"<p><p>Diabetic retinopathy (DR) represents one of the most common microvascular complications of diabetes, and proliferative diabetic retinopathy (PDR) is the most vision-threatening form. Carbonic anhydrase IX (CA9), a hypoxia-inducible enzyme, has been implicated in several pathological processes, but its involvement in DR has not been clarified. In this study, three <i>CA9</i> single nucleotide polymorphisms (rs3829078, rs2071676, and rs1048638) were genotyped in diabetic patients with and without DR. Clinical characteristics were compared between groups, and expression analyses were conducted using public databases and ARPE-19 cells under hyperglycemic and hypoxic conditions. No significant association was observed between <i>CA9</i> variants and DR susceptibility in the overall cohort. However, among patients aged ≤60 years, carriers of the rs1048638 C/A and C/A + A/A genotypes exhibited a significantly increased risk of PDR. Expression quantitative trait locus (eQTL) data from the GTEx database revealed higher CA9 mRNA expression in tissues harboring the rs1048638 A allele. Moreover, both transcriptomic data and <i>in vitro</i> experiments demonstrated upregulation of CA9 in ARPE-19 cells exposed to high glucose and hypoxia. These findings suggest that the rs1048638 polymorphism may modulate CA9 expression and contribute to PDR development in younger diabetic patients through hypoxia- and glucose-related mechanisms. Collectively, our findings suggest that CA9 may serve as a potential risk biomarker associated with the progression of DR, particularly in younger patients.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"23 5","pages":"1738-1747"},"PeriodicalIF":3.2,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814575","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":"Synergistic Effect of Ambient PM_2.5 Exposure and Waist-Hip Ratio on Non-Alcoholic Fatty Liver Disease Risk in a Taiwanese Population.","authors":"Shih-Tsung Chang, Ying-Hsiang Chou, Chih-Da Wu, Oswald Ndi Nfor, Wen Yu Lu, Chien-Ning Huang, Yung-Po Liaw","doi":"10.7150/ijms.126734","DOIUrl":"https://doi.org/10.7150/ijms.126734","url":null,"abstract":"<p><p>Epidemiological studies have established a connection between environmental factors and the prevalence of non-alcoholic fatty liver disease (NAFLD). Fine particulate matter with an aerodynamic diameter ≤ 2.5 μm (PM_2.5), a major component of ambient air pollution, has been implicated in systemic inflammation and metabolic dysfunction. The waist-hip ratio (WHR), an important measure of body composition, is a key risk factor for metabolic syndrome and NAFLD. We investigated the association between ambient PM_2.5 exposure, WHR, and NAFLD. We used data from the Taiwan Biobank collected between 2016 and 2020, involving 15,049 individuals aged 30 to 70 years. Ambient PM_2.5 exposure was estimated using a land-use regression model and categorized into quartiles. NAFLD was identified using liver function tests and imaging, and WHR was classified as normal or abnormal based on sex-specific cutoffs. Participants with NAFLD (n = 7179) had higher body mass index, a greater prevalence of abnormal WHR, and less favorable lipid profiles compared with those without NAFLD (n = 7870). Higher PM_2.5 exposure was associated with increased odds of NAFLD, with participants in the highest quartile (PM_2.5 > 39.85 μg/m³) showing an odds ratio (OR) of 1.251 (95% CI: 1.114-1.404). An abnormal WHR was also associated with higher odds of NAFLD (OR = 1.641, 95% CI: 1.507-1.787). A statistically significant interaction between PM_2.5 exposure and WHR was observed, with individuals with abnormal WHR exhibiting consistently higher odds of NAFLD across all PM_2.5 quartiles. In the highest PM_2.5 quartile, participants with abnormal WHR had an OR of 2.020 (95% CI: 1.708-2.389), compared with an OR of 1.442 (95% CI: 1.215-1.712) among those with normal WHR. These findings suggest that central obesity may amplify the association between PM_2.5 exposure and NAFLD, highlighting the importance of integrated public health strategies targeting both air pollution and metabolic health.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"23 5","pages":"1761-1767"},"PeriodicalIF":3.2,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814759","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":"Risk Factors for Anti-Glaucoma Surgery in Posner-Schlossman Syndrome Patients: an 8-Year Retrospective Study.","authors":"Jiaxing Xie, Ruofan Li, Qianqian Ji, Haoyuan Yang, Jingfei Bin, Chi Zhang, Jingyi Ren, Ying Hong","doi":"10.7150/ijms.131284","DOIUrl":"https://doi.org/10.7150/ijms.131284","url":null,"abstract":"<p><p>This study identifies older age, higher attack frequency and RNFL defect as risks for anti-glaucoma surgery in 106 Chinese Posner-Schlossman Syndrome (PSS) patients via an 8-year retrospective study.</p><p><strong>Purpose: </strong>To investigate the risk factors for anti-glaucoma surgery in Chinese patients with PSS.</p><p><strong>Patients and methods: </strong>Retrospective study<b>.</b> All PSS patients visiting Peking University Third Hospital Department of Ophthalmology between June 2016 and May 2023 with a minimum follow-up of 12 months were enrolled. Patients were divided into low-frequency group and high-frequency group (whether average attacks were less than 2 times/year or not). General information, ocular manifestation and medical treatment were compared between the two groups. Risk factors for anti-glaucoma surgery were analyzed.</p><p><strong>Results: </strong>Among 106 patients, 62 cases were in the low-frequency group and 44 were in the high-frequency group. Patients in high-frequency group had a longer duration of attacks, more iris atrophy, and systemic administration of ganciclovir (p = 0.044, 0.044, 0.012, respectively). They also had a higher tendency to develop secondary glaucoma and more probability of undergoing anti-glaucoma surgery (p = 0.014, 0.017 respectively). 18 cases (17%) received anti-glaucoma surgery while binary logistic regression showed that the risk factors for receiving anti-glaucoma surgery were elder age of onset (odds ratio (OR) = 1.080; 95% confidence interval (CI): 1.012-1.153; p = 0.021), higher frequency of attacks (OR = 6.186; 95% CI: 1.276, 29.976; p = 0.024), and RNFL defect (OR = 4.804; 95% CI: 1.040, 22.184; p = 0.044).</p><p><strong>Conclusion: </strong>Risk factors for anti-glaucoma surgery in patients with PSS were elder age of onset, higher frequency of attacks and RNFL defect.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"23 5","pages":"1776-1781"},"PeriodicalIF":3.2,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814803","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":"Fermented <i>Lactobacillus plantarum</i> GKD7 prevents osteoarthritis pain and progression in a preclinical <i>in vivo</i> model.","authors":"Chin-Jung Hsu, Kun-Tsan Lee, Li-Chai Chen, You-Shan Tsai, Yen-Po Chen, Yen-Lien Chen, Chin-Chu Chen, Yen-You Lin, Tzu-Ching Chang, Chih-Hsin Tang","doi":"10.7150/ijms.129270","DOIUrl":"https://doi.org/10.7150/ijms.129270","url":null,"abstract":"<p><p>Osteoarthritis (OA) brought on by aging damages joints and impairs function. Probiotics are known to be safe to eat, and many of them have positive bioactivity for human health issues. <i>Lactobacillus plantarum</i> GKD7 mitigates inflammatory cytokine production and has potential for OA treatment. This study investigated whether fermented GKD7 is effective at preventing the advancement of OA. Anterior cruciate ligament transaction-related bone discomfort and OA are lessened by fermented GKD7. Fermented GKD7 prevented the breakdown of aggrecan and type II collagen alpha 1 chain (COL2A1) by lowering pro-inflammatory cytokines interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α), as well as the chondrolytic factors metalloproteinase-3 (MMP)-3, MMP-13, and a disintegrin and metalloproteinase with thrombospondin motifs 5 (ADAMTS5). This activity prevented cartilage deterioration and bone loss. Our results show that fermented GKD7 improves the prevention of OA formation.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"23 5","pages":"1768-1775"},"PeriodicalIF":3.2,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814908","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":"Early Identification of Endometrial Malignancy in Postmenopausal Women with Asymptomatic Endometrial Thickening: A Novel Explainable Machine Learning Model.","authors":"Ting Ni, Yanhui Meng, Kefan Peng, Chen Xu, Qiong Fan, Shujun Gao, Yuhong Li, Linlin Yang, Yudong Wang","doi":"10.7150/ijms.131192","DOIUrl":"https://doi.org/10.7150/ijms.131192","url":null,"abstract":"<p><strong>Objective: </strong>Early screening and management of asymptomatic postmenopausal women with endometrial thickening are essential to optimize diagnosis and treatment outcomes. However, no unified intervention standards or predictive models for high-risk subgroups exist. This study aimed to develop and validate a SHapley Additive exPlanations (SHAP)-based machine learning (ML) model to identify key risk factors for non-benign lesions in this population.</p><p><strong>Methods: </strong>Enrolled in this retrospective cohort were 1031 asymptomatic postmenopausal women with endometrial thickening (≥ 5 mm) who underwent hysteroscopy at International Peace Maternity and Child Health Hospital from January 1, 2017, to July 31, 2025. This study comprehensively compiled 33 candidate predictors from accessible clinical datasets, covering demographic characteristics, disease attributes, transvaginal ultrasound results, and laboratory data. Least absolute shrinkage and selection operator (LASSO) regression was adopted for feature selection. Eight machine learning methods (Logistic Regression, Random Forest, Gradient Boosting, XGBoost, LightGBM, Naive Bayes, LDA, QDA) were leveraged to construct the model. Outcome interpretation was performed with the SHAP method, and a dynamic online nomogram was created to support clinical practice.</p><p><strong>Results: </strong>Parity, endometrial thickness (ET), mean platelet volume (MPV), platelet distribution width (PDW), and D-dimer were identified as independent risk factors. An online nomogram built upon these variables facilitated the real-time prediction of endometrial atypical hyperplasia (EAH)/ endometrial carcinoma (EC). Among eight machine learning models, the Gradient Boosting model achieved the superior performance, with an AUC of 0.763 (95% CI: 0.640-0.865), accuracy of 0.791, sensitivity of 0.667, and specificity of 0.805. Visualized interpretation at the individual patient level was achieved using the SHAP force plot.</p><p><strong>Conclusion: </strong>We proposed a robust and interpretable ML-driven strategy for EAH/EC risk assessment in postmenopausal women with asymptomatic endometrial thickening. The model demonstrated superior predictive performance and feasibility for population-wide screening, serving as an efficient tool for the risk stratification of early endometrial malignancy prior to surgery and thus preventing overtreatment in low-risk individuals.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"23 5","pages":"1667-1684"},"PeriodicalIF":3.2,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814854","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 role of mitoxantrone hydrochloride in lymph node harvesting and parathyroid gland identification in conventional and endoscopic thyroidectomy.","authors":"Yifan Liu, Di Zhou, Rong Cong, Botao Sun, Fada Xia, Xinying Li","doi":"10.7150/ijms.126168","DOIUrl":"https://doi.org/10.7150/ijms.126168","url":null,"abstract":"<p><strong>Introduction: </strong>This retrospective study investigates the role of Mitoxantrone Hydrochloride Injection (MHI) in enhancing lymph node yield and protecting the parathyroid glands (PGs) in conventional and endoscopic thyroid surgery.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 397 thyroid cancer patients who underwent surgery from May 2023 to May 2024. The patients were divided into MHI and control groups based on the intraoperative use of MHI. Clinical data, including lymph node harvest and PGs identification, as well as perioperative parathyroid hormone and calcium levels, were reviewed.</p><p><strong>Results: </strong>The study included 258 patients in the conventional surgery cohort and 139 in the endoscopic cohort (transoral, axillary, and periareolar approaches). No MHI-related complications were observed. In the conventional surgery cohort, MHI increased the lymph node yield per unilateral central neck dissection from 4.59 to 5.89, and in the endoscopic cohort, from 4.15 to 5.29. No difference was observed in the identification of superior PGs between groups. MHI enhanced the identification of inferior PGs from 42.45% to 60.87% in the conventional surgery cohort and from 41.00% to 60.92% in the endoscopic cohort. However, during the follow-up period, there was no significant difference in the incidence of hypoparathyroidism between the groups.</p><p><strong>Conclusions: </strong>MHI is a safe and effective adjunct for thyroid surgery, improving lymph node detection and inferior PGs exposure, although its measurable impact on postoperative parathyroid function in a high-volume center appears limited.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"23 5","pages":"1656-1666"},"PeriodicalIF":3.2,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814735","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 Potential Role of Auditory Nerve Development in Sensorineural Hearing Loss: from Pathophysiology to Treatment Insights.","authors":"Li Tian, Juanjuan Li, Yun Hu, Mengdi Li, Wenwen Xie, Jiaxue Feng, Peng Zhang, Xianhai Zeng","doi":"10.7150/ijms.131458","DOIUrl":"https://doi.org/10.7150/ijms.131458","url":null,"abstract":"<p><p>Sensorineural hearing loss (SNHL), as one of the most common types of hearing impairment, has seen a continuous increase in global incidence. It has seriously affected patients' quality of life and is closely associated with a range of psychological and mental health issues, while also posing a significant burden on healthcare systems. It is known that the etiologies of SNHL mainly include environmental factors (such as noise exposure, ototoxic drugs, and viral infections), genetic factors (including relevant gene mutations), and age-related degenerative changes in the auditory system (presbycusis). These pathogenic factors, whether acting individually or synergistically, can interfere with the normal development and function of the auditory nerves, resulting in damage to cochlear hair cells and auditory neurons, thereby causing irreversible hearing impairment. Therefore, a deep understanding of the regulatory mechanisms of auditory nerve development, structural and functional maturation, as well as its survival capacity and plasticity changes after injury, is crucial for elucidating the pathological basis of SNHL heterogeneity and promoting the development of precise treatment strategies. This article systematically reviews the molecular basis of auditory nerve development, the related pathological mechanisms, and causes of injury, while also exploring the cutting-edge therapeutic advances in this field, aiming to provide new insights for clinical interventions in sensorineural hearing loss and ultimately improve patients' auditory function and quality of life.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"23 5","pages":"1707-1719"},"PeriodicalIF":3.2,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814732","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":"Fractal Analysis of Intramuscular Adipose Tissue on CT Serves as a Novel Imaging Biomarker for Metabolic Syndrome.","authors":"Bowen Hou, Zheng Ran, Jinhan Qiao, Yitong Li, Zhongyichen Huang, Xiaolong Luo, Xiaoming Li","doi":"10.7150/ijms.126142","DOIUrl":"https://doi.org/10.7150/ijms.126142","url":null,"abstract":"<p><strong>Objectives: </strong>Metabolic Syndrome (MetS) is a cluster of metabolic risk factors, which elevate the risk of cardiovascular diseases and mortality. Body composition, especially the muscle and adipose tissue, plays a critical role in MetS development. The objectives were to explore fractal analysis to quantify the spatial distribution pattern of body composition from computed tomography (CT) and combine with clinical data to develop and validate a diagnostic model for MetS.</p><p><strong>Methods: </strong>In this two-center retrospective study, participants were classified into MetS and control groups based on International Diabetes Federation criteria. Clinical and CT images of lower extremities were analyzed. A 3D box-counting fractal analysis on CT images was applied to assess the microstructural complexity of body compositions. Feature selection involved univariate analysis, variance inflation factor assessment and multivariate logistic regression. Model performance was evaluated using receiver operating characteristic, decision curve analysis, and calibration curves.</p><p><strong>Results: </strong>The cohort included 184 subjects from center 1 (split 7:3 into training/internal test sets) and 74 from center 2 for external validation. The final combined model identified five independent predictors: triglyceride (odds ratio (OR) = 2.136), history of diabetes (OR = 7.774), fractal dimension of intramuscular adipose tissue (IMAT) (OR = 3.100), and IMAT multifractal range (OR = 3.613), IMAT/muscle (OR = 1.927). Model combined clinical and radiological features demonstrated robust discrimination, with area under the curves of 0.932 (training), 0.861(test) and 0.855 (validation).</p><p><strong>Conclusion: </strong>Fractal properties of IMAT derived from CT scans are potent, non-invasive biomarkers for MetS. A diagnostic model integrating radiological features with clinical factors provides excellent, externally validated performance for MetS identification.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"23 5","pages":"1645-1655"},"PeriodicalIF":3.2,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814840","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 Factors for Mortality in Patients with Pyogenic Liver Abscess: A Systematic Review and Meta-Analysis.","authors":"Jin-Wei Lin, Tai-Hung Ho, Min-Chi Shiang, Hao-Min Cheng, Yi-Tzu Lee, Chorng-Kuang How, Teh-Fu Hsu","doi":"10.7150/ijms.130156","DOIUrl":"https://doi.org/10.7150/ijms.130156","url":null,"abstract":"<p><strong>Background: </strong>Pyogenic liver abscess (PLA) is an infectious and potentially fatal disease, yet no systematic reviews have comprehensively analyzed the prognostic factors associated with mortality. This study aims to identify prognostic factors associated with mortality in PLA.</p><p><strong>Methods: </strong>Databases including PubMed, Cochrane Library, Web of Science, Europe PMC, EMBASE, Airiti Library, LILACS, Google Scholar, ClinicalTrials.gov, and ICTRP were searched from inception to July 31, 2023. Reference lists, relevant reviews, and conference abstracts were also screened. Studies investigating predictors of mortality in PLA were included, with short-term mortality as the primary outcome. Pooled estimates were calculated using a random-effects model. Subgroup, meta-regression, and sensitivity analyses were performed.</p><p><strong>Results: </strong>Seventy-one observational studies were included in this systematic review, and 57 studies involving 126,056 patients contributed to the meta-analyses. Pooled adjusted estimates identified significant mortality predictors: older age, female sex, malignancy, chronic kidney disease, septic shock, higher APACHE II score, gas-formation, metastatic infection, anemia, thrombocytopenia, hypoalbuminemia, hyperbilirubinemia, elevated ALT, impaired renal function, bacteremia, <i>Escherichia coli</i> infection, anaerobic infection, multidrug-resistant organism infection, pneumonia, and ICU admission. Fever, <i>Klebsiella pneumoniae</i> infection, and percutaneous drainage were associated with lower short-term mortality.</p><p><strong>Conclusion: </strong>In PLA, significant mortality predictors included demographic, comorbidity, clinical, laboratory, radiographic, microbiological, and complication-related factors. Percutaneous drainage was associated with lower short-term mortality in selected patients, although this association should not be interpreted as causal, and treatment decisions should be individualized according to the underlying etiology and clinical context. Future high-quality prospective studies to identify etiology-specific prognostic factors are warranted.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"23 5","pages":"1685-1706"},"PeriodicalIF":3.2,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814638","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}