International Journal of Medical Sciences最新文献

{"title":"Beyond Angiography: Integrating Advanced Diagnostic Modalities in Coronary Stent Restenosis-a Systematic Review.","authors":"Zihan Liu, Mingduo Zhang, Min Zhang, Xiantao Song, Dongfeng Zhang","doi":"10.7150/ijms.119908","DOIUrl":"https://doi.org/10.7150/ijms.119908","url":null,"abstract":"<p><p>In-stent restenosis (ISR) continues to be a significant problem after percutaneous coronary intervention (PCI), negatively affecting patient care. This review offers a thorough examination of current ISR diagnostic methods - which combine anatomical and functional assessments with cutting-edge technologies - with holistic recommendations for ISR management, from optimized prevention during PCI to effective treatment. Anatomically, coronary angiography (CAG) persists as the gold standard, while intravascular ultrasound (IVUS) and optical coherence tomography (OCT) enhance stent optimization and ISR detection through high-resolution imaging. Functionally, fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) quantify ischemic risk, whereas non-invasive techniques like Computed Tomography-derived Fractional Flow Reserve (CT-FFR) and quantitative flow ratio (QFR) are transforming clinical paradigms. Multimodal imaging fusion and artificial intelligence markedly improve diagnostic accuracy and efficiency. Biomarkers and genomics are valuable tools for assessing ISR risk. Future directions emphasize integrated anatomical-functional-molecular assessments and AI-driven personalized management to refine ISR care and patient prognosis.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"23 5","pages":"1630-1644"},"PeriodicalIF":3.2,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814796","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":"Artificial Intelligence Assisted Smartphone System for Real-Time Detection and Severity Assessment of Digital Clubbing.","authors":"Wei-Hsun Wang, Guan-Tsen Liu, Su-Juan Chen, Yu-Chu Chiang, Hsiao-Hsuan Wang, Yong-Hong Chiang, Yu-Tzu Hu, Wen-Shin Hsu","doi":"10.7150/ijms.126125","DOIUrl":"https://doi.org/10.7150/ijms.126125","url":null,"abstract":"<p><p>Digital clubbing is an important clinical sign associated with a range of cardiopulmonary diseases; however, its detection and severity assessment in routine practice largely rely on subjective visual inspection. This study proposes an automated, smartphone-based system for real-time detection and severity assessment of digital clubbing using deep learning techniques. The system integrates the YOLOv8 object detection model for initial clubbing classification, the KeypointNet model for anatomical landmark localization, and a novel Clubbing Fingers Severity Analysis (CFSA) algorithm to quantify the Lovibond angle and grade disease severity. Finger images were acquired using a smartphone camera with an OpenCV-based preprocessing strategy to standardize finger-to-camera distance and improve image consistency. Model performance was evaluated using publicly available anonymized datasets. The proposed system achieved an overall accuracy of 94.7% for digital clubbing detection and severity classification. The YOLOv8 model attained a classification accuracy of 92.5%, while the KeypointNet model achieved a landmark localization accuracy of 96.5%. Notably, the recall for severe digital clubbing reached 94.0%, indicating strong sensitivity for identifying high-risk cases. By providing real-time, non-invasive, and reproducible assessments, the proposed system addresses the limitations of conventional visual examination and supports objective severity grading. Although further clinical validation is required, this smartphone-based approach demonstrates strong potential as a preliminary screening support tool for early identification of digital clubbing in clinical and community-based settings, particularly in resource-limited environments.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"23 5","pages":"1613-1629"},"PeriodicalIF":3.2,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814790","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":"Magnesium Oxide Use and Clinical Outcomes in CKD Patients: Evidence from a Nationwide Population-Based Cohort Study in Taiwan.","authors":"Po-Jen Hsiao, Liam Li-An Tsou, Chung-Chi Yang, Li-Yen Huang, Ruei-Lin Wang, Jenq-Shyong Chan, Kun-Lin Wu, Yung-Hsi Kao, Chu-Lin Chou","doi":"10.7150/ijms.125059","DOIUrl":"https://doi.org/10.7150/ijms.125059","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Magnesium homeostasis in chronic kidney disease (CKD) is complex, and serum magnesium concentrations reflect only approximately 1% of total body magnesium. Both magnesium deficiency (hypomagnesemia) and excess (hypermagnesemia) have been linked to adverse cardiovascular outcomes, a concern that is particularly relevant in patients with CKD. Magnesium oxide (MgO) is frequently prescribed for dyspepsia and constipation in clinical practice; however, its clinical impact in CKD patients remains uncertain and warrants further investigation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;We included non-dialysis CKD patients identified from the Taipei Medical University Clinical Research Database (TMUCRD) between 1998 and 2021. Adherence to MgO was assessed using the medication possession ratio (MPR). The primary outcomes were acute kidney injury (AKI), acute kidney disease (AKD), hospitalization for AKI, end-stage renal disease (ESRD) requiring dialysis, congestive heart failure with pulmonary edema, cardiac arrhythmia, and acute myocardial infarction. Baseline comorbidities assessed prior to the index date included hypertension, diabetes, hyperlipidemia, ischemic heart disease (IHD), ischemic stroke, congestive heart failure, atrial fibrillation (AF), peripheral arterial disease (PAD), chronic obstructive pulmonary disease (COPD), chronic liver disease (CLD), and dementia. These variables, along with relevant medications, were included as covariates in multivariable models to adjust for potential confounders.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Before matching, 6,105 MgO users and 10,143 non-users were identified; approximately 73% of MgO users had MPR &lt;40%. In the ACE inhibitor (ACEI)/angiotensin receptor blocker (ARB) and pre-end-stage renal disease (pre-ESRD) program cohort, 207 MgO users and 1,401 non-users were included; after matching, 151 MgO users and 302 non-users remained. Dementia was more prevalent among MgO users, whereas diabetes was more common in non-users. MgO use was associated with higher risks of AKI, AKD, ESRD requiring dialysis, cardiac arrhythmia, and myocardial infarction in both unmatched and matched cohorts. In matched CKD patients, adjusted hazard ratios (aHRs) were 37.0 for AKI, 6.26 for AKD, 3.13 for ESRD, 2.06 for cardiac arrhythmia, and 1.86 for acute myocardial infarction. In the matched ACEI/ARB and pre-ESRD cohort, MgO users also demonstrated higher risks of AKI (aHR = 16.1) and AKD (aHR = 2.79). Cumulative incidence analyses consistently showed worse outcomes among MgO users. Among MgO users, advancing CKD stage was associated with progressively higher risks of adverse outcomes, particularly in stages 4-5. Both unmatched and matched analyses demonstrated a dose-response pattern, with the highest hazards observed for dialysis progression and cardiac arrhythmia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;In this large cohort study, MgO use in CKD patients was associated with increased risks of AKI, ","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"23 4","pages":"1519-1534"},"PeriodicalIF":3.2,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13048899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147622862","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":"Metabolomics Reveals the Anti-hepatic Fibrosis Mechanisms of <i>Pueraria lobata</i> (Willd.) Ohwi Extract and Potential Metabolites Alterations.","authors":"Yu-Ju Chen, Lo-Yun Chen, Ngoc-Thac Pham, John Louie Dela Vega, Federica Fulgheri, Ching-Chiung Wang, Maria Letizia Manca, Chia-Jung Lee","doi":"10.7150/ijms.129139","DOIUrl":"https://doi.org/10.7150/ijms.129139","url":null,"abstract":"<p><p>Liver fibrosis is a progressive disorder characterized by excessive extracellular matrix (ECM) accumulation, leading to impaired liver function and potentially cirrhosis. <i>Pueraria lobata</i> (Willd.) Ohwi, a traditional medicinal plant, has shown promise for hepatoprotection. In this study, we evaluated the antifibrotic effects of a 50% ethanol extract of <i>Pueraria lobata</i> (PUR50E) using integrated network pharmacology, metabolomics, and a CCl₄-induced mouse model of liver fibrosis. Network pharmacology analysis identified key PUR50E-associated targets involved in ECM organization, oxidative stress regulation, and TGF-β-related fibrogenic signaling pathways. PUR50E markedly reduced ECM markers, including α-SMA and fibronectin, and enhanced ECM remodeling through upregulation of MMP-3 and MMP-13. It also activated the Nrf2/HO-1 pathway to alleviate oxidative stress. Metabolomic profiling revealed key alterations, including reduced malate, fumarate, succinate, and isocitrate in the TCA cycle; decreased tryptophan, indole, and N-acetylserotonin with increased melatonin in tryptophan metabolism; and elevated glycine and homoserine in glyoxylate and dicarboxylate metabolism. These findings suggest that PUR50E mitigates liver fibrosis by promoting ECM degradation, enhancing antioxidant defense, and restoring metabolic homeostasis. The identified metabolites may serve as potential biomarkers and therapeutic targets, supporting the development of PUR50E as a promising multi-target natural therapy for liver fibrosis.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"23 4","pages":"1491-1508"},"PeriodicalIF":3.2,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13048894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147622868","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":"Cisplatin Induces Inflammation by Activating IL-6 via Suppressing rno-let-7g-5p and rno-let-7f-5p Expression in Intestinal Epithelial Cells.","authors":"Chi-Jen Chang, Tsung-Ming Chang, Ying-Sui Sun, Kuan-Ting Lu, Ju-Fang Liu","doi":"10.7150/ijms.131043","DOIUrl":"https://doi.org/10.7150/ijms.131043","url":null,"abstract":"<p><p>Cisplatin is a widely used chemotherapeutic agent; however, its therapeutic efficacy is often limited by severe cytotoxic side effects, particularly gastrointestinal toxicity, which manifests as intestinal mucositis. MicroRNAs (miRNAs) are small non-coding RNAs that play critical roles in both normal physiological and pathological processes by regulating gene expression. However, their role in cisplatin-induced gastrointestinal toxicity remains unclear. In this study, we investigated the regulatory effects of miRNAs on cisplatin-induced inflammation in intestinal epithelial cells (IEC-6). Our results demonstrate that cisplatin significantly decreases cell viability while inducing interleukin-6 (IL-6) expression in a dose-dependent manner. Moreover, we observed that cisplatin activates the phosphorylation of p38 and ERK but does not activate JNK in IEC-6 cells. Using specific inhibitors of p38 and ERK, we confirmed their roles in regulating IL-6 expression. Through analysis of the miRNA database, we identified several miRNAs that potentially target IL-6. Notably, rno-let-7f-5p and rno-let-7g-5p showed significant downregulation following cisplatin treatment. Transfection mimics and inhibitors of rno-let-7f-5p and rno-let-7g-5p further confirmed their regulatory role in IL-6 expression. Importantly, inhibition of the p38 and ERK pathways attenuated the cisplatin-induced reduction of rno-let-7f-5p and rno-let-7g-5p levels, suggesting a potential regulatory link between MAPK signaling and miRNA expression. In conclusion, our findings support a model in which cisplatin promotes inflammation in intestinal epithelial cells by activating the p38 and ERK pathways and is associated with the suppression of rno-let-7f-5p and rno-let-7g-5p. These findings provide mechanistic rationale that may inform future efforts to mitigate cisplatin-associated gastrointestinal toxicity.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"23 4","pages":"1554-1566"},"PeriodicalIF":3.2,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13048891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147622772","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 retinal microvascular abnormalities with cardiovascular diseases in patients with severe carotid artery stenosis.","authors":"Li Zhang, Qi-Bo Ran, Chun-Yan Lei, Fei-Peng Jiang, Tian-Yu Yang, Zhi-Hao Xiao, Sheng Gao, Mei-Xia Zhang","doi":"10.7150/ijms.126670","DOIUrl":"https://doi.org/10.7150/ijms.126670","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate and summarize the characteristics of retinal microvascular abnormalities (RMAs) in patients with severe carotid artery stenosis (CAS) and explore the association between the presence of RMAs and cardiovascular diseases (CVD).</p><p><strong>Methods: </strong>Color fundus photography and wide-field swept-source optical coherence tomography angiography (SS-OCTA) examinations were performed on all participants. Images were reviewed to identify RMAs. The occurrence and characteristics of RMAs were summarized. CAS patients with or without CVD were divided into different groups, and the association between the presence of RMAs and CVD were explored using multivariable logistic regression analysis.</p><p><strong>Results: </strong>This observational, cross-sectional study included 258 eyes from 129 patients with severe CAS. A total of 39/129 patients (30.2%) were identified with RMAs. These RMAs included branch retinal artery occlusion, asymptomatic retinal emboli, cotton wool spots, retinal hemorrhage, branch retinal vein occlusion, inner retinal layer hyperreflectivity, retinal nonperfusion and neovascularization of the optic disk. Multivariable logistic regression analysis revealed that RMAs was significantly associated with the presence of CVD in patients with severe CAS.</p><p><strong>Conclusions: </strong>This cross-sectional study summarized the characteristics of RMAs associated with CAS and identified RMAs as biomarkers of CVD in patients with severe CAS. Patients with RMAs were at high risk and should be carefully managed.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"23 4","pages":"1482-1490"},"PeriodicalIF":3.2,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13048890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147622776","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 Glucagon-like Peptide-1 Receptor Agonists with Mortality and Aspiration Pneumonia in Patients with Type 2 Diabetes After Gastrostomy: A Target Trial Emulation Study.","authors":"Yuan-Tsung Tseng, Chung-Hung Chen, Li-Ping Chou, Shu-Ying Chen, Huai-Yi Huang, Jyun-Wei Wang, Chung-Yi Li","doi":"10.7150/ijms.128956","DOIUrl":"https://doi.org/10.7150/ijms.128956","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to compare the safety and effectiveness of glucagon-like peptide-1 receptor agonists (GLP-1 RA) versus dipeptidyl peptidase-4 inhibitors (DPP-4i) in patients with type 2 diabetes following gastrostomy.</p><p><strong>Methods: </strong>We conducted a target trial emulation using real-world data. From January 1, 2015, to December 31, 2024, we identified 728 patients who initiated either GLP-1 RA or DPP-4i after gastrostomy. After 1:1 propensity score matching to balance baseline covariates, 364 patients were included in each group. The primary analysis followed an intention-to-treat principle, and follow-up continued until June 30, 2025. Several sensitivity analyses, including landmark analysis and E-value calculation, were performed to assess the robustness of the findings.</p><p><strong>Results: </strong>Compared with DPP-4i initiation, GLP-1 RA initiation was associated with lower all-cause mortality (adjusted hazard ratio [aHR], 0.71; 95% confidence interval [CI], 0.54-0.93) and aspiration pneumonia (aHR, 0.64; 95% CI, 0.44-0.93).</p><p><strong>Conclusions: </strong>Our findings indicate that initiation of GLP-1 RA, compared with initiation of DPP-4i, was associated with lower all-cause mortality and a lower risk of aspiration pneumonia in patients with type 2 diabetes following gastrostomy. Further prospective studies are warranted to confirm these findings in this vulnerable population.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"23 4","pages":"1444-1455"},"PeriodicalIF":3.2,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13048897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147622583","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":"Changes of the QRS-T angle in Patients Undergoing Transcatheter Aortic Valve Implantation.","authors":"Scharbanu Amirie, Behnam Zadeh, Oliver Bruder, Thomas Schmitz, Karl Toischer, Christoph Julian Jensen","doi":"10.7150/ijms.130315","DOIUrl":"https://doi.org/10.7150/ijms.130315","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate changes in the frontal QRST angle in patients who underwent transcatheter aortic valve implantation (TAVI).</p><p><strong>Background: </strong>The QRS-T angle is a prognostic marker in several clinical settings. The impact of TAVI on the QRS-T angle, especially in the long term, has not been investigated thus far.</p><p><strong>Methods: </strong>A total of 104 patients undergoing transcatheter aortic valve replacement due to severe aortic stenosis underwent a standardized digital 12-lead ECG for the calculation of the QRS-T angle before and 24 h after the intervention, as well as 30 days after the intervention.</p><p><strong>Results: </strong>There was a significant and dynamic change in the QRS-T angle during the TAVI procedure. An initial increase in the number of patients with a wider QRS-T angle (>90°) was notable immediately after valve replacement. After 30 days, there was a significant decrease in the number of patients with a wide QRS T-angle.</p><p><strong>Conclusion: </strong>The QRS-T angle widens early after transcatheter aortic valve replacement and improves below the baseline during a 3 months follow-up. This could be related to the cardiacischemic stress during valve intervention. In contrast, QRS-T angle narrowing during follow-up might reflect the normalization of left ventricular hemodynamics and prognostic improvement.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"23 5","pages":"1588-1594"},"PeriodicalIF":3.2,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814783","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 Ranolazine on Vascular Adrenergic Receptors in Rabbit Aorta.","authors":"Adrian Jorda, Maria Dolores Mauricio, Solanye Guerra-Ojeda, Jose M Vila, Soraya L Valles, Martin Aldasoro","doi":"10.7150/ijms.128068","DOIUrl":"https://doi.org/10.7150/ijms.128068","url":null,"abstract":"<p><strong>Background: </strong>Different mechanisms of action have been proposed for Ranolazine (Rn), mainly the inhibition of the late sodium current and antagonism of α₁-adrenergic receptors. In the present study, we evaluated the possible involvement of other adrenergic receptors, specifically α₂, β₂, and β₃, as mediators of the vascular effects of Rn.</p><p><strong>Methods: </strong>Segments of rabbit aorta were mounted in an organ bath. Electrical field stimulation (EFS; 2, 4, and 8 Hz) induced frequency-dependent contractions that were abolished by tetrodotoxin, prazosin, or guanethidine (10⁻⁶ M), confirming the neural origin of the vascular responses. The effects of Rn on vascular responses to adrenergic stimulation were evaluated by incubating the preparations with increasing concentrations of the drug (10⁻⁷-10⁻⁴ M) for 20 minutes prior to neural stimulation (4 Hz). The involvement of α₁-, α₂-, β₂-, or β₃-adrenergic receptors was assessed using specific antagonists (10⁻⁶ M): prazosin (α₁), yohimbine (α₂), butaxamine (β₂), and SR59230A (β₃). Subsequently, the sequence of electrical field stimulations was performed in the presence of Rn. Expression levels of α₁-, α₂-, β₂-, and β₃-adrenergic receptors were determined by Western blot analysis.</p><p><strong>Results: </strong>Rn decreases the contractile effect induced by adrenergic nerve stimulation in the rabbit aorta. In the presence of prazosin or yohimbine, the vasoconstrictor response was significantly reduced. However, incubation with butaxamine or SR59230A significantly increased the contractile response to adrenergic nerve stimulation. The protein expression of α₁ and α₂ receptors significantly decreased compared to the control when incubated with Rn. In contrast, the expression of β₂ and β₃ receptors increased only at 10⁻⁷ M, a concentration lower than that reached with therapeutic doses of Rn.</p><p><strong>Conclusion: </strong>Rn inhibits the vasoconstrictor response to adrenergic nerve stimulation through an antagonistic effect on α₁ and α₂ receptors and enhancing the vasodilatory responses mediated by β₂ and β₃ adrenergic receptors.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"23 5","pages":"1595-1604"},"PeriodicalIF":3.2,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814888","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 of peripheral vestibular disorders and hearing impairment among users of glucagon-like peptide-1 receptor agonists.","authors":"Jing-Yang Huang, Yen-Ting Lu, Chung-Han Hsin, Tun-Shin Lo, Chia-Yi Lee, Shun-Fa Yang, Miao-Yu Liao","doi":"10.7150/ijms.131397","DOIUrl":"https://doi.org/10.7150/ijms.131397","url":null,"abstract":"<p><p>Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are widely used antidiabetic agents with established glycemic efficacy. Peripheral vestibular disorders and hearing impairment are inner ear conditions that may be influenced by metabolic and glycemic status. This study aimed to investigate the association between GLP-1 RA use and the development of peripheral vestibular disorders, dizziness, and hearing impairment. This retrospective cohort study identified patients who received GLP-1 RA treatment and matched them with non-GLP-1 RA users. After propensity score matching, a total of 684,092 participants were included, with 342,046 in the GLP-1 RA group and 342,046 in the non-GLP-1 RA groups. The primary outcomes were newly diagnosed peripheral vestibular disorders, dizziness, and hearing impairment. Cox proportional hazards regression models were applied to compare outcome incidences between groups. During the follow-up period, 4,407 cases of peripheral vestibular disorders occurred in the GLP-1 RA group compared with 3,946 cases in the non-GLP-1 RA group, indicating a significantly higher incidence among GLP-1 RA users (P < 0.001). Dizziness was diagnosed in 32,545 GLP-1 RA users and 29,931 nonusers, while hearing impairment occurred in 9,522 and 7,898 participants, respectively; both outcomes were significantly more frequent in the GLP-1 RA group (P < 0.001). Cumulative incidence analyses showed significantly higher risks for all three outcomes in the GLP-1 RA group. In conclusion, GLP-1 RA use may presented be with higher incidences of peripheral vestibular disorders, dizziness, and hearing impairment in white population.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"23 4","pages":"1577-1587"},"PeriodicalIF":3.2,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13048892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147622944","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}