International Journal of Medical Sciences最新文献

{"title":"An Easy-to-Use Risk Stratification System for NSTE-ACS Patients Combining Autonomic Nervous System and Coronary Physiology.","authors":"Xiaomeng Yang, Zeyan Li, Xinyu Liu, Tianyou Xu, Fu Yu, Shoupeng Duan, Qiang Deng, Lang Wang, Zhuo Wang, Hong Jiang, Lilei Yu","doi":"10.7150/ijms.111214","DOIUrl":"10.7150/ijms.111214","url":null,"abstract":"<p><p><b>Background:</b> The evaluation of autonomic nervous system (ANS) function and coronary physiology through quantitative flow ratio (QFR) analysis provides a precise method for assessing the severity and prognosis of acute coronary syndrome (ACS). <b>Aims:</b> This study aimed to develop and validate a risk score model for predicting the long-term prognosis of non-ST-elevation ACS (NSTE-ACS) patients who underwent complete and successful percutaneous coronary intervention (PCI). <b>Methods:</b> NSTE-ACS patients who underwent complete and successful PCI with preoperative and postoperative QFR measurements between January 2018 and December 2020 in our medical center were included. 24-hour Holter monitoring was performed to assess deceleration capacity (DC) and heart rate variability (HRV) parameters. The primary endpoint was the occurrence of major adverse cardiac events (MACEs). <b>Results:</b> The training cohort consisted of 271 patients, while the testing cohort consisted of 119 patients. The nomogram considered diabetes, normalized low-frequency (nLF) power/normalized high-frequency (nHF) power, DC, cardiac troponin I (cTnI), post-PCI QFR of the target vessel. The model demonstrated excellent discriminative ability, with area under the curve (AUC) values of 0.874 (95% CI: 0.809-0.939) for 1-year MACE prediction in the training cohort and 0.893 (95% CI: 0.808-0.978) in the testing cohort. For 2-year MACE prediction, the AUC values were 0.882 (95% CI: 0.822-0.942) and 0.842 (95% CI: 0.724-0.960) in the training and testing cohorts. <b>Conclusions:</b> We successfully developed and validated a risk stratification system that integrates baseline clinical characteristics (diabetes, cTnI levels), ANS parameters (nLF/nHF ratio, DC), and coronary physiological assessment (post-PCI QFR). This model effectively predicts MACEs in NSTE-ACS patients following PCI, providing valuable prognostic information for clinical decision-making.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"22 10","pages":"2342-2353"},"PeriodicalIF":3.2,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093731","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":"Population Pharmacokinetic-pharmacodynamic Model Analysis of Dapagliflozin for HbA1c-lowering Effects in Japanese Patients with Type 2 Diabetes Mellitus using Long-term Real-world Data.","authors":"Shinji Kobuchi, Shuhei Sakai, Ryosuke Terada, Ken-Ichiro Kato, Tetsuo Hayakawa, Toshiyuki Sakaeda","doi":"10.7150/ijms.111519","DOIUrl":"10.7150/ijms.111519","url":null,"abstract":"<p><p><b>Objectives:</b> Dapagliflozin, a sodium-glucose cotransporter 2 inhibitor, has demonstrated population-level benefits in patients with various metabolic, cardiovascular, and renal comorbidities. However, significant inter-individual differences exist in plasma exposure and response to dapagliflozin. This study aimed to identify factors influencing the HbA1c-lowering effects of dapagliflozin using long-term real-world data and a population pharmacokinetic-pharmacodynamic (PK-PD) modeling approach. <b>Methods:</b> A PK-PD model was applied to analyze 415 plasma dapagliflozin concentrations and 508 HbA1c measurements from 85 patients with type 2 diabetes mellitus (T2DM) treated with dapagliflozin for one year. The long-term real-world data enabled the evaluation of treatment variability over time. Inter-individual variability in PK-PD parameters was assessed, and covariate analysis was performed to identify patient-specific factors affecting drug response. <b>Results:</b> HbA1c time profiles were well described using the PK-PD turnover model with an E_max function. Body weight significantly influenced the apparent clearance of dapagliflozin, though its clinical impact on systemic exposure was minimal. Long-term real-world data analysis revealed substantial inter-individual variability in HbA1c response. <b>Conclusion:</b> By integrating pharmacometric modeling with long-term real-world data, this study provided unique insights into the determinants of dapagliflozin efficacy in routine clinical practice. These findings highlight factors that may not be captured in short-term clinical trials. These findings emphasize the importance of individualized treatment strategies and suggest that future research should incorporate additional covariates, such as variations in glycemic response dynamics, to further refine dose optimization and personalized diabetes management.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"22 10","pages":"2333-2341"},"PeriodicalIF":3.2,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093489","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":"Cracking Chordoma's Conundrum: Immune Checkpoints Provide a Potential Modality.","authors":"Weihai Liu, Moksada Regmi, Xiaodong Chen, Shikun Liu, Ying Xiong, Yuwei Dai, Yingjie Wang, Jun Yang, Chenlong Yang","doi":"10.7150/ijms.109721","DOIUrl":"10.7150/ijms.109721","url":null,"abstract":"<p><p><b>Objectives:</b> Chordoma, a rare malignant tumor, is notably resistant to conventional treatments including chemotherapy, radiotherapy, and targeted approaches. Immunotherapy, successful in treating other cancer types, presents a promising avenue. However, the immune microenvironment of chordoma is poorly understood, highlighting the need to investigate immune checkpoints and their potential as therapeutic targets in this context. <b>Methods:</b> We performed an integrated analysis of chordoma using public datasets (GSE224776, GSE56183, GSE239531) and our RNA-seq data (11 samples). Differential expression analysis (limma), gene set enrichment analysis (GSEA, clusterProfiler), immune cell infiltration assessment (ESTIMATE, immunedeconv), weighted gene co-expression network analysis (WGCNA), consensus clustering, and machine learning were employed to identify key immune-related gene modules, immunogenic subtypes, and central immune regulators. <b>Results:</b> Hierarchical clustering and principal component analysis segregated chordoma from control samples post quality control. Differential expression analysis identified 2825 upregulated and 1693 downregulated genes, with significant upregulation of immune checkpoints, including PD-1 and CTLA-4. GSEA highlighted enhanced immune-related processes, particularly inflammatory responses, antigen presentation, and immune cell activation. Immune cell deconvolution demonstrated selective enrichment of memory T cells and macrophages, alongside downregulation of neutrophils and decreased effector cell scores. Consensus clustering identified a highly immunogenic chordoma subtype (Cluster 1), and WGCNA and machine learning converged on CCR7 as a central immune regulator, with core T cell-associated genes correlating with immune cell distribution patterns. <b>Conclusion:</b> This study characterizes the chordoma immune landscape, highlighting elevated immune checkpoints, distinct immunogenic subtypes, and a T cell-centered regulatory network. These findings support immune checkpoint inhibitors and other immunotherapies as promising treatments.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"22 10","pages":"2318-2332"},"PeriodicalIF":3.2,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093548","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 Load Distribution in Subperiosteal Implants and Mini Plates in Orthognathic Surgery.","authors":"Metin Berk Kasapoglu, Zeynep Afra Akbiyik Az","doi":"10.7150/ijms.111111","DOIUrl":"10.7150/ijms.111111","url":null,"abstract":"<p><p><b>Background:</b> Orthognathic surgery is important for correcting craniofacial deformities and restoring occlusion. However, in edentulous patients with severe maxillary atrophy, traditional fixation methods, such as mini plates, may not provide sufficient stability and support for prosthetic rehabilitation. Advances in additive manufacturing have enabled the development of patient-specific subperiosteal implants, offering improved biomechanical performance and more favourable load distribution. <b>Methods:</b> This study utilized finite element analysis to compare the biomechanical performance of traditional mini plates and customized subperiosteal implants in maxillary orthognathic surgery. Computed tomography data were used to construct patient-specific models, and a Le Fort I osteotomy with a 9-mm maxillary advancement was simulated. Displacement and stress distribution were analysed under vertical and oblique loading conditions, focusing on critical regions such as osteotomy sites and screw interfaces. <b>Results:</b> Subperiosteal implants exhibited superior biomechanical performance, with significantly lower displacement (0.58 mm) compared to mini plates (4.50 mm). Stress levels in mini plates frequently exceeded the yield strength of grade IV titanium, whereas subperiosteal implants remained within the elastic limit of Ti6Al4V. Additionally, screw stresses were reduced by 38-42% in the subperiosteal implant group, thereby reducing the risk of mechanical failure. <b>Conclusions:</b> Customized subperiosteal implants provided enhanced stability, reduced stress concentrations, and improved load distribution compared to traditional mini plates. These findings highlight their potential as a transformative solution in orthognathic surgery, particularly for edentulous patients with severe maxillary atrophy. Future research should focus on long-term clinical outcomes and cost-effectiveness to further establish their role in maxillofacial reconstruction.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"22 10","pages":"2257-2268"},"PeriodicalIF":3.2,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093389","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":"Circulating short chain fatty acid levels and body composition in type 2 diabetes mellitus.","authors":"Ching-Hua Hsu, Yi-Chun Tsai, Ping-Shaou Yu, Wei-Wen Hung, Wei-Chun Hung, Shang-Jyh Hwang, Hui-Ju Tsai","doi":"10.7150/ijms.111920","DOIUrl":"10.7150/ijms.111920","url":null,"abstract":"<p><p><b>Background:</b> Short-chain fatty acids (SCFAs) may play key functional roles in the pathophysiology of type 2 diabetes (T2D) through regulating energy intake and substrate metabolism. Body composition, including fat tissue, muscle tissue and the pattern of their distribution in the body, can represent health status and be the cause or consequence of T2D complications. The aim of this study was to explore the relationship between serum SCFA levels and body composition distribution in patients with T2D. <b>Methods:</b> This observational cross-sectional study enrolled 430 patients with T2D from October 2016 to June 2020. The levels of nine kinds of SCFAs in serum were measured using liquid chromatography mass spectrometry. Body composition, including lean tissue and fat tissue, was measured once using bioimpedance spectroscopy at enrollment. <b>Results:</b> The mean age of the patients was 61.7 ± 12.3 years and 54.0% were male. Multivariate linear analysis revealed that the patients with the highest tertile of serum methylbutyrate level (β = -0.81, 95% CI = -1.56, -0.06, p = 0.03) and valerate/isovalerate ratio (β = -1.15, 95% CI = -1.86, -0.44, p = 0.002) had a lower fat tissue index (FTI). In subgroup analysis, the negative association of FTI with serum methylbutyrate level and valerate/isovalerate ratio was only found in the patients who were older, female, and had glycated hemoglobin ≤ 7%, urinary albumin-creatinine ratio < 30 mg/g, homeostatic model assessment for insulin resistance ≤ median value, and body mass index < 30 kg/m². Conversely, none of the nine SCFAs were associated with lean tissue index. <b>Conclusions:</b> This study found that T2D patients with a higher circulating methylbutyrate level and serum valerate/isovalerate ratio had lower FTI. The relationship was consistent in older, female patients with well-controlled glucose. Further research is needed to analyze the interactions between SCFAs and body composition with clinical metabolic outcomes in T2D patients.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"22 10","pages":"2289-2297"},"PeriodicalIF":3.2,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093841","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":"Long-term BPV is an Independent Risk Factor for Renal Prognosis in Hypertensive Patients - a Post-hoc Analysis of the SPRINT Study.","authors":"Yuyi Ruan, Yutong Chen, Naya Huang, Dan Wang, Yuzhu Xu, Jinjin Fan, Wei Chen, Xin Wang","doi":"10.7150/ijms.111843","DOIUrl":"10.7150/ijms.111843","url":null,"abstract":"<p><p><b>Background:</b> Long-term blood pressure variability (BPV) reflects fluctuations in BP over time, which may indicate instability in precise blood pressure control. We conducted a post hoc analysis of the data from the SPRINT (Systolic Blood Pressure Intervention Trial) to assess the effect and associated variables of BPV on the renal prognosis of patients with hypertension. <b>Methods:</b> Excluding patients with CKD, the systolic blood pressure (SBP) at the 1^st, 6^th, and 12^th follow-up months were employed to calculate the SBP coefficient of variation (CV) which represented BPV. Patients were divided into four groups based on the quartiles of BPV, namely Q1 to Q4. <b>Results:</b> Group Q4 patients had higher baseline SBP. Multiple regression identified age, sex, treatment, current smoker, SBP, diastolic blood pressure (DBP), renin-angiotensin-system inhibitors (RASi), β-receptor antagonists, calcium channel blockers (CCBs), and other medications use were factors associated with BPV. The survival analysis showed that group Q4 had significantly more renal outcome events, and BPV was independently associated with the risk of renal outcome events (HR = 1.38, 95% CI: 1.23 - 1.54, <i>P</i> < 0.001). There was a direct correlation between the BPV and risk of renal outcomes when BPV exceeded 0.037. In addition, the RASi preference group reported a significantly higher incidence of renal outcome events compared to the non-preference group (log-rank test χ² = 6.218, <i>P</i> = 0.013) and exhibited a tendency towards higher BPV. <b>Conclusions:</b> High BPV is an independent risk factor for renal outcome events in hypertensive aging patients. The preference of RASi use can increase renal outcome events, but is not related to the rise in BPV. These findings suggest that in elderly hypertensive patients with elevated BPV, the potential risks of RASi-associated renal outcomes may outweigh its established benefits, necessitating cautious consideration of alternative antihypertensive strategies.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"22 10","pages":"2298-2307"},"PeriodicalIF":3.2,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093486","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 New-Onset Hidradenitis Suppurativa in People with Polycystic Ovary Syndrome: a large-scale propensity-score-matched cohort study.","authors":"Shuo-Yan Gau, Chia-Chi Chang, Wei-Ting Hsu, Yen-Ju Chu, Yu-Chiao Ku, Hao Lin, Shiu-Jau Chen, Hui-Chin Chang","doi":"10.7150/ijms.110774","DOIUrl":"10.7150/ijms.110774","url":null,"abstract":"<p><p><b>Background:</b> Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease, while polycystic ovary syndrome (PCOS) is an endocrine disorder. Both conditions share common risk factors, such as androgen excess and obesity. This study aimed to investigate the association between PCOS and the risk of developing HS. <b>Method:</b> A retrospective cohort study was conducted using data from the TriNetX research network, focusing on female patients aged over 18 with PCOS. A control group without PCOS was matched based on age, race, and body mass index using propensity score matching. Hazard ratios (HRs) were calculated to evaluate the risk of HS in PCOS patients across various models. <b>Results:</b> After matching, 141,661 PCOS patients and an equal number of controls were analyzed. PCOS patients showed a significantly increased risk of developing HS (HR: 2.061, 95% confidence interval (CI): 1.910-2.225). The risk remained elevated across different models and sensitivity analyses. Stratified analyses revealed the highest HS risk in younger women (aged 18-39; HR: 2.103, 95% CI: 1.911,2.315), those with a BMI less than 30 (HR: 2.053, 95% CI: 1.761,2.393) and those without diabetes (HR: 1.814, 95% CI: 1.657,1.986). <b>Conclusion:</b> PCOS patients are at a significantly higher risk of developing HS, particularly among younger and more severely affected individuals. Clinical awareness and early detection are essential for managing inflammatory comorbidities in PCOS patients.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"22 10","pages":"2269-2276"},"PeriodicalIF":3.2,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093506","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 Uric Acid to Albumin Ratio Predicts All-cause and Cardiovascular Mortality Among U.S. Adults Results from the National Health and Nutrition Examination Survey in 2003-2018.","authors":"Guangyu Wang, Guangyu Li, Pengfei Wang, Minhua Zang, Jun Pu","doi":"10.7150/ijms.106664","DOIUrl":"10.7150/ijms.106664","url":null,"abstract":"<p><p><b>Background:</b> The association between the uric acid to albumin ratio (UAR) and mortality in the general population remains poorly understood. This study aimed to investigate the associations of UAR with all-cause and cardiovascular mortality among American adults. <b>Methods:</b> The study population comprised 19190 U.S. adults from the National Health and Nutrition Examination Survey (NHANES) conducted between 2003 and 2018. Mortality outcomes were ascertained through linkage to National Death Index (NDI) records, with follow-up extending to December 31, 2019. Multivariate Cox proportional hazards regression models with restricted cubic splines and trend analyses were utilized to assess the association between UAR and both all-cause and cardiovascular mortality. Subgroup analyses were conducted to assess whether the association between UAR and mortality varied across different demographic and clinical groups. <b>Results:</b> During a median follow-up period of 98 months, 2296 all-cause deaths were recorded, including 597 deaths related to cardiovascular disease (CVD). After multivariable adjustment, no linear trends were observed between UAR and either all-cause or CVD mortality. Kaplan-Meier curves revealed a significant increase in both all-cause and CVD mortality with associated with higher UAR levels (p for log-rank test < 0.001 for both). Restricted cubic spline models indicated a J-shaped nonlinear association between UAR and both all-cause and CVD mortality, with inflection points at UAR levels of 1.40 for all-cause mortality and 1.88 for CVD mortality. Specifically, UAR values exceeding these inflection points were positively associated with mortality (HR 2.11, 95% CI = 1.74-2.55 for all-cause mortality; HR 5.21, 95% CI = 3.06-8.87 for CVD mortality). Conversely, UAR values below the inflection points were inversely associated with all-cause mortality (HR 0.68, 95% CI = 0.50-0.93) but not significantly associated with CVD mortality (HR 1.07, 95% CI = 0.73-1.58). This association remained consistent across subgroup analyses stratified by sex, age, race, diabetes, hypertension, BMI, and smoking status, with no significant interactions between these characteristics and UAR (p for interaction > 0.05). <b>Conclusion:</b> This study identified a significant association between the UAR and both all-cause and CVD mortality in the general population. A J-shaped nonlinear association was observed, with inflection points at UAR levels of 1.40 for all-cause mortality and 1.88 for CVD mortality.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"22 10","pages":"2277-2288"},"PeriodicalIF":3.2,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093671","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 Sleep Disorders among Patients with Tourette Syndrome: A Population-Based Cohort Study in Taiwan.","authors":"Ning-Jen Chung, Yung-Rung Lai, Yih Yang, Shuo-Yan Gau, Shiang-Wen Huang, Tung-Han Tsai, Kuang-Hua Huang, Chien-Ying Lee","doi":"10.7150/ijms.107983","DOIUrl":"https://doi.org/10.7150/ijms.107983","url":null,"abstract":"<p><p><b>Background:</b> Tourette syndrome (TS) is a complex neurodevelopmental disorder often linked with various neuropsychiatric comorbidities. This population-based cohort study examined the association between TS and sleep disorders. <b>Materials and methods:</b> Utilizing data from a nationwide database, this retrospective cohort study assessed the risk of sleep disorders in patients with TS. We enrolled 13,646 patients with new-onset TS from 2002 to 2015, each matched with four controls by age, sex, insured salary, urbanization level, Charlson comorbidity index, and year of inclusion. Follow-up continued until the development of sleep disorders, death, or the end of 2018. The risk was evaluated using a Cox proportional hazards model, with sensitivity analyses at ≤1, 1-5, and >5 years. <b>Results:</b> After adjusting for several variables, patients with TS had a higher risk of sleep disorders (adjusted hazard ratio [aHR] = 1.76, 95% confidence interval [CI] = 1.58-1.96). Those aged over 18 years had a higher risk than those under 7 years (aHR = 7.76, 95% CI = 6.32-9.53). Patients with comorbid attention deficit hyperactivity disorder (ADHD) and anxiety also showed increased risks (aHR = 1.35, 95% CI = 1.09-1.67 and aHR = 2.33, 95% CI = 1.88-2.88, respectively). Sensitivity analyses confirmed a higher risk of sleep disorders in TS patients at <1-, 1-5-, and >5-year follow-up periods. <b>Conclusion:</b> TS is a significant risk factor for sleep disorders. Patients with comorbid ADHD and anxiety are particularly at higher risk for sleep disturbances.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"22 9","pages":"2247-2256"},"PeriodicalIF":3.2,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965564","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":"Ellagic acid suppresses the human renal carcinoma cell migration and invasion by targeting the RUNX2/MMP1 expression.","authors":"Po-Yu Huang, Tung-Wei Hung, Yi-Hsien Hsieh, Pei-Jen Wu, Pei-Ni Chen, Chu-Che Lee, Jen-Pi Tsai","doi":"10.7150/ijms.112117","DOIUrl":"10.7150/ijms.112117","url":null,"abstract":"<p><p>Ellagic acid (EA) exerts anti-carcinogenic activity in various types of cancer. Matrix metalloproteinases (MMPs) are critical mediators in the pathogenesis of renal cell carcinoma (RCC) metastasis. Using <i>in vitro</i> experiments, this study aims to investigate the mechanisms by which EA inhibits RCC migration and invasion. The findings show that EA treatment inhibited RCC cell migration and invasion without reducing cell viability in normal human kidney cells (HK2 cells) and RCC cells (786-O and ACHN). A human proteinase array showed that EA treatment decreased MMP1 mRNA and protein expression levels in 786-O and ACHN cell lines. MMP1 expression is elevated in RCC tissues and correlates with tumor grade, stage, and overall survival in RCC patients. Our molecular docking model indicates a strong interaction between EA and MMP1. The addition of recombinant human MMP1 (Rh-MMP1) to RCC cells increased their migration and invasion; co-treatment with Rh-MMP1 and EA effectively reversed these effects. EA reduced the expression of the transcription factor RUNX2 in both RCC cell lines and knockdown of RUNX2 significantly decreased the migration and invasion abilities of EA-treated 786-O cells. High expression of RUNX2 in RCC patients is associated with higher tumor grade, stage, and poorer survival and correlates positively with MMP1 expression level. These results suggest that EA suppresses RUNX2 targeting of MMP1 expression, thereby conferring anti-invasive properties on RCC cells.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"22 10","pages":"2308-2317"},"PeriodicalIF":3.2,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093550","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}