International Journal of Medical Sciences最新文献

{"title":"Lactate and Lactylation in Pulmonary Hypertension: Comprehensive Landscape and Future Perspectives.","authors":"Qing Dai, Yichao Cai, Xinyu Wang, Xia Li, Runxiu Zheng, Xianya Cao, Chao Zhang, Jun Xu, Jian Yi, Lan Song, Aiguo Dai","doi":"10.7150/ijms.125397","DOIUrl":"10.7150/ijms.125397","url":null,"abstract":"<p><p>Pulmonary hypertension (PH) is a progressive pulmonary vascular disease with a poor prognosis and limited treatment options. Emerging evidence suggests that metabolic reprogramming plays a central role in driving PH pathogenesis. Among the key metabolic factors, lactate-the end product of glycolysis-has gained increasing recognition as a crucial regulator linking cellular metabolism to functional activity. Additionally, lactylation, a newly identified post-translational modification associated with lactate metabolism, has been shown to influence protein function and gene expression, further implicating its role in PH. While previous reviews have introduced these concepts, a systematic framework that directly integrates these molecular mechanisms into the core pathological hallmarks of the disease has been notably absent. In this review, we systematically examine the potential molecular mechanisms by which lactate and lactylation contribute to PH pathogenesis. Specifically, we systematically dissect the multifaceted roles of lactate and lactylation through the lens of five distinct pathological pillars of PH: (1) aberrant proliferation of pulmonary artery smooth muscle cells (PASMCs), (2) dysregulated immune-inflammatory responses, (3) progressive pulmonary fibrosis, (4) abnormal vasoconstriction, and (5) PASMC ferroptosis. By structuring our analysis around these core processes, we offer a novel, integrated perspective on how a single metabolic axis-lactate and lactylation-concertedly drives the complex pathophysiology of PH. This review aims to provide a comprehensive and forward-looking perspective that may guide future research into PH pathophysiology and treatment.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"23 7","pages":"2392-2407"},"PeriodicalIF":3.7,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13280737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148294878","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":"Examining the influence of scarcity, weather, and vacation on physicians' performance, mortality, and costs.","authors":"Óscar Gasulla, Antonio Sarría-Santamera, Ferran A Mazaira-Font, Cielo García-Montero, Oscar Fraile-Martinez, Diego Cantalapiedra, Manuel F Carrillo-Rodríguez, Belen Gómez-Valcárcel, Miguel Á Ortega, Melchor Álvarez-Mon, Angel Asúnsolo","doi":"10.7150/ijms.124438","DOIUrl":"10.7150/ijms.124438","url":null,"abstract":"<p><p>Healthcare professionals are exposed to different factors that may affect their ability for decision-making. The socioeconomic and health system impacts of scarcity and focus on workflow serve as a challenge to improve resource management and maintain focus. In this study, we analyze a dataset of patients who underwent percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) in Spain between 2010 to 2012, and 2016 to 2019, being either programmed or urgent interventions. We associated the results with a dataset from the Spanish Meteorological Agency to assess if the weather could affect the focus of physicians and the results of mortality after the intervention. We also considered if there was a relationship when intervention was made on vacation days or weekends. The results show that scarcity, studied as urgent interventions, and lack of focus, such as vacation days, increase mortality and costs of surgical interventions. Rainy days were found to be a factor that increases focus. Eventually, these results may allow proposing strategies that benefit physicians' performance, resource management, and treatment options, besides the psychological impact on patients, or even avoiding medical errors. Moreover, the same analysis could be applied to other jobs to increase productivity in the economy.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"23 7","pages":"2387-2391"},"PeriodicalIF":3.7,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13280756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148294953","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":"<i>Zingiber officinale</i> Leaf Subcritical Water Extract Suppresses Adipogenesis and Lipogenesis in 3T3-L1 Adipocytes via the AMPK-SREBP-1c Signaling Pathway.","authors":"Eun-Min Jun, Jong-Yeon Kim, Jeong-Sook Choe, Eun-Jung Park, Hae-Jeung Lee","doi":"10.7150/ijms.121198","DOIUrl":"10.7150/ijms.121198","url":null,"abstract":"<p><p><i>Zingiber officinale</i>, commonly known as ginger, has long been utilized as a medicinal plant due to its diverse pharmacological properties. However, research has predominantly focused on the rhizome, while the leaf is frequently regarded as a byproduct. In this study, we investigated the functional relevance of the ginger leaf, concentrating on the anti-obesity effects of ginger leaf subcritical water extract (GLE) and the underlying mechanisms in 3T3-L1 adipocytes. GLE reduced lipid accumulation in a concentration-dependent manner on day 7 of differentiation and suppressed the expression of adipogenesis-associated factors, including CCAAT/enhancer-binding protein α (C/EBPα), peroxisome proliferator-activated receptor γ, fatty acid binding protein 4, and lipoprotein lipase on both days 2 and 7. GLE also modulated early adipogenesis by inhibiting p38 phosphorylation and downregulating C/EBPβ expression at 4 h of differentiation. Additionally, GLE decreased the expression of acetyl-CoA carboxylase, fatty acid synthase, and stearoyl-CoA desaturase 1-key enzymes involved in lipogenesis-from the early stages of adipocyte differentiation. Furthermore, GLE directly phosphorylated adenosine monophosphate-activated protein kinase (AMPK), leading to inhibition of the expression of sterol regulatory element-binding protein-1c (SREBP-1c), an upstream regulator of both adipogenesis and lipogenesis. In summary, GLE exerted anti-obesity effects in 3T3-L1 adipocytes by inhibiting the transcriptional activation of adipogenic and lipogenic regulators during the early stage of differentiation, and maintaining their downregulation at later stages, and it was found to be mediated by the AMPK-SREBP-1c signaling pathway.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"23 7","pages":"2408-2422"},"PeriodicalIF":3.7,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13280736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148294858","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 interplay between type 2 diabetes mellitus and sepsis: a scoping review.","authors":"Sarah Sharul Sham, Sok Kuan Wong, Kok-Yong Chin, Nur Liyana Mohammed Yusof, Toh Leong Tan, Evelyn Yi Wen Chau, Aireen Zamhot, Amirudin Sanip, Amir Muharram","doi":"10.7150/ijms.126520","DOIUrl":"10.7150/ijms.126520","url":null,"abstract":"<p><p>Type 2 diabetes mellitus (T2DM) influence sepsis onset and progression. This scoping review mapped 33 studies from PubMed and Scopus up to June 2025 that examined immune, genetic, metabolic, prognostic, clinical, or treatment-related outcomes in patients with T2DM and sepsis. Sepsis patients with T2DM were prone to infections. Immune dysregulation in diabetic sepsis involved sustained pro-inflammatory cytokine release, impaired anti-inflammatory responses and altered immune cell profiles. Multi-organ dysfunction was more severe in T2DM. Monocyte chemoattractant protein-1 polymorphisms increased sepsis susceptibility and amplified inflammation. Poor glycaemic control, advanced diabetes, and comorbidities worsened sepsis outcomes and prolonged hospitalisation. Mortality findings in diabetic sepsis were inconsistent. Insulin influenced sepsis outcomes by C-peptide modulation. Metformin, sodium-glucose co-transporter-2 inhibitors, dipeptidyl peptidase-4 inhibitors, and statins exhibited immunomodulatory effects. Granulocyte-macrophage colony-stimulating factor and ulinastatin restored immune function and suppressed inflammation. Larger multi-ethnic studies are warranted to define optimal glycaemic targets, uncover immune-metabolic interactions, identify biomarkers, and optimise T2DM management in sepsis.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"23 7","pages":"2423-2447"},"PeriodicalIF":3.7,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13280749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295067","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":"Biological Applications of Functionalized Cerium Oxide Nanoparticles.","authors":"Siyu Chen, Yuqi Gong, Fagang Jiang, Xinghua Wang","doi":"10.7150/ijms.134122","DOIUrl":"10.7150/ijms.134122","url":null,"abstract":"<p><p>The rapid expansion and advancement of nanotechnology have presented potential applications in the diagnosis and treatment of various diseases. In recent years, cerium oxide nanoparticles (CeO₂ NPs) have been extensively studied and applied in biological systems due to their unique physical and chemical properties, such as high antioxidant activity, enzyme-mimicking activity and good biocompatibility. This review summarizes the latest research progress of functionalized CeO₂ NPs in anti-cancer activity, anti-infection, anti-inflammation, antioxidant activity, wound healing, neuroprotection and imaging applications. It explores their mechanisms of action and potential clinical application prospects, as well as the concerns about toxicity and safety.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"23 7","pages":"2328-2354"},"PeriodicalIF":3.7,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13280748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148294828","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":"IFN-γ+ NK cells as a potential predictor of pregnancy loss in unexplained recurrent pregnancy loss.","authors":"Niwei Yan, Pingyin Lee, Huiying Jie, Lingli Long, Yu Fu, Canquan Zhou, Yuan Yuan","doi":"10.7150/ijms.121925","DOIUrl":"10.7150/ijms.121925","url":null,"abstract":"<p><strong>Background: </strong>Natural Killer (NK) cells are the largest population of lymphocytes in the endometrium during early pregnancy and play a key regulatory role in trophoblast cell invasion and embryo implantation at the maternal-fetal interface. Previous studies on the roles of NK cells with distinct phenotypes in pregnancy loss were based on NK cells derived from the peripheral blood or decidua, and it is difficult to determine whether the reported changes in decidual NK cells are causes or consequences of pregnancy loss.</p><p><strong>Objective: </strong>We aimed at exploring the functional NK cells during the implantation window and their associations with pregnancy outcome.</p><p><strong>Methods: </strong>Using flow cytometry, we assessed the expression of functional markers including Interferon-gamma (IFN-γ) and CD107a in NK cells from unexplained recurrent pregnancy loss <b>(</b>uRPL<b>)</b> patients following coculture with HTR-8/SVneo trophoblast cells during the implantation window, then the associations of functional NK cells with early pregnancy outcomes (≤12 weeks) were explored.</p><p><strong>Result: </strong>In this exploratory cohort, we found that an increase in the frequency of CD3^-CD56⁺IFN-γ⁺ uNK cells was associated with the recurrence of pregnancy loss in uRPL.</p><p><strong>Conclusion: </strong>Elevated CD3⁻CD56⁺IFN-γ⁺ uNK cells during the implantation window were associated with early pregnancy loss (≤12 weeks) in women with uRPL, suggesting a potential biomarker that requires validation in larger studies.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"23 7","pages":"2302-2314"},"PeriodicalIF":3.7,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13280750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148294924","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":"Increased Risk of Injury in Patients with Fabry Disease: A Nationwide Population-Based Cohort Study in Taiwan.","authors":"Chun-Gu Cheng, Yu-Hsuan Chen, Wu-Chien Chien, Hung-Wen Chiu, Fei-Hung Hung, Hung-Pin Peng, Chi-Hsiang Chung, Chun-An Cheng","doi":"10.7150/ijms.120352","DOIUrl":"10.7150/ijms.120352","url":null,"abstract":"<p><strong>Background: </strong>Fabry disease (FD) is a lysosomal storage disorder leading to α-galactosidase A deficiency and glycosphingolipid accumulation. Neurological manifestations of FD, such as central nervous system involvement, peripheral neuropathy, and vestibular dysfunction that results in postural and cognitive impairment, may predispose individuals to injuries. However, the associations between the risk of injury and FD remains underexplored.</p><p><strong>Methods: </strong>Using the Taiwanese National Health Insurance Research Database, we conducted a nationwide cohort study of adult FD patients (International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code 272.7)) who were diagnosed between 2001 and 2015. The comparison group was matched at a 1:4 ratio by age, sex, and index date. Injuries were identified via ICD-9-CM codes 800-999. Multivariate Cox proportional hazards models were applied to study the risk of injury, adjusting for sociodemographic factors and comorbidities.</p><p><strong>Results: </strong>The injury incidence rate was higher in the FD cohort (32.97/1,000 person-years) than in the control cohort (22.52/1,000 person-years). FD was significantly related to an increased risk of injury (adjusted hazard ratio: 1.642; 95% CI: 1.375-1.980; p < 0.001). FD patients had an 86% greater risk of motor vehicle traffic accidents and a 56% greater risk of falls than the control group. Higher risks of injury were also associated with the winter season, more complicated comorbidities, greater urbanization, and treatment at higher-level hospitals.</p><p><strong>Conclusion: </strong>This is the first large-scale study to demonstrate a significantly increased risk of injury among FD patients. These findings highlight the need for proactive injury risk assessments and tailored prevention strategies for this population. Future research should investigate the role of FD-related clinical phenotypes in injury susceptibility to enhance personalized care and improve outcomes.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"23 7","pages":"2376-2386"},"PeriodicalIF":3.7,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13280734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148294899","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":"Plumbagin sensitizes leukemia cells to cisplatin by promoting oxidative stress, apoptosis, and DNA damage.","authors":"Yan-Ning Chen, Jai-Wei Lee, Tsu-Ming Chien, Chia-Hung Yen, Bing-Hung Chen, Hsueh-Wei Chang","doi":"10.7150/ijms.124444","DOIUrl":"10.7150/ijms.124444","url":null,"abstract":"<p><p>This study focused on validating the synergistic antiproliferative activity and mechanism of cisplatin/plumbagin (PLB) in leukemic cells versus normal macrophages. Leukemic cells (MOLT-4) treated with cisplatin/PLB (3 μM/0.4 μM) for 24 h showed markedly reduced viability (45.51%) compared to cisplatin or PLB (81.07% or 76.36%), while normal macrophages (NR8383) retained high viability in cisplatin/PLB (~93.15%). The enhanced cytotoxicity in leukemia cells was driven by oxidative stress: the general antioxidant <i>N</i>-acetylcysteine (NAC) and the mitochondrial ROS scavenger MitoTEMPO substantially reversed the combination effect. Cisplatin/PLB increased total ROS and mitochondrial superoxide in MOLT-4 cells more than in macrophages, and provoked loss of mitochondrial membrane potential and depletion of glutathione; these alterations were mitigated by NAC and MitoTEMPO. Oxidative stress led to higher apoptosis in leukemia cells than normal macrophages, shown by increased subG1 fraction (validated via NAC), higher annexin V positivity (validated via NAC and MitoTEMPO), elevated cleaved PARP and caspases-9/-3, Bax upregulation, and a reduced p-Bcl-2 (anti-apoptotic Ser70)/Bcl-2 ratio (validated via NAC), whereas caspase-8 changed only modestly. DNA damage markers (γH2AX and 8-OHdG) were also increased in MOLT-4 cells and attenuated by NAC and MitoTEMPO. Overall, cisplatin/PLB triggers selective and oxidative stress-dependent in leukemia cells while sparing normal macrophages, supporting the combination as a promising antileukemic approach with limited toxicity.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"23 7","pages":"2290-2301"},"PeriodicalIF":3.7,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13280767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148294892","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":"Dual Metabolic Inhibition by Berberine and Glutor Triggers AMPK/JNK-Dependent DNA Damage in Cancer Cells.","authors":"Meina Shi, Chengming Wei, Dayuan Zheng, Dongfan Yang, Tong Chu, Shaokui Liang, Lu Yang, Kuanyun Zhang, Yanchao Yang, Wenzhe Ma","doi":"10.7150/ijms.132977","DOIUrl":"10.7150/ijms.132977","url":null,"abstract":"<p><p>Metabolic reprogramming is a key adaptive feature of malignant tumors and often leads to the failure of therapeutic strategies targeting a single metabolic pathway. In this study, we investigated the antitumor activity of combining berberine (BBR), a mitochondrial complex I inhibitor, with Glutor, a pan-glucose transporter inhibitor that blocks glucose uptake across multiple GLUT isoforms. The combination produced strong synergistic antiproliferative effects in HeLa, HepG2, and HCT116 cells, with Bliss synergy scores of 45.967, 34.219, and 26.972, respectively. Co-administration simultaneously suppressed glycolysis and oxidative phosphorylation (OXPHOS), resulting in severe ATP depletion and persistent activation of the AMPK signaling pathway, thereby inducing pronounced metabolic stress. Further mechanistic investigations revealed that such sustained metabolic stress effectively activated the JNK signaling pathway, which in turn exacerbated DNA damage, impaired homologous recombination repair, and ultimately triggered caspase-dependent apoptosis. Pharmacological inhibition or genetic silencing of JNK attenuated DNA damage and partially restored HR repair-related proteins, supporting JNK as a key functional mediator of the downstream stress response. In <i>ex vivo</i> tumor explant models, the combination also showed cooperative antitumor activity. These findings indicate that simultaneous restriction of glucose uptake/glycolysis and mitochondrial oxidative phosphorylation, termed \"dual metabolic inhibition\" cooperatively impairs tumor cell survival. The AMPK/JNK axis appears to be a critical mechanistic link underlying this antitumor effect.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"23 7","pages":"2355-2375"},"PeriodicalIF":3.7,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13280739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148294937","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":"Pulmonary Function Tests as Predictors of Successful Tracheostomy Decannulation: A 60-Day Prospective Study.","authors":"Chin-Chia Yang, Wen-Lin Yu, Meng-Heng Hsieh, Ching-Tzu Huang, Mei-Hsiu Chuang, Hsing-Yu Chen","doi":"10.7150/ijms.126157","DOIUrl":"10.7150/ijms.126157","url":null,"abstract":"<p><strong>Background: </strong>Early tracheostomy decannulation prevents complications, but premature removal poses risks. While various methods exist to assess readiness, the predictive role of pulmonary function tests remains unclear.</p><p><strong>Methods: </strong>This exploratory prospective observational study enrolled 46 patients at Chang Gung Memorial Hospital, Taoyuan, from March 2020 to December 2023. Participants underwent pulmonary function and coughing ability assessments-including forced vital capacity (FVC), peak expiratory flow rate (PEFR), maximum expiratory pressure (MEP), and oxygen saturation (SpO₂)-prior to decannulation. Success was defined as no reinsertion within 60 days. Logistic regression analysis and receiver operating characteristic (ROC) curve analysis were performed.</p><p><strong>Results: </strong>Factors associated with a successful outcome were younger age, male sex, strong cough function, no nasogastric tube, and higher albumin levels. Key respiratory-function metrics (higher MEP, PEFR, FVC, and SpO₂) were significantly linked to successful decannulation. FVC (≥ 1.35 L) and PEFR (≥ 95 L/min) strongly predicted success, with a combined metric (FVC + PEFR + MEP) achieving the highest accuracy.</p><p><strong>Conclusion: </strong>For patients with an average tracheostomy duration of > 300 days, FVC, PEFR and MEP are feasible predictors of successful decannulation. Further studies are needed to validate these results.</p>","PeriodicalId":14031,"journal":{"name":"International Journal of Medical Sciences","volume":"23 7","pages":"2315-2327"},"PeriodicalIF":3.7,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13280732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295049","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}