International Journal of General Medicine最新文献

{"title":"A Clinical Risk Prediction Model for Depressive Disorders Based on Seven Machine Learning Algorithms.","authors":"Weifeng Jin, Shuzi Chen, Mengxia Wang, Ping Lin","doi":"10.2147/IJGM.S524016","DOIUrl":"10.2147/IJGM.S524016","url":null,"abstract":"<p><strong>Objective: </strong>To develop a clinical risk prediction model for depressive disorders using seven machine learning algorithms based on routine blood test indicators.</p><p><strong>Methods: </strong>A retrospective study was conducted, involving 284 patients with depressive disorders and 214 healthy controls recruited between January and October 2024. Clinical data, including age, sex, and routine blood test results, were collected. The dataset was randomly divided into a training set (70%; n=348) and a test set (30%; n=150). Univariate logistic regression analysis (p<0.1) was initially performed to identify potential predictors, followed by feature selection using the Boruta and LASSO algorithms. Seven machine learning algorithms were employed to construct predictive models, with their performance evaluated using metrics such as AUC, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), precision, recall, and F1 score. A multivariable logistic regression model was subsequently used to develop a nomogram, and its discrimination, calibration, and clinical utility were comprehensively assessed.</p><p><strong>Results: </strong>Four significant predictors (alkaline phosphatase [AKP], serotonin, phenylalanine [Phe], and arginine [Arg]) were identified through univariate logistic regression combined with Boruta and LASSO feature selection. Among the seven algorithms, the random forest model exhibited the highest AUC, achieving an AUC of 1.000 (95% CI: 1.000-1.000) in the training set and 0.958 (95% CI: 0.931-0.985) in the test set. However, due to concerns about potential overfitting, the multivariable logistic regression model was selected as the final predictive model. A nomogram was constructed based on this model.</p><p><strong>Conclusion: </strong>This study successfully developed a clinically interpretable risk prediction model for depressive disorders by integrating machine learning algorithms and routine blood test indicators. The logistic regression model demonstrated robust performance across all metrics and holds potential as a reliable auxiliary tool for the diagnosis of depressive disorders.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"2461-2473"},"PeriodicalIF":2.1,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12069924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of the Relationship Between Cervical Cancer Progression and the Microbiome.","authors":"Yue-Yue Gao, Xiao-Xue Li, Hui Zuo, Ping Zhang","doi":"10.2147/IJGM.S520936","DOIUrl":"https://doi.org/10.2147/IJGM.S520936","url":null,"abstract":"<p><strong>Background: </strong>Cervical cancer remains a leading malignancy among women worldwide. Emerging evidence suggests that alterations in the cervical microbiota may influence its development and progression.</p><p><strong>Objective: </strong>To compare the cervical microbiota composition and diversity between cervical cancer patients and healthy women using 16S rRNA gene sequencing.</p><p><strong>Methods: </strong>Between January and June 2024, cervical tissue samples were collected from 40 cervical cancer patients and 40 healthy women. Microbial DNA was extracted and the V3-V4 region of the 16S rRNA gene was sequenced using the Illumina Novaseq 6000 platform. QIIME2 and R software were used for microbial classification and diversity analysis. LEfSe was applied to identify differentially abundant taxa between groups.</p><p><strong>Results: </strong>At the phylum level, <i>Firmicutes</i> dominated the control group (67.91%), while dropped to 31.03% in cervical cancer patients. <i>Actinobacteria</i> (26.22% vs 14.37%) and <i>Proteobacteria</i> (27.61% vs 0.72%) were significantly elevated in the cancer group. At the genus level, <i>Lactobacillus</i> was predominant in controls (46.27%), while reduced in patients, and Rhodococcus and Klebsiella were notably enriched. Alpha diversity (Shannon index) exhibited no significant difference between groups, whereas richness indices (Chao1 and ACE) were significantly higher in the cancer group (p < 0.05). Beta diversity analysis revealed a clear distinction in community structure (t = 10.225, P = 0.001). LEfSe identified Rhodococcus (LDA = 5.24), Klebsiella (LDA = 5.17), and Ralstonia as significantly more abundant in the cancer group, while <i>Firmicutes</i> (LDA = 5.31) was characteristic of the control group.</p><p><strong>Conclusion: </strong>Cervical cancer patients exhibited distinct cervical microbiota profiles, with reduced Firmicutes and elevated Actinobacteria and Proteobacteria. Increased levels of Rhodococcus and Klebsiella suggested a potential association between microbial dysbiosis and cervical cancer. These findings highlight the microbiome's relevance to tumor biology and support further investigation into its diagnostic and therapeutic potential.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"2449-2460"},"PeriodicalIF":2.1,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Radial Shock Wave Therapy to Control Cerebral Palsy-Related Dysfunctions: A Randomized Controlled Trial [Letter].","authors":"Sumyia Mehrin Omar, Aboma Zewude Abdissa, Maryam Mohammed Bashir","doi":"10.2147/IJGM.S535117","DOIUrl":"10.2147/IJGM.S535117","url":null,"abstract":"","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"2475-2476"},"PeriodicalIF":2.1,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Relationship Between Aortic Stiffness and Elasticity and Left Ventricular Functional Parameters in Patients with ANOCA Using CCTA.","authors":"Aizhu Sheng, Lili Zhang, Darong Zhu, Guangzhu Hu, Xiaobei Shi, Qianqian Zong, Pengli Wang, Zhen Wang","doi":"10.2147/IJGM.S508938","DOIUrl":"https://doi.org/10.2147/IJGM.S508938","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the clinical value of coronary CT angiography (CCTA) for evaluating aortic stiffness and elasticity in patients with angina and non-obstructive coronary artery (ANOCA).</p><p><strong>Methods: </strong>The case data of 120 patients who were diagnosed with ANOCA and underwent CCTA in our hospital were collected and set as the case group, and 86 healthy subjects who underwent medical check-up and ANOCA testing in our hospital during the same period were set as the control group. The differences in CCTA indices of ascending aortic stiffness and aortic elasticity, left ventricular function indices of left ventricular ejection fraction (LVEF) and cardiac output (CO) were compared between the two groups.</p><p><strong>Results: </strong>The arterial compliance (AC) and arterial distensibility (AD) values in the case group were significantly lower than those in the control group, while arterial stiffness (β) value was significantly higher in the case group compared to the control group (P<0.05). The LVEF and CO values of patients in the case group were significantly lower than those in the control group (P<0.05). The CCTA indices AC and AD of patients in the case group exhibited a significant positive correlation with their LVEF (r=0.133, r=0.062, P<0.05), while β showed a negative correlation with LVEF (r=-0.092, P=0.005).</p><p><strong>Conclusion: </strong>Aortic stiffness and elasticity in CCTA indices of ANOCA patients exhibited significant alterations, and the correlation analysis suggested a correlation of CCTA aortic stiffness and elasticity indices with left ventricular performance indices.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"2439-2447"},"PeriodicalIF":2.1,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemoglobin, Albumin, Lymphocyte and Platelet Score as a Novel Predictor of Mortality and Rebleeding in Patients with Upper Gastrointestinal Bleeding.","authors":"Burcu Azapoğlu Kaymak, Merve Eksioglu, Tuba Cimilli Öztürk, Mehmet Köroğlu","doi":"10.2147/IJGM.S520925","DOIUrl":"https://doi.org/10.2147/IJGM.S520925","url":null,"abstract":"<p><strong>Purpose: </strong>Upper gastrointestinal bleeding (UGIB) poses significant risks of morbidity and mortality, necessitating effective risk stratification tools. Traditional scoring systems such as the Rockall (RS), Glasgow-Blatchford (GBS), and AIMS65 have limitations in accurately predicting mortality and rebleeding. The Hemoglobin, Albumin, Lymphocyte, Platelet (HALP) score, initially developed for cancer prognosis, has demonstrated prognostic value in various conditions. This study aims to evaluate whether the HALP score, when assessed at admission, aligns with the Rockall score and can be used to predict rebleeding and 30- day mortality in UGIB patients.</p><p><strong>Patients and methods: </strong>This retrospective study included 256 patients with confirmed UGIB admitted to a tertiary hospital in Istanbul, Turkey, between 2017 and 2024. Patient data, including demographics, vital signs, laboratory parameters, endoscopic findings, and clinical outcomes, were collected. The HALP score was calculated at admission to the emergency department. ROC curve analysis assessed the predictive accuracy of the HALP score for 30-day mortality, rebleeding, and its performance was compared with the Rockall score.</p><p><strong>Results: </strong>The predictive performance of the HALP and Rockall scores for 30-day mortality and rebleeding was evaluated using ROC analysis, with AUC values of 0.772 (95% CI: 0.715-0.822) and 0.770 (95% CI: 0.714-0.820) for mortality prediction, respectively (<i>p</i> = 0.9801). For rebleeding prediction, the Rockall score had a higher AUC (0.739, 95% CI: 0.681-0.792) than the HALP score (0.688, 95% CI: 0.627-0.744), though the difference was not statistically significant (<i>p</i> = 0.2969).</p><p><strong>Conclusion: </strong>The results of this study demonstrate that the HALP score can be used for prognosis prediction in UGIB, exhibiting comparable sensitivity and specificity to the Rockall score. Its ease of calculation using routine laboratory parameters offers a practical complement to existing scoring systems.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"2391-2400"},"PeriodicalIF":2.1,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum Folic Acid Predicted Pre-Operative Aortic Rupture in Symptomatic Aortic Aneurysm Dissection: A Prospective, Single-Center, Observational Study.","authors":"Feier Song, Zhengbo Chen, Zhibo Yang, Guoxiang Zou, Baojuan Liu, Weifeng Li, Yimei Hong, Jinxiu Meng, Gang Zhao, Abdelouahab Bellou, Xin Li","doi":"10.2147/IJGM.S517646","DOIUrl":"https://doi.org/10.2147/IJGM.S517646","url":null,"abstract":"<p><strong>Background and aims: </strong>Folate metabolites have been identified as prognostic markers in cardiovascular, oncologic, and congenital diseases. However, few studies have explored the association between serum folic acid levels and aortic rupture. The aim of this study was to evaluate the predictive value of serum folic acid level for pre-operative adverse events in patients with symptomatic aortic aneurysm/aortic dissection.</p><p><strong>Methods and results: </strong>Patients with symptomatic aortic aneurysm/aortic dissection, presenting to the emergency department (ED), were enrolled in the study. Both univariate and multivariate analyses were performed to identify predictors of pre-operative aortic rupture. The optimal cut-off value for folic acid was determined, and a prognostic nomogram was subsequently developed for potential clinical application. Among 639 symptomatic aortic aneurysm/aortic dissection patients, 8.61% experienced rupture prior to surgery/intervention, with a significantly higher incidence observed in patients with higher serum folic acid levels. Multivariate logistic regression analysis revealed that folic acid levels ≥9ng/mL were an independent risk factor for pre-operative aortic rupture (OR=2.41). A nomogram was developed based on the combination of Stanford type A aortic dissection, folic acid level, white blood cell count, serum potassium, and random blood glucose, demonstrating excellent discrimination ability with the area under the curve of 0.801.</p><p><strong>Conclusion: </strong>This large-sample, prospective study suggested that the serum folic acid level was an independent predictor of pre-operative aortic rupture in patients with symptomatic aortic aneurysm/aortic dissection. The developed nomogram highlighted the prognostic value of folic acid and other objective clinical markers, offering a practical tool for early risk stratification, particularly in the ED setting.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"2417-2427"},"PeriodicalIF":2.1,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting Glioma Recurrence Using 18F-FDG PET/CT, MRI, and Tumor Markers: A Combined Approach.","authors":"Jingsong Wei","doi":"10.2147/IJGM.S520876","DOIUrl":"https://doi.org/10.2147/IJGM.S520876","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the combined predictive value of 18F-FDG PET/CT, MRI, and tumor markers for glioma recurrence.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the clinical data of 82 glioma patients treated at our hospital from January 2023 to April 2024. Patients were divided into Group A (n = 19, recurrence) and Group B (n = 63, no recurrence) based on whether recurrence occurred. All patients underwent 18F-FDG PET/CT to obtain maximum standardized uptake value (SUVmax) and lesion-to-normal tissue ratio (L/N). MRI was performed to measure the apparent diffusion coefficient (ADC) of the tumor parenchyma and cerebral blood flow (CBF). Serum samples were collected from all patients, and tumor markers, including monocyte-to-lymphocyte ratio (MLR) and neutrophil-to-lymphocyte ratio (NLR), were measured using an automated blood analyzer. Differences in SUVmax, L/N, ADC, CBF, MLR, and NLR levels between Groups A and B were compared. Spearman correlation analysis was used to assess the relationships between SUVmax, L/N, ADC, CBF, MLR, NLR, and glioma recurrence. Receiver operating characteristic (ROC) curves were plotted to evaluate the diagnostic value of each parameter for glioma recurrence.</p><p><strong>Results: </strong>Recurrent patients demonstrated significantly higher SUVmax, L/N, NLR, and MLR, alongside lower ADC and CBF (all P < 0.05). These parameters correlated with recurrence (SUVmax, L/N, NLR, MLR positively; ADC and CBF negatively; all P < 0.05). ROC analysis highlighted the superiority of combined modalities, achieving an AUC of 0.856, with higher sensitivity and specificity than individual markers.</p><p><strong>Conclusion: </strong>SUVmax, L/N, ADC, CBF, MLR, and NLR are correlated with glioma recurrence. The combined use of SUVmax, L/N, ADC, CBF, MLR, and NLR provides higher diagnostic value for glioma recurrence.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"2429-2438"},"PeriodicalIF":2.1,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long COVID Symptoms and Five Dimensions of HRQoL: A Retrospective Regional Study of Patients Recovered from COVID-19 Infection in Saudi Arabia.","authors":"Mokhtar Abdo Almoliky, Bandar Alsaif, Khalil A Saleh, Sameer A Alkubati, Sehar-Un-Nisa Hassan, Fahad D Algahtani, Badr Khalaf Mubarak Aldhmadi, Hamza Mohammad Assaggaf, Mohamed Ali Alzain","doi":"10.2147/IJGM.S518258","DOIUrl":"https://doi.org/10.2147/IJGM.S518258","url":null,"abstract":"<p><strong>Background/aim: </strong>10-20% of people infected with the coronavirus infection have long COVID symptoms, therefore, current research is the first regional assessment in Saudi Arabia to determine the relationship between long-term health complaints of COVID-19 survivors and health-related quality of life (HRQoL).</p><p><strong>Methods: </strong>The study population comprised COVID-19 infection cases registered in the Ha'il region of Saudi Arabia from the beginning of the COVID-19 pandemic until September 2022. A retrospective research design was employed, and 295 participants completed a self-report questionnaire to assess long COVID symptoms and the Arabic version of the European 5-Dimensional Quality of Life (EQ-5D). Multiple linear regression was used to evaluate the predictive role of long COVID symptoms on the HRQoL of patients by choosing (p-value < 0.05).</p><p><strong>Results: </strong>The mean (SD) age of the participants was 38 years, (67.1%) were male and (58.6%) were married. On the long COVID-19 symptoms, the highest mean values were fatigue (M=2.3; 95% CI 2.1-2.4) followed by headache (M=2.1; 95% CI 2.0-2.3) and persistent cough (M=1.9; 95% CI 1.8-2.1). Findings show that HRQoL was problematic in domains of pain/discomfort as depicted by a highest mean score on this domain (M=4.24; 95% CI 4.14-4.33) followed by anxiety/depression (M=4.17: 95% CI 4.08-4.27). Multiple regression analysis showed that marital status (p=0.05), irregular exercise (p<0.01), duration of hospitalization (p<0.01), and oxygen therapy (p<0.05) were the independent background factors affecting HRQoL post-COVID-19. Among the long-COVID-19 symptoms, fatigue (p=0.05), persistent cough (p=0.001), dyspnea (p=0.02), and sexual dysfunction (p<0.001) were the independent factors that impacted the HRQoL after controlling for background variables.</p><p><strong>Conclusion: </strong>The study has significant implications for Saudi Arabia's Health Sector Transformation Program that could achieve its goals of human centric care and patient satisfaction though addressing the negative impacts of specific long-COVID symptoms such as fatigue, persistent cough, dyspnea and sexual dysfunction and improving the HRQoL in domains of pain/discomfort and anxiety/depression.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"2401-2416"},"PeriodicalIF":2.1,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Future of Hospital Medicine in Japan: Lessons From the United States Hospital Medicine System.","authors":"Tomoharu Suzuki, Kohta Katayama, Nathan Houchens, Sarah Hartley, Yasuharu Tokuda, Takashi Watari","doi":"10.2147/IJGM.S520518","DOIUrl":"https://doi.org/10.2147/IJGM.S520518","url":null,"abstract":"<p><strong>Purpose: </strong>To compare hospitalist roles and training systems between the United States (US) and Japan, identifying strengths and challenges to guide development of Japan's emerging hospital medicine program.</p><p><strong>Methods: </strong>A qualitative, descriptive narrative study was conducted during a 10-day observational site visit to the Veterans Affairs Ann Arbor Healthcare System and University of Michigan Hospital in October 2022. Two experienced Japanese hospitalist authors independently observed clinical rounds, interprofessional meetings, and educational sessions. Data were collected through direct observation and structured discussions focusing on care-team structures, workflows, multidisciplinary collaboration, educational approaches, and quality improvement activities. The authors subsequently developed a comparative analysis report of Japan-US differences. Guided discussions based on this report were conducted with experienced US hospitalists and a pioneer physician of General Medicine in Japan to obtain expert commentary on the analyses. No quantitative data analysis or specific analytical software was utilized for this narrative comparison.</p><p><strong>Results: </strong>The US hospitalist model demonstrated group practice approaches with shift-based schedules supporting work-life balance. Multidisciplinary teams actively incorporated residents and students in patient care, quality improvement, and teaching. Japan's traditional attending physician model emphasized continuity of care but showed high workloads and limited multidisciplinary integration. Japanese hospitalists faced challenges including extensive work hours, fewer specialized training opportunities in quality improvement and patient safety, and less robust team-based learning environments.</p><p><strong>Conclusion: </strong>Incorporating elements from the US model-such as group practice with shift-based systems, enhanced multidisciplinary collaboration, and structured educational and quality improvement initiatives-could address workload issues and foster professional development in Japan's hospital medicine system while preserving valued aspects of continuity of care. These findings provide specific actionable guidance for healthcare administrators, medical education directors, and policymakers involved in developing Japan's hospitalist system, as well as to practicing Japanese hospitalists seeking to enhance their professional practice environments and educational frameworks.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"2379-2390"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in Serum PDGF-C and TGF-β1 Levels After PCI in Premature Coronary Artery Disease: Combined Predictive Value for MACCE.","authors":"Haide Liu, Shanglang Tan, Jiaxin Zhao, Xuejuan Lin","doi":"10.2147/IJGM.S510456","DOIUrl":"https://doi.org/10.2147/IJGM.S510456","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluates dynamic changes in platelet derived growth factor C (PDGF-C) and transforming growth factor β1 (TGF-β1) levels after percutaneous coronary intervention (PCI) in patients with premature coronary artery disease (PCAD) and their combined predictive value for major adverse cardiac and cerebrovascular events (MACCE).</p><p><strong>Methods: </strong>A total of 100 PCAD patients admitted to the hospital from July 2021 to July 2023 who had completed 2 years of follow-up were retrospectively selected as the research objects. The patients were divided into MACCE group and non-MACCE group according to the occurrence of MACCE. The changes of serum PDGF-C and TGF-β1 levels were compared before operation, 1 year after operation and 2 years after operation. Cox regression was used to test the influencing factors. Receiver operating characteristic (ROC) curve was used to predict the predictive value. The decision curve was used to analyze the predicting value of serum PDGF-C and TGF-β1.</p><p><strong>Results: </strong>Compared with that before operation, serum PDGF-C levels increased, while TGF-β1 levels decreased at 1 year and 2 years post-PCI (<i>P</i><0.05). The levels of hs-CRP, HDL-C, MPV and PDGF-C in the MACCE group were higher than those in the non-MACCE group, and the level of TGF-β1 was lower than that in the non-MACCE group (<i>P</i><0.05). The hs-CRP, MPV and PDGF-C were identified as independent risk factors for MACCE (<i>HR</i>>1, <i>P</i><0.05), and TGF-β1 was identified as a protective factor (<i>HR</i><1, <i>P</i><0.05). The AUC of PDGF-C levels and TGF-β1 levels n in predicting MACCE after PCI in PCAD patients were 0.796 and 0.837, respectively. Combined prediction has higher sensitivity and specificity than individual markers. The decision curve showed that within the threshold range of 0.141-0.202 and 0.216-0.998, the net return rate of the combination of PDGF-C and TGF-β1 levels in predicting MACCE after PCI in PCAD patients was better than that of either alone.</p><p><strong>Conclusion: </strong>hs-CRP, MPV, PDGF-C and TGF-β1 were the influencing factors of MACCE in PCAD patients after PCI. Combined detection of PDGF-C and TGF- β1 enhanced predictive accuracy for MACCE, offering potential value for risk stratification in PCAD patients post-PCI.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"2367-2377"},"PeriodicalIF":2.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12050022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}