International Journal of General Medicine最新文献

{"title":"Diagnostic and Prognostic Predictive Value of Serum Selenium and Redox Biomarkers in Retinal Vein Occlusion.","authors":"Danqing Shen, Meixiu Li, Wencai Sun, Zhifu Tao","doi":"10.2147/IJGM.S522918","DOIUrl":"10.2147/IJGM.S522918","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the diagnostic efficacy and prognostic predictive value of serum selenium (Sse) and redox biomarkers in retinal vein occlusion (RVO).</p><p><strong>Methods: </strong>A prospective analysis was conducted on 112 RVO patients (RVO Group) admitted to the hospital between January 2022 and February 2024, along with 112 non-RVO ophthalmic patients (non-RVO Group) during the same period. The levels of Sse and redox factors [high mobility group protein B1 (HMGB1), reduced glutathione (GSH), nitric oxide (NO), and superoxide dismutase (SOD)] were compared between the two groups, and the receiver operating characteristic (ROC) curves were plotted to analyze their diagnostic efficacy for RVO. The RVO Group received treatment and was divided into poor prognosis group and good prognosis group based on prognosis. The changes in Sse and redox biomarker levels were compared to analyze factors influencing RVO patient prognosis, and a nomogram was constructed to validate the calibration curve.</p><p><strong>Results: </strong>Compared with the non-RVO group, the levels of Sse, GSH, and SOD were lower, while the levels of HMGB1 and NO were higher in the RVO group (<i>P</i> <0.05). The ROC curve showed that Sse and various oxidative stress factors had good diagnostic efficacy for RVO. In the Poor Prognosis Group, Sse, GSH, NO, and SOD levels were lower than those in the Good Prognosis Group, while HMGB1 levels were higher than those in the Good Prognosis Group (<i>P</i> <0.05). Cox regression analysis showed that all these indicators were factors influencing the prognosis of RVO patients (all P < 0.05). Additionally, the consistency of theroc curves constructed using these factors was good, and the calibration curves were close to the ideal curve.</p><p><strong>Conclusion: </strong>The combined detection of Sse and redox biomarkers can effectively assist in RVO diagnosis, while their dynamic changes have important clinical value in prognosis evaluation.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"5731-5742"},"PeriodicalIF":2.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12456751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137667","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":"Fire Acupuncture Combined with Pulse Radiofrequency Relieves Tactile Allodynia in Rats with Postherpetic Neuralgia.","authors":"Yajun Ding, Hanzhong Cao, Ying Huang, Hong Xue, Shenquan Cai, Xiaohong Chen, Manlin Duan","doi":"10.2147/IJGM.S541807","DOIUrl":"10.2147/IJGM.S541807","url":null,"abstract":"<p><strong>Background: </strong>Postherpetic neuralgia (PHN) remains challenging to treat, with 40%-50% of patients experiencing inadequate pain relief despite comprehensive interventions. Neuromodulation techniques such as pulsed radiofrequency (RF) and traditional methods such as fire acupuncture (FA) are increasingly used for PHN. This study investigated the combined effect of FA and RF on tactile allodynia in a rat model of PHN and explored its underlying mechanisms.</p><p><strong>Methods: </strong>Adult male rats were randomly divided into: Control, PHN, FA, RF, and combined FA_RF groups. PHN was induced by varicella-zoster virus inoculation. FA and/or RF interventions began on Day 15. Pain behavior was assessed via mechanical allodynia and thermal hyperalgesia tests. On Day 37, spinal cord tissues and cerebrospinal fluid were collected to evaluate astrocyte and microglial activation, neuronal apoptosis, expression of Insulin-Like Growth Factor 2 (IGF2), Peripheral Myelin Protein 2 (PMP2), Claudin-19 (CLDN19), Homeobox C8 (HOXC8), and levels of interleukin-1β (IL-1β), interleukin-6 (IL-6), interleukin-10 (IL-10), and tumor necrosis factor-α (TNF-α). The role of the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT) pathway was verified using a PI3K/AKT agonist.</p><p><strong>Results: </strong>The results revealed that mechanical allodynia thresholds decreased on Day 8 post-inoculation. Compared to the PHN group, FA_RF combination significantly increased mechanical thresholds and prolonged thermal hyperalgesia latency, with superior effects versus FA or RF alone. The FA_RF group showed increased spinal IGF2, PMP2, and CLDN19 expression, decreased HOXC8, reduced astrocyte activation, and modulated cytokine levels (IL-1β, IL-6, TNF-α, IL-10). The PI3K/AKT agonist reversed the analgesic effects of FA_RF.</p><p><strong>Conclusion: </strong>Combined fire acupuncture and pulsed radiofrequency alleviates tactile allodynia in PHN rats, possibly by inhibiting spinal astrocyte activation, modulating inflammatory responses, and promoting nerve repair via IGF2, PMP2, and CLDN19 expression. The PI3K/AKT pathway may be critically involved in this analgesic mechanism.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"5699-5716"},"PeriodicalIF":2.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12456442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137677","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":"Continuum of Care and 3-month Outcomes in Acute Ischemic Stroke Patients Stratified by Discharge Functional Status: A Single-Center Retrospective Cohort Study.","authors":"Wei-Ting Liu, Huey-Juan Lin, Poh-Shiow Yeh","doi":"10.2147/IJGM.S547223","DOIUrl":"10.2147/IJGM.S547223","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate use of continuous care resources among stroke survivors and their 3-month outcomes by discharge functional status.</p><p><strong>Patients and methods: </strong>This single-center retrospective cohort study included patients with transient ischemic attack or acute ischemic stroke admitted to Chi Mei Medical Center from July 2021 to June 2022. Discharge functional status was categorized by the modified Rankin Scale (mRS): Group I (0-2), Group II (3), and Group III (4-5). Data on discharge planning, medical adherence, readmissions, and 3-month outcomes were collected from medical records and telephone follow-ups. Group comparisons used Kruskal-Wallis and chi-square or Fisher's exact tests (two-sided, α<0.05).</p><p><strong>Results: </strong>Of 897 patients, 754 met inclusion criteria: Group I (50%), Group II (21%), and Group III (29%). Groups II and III were older with more severe strokes and comorbidities. Discharge destination varied: 96% of Group I returned home, versus 59% of Group II, and 33% of Group III. About one-third of Groups II and III received post-acute care (PAC), and 27% of Group III were discharged to nursing facilities. Medical adherence was high (96-97%), and 17% of Group III received home medical care. Long-Term Care (LTC) 2.0 services were utilized by 14% of Groups II and III. At 3 months, disability (mRS > 2) or death occurred in 10% of Group I, 50% of Group II, and 89% of Group III. Two-thirds of Groups II and III had medical tubes removed. Readmissions ranged from 10-17%, highest in Group III, mainly due to recurrent strokes or infections. Half of PAC participants showed functional improvements.</p><p><strong>Conclusion: </strong>Stroke survivors have distinct care needs and outcomes by discharge functional status. Optimizing discharge planning and facilitating PAC and LTC 2.0 services may improve recovery, particularly for patients with significant disabilities.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"5665-5672"},"PeriodicalIF":2.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130715","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 Risk Factors for Severe Pneumonia Progression in Chlamydia psittaci Infections: A Retrospective Study.","authors":"Han Hu, Yang Yang, Wei Lu, Xin-Er Huang","doi":"10.2147/IJGM.S545097","DOIUrl":"10.2147/IJGM.S545097","url":null,"abstract":"<p><strong>Introduction: </strong>Psittacosis pneumonia, caused by <i>Chlamydia psittaci</i>, is a zoonotic infection with a severe-case mortality rate of 15-20%. This study aimed to identify risk factors for severe pneumonia and evaluate the discriminative performance of corresponding predictive models.</p><p><strong>Methods: </strong>In this retrospective study, 51 patients with metagenomic next-generation sequencing (mNGS)-confirmed psittacosis pneumonia were classified into severe (n=20) and non-severe (n=31) groups. Demographic characteristics, clinical manifestations, laboratory parameters, and imaging features were collected. Variables were analyzed using univariate screening, variance inflation factor (VIF)-based multicollinearity control, least absolute shrinkage and selection operator (LASSO) regression, and Firth-penalized logistic regression. Receiver operating characteristic (ROC) analysis evaluated predictive performance.</p><p><strong>Results: </strong>Patients with severe pneumonia were significantly older (<i>p</i> = 0.043) and showed a higher prevalence of underlying diseases (<i>p</i> = 0.025) and cardiovascular diseases (CVD, <i>p</i> = 0.028). They also exhibited persistent lymphocytopenia, progressive decreases in hemoglobin (Hb) levels, and a higher rate of bilateral lung involvement. LASSO regression identified four key predictors: history of CVD, first lymphocyte count (LYM), second Hb measurement, and lactate dehydrogenase (LDH) level. Firth-penalized logistic regression confirmed that a history of CVD (OR = 4.874, 95% CI: 1.270-22.763) and a decreased second Hb measurement (OR = 0.415, 95% CI: 0.169-0.844) were independent risk factors for severe pneumonia. ROC analysis demonstrated that the combination of CVD history and the second Hb measurement achieved a specificity of 90.32%, while the combination of CVD history and LDH exhibited a sensitivity of 90%. The final multivariable model showed good discriminatory performance, with an area under the curve (AUC) of 0.885, sensitivity of 75%, and specificity of 93.50%.</p><p><strong>Conclusion: </strong>CVD history and progressive Hb decrease are independent risk factors for severe psittacosis pneumonia. Dynamic monitoring of LYM, Hb, LDH, and CVD history facilitates early risk stratification. The multivariate model demonstrates high predictive accuracy and clinical utility.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"5605-5615"},"PeriodicalIF":2.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130750","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":"Identification of Plasma Cell Subsets and Molecular Markers of Alzheimer's Disease Based on Single-Cell Weighted Gene Co-Expression Network Analysis, Mendelian Randomization Analysis and Clinical Validation.","authors":"Chao Xin, Hong-Wei Zhi, Da-Hua Wu, Peng-Li Ding, Zhong-Lin Wang, Ya-Han Wang","doi":"10.2147/IJGM.S539547","DOIUrl":"10.2147/IJGM.S539547","url":null,"abstract":"<p><strong>Introduction: </strong>Alzheimer's disease (AD) is a neurodegenerative disorder characterized by gene expression alterations and immune dysregulation.</p><p><strong>Methods: </strong>In this study, we downloaded the GSE181279 single-cell dataset from the Gene Expression Omnibus (GEO) and applied bioinformatic analysis and clinical subject validation.</p><p><strong>Results: </strong>After quality control and harmony integration, we identified 21 cell subsets, including T cells, B cells, plasma cells, and macrophages. Plasma cells were significantly elevated in AD patients, and six plasma cell subtypes were associated with AD. High-dimensional weighted gene co-expression network analysis (hdWGCNA) revealed two AD-related modules. Mendelian randomization identified <i>RGS1</i> as a key risk gene (p = 0.0123). Immune infiltration analysis showed <i>RGS1</i> negatively correlated with macrophages and positively with tumor-infiltrating lymphocytes. Functional enrichment indicated that <i>RGS1</i> is involved in JAK-STAT, NF-κB, and Wnt-β-catenin signaling pathways, suggesting a role in immune regulation and neuroinflammation. Furthermore, validation in AD patients confirmed that <i>RGS1</i> expression levels were higher than in controls (p < 0.01).</p><p><strong>Discussion: </strong>This study identified the key gene <i>RGS1</i> related to AD and explored multiple signaling pathways associated with it, which provided important clues for the research on AD-related inflammation, gut microbiota, stretch-gated ion channel, and the evaluation of AD therapeutic targets.</p><p><strong>Clinical trial registration number: </strong>CTR20210477.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"5641-5664"},"PeriodicalIF":2.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12454592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137696","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 Influence of Characteristics and Indexes (NLR, PNI, and SII) Evaluated at Admission on the Mortality Prediction of Infectious Endocarditis Patients.","authors":"Aysegul Inci Sezen, Yusuf Emre Ozdemir, Deniz Borcak, Busra Nur Goklu, Zeynep Bilgin, Gulsum Turkyilmaz, Fatma Nihan Turhan Caglar, Habip Gedik, Kadriye Kart Yasar","doi":"10.2147/IJGM.S535813","DOIUrl":"10.2147/IJGM.S535813","url":null,"abstract":"<p><strong>Background: </strong>Infective endocarditis (IE) is a serious and potentially life-threatening infection with high morbidity and mortality. Early risk identification is critical for enabling timely treatment and preventing adverse outcomes. Recently, several low-cost and accessible inflammatory markers, such as the neutrophil-to-lymphocyte ratio (NLR), prognostic nutritional index (PNI), and systemic immune-inflammation index (SII), have gained attention for their potential prognostic value in infectious diseases.</p><p><strong>Methods: </strong>This retrospective study evaluated patients diagnosed with definite IE between May 2014 and May 2024 at Bakırköy Dr. Sadi Konuk Training and Research Hospital. Clinical characteristics, laboratory parameters, complications, and outcomes were compared between survivors and non-survivors. The predictive value of NLR, PNI, and SII for in-hospital mortality was assessed.</p><p><strong>Results: </strong>A total of 78 patients with IE were included, with an overall mortality rate of 52.5%. Non-survivors were significantly older (p = 0.001) and had higher rates of cardiac complications (p < 0.05). PNI values were significantly lower in non-survivors (p = 0.014). Undergoing cardiac surgery was associated with a lower mortality rate (p = 0.024).</p><p><strong>Conclusion: </strong>PNI, a simple, inexpensive, and readily available marker, may provide valuable prognostic information in patients with infective endocarditis. This index could help in early risk stratification and clinical decision.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"5617-5627"},"PeriodicalIF":2.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130681","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":"Enhancing Psychosomatic Medicine Skills in General Practitioners: Insights from Ecological Systems Theory.","authors":"Zixuan Zeng, Yingli Qian, Wei Zhang, Jia Hu, Jiahui Jiang, Lianhua Zeng, You Chen, Lei Huang","doi":"10.2147/IJGM.S527054","DOIUrl":"10.2147/IJGM.S527054","url":null,"abstract":"<p><strong>Purpose: </strong>Based on the Ecological Systems Theory, this study aims to identify multilevel factors that influence the psychosomatic medical service competency (PMSC) of general practitioners (GPs).</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among 699 community general practitioners in Shanghai from December 2022 to March 2023 using a stratified random cluster sampling method. GPs' PMSC was assessed using a validated 27-item scale, covering knowledge, attitude and skills dimensions, with additional self-evaluative measures on perceived competency and training needs. Based on ecological systems theory, individual, institutional and systemic factors were examined. A three-stage hierarchical regression analysis was performed to identify multilevel determinants of PMSC.</p><p><strong>Results: </strong>A total of 713 questionnaires were distributed, yielding 699 valid responses. The response rate was 98.04%. According to the multiple hierarchical regression analysis, higher educational attainment (<i>p</i> < 0.05) and greater empathy (<i>β</i> = 0.256, <i>p</i> < 0.001) were significantly associated with higher PMSC, explaining 7% of the variance (<i>R</i>² = 0.07, <i>p</i> < 0.001). While institutional factors (including psychological services, medication availability and referral pathways) were associated with PMSC in bivariable analysis (<i>p</i> < 0.01), they were not significant in multivariable models. PMSC training emerged as the strongest predictor of PMSC (<i>R</i>² = 0.263, <i>p</i> < 0.001), emphasizing its critical role in competency development.</p><p><strong>Conclusion: </strong>Educational attainment, empathy, and training significantly influence general practitioners' psychosomatic medical service competency, with training coverage being the strongest predictor. This study highlighted the urgent need for targeted training and policy reforms to enhance psychosomatic care in Chinese primary care settings.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"5591-5603"},"PeriodicalIF":2.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124736","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":"Controlled Nutritional Status Score and Prognostic Nutritional Index for the Prediction of Postoperative Subdural Hematoma.","authors":"Huisong Chu, Shuang Sun, Hui Jiang, Ling Li, Yu Tian","doi":"10.2147/IJGM.S532358","DOIUrl":"10.2147/IJGM.S532358","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the predictive value of the prognostic nutritional index (PNI) and controlled nutritional status score (CONUT) on the neurological outcomes of patients with chronic subdural hematoma (CSDH) following burr-hole drainage.</p><p><strong>Methods: </strong>A retrospective analysis of patients with CSDH was conducted. The CONUT and PNI values and the modified Rankin scale (mRS) scores were calculated based on the patients' conditions at the time of hospital discharge. The poor prognosis was defined as an mRS score of 3. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive value of CONUT and PNI for the postoperative prognosis of CSDH. Nutritional risk was defined using established cutoffs: PNI < 45 and CONUT ≥ 2.</p><p><strong>Results: </strong>In 205 patients with CSDH, 17 patients (8.3%) had a poor prognosis. On ROC curve analysis, the area under the curve (AUC) for the CONUT in predicting poor prognosis of CSDH was 0.719 (95% Confidence Interval [CI]: 0.5867-0.8523, P=0.002). The AUC for the PNI and combined CONUT and PNI were 0.803 (95% CI: 0.7031-0.9042, P<0.001) and 0.805 (95% CI: 0.7039-0.9059, P<0.001), respectively. Moreover, multivariate logistic regression analysis showed that CONUT (OR=1.485, 95% CI: 1.096-2.011) and PNI (OR=0.850, 95% CI: 0.763-0.947) were independent risk factors for poor prognosis of CSDH following surgical intervention, after adjusting for age, hypertension, and pre-discharge intracranial fluid volume.</p><p><strong>Conclusion: </strong>The combined score of PNI and CONUT displayed higher sensitivity and specificity, compared to PNI or CONUT alone. Therefore, the combined score might be useful in predicting the prognosis of CSDH.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"5629-5639"},"PeriodicalIF":2.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124726","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":"Predictive Value of Preoperative [¹⁸F]FDG PET/CT-Derived Heterogeneity Index for Occult Lymph Node Metastasis in Clinical N0 Gastric Adenocarcinoma.","authors":"Bo Wu, Wen-Jie Tian, Lin Li, Yuan-Qing Zhu, Ying-Gang Sun","doi":"10.2147/IJGM.S513034","DOIUrl":"10.2147/IJGM.S513034","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the predictive value of preoperative [¹⁸F]fluorodeoxyglucose ([¹⁸F]FDG) positron emission tomography/computed tomography (PET/CT)-derived heterogeneity index (HI) for occult lymph node metastasis (OLM) in clinical N0 gastric adenocarcinoma.</p><p><strong>Methods: </strong>This retrospective study included 83 patients with clinical N0 gastric adenocarcinoma who underwent [¹⁸F]FDG PET/CT scans before radical surgery between March 2018 and June 2024. Patients were classified as OLM-positive (n=40) or OLM-negative (n=43) based on postoperative pathology. Clinical characteristics, PET/CT metabolic parameters [maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), peak standardized uptake value (SUVpeak), tumor-to-liver ratio (TLR), metabolic tumor volume (MTV), and total lesion glycolysis (TLG)], and heterogeneity indices (HI-1 and HI-2) were analyzed. Univariate and multivariate logistic regression models were applied to identify independent predictors of OLM. ROC curve analysis was performed to assess diagnostic performance. Statistical analysis was conducted using SPSS version 26.0, with P<0.05 considered statistically significant.</p><p><strong>Results: </strong>Gender, tumor differentiation, and pathological T stage differed significantly between the two groups (P<0.05). HI-2 was significantly higher, while SUVmax, SUVmean, and HI-1 were significantly lower in the OLM-positive group (P<0.05). Multivariate analysis identified pathological T stage (T3-T4, OR=4.778, P=0.022) and HI-2 >4.959 (OR=6.887, P=0.002) as independent predictors of OLM. ROC analysis revealed that HI-2 had an AUC of 0.711 (95% CI: 0.596-0.824, P=0.001), with 52.5% sensitivity and 88.37% specificity at the optimal threshold.</p><p><strong>Conclusion: </strong>HI-2 derived from preoperative [¹⁸F]FDG PET/CT is a significant independent predictor of OLM in clinical N0 gastric adenocarcinoma patients, alongside pathological T stage.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"5581-5589"},"PeriodicalIF":2.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124704","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":"Acute Cholecystitis: Integrated Traditional Chinese and Western Medicine Approaches to Epidemiology, Diagnosis, and Treatment.","authors":"Jia Luan, Kuanyu Wang","doi":"10.2147/IJGM.S540729","DOIUrl":"10.2147/IJGM.S540729","url":null,"abstract":"<p><p>Acute cholecystitis is a common clinical condition with complex pathological mechanisms and significant clinical impact. This review focuses on integrated traditional Chinese and Western medicine approaches to its management. We first summarize theoretical foundations and recent findings in epidemiology and pathophysiology. Diagnostic strategies are then discussed, with emphasis on how modern imaging methods and traditional Chinese medicine diagnostic approaches complement each other to improve accuracy. Clinical practice is reviewed in terms of therapeutic efficacy, combined medication, and surgical options, underscoring the benefits of integrative treatment. Advances such as the development of new traditional Chinese medicine preparations and the adoption of minimally invasive techniques have introduced promising directions, although controversies and challenges remain. Finally, we highlight the need for further research to optimize integrative strategies, establish standardized treatment protocols, and improve patient outcomes. By synthesizing current evidence, this review aims to inform clinical decision-making and guide future research on integrative approaches to acute cholecystitis.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"5569-5580"},"PeriodicalIF":2.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12449890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113025","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}