International Journal of General Medicine最新文献

{"title":"The Effect of Malnutrition, Inflammatory Biomarkers, and Stress-Induced Hyperglycemia on the Glomerular Filtration Rate in Renal Dysfunction.","authors":"Woori Jang, Noriyoshi Fujii, Tatsuyoshi Fujii, Jong Weon Choi","doi":"10.2147/IJGM.S540385","DOIUrl":"10.2147/IJGM.S540385","url":null,"abstract":"<p><strong>Background: </strong>The risk of malnutrition can be assessed using the prognostic nutritional index (PNI) and the controlling nutritional status (CONUT) score. The stress hyperglycemia ratio (SHR) is a useful marker for assessing stress-induced hyperglycemia (SIH). This study examined the effects of malnutrition, SIH, and inflammatory biomarkers on the estimated glomerular filtration rate (eGFR) in patients with renal dysfunction.</p><p><strong>Methods: </strong>This study used the data obtained from 1815 patients with reduced eGFR. Serum amyloid A (SAA), procalcitonin, presepsin, C-reactive protein (CRP), and corrected erythrocyte sedimentation rate (cESR) were included as inflammatory biomarkers. The nutritional status was assessed using the PNI, CONUT score, and a new index, nutritional index of kidney diseases (NIKD). The CONUT scores ≥ 5.0 were defined as malnutrition. SIH was evaluated using the stress hyperglycemia ratio (SHR).</p><p><strong>Results: </strong>Patients with malnutrition had significantly lower eGFR than those without malnutrition, which was still significant even after excluding patients with inflammation. The eGFR was more strongly correlated with NIKD, SHR, procalcitonin, and presepsin than SAA and hemoglobin A1c. Procalcitonin, presepsin, and CRP levels were significantly higher in patients with moderately reduced eGFR than in those with mildly reduced eGFR. In contrast, the SAA and cESR levels were not significantly different between the two groups. After adjusting for potential confounders, low NIKD and high SHR were strongly associated with an increased risk of moderately reduced eGFR (odds ratio: 1.513, 95% confidence interval [CI], 1.074-2.951; and 1.832, 95% CI, 1.274-2.503, respectively, p < 0.001).</p><p><strong>Conclusion: </strong>Malnutrition and SIH are closely associated with a deterioration of kidney function. Measuring NIKD and SHR may provide additional information for monitoring potential disease progression in patients with renal dysfunction.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"4481-4494"},"PeriodicalIF":2.0,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953505","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":"Effect of Bdq-Containing Regimen and Molecular Detection of Bdq Resistance among Pre-XDR-TB Patients with Unfavorable Outcomes.","authors":"Feng Ding, Sinian Li, Xiangxiang Liu, Guoju Shao, Youfeng Su, Yan Qian, Zhi Mao, Jianfeng Zeng, Shuihua Lu, Mutong Fang","doi":"10.2147/IJGM.S538660","DOIUrl":"10.2147/IJGM.S538660","url":null,"abstract":"<p><strong>Purpose: </strong>The objective of this study was to evaluate the efficacy of bedaquiline (Bdq)-containing regimens in pre-extensively drug-resistant tuberculosis (pre-XDR-TB) patients in Shenzhen, China, and to investigate the association between Bdq resistance and unfavorable outcomes.</p><p><strong>Methods: </strong>Data were collected from 84 pre-XDR-TB patients categorized into Bdq (n = 46) and non-Bdq (n = 38) groups. Individuals in the Bdq group were treated with Bdq alongside individualized background drugs. Commonly used drugs (>50% of patients) in both groups were linezolid (Lzd), clofazimine (Cfz), cycloserine (Cs) and pyrazinamide (Pza). Treatment outcomes were classified as cure, treatment completion, treatment failure, loss to follow-up, or death. Logistic regression analysis was conducted to determine independent predictors of treatment success using potential risk factors, including age, sex, body mass index (BMI), TB treatment history, and other factors. Whole-genome sequencing (WGS) was conducted on clinical isolates from 4 patients with unfavorable outcomes and 4 patients with favorable outcomes in the Bdq group.</p><p><strong>Results: </strong>Favorable treatment outcomes were observed in 89.13% (41/46) of the Bdq group and 52.63% (20/38) of the non-Bdq group (P = 0.0005). Univariate and multivariate analyses identified Bdq was an independent factor associated with treatment success (odds ratio [OR] = 11.572, 95% CI: 2.183-61.343, P = 0.004). WGS identified an atpE_Ala63Pro mutation conferring Bdq resistance in one patient with an unfavorable outcome. Additional resistance mutations included Rv0678_Arg156fs (Bdq and Cfz resistance) and rplC_Cys154Arg (Lzd resistance).</p><p><strong>Conclusion: </strong>Bdq-containing regimens significantly improved the treatment outcomes among pre-XDR-TB patients. The emergence of resistance mutations highlights the importance of routine drug resistance monitoring and rational drug use. Expanding access to Bdq and other novel drugs at affordable prices is vital for improving the success of pre-XDR-TB treatment.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"4469-4480"},"PeriodicalIF":2.0,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953450","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":"Acupoint Catgut Embedding at Stellate Ganglion Combined with Oral Mecobalamin Versus Mecobalamin Monotherapy in Managing Taxane-Induced Peripheral Neurotoxicity: A Clinical Observational Study.","authors":"Linbo Liu, Yiwen Li, Meijuan Ding, Xiaofei Guo, Qun Zhang, Beibei Su, Helong Wang, Jiashuo Yan, Shasha Dong, Dan Lu","doi":"10.2147/IJGM.S521754","DOIUrl":"10.2147/IJGM.S521754","url":null,"abstract":"<p><strong>Purpose: </strong>Taxane-induced peripheral neurotoxicity (TIPN) severely impacts the quality of life of patients and worsens over time with cumulative drug exposure. This study aims to evaluate the efficacy and safety of Stellate Ganglion Catgut Embedding (SGCE) therapy in treating TIPN patients, exploring a novel approach to managing TIPN.</p><p><strong>Patients and methods: </strong>The study was conducted from June 2023 to June 2024 at the Second Affiliated Hospital of Harbin Medical University. Patients (at least two cycles of taxane treatment, including albumin-bound paclitaxel, paclitaxel, docetaxel, etc) were divided into methylcobalamin (MeCbl, n=25) and SGCE (n=21) groups. The former received oral methylcobalamin therapy, while the SGCE group underwent Stellate Ganglion Blockade with Catgut Implantation combined with oral methylcobalamin therapy. Neurotoxicity was assessed using the EORTC QLQ-CIPN15 and FACT/GOG-Ntx scales, with patient quality of life evaluated using the FACT-G scale. Comprehensive outcomes would be assessed on the day of treatment (SGCE or MeCbl treatment) and at the 1st and 3rd weeks post-treatment for all participants. Adverse events were assessed using the CTCAE scales.</p><p><strong>Results: </strong>The principal findings revealed that according to the EORTC QLQ-CIPN15 sensory, motor, overall scores and FACT/GOG-Ntx scale scores, there were significant decreases in the SGCE group compared to the MeCbl group after 3 weeks of treatment (<i>P</i><0.05). The secondary outcomes showed that the FACT-G scores in the SGCE group significantly increased from baseline ( <b><i>P</i></b> =0.011). Throughout the assessment period before and after treatment, no significant adverse reactions were observed in the patients.</p><p><strong>Conclusion: </strong>SGCE group produced a more pronounced improvement in symptoms among TIPN patients compared to MeCbl group, enhanced the quality of life of the patients compared with the pre-treatment period, this improvement could be linked to SGCE. Moreover, the patients did not show significant adverse effects.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"4411-4423"},"PeriodicalIF":2.0,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873025","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 Role of <i>ADIPOQ</i> and AMPK Signaling Pathway in Sarcopenia.","authors":"Rihong Bin, Xinsheng Zheng, Ju Luo, Zhijie Liu, Haiyan Zhong, Feike Yang","doi":"10.2147/IJGM.S516414","DOIUrl":"10.2147/IJGM.S516414","url":null,"abstract":"<p><strong>Objective: </strong>To identify the hub genes involved in sarcopenia and analyze their correlation with lipid metabolism.</p><p><strong>Methods: </strong>Differentially expressed genes (DEGs) from sarcopenia/non-sarcopenia cohorts in <i>GSE111006</i> and <i>GSE111010</i> datasets were cross-analyzed with diabetes-related genes (GeneCards). Key genes underwent functional enrichment and protein-protein interaction (PPI) network analysis. The expression and receiver operating characteristic (ROC) curve of the hub gene was analyzed in both datasets. Enzyme-linked immunosorbent assay (ELISA) was utilized to quantify hub gene levels in sarcopenia, type 2 diabetes (T2DM), and healthy samples.</p><p><strong>Results: </strong>Twenty key genes were identified through differential expression and diabetes-related gene screening. Functional enrichment analysis revealed their involvement in external stimulus response, inflammatory regulation, extracellular processes, adenosine monophosphate-activated protein kinase (AMPK) signaling pathway, and insulin signaling pathways (p<0.05). Adiponectin (<i>ADIPOQ</i>) emerged as the hub gene via PPI network analysis, showing significant overexpression in sarcopenia (GSE111006: p<0.01; GSE111010: p<0.05) with diagnostic AUCs of 0.944 (0.869-1.000) and 0.696 (0.471-0.920) respectively. Ultimately, 60 sarcopenia, 10 type 2 diabetes, 10 healthy samples were collected. Seventy percent of the samples exhibited abnormal lipid metabolism. Adiponectin <i>(ADIPOQ)</i> and AMPK were overexpressed in sarcopenia samples (<i>p</i> < 0.01). However, <i>ADIPOQ</i> and AMPK were no difference in the expression levels between individuals with T2DM and healthy individuals (<i>p</i>>0.05). This study identified a significant correlation between <i>ADIPOQ</i>, AMPK, and blood lipids in sarcopenia (<i>ADIPOQ</i> vs AMPK, <i>p</i> < 0.0001, <i>r</i> = 0.736; <i>ADIPOQ</i> vs HDL-C, <i>p</i> = 0.0003, <i>r</i> = -0.448; AMPK vs HDL-C, <i>p</i> = 0.001, <i>r</i> = -0.415).</p><p><strong>Conclusion: </strong>The present study confirms that glycolipid metabolism is a risk factor for sarcopenia. Both ADIPOQ and AMPK are overexpressed in sarcopenia and demonstrate a significant positive correlation. This study hypothesizes that <i>ADIPOQ</i> may regulate AMPK activity, affect lipid metabolism, and accelerate the occurrence and development of sarcopenia.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"4369-4378"},"PeriodicalIF":2.0,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873031","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":"Advances in Intermittent Fasting Applications for Critically Ill Patients.","authors":"Xiang An, Yun Liu, Lizhen Zhu","doi":"10.2147/IJGM.S535478","DOIUrl":"10.2147/IJGM.S535478","url":null,"abstract":"<p><p>Enteral nutrition remains the standard approach for nutritional support in critically ill patients, with established benefits for immune function and recovery. Intermittent fasting, a dietary strategy characterized by extended fasting intervals, has emerged as a potential adjunctive therapy. IF may induce beneficial metabolic responses such as autophagy activation and ketogenesis, contributing to improved glucose regulation, reduced intestinal permeability, modulation of gut microbiota, enhanced insulin sensitivity, and preservation of muscle mass. Unlike prolonged fasting, IF elicits these effects without causing sustained caloric deprivation. This review summarizes the current evidence regarding the physiological mechanisms, implementation strategies, clinical outcomes, and safety considerations of IF in the intensive care setting to provide a theoretical basis for further validation of the safety efficacy of the intermittent fasting paradigm for use in the ICU.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"4437-4444"},"PeriodicalIF":2.0,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873026","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":"Individuals Recovered from Severe COVID-19 are Predispose to Develop Atrial Fibrillation.","authors":"Mücahid Yılmaz, Çetin Mirzaoğlu","doi":"10.2147/IJGM.S527058","DOIUrl":"10.2147/IJGM.S527058","url":null,"abstract":"<p><strong>Aim: </strong>One of the primary contributors of the development of atrial fibrillation (AF) is autonomic dysfunction. It is suggested that heart rate turbulence (HRT) be utilized to assess autonomic nervous system (ANS) function. In this research, we analyzed the impact of COVID-19 on atrial fibrillation predisposition in the post-recovery period by analyzing atrial HRT measurements of patients who described palpitations in the post-COVID-19 period.</p><p><strong>Methods: </strong>This study included 407 healthy participants without a positive COVID-19 record and 328 patients having a verified positive COVID-19 record (recovered COVID-19). All subjects were categorized into four groups (controls, recovered mild COVID-19, recovered moderate COVID-19 and recovered severe COVID-19) based on the severity value of their chest CT scan. The atrial HRT analyses were taken from a 24-hour electrocardiography- Holter recording.</p><p><strong>Results: </strong>This study revealed that atrial HRT Onset values were significantly higher in the recovered severe COVID-19 group than the other groups. A positive association was found between the atrial HRT onset value and the chest CT severity value. However, no relationship was found between the atrial HRT onset value and the number of positive PCR test for COVID-19 or the amount of time that had passed since COVID-19. Regression analysis showed that the chest CT severity score, HT, smoking, and recovery from severe COVID-19, were independent predictors of atrial HRT Onset values and abnormal atrial HRT Onset existence.</p><p><strong>Conclusion: </strong>Blunted atrial HRT, considered a significant predisposition to the development of atrial fibrillation, is more likely to occur in people who recovered from serious COVID-19 than in individuals who have never had severe COVID-19. These individuals should be carefully evaluated for atrial HRT.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"4379-4390"},"PeriodicalIF":2.0,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873028","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 Diagnosis and Prognosis Value of Exosomal MascRNA in Patients with Acute Coronary Syndrome.","authors":"Jingyuan Hou, Ruiqiang Weng, Xiaodong Gu, Junli Zhao, Xia Li, Sudong Liu","doi":"10.2147/IJGM.S538127","DOIUrl":"10.2147/IJGM.S538127","url":null,"abstract":"<p><strong>Objective: </strong>MascRNA is involved in regulating the immune inflammatory response, but its role in acute coronary syndrome (ACS) remains unclear. This study aims to investigate the diagnostic and prognostic value of plasma exosomal mascRNA for ACS.</p><p><strong>Methods: </strong>A total of 140 ACS patients and 50 patient with non-ACS were enrolled. Exosomes were isolated from plasma utilizing ultracentrifugation, and mascRNA expression in exosomes was quantified by qRT-PCR. Major adverse cardiovascular events (MACEs) occurring during the 1-year follow-up after stent implantation were recorded. The diagnostic value of exosomal mascRNA for ACS was evaluated utilizing receiver operating characteristic (ROC) analysis. The association between exosomal mascRNA level and MACEs was assessed by Kaplan-Meier survival analysis and Cox proportional-hazards regression.</p><p><strong>Results: </strong>Exosomal mascRNA expression was significantly elevated in ACS patients, and positively correlated with Gensini score, white blood cells and age. Exosomal mascRNA demonstrated a diagnostic value for ACS (AUC: 0.763, 95% CI: 0.702-0.824). Combined detection of exosomal mascRNA with cTnI improved the diagnostic preformation for ACS (AUC: 0.866, 95% CI: 0.815-0.916). Exosomal mascRNA expression was higher in patients with MACEs, and patients with high mascRNA exhibited low incidence of MACE-free survival. Cox regression analysis suggested that exosomal mascRNA was independently associated with the risk of MACEs (HR: 3.710, 95% CI: 2.158-6.376, <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>Plasma exosomal mascRNA has the potential to function as a diagnostic biomarker for ACS and as a predictor for the incidence of 1-year MACEs.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"4425-4436"},"PeriodicalIF":2.0,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873030","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":"Knowledge, Attitudes, and Practices Towards Waldenström's Macroglobulinemia Among Patients and Their Family Members.","authors":"Yang Yang, Xiaolin Gu, Enfan Zhang, Jingsong He, Zhen Cai","doi":"10.2147/IJGM.S519598","DOIUrl":"10.2147/IJGM.S519598","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the knowledge, attitude, and practice (KAP) regarding Waldenström's Macroglobulinemia (WM) among patients and their family members, and to compare differences between these two groups.</p><p><strong>Methods: </strong>This cross-sectional survey was conducted in October 27, 2023 to Nov 27, 2023 at a tertiary hospital in Zhejiang Province, targeting WM patients and their family members. Demographic characteristics and KAP scores were collected through self-administered questionnaires.</p><p><strong>Results: </strong>A total of 220 valid questionnaires were analyzed, with 98 (44.55%) from patients. The overall mean knowledge, attitude, and practice scores were 10.38±4.07 (possible range: 0-16), 15.78±2.34 (possible range: 5-25), and 23.19±3.31 (possible range: 6-30), respectively. Patients had significantly higher knowledge scores than family members (11.13±4.28 vs 9.78±3.79, P = 0.004), while no significant differences were found in attitude (15.78±2.27 vs 15.77±2.40, P = 0.889) or practice scores (23.59±2.94 vs 22.87±3.56, P = 0.134). Correlation analysis revealed a positive correlation between knowledge and attitude (r = 0.1879, P = 0.0052) and practice (r = 0.1670, P = 0.0132). However, the correlation between attitudes and practices was not significant. Structural equation modeling (SEM) results showed no direct effect between knowledge and attitude (P = 0.312) or knowledge and practice (P = 0.067). In contrast, attitude directly and negatively affected practice (β = -0.10, P = 0.036).</p><p><strong>Conclusion: </strong>WM patients and their family members demonstrated moderate levels of knowledge, attitudes, and practices toward WM. To enhance clinical outcomes, interventions should focus on improving attitudes, given their direct and negative impact on practices.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"4359-4367"},"PeriodicalIF":2.0,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12358312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882856","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":"Association of the Neutrophil Percentage-to-Albumin Ratio with All-Cause Mortality in Patients with Hypercapnic Respiratory Failure: A Prospective Cohort Study.","authors":"Zhimin Chen, Zongbo Shen, Jing Sun, Honglan Gao, Zhongxiang Liu, Hui Lu","doi":"10.2147/IJGM.S520510","DOIUrl":"10.2147/IJGM.S520510","url":null,"abstract":"<p><strong>Background: </strong>The neutrophil percentage-to-albumin ratio (NPAR) has emerged as a widely used inflammatory marker for predicting clinical outcomes across various diseases; however, its prognostic value in hypercapnic respiratory failure (HRF) remains uncertain. This study aimed to examine the association between NPAR and all-cause mortality in patients with HRF.</p><p><strong>Methods: </strong>This prospective cohort study enrolled 561 HRF patients hospitalized at Yancheng First People's Hospital between October 2020 and September 2021. The primary outcome was 24-month all-cause mortality; secondary outcomes included mortality at 3, 6, and 12 months. The association between NPAR and all-cause mortality was assessed using restricted cubic spline (RCS) modeling, multivariate Cox proportional hazards models, Kaplan-Meier survival analysis, and subgroup analyses. Discriminatory performance was evaluated using the area under the receiver operating characteristic curve (AUC).</p><p><strong>Results: </strong>RCS modeling demonstrated a significant linear association between NPAR and all-cause mortality in HRF patients (P for overall association < 0.001). Both the Cox models and Kaplan-Meier analyses indicated that elevated NPAR levels were significantly associated with increased 3-, 6-, 12-, and 24-month all-cause mortality (all P < 0.05). Subgroup analysis further supported an independent association between NPAR and mortality. The AUC for NPAR in predicting 12-month all-cause mortality was 0.66 (95% confidence interval [CI], 0.61-0.71), which was significantly higher than that of neutrophil percentage or albumin alone (AUC =0.62; 95% CI, 0.57-0.67; P < 0.05).</p><p><strong>Conclusion: </strong>Elevated NPAR is independently associated with increased all-cause mortality in patients with HRF. As a composite marker reflecting both systemic inflammation and nutritional status, NPAR may serve as a robust prognostic indicator to enhance risk stratification and guide clinical decision-making in HRF management.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"4445-4456"},"PeriodicalIF":2.0,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873027","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":"Metabolic and Renal Profile Differences in Pure vs Mixed Uric Acid Kidney Stones: A Retrospective Study.","authors":"Tianjie Li, Meng Fu, Xiaodong Liu, Bo Xiao, Jianxing Li","doi":"10.2147/IJGM.S530926","DOIUrl":"10.2147/IJGM.S530926","url":null,"abstract":"<p><strong>Objective: </strong>Uric acid stones are commonly classified into pure uric acid stones (PUCS) and mixed uric acid stones with calcium oxalate (MUCS). This study aims to investigate the metabolic differences between PUCS and MUCS patients, in order to inform prevention strategies and guide management and follow-up care for uric acid urolithiasis.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 88 patients diagnosed with uric acid stones (PUCS: 37, MUCS: 51). Comprehensive data were collected, including blood tests and stone composition analysis.</p><p><strong>Results: </strong>Both PUCS and MUCS patients exhibited obesity, but only PUCS patients showed significant lipid metabolism abnormalities, with HDL levels significantly lower than in MUCS patients (p < 0.05). Renal dysfunction was observed in both groups, but was more severe in the PUCS group, as indicated by higher serum creatinine levels (p < 0.05). Additionally, serum calcium levels were significantly higher in the MUCS group compared to the PUCS group (p < 0.05). No significant differences were found in 24-hour urinary excretion of uric acid, sodium, potassium, chloride, or phosphorus between the two groups.</p><p><strong>Conclusion: </strong>Patients with PUCS exhibit more pronounced disturbances in lipid metabolism and renal function compared to those with MUCS. It is essential to prioritize and enhance the monitoring of metabolic assessments and renal function during the postoperative follow-up of patients with PUCS.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"4403-4410"},"PeriodicalIF":2.0,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12358317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882857","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}