International Journal of General Medicine最新文献

{"title":"Longitudinal Hemoglobin Trajectories and Their Association with Growth Response in Short Stature Children (Aged <15 Years) Undergoing Weekly Growth Hormone Therapy: A Real-World Cohort Study.","authors":"Qingbo Xu, Yu Yang, Liling Xie, Dongguang Zhang, Haiying Zou, LanFang Cao, Li Yang","doi":"10.2147/IJGM.S541514","DOIUrl":"10.2147/IJGM.S541514","url":null,"abstract":"<p><strong>Background: </strong>Growth hormone (GH) therapy affects linear growth and may influence hematopoiesis, but dynamic hemoglobin (Hb) changes in children remain unclear.</p><p><strong>Objective: </strong>To characterize longitudinal Hb trajectories during weekly GH treatment in short stature, including idiopathic short stature (ISS) and growth hormone deficiency (GHD), and to assess their associations with growth response.</p><p><strong>Methods: </strong>This retrospective cohort study included 165 children with short stature who received once-weekly PEGylated GH therapy for at least 12 months. Hematologic/growth-related parameters were collected at baseline, 6 and 12 months. Group-based trajectory modeling (GBTM) identified Hb trajectory groups. Spearman correlation analysis was performed to evaluate the association between Hb, red blood cell (RBC) count, and insulin-like growth factor 1 (IGF-1). Multivariate logistic regression was used to identify predictors of Hb improvement (≥5 g/L).</p><p><strong>Results: </strong>Three distinct Hb trajectory groups were identified: ascending (n = 82), ascending-then-descending (n = 51), and stable (n = 32). The ascending group demonstrated the most favorable height SDS improvement at 12 months (mean ΔHtSDS = 1.01), while the ascending-then-descending and stable groups showed more modest gains. IGF-1 levels were moderately correlated with Hb at 12 months (<i>ρ</i> = 0.308, <i>p</i> = 0.001) and RBC counts (<i>ρ</i> = 0.236, <i>p</i> = 0.014). Logistic regression revealed no independent baseline predictor of Hb improvement; however, the inclusion of Hb trajectory group significantly enhanced the predictive model for growth response (adjusted <i>R²</i> increased from 0.129 to 0.240; <i>p</i> = 0.018).</p><p><strong>Conclusion: </strong>Hb trajectories vary significantly among children receiving GH therapy and are moderately associated with height outcomes. Longitudinal monitoring of Hb may serve as a cost-effective dynamic biomarker to guide personalized GH dose titration in pediatric growth disorders. If validated, Hb monitoring may serve as a practical biomarker for personalized GH dosing in pediatric growth disorders.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"5433-5446"},"PeriodicalIF":2.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12439840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080586","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":"Traditional Chinese Medicine Treatment of Thyroid Cancer: A Review.","authors":"Haixin Zhang, Jialin Lu, Likun Du","doi":"10.2147/IJGM.S543824","DOIUrl":"10.2147/IJGM.S543824","url":null,"abstract":"<p><p>Thyroid cancer is the most common malignancy of the endocrine system, and its incidence has been increasing in recent years. Traditional Chinese Medicine (TCM) has shown unique advantages in supporting the treatment and management of thyroid cancer. This review provides a comprehensive overview of current literature on TCM-related interventions for thyroid cancer, covering theoretical foundations, epidemiological features, pathophysiological mechanisms, diagnostic applications, clinical practices, technological progress, and existing challenges to summarize the clinical effectiveness of TCM, clarify its role in integrated treatment strategies, and outline future directions for research and clinical application.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"5447-5464"},"PeriodicalIF":2.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12439836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080567","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":"Diagnostic Value of Bedside Lung Ultrasound and Chest CT on Subpleural Lesions and Lung Consolidation in ICU Patients with Severe Pneumonia.","authors":"Ming Chen, Xiaopei Zhou","doi":"10.2147/IJGM.S527919","DOIUrl":"10.2147/IJGM.S527919","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the diagnostic value of bedside lung ultrasound and chest computed tomography (CT) for subpleural lesions and lung consolidation in intensive care unit (ICU) patients with severe pneumonia.</p><p><strong>Methods: </strong>A retrospective selection was made of 100 ICU patients with severe pneumonia who were treated in our hospital from June 2020 to July 2024 as the research subject group. All patients underwent bedside lung ultrasound and chest CT examinations, and the CT imaging manifestations of the patients were observed. Using the CT examination results as the gold standard, the patients were divided into the lung consolidation group and non-lung consolidation group. The relevant data were collected and the clinical data of the two groups were observed. The positive predictive value, negative predictive value, specificity, sensitivity and accuracy of bedside lung ultrasound in the diagnosis of subpleural lesions and lung consolidation were analyzed.</p><p><strong>Results: </strong>Chest CT showed that 73.00% of the patients had ≥2 lung lobes involved, mainly in the right lung (61.00%). 56.00% patients had 1-2 organs involved, mainly kidney (77.00%) or heart (87.00%). 69.00% of patients had pulmonary consolidation, 86.00% had bronchial shadow, and 82.00% had mass, patchy or nodular shadow. Compared with the non-lung consolidation group, the lung ultrasound score of the lung consolidation group was significantly increased (<i>P</i><0.05), and the proportion of lung parenchyma, the number of subpleural lesions and the number of pleural intercostal changes were significantly increased (<i>P</i><0.05). The consistency test showed that bedside ultrasound had a high consistency with chest CT in the diagnosis of subpleural lesions and lung consolidation (Kappa=0.678, <i>P</i><0.05; Kappa=0.743, <i>P</i>< 0.05).</p><p><strong>Conclusion: </strong>Bedside lung ultrasound and chest CT had a high consistency in the diagnosis of subpleural lesions and lung consolidation, which may be used as an important method to judge the development of severe pneumonia in ICU.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"5421-5431"},"PeriodicalIF":2.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12441206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086144","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 Distant Metastasis in Papillary Thyroid Carcinoma: A Postoperative Nomogram Integrating Sex, Histology, Bilaterality, and Extrathyroidal Extension.","authors":"Jiaxi Wang, Zhiyu Li, Chuang Chen","doi":"10.2147/IJGM.S547317","DOIUrl":"10.2147/IJGM.S547317","url":null,"abstract":"<p><strong>Background: </strong>Papillary thyroid carcinoma (PTC) generally has a good prognosis, but distant metastasis (DM) significantly reduces survival. Existing predictive models for DM have limited accuracy. This study aimed to identify independent risk factors for DM in PTC and develop a clinical prediction model using routine pathological parameters.</p><p><strong>Methods: </strong>We retrospectively analyzed a cohort of 4127 PTC patients who underwent surgery between 2017 and 2022. Patients were divided into DM (n = 30) and non-DM (n = 4097) groups. Key variables, including sex, age, pathological subtype, tumor size, bilaterality, multifocality, extrathyroidal extension (ETE), and lymph node metastasis (LNM), were collected. We used univariate and multivariate logistic regression to identify independent predictors. A nomogram model was built and its performance was evaluated using ROC curves and other metrics.</p><p><strong>Results: </strong>Univariate analysis identified male sex (OR = 0.362, <i>p</i> = 0.006), solid variant (OR = 36.509, <i>p</i> < 0.001), Multifocal (OR = 0.247, <i>p</i> < 0.001), bilaterality (OR = 2.847, <i>p</i> = 0.004), and ETE (OR = 4.360, <i>p</i> = 0.016) as significant risk factors. Multivariate analysis confirmed male sex (OR = 0.434, <i>p</i> = 0.029), solid variant (OR = 23.483, <i>p</i> < 0.001), bilaterality (OR = 1.309, <i>p</i> = 0.047), and ETE (OR = 3.094, <i>p</i> = 0.012) as independent predictors. The nomogram model showed a moderate discriminative ability with an AUC of 0.737, a sensitivity of 66.7%, and a specificity of 68.7%.</p><p><strong>Conclusion: </strong>In this large-scale Chinese cohort study, we identified male sex, solid variant, bilaterality, and ETE as independent risk factors for PTCDM. The resulting model offers a practical tool for postoperative risk assessment, which can help guide customized surveillance and treatment for high-risk patients. Future research should focus on validating this model with external and multicenter cohorts and incorporating molecular biomarkers to further improve its predictive accuracy.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"5409-5419"},"PeriodicalIF":2.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12439841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080576","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 Hidden Angles: Predictive Indices of Degenerative Spondylolisthesis at L4-5.","authors":"Zhiqiang Tao, Wenhua Li, Mingming Wu, Xinquan Liu, Jie Xiong, Jiangtao Yu, Huan Liu","doi":"10.2147/IJGM.S537228","DOIUrl":"10.2147/IJGM.S537228","url":null,"abstract":"<p><strong>Objective: </strong>To examine the relationship between facet joint orientation, alignment, degeneration, and degenerative spondylolisthesis (DS) at lumbar vertebra L4-5.</p><p><strong>Methods: </strong>A retrospective study of 114 DS patients and 114 non-DS patients admitted to our hospital from May 2019 to April 2024. We compared facet joint angle (FJA), FJA difference, FJA asymmetry, L4 inclination angle (L4IA), Weishaupt classification, paraspinal muscle cross-sectional area (CSA), pedicle-facet angle (P-F angle), and P-F angle asymmetry between the two groups. We also analyzed FJA and slippage index changes across Weishaupt grades and their correlation using Pearson correlation. The predictive value of facet joint direction indices for DS at L4-5 was assessed using ROC curves.</p><p><strong>Results: </strong>The DS group showed reduced FJA and FJA difference, increased left asymmetry, higher L4IA levels, and a greater proportion of grade II and III in Weishaupt classification compared to the non-DS group (P<0.05). FJA decreased while the slippage index increased with more degeneration (P<0.05). Weishaupt classification was negatively correlated with FJA (r=-0.823, P<0.001), but positively with the slippage index (r=0.756, P<0.001). The P-F angle was significantly higher in the DS group (P<0.05). Cut-off values for FJA, L4IA, and P-F angle were 42.57, 9.63, and 122.17, with AUC values of 0.893, 0.766, and 0.858, respectively, indicating predictive value for DS at L4-5.</p><p><strong>Conclusion: </strong>The DS group had smaller FJA, larger L4IA and P-F angle, and more severe facet joint degeneration at L4-5, suggesting a strong link between DS at L4-5 and facet joint sagittalization, levelization, and degeneration.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"5395-5407"},"PeriodicalIF":2.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12439702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080627","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":"Inverse Association Between D-Dimer Levels and Glasgow Coma Scale Scores in Hemorrhagic Stroke Patients: A Cross-Sectional Study.","authors":"Dapeng Dai, Yong Sun, Hongwei Zhang, Aimin Li","doi":"10.2147/IJGM.S540186","DOIUrl":"10.2147/IJGM.S540186","url":null,"abstract":"<p><strong>Aim: </strong>Hemorrhagic stroke (HS) represents one of the major causes of death in China. The research work focuses on the correlation between Glasgow Coma Scale (GCS) score and D-dimer level, and the role of modified factors such as platelet count in HS patients.</p><p><strong>Methods: </strong>This was a cross-sectional study that was conducted at the First People's Hospital of Lianyungang, Lianyungang City, China. HS Patients were divided into three groups according to their GCS scores: GCS < 9 (severe, n = 43), 9 ≤ GCS < 13 (moderate, n = 97), and GCS ≥ 13 (mild, n = 487).</p><p><strong>Results: </strong>The analysis comprised 627 participants. D-dimer levels were 142.0 ng/mL on average. The average GCS score was 13.6, and the average age was 61.0 years. The three GCS groups showed significant differences in D-dimer concentrations, diastolic blood pressure (DBP), and systolic blood pressure (SBP) (P < 0.001, P = 0.028, and P = 0.005, respectively). Among severe GCS scores (<9), the D-dimer level was the highest at 237.0 ng/mL. After adjustment for possible confounders, the D-dimer concentrations were significantly lower in the moderate and mild GCS groups than in the severe group (P = 0.030 and P = 0.038, respectively). In the stratified analysis, the association between GCS categories and D-dimer levels was stronger among participants with low platelet counts (<194 × 10^9/L; P for interaction = 0.017).</p><p><strong>Conclusion: </strong>This study reveals a significant inverse association between D-dimer levels and GCS scores in HS patients, especially those with lower platelet counts. Elevated D-dimer levels may reflect coagulation and fibrinolysis activation, contributing to worse outcomes. Clinically, more attention and monitoring should be paid to the HS patients with elevated D-dimer levels.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"5345-5353"},"PeriodicalIF":2.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074991","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":"Molecular Aspects of Mitochondrial Dysfunction in Diabetes, Pearson and Kearns-Sayre Syndromes, and Neurodegenerative Disorders.","authors":"Amirmohammad Shafiee, Amir Ali Akhlaghi, Abigail Ellstrom, Seyed Omid Mohammadi, Alimohammad Shafiee, Mohanakrishnan Sathyamoorthy","doi":"10.2147/IJGM.S539967","DOIUrl":"10.2147/IJGM.S539967","url":null,"abstract":"<p><p>Mitochondrial dysfunction results in complex pathophysiological alterations associated with clinical disease states including cancer, cardiovascular diseases, diabetes mellitus, and anxiety disorders. As a key organelle within mammalian cells, the mitochondrion serves as the energetic source of cellular function which are crucial to cellular homeostasis, and cell death. In this report, we review key molecular causes of mitochondrial dysfunction and discuss how it influences insulin resistance, Pearson Syndrome and Kearns-Sayre syndrome, the latter of which occur due to pathogenic variants in mitochondrial DNA that lead to direct cellular pathology. We discuss the molecular and cellular pathophysiological mechanisms, disease interplays, and clinical considerations related to these diseases influenced by mitochondrial dysfunction.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"5355-5366"},"PeriodicalIF":2.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075032","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":"Platelet/Neutrophil Count Ratio (PNR) and Fibrinogen/Lymphocyte Count Ratio (FLR) Can Be Used as Predictive Indicators of Bone Metastasis in Non-Smoking Patients with Lung Cancer, but Not in Smoking Patients.","authors":"Kunlun Li, Yuqing Jiang, Delun Li, Jianguang Sun","doi":"10.2147/IJGM.S547045","DOIUrl":"10.2147/IJGM.S547045","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study is to evaluate the relationship between some comprehensive indices (platelet-to-neutrophil ratio (PNR), fibrinogen-to-lymphocyte ratio (FLR), albumin-to-monocyte ratio (AMR)) and bone metastasis of lung cancer.</p><p><strong>Methods: </strong>A total of 1535 patients with lung cancer treated in Meizhou People's Hospital from November 2017 to May 2025 were retrospectively analyzed. Clinical characteristics (age, body mass index (BMI), bone metastasis, and PNR, FLR, and AMR levels) were collected. The optimal cutoff values of PNR, FLR, and AMR were calculated through the receiver operating characteristic (ROC) curve. The relationships between PNR, FLR, AMR and bone metastasis were analyzed.</p><p><strong>Results: </strong>There were 665 (665/1535, 43.3%) patients had bone metastasis and 870 (870/1535, 56.7%) without. The levels of PNR (54.11 (38.11, 79.59) vs 50.06 (33.55, 72.10), <i>p</i>=0.004), and FLR (3.88 (2.67, 6.03) vs 3.36 (2.26, 5.27), <i>p</i><0.001) in patients with bone metastasis were higher, and AMR (67.22 (47.55, 97.00) vs 70.45 (50.66, 104.91), <i>p</i>=0.027) was lower than those in patients without bone metastasis. The levels of PNR and FLR in bone metastasis group were higher than those in non-bone metastasis group among non-smoking patients, while AMR in bone metastasis group was lower than those in non-bone metastasis group among smoking patients. ROC analyses revealed that the critical value was 75.40 and area under the ROC curve (AUC) was 0.673 for PNR as an indicator for bone metastasis, while the critical value was 4.515 and AUC was 0.659 for FLR in non-smoking patients.</p><p><strong>Conclusion: </strong>In conclusion, lung cancer mainly occurs in elderly men, among whom approximately 43% of patients have bone metastases. PNR and FLR have good predictive value in bone metastasis of non-smoking lung cancer patients.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"5303-5314"},"PeriodicalIF":2.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075076","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":"Acupuncture for Ischemic Stroke: A Critical Evaluation of Biological Mechanisms and Methodological Challenges.","authors":"Yining Wang, Hongtao Yu, Yuyu Chen, Yuxin Hu, Haichun Zhou, Jian Zhao","doi":"10.2147/IJGM.S535590","DOIUrl":"10.2147/IJGM.S535590","url":null,"abstract":"<p><p>Ischemic stroke (IS) is a leading cause of long-term disability worldwide, creating an urgent need for effective adjunctive therapies to complement conventional treatments. Acupuncture has emerged as a widely investigated intervention for post-stroke recovery. This review provides a critical evaluation of the proposed biological mechanisms underlying acupuncture's effects in IS. We synthesize evidence from preclinical and clinical studies on its potential to promote the dynamic repair of the neurovascular unit (NVU), modulate intercellular communication, improve cerebral hemodynamics, enhance angiogenesis, and support neurorestoration. While a significant body of preclinical evidence suggests multifaceted benefits, we highlight a critical translational gap and the methodological limitations that currently temper clinical certainty. Key challenges include the heterogeneity of treatment protocols, the complexity of sham controls, and a frequent lack of objective biomarkers. Consequently, we conclude by outlining a clear agenda for future research, emphasizing the need for protocol standardization, rigorous large-scale randomized controlled trials (RCTs), and the integration of biomarkers to bridge the gap between proposed mechanisms and validated clinical outcomes. This critical perspective aims to guide future research toward definitively establishing acupuncture's role in the stroke care continuum.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"5379-5393"},"PeriodicalIF":2.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074914","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":"Emerging Antimicrobial Strategies Against Heterogeneous and Vancomycin-Intermediate <i>Staphylococcus aureus</i>.","authors":"Yaru Wang, Yanwen Sun, Guang Chen, Xin Cheng","doi":"10.2147/IJGM.S532471","DOIUrl":"10.2147/IJGM.S532471","url":null,"abstract":"<p><p>Heterogeneous vancomycin-intermediate and vancomycin-intermediate <i>Staphylococcus aureus</i> (hVISA and VISA) presents significant therapeutic challenges due to high treatment failure rates and limited options. Conventional monotherapies, including daptomycin and linezolid, are often compromised by cross-resistance and inconsistent efficacy. Combination therapies incorporating β-lactams, quinolones, or lipopeptides with vancomycin exploit synergistic mechanisms (eg, the \"seesaw effect\") but exhibit variable success depending on bacterial strain, drug concentration, and experimental models. Novel antimicrobials, such as next-generation glycopeptides (LY333328, oritavancin, YV4465), synthetic agents (pyridyl disulfides, alpha-amyrin), and natural derivatives (plant flavonoids, cyanobacterial metabolites), have demonstrated enhanced activity against VISA/hVISA by disrupting membranes, suppressing virulence, or reversing resistance. Antimicrobial peptides and non-classical agents (eg, nybomycin, telomycin) further expand therapeutic options by targeting RNA degradation, biofilms, or toxin production. Additionally, advanced drug delivery systems, including nanoemulsions and nanoliposomes, improve drug stability, biofilm penetration, and localized efficacy. Despite these promising advances, clinical translation remains challenging, requiring rigorous validation of synergistic mechanisms, optimized dosing strategies, and resistance mitigation approaches. Continued innovation in antimicrobial development is essential to address the growing threat of multidrug-resistant <i>Staphylococcus aureus</i> infections.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"5329-5344"},"PeriodicalIF":2.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074926","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}