Journal of International Medical Research最新文献

{"title":"Middle ear lymphoepithelioma-like carcinoma with cerebellopontine angle invasion misdiagnosed as meningioma: A case report and literature review.","authors":"Dabiao Deng, Yanying Yang, Baijie Cheng, Chongzhu Fan, Wensheng Wang, Huafei Zhao","doi":"10.1177/03000605261438958","DOIUrl":"10.1177/03000605261438958","url":null,"abstract":"<p><p>Lymphoepithelioma-like carcinoma typically arises in the nasopharynx. Primary occurrence in the middle ear with subsequent intracranial extension remains exceedingly rare, and its diagnosis is often challenging owing to the paucity of detailed clinicoradiological data. Herein, we describe a case of an 82-year-old male presenting with a 2-year history of left-sided hearing loss, a 3-year history of left facial asymmetry (including mouth deviation and eyelid insufficiency), and a 10-day history of nausea/vomiting. His medical history included chronic otitis media. Imaging studies revealed a left cerebellopontine angle mass and chronic left otomastoiditis. Subtotal tumor resection was performed, and pathological analysis confirmed the diagnosis of lymphoepithelioma-like carcinoma. The patient received only supportive care and survived for 23 months. This case report aimed to emphasize the need for clinicians consider atypical cerebellopontine angle tumors in patients with chronic otitis media from Epstein-Barr virus-endemic regions and highlight the importance of a comprehensive diagnostic and therapeutic approach.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"54 4","pages":"3000605261438958"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13087352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147690411","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":"Diabetic retinopathy and kidney involvement in adults with type 2 diabetes in high-altitude Tibet: A cross-sectional subanalysis of the China National Diabetic Chronic Complications Study.","authors":"Lihui Yang, Zexin Zhang","doi":"10.1177/03000605261437612","DOIUrl":"10.1177/03000605261437612","url":null,"abstract":"<p><p>ObjectiveTo estimate the prevalence, severity, awareness, and clinical correlates of diabetic retinopathy among adults with type 2 diabetes living at very high altitude in Tibet.MethodsThis cross-sectional, community-based subanalysis used prospectively collected data from the China National Diabetic Chronic Complications Study data. Adults with physician-diagnosed type 2 diabetes from three Tibet sites (3650-4300 m) with ≥1 gradable nonmydriatic fundus photograph were included (N = 320). Diabetic retinopathy was centrally graded using the International Clinical scale. Vision-threatening diabetic retinopathy was defined as severe nonproliferative or proliferative diabetic retinopathy. Kidney indices included the urinary albumin-to-creatinine ratio and estimated glomerular filtration rate. Parsimonious multivariable logistic regression (complete-case n = 318) was used to evaluate correlates of any diabetic retinopathy.ResultsThe prevalence of any diabetic retinopathy was 16.6% (95% confidence interval: 12.9-21.0), whereas vision-threatening diabetic retinopathy was observed in 4.4% of participants (95% confidence interval: 2.6-7.2). Diabetic retinopathy was predominantly nonproliferative, and proliferative diabetic retinopathy was rare (0.3%). Only 36.5% of participants with diabetic retinopathy reported prior awareness. Higher urinary albumin-to-creatinine ratio and estimated glomerular filtration rate <60 mL/min/1.73 m² were independently associated with diabetic retinopathy, whereas glycated hemoglobin was not significant after adjustment.ConclusionsIn community-dwelling Tibetans with type 2 diabetes living at very high altitude, diabetic retinopathy is common, awareness is low, and markers of kidney damage are strongly associated with diabetic retinopathy, supporting integrated retinal-renal screening.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"54 4","pages":"3000605261437612"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13070160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147639157","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":"Endothelial activation and stress index links to cardiovascular disease in postmenopausal women mediated by arterial stiffness: A cross-sectional study of National Health and Nutrition Examination Survey 1999-2018.","authors":"Huidong Long, Ruoyue Guo, Jingyu Zhou, Guancheng Liu, Hanrui Chen, Yunen Lin","doi":"10.1177/03000605261434398","DOIUrl":"10.1177/03000605261434398","url":null,"abstract":"<p><p>ObjectiveTo investigate the association between the endothelial activation and stress index and cardiovascular disease prevalence among postmenopausal women and to evaluate whether arterial stiffness, assessed by estimated pulse wave velocity, statistically accounts for part of this association.MethodsWe conducted a cross-sectional analysis of 9877 postmenopausal women from the National Health and Nutrition Examination Survey (1999-2018). Endothelial activation and stress index was log-transformed (LnEASIX), and arterial stiffness was assessed using estimated pulse wave velocity. Logistic regression was used to evaluate associations with cardiovascular disease after adjusting for demographic, lifestyle, and clinical factors. Nonlinear trends were explored using restricted cubic splines, and mediation analysis were performed to assess the contribution of estimated pulse wave velocity.ResultsHigher LnEASIX was associated with greater cardiovascular disease prevalence (adjusted odds ratio per unit = 1.62, 95% confidence interval: 1.35-1.95). Risk increased sharply above an LnEASIX threshold of -0.97 (endothelial activation and stress index of approximately 0.38; odds ratio = 2.16, 95% confidence interval: 1.71-2.72). Estimated pulse wave velocity statistically accounted for 4.82% of this association. Associations were stronger in women with diabetes.ConclusionElevated endothelial activation and stress index is associated with increased cardiovascular disease risk in postmenopausal women, with arterial stiffness partially mediating this relationship. These findings highlight the potential utility of endothelial activation and stress index as a practical biomarker for cardiovascular risk assessment and prevention.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"54 4","pages":"3000605261434398"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13145048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773752","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 between appendicular lean mass-to-body weight ratio and metabolic syndrome in community-dwelling older adults in Taiwan: A cross-sectional study.","authors":"Chun-Yung Chang, Nain-Feng Chu, Der-Min Wu, Wen-Chen Liang, Shu-Chuan Yeh, Cheng-Hsin Chuang","doi":"10.1177/03000605261443913","DOIUrl":"10.1177/03000605261443913","url":null,"abstract":"<p><p>ObjectiveMetabolic syndrome increases the risk of cardiovascular diseases and diabetes. This study examined the associations of body mass index and the appendicular lean mass-to-body weight ratio with metabolic syndrome in Taiwanese older adults.MethodsA cross-sectional study of 3739 participants from community surveys (2017-2019) was conducted. Anthropometric measurements, blood pressure, handgrip strength, and biochemical markers were assessed. Appendicular lean mass-to-body weight ratio was calculated using a validated equation. Lifestyle factors and comorbidities were evaluated using questionnaires.ResultsThe prevalence of metabolic syndrome was 47.1% in males and 50.0% in females. Participants with metabolic syndrome had higher body mass index and waist circumference but lower appendicular lean mass-to-body weight ratio. Higher appendicular lean mass-to-body weight ratio was inversely associated with metabolic syndrome (odds ratio = 0.877 in males; odds ratio = 0.885 in females).ConclusionsHigher body mass index was positively associated with metabolic syndrome, whereas higher appendicular lean mass-to-body weight ratio was inversely associated with metabolic syndrome. Maintaining greater muscle mass relative to body weight may help reduce the risk of metabolic syndrome in older adults.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"54 4","pages":"3000605261443913"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773744","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":"Lipoprotein(a) and acute myocardial infarction: Differential risk across age and sex subgroups.","authors":"Zhe Liu, Hui Li, Wen Chang, Baoyu Geng, Lei Wu, Zhen Chen","doi":"10.1177/03000605261436667","DOIUrl":"10.1177/03000605261436667","url":null,"abstract":"<p><p>ObjectiveLipoprotein(a) is an identified risk factor for acute myocardial infarction; however, its role in specific subgroups is inconclusive. This case-control study examined whether classical risk factors modify the association between lipoprotein(a) levels and acute myocardial infarction across subgroups.MethodsOur study involved 2946 patients with initial acute myocardial infarction and 14,571 controls. Data were processed using multiple imputation and propensity score-based matching. Binary logistic regression, stratification, and sensitivity analyses were performed to explore associations.ResultsThe acute myocardial infarction group had a significantly greater proportion of men, smokers, and alcohol consumers as well as higher lipoprotein(a) levels. After risk factor adjustment in Model 2, the odds ratios and 95% confidence intervals for lipoprotein(a) (Quartile 2-Quartile 4) were 1.11 (0.97, 1.28), 1.24 (1.07, 1.42), and 1.45 (1.26, 1.66), respectively. In older patients, the adjusted odds ratio for acute myocardial infarction in Quartile 4 (vs. Quartile 1) was 2.15 (1.76-2.63)-higher than that in younger patients. Among female participants, the odds ratio for Quartile 4 was 2.61 (1.98-3.45), exceeding that in men. Compared with the younger/male group, the older/female group exhibited escalating acute myocardial infarction risks (adjusted odds ratios: Quartile 2 = 1.48 (1.00-2.18); Quartile 3 = 1.97 (1.38-2.81); and Quartile 4 = 2.88 (2.04-4.05)), culminating in a 2.88-fold elevation in Quartile 4. Repeat analyses of the complete dataset yielded the same results.ConclusionsHigh lipoprotein(a) levels independently increased the risk of initial acute myocardial infarction in older women, suggesting its role as a lipid-lowering therapy target in this population.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"54 4","pages":"3000605261436667"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773730","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":"Three-dimensional-printed shape-memory composite scaffold for meniscus repair.","authors":"Li Jiatong, Lun Haochi, Qi Yulong, Wang Jie, Ye Sufen, Zou Mingyang, You Tian","doi":"10.1177/03000605251410411","DOIUrl":"10.1177/03000605251410411","url":null,"abstract":"<p><p>ObjectiveThe meniscus has poor intrinsic healing capacity, particularly in avascular regions. Meniscal injury is strongly associated with progressive knee dysfunction, chronic pain, and accelerated osteoarthritis development. Current treatments, such as allografts and partial meniscectomy, are limited by donor scarcity and secondary joint degeneration. Therefore, this study aimed to develop a regenerative meniscal scaffold with integrated biomechanical and biological functionality.MethodsA biomimetic composite scaffold was fabricated via low-temperature three-dimensional printing using poly(D,L-lactic acid-co-trimethylene carbonate) and bacterial cellulose. Native meniscal architecture was reproduced using micro-computed tomography-based modeling, and interconnected porosity was designed to promote cell infiltration. Material integration employed dichloromethane as a shared solvent, enabling dual-ink (poly(D,L-lactic acid-co-trimethylene carbonate) + bacterial cellulose) co-printing. Scaffold performance was assessed using scanning electron microscopy morphology, porosity and water absorption assays, mechanical testing, Fourier-transform infrared spectroscopy, and <i>in vitro</i> cytocompatibility studies with rat bone mesenchymal stem cells.ResultsThe scaffold exhibited a tensile modulus of 16.6 MPa and compressive modulus of 2.97 MPa, closely matching native meniscal mechanics. Porosity reached 63.57% ± 5.72%, supporting cell adhesion, while water absorption exceeded 138% after 7 days. Notably, the scaffold exhibited temperature-responsive shape memory behavior, allowing minimally invasive implantation and anatomic recovery at 37°C. Bone mesenchymal stem cells exhibited 95% viability (live/dead staining), significant proliferation (cell counting kit-8), and spontaneous chondrogenic differentiation (SRY-box transcription factor 9/collagen type II (SOX9/COLII) expression) without exogenous induction.ConclusionThis three-dimensional-printed poly(D,L-lactic acid-co-trimethylene carbonate)/bacterial cellulose composite scaffold integrates biomimetic mechanics, shape-memory functionality, and pro-chondrogenic bioactivity, offering a promising strategy for meniscal regeneration. Further <i>in vivo</i> studies are warranted to confirm long-term efficacy and clinical translational potential.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"54 4","pages":"3000605251410411"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13070161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147639152","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":"Correlation of E-cadherin, vimentin, CD206, programmed cell death receptor 1, and programmed cell death ligand 1 expressions with clinicopathological factors and prognosis in oral squamous cell carcinoma.","authors":"Zheng-Yi Lai, Jie Ma, Jia-Yi Yin, Xiu-An Zhu, Jing-Ping Zhou, De-Tao Tao","doi":"10.1177/03000605261431055","DOIUrl":"10.1177/03000605261431055","url":null,"abstract":"<p><p>ObjectiveOral squamous cell carcinoma is the most common malignant tumor occurring in the head and neck region. Current treatment principles are based on radical surgery, supplemented by radiotherapy and chemotherapy. However, the 5-year survival rate for patients remains approximately 50%. Therefore, further research into the molecular mechanisms underlying oral squamous cell carcinoma development is needed to identify more effective treatment methods.MethodsIn this study, immunohistochemical techniques were used to quantitatively analyze the expression levels of E-cadherin, vimentin, CD206, programmed cell death receptor 1 (PD-1), and programmed cell death ligand 1 (PD-L1) in 45 pathological sections of oral squamous cell carcinoma. The results showed that the expression levels of vimentin, CD206, and programmed cell death ligand 1 were significantly associated with overall survival. Additionally, Cox multivariate analysis indicated that the M2 macrophage marker, CD206, is an independent risk factor for poor prognosis in oral squamous cell carcinoma. Furthermore, correlation analysis revealed that E-cadherin expression was negatively correlated with vimentin, CD206, and programmed cell death ligand 1 expression levels. Vimentin expression was positively correlated with programmed cell death receptor 1 and programmed cell death ligand 1 expressions.ResultsImmunohistochemical examination indicated that M2 macrophages are an independent risk factor for poor prognosis in oral squamous cell carcinoma and are closely associated with overall survival. Furthermore, they may influence the development and progression of oral squamous cell carcinoma tumors by inducing epithelial-mesenchymal transition in oral squamous cell carcinoma tumor cells. Third, programmed cell death ligand 1 expression has an adverse impact on oral squamous cell carcinoma prognosis and is significantly correlated with the expression levels of CD206, E-cadherin, and vimentin.ConclusionsThis study indicates that programmed cell death receptor 1/programmed cell death ligand 1 and CD206 expressions are independent risk factors for poor oral squamous cell carcinoma prognosis; however, whether programmed cell death receptor 1/programmed cell death ligand 1 expression influences the occurrence and development of oral squamous cell carcinoma through M2 macrophages requires further investigation.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"54 4","pages":"3000605261431055"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13070152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147645574","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":"Vascular endothelial cell-derived small extracellular vesicles: A protective role against cardiomyocyte apoptosis in ischemia-reperfusion injury through miR410-3p-modulated <i>smad7</i> pathway.","authors":"Xiaoqiang Liu, Yulong Ge, Xing Xing, Junyi Liu, Hangwei Chen, Di Wang, Huaner Ni, Weifeng Li, Fang Wang","doi":"10.1177/03000605261435745","DOIUrl":"10.1177/03000605261435745","url":null,"abstract":"<p><p>ObjectiveReperfusion therapy is essential for preserving cardiac tissue in patients with acute myocardial infarction. However, ischemia-reperfusion exacerbates cardiac damage. Vascular endothelial cell-derived small extracellular vesicles play a pivotal role in ischemia-reperfusion injury; although the underlying mechanisms remain poorly understood. Therefore, this study aimed to elucidate the mechanisms of vascular endothelial cell-derived small extracellular vesicles and investigate their potential therapeutic roles.MethodsSmall extracellular vesicles derived from vascular endothelial cells were isolated using ultracentrifugation, and their characteristics were confirmed using transmission electron microscopy, nanoparticle tracking analysis, and western blotting. Their effects on myocardial injury was evaluated in vivo using a mouse myocardial ischemia-reperfusion model, and their role was further examined in vitro using a cellular hypoxia/reoxygenation model. The key micro ribonucleic acid in small extracellular vesicles was screened via high-throughput sequencing, and its regulatory effect on cardiomyocyte apoptosis was verified in vitro through intervention experiments. The key gene was predicted using miRanda and TargetScan, and the related interaction was verified by a dual-luciferase reporter assay and ribonucleic acid immunoprecipitation.ResultsOur in vivo study revealed that small extracellular vesicles significantly attenuated ischemia-reperfusion-induced cardiomyocyte apoptosis and improved cardiac function. We also analyzed micro ribonucleic acid expression in small extracellular vesicles and found that miR410-3p was highly expressed and associated with cellular apoptosis. In vitro experiments demonstrated that small extracellular vesicles increased miR410-3p expression in cardiomyocytes and that miR410-3p effectively inhibited cardiomyocyte apoptosis in a cellular ischemia-reperfusion model. Conversely, miR410-3p inhibition attenuated the protective effect of small extracellular vesicles. Moreover, we found that SMAD family member 7 is one of the target messenger ribonucleic acids of miR410-3p and affects cellular apoptosis by modulating nuclear factor kappa-light-chain-enhancer of activated B cells. Cellular experiments verified that the antiapoptotic effect of miR410-3p was neutralized by SMAD family member 7 overexpression.ConclusionsThese results revealed that vascular endothelial cell-derived small extracellular vesicles attenuate ischemia-reperfusion-induced cardiomyocyte apoptosis via the miR410-3p/SMAD family member 7 axis. This study provides valuable insights into the molecular mechanisms underlying ischemia-reperfusion-induced myocardial damage and highlights potential therapeutic opportunities for mitigating it.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"54 4","pages":"3000605261435745"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13087350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147690369","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":"Neurodevelopmental treatment needs after severe acute respiratory syndrome coronavirus 2 infection in young children: A cohort study.","authors":"Davidovitch Michael, Leventer Matan, Patalon Tal, Rappoport Nadav","doi":"10.1177/03000605261436920","DOIUrl":"10.1177/03000605261436920","url":null,"abstract":"<p><p>ObjectiveThis cohort study examined whether documented coronavirus disease 2019 in young children affects the need for neurodevelopmental treatment and its association with developmental diagnoses and other medical conditions.MethodsChildren with and without coronavirus disease 2019 were compared before and after an index date, defined as the first confirmed severe acute respiratory syndrome coronavirus 2 infection for participants with an infection and a matched reference date for controls. Data were obtained from a large health maintenance organization.ResultsThe study included 227,728 children born between 1 January 2017 and 31 January 2022 who were followed up from birth until 1 January 2024. Before the index date, there was no significant difference in the neurodevelopmental treatment between the two groups. After diagnosis, the affected children received significantly more treatments than those without an infection. Diagnosed children also exhibited higher rates of ear, nose, and throat; respiratory; and gastrointestinal conditions both before and after diagnosis. Emotional difficulties, including anxiety and acute stress reactions, were more common post-infection, whereas no increase in developmental diagnoses, such as developmental delay and autism spectrum disorder, was observed.ConclusionObservations on the same cohort before and after severe acute respiratory syndrome coronavirus 2 exposure suggest that the infection rather than adverse neurodevelopmental outcomes prompted greater parental concern and increased therapeutic support.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"54 4","pages":"3000605261436920"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13145061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773794","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":"A novel low-metabolism strategy combined with multimodal detoxification for successful management of high-dose diquat-paraquat mixed poisoning: A comprehensive therapeutic analysis.","authors":"Zhenhua Li, Zhiyuan Cen, Jing Wei, Gui Huang, Kai Mo, Huaixing Yan, Lijian Liang, Haihua Du, Xinwen Mai, Shixiong Yang, Shizhuang Wei, Wei Wang","doi":"10.1177/03000605261443923","DOIUrl":"10.1177/03000605261443923","url":null,"abstract":"<p><p>Combined diquat and paraquat poisoning is a rare but clinically significant form of poisoning, associated with severe oxidative stress and multiorgan failure. Historical case series have reported high case fatality, particularly following high-dose exposure. The absence of specific antidotes and standardized treatment protocols for mixed poisoning necessitate innovative therapeutic approaches. We present the case of an adolescent girl in her early teens who ingested 100 mL of a commercially obtained but illegally formulated diquat-paraquat mixture (200 g/L). A novel low-metabolism strategy was implemented, comprising low-concentration oxygen therapy (fraction of inspired oxygen (21%-30%), targeted sedation/analgesia, β-blockade, temperature management, and multimodal detoxification). Plasma toxin levels decreased by >97% within 20 h. Despite complications including anuria, cerebral edema, and respiratory failure, the patient achieved complete recovery after 49 days. Low-metabolism strategy reduced cellular oxygen consumption, mitigated oxidative damage, and enabled effective elimination of toxins. Dynamic monitoring guided tailored organ support. The integration of low-metabolism strategy timely and multimodal detoxification may represent a promising, albeit resource-intensive, approach for severe bipyridinium herbicide poisoning. This strategy warrants further validation in controlled studies and offers a potential framework for cases with severe poisoning.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"54 4","pages":"3000605261443923"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773682","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}