Journal of International Medical Research最新文献

{"title":"Association between lactate-to-albumin ratio and 28-day all-cause mortality in critically ill patients with chronic kidney disease: A retrospective cohort study from the Medical Information Mart for Intensive Care IV database.","authors":"Lei Chen, Chenwei Lv, Haibin Ni, Xingxing Hu, Xiaomei Cheng","doi":"10.1177/03000605261478720","DOIUrl":"10.1177/03000605261478720","url":null,"abstract":"<p><p>ObjectiveThe lactate-to-albumin ratio has been associated with adverse outcomes in various diseases. However, the impact of the lactate-to-albumin ratio on the prognosis of critically ill patients with chronic kidney disease remains unclear. Therefore, this study aimed to investigate the predictive ability of the lactate-to-albumin ratio for 28-day all-cause mortality in critically ill patients with chronic kidney disease.MethodsThis retrospective cohort study included 4271 critically ill patients with chronic kidney disease from the Medical Information Mart for Intensive Care IV database. The exposure factor was the lactate-to-albumin ratio, and the outcome was the 28-day mortality rate. Hazard ratios were computed along with their corresponding 95% confidence intervals using multivariate Cox regression.ResultsMultivariable Cox regression revealed that, compared with the Tertile 1 group, the hazard ratio for 28-day mortality was 1.55 (95% confidence interval: 1.26-1.92, <i>p</i> < 0.001) in the Tertile 2 group and 1.91 (95% confidence interval: 1.54-2.36, <i>p</i> < 0.001) in the Tertile 3 group. Kaplan-Meier analysis demonstrated that the higher lactate-to-albumin ratio group had higher 28-day, 90-day, and 1-year mortality rates (<i>p</i> < 0.001).ConclusionsIn our study population, the lactate-to-albumin ratio was independently associated with 28-day all-cause mortality, and this ratio may provide incremental prognostic value when combined with established severity of illness scores.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"54 9","pages":"3000605261478720"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865359","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":"Quantitative comparison of virtual non-contrast and true non-contrast computed tomography pulmonary angiography images across eight thoracic tissue types: A retrospective cross-sectional study.","authors":"Jiulong Yan, Ziyu Zhao, Xin Zhou, Yuxuan Chen, Ying Shen, Jin Gao, Xinxing Ma, Yue Teng","doi":"10.1177/03000605261487280","DOIUrl":"https://doi.org/10.1177/03000605261487280","url":null,"abstract":"<p><p>ObjectiveTo evaluate the quantitative reliability of virtual non-contrast images derived from spectral computed tomography pulmonary angiography across eight thoracic tissues, assessing their feasibility as a true non-contrast substitute.MethodsIn this retrospective cross-sectional study, we analyzed 169 patients undergoing spectral computed tomography pulmonary angiography. Attenuation differences between true non-contrast and virtual non-contrast images were evaluated across eight anatomical regions. Statistical assessments included Bonferroni-corrected Wilcoxon signed-rank tests, Pearson correlation (<i>r</i>), Lin's concordance correlation coefficient, and Bland-Altman analysis.ResultsVirtual non-contrast performance showed four distinct patterns. (1) <i>Excellent agreement.</i> Lung parenchyma and erector spinae muscle demonstrated high absolute concordance (concordance correlation coefficient = 0.981 and 0.876, respectively) with clinically negligible biases (3.8 Hounsfield units and -1.0 Hounsfield units). (2) <i>Moderate agreement.</i> The aorta and pulmonary artery shared identical concordance correlation coefficient values (0.430) but exhibited divergent clinical threshold exceedances, primarily driven by a larger mean bias in the pulmonary artery (8.8 Hounsfield units). (3) <i>Stable systematic offsets.</i> The T6 vertebral body and mediastinal fat exhibited massive systematic biases (66.2 Hounsfield units and -11.1 Hounsfield units, respectively), leading to poor absolute agreement (concordance correlation coefficient = 0.390 and 0.531). However, both maintained strong linear correlations (<i>r</i> = 0.902 and 0.816) and extremely low outlier rates beyond the 95% limits of agreement. (4) <i>Unacceptable agreement.</i> The thyroid gland and superior vena cava yielded clinically unacceptable reliability due to proportional bias and beam-hardening artifacts. The physical true non-contrast acquisition accounted for 53.0% of the total effective radiation dose.ConclusionsSpectral virtual non-contrast imaging accurately substitutes true non-contrast imaging in the lung parenchyma and erector spinae muscle. Although major vessels show moderate reliability, the massive systematic underestimation in vertebral bone precludes its direct clinical use for quantitative assessment without validated mathematical correction factors. Intrinsically iodine-rich organs and structures prone to streak artifacts remain unsuitable for virtual non-contrast substitution.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"54 9","pages":"3000605261487280"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resveratrol attenuates moxifloxacin-induced oxidative damage in the liver, kidneys, brain, and serum of Wistar rats.","authors":"Gülfem Yıldırım, Ayşen Çakır","doi":"10.1177/03000605261488102","DOIUrl":"https://doi.org/10.1177/03000605261488102","url":null,"abstract":"<p><p>ObjectiveMoxifloxacin, a widely used fluoroquinolone, has been associated with oxidative stress and tissue injury. Resveratrol may attenuate oxidative damage. This study investigated the effects of resveratrol co-administration on oxidative and apoptotic biomarkers in rats exposed to moxifloxacin.MethodsTwenty-four male Wistar albino rats were randomly assigned to three groups (n = 8 per group): (a) control; (b) moxifloxacin; and (c) moxifloxacin + resveratrol groups. Moxifloxacin was administered intraperitoneally at 50 mg/kg/day during the final 7 days of a 28-day experimental period, whereas resveratrol was administered at 40 mg/kg/day for 28 days. Levels of superoxide dismutase, malondialdehyde, and caspase-3 as well as total antioxidant status and total oxidant status were assessed in the serum, brain, kidney, and liver tissues.ResultsSerum total antioxidant status significantly decreased in the moxifloxacin group compared with that in the control group (2.639 ± 0.169 vs. 3.531 ± 0.176 mmol Trolox equivalent/L, <i>p</i> = 0.007). Co-administration of moxifloxacin and resveratrol significantly increased serum total antioxidant status compared with administration of moxifloxacin alone (3.380 ± 0.190 vs. 2.639 ± 0.169 mmol Trolox equivalent/L, <i>p</i> = 0.018), whereas no significant difference was observed in the control group (<i>p</i> = 0.557). Kidney total oxidant status was significantly higher in the moxifloxacin group than in the control (<i>p</i> = 0.008) and moxifloxacin + resveratrol (<i>p</i> = 0.002) groups. Liver superoxide dismutase levels were significantly lower in the moxifloxacin group than in the control (<i>p</i> < 0.001) and moxifloxacin + resveratrol (<i>p</i> = 0.001) groups. Kidney caspase-3 levels were significantly increased in the moxifloxacin group compared with those in the control group (<i>p</i> < 0.001), whereas co-administration of moxifloxacin and resveratrol partially attenuated this alteration. Additionally, moxifloxacin increased the levels of malondialdehyde in the kidney, liver, and brain tissues, with attenuation following resveratrol co-administration.ConclusionsResveratrol co-administration attenuated several moxifloxacin-associated oxidative and apoptotic alterations, particularly in the kidney and liver tissues. However, the absence of a resveratrol-only group and the preconditioning design limit the interpretation of its independent effects and clinical applicability. Further pharmacokinetic, mechanistic, and clinical studies are required.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"54 9","pages":"3000605261488102"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148976880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anxiety disorders in China and G20 countries: A comparative burden study.","authors":"Yuling Wang, Wenjun Wang, Xiao Liu, Mengqi Zhou, Rubing Gu, Fengjuan Lv","doi":"10.1177/03000605261485098","DOIUrl":"10.1177/03000605261485098","url":null,"abstract":"<p><p>ObjectiveTo compare the burden and temporal patterns of anxiety disorders in China with those in Group of Twenty (G20) countries from 1990 to 2021 and to project future disease burden.MethodsThis ecological secondary analysis used publicly available, aggregated estimates from the Global Burden of Disease Study 2021 for China and G20 countries. We assessed incidence, prevalence, and disability-adjusted life years using decomposition analysis, autoregressive integrated moving average models, and Bayesian age-period-cohort models.ResultsChina's age-standardized anxiety disorder burden decreased after 2000 (average annual percentage change, -1.2%). Its age profile differed from those of G20 countries, with a relatively greater disease burden among middle-aged and older adults. The prevalence of anxiety was 1.8-fold higher in females than in males. Decomposition analysis attributed 68% of the increase in anxiety prevalence in China to epidemiological change and population growth, whereas population aging accounted for 52% of the increase in G20 countries with a high sociodemographic index. The total number of anxiety cases in China were projected to rise by 22% by 2040, despite stable age-standardized rates.ConclusionsAnxiety disorder burden patterns differed between China and G20 countries and were associated with demographic and developmental contexts. These ecological findings support development-sensitive mental health planning and warrant confirmation in studies using individual-level data.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"54 9","pages":"3000605261485098"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919885","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":"Clinical and etiological characteristics of severe community-acquired pneumonia: A two-center retrospective analysis from Xi'an and Jiaxing in China.","authors":"Xiaoni Ma, Lin Zhong, Ting Wang, Yi Zhang, Xiaoqian Liu, Sirui Ma, Dan Dang","doi":"10.1177/03000605261489324","DOIUrl":"10.1177/03000605261489324","url":null,"abstract":"<p><p>ObjectiveThis study was conducted to evaluate the baseline clinical profile, causative pathogens, and treatment patterns of severe community-acquired pneumonia across two medical centers (Xi'an and Jiaxing) from January 2023 to August 2025.MethodsWe extracted data regarding medical profile, demographic characteristics, comorbidities, laboratory parameters, treatments during hospitalization, and outcomes for these patients from electronic records. Pathogens were detected using a combination of sputum culture/throat-swab polymerase chain reaction with metagenomic next-generation sequencing or targeted next-generation sequencing.ResultsAmong the 204 severe community-acquired pneumonia patients, majority were men (72.55%, 95% confidence interval: 66.05%-78.21%); the age range of the population was 65-79 years (41.18%, 95% confidence interval: 34.65%-48.03%), and chronic obstructive pulmonary disease was the predominant chronic pulmonary condition, present in 28.92% of the study participants. Laboratory evaluations revealed high illness severity scores (Acute Physiology and Chronic Health Evaluation II score: 19.00 (14.00, 24.00) and Sequential Organ Failure Assessment score: 7.00 (6.00, 10.00)). Pathogens were identified using metagenomic next-generation sequencing or targeted next-generation sequencing of blood/sputum/bronchoalveolar lavage fluid and polymerase chain reaction of sputum culture/throat-swab in 117 and 85 cases, respectively. <i>Klebsiella pneumoniae</i> was the most common pathogen, present in 20.10% of the participants (95% confidence interval: 15.18%-26.13%), followed by coronavirus 2019 (16.18%, 95% confidence interval: 11.76%-21.85%), and influenza A virus (12.75%, 95% confidence interval: 8.85%-18.02%). Most frequently administered medicines were β-lactam/β-lactamase-inhibitor combinations (89.22%) and carbapenems (60.78%). All patients received respiratory support, with 15.69% undergoing continuous renal-replacement therapy and 5.39% receiving extracorporeal membrane oxygenation. The in-hospital mortality rate was 38.73% (79/204, 95% confidence interval: 32.31%-45.56%).ConclusionSevere community-acquired pneumonia, which is most often caused by <i>K. pneumoniae</i> in our region, regularly complicates chronic obstructive pulmonary disease and other chronic pulmonary diseases, requires broad-spectrum antibiotics and life-support, and is associated with a relatively high mortality rate.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"54 9","pages":"3000605261489324"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Behavior Change Wheel-based health education for cancer pain: A systematic review of randomized controlled trials.","authors":"Yuxuan Shi, Wenjuan Li, Rong Tang, Huan Wang, Qi Jin, Xi Wang, Caiping Wang","doi":"10.1177/03000605261487054","DOIUrl":"10.1177/03000605261487054","url":null,"abstract":"<p><p>ObjectiveTo evaluate the effectiveness and implementation characteristics of health education interventions based on the Behavior Change Wheel for adults with cancer pain.MethodsTen databases (CNKI, VIP, Wanfang, CBM, PubMed, Embase, Web of Science, Cochrane Library, CINAHL, and Scopus) were searched from inception to January 2025. Randomized controlled trials evaluating Behavior Change Wheel- or Capability-Opportunity-Motivation-Behavior-informed health education for patients with cancer pain were included. Two reviewers independently screened studies, extracted data, and assessed the risk of bias using the Cochrane risk of bias 2 tool. Because of substantial heterogeneity in intervention content, duration, delivery mode, and outcome measures, no meta-analysis was performed. Findings were synthesized narratively according to the Synthesis Without Meta-analysis reporting guidance. Between-group differences were calculated or extracted from individual studies and summarized as ranges across trials.ResultsOf 367 records identified, seven randomized controlled trials involving 954 patients met the inclusion criteria. All interventions were explicitly designed around Behavior Change Wheel/Capability-Opportunity-Motivation-Behavior principles. Behavior Change Wheel based health education was associated with reduced pain intensity, improved medication adherence, and better quality of life. For secondary outcomes, favorable effects on sleep quality and self-management ability were reported in a subset of trials, but the evidence was less consistent. Interpretation of these findings is limited by short follow-up, considerable heterogeneity in intervention content and outcome measures, and an overall moderate risk of bias.ConclusionBehavior Change Wheel based health education appears to be a promising adjunct for cancer pain management, plausibly by strengthening patients' capability, opportunity, and motivation. However, the current evidence is limited to a small number of trials with methodological concerns. Larger multicenter trials with standardized core outcomes and follow-up of at least 3-6 months are needed to confirm these findings.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"54 9","pages":"3000605261487054"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of hematologic disorders on decline in hemoglobin levels after total hip arthroplasty.","authors":"Ming Jiang, Zhiyuan He, Yong Zhang, Huilin Yang, Dinghua Jiang, Lixin Huang, Yijian Zhang, Wu Xu, Linyan Liu","doi":"10.1177/03000605261483881","DOIUrl":"10.1177/03000605261483881","url":null,"abstract":"<p><p>ObjectiveBlood loss and postoperative anemia are common complications following total hip arthroplasty. Patients with hematologic disorders are at an increased risk of perioperative complications, especially those related to bleeding. This study aimed to investigate the impact of hematologic disorders on blood loss after total hip arthroplasty.MethodsThis single-center, matched retrospective cohort study included 64 patients who had undergone unilateral total hip arthroplasty for osteonecrosis of the femoral head. Patients were allocated in a 1:1 matched design to a control or a hematologic disorders group. Primary outcomes included postoperative red blood cell count, hemoglobin level, reductions in red blood cell count and hemoglobin level, postoperative drainage volume, transfusion rate, and estimated blood loss. Secondary outcomes comprised postoperative white blood cell and platelet counts, maximum perioperative changes, operative duration, length of hospital stay, and the incidence of lower-extremity deep venous thrombosis.ResultsPostoperative red blood cell counts and hemoglobin levels were significantly lower in the hematologic disorders group, and reduction in both parameters was more pronounced in this cohort. The rate of blood transfusion was also significantly higher in the hematologic disorders group. Postoperative white blood cell and platelet counts and perioperative changes in white blood cell counts were less favorable among patients with hematologic disorders. No statistically significant differences were detected in the operative duration, hospital stay, postoperative drainage volume, estimated blood loss, or incidence of lower-extremity deep venous thrombosis.ConclusionsPerioperative blood management following total hip arthroplasty may be more challenging in patients with hematologic disorders. Enhanced and targeted blood management strategies are warranted in this patient population.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"54 9","pages":"3000605261483881"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13554577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900704","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 key genes and mechanistic exploration of metabolic reprogramming in osteoporosis.","authors":"Yunfei He, Caihong Shi, Xin Yu, An Wang","doi":"10.1177/03000605261491503","DOIUrl":"https://doi.org/10.1177/03000605261491503","url":null,"abstract":"<p><p>ObjectiveTo identify metabolism-related genes associated with osteoporosis and evaluate their diagnostic potential through integrative transcriptomic analysis and clinical validation.MethodsSingle-cell RNA sequencing data from GSE169396 were analyzed using the Seurat package to investigate interactions between monocytes and other cell types. Metabolic pathway alterations in osteoporosis were evaluated using single-sample gene set enrichment analysis. Differentially expressed genes were intersected with metabolism-related genes to identify differentially expressed metabolism-related genes. Key metabolic genes were screened using the least absolute shrinkage and selection operator, support vector machine-recursive feature elimination, and Boruta algorithms, and a logistic regression model was established to assess their diagnostic value. External quantitative reverse transcription polymerase chain reaction validation was performed using peripheral blood mononuclear cells from patients with osteoporosis and healthy controls. Receiver operating characteristic curve analysis was used to evaluate the predictive performance of individual genes and the combined model.ResultsSingle-cell interaction analysis revealed close communication between monocyte subsets and hematopoietic stem cells, endothelial cells, cDC2, cDC1, T cells, and plasmacytoid dendritic cells. Significant alterations were observed in valine, leucine, and isoleucine biosynthesis; purine metabolism; fatty acid biosynthesis and elongation; ascorbate and aldarate metabolism; and steroid biosynthesis. Intersection analysis identified 11 differentially expressed metabolism-related genes from 232 metabolism-related genes and 395 differentially expressed genes. Integrative machine learning identified seven key metabolic genes: ADSL, BCAT1, BCAT2, PDE8A, NPR2, SOAT2, and XDH. External validation confirmed significant differential expression of these genes between patients with osteoporosis and healthy controls. The logistic regression model showed excellent diagnostic performance, with an area under the curve of 0.935, whereas all individual genes achieved area under the curve values above 0.7. Gene set enrichment analysis indicated that these genes were enriched in pathways related to G protein-coupled receptor activity.ConclusionsWe identified seven key metabolic genes associated with osteoporosis, namely, ADSL, BCAT1, BCAT2, PDE8A, NPR2, SOAT2, and XDH, and demonstrated their promising diagnostic potential. These findings provide new insights into the metabolic mechanisms underlying osteoporosis and may support the development of future diagnostic biomarkers and therapeutic targets.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"54 9","pages":"3000605261491503"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demographic characteristics and self-reported motivations of women undergoing genital aesthetic surgery: A descriptive cohort of 927 patients in Turkey (2017-2024).","authors":"Ayse Konac","doi":"10.1177/03000605261487263","DOIUrl":"https://doi.org/10.1177/03000605261487263","url":null,"abstract":"<p><p>ObjectiveGenital aesthetic surgery, within the broader domain of female genital cosmetic surgery, has become increasingly visible in clinical practice. However, descriptive data on patient characteristics and self-reported motivations remain limited. This study describes the demographic profile, psychosocial context, motivations, and procedural patterns among women undergoing genital aesthetic surgery in Turkey.MethodsThis descriptive cohort included 927 consecutive women who underwent genital aesthetic surgery between 2017 and 2024. Data were collected during clinical evaluation using a structured questionnaire and medical records, including lifestyle factors, partner-related decision context, psychiatric history markers, motivations, procedure type, and post-treatment status. Analyses were purely descriptive, with continuous variables reported as mean ± SD and median.ResultsThe mean age was 42.0 ± 12.4 years, and 62.4% were married. Educational attainment most commonly reflected an associate degree (45.5%). Current smoking was reported by 629 of 927 participants (67.9%), alcohol use by 32.4%, and a history of prior cosmetic surgery by 33.1%. A psychiatric diagnosis was documented in 10.0%, and psychiatric medication use in 11.4%. Partner involvement was frequent: 64.2% presented at their spouse's request; decisions were self-driven in 53.0%, partner-driven in 32.6%, and joint in 14.5%. The most commonly endorsed motivations were personal aesthetic concern (63.0%) and relationship anxiety/relationship repair (38.0%). The most frequent procedures were perineoplasty + vaginoplasty (24.3%). Recorded post-treatment status was categorized as successful in 76.9%, with wound-healing problems (9.8%) and unrealistic expectations (6.0%) among the most common nonsuccess categories.ConclusionIn this large descriptive cohort, genital aesthetic surgery was commonly pursued in mid-adulthood and often occurred within partner-related decision-making contexts, with motivations frequently spanning aesthetic, relational, and functional domains. These findings support the clinical importance of autonomy-sensitive counseling, expectation management, and structured psychosocial documentation in routine genital aesthetic surgery care.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"54 9","pages":"3000605261487263"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between serum 25-hydroxyvitamin D and visceral fat area in adults with type 2 diabetes: A cross-sectional study.","authors":"Junling Zhu, Xujie Tang, Chunyan Zhu, Yiming Zhang, Zichen Rao, Qianru Zhu, Lulu Zheng","doi":"10.1177/03000605261487246","DOIUrl":"https://doi.org/10.1177/03000605261487246","url":null,"abstract":"<p><p>ObjectiveTo examine the association between serum 25-hydroxyvitamin D and visceral fat area in adults with type 2 diabetes and assess the exposure-response pattern.MethodsThis retrospective cross-sectional study included 1271 adults with type 2 diabetes. Serum 25-hydroxyvitamin D was analyzed as a continuous variable and by quartiles. Multivariable linear regression models were sequentially adjusted for demographic, lifestyle, and metabolic factors, with body mass index added separately in the fully adjusted model. A generalized additive model was used to assess the exposure-response relationship. Prespecified subgroup analyses were also performed.ResultsVisceral fat area differed across quartiles of serum 25-hydroxyvitamin D, with a lower median value in Q4 than in Q1 (87.0 vs. 96.0 cm²; p = 0.002). Higher serum 25-hydroxyvitamin D was associated with lower visceral fat area in the multivariable model without body mass index (β = -0.77, 95% confidence interval: -1.13 to -0.41; p < 0.0001) and in the body mass index-adjusted model (β = -0.53, 95% confidence interval: -0.80 to -0.27; p < 0.0001). In quartile analyses, participants in Q4 had lower visceral fat area than those in Q1 in the body mass index-adjusted model (β = -10.04, 95% confidence interval: -16.19 to -3.89; p = 0.0015), whereas the associations for Q2 and Q3 were not statistically significant; nevertheless, a significant trend was observed across quartiles (p for trend = 0.0005). The generalized additive model suggested an approximately linear inverse association between serum 25-hydroxyvitamin D and visceral fat area.ConclusionsIn adults with type 2 diabetes, higher serum 25-hydroxyvitamin D levels were associated with lower HDS-2000-estimated visceral fat area, although the association was attenuated after adjustment for body mass index. This cross-sectional association should not be interpreted as independent of overall adiposity or unmeasured lifestyle, comorbidity, and treatment-related factors. Longitudinal studies are needed to clarify temporality.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"54 9","pages":"3000605261487246"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148976897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}