Medicine最新文献

{"title":"Diabetes mellitus and hypertension care in Bidur Municipality, Nuwakot District, Nepal: A cross-sectional study.","authors":"Gambhir Shrestha, Deepak Raj Joshi, Pranil Man Singh Pradhan, Sushan Man Shrestha, Namrata Karki, Prem Basel, Smriti Pant, Tanweer Ahmad Mikrani, Khem Bahadur Karki","doi":"10.1097/MD.0000000000044303","DOIUrl":"10.1097/MD.0000000000044303","url":null,"abstract":"<p><p>Chronic diseases, such as diabetes mellitus (DM) and hypertension (HTN), are growing public health concerns globally, with notably low management rates in low- and middle-income countries. This study aimed to assess the care-related outcomes of DM and HTN in Bidur Municipality, Nepal. This cross-sectional study was conducted in Bidur Municipality in Nuwakot District of Nepal. A convenient sampling method was used to select 3183 households, and 1 preferably the head of the household ≥18 years, was interviewed. Data were collected using a Nepali-translated questionnaire consisting of sociodemographic characteristics, health-seeking behavior, insurance, substance use, family history, and screening, diagnosis, and treatment for both DM and HTN. Multiple logistic regression was applied to examine associations between care-related outcomes and explanatory variables. Among 3183 participants, 43% had ever been screened for DM and 65% for HTN. Of those screened, 68% had DM screening, and 82% had blood pressure checks within the past 6 months. The prevalence of DM and HTN was 18.7% and 26.1%, respectively. Among those diagnosed, 74.3% with DM and 76% with HTN were receiving treatment, with continuation rates of 98.4% and 97%, respectively. DM screening was significantly associated with age, ethnicity, family history, and insurance; diagnosis with age, ethnicity, and family history; and treatment adherence with family history. HTN screening was linked to age, family size, and family history; diagnosis to older age, family type, and family history; and adherence to treatment to age, ethnicity, family history, and insurance. Screening rates for DM and HTN were higher in Bidur Municipality compared to that of the national data. However, disparities persist, particularly among certain ethnic groups and uninsured individuals, who have lower screening rates. Older age and a positive family history consistently predicted screening, diagnosis, and treatment adherence for both conditions.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 36","pages":"e44303"},"PeriodicalIF":1.4,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12419325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023660","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":"Effectiveness of emotional freedom techniques therapy in alleviating anticipatory grief for cancer patients.","authors":"Dandan Zheng, Wei Xiao, Dan Duan, Chunhua Tang, Xianghao Lin","doi":"10.1097/MD.0000000000044211","DOIUrl":"10.1097/MD.0000000000044211","url":null,"abstract":"<p><strong>Background: </strong>Cancer patients frequently experience anticipatory grief (AG), anxiety, and sleep disturbances. This randomized controlled trial evaluates the efficacy of the emotional freedom technique (EFT) therapy in alleviating these symptoms.</p><p><strong>Methods: </strong>A total of 58 cancer patients were randomly assigned to an intervention group (n = 30) receiving 4-week EFT therapy (acupoint tapping + scripted prompts, 5 minutes per prompt) plus routine care, or a control group (n = 28) receiving routine care alone. AG was measured using the Preparatory Grief in Advanced Cancer Patients scale, anxiety with the Hamilton Anxiety Rating Scale, and sleep quality via the Pittsburgh Sleep Quality Index at baseline and postintervention.</p><p><strong>Results: </strong>After 4 weeks, the intervention group demonstrated: Significantly lower AG scores versus control (P < .01); greater anxiety reduction (P = .04); improved sleep quality (P < .01).</p><p><strong>Conclusion: </strong>EFT therapy produces clinically significant improvements in AG, anxiety symptoms, and sleep quality among cancer patients within 4 weeks.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 36","pages":"e44211"},"PeriodicalIF":1.4,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12419430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023678","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":"Comparison of postoperative pain rates with different hysterectomy techniques: A retrospective study.","authors":"Mustafa Kurçaloğlu, Mesut Önal, Cemal Yaşar, Firdevs Yilmazlar, Pinar Uzun Uslu, Yasemin Yoleri","doi":"10.1097/MD.0000000000044374","DOIUrl":"10.1097/MD.0000000000044374","url":null,"abstract":"<p><p>This study aimed to compare different hysterectomy techniques regarding postsurgical pain. Women who underwent hysterectomy for nonmalignant etiologies between January 2019 and March 2023 were included in this retrospective study. The participants were divided into 4 groups based on the surgical techniques performed: abdominal hysterectomy (AH), laparoscopic hysterectomy, vaginal hysterectomy, and vaginal natural orifice transluminal endoscopic surgery (vNOTES). Pain scores and analgesic consumption were used for pain assessment. Parameters before the surgery and 24 hours, 1 week, 1, 3, and 6 months after the operation were retrospectively evaluated. Additionally, possible factors associated with pain, such as age, previous pelvic pain, previous abdominal surgery, indications for surgery duration of the surgery, volume of hysterectomy material, mean postoperative hospital stay, and blood transfusion were analyzed. A total of 264 patients were enrolled in this study. Thirty (11.3%) patients reported postsurgical chronic pain (PSCP). The mean number of days with postoperative pain was highest in the AH group and lowest in the vNOTES group. AH patients had the highest pain scores at the 24th hour and 1 week after surgery, and vNOTES cases had the lowest pain frequency in the 3rd- and 6th-month records. The preoperative presence of pain and higher pain intensity in the early postoperative period were other factors associated with PSCP. There was no significant difference in perioperative complications. The results of this study suggest that vNOTES is superior to other hysterectomy techniques in terms of postoperative chronic pain control without increased perioperative complication rates. Effective pain control during the early postoperative period may decrease the frequency of PSCP.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 36","pages":"e44374"},"PeriodicalIF":1.4,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12419311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023680","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":"Timely diagnosis of atypical Japanese spotted fever: A case report.","authors":"Jiarong Li, Junning He, Yijie Yin, Yongfang Liu","doi":"10.1097/MD.0000000000044345","DOIUrl":"10.1097/MD.0000000000044345","url":null,"abstract":"<p><strong>Rationale: </strong>Japanese spotted fever (JSF) is a rare tick-borne disease caused by Rickettsia japonica. Atypical manifestations and a lack of standardized diagnostic assays often result in delayed diagnosis and treatment, potentially leading to life-threatening complications.</p><p><strong>Patient concerns: </strong>A 57-year-old immunocompetent female from a region with no previously reported JSF cases presented with acute-onset high-grade fever (39.5°C), a generalized maculopapular rash, and systemic symptoms after participating in agricultural activities. The patient denied having any history of tick exposure and presented without eschar, leading to the initial misdiagnosis of respiratory infection.</p><p><strong>Diagnoses: </strong>Metagenomic sequencing (MetaCAP) technology enabled a definitive diagnosis by identifying Rickettsia japonica-specific DNA sequences in the patient's blood. The genomic results completely aligned with the clinical presentation.</p><p><strong>Interventions: </strong>The patient was treated with doxycycline, which achieved rapid clinical resolution.</p><p><strong>Outcomes: </strong>The patient achieved full recovery with only residual lower-limb hyperpigmentation at the month follow-up, without disease recurrence.</p><p><strong>Lessons: </strong>This case demonstrates the diagnostic value of metagenomic testing for fevers of unknown origin. JSF should be a key consideration for agricultural and forestry workers presenting with compatible symptoms, even in nonendemic areas without documented insect bites. The optimal diagnostic approach combines clinical evaluation with advanced molecular testing to ensure the accurate identification and proper management of tropical febrile illnesses.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 36","pages":"e44345"},"PeriodicalIF":1.4,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12419431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023724","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":"Treatment of advanced cervical cancer with Cinobufacini and Paclitaxel-Cisplatin combination: A meta-analysis.","authors":"Zixin Chen, Lu Zhang, Die Li, Rui Zhu, Yue Luo","doi":"10.1097/MD.0000000000044146","DOIUrl":"10.1097/MD.0000000000044146","url":null,"abstract":"<p><strong>Background: </strong>Standard treatments for advanced cervical cancer, such as paclitaxel-cisplatin combination (TP) chemotherapy, are often limited by reduced efficacy and significant toxicity. Cinobufacini (Huachansu), a traditional Chinese medicine, has demonstrated potential in enhancing the effectiveness of conventional cancer therapies.</p><p><strong>Methods: </strong>A systematic search of Web of Science, PubMed, Cochrane, Embase, China National Knowledge Infrastructure, and other databases was conducted up to July 30, 2024. Studies included were randomized controlled trials comparing cinobufacini combined with TP chemotherapy to TP chemotherapy alone in patients with advanced cervical cancer. The outcomes were clinical response rate, Karnofsky Performance Status, myelosuppression, platelet count, and incidences of vomiting and diarrhea. Data analysis was performed using RevMan 5.3, and risk ratios (RRs) and mean differences (MDs) were calculated with 95% confidence intervals (CIs). Heterogeneity was assessed using the I2 statistic, and sensitivity analysis was performed to ensure robustness.</p><p><strong>Results: </strong>Six randomized controlled trials involving 814 participants were included. Cinobufacini combined with TP chemotherapy significantly improved the clinical response rate (RR 1.22, 95% CI [1.05-1.41], P = .009) and KPS (MD 7.37, 95% CI [6.40-8.34], P < .00001). The intervention also reduced myelosuppression (RR 0.53, 95% CI [0.41-0.68], P < .0001), platelet count decline (MD -94.25, 95% CI [-96.96 to -91.52], P < .00001), vomiting (RR 0.58, 95% CI [0.45-0.76], P < .0001), and diarrhea (RR 0.60, 95% CI [0.39-0.92], P = .02). Heterogeneity was moderate for the clinical response rate but reduced after sensitivity analysis, with stable overall effect estimates.</p><p><strong>Conclusion: </strong>Cinobufacini combined with TP chemotherapy significantly improves clinical outcomes and reduces treatment-related adverse effects. These findings suggest that cinobufacini may be a valuable adjunctive therapy in enhancing the efficacy and reducing the toxicity of TP chemotherapy, though further large-scale studies are needed to confirm its efficacy and safety.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 36","pages":"e44146"},"PeriodicalIF":1.4,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12419433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023728","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":"Military service and mortality risk in older adults: A nationwide retrospective cohort analysis of NHANES data.","authors":"Yizhou Luo, Cui Pang","doi":"10.1097/MD.0000000000044171","DOIUrl":"10.1097/MD.0000000000044171","url":null,"abstract":"<p><p>Military service presents a paradoxical health impact, simultaneously enhancing physical fitness while increasing risks of injuries, mental health disorders, and war-related illnesses. The long-term mortality consequences for aging veterans remain insufficiently characterized. This study examines the association between military service and mortality outcomes among US adults aged 50 years and older, including all-cause mortality, premature death, and cause-specific mortality. We analyzed 17,984 participants from the National Health and Nutrition Examination Survey (1999-2018) with complete data on military service status and mortality outcomes. Using weighted multivariate modeling, Kaplan-Meier survival analyses, and subgroup analyses, we evaluated mortality risks while adjusting for demographic, socioeconomic, and health covariates (gender, age, ethnicity, education, marital status, income, diabetes, and hypertension). During 250 months of follow-up (3985 deaths), veterans showed longer mean survival time (139.36 ± 1.38 months) than nonveterans (129.66 ± 1.43 months). In fully adjusted models, military service was positively associated with survival time (β = 21.87, 95% confidence interval [CI] = 17.03-26.70, P < .001). However, non-veterans demonstrated reduced risks for premature mortality (odds ratio = 0.69, 95% CI = 0.58-0.82, P < .001), malignancy-related deaths (odds ratio = 0.73, 95% CI = 0.55-0.96, P = .025), and other cause-specific mortality compared to veterans. While military service is associated with longer overall survival in older adults, it confers increased risks of premature death and cancer mortality. These findings highlight the need for targeted health interventions for aging veterans, particularly for cancer prevention and early detection.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 36","pages":"e44171"},"PeriodicalIF":1.4,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12419436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023740","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":"Investigating the mechanism of gastrodin-regulated miR-128-3p in methamphetamine dependence via integrated pharmacology.","authors":"Hancheng Li, Yunbing He, Yangkai Wu, Chaohua Luo, Yongen Peng, Wenhua Liu, Jieyu Li, Yuting Huang, Rimeng Chen, Deyun Ma, Zhixian Mo","doi":"10.1097/MD.0000000000044274","DOIUrl":"10.1097/MD.0000000000044274","url":null,"abstract":"<p><p>Gastrodin (GAS), the principal bioactive component derived from Gastrodia elata Bl., has demonstrated efficacy in attenuating methamphetamine (MA) induced conditioned place preference (CPP) in animal models. However, the molecular mechanisms underlying its anti-addictive effects, particularly the role of miRNAs, remain insufficiently understood. A CPP model of MA dependence was established in rats. Hippocampal tissues were subjected to microarray analysis to identify differentially expressed miRNAs following GAS intervention. Key techniques including behavioral evaluation, stereotaxic injection of miR-128-3p antagomir, quantitative real time PCR, network pharmacology analysis, molecular docking, and dual-luciferase reporter assays were employed to elucidate the involvement of miR-128-3p in the anti-MA effects of GAS. GAS treatment significantly reversed MA induced CPP behaviors and mitigated the upregulation of hippocampal miR-128-3p. Inhibition of miR-128-3p via antagomir also attenuated MA induced CPP, mirroring the effect of GAS administration. Network pharmacology analysis identified 106 putative miR-128-3p targets enriched in learning, memory, and behavioral regulation pathways including PI3K Akt, MAPK, and FoxO signaling. Molecular docking revealed strong binding affinities between GAS, MA, and 6 key targets, with miR-128-3p interacting at multiple 3' UTR sites. dual-luciferase reporter assays confirmed the suppressive effect of miR-128-3p on these targets. GAS exerts its inhibitory effect on MA dependence through modulation of miR-128-3p and its downstream targets. These findings suggest that miR-128-3p represents a promising therapeutic target, and GAS may serve as a novel miRNA based intervention strategy for MA addiction.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 36","pages":"e44274"},"PeriodicalIF":1.4,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12419275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023748","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":"Predictors of job maintenance in young and middle-aged patients after percutaneous coronary intervention: A retrospective cohort study.","authors":"Yajun Hua, Ya Wang, Fan Fan, Ting Chen, Wei Yan, Xudan Huang, Yimao Sang","doi":"10.1097/MD.0000000000044318","DOIUrl":"10.1097/MD.0000000000044318","url":null,"abstract":"<p><p>This study evaluates job maintenance status and predictors of young and middle-aged patients after percutaneous coronary intervention (PCI). A total of 221 young and middle-aged patients after PCI from November 1, 2023 to January 31, 2025 were selected. The job readiness of patients who have not returned to work and the job maintenance of patients who have returned to work were investigated. The survey tools included general information questionnaire, readiness for return-to-work scale (RRTW), social support rating scale, cardiac rehabilitation inventory and self-rating anxiety scale (SAS). At 3-month follow-up, 81% (n = 179) of patients returned to work, with 19% (n = 42) remaining unemployed. Among patients returning to work, including high-maintenance (n = 109), low-maintenance (n = 52) and invalid (n = 18). Multivariate analysis identified cardiac rehabilitation inventory (OR = 1.122, 95% CI 1.051-1.199, P = .001), SAS (OR = 0.912, 95% CI 0.863-0.962, P = .001), and number of chronic conditions (OR = 0.580, 95% CI 0.365-0.920, P = .021) as independent predictors of job maintenance after PCI. The AUC of receiver operating characteristic curve is 0.795 (95% CI 0.725-0.865, P <.001), with 77.1% sensitivity and 69.2% specificity. Hosmer-Lemeshow test showed that the model had a good fitting degree (χ²=7.077, P = .528). Job maintenance of patients after PCI may be predicted by their cardiac rehabilitation information needs, anxiety levels, and chronic disease burden. The integration of psychosocial and clinical parameters provides a novel framework for personalized interventions targeting modifiable barriers to work resumption.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 36","pages":"e44318"},"PeriodicalIF":1.4,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12419261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023759","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":"Left ventricular hypertrophy and cardiac valve calcification and their impacts on survival in maintenance hemodialysis patients: A retrospective cohort study.","authors":"Xiaochun Wu, Zhiping Sun, Gang Yao, Fuhua Zhou","doi":"10.1097/MD.0000000000044181","DOIUrl":"10.1097/MD.0000000000044181","url":null,"abstract":"<p><p>The purpose of this article was to study the distribution of left ventricular hypertrophy (LVH) and cardiac valve calcification (CVC), relevant factors, and the relationship of LVH and CVC with survival in maintenance hemodialysis (MHD) patients. A total of 281 MHD patients were included in this retrospective and follow-up study. Echocardiography measurements were performed to evaluate the left ventricular structure and cardiac valve. Left ventricular mass (LVM), LVM index, relative wall thickness, and prevalence of LVH and CVC were calculated. Factors related to LVH and CVC and patients' death risk were analyzed. The primary outcome was death. The prevalence of LVH in this study was 50.53% (142 patients). Concentric hypertrophy, concentric remodeling, and eccentric hypertrophy were found in 39.86%, 25.98%, and 10.68% of patients, respectively. Factors associated with LVH included systolic pressure, CVC, hemoglobin, and calcium carbonate in a multivariate logistic regression model (all P <.01). The log-rank χ2, which were 10.957, 12.668, 10.181, and 8.474 at 6, 12, 18, and 24 months follow-up, respectively, in the Kaplan-Meier model demonstrated the lower survival rates in patients with LVH than in those without (all P <.01). The prevalence of CVC was 60.14% (169 patients). Aortic valve calcification, mitral valve calcification, or both were found in 54.09%, 33.10%, and 27.05% of patients, respectively. In a multivariate logistic regression model, the factors associated with CVC were coronary heart disease, LVH, calcium, age, dialysis age, and diastolic pressure (P <.05). In COX proportional hazard model, LVH resulted as an independent risk factor to all-cause death; the adjusted HR was 11.045, 4.382, 3.075, and 2.586 at 6, 12, 18, and 24 months follow-up, respectively (all P <.05). In MHD patients, LVH and CVC were highly prevalent, and LVH resulted as an independent risk factor for all-cause death.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 36","pages":"e44181"},"PeriodicalIF":1.4,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12419373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023761","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 degree of vascular calcification affects endovascular recanalization in chronic intracranial and extracranial large artery occlusion: A retrospective study.","authors":"Lijuan Liu, Kun Zhang, Xudong Su, Jianghua Yu, Zengpin Liu, Cunhe Zhou, Binbin Wang, Yanying Zhao, Ruomeng Chen, Zhou Zhou, Minghan Zhao, Xiaoyun Liu","doi":"10.1097/MD.0000000000044247","DOIUrl":"10.1097/MD.0000000000044247","url":null,"abstract":"<p><p>Chronic cerebral artery occlusion is an important cause of cerebral ischemic events. Endovascular recanalization is an effective treatment for this condition, but its success depends on appropriate patient selection and assessment. This is a retrospective study that collected patients with chronic cerebral artery occlusion who underwent endovascular recanalization to determine how imaging features from computed tomography angiography - including the extent of internal carotid artery occlusion, the number of calcified vessels, and the degree of calcification in the occluded vessels - affect the success rate of recanalization. A total of 147 patients were included, 103 (70.1%) were successfully recanalized. Lipoprotein(a) (Lp[a]) levels were significantly higher in the failed group (38.40 ± 34.41 mg/dL) compared to the successful group (22.93 ± 22.84 mg/dL) (P = .008). Among these patients, 49 underwent preoperative CTA, and 36 (73.5%) achieved successful recanalization. There was no significant association between the number of calcified vessels and the endovascular recanalization rate (P = 1.000). However, patients with a calcification degree >50% had a lower recanalization rate (40%) than those with 50% or less calcification (82.1%, P = .014), and the same result was seen in patients with chronic anterior circulation large artery occlusion (P = .019). In patients with chronic intracranial and extracranial large artery occlusion, the degree of vascular calcification in the occluded vessels significantly influences the success of endovascular recanalization.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 36","pages":"e44247"},"PeriodicalIF":1.4,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12419393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023771","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}