Medicine最新文献

{"title":"Exclusive liposuction with glandular tissue redistribution for severe gynecomastia: A case report.","authors":"Bingwen Yan, Xuezhe Hong, Dongyue Hao, Juan Zhang, Jiaomiao Pei, Liming Sun, Zhengqiang Cang, Yongjun Chen, Ying Ma, Baoqiang Song, Chaohua Liu","doi":"10.1097/MD.0000000000041299","DOIUrl":"10.1097/MD.0000000000041299","url":null,"abstract":"<p><strong>Rationale: </strong>Gynecomastia, characterized by abnormal enlargement of male breast tissue, can lead to significant psychological distress, particularly among younger men. Traditional surgical options, such as subcutaneous mastectomy and liposuction, often result in visible scarring and contour deformities. This study introduces the \"Stab Flatten\" technique, a novel, minimally invasive approach for treating severe gynecomastia, designed to preserve chest aesthetics while minimizing postoperative complications, including scarring and contour irregularities.</p><p><strong>Patient concerns: </strong>A 28-year-old male with a 15-year history of progressive bilateral breast enlargement presented with psychological distress and concerns about the cosmetic outcomes of traditional surgery. He sought a minimally invasive procedure to address both physical discomfort and aesthetic concerns, aiming for minimal scarring.</p><p><strong>Diagnoses: </strong>The patient was diagnosed with grade III gynecomastia according to Simon classification, characterized by significant glandular hypertrophy and excess skin. Diagnostic imaging and laboratory tests confirmed the absence of underlying medical conditions.</p><p><strong>Interventions: </strong>The patient underwent the \"Stab Flatten\" technique, which involved exclusive liposuction with glandular tissue redistribution. A 4-mm incision was made at the inframammary crease, and power-assisted liposuction was used to flatten fibroglandular tissue without excision. Postoperative care included a compression garment for 6 months.</p><p><strong>Outcomes: </strong>At the 6-month follow-up, the patient showed excellent cosmetic results, with significant improvement in breast contour and symmetry. There were no complications such as hematoma, seroma, or nipple-areola complex deformities. The patient reported high satisfaction with the aesthetic outcome, alongside improved psychological well-being and physical comfort.</p><p><strong>Limitations: </strong>This study is limited by its single-patient case report, which restricts the generalizability of the findings. Long-term outcomes of the \"Stab Flatten\" technique require further validation through larger, prospective studies with more diverse patient populations. Additionally, the technique may not be applicable to all grades of gynecomastia or patients with more complex conditions.</p><p><strong>Lessons: </strong>The \"Stab Flatten\" technique offers an effective, minimally invasive alternative for treating severe gynecomastia, providing excellent cosmetic and functional outcomes while minimizing scarring. This method may enhance patient satisfaction and reduce recovery times compared to traditional surgical approaches. However, further studies with larger cohorts are necessary to validate its efficacy and generalizability.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 3","pages":"e41299"},"PeriodicalIF":1.3,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008231","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 effect of maternal and fetal weight on the risk of emergency cesarean section in nulliparous women.","authors":"Jing Bao, Ping Guan","doi":"10.1097/MD.0000000000041095","DOIUrl":"10.1097/MD.0000000000041095","url":null,"abstract":"<p><p>Although many studies based on different ethnic groups have analyzed the impact of maternal and infant weight on overall cesarean section rates in recent years, research on the impact of maternal and infant weight on emergency cesarean section (EmCS) rates is lacking, especially in the Chinese population. This study aimed to analyze whether maternal and fetal weight could influence the risk of EmCS. A total of 8427 nulliparous women who delivered vaginally (full-term, singleton, and cephalic presentation) were included in this study and divided into the normal vaginal delivery (VD) and EmCS groups. Of 8427 cases, 909 (10.8%) were delivered by EmCS because of failed VD. Compared with pregnant women with a normal body mass index, the risk of EmCS in overweight women increased significantly (P < .001). Birth weight > 3550 g was associated with an increased risk of EmCS. Subgroup analyses showed that among women with underweight and normal weight, old age, inadequate gestational weight gain, and large for gestational age were independent high-risk factors for EmCS (P < .05), whereas small for gestational age was the low-risk factor. Compared with the fetal distress group, the weight of newborns in the nonfetal distress group was significantly higher (P < .001), and the main cause of EmCS in women with macrosomia, large for gestational age, or birth weight ≥ 3550 g was fetal distress (P < .05). The prepregnancy maternal and fetal weights can affect the risk of EmCS. Weight management should be enhanced to control gestational weight gain according to the prepregnancy body mass index to reduce the risk of EmCS due to failed VD.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 3","pages":"e41095"},"PeriodicalIF":1.3,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008284","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":"Surgical treatment of cerebellar pontine angle lipoma combined with trigeminal neuralgia: A case report.","authors":"Yu-Ting Yin, Chao Gui","doi":"10.1097/MD.0000000000041295","DOIUrl":"10.1097/MD.0000000000041295","url":null,"abstract":"<p><strong>Rationale: </strong>Cerebellar pontine angle lipomas with trigeminal neuralgia are rare. The treatment choice is influenced by whether the pain is caused by the lipoma or the compression of blood vessels. Herein, we aimed to report a case of the disease and provide a reference for its treatment.</p><p><strong>Patient concerns: </strong>The patient was a 54-year-old female who presented with a 20-year history of left-sided facial pain. Her pain had gradually worsened over time and oral medications became progressively less effective.</p><p><strong>Diagnoses: </strong>Brain magnetic resonance imaging detected a left cerebellar horn lesion, which was deemed a lipoma. Three-dimensional time-of-flight magnetic resonance angiography revealed a superior cerebellar artery adjacent to the trigeminal nerve root. Trigeminal nerve roots may have been compressed by lipomas and blood vessels.</p><p><strong>Interventions: </strong>The patient underwent a microvascular decompression of the trigeminal nerve. Part of the lipoma was removed, and the trigeminal nerve was isolated from the blood vessels and tumor.</p><p><strong>Outcomes: </strong>Postoperative pathology confirmed a lipoma. Neuralgia was completely relieved postoperatively, and no new neurological disorder was detected during the 6-month follow-up.</p><p><strong>Lessons: </strong>Surgery is recommended for patients with cerebellar pontine angle lipomas combined with trigeminal neuralgia when conservative treatment fails. Detailed preoperative imaging is crucial to identify lipomas and trigeminal root compression by the responsible artery. Complete decompression of the trigeminal nerve root is necessary for complete pain relief.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 3","pages":"e41295"},"PeriodicalIF":1.3,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008247","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":"Analyzing gene-based apoptotic biomarkers in insomnia using bioinformatics.","authors":"Wenwen Zhu, Xingchun Yang, Nanxi Li, Bin Zhang, Lishan Huang, Hanxing Cheng, Xiao Wu, Dechou Zhang, Sen Li, Houping Xu","doi":"10.1097/MD.0000000000040965","DOIUrl":"10.1097/MD.0000000000040965","url":null,"abstract":"<p><p>Insomnia is increasingly common and poses significant health risks. The aims of this study are to identify apoptosis-related genes and potential biomarkers for insomnia and to find new therapeutic targets. Insomnia gene expression profiles were downloaded from the Gene Expression Omnibus database, and differentially expressed genes in normal and insomnia samples were identified by limma rapid differential analysis, and then the major modular genes with clinical relevance to insomnia were analyzed using the Weighted Gene Co-Expression Network Analysis, and intersections were obtained with the differentially expressed genes as well as with apoptotic gene databases. We validated apoptosis-related differentially expressed genes, enriched and analyzed the specific biological process of insomnia and related signaling pathways. In addition, we constructed a protein-protein interaction network and obtained Top10 hub genes using Cytoscape. We selected 3 of them as hub genes and compared their expression in normal hippocampal neuronal cells and hippocampal neuronal cells of the model group exposed to corticosterone induction by Western Blot and qRT-PCR experiments. A total of 190 differentially expressed apoptosis-related genes were identified in insomnia, and BCL2, SOCS3, and IL7R were identified as important hub genes. Enrichment analysis showed that the occurrence of apoptosis in insomnia was mainly related to \"PI3K-Akt signaling pathway,\" \"JAK-STAT signaling pathway,\" \"P53 signaling pathway\" and so on. GO analysis showed that apoptosis in insomnia was mainly related to \"immune response,\" \"T cell differentiation in thymus,\" and \"positive regulation of MAPK cascade.\" Western Blot and qRT-PCR experiments showed that BCL2, SOCS3, IL7R antiapoptotic indexes were under-expressed in modeled hippocampal neuronal cells compared to normal hippocampal neuronal cells. This study emphasizes the role of apoptosis-related genes in insomnia and preliminarily predicts that the occurrence of insomnia is closely related to apoptosis. Compared to the normal group, the antiapoptotic ability of hippocampal neurons in the model group is reduced. Although BCL2 has been studied in the context of sleep deprivation, SOCS3 and IL7R have not yet been explored in insomnia. Insomnia and sleep deprivation involve similar pathways, but due to different mechanisms and types of insomnia, gene expression may vary.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 3","pages":"e40965"},"PeriodicalIF":1.3,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007888","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":"Prenatal phenotype of PNKP-related microcephaly, seizures, and developmental delay: A case report and literature review.","authors":"Jin-Long Xie, Chun-Yan Jiang, Ping-Ping Sun, Yan Zhang, Na Sun, Su-Xian Luan","doi":"10.1097/MD.0000000000041300","DOIUrl":"10.1097/MD.0000000000041300","url":null,"abstract":"<p><strong>Rationale: </strong>Microcephaly, epilepsy, and developmental delay (MCSZ) is a rare neurodevelopmental disorder associated with autosomal recessive inheritance of mutations in the polynucleotide kinase 3'-phosphatase (PNKP) gene. Prompt identification and management are essential, as delayed diagnosis or intervention may result in severe complications or mortality. In this case, prenatal screening in the second trimester detected fetal microcephaly with a gradual decline in head circumference, prompting the decision to terminate the pregnancy. Subsequent genetic analysis of the fetal tissue confirmed the presence of compound heterozygous mutations in the PNKP gene.</p><p><strong>Patient concerns: </strong>The patient, a 34-year-old remarried female with no history of consanguineous marriage, underwent 2 mid-trimester termination procedures due to fetal microcephaly and sought counseling for reproductive assistance.</p><p><strong>Diagnoses: </strong>The patient's carrier status for PNKP mutations was ascertained through whole-exome sequencing of the termination tissue and molecular genetic testing for monogenic disorders. The terminated fetus was diagnosed with MCSZ, a condition associated with compound heterozygous mutations in the PNKP gene.</p><p><strong>Interventions: </strong>Fetal microcephaly was identified via mid-trimester prenatal ultrasound, leading to the termination of the pregnancy during the same trimester. Subsequent genetic analysis of the immediate family revealed compound heterozygous mutations in the PNKP gene as the underlying cause of MCSZ. Genetic counseling was provided, followed by 1 cycle of preimplantation genetic testing for monogenic.</p><p><strong>Outcomes: </strong>The patient carried the heterozygous c.1188 + 1G > A PNKP mutation, whereas her husband carried the heterozygous c.976G > A PNKP mutation. The fetus was found to have compound heterozygous mutations c.976G > A and c.1188 + 1G > A. After counseling, the couple underwent 1 cycle of preimplantation genetic testing for monogenic, unfortunately, no pregnancy occurred after the 2 embryos were transferred.</p><p><strong>Lessons: </strong>MCSZ, a condition caused by PNKP mutations, is exceedingly rare. Women with a history of adverse pregnancy outcomes should undergo close monitoring during prenatal checkups. If fetal microcephaly is detected, it is essential to strictly follow obstetric guidelines for prenatal care, such as comprehensive cranial magnetic resonance imaging and genetic testing for confirmation. Avoidance of consanguineous marriages is advised. Early detection and timely intervention are key to preventing adverse pregnancy outcomes.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 3","pages":"e41300"},"PeriodicalIF":1.3,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008149","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":"Relationship between TyG-BMI index and glycemic index with diet quality, anthropometric indices, and blood pressure in patients with metabolic syndrome.","authors":"Paria Moulavi, Afsane Ahmadi, Seyed Jalil Masoumi, Morteza Zare, Mahdi Honardoust, Rahil Ranjbar","doi":"10.1097/MD.0000000000041276","DOIUrl":"10.1097/MD.0000000000041276","url":null,"abstract":"<p><p>A recently introduced metric for assessing metabolic syndrome (MetS) is the triglyceride glucose-body mass index (TyG-BMI). Additionally, the glycemic index (GI) is recognized as a significant measure for evaluating conditions associated with blood glucose. In this context, our research explores the correlation between TyG-BMI and GI in relation to diet quality, anthropometric measurements, and blood pressure among individuals diagnosed with MetS. A cross-sectional descriptive-analytical study was conducted on 431 employees with MetS at Shiraz University of Medical Sciences (SUMS). Anthropometric measurements of height, weight, waist circumference (WC), and hip circumference (HC) were taken according to Persian cohort protocols. BMI, C-index, visceral adiposity index (VAI), body adiposity index (BAI), body shape index (ABSI), abdominal volume index (AVI), potential renal acid load (PRAL), TyG-BMI and GI were calculated. A physician measured blood pressure, while the dietary inflammatory index was determined using guidelines. Biochemical parameters were analyzed using standard laboratory techniques. Data analysis was conducted using SPSS software version 21, with a significance threshold set at <.05. A significant correlation was identified between the TyG-BMI index and the PRAL index (β = 0.094, P-value = .026), WC (β = 0.627, P-value < .001), BAI (β = 0.396, P-value < .001), and blood pressure (β = 0.063, P-value = .002). Furthermore, the findings indicated a notable association between the GI and blood pressure (β = 0.610, P-value < .001). The results of this study suggest that managing the PRAL index, body weight, and blood pressure may be associated with an enhanced status of TyG-BMI. Additionally, appropriate GI may be linked to regulated blood pressure. These findings can inform health-related policy decisions for these patients.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 3","pages":"e41276"},"PeriodicalIF":1.3,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008155","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":"Different treatment for humeral shaft fractures: A network meta-analysis.","authors":"Jiankuo Guo, Hua Ma","doi":"10.1097/MD.0000000000040948","DOIUrl":"10.1097/MD.0000000000040948","url":null,"abstract":"<p><strong>Background: </strong>The main treatment methods for humeral shaft fractures include minimally invasive plate osteosynthesis (MIPO), intramedullary nailing (IMN), open reduction and internal fixation (ORF), and non-operative treatment (NonOP). However, the optimal treatment plan remains unclear. This article utilizes a network meta-analysis to compare the therapeutic effects of MIPO, IMN, ORF, and NonOP for the treatment of humeral shaft fractures.</p><p><strong>Methods: </strong>We searched electronic databases, including the PubMed, Embase, The Cochrane Library, and the Web of Science Databases, from inception to June 1, 2024. The \"Risk of Bias Assessment\" tool recommended by the Cochrane Collaboration was used to evaluate the quality of the included literature. RevMan 5.4 software and R software with gemtc package was used for the graphical representation and data analysis of the network meta-analysis.</p><p><strong>Results: </strong>A total of 23 randomized controlled trials were finally included. The results indicated that the efficacy of disabilities of the arm, shoulder and hand score was significantly higher in the MIPO group than in the open reduction and internal fixation (ORIF) group (weighted mean difference = 4.7, 95% confidence intervals, 1.8-7.75). IMN was associated with a decrease of the constant-Murley scores score than NonOP (weighted mean difference = -4.4, 95% confidence intervals, -8.7 to -0.068). IMN, MIPO, and ORIF was associated with a decrease of the fracture healing time than NonOP. The difference for nonunion rate and iatrogenic radial nerve injuries between any 2 groups was not statistically significant (P > .05).</p><p><strong>Conclusion: </strong>The evidence from current meta-analysis indicated that ORIF provides the best recovery effects for upper limb and shoulder joint function after the treatment of humeral shaft fractures, with the drawback of a relatively higher incidence of complications. To ensure the reliability of this study's results, more high-quality randomized controlled trials are needed in the future to verify these findings.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 3","pages":"e40948"},"PeriodicalIF":1.3,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008207","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":"Fertility problems in men carrying chromosome 7 inversion: A retrospective, observational study.","authors":"Zhiqiang Song, Qiuyu Wang, Jianchen Wu, Ranwei Li","doi":"10.1097/MD.0000000000041358","DOIUrl":"10.1097/MD.0000000000041358","url":null,"abstract":"<p><p>Infertility is a worldwide public health issue. Fifty percent of infertile couples are male-only. A number of male infertility etiologies are significantly influenced by chromosomal abnormalities. Clinical manifestations, however, differ according to the presence of aberrant chromosomes and distinct breakpoints. The reproductive effects of inversion are evident in those who carry it. The influence of inverted carriers on male infertility may be explained by the interchromosomal effect, although further research is still needed to determine the precise mechanism. Furthermore, selecting clinical reproductive technology presents difficulties for both physician and patients. The aim of this study is to determine the clinical characteristics of 4 males who have an inversion of chromosome 7, and to investigate the connection between the breakpoints of this chromosome and male infertility. For each patient, cytogenetic and semen analyses were carried out. Using PubMed or Online Mendelian Inheritance in Man, relevant research and genes on breakpoints on chromosome 7 were found. This study includes 4 male infertile patients, all of whom had chromosome 7 inversions. 46,XY,inv(7)(p22q22), 46,XY,inv(7)(p21q11.2), 46,XY,inv(7)(p21q21), and 46,XY,inv(7)(p15q36) were the results of the cytogenetic analysis. Three cases of aberrant semen parameters were detected by semen detection. After a literature search, 21 cases of chromosome 7 inversion carriers were found. These carrier couples have varying reproductive histories. Among the 5 cases where semen parameters are available, 1 is azoospermia and 1 is oligoasthenozoospermia. Five significant genes on chromosome 7 have been linked to male infertility. Changes in semen parameters may be connected to the breakpoints 7q11, 7q21, 7q22, and 7q36. Physicians should take into account the relevant breakpoints when offering genetic counseling to patients who have chromosome 7 inversion.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 3","pages":"e41358"},"PeriodicalIF":1.3,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008241","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 case series of ultrasound and pathological assessment of follicular thyroid tumors: Addressing indeterminate malignancy.","authors":"Xian Wang, Hui Zhou, Muhammad Asad Iqbal, Donggang Pan, Junbo Zuo, Nida Fatima Moazzam, Jin Zhang, Hui Sun","doi":"10.1097/MD.0000000000041196","DOIUrl":"10.1097/MD.0000000000041196","url":null,"abstract":"<p><strong>Rationale: </strong>Follicular tumors with uncertain malignant potential of the thyroid are a new classification of thyroid tumors in the World Health Organization (2017). Only a few cases of evaluating the value of ultrasound combined with pathological examination in diagnosing follicular tumors with uncertain malignant potential of the thyroid have been reported in recent decades.</p><p><strong>Patient concerns: </strong>A retrospective analysis was performed on 18 patients with follicular tumors with uncertain thyroid malignant potential who underwent preoperative ultrasonography and were confirmed by operation and pathology in our hospital from January 2019 to November 2024. Ultrasonic characteristics, histopathology, and immunohistology were recorded.</p><p><strong>Diagnoses: </strong>The patient was pathologically diagnosed as follicular tumor of uncertain malignant potential.</p><p><strong>Interventions: </strong>All the 18 patients underwent ultrasound, surgical treatment and immunohistochemical staining in our hospital.</p><p><strong>Outcomes: </strong>The patients underwent surgery. There was no complication or recurrence.</p><p><strong>Lessons: </strong>This case series indicates that the ultrasonographic manifestations of follicular tumors with uncertain thyroid malignant potential were regular and well-defined hypoechoic thyroid masses with an elastic grade of 2. The pathological characteristics were positive expression of P53, TG, CD56, Ki67, TTF-1, and Gal-3 mutations in most lesions.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 3","pages":"e41196"},"PeriodicalIF":1.3,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008282","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":"To analyze the risk factors associated with mortality within 1 year after surgery in elderly patients with hip fracture and to assess the value of the age-corrected Charlson comorbidity index in predicting this mortality risk.","authors":"Yu-Chen Xiao, Ayidan Ailihemaiti, Jiangannuer Zheyiken","doi":"10.1097/MD.0000000000041263","DOIUrl":"10.1097/MD.0000000000041263","url":null,"abstract":"<p><p>To investigate the determining risk factors for 1-year postoperative mortality in elderly patients with hip fracture and to assess the efficacy of the age-adjusted Charlson comorbidity index (ACCI) in predicting the risk of death. This study adopted a retrospective analysis method to focus on 652 elderly patients who underwent hip fracture surgery between January 2018 and November 2022 in our hospital. By systematically combing the patients' medical records, relevant data were collected and analyzed in depth for their association with morbidity and mortality rates within 1 year. In the 1-year follow-up for 652 elderly patients who underwent hip fracture surgery, the proportion of deaths due to disease amounted to 21.5% (140/652). Univariate analysis using the Cox proportional hazard model revealed that age, number of hospital days, ACCI, and the occurrence of postoperative pneumonia were significantly associated with the rate of morbidity and mortality within 1 year. Further multivariate Cox regression analysis confirmed that age (hazard ratio [HR], 1.087 [95% confidence interval [CI], 1.060-1.114]), ACCI (HR, 1.645 [95% CI, 1.548-1.747]), and postoperative pneumonia (HR, 2.353 [95% CI, 1.624-3.408]) served as independent risk factors that significantly influenced the patients' 1-year survival. The ACCI excelled in predicting the risk of 1-year postoperative mortality, with an AUC of 0.912 for its prediction model and a specificity and sensitivity of 0.834 and 0.871, respectively, when the threshold was set at 5.5. The results of this study emphasize that age, ACCI, and postoperative pneumonia are key risk factors affecting the survival of elderly patients with hip fracture at 1-year postoperatively. ACCI, as an effective predictive tool, can provide an important reference for the clinical assessment of patients' postoperative risk and help precision medical decision-making.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 3","pages":"e41263"},"PeriodicalIF":1.3,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008288","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}