Medicine最新文献

{"title":"Association between estimated pulse wave velocity and gynecological cancer risk and mortality: Insights from NHANES 2003 to 2016.","authors":"Chunlin Liu, Li Hua, Xilin Wu, Shaojun Chen","doi":"10.1097/MD.0000000000044973","DOIUrl":"10.1097/MD.0000000000044973","url":null,"abstract":"<p><p>Arterial stiffness is measured by pulse wave velocity (PWV), which has a well-established correlation with a number of health consequences. Nevertheless, it is still unknown how estimated pulse wave velocity (ePWV) and the risk and mortality of gynecological cancer (GC) are related. This study examined the association between ePWV and GC risk and mortality using data from the National Health and Nutrition Examination Survey (NHANES) conducted between 2003 and 2016. We initially performed a cross-sectional study in which we separated participants into 3 groups based on their ePWV tertiles in order to assess the relationship between ePWV and GC risk. A survival analysis was conducted to examine the relationship between ePWV and mortality risk in patients with GC. Multivariable logistic regression, Cox proportional hazards models and restricted cubic splines (RCS) were performed for analysis. A total of 19,590 participants were included in the study, with 464 diagnosed with GC (238 cervical cancer, 88 ovarian cancer, and 157 uterine cancer). Compared to the lowest ePWV group, the highest ePWV group had a 70% increased risk of GC (odds ratio (OR): 1.70, 95% confidence interval (CI): 1.10-2.62). RCS analysis revealed a nonlinear positive association between ePWV and GC risk (P for nonlinear = .044). The predictive value of ePWV for GC risk was 59.1% (area under the curve (AUC): 0.591, 95% CI: 0.567-0.616). Among GC patients, the highest ePWV group had a 6.45-fold increased risk of death compared to the lowest ePWV group (hazard ratio (HR): 6.45, 95% CI: 1.32-31.53). RCS analysis further showed a linear positive association between ePWV and mortality in GC patients (P for nonlinear = .131). The predictive value of ePWV for mortality risk in GC patients was 80.6% (AUC: 0.806, 95% CI: 0.756-0.855). Higher levels of ePWV are associated with an increased risk of GC and higher mortality in GC patients, although ePWV exhibits relatively poor discriminatory ability for GC risk. ePWV may serve as a useful predictor of both cancer risk and prognosis, highlighting its potential as a clinical marker for identifying at-risk individuals and improving patient management.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 40","pages":"e44973"},"PeriodicalIF":1.4,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12499780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239098","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":"Analysis of the effect of combined vaginal and abdominal ultrasound in the diagnosis of ectopic pregnancy.","authors":"Na Li, Fang Wang, Yong Liu, Deng Guanghua","doi":"10.1097/MD.0000000000044200","DOIUrl":"10.1097/MD.0000000000044200","url":null,"abstract":"<p><p>This study investigates the role of vaginal ultrasound and abdominal ultrasound in the diagnosis of ectopic pregnancy. A total of 240 patients with suspected ectopic pregnancy admitted to Longquanyi District People's Hospital from January 2020 to December 2024 were enrolled, and all patients underwent vaginal ultrasound and abdominal ultrasound. The diagnostic effect, the detection rate of sonographic features, and the detection rate of different disease types were compared with the surgical pathological results (gestational villous tissue in the blood clot and visible villous matter) as the gold standard. In this study, 240 patients with suspected ectopic pregnancy were analyzed, and the results showed that the sensitivity, specificity, and accuracy of abdominal ultrasound, vaginal ultrasound, and combined examination were 89.04%, 93.15%, and 95.89%, respectively, and 42.86%, 57.14%, and 71.43%, respectively, and 85.00%, 90.00%, and 93.75%, respectively. There was no significant difference between the groups (P > .05). The detection rate of combined examination in embryo, yolk sac, original heart tube beat, pelvic effusion, adnexal mass, intrauterine pseudogestational sac, and extrauterine gestational sac was significantly higher than that of abdominal ultrasound or vaginal ultrasound alone (P < .05). There was no significant difference in the detection rate of fallopian tube pregnancy, ovarian pregnancy, abdominal pregnancy, and cervical pregnancy among the 3 examination methods (P > .05). The combined examination of vaginal ultrasound and abdominal ultrasound has high diagnostic efficacy in the diagnosis of ectopic pregnancy, which can effectively reduce missed diagnosis and misdiagnosis, clearly display relevant sonographic features, and help to determine the location of ectopic pregnancy.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 40","pages":"e44200"},"PeriodicalIF":1.4,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12499843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239100","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":"TMEM258 modulates immune infiltration networks underlying co-susceptibility to Crohn disease and acute pancreatitis.","authors":"Guijun Lu, Shengyi Zhou, Jiaxin Shen, Xintong Chi, Yuping Wang, Xinyi Zhang, Xujin Wei, Wenming Liu","doi":"10.1097/MD.0000000000044807","DOIUrl":"10.1097/MD.0000000000044807","url":null,"abstract":"<p><p>Crohn disease (CD) is an immune-mediated chronic inflammatory disease of the gastrointestinal tract. In addition to common intestinal symptoms such as abdominal pain and diarrhea, it may be combined with extraintestinal manifestations in the joints, skin, and biliopancreatic tract. Previous studies have reported a causal association between inflammatory bowel disease and acute pancreatitis (AP), but the underlying pathogenesis remains unclear. It is clinically important to investigate the genetic co-morbidity between CD and AP for the diagnosis and management of extraintestinal manifestations. Bibliometric analysis was utilized to explore the CD-AP relationship. A two-sample Mendelian Randomization (MR) approach assessed the causality. Clinical data from 23 patients with a documented history of CD at 3 major gastroenterology centers were examined. Expression quantitative trait loci data including 5421 cis-expression quantitative trait loci genes from blood samples of 31,684 individuals across 37 cohorts identified variant-associated genes. Transmembrane protein 258 (TMEM258) was further investigated through bulk and single-cell RNA sequencing. Its expression was quantified via RT-PCR in intestinal samples from a dextran sulfate sodium-induced acute colitis mouse model. Immune cell infiltration analysis was performed to evaluate the immune correlations. Mediators between CD and AP were identified from 731 candidate immune cells by two-step MR and mediation analysis. Persistent literature reports have noted associations between inflammatory bowel disease and AP. Our two-sample MR analysis revealed a potential causal relationship between CD and AP (odds ratio = 1.043; 95% CI: 1.011-1.075; P = .008). In 23 patients with CD and AP co-morbidity, late-onset AP predominantly occurs in CD patients with the L1B2 phenotype compared to early-onset AP. DHX58, KLRG1, MARK3, and TMEM258 were causal biomarkers in both conditions. TMEM258 mediates the immune response in this comorbidity and is highly expressed in mesenchymal cells within the inflamed intestinal tissues of CD patients. TMEM258 expression positively correlated to M1 macrophages and plasma cells, and negatively correlated to neutrophils and naïve CD8+ T cells. CD28+ double negative T cells and naïve CD8+ T cells mediate the predictive effect of CD on the onset of AP. Through MR and multi-omics analyses, our study demonstrates that TMEM258 is a shared susceptibility gene for CD and AP, increasing the risk of AP in CD by reducing T cell infiltration.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 40","pages":"e44807"},"PeriodicalIF":1.4,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12499840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239201","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":"Background parenchymal enhancement in MR and breast mammographic density in full-field digital mammography: Correlations with breast cancer risk.","authors":"Yuanyuan Ye, Wanhua Liu, Bo Xie, Qi Zhang, Chengyu Peng, Zhi Qin","doi":"10.1097/MD.0000000000044843","DOIUrl":"10.1097/MD.0000000000044843","url":null,"abstract":"<p><p>We attempt to reveal the correlations between breast cancer (BC) risk with mammographic density (MD) in full-field digital mammography (FFDM) and background parenchymal enhancement (BPE) in dynamic enhanced magnetic resonance imaging (MRI). 216 women who received MRI and FFDM from January 2019 to December 2020 were reviewed, among which 72 BC cases were identified histopathologically. The control was matched with the BC case in 2:1. MD in FFDM were categorized as ACR a, ACR b, ACR c, or ACR d. BPE in MR was categorized into 4 grades, minimal, mild, moderate, or marked. Logistic regression analysis was utilized to investigate the associations between BC risk with BPE and MD, resulting in the odds ratios (ORs). The review was performed with a cohort of 216 women, including 72 BC cases and 144 normal controls. Among BC cases, 64 patients were graded as ACR c or ACR d (88.9%), and 40 patients were graded as moderate or marked BPE (55.6%). The ORs for ACR c or d cases versus ACR a or b were 4.7 and 5.8 for different readers, respectively (P = .002). The ORs for cases exhibiting marked or moderate BPE compared to mild or minimal BPE were 5.0 and 3.3 (P < .001). MD and BPE categories were identified as potential risk factors for BC. Increased levels of BPE or MD are strongly predictive of BC.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 40","pages":"e44843"},"PeriodicalIF":1.4,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12499845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238939","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 impact of physical activity variability with the risk of hypertension: Insights from a national longitudinal study.","authors":"Shan Chen, Chunmei Liu, Juan Huang, Huaying Deng, Jie Cao, Meng Jia, Qinke Li","doi":"10.1097/MD.0000000000044289","DOIUrl":"10.1097/MD.0000000000044289","url":null,"abstract":"<p><p>This study evaluates the relationship between physical activity (PA) variability (PAVar) and the risk of hypertension in middle-aged and older adults. This longitudinal cohort study utilized data from the China Health and Retirement Longitudinal Study, spanning from 2011 to 2020. A total of 4870 participants with complete PA data were categorized into quartiles based on the coefficient of variation for PAVar. Hypertension incidence was assessed through self-reported physician diagnosis, blood pressure measurements, and antihypertensive medication use. Cox proportional hazards models, adjusted for demographic, socioeconomic, and lifestyle factors, were employed to estimate hazard ratios. Mediation analysis examined the potential role of sleep duration in the PAVar-hypertension relationship, and sensitivity analyses excluded participants with missing baseline data to ensure robustness. Higher PAVar was associated with increased hypertension risk. In fully adjusted models, participants in the highest coefficient of variation quartile had a 75% higher risk of hypertension (HR: 1.75, 95% CI: 1.57-1.95) compared to the lowest quartile. Sleep duration mediated 26.3% of the total effect of PAVar on hypertension risk. Sensitivity analyses confirmed the stability of these findings. This study identifies a significant association between high PAVar and elevated hypertension risk, emphasizing the importance of consistent PA and adequate sleep for hypertension prevention. These findings provide evidence to support tailored public health strategies for hypertension management in aging populations.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 40","pages":"e44289"},"PeriodicalIF":1.4,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12499712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238956","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 of neutrophil percentage-to-albumin ratio and sarcopenia: Data from NHANES 2011-2018.","authors":"Qi Cheng, Yuan Liu, Weiming Cai, Pengfei Zhu, Yan Guo, Han Wang, Lijie Shi","doi":"10.1097/MD.0000000000045056","DOIUrl":"10.1097/MD.0000000000045056","url":null,"abstract":"<p><p>The precise correlation between the neutrophil percentage-to-albumin ratio (NPAR) and the incidence of sarcopenia has not yet been definitively established. This investigation seeks to ascertain if an elevated NPAR correlates with an increased risk of developing sarcopenia. This analysis encompassed 6943 individuals derived from the National Health and Nutrition Examination Survey (2011-2018), whose mean age was 38.99 ± 11.50 years. Of these, 3480 (50.12%) were male, and 3463 (49.88%) were female. The NPAR was expressed as the ratio of neutrophil percentage-to-albumin levels. The sarcopenia index is defined as the appendicular skeletal muscle mass divided by body mass index. A sarcopenia index of <0.512 for females and <0.789 for males indicates sarcopenia. Weighted multivariable logistic regression, subgroup analyses, and interaction terms were employed to assess the independent association between NPAR and sarcopenia. In the model with full adjustments, a significant association between NPAR and sarcopenia was noted (odds ratio = 1.110 [1.047-1.177], P = .005). The tests for interaction indicated that variables encompassing age, gender, hypertension, smoking habits, and alcohol intake did not substantially influence the link between NPAR and sarcopenia. However, a more pronounced positive association between NPAR and sarcopenia was detected among participants who did not have diabetes (odds ratio = 1.13 [1.09-1.18], P for interaction = .001). Elevated NPAR is significantly associated with sarcopenia risk and serves as a key predictive biomarker, offering new insights for early detection, intervention, and targeted treatment to improve patient outcomes.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 40","pages":"e45056"},"PeriodicalIF":1.4,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12499670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238988","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 diagnostic value of artificial intelligence in differentiating follicular thyroid cancer from follicular thyroid adenoma: A meta-analysis.","authors":"Di Wu, Chengfei Sun, Yilin Hou, Jiayue Sun, Xiyu Zhang, Yunfei Zhang","doi":"10.1097/MD.0000000000044745","DOIUrl":"10.1097/MD.0000000000044745","url":null,"abstract":"<p><strong>Background: </strong>Follicular thyroid carcinoma (FTC) is the second most common thyroid malignancy but is challenging to preoperatively distinguish from follicular adenoma. Artificial intelligence (AI) has emerged as an auxiliary diagnostic tool, yet published studies show variable performance. This meta-analysis aims to evaluate the overall diagnostic accuracy of AI in differentiating FTC from benign lesions.</p><p><strong>Methods: </strong>Literature searches were independently conducted across the PubMed, Embase & Medline (via Embase.com), Web of Science, Cochrane Library, and Ovid English medical databases. The diagnostic accuracy of AI was compared against the reference standard of histopathology. Pooled sensitivity, specificity, diagnostic odds ratio and area under the curve were calculated to assess AI accuracy. Meta-regression analyses were performed to investigate heterogeneity related to test set size, validation strategy, and machine learning model type.</p><p><strong>Results: </strong>We analyzed a total of 7 studies involving 3163 follicular thyroid neoplasms (comprising 1876 follicular thyroid adenomas [FTAs] and 1287 FTCs). The pooled sensitivity and specificity of AI for differentiating FTC from FTA were 0.73 (95% CI: 0.70-0.75) and 0.87 (95% CI: 0.86-0.89), respectively. The pooled positive and negative likelihood ratios were 6.19 (95% CI: 3.92-9.79) and 0.28 (95% CI: 0.17-0.46). The diagnostic odds ratio was 22.81 (95% CI: 10.17-51.16), and the area under the curve was 0.94. Meta-regression results indicated no significant heterogeneity associated with validation strategy (P = .25). However, test set size (P = .02) and publication year (P = .04) were identified as potential significant sources of heterogeneity. Subgroup analyses revealed that studies with a test set size > 1000 cases demonstrated superior accuracy compared to those with <1000 cases. Regarding validation strategy, studies utilizing cross-validation yielded better performance than those using holdout validation.</p><p><strong>Conclusion: </strong>Overall, AI demonstrates promising diagnostic utility in differentiating FTC and FTA. Studies employing larger test sets (>1000 cases) achieved higher accuracy than those with smaller test sets (<1000 cases). Furthermore, validation using cross-validation strategies outperformed non-cross-validation (holdout) approaches.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 40","pages":"e44745"},"PeriodicalIF":1.4,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12499825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238991","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 different types of lung cancer and neurodegenerative diseases: A two-sample Mendelian randomization study.","authors":"Wentao Zheng, Ying Wang, Enjiang Zhu, Rui Xu, Ling Zhu","doi":"10.1097/MD.0000000000045048","DOIUrl":"10.1097/MD.0000000000045048","url":null,"abstract":"<p><p>Previous observational studies demonstrated that lung cancer and both Alzheimer disease (AD) and Parkinson disease (PD) may be related. However, the results of different studies are still controversial, possibly due to differences in the types of lung cancer examined. To date, no research has discussed it further yet. In this study, Mendelian randomization (MR) analysis was employed to investigate the relationship between different types of lung cancer and neurodegenerative diseases. We extracted data sets related to the exposure (lung cancer) and outcomes (AD/PD) from the Integrative Epidemiology Unit open Genome-Wide Association Study project. Then, we carried out two-sample MR analyses to explore the connection between lung cancer and both AD and PD. We also conducted sensitivity analyses on positive results from the MR analysis to make sure the results were accurate. Our two-sample MR analyses revealed that lung squamous cell carcinoma (LUSC) is negatively related to AD (OR = 0.935, 95% CI [0.892-0.980], P = .005). According to the sensitivity and heterogeneity analyses, no heterogeneity (P = .223) and pleiotropy (P = .548) were observed in this positive result. Thus, the findings were reliable. The IVW findings suggested that LUSC and PD did not significantly correlate (OR = 0.920, 95% CI [0.778-1.089], P = .332). Similarly, there was no obvious connection between lung adenocarcinoma and AD (OR = 0.968, 95% CI [0.915-1.025], P = .270) and PD (OR = 0.981, 95% CI [0.851-1.130], P = .787), according to IVW results. Results of two-sample MR analyses revealed that LUSC and a decreased risk of AD may be related.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 40","pages":"e45048"},"PeriodicalIF":1.4,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12499675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239024","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":"Amyloid cardiomyopathy presenting with gastrointestinal symptoms of abdominal pain, back pain, and constipation: A case report.","authors":"Yike Zhang, Tingting Zhang, Manli Zhao, Peichun Li, Jiangbo Xie","doi":"10.1097/MD.0000000000045049","DOIUrl":"10.1097/MD.0000000000045049","url":null,"abstract":"<p><strong>Rationale: </strong>Amyloid cardiomyopathy (AC) is a rare and fatal condition, often with a delayed diagnosis due to its nonspecific initial presentations. This case underscores the diagnostic challenge and critical importance of early recognition when patients present with seemingly unrelated gastrointestinal symptoms.</p><p><strong>Patient concerns: </strong>A 48-year-old woman initially presented with abdominal pain, back pain, and constipation, which were managed as gastrointestinal disorders. Her condition progressed rapidly to include severe cardiac symptoms, including chest tightness and dyspnea.</p><p><strong>Diagnoses: </strong>Cardiac magnetic resonance imaging revealed findings indicative of AC, including left ventricular hypertrophy, diffuse delayed enhancement, and atrial enlargement. The diagnosis of immunoglobulin light chain amyloidosis was confirmed by endomyocardial biopsy, which was positive for κ light chains.</p><p><strong>Interventions: </strong>Supportive care for heart failure, including diuretics and beta-blockers, was initiated. However, specific therapies targeting the underlying immunoglobulin light chain amyloidosis could not be administered due to the patient's rapid clinical deterioration.</p><p><strong>Outcomes: </strong>The patient died 2 days after the pathological diagnosis was established, highlighting the aggressively progressive nature of the disease.</p><p><strong>Lessons: </strong>This case highlights that AC can manifest with prominent gastrointestinal symptoms before overt cardiac involvement. It is crucial to consider systemic amyloidosis in the differential diagnosis for patients with multisystem involvement, as early, multidisciplinary evaluation is essential for potentially improving outcomes in this fatal condition.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 40","pages":"e45049"},"PeriodicalIF":1.4,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12499654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239047","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":"Posterior versus anterior approach for contralateral C7 nerve transfer in post-stroke upper limb spastic hemiplegia: A comparative retrospective study.","authors":"Shuide Chen, Siyuan Pan, Seidu A Richard, Zhigang Lan","doi":"10.1097/MD.0000000000045086","DOIUrl":"10.1097/MD.0000000000045086","url":null,"abstract":"<p><p>Several surgical approaches for contralateral C7 (CC7) nerve root transfer (NRT) exist, but they come with challenges such as long nerve bridging distances, complex surgical anatomy, and prolonged recovery times. Our objective was to evaluate and compare the clinical efficacy and safety of the posterior single-incision CC7 (PSCC7) NRT approach (posterior group) with the traditional anterior CC7 (ACC7) NRT approach (anterior group) for treating post-stroke upper limb spastic hemiplegia (PULSH). In this retrospective study, we retrieved and compared clinical efficacy as well as safety of the posterior group with the traditional anterior group for treating PULSH between February 2024 and February 2025. Key outcome measures included operative time, intraoperative blood loss, postoperative complications, and functional recovery at 6-month follow-up. In all, 12 patients who underwent the posterior group and 30 patients (control group) who underwent the traditional anterior group were retrieved from the hospital records. The posterior group demonstrated significantly shorter operative times (3.2 ± 0.5 hours vs 4.5 ± 0.8 hours, P < .01) and less intraoperative blood loss (150 ± 4 0 mL vs 280 ± 70 mL, P < .01) compared to the anterior group. The posterior group achieved comparable or superior improvements in Modified Ashworth Scale scores (1.2 ± 0.3 vs 1.5 ± 0.4, P > .05) and Berg Balance Scale scores (42 ± 5 vs 39 ± 6, P > .05). The posterior group is a safe and effective treatment for PULSH. It offers the advantages of reduced surgical trauma and shorter operative time.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 40","pages":"e45086"},"PeriodicalIF":1.4,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12499671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239050","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}