Medicine最新文献

{"title":"Repetitive transcranial magnetic stimulation for the treatment of restless legs syndrome: A meta-analysis.","authors":"Zhenchao Dong, Xiaojun Zhang, Jiaqin Zhang, JinTao Yuan, Hanbo Li, Weigang Tang, Wei Jiang, Wei Xu","doi":"10.1097/MD.0000000000051088","DOIUrl":"10.1097/MD.0000000000051088","url":null,"abstract":"<p><strong>Background: </strong>The benefit of repetitive transcranial magnetic stimulation (rTMS) in patients with Restless Legs Syndrome (RLS) is uncertain. This study was performed to explore the therapeutic effect of rTMS in treating RLS.</p><p><strong>Methods: </strong>Databases including PubMed, EMbase, the Cochrane Library, China National Knowledge Infrastructure, and Wanfang database were searched from their inception to May 1, 2026. Eligible studies comparing rTMS with sham stimulation were included. Data were analyzed using Review Manager Version 5.3.</p><p><strong>Results: </strong>Four studies were included in the meta-analysis. The overall pooled analysis confirmed that rTMS could effectively reduce International RLS-Rating Scale (IRLS-RS) scores (mean difference [MD] = 6.46, 95% confidence interval [CI]: 4.44 -8.48, P < .00001) and Pittsburgh sleep quality index (PSQI) scores (MD = 4.80, 95% CI: 3.51-6.08, P < .00001) at different follow-up periods. Meanwhile, the overall pooled analysis confirmed that rTMS could effectively reduce IRLS-RS scores (MD = 7.79, 95% CI: 3.90-11.68, P < .0001) and PSQI scores (MD = 5.58, 95% CI: 3.81-7.35, P < .00001) in the subgroup analysis by RLS subtype. However, rTMS showed no significant effect on PSQI scores in primary RLS (MD = 1.86, 95% CI: -2.65-6.37, P = .42). In addition, the overall pooled analysis confirmed that both low-frequency and high-frequency rTMS could effectively reduce IRLS-RS scores (MD = 7.79, 95% CI: 3.90-11.68, P < .0001) and PSQI scores (MD = 5.58, 95% CI: 3.81-7.35, P < .00001). Finally, the overall pooled analysis confirmed that rTMS could not significantly reduce Hamilton anxiety scale and Hamilton depression scale scores in subgroup analyses of follow-up period, RLS subtype, or rTMS frequency (P > .05).</p><p><strong>Conclusion: </strong>rTMS might alleviate core limb discomfort symptoms measured by IRLS-RS and improve sleep quality assessed by PSQI in patients with RLS. However, rTMS might not be effective in improving symptoms of anxiety and depression. To further confirm the conclusion, more large randomized controlled trials are necessary.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"105 42","pages":"e51088"},"PeriodicalIF":2.0,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13681145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207252","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":"Retrospective observational study of transcatheter arterial chemoembolization (TACE) combined with PD-1 inhibitor and tyrosine kinase inhibitor (TKI) in advanced hepatocellular carcinoma.","authors":"Guohui Xu, Jianlong Zhang, Xiaojun Li, Shilan Fan, Xiao Wu, Cuncai Zhou","doi":"10.1097/MD.0000000000050965","DOIUrl":"10.1097/MD.0000000000050965","url":null,"abstract":"<p><p>Transcatheter arterial chemoembolization (TACE) induces tumor necrosis and antigen release, but the resulting hypoxic microenvironment upregulates programmed death-ligand 1and vascular endothelial growth factor, providing a biological rationale for adding a programmed death-1 (PD-1) inhibitor and a TKI. The study aims to assess the effectiveness and safety of a treatment regimen consisting of TACE, tyrosine kinase inhibitors, and PD-1 inhibitors in patients diagnosed with advanced hepatocellular carcinoma (HCC) that cannot be treated surgically. This retrospective observational study (Jiangxi Cancer Hospital, Jan 2021-Jun 2023) enrolled 52 advanced HCC patients, with 45 included in final analysis. Primary endpoints were progression-free survival (PFS) and overall survival (OS); secondary endpoints covered objective response rate, Disease Association for the Study of the Liver and safety. Survival was analyzed via Kaplan-Meier method and Cox proportional hazards regression. The cohort comprised 38 men and 7 women with a mean age of 50.9 ± 12.06 years, and 36 patients (80.0%) were hepatitis B virus antigen positive. At 6 months, the PFS rate stood at 71.1%, while at twelve months, it was recorded at 51.7%. The median PFS reached 12.4 months (95% confidence interval: 9.8-15.0), while the median OS was found to be 24.2 months (95% confidence interval: 20.1-28.3). The objective response rate was 44.4% and Disease Association for the Study of the Liver was 91.1%. Barcelona Clinic Liver Cancer (BCLC) staging significantly affected prognosis, with median PFS for BCLC A, B, C, and D being 19.2, 16.5, 12.1, and 4.8 months, respectively (log-rank P = .016). Median PFS for first-, second-, and third-line treatments were 17.1, 12.6, and 3.2 months, respectively (log-rank P < .001). Patients with positive node expression had significantly shorter PFS (5.1 vs 9.9 months, HR = 2.89, P = .005) and OS (14.9 vs 25.0 months, HR = 3.24, P = .002) compared to those with negative node expression. No grade 5 adverse events occurred. TACE combined with tyrosine kinase inhibitor and PD-1inhibitors shows promising efficacy and acceptable safety for advanced HCC. BCLC staging, treatment line and node status significantly affect outcomes, with earlier intervention yielding greater survival benefit. These exploratory findings from a small retrospective single-arm study require confirmation in larger prospective trials.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"105 42","pages":"e50965"},"PeriodicalIF":2.0,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13680917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207257","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":"Completed clinical trials of p53-targeted therapeutic strategies in cancer: A cross-sectional ClinicalTrials.gov registry analysis.","authors":"Nasser M Alorfi, Nouf M Alourfi","doi":"10.1097/MD.0000000000050949","DOIUrl":"10.1097/MD.0000000000050949","url":null,"abstract":"<p><p>The tumor suppressor gene TP53 is one of the most frequently altered genes in human cancers and plays a central role in regulating cell cycle arrest, apoptosis, and genomic stability. Therapeutic strategies targeting the p53 pathway have been investigated to restore or exploit p53 function in human malignancies. However, the characteristics, reporting completeness, and clinical development patterns of completed trials evaluating p53-targeted therapeutic strategies have not been comprehensively summarized. This study aims to characterize the design, therapeutic strategies, reporting completeness, and primary objectives of completed clinical trials investigating p53-targeted therapeutic strategies for cancer. A cross-sectional registry analysis of ClinicalTrials.gov was conducted using the search terms \"Cancer\" AND \"p53 gene therapy.\" Completed studies available as of 1 July 2025 were screened for eligibility. Trials investigating p53-targeted therapeutic strategies, including p53 gene therapy and other therapeutic approaches directly targeting the p53 pathway, were included. Data extracted included study design, cancer type, therapeutic strategy, clinical phase, enrollment, and primary outcome measures. Descriptive statistics were used to summarize study characteristics; no inferential statistical analyses were performed. Twenty-three completed studies met the eligibility criteria, including 20 (87.0%) interventional and 3 (13.0%) observational studies. The included studies evaluated diverse p53-targeted therapeutic strategies, including adenoviral vector-mediated p53 gene therapy, chemotherapy combinations, immunotherapeutic approaches, biomarker-guided treatment strategies, and molecularly targeted therapies. Early-phase clinical development predominated, with Phase I studies accounting for the largest proportion of completed trials. Enrollment information was available for 17 (73.9%) studies, whereas six (26.1%) did not report participant numbers. Primary outcome measures were reported for 15 (65.2%) studies, while eight (34.8%) lacked clearly defined primary outcomes. Five studies (21.7%) had publicly posted study results on ClinicalTrials.gov, whereas 18 (78.3%) had no posted results available. Reported primary endpoints predominantly focused on safety, dose escalation, treatment feasibility, and biomarker evaluation. Completed clinical trials investigating p53-targeted therapeutic strategies remain predominantly in the early stages of clinical development and have primarily focused on evaluating safety, feasibility, and preliminary biological activity rather than definitive treatment efficacy. Variability in registry reporting, including incomplete enrollment, primary outcome, and study result reporting, limits comprehensive assessment of the current evidence base.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"105 42","pages":"e50949"},"PeriodicalIF":2.0,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13680912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207208","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 frailty and multisite chronic pain in middle-aged and older adults: A population-based cross-sectional study with mediation analysis.","authors":"Yating Cheng, Yang Ji, Yuning Bai","doi":"10.1097/MD.0000000000051255","DOIUrl":"10.1097/MD.0000000000051255","url":null,"abstract":"<p><p>The corrected modified frailty index (CMFI), based on the accumulation of multidimensional health impairments, provides a more comprehensive reflection of an individual's overall frailty. Although chronic pain is associated with aging, its relationship with CMFI, in population-based cohorts remains unclear. This cross-sectional study included 5821 participants aged ≥45 years from the 2011 baseline wave of the China Health and Retirement Longitudinal Study. Chronic pain, including low back pain, multisite pain, and the number of pain sites, was assessed via self-reported questionnaires. Frailty was assessed using the CMFI. Weighted logistic regression models, restricted cubic splines, and mediation analyses were employed to investigate associations and the potential roles of depression and C-reactive protein. Analysing data from 5281 participants, higher CMFI was strongly associated with increased risk and burden of chronic pain. Compared with the lowest quartile, the highest CMFI quartile showed significantly higher risks of low back pain (odds ratio = 11.6, 95% confidence interval [CI]: 8.96-15.0), multisite pain (odds ratio = 17.0, 95% CI: 13.1-22.2), and a greater number of pain sites (incidence rate ratio = 11.5, 95% CI: 8.90-14.8). Associations varied across subgroups defined by age, education, and residence. Depression mediated approximately 30% of these associations. Higher CMFI levels were associated with greater risk and burden of chronic pain, with depression potentially accounting for part of the association. These findings highlight the importance of incorporating mental health assessments into frailty and pain management among the middle-aged and older adults included in China Health and Retirement Longitudinal Study.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"105 42","pages":"e51255"},"PeriodicalIF":2.0,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13681156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206848","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 baseline non-severe anemia with clinical outcomes following the first recorded diagnosis of systemic sclerosis: A matched cohort study.","authors":"Yi-Chen Lai, Hsiu-Lan Weng, Kuo-Chuan Hung, I-Chia Teng, Kuo-Mao Lan, I-Wen Chen","doi":"10.1097/MD.0000000000051159","DOIUrl":"10.1097/MD.0000000000051159","url":null,"abstract":"<p><p>Systemic sclerosis (SSc) carries the highest mortality among systemic autoimmune diseases, yet the prognostic significance of anemia around the time of the first recorded SSc diagnosis is unclear. We examined whether baseline anemia is associated with early mortality and complications. This retrospective matched cohort study identified female adults with a first recorded SSc diagnosis between January 2010 and December 2024 from the TriNetX Research Network. Patients were required to have at least 5 years of pre-index observation without a documented SSc diagnosis. The network comprised 140 healthcare organizations, with approximately 70% of patients in the United States across all 9 census regions and 30% at international sites. Anemia was defined as hemoglobin (Hb) ≥8.0 and <12.0 g/dL and non-anemia as ≥12.0 g/dL, measured within ±30 days of diagnosis. For the Hb-stratified analysis, the anemia cohort was categorized as Hb ≥10.0 to <12.0 g/dL or ≥8.0 to <10.0 g/dL. One-to-one propensity score matching balanced baseline characteristics, and Cox proportional hazards models estimated hazard ratios (HRs) with 95% confidence intervals (CIs). The primary outcome was all-cause mortality during days 31 to 365 among patients surviving the 30-day landmark period; secondary outcomes were sepsis, acute kidney injury, intensive care unit admission, pulmonary fibrosis, and elevated C-reactive protein (≥10 mg/L). After matching, 5410 patients remained in each cohort. Baseline anemia was significantly associated with higher 1-year mortality (HR, 2.54; 95% CI, 1.99-3.22; P < .001) and with increased risks of sepsis (HR, 3.20; 95% CI, 2.38-4.30), acute kidney injury (HR, 2.24; 95% CI, 1.80-2.78), intensive care unit admission (HR, 1.92; 95% CI, 1.47-2.51), and elevated C-reactive protein (HR, 1.55; 95% CI, 1.37-1.74; all P < .001); no significant association was observed for pulmonary fibrosis (HR, 1.06; 95% CI, 0.96-1.17; P = .229). Associations persisted in sensitivity analyses and over 3-year follow-up. Mortality risk showed a graded pattern across Hb strata (Hb ≥10.0-<12.0 g/dL: HR, 1.66; Hb ≥8.0-<10.0 g/dL: HR, 3.33). Baseline anemia was associated with increased mortality and acute systemic complications following the first recorded SSc diagnosis; these observational findings warrant prospective validation.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"105 42","pages":"e51159"},"PeriodicalIF":2.0,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13681093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206879","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":"Diagnosis of prostate cancer by multi-modal ultrasound imaging.","authors":"Jin Li, Kang He, Hao Zhang, Dejun Hu, Xin Wei, Le Luo","doi":"10.1097/MD.0000000000051135","DOIUrl":"10.1097/MD.0000000000051135","url":null,"abstract":"<p><p>To evaluate the diagnostic performance of multi-modal ultrasound imaging, combining transrectal ultrasound (TRUS), shear wave elastography (SWE), and contrast-enhanced ultrasound (CEUS), for differentiating benign and malignant prostate lesions, and to provide new evidence for the early diagnosis of prostate cancer. A total of 85 patients who prospectively underwent multi-modal ultrasound examination, ultrasound-guided prostate biopsy, and pathological and immunohistochemical marker detection at our hospital between September 2022 and June 2023 were included. All ultrasound examinations and biopsies were performed within a 2-week interval. The diagnostic performance of TRUS, SWE, CEUS, and multi-modal ultrasound imaging was compared, with 95% confidence intervals (CIs) calculated for all accuracy measures. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 89.80% (95% CI: 77.81 to 95.83), 86.11% (95% CI: 70.98-93.91), 88.24%, 89.80%, and 86.11% for TRUS; 85.71% (95% CI: 72.87-92.96), 72.22% (95% CI: 55.72-84.09), 80.00%, 80.77%, and 78.79% for SWE; 93.88% (95% CI: 83.13-97.97), 91.67% (95% CI: 77.46-97.20), 92.94%, 93.88%, and 91.67% for CEUS; and 97.96% (95% CI: 89.21-99.65), 94.44% (95% CI: 81.34-98.48), 96.47%, 96.00%, and 97.14% for multi-modal ultrasound imaging, respectively. The areas under the receiver operating characteristic curves (AUCs) were 0.880 (95% CI: 0.808-0.952), 0.790 (95% CI: 0.694-0.886), 0.928 (95% CI: 0.872-0.984), and 0.962 (95% CI: 0.924-1.000) for TRUS, SWE, CEUS, and multi-modal ultrasound imaging, respectively. The diagnostic performance of multi-modal ultrasound was significantly superior to that of TRUS and SWE (P < .05). Multi-modal ultrasound imaging demonstrates complementary diagnostic advantages, particularly for prostate tumors with atypical ultrasound features that are difficult to diagnose by a single modality. For these tumors, multi-modal ultrasound imaging improves diagnostic accuracy and provides a reliable basis for the differential diagnosis of prostate tumors, warranting further clinical application.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"105 42","pages":"e51135"},"PeriodicalIF":2.0,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13681124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206925","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":"Persistent hyperparathyroidism and its predictive factors in end-stage renal disease patients after kidney transplantation: A prospective study.","authors":"Kim-Ngan Huynh Lam, Hen Huu Phan, Sam Minh Thai, Minh Duc Do","doi":"10.1097/MD.0000000000051216","DOIUrl":"10.1097/MD.0000000000051216","url":null,"abstract":"<p><p>Hyperparathyroidism (HPT) may persist in patients after kidney transplantation (KT). A better understanding of which patients are likely to have persistent HPT after KT would help in the development of optimal management strategies. Our aim was to examine the prevalence of persistent HPT after KT in a contemporary cohort and to identify risk factors associated with persistent HPT at 6 months. We followed 104 KT subjects in a longitudinal prospective cohort at Cho Ray Hospital, Vietnam, from October 2023 to May 2025. Persistent HPT was defined as a parathyroid hormone (PTH) level of 150 pg/mL at 6 months after KT. Among the 104 patients, the prevalence of persistent HPT at 6 months was 58.65%. The average PTH levels pretransplant and at 6 months posttransplant were 375.70 (IQR = 259.00-603.25) pg/mL and 167.95 (IQR = 112.53-227.30) pg/mL, respectively. Patients with persistent HPT had significantly higher baseline PTH (median 489 vs 273, P < .001) and alkaline phosphatase levels (median 102.0 vs 89.5, P = .025), and also experienced longer durations of chronic kidney disease (median 5.0 vs 2.0, P = .007) and dialysis therapy (2.0 vs 1.0, P < .001). Higher pretransplant intact PTH was independently associated with persistent HPT across both multivariable models, whereas the association with dialysis duration was significant only when categorized as ≥1 year. Our findings suggest that high pretransplant intact PTH independently predicts persistent HPT at 6 months, whereas dialysis duration is only significant when it reaches 1 year or longer.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"105 42","pages":"e51216"},"PeriodicalIF":2.0,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13681121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207053","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":"Trends in HIV-related mortality by sex, race, age, and region in the United States, 1999-2023: A retrospective CDC WONDER database study.","authors":"Feng Jiang, Ming-Jie Jia, Ying-Lu Ma, Fei-Qing Liang, Weiwei Zeng","doi":"10.1097/MD.0000000000050986","DOIUrl":"10.1097/MD.0000000000050986","url":null,"abstract":"<p><p>Although antiretroviral therapy has improved human immunodeficiency virus (HIV) prognosis, mortality and demographic disparities remain critical public health issues in the United States (US). This study analyzed long-term trends in HIV-related mortality from 1999 to 2023 using Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research data. This retrospective database study analyzed death certificate data for HIV-related deaths in the US from 1999 to 2023. Crude and age-adjusted mortality rates were calculated. Joinpoint regression was used to assess trends using annual percent change (APC) and average APC (AAPC), stratified by sex, race/ethnicity, age group, census region, and urbanization level. A total of 221,831 HIV-related deaths occurred from 1999 to 2023. Annual deaths declined from 14,499 in 1999 to 4719 in 2023, representing a 67.45% reduction. The age-adjusted mortality rate decreased from 8.05 to 1.92 per 100,000 population, with an AAPC of -5.73. The decline was fastest from 2007 to 2011 (APC = -10.99) but slowed from 2019 to 2023 (APC = -2.79). Mortality rates remained higher among men, non-Hispanic Black individuals, and residents of the Southern US. Although mortality declined in both metropolitan and nonmetropolitan areas, the decline was slower in nonmetropolitan areas than in metropolitan areas (AAPC = -3.92 vs -6.54). Mortality increased among older age groups, particularly those aged 75 to 84 years. HIV-related mortality in the US decreased substantially from 1999 to 2023, but the pace of decline slowed in recent years. Persistent racial, geographic, urban-rural, and age-related disparities highlight the need for targeted interventions, improved access to HIV care, and strategies addressing the growing burden among older adults.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"105 42","pages":"e50986"},"PeriodicalIF":2.0,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13680913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207056","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":"Efficacy of auricular bloodletting therapy for acute urticaria: A propensity score-matched retrospective cohort study.","authors":"Lan Xu, Xiujuan Xu, Yuejun Han, Ruyi Ju, Yueping Wang, Xuan Wu, Jiahui Zhou, Yi Cao","doi":"10.1097/MD.0000000000051145","DOIUrl":"10.1097/MD.0000000000051145","url":null,"abstract":"<p><p>Acute urticaria is a common condition that can affect individuals across all age groups. Current pharmacological treatments primarily rely on antihistamines and corticosteroids. However, these therapies may be limited by suboptimal efficacy, dose- and time-dependence, and potential adverse effects. Therefore, the incorporation of effective adjunctive therapies is of considerable clinical value. This study aimed to evaluate the impact of auricular bloodletting (BL) therapy on the length of hospital stay in patients with acute urticaria. Poisson regression was used to compare differences in hospitalization duration between groups. Propensity score matching (PSM) was applied to minimize selection bias. Subgroup analyses by sex and age, as well as robustness checks using bootstrap resampling and Rosenbaum sensitivity analysis, were also performed. Before PSM, Poisson regression indicated that the bloodletting group had significantly shorter hospital stays. The effect was significant in the male, female, and adult subgroups. After PSM, the incidence rate ratios remained below 1 in all models, and statistical significance was observed. No significant differences were observed in the female or adult subgroups post-matching, whereas statistical significance was retained in the male subgroup. No adverse events were reported. Bootstrap and Rosenbaum sensitivity analyses confirmed the robustness of the findings. Patients who received auricular BL experienced shorter hospital stays. Post-matching results showed that statistical significance was retained in the male subgroup. Given the limited sample size in the intervention group, further prospective studies with larger cohorts are warranted to validate these findings and elucidate the underlying mechanisms.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"105 42","pages":"e51145"},"PeriodicalIF":2.0,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13681108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207059","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":"PLCG1 regulates pyroptosis to inhibit the progression of non-small cell lung cancer: A Mendelian randomization study.","authors":"Yihui Zhang, Guihui Wang, Ziwen Qin, Ziyan Mo, Jixian Liu","doi":"10.1097/MD.0000000000050908","DOIUrl":"10.1097/MD.0000000000050908","url":null,"abstract":"<p><p>Pyroptosis, an inflammatory form of programmed cell death, has been implicated in non-small cell lung cancer (NSCLC) progression. However, the specific pyroptosis-related genes causally linked to NSCLC and their upstream regulatory mechanisms remain poorly understood. We performed a two-sample Mendelian randomization (MR) study to assess causal relationships between 33 pyroptosis-related genes and NSCLC risk using genetic instruments from the deCODE database and outcome data from the FinnGen consortium (6446 NSCLC cases, 378,749 controls). Inverse-variance weighting was the primary analysis method, with MR-Egger, weighted median, and MR-PRESSO as sensitivity analyses. To identify upstream regulators, we integrated pQTL data from the The UK Biobank Pharma Proteomics Project and performed two-step MR mediation analysis. Identified genes were further validated using mRNA expression data from The Cancer Genome Atlas (TCGA) and genotype-tissue expression (GTEx) databases. MR analysis identified 2 pyroptosis-related genes significantly associated with NSCLC: IL1B (odds ratio [OR] = 1.087, 95% confidence interval [CI] = 1.009-1.171, P = .028) and PLCG1 (OR = 0.874, 95% CI = 0.766-0.997, P = .044). Upstream analysis revealed that AMBP and CCNE1 were causally associated with PLCG1 expression. Mediation analysis demonstrated that PLCG1 mediated 11.7% of the total effect of AMBP on NSCLC risk (mediation effect: OR = 1.02, 95% CI = 1.01-1.03, P = .008). mRNA expression validation confirmed that AMBP and PLCG1 were significantly upregulated in NSCLC tissues compared to normal tissues (P < .001). This study establishes causal links between pyroptosis-related genes and NSCLC, identifying IL1B as a risk factor and PLCG1 as a protective factor. We further demonstrate that AMBP may promote NSCLC progression partly through upregulating PLCG1 expression, with PLCG1 mediating 11.7% of this effect. These findings provide novel insights into pyroptosis regulation in NSCLC and highlight potential therapeutic targets.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"105 42","pages":"e50908"},"PeriodicalIF":2.0,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13680930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207095","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}