Medicine最新文献

{"title":"Folate intake and the risk of endometrial cancer: A dose-response meta-analysis.","authors":"Jiaye Long, Du Wang, Miyang Yang, Yingrong Pang, Meiqiong Li, Shuxin Qin, Kai Cui","doi":"10.1097/MD.0000000000039775","DOIUrl":"10.1097/MD.0000000000039775","url":null,"abstract":"<p><strong>Background: </strong>The relationship between folate intake and risk of endometrial cancer (EC) is debatable. The goal of this study was to examine the relationship between folate consumption and EC and then conduct a dose-response analysis in accordance with this.</p><p><strong>Methods: </strong>Up until February 1, 2024, we conducted a thorough search using PubMed, EMBASE, the Cochrane Library, and Web of Science. Stata 14 software was used to analyze the findings of the article. The study protocol was registered in PROSPERO (CRD42024505943), and the meta-analysis was conducted in accordance with PRISMA guidelines.</p><p><strong>Results: </strong>Nine case-control studies and 6 cohort studies were included, comprising 379,570 participants and 8660 EC cases. The highest level of folate consumption was associated with a 10% reduction in the occurrence of EC (relative risk [RR] = 0.90, 95% confidence intervals [CIs]: 0.78-1.05, I2 = 63.2%) compared to the lowest level of intake. The association exhibited a statistically significant linear trend (P = .231), with a combined RR of 0.974 (95% CI: 0.968-0.981) for each daily intake of 50 µg folate.</p><p><strong>Conclusion: </strong>Folate intake may reduce the risk of EC.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142291149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of nephropathy among diabetic patients in North American region: A systematic review and meta-analysis.","authors":"Sabahat Zahra, Muhammad Khurram Saleem, Khawaja Faizan Ejaz, Amna Akbar, Sarosh Khan Jadoon, Shoukat Hussain, Amir Iqbal Ali, Mehzabeen Ifty, Sadia Zafur Jannati, Fariza Armin, Deepannita Sarker, Dewan Zubaer Islam, Shahad Saif Khandker, Mohammad Saleem Khan, Sarosh Alvi","doi":"10.1097/MD.0000000000039759","DOIUrl":"10.1097/MD.0000000000039759","url":null,"abstract":"<p><strong>Background: </strong>Nephropathy is one of the most common microvascular impediments of diabetes mellitus. In this study, we aimed to estimate the prevalence of nephropathy in diabetic patients across the North American region.</p><p><strong>Methods: </strong>Eligible studies were screened out from 3 electronic databases, for example, PubMed, Google Scholar, and ScienceDirect using specific search keywords based on the eligibility criteria. Extracting the data from the included studies publication bias, quality assessment, outlier investigation, and meta-analysis was done followed by the subgroup analysis. A total of 11 studies met the study inclusion criteria. Meta-analysis was performed with the extracted data.</p><p><strong>Results: </strong>Pooled prevalence of 28.2% (95% confidence interval [CI]: 19.7-36.7) with a high rate of heterogeneity (I2 = 100%) was identified. The pooled prevalence of nephropathy among diabetic patients in the United States of America, Canada, and Mexico was 24.2% (95% CI: 13.8-34.5), 31.2% (95% CI: 25.8-36.5), and 31.1% (95% CI: 20.8-41.5), respectively.</p><p><strong>Conclusion: </strong>The prevalence of nephropathy among diabetic patients was found lower in the United States of America as compared to Canada and Mexico. Besides, the pooled prevalence of the North American region was found to be lower as compared to the African, European, and Asian regions. Minimizing the pathogenic factors, sufficient diagnostic, healthcare facilities, and awareness are recommended to improve the situation.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142291156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and effectiveness of dual channels vancomycin administration in the treatment of intracranial infection after severe brain injury surgery.","authors":"Ao Jiao, Wanjiang Hao, He Yang, Yanli Du","doi":"10.1097/MD.0000000000039410","DOIUrl":"10.1097/MD.0000000000039410","url":null,"abstract":"<p><p>To observe the clinical efficacy and safety of vancomycin intravenous drip combined with vancomycin intrathecal injection in the treatment of intracranial infection after severe brain injury surgery. From January 2020 to June 2022, 80 patients with intracranial infection after severe brain injury surgery were selected and randomly divided into 2 subgroups; there were 40 patients in each subgroup. All patients were treated with vancomycin. The control subgroup was medicated with intravenous drip, and the observation subgroup was treated through 2 channels (intravenous drip + intrathecal injection), with a course of 7 days. The clinical efficacy, intracranial pressure, infection control time, routine indexes of cerebrospinal fluid (white blood cell count [WBC], glucose content [Glu], and total protein content [Pro]) and the incidence of adverse reactions were contrasted between the 2 subgroups. Versus the control subgroup, the total effective rate in the observation subgroup was notably higher (95.00% vs 77.50%). After treatment, aiming at the intracranial pressure and infection control time, versus the control subgroup (146.20 ± 22.37) mmH2O and (9.86 ± 1.62) days, the observation subgroup were (125.43 ± 18.5) mmH2O and (7.35 ± 1.57) days respectively, which were notably lower. After treatment, versus the control subgroup, the concentrations of WBC and Pro in cerebrospinal fluid in the observation subgroup were lower, and the content of Glu was higher. There was no statistical distinction in the incidence of adverse reactions between the 2 subgroups (17.50% vs 10.00%). Two-channel administration of vancomycin can improve the clinical efficacy of internal infection after severe craniocerebral injury, reduce intracranial pressure, and cerebrospinal fluid WBC and Pro levels, and has high safety.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142291161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical study on the establishment of radio-cephalic autogenous arteriovenous fistulas in small blood vessels by multi-segment balloon dilation technique.","authors":"Qiyu Kang, Yajie Hao, Huifeng Zhang, Weimin Yu, Xiaoguang Huang","doi":"10.1097/MD.0000000000039758","DOIUrl":"10.1097/MD.0000000000039758","url":null,"abstract":"<p><strong>Background: </strong>To investigate the effect of dilating small blood vessels using a balloon dilation (BD) technique on the occurrence of radio-cephalic autogenous arteriovenous fistulas in terms of patency, blood flow, and vein diameter (VD).</p><p><strong>Methods: </strong>The subjects included in this study were all patients with chronic renal failure and required radio-cephalic arteriovenous fistula surgery for the first time and had not received dialysis before. Patients with VDs <2 mm were included as study subjects. They were either assigned treatment using a BD group or a control group that received hydrostatic dilation. The differences between the 2 groups were analyzed in terms of patency, blood flow, and VD.</p><p><strong>Results: </strong>A total of 22 patients were enrolled in the balloon dilatation group and 20 patients in the control group. The diameters of cephalic veins (mm) of the experimental and control group were compared at various time points: immediately postoperation, 2.89 ± 0.42 versus 1.99 ± 0.28 (P < .001); 1 week later, 3.16 ± 0.59 versus 2.66 ± 0.60 (P = .022); 1 month later, 3.76 ± 0.91 versus 3.18 ± 0.83 (P = .087); and 2 months later, 4.08 ± 1.15 versus 3.38 ± 1.13 (P = .169). Brachial artery flows (mL/min) of the 2 groups at various time points were given as follows: immediately postoperation, 413.49 ± 145.09 versus 235.61 ± 87.77 (P < .001); 1 week later, 563.26 ± 206.83 versus 331.30 ± 126.78 (P < .001); 1 month later, 679.34 ± 218.56 versus 376.79 ± 156.25 (P < .001); and 2 months later, 736.31 ± 202.61 versus 394.60 ± 161.96 (P < .001). The primary patency at 1 year for the experimental group was 61.9% compared to 11.1% for the control group (P = .045). Similarly, the secondary patency rates at 1 year were 90.5% for the experimental group and 55.6% for the control group (P = .030). The results showed that the functional primary patency rate within 1 year was 57.1% versus 16.7% (P = .032), and the functional secondary patency rate within 1 year was 85.7% versus 50.0% (P = .038).</p><p><strong>Conclusion subsections: </strong>BD has obvious advantages over hydrostatic dilation for chronic renal failure patients with small veins in establishing arteriovenous fistula in terms of patency and blood flow.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142291116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An observational study on the modulation of anxiety, depression, and adverse event incidence in painless colonoscopy patients through venous access nursing.","authors":"Linzhen Zhu, Linlin Zhu, Chengfeng Jin","doi":"10.1097/MD.0000000000039575","DOIUrl":"10.1097/MD.0000000000039575","url":null,"abstract":"<p><p>To investigate the clinical significance of venous access nursing in modulating anxiety, depression, and adverse event incidence among patients undergoing painless colonoscopy. Sixty patients who underwent painless colonoscopy in our hospital from September 2021 to September 2022 were selected as the control group (CG, receiving routine perioperative nursing). Sixty patients who underwent painless colonoscopy in our hospital from October 2022 to August 2023 were taken as the study group (SG, receiving venous access nursing modulation). After nursing, patients in the SG exhibited lower scores of the Self-Rating Anxiety Scale and the Self-Rating Depression Scale than those in the CG (P < .05). The SG showed significantly lower mean Ottawa Bowel Preparation Score, but exhibited higher adequacy of bowel preparation compared with the CG (P < .05). The colonoscopy insertion time was (7.18 ± 1.02) minutes in the SG and (8.69 ± 1.00) minutes in the CG, and the colonoscopy withdrawal time was (4.66 ± 1.66) minutes in the SG and (5.64 ± 1.06) minutes in the CG, which showed statistically significant differences between the 2 groups (P < .05). The total incidence of adverse events did not have statistical significance between the 2 groups (P > .05). Application of venous access nursing in patients undergoing painless colonoscopy may help alleviate adverse emotions and shorten colonoscopy insertion time and colonoscopy withdrawal time, thus warranting recognition for its safety and efficacy.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142291105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insights into multilevel tissue-level collateral status using ColorViz maps from dual data sources in acute ischemic cerebrovascular diseases: A STARD-compliant retrospective study.","authors":"Xiaoxiao Zhang, Qingyu Liu, Luxin Guo, Xiaoxi Guo, Xinhua Zhou, Shaomao Lv, Yu Lin, Jinan Wang","doi":"10.1097/MD.0000000000039787","DOIUrl":"10.1097/MD.0000000000039787","url":null,"abstract":"<p><p>This study aims to explore the utility of ColorViz mapping from dual data sources for assessing arterial collateral circulation and predicting cerebral tissue-level collateral (TLC) in patients with acute ischemic cerebrovascular diseases. A retrospective study was conducted at a single center on a cohort of 79 patients diagnosed with acute ischemic cerebrovascular diseases between November 2021 and April 2022, who had undergone both multi-phase CT angiography (mCTA) and computed tomography perfusion (CTP). The quality of images and arterial collateral status depicted on ColorViz maps from dual data-sets (mCTA and CTP) were assessed using a \"5-point scale\" and a \"10-point scale,\" respectively. The status of TLC was evaluated by analyzing multilevel hypoperfusion volume and the hypoperfusion intensity ratio (HIR). The Spearman correlation coefficient was employed to examine the association between arterial collateral status derived from dual data sources and TLC. Receiver operating characteristic curve analysis was used to determine the diagnostic efficacy in detecting large vessel occlusive acute ischemic stroke (LVO-AIS). The ColorViz maps derived from dual data sources facilitated comparable image quality, with over 95% of cases meeting diagnostic criteria, for the evaluation of arterial level collateral circulation. Patients with robust arterial collateral circulation, as determined by dual data sources, were more likely to exhibit favorable TLC status, as evidenced by reductions in hypoperfusion volume (Tmax > 4 seconds, Tmax > 6 seconds, Tmax > 8 seconds, and Tmax > 10 seconds, P < .05) and HIR (Tmax > 6 seconds/4 seconds, Tmax > 8 seconds/4 seconds, Tmax > 10 seconds/4 seconds, and Tmax > 8 seconds/6 seconds, P < .05). The sensitivity and specificity in detecting LVO-AIS was 60.00% and 97.73% for mCTA source maps, while 74.29% and 72.73% for CTP source maps (P > .05 based on De-Long test). In conclusion, this study indicates that ColorViz maps derived from both data sources are equally important in evaluating arterial collateral circulation and enhancing diagnostic efficiency in patients with LVO-AIS, as well as offering insights into the TLC status based on hypoperfusion volume and HIR.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142291167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A review on antitumor effect of pachymic acid.","authors":"Yubo Xiao, Zhaotun Hu, Hang Liu, Xinglin Jiang, Taimei Zhou, Haiying Wang, Heng Long, Ming Li","doi":"10.1097/MD.0000000000039752","DOIUrl":"10.1097/MD.0000000000039752","url":null,"abstract":"<p><p>Poria cocos, also known as Jade Ling and Songbai taro, is a dry fungus core for Wolfiporia cocos, which is parasitic on the roots of pine trees. The ancients called it \"medicine of four seasons\" because of its extensive effect and ability to be combined with many medicines. Pachymic acid (PA) is one of the main biological compounds of Poria cocos. Research has shown that PA has various pharmacological properties, including anti-inflammatory and antioxidant. PA has recently attracted much attention due to its anticancer properties. Researchers have found that PA showed anticancer activity by regulating apoptosis and the cell cycle in vitro and in vivo. Using PA with anticancer drugs, radiotherapy, and biomaterials could also improve the sensitivity of cancer cells and delay the progression of cancer. The purpose of this review was to summarize the anticancer mechanism of PA by referencing the published documents. A review of the collected data indicated that PA had the potential to be developed into an effective anticancer agent.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142291036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acupuncture for the treatment of anxiety and depression in patients with spinal cord injury: A study protocol for systematic review and meta analysis.","authors":"Ke Liu, Xiaoyong Gao, Liang Ou, Zuyu Tang, Haoming Zhao, Sheng Hua, Yixiao Xiong, Le Zhang, Jianjun Kuang","doi":"10.1097/MD.0000000000039701","DOIUrl":"10.1097/MD.0000000000039701","url":null,"abstract":"<p><strong>Background: </strong>Spinal cord injury patients frequently suffer from anxiety and depression, which can seriously affect their quality of life and recovery. Acupuncture, as a traditional Chinese therapy, has been used to treat anxiety and depression for more than 2000 years. The aim is to evaluate the clinical efficacy of acupuncture in the treatment of anxiety and depression in spinal cord injury patients.</p><p><strong>Methods: </strong>The literature on acupuncture treating anxiety and depression in patients with spinal cord injury in PubMed, Embase, Cochrane Library, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Chinese Scientific Journal Data, and Wanfang data were searched through computers from the establishment of the database to May 2024. In the study, the Cochrane tool for assessing the risk of bias was used and the meta-analyses were carried out using the software package Review Manager 5.4.</p><p><strong>Results: </strong>Ten trials were included in this systematic review, with 361 cases in the experimental group and 355 cases in the control group. Meta-analysis showed that compared with conventional treatment, acupuncture combined with conventional treatment was beneficial in improving the total clinical efficacy (odds ratio = 3.55 [95% confidence interval {CI}: 1.34-9.37], P < .001). We found acupuncture-assisted therapy could be beneficial in improving the Modified Barthel Index (MD = 10.48 [95% CI: 4.78-16.19], P < .001) and reducing anxiety or depression scores (such as the Self-Rating Anxiety Scale [MD = -6.08 {95% CI: -6.85 to -5.30}, P < .001]; reducing the Self-Rating Depression Scale [MD = -6.01 {95% CI: -6.95 to -5.07}, P < .001]). In addition, the study showed that the application of acupuncture treatment could improve 5-hydroxytryptamine compared to control group (MD = 44.99 [95% CI: 40.04-49.95], P < .001) and reduce TNF-α compared to control group (MD = -7.78 [95% CI: -8.73 to -6.83], P < .001).</p><p><strong>Conclusion: </strong>Acupuncture could be used as a complementary therapy to reduce anxiety and depression in spinal cord injury patients. Further original and high-quality research is needed to verify the conclusions of this study.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142291103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Construction and validation of a nomogram for predicting cancer-specific survival in middle-aged patients with advanced hepatocellular carcinoma: A SEER-based study.","authors":"Ziqiang Li, Qingyong Hong, Zhidong Guo, Xiaohong Liu, Chengpeng Tan, Zhe Feng, Kun Li","doi":"10.1097/MD.0000000000039480","DOIUrl":"10.1097/MD.0000000000039480","url":null,"abstract":"<p><p>Hepatocellular carcinoma is the predominant form of primary liver cancer and is the leading cause of cancer-related death. The aim of this study was to construct a nomogram to predict cancer-specific survival (CSS) in middle-aged patients with advanced hepatocellular carcinoma. Clinical data were downloaded from the Surveillance, Epidemiology and End Results (SEER) database for middle-aged patients diagnosed with advanced hepatocellular carcinoma (AJCC stage III and IV) from 2000 to 2019. The patients were randomized in a 7:3 ratio into training cohort and validation cohort. Univariate and multivariate Cox regression analyses were performed in the training cohort to screen for independent risk factors associated with cancer-specific survival for the construction of nomogram. The nomogram was examined and evaluated using the consistency index (C-index), area under the curve (AUC), and calibration plots. The clinical application value of the model was evaluated using decision curve analysis (DCA). A total of 3026 patients were selected, including 2244 in the training cohort and 962 in the validation cohort. Multivariate analysis revealed gender, marital status, American Joint Committee on Cancer (AJCC) stage, tumor size, bone metastasis, lung metastasis, alpha-fetoprotein (AFP) level, surgery, radiotherapy, chemotherapy as independent risk factors, which were all included in the construction of the nomogram. In the training cohort, the AUC values were 0.74 (95% CI: 0.76-0.72), 0.78 (95% CI: 0.82-0.75), and 0.82 (95% CI: 0.86-0.78) at 1-, 3-, and 5-year CSS, respectively. The calibration plots showed good consistency between the actual and predicted values. The DCA curves indicated that the nomogram model could more accurately predict CSS at 1-, 3-, and 5-year in middle-aged patients with advanced hepatocellular carcinoma compared with the AJCC staging system. Highly similar results to the training cohort were also observed in the validation cohort. In the risk stratification system, good differentiation was shown between the 2 groups, and Kaplan-Meier survival analysis indicated that surgery could prolong patient survival. In this study, we developed a nomogram and risk stratification system for predicting CSS in middle-aged patients with advanced hepatocellular carcinoma. The prediction model has good predictive performance and can help clinicians in judging prognosis and clinical decision making.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142291121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dissecting causal relationships between gut microbiome, immune cells, and brain injury: A Mendelian randomization study.","authors":"Lina Xian, Xiaochen Xu, Yongmeng Mai, Tongwu Guo, Zhen Chen, Xiaoyan Deng","doi":"10.1097/MD.0000000000039740","DOIUrl":"10.1097/MD.0000000000039740","url":null,"abstract":"<p><p>Increasing literature has affirmed that changes in the gut microbiome (GM) composition were linked to distinct brain injury (BI) through the gut-brain axis, but it is uncertain if such links reflect causality. Further, the immune cell changes mediating the impact of GM on BI are not completely understood. We made use of the summary statistics of 211 GM (MiBioGen consortium), 731 immune cells, and 2 different BIs (FinnGen consortium), namely traumatic BI (TBI) and focal BI (FBI), from the extensive genome-wide association studies to date. We executed bidirectional Mendelian randomization (MR) analyses to ascertain the causal relationships between the GM and BI, and 2-step MR to validate possible mediating immune cells. Additionally, thorough sensitivity analyses verified the heterogeneity, robustness, as well as horizontal pleiotropy of the results. Based on the results of inverse-variance weighted (IVW) and sensitivity analyses, in MR analyses, 5 specific GM taxa and 6 specific GM taxa were causally associated with FBI and TBI, respectively; 27 immunophenotypes and 39 immunophenotypes were causally associated with FBI and TBI, respectively. Remarkably, Anaerofilum, LachnospiraceaeNC2004group, RuminococcaceaeUCG004, CCR2 on myeloid dendritic cell (DC), CD123 on CD62L+ plasmacytoid DC, and CD123 on plasmacytoid DC were causally associated with TBI and FBI (all P < .040). However, our reverse MR did not indicate any influence of TBI and FBI on the specific GM. In mediation analysis, we found that the associations between Escherichia.Shigella and FBI were mediated by CD123 on CD62L + plasmacytoid DC in addition to CD123 on plasmacytoid DC, each accounting for 4.21% and 4.21%; the association between FamilyXIIIAD3011group and TBI was mediated by CCR2 on myeloid DC, with mediated proportions of 5.07%. No remarkable horizontal pleiotropy or heterogeneity of instrumental variables was detected. Our comprehensive MR analysis first provides insight into potential causal links between several specific GM taxa with FBI/TBI. Additionally, CD123 on plasmacytoid DC in conjunction with CCR2 on myeloid DC may function in gut microbiota-host crosstalk in FBI and TBI, correspondingly. Further studies are critical to unravel the underlying mechanisms of the links between GM and BI.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142291126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}