Medicine最新文献

{"title":"Changes of diamine oxidase and D-lactate in human breast and gynecologic cancers after chemotherapy.","authors":"Lixia Hu, Fanliang Kong, Qianqian Yuan, Mengqin Huang, Yong Huang","doi":"10.1097/MD.0000000000041442","DOIUrl":"10.1097/MD.0000000000041442","url":null,"abstract":"<p><p>This study investigates the changes in diamine oxidase (DAO) and D-lactate levels in cancer patients undergoing chemotherapy and their clinical significance in evaluating intestinal barrier function. Breast and gynecologic cancer patients who received chemotherapy between January 2020 and December 2023 were enrolled from our hospital. Blood samples were taken before chemotherapy, within 3 days after chemotherapy, and before the next course of chemotherapy. The level of plasma DAO and D-lactate were measured by enzyme-linked immunosorbent assay (ELISA). After chemotherapy, nutritional markers such as albumin (ALB) and prealbumin (PAB) were evaluated. Anorexia, vomiting, nausea and diarrhea were evaluated during the chemotherapy cycle. There were no notable differences in serum DAO and D-lactate levels before chemotherapy among different tumor types, tumor stage and chemotherapy type. Serum DAO and D-lactate levels after chemotherapy were significantly elevated compared to their levels before chemotherapy (P < .05). The plasma DAO and D-lactate levels in cancer patients before the next course of chemotherapy were higher than those observed before the initial treatment, but the difference failed to achieve statistical significance (P > .05). The levels of DAO before chemotherapy were higher in patients with diarrhea and anorexia after chemotherapy than those without diarrhea and anorexia (P < .05). The levels of D-lactate before chemotherapy were notably elevated in patients with vomiting, diarrhea and nausea after chemotherapy than those without vomiting, diarrhea and nausea (P < .05). Monitoring serum levels of DAO and D-lactate in cancer patients undergoing chemotherapy can serve as indicators for evaluating gastrointestinal dysfunction and nutritional status.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 6","pages":"e41442"},"PeriodicalIF":1.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389962","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":"Clinical and genetic analysis of a female child with duplications at 7p22.3p22.1 and Xp22.31p21.1: A case report.","authors":"Chenchen Bu, Quzhen Zha Xi, Ying Deng","doi":"10.1097/MD.0000000000041452","DOIUrl":"10.1097/MD.0000000000041452","url":null,"abstract":"<p><strong>Rationale: </strong>Intellectual disability (ID) is a neurodevelopmental disorder with diverse etiologies. Chromosomal duplications are recognized as a common cause of ID, with manifestations typically milder than those associated with deletions. Duplications involving the short arm of chromosome 7 or the X chromosome have been linked to ID. Limited data exist on duplications at 7p22.1p22.3 and Xp22.31p21.1, leaving their clinical significance largely unexplored. This case report aims to expand the phenotype and genetics spectrum of 7p22 duplication syndrome and X-linked ID. Special attention should be paid to closely monitoring the pubertal progression of such patients.</p><p><strong>Patient concerns: </strong>A 9-year-10-month-old female was admitted to our hospital due to distinctive dysmorphic features and ID.</p><p><strong>Diagnoses: </strong>Upon examination, features of craniofacial dysmorphism were observed, including micrognathia, a prominent lower lip, a thin upper lip, a flat nasal bridge, and hypertelorism. The child's pubertal development is progressing extremely rapidly; at under 10 years old, the breasts have already advanced to Tanner Stage 4. Her height was within the median range, but her bone age was advanced (12.1 years). Her full-scale intelligence quotient, assessed using the Wechsler Intelligence Scale for Children: 4th edition, was 41.</p><p><strong>Interventions: </strong>Whole exome sequencing identified a de novo duplication spanning overlapping regions at Xp21-22 and 7p22. This duplication encompasses several genes implicated in ID, including Duchenne muscular dystrophy, Aristaless-related homeobox, interleukin-1 receptor accessory protein like 1, adaptor-related protein complex 1 subunit sigma 2, and cyclin-dependent kinase-like 5.</p><p><strong>Outcomes: </strong>A novel duplication in the Xp and 7p of a Chinese female child diagnosed with ID and dysmorphic features has been studied by whole exome sequencing analysis. The novel duplications were a large duplication located in the 7p22.1 to p22.3 region, spanning 12.07 Mb, and a large duplication located in the Xp22.31 to p21.1 region, spanning 24.7 Mb.</p><p><strong>Lessons: </strong>Our study underscores the importance of comprehensive clinical and genetic evaluation in individuals with duplication on the X chromosome and the terminal region of chromosome 7's short arm. We highlight the need for monitoring these patients for growth and sexual development issues. Our findings also suggest that chromosomal duplication can lead to severe clinical manifestations, emphasizing the critical role of genetic assessment in managing such cases.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 6","pages":"e41452"},"PeriodicalIF":1.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390368","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 comparison of the efficacy and safety of Chinese patent medicine combined with Western medicine for Helicobacter pylori-related gastric ulcer: A systematic review and network meta-analysis.","authors":"Meiqi Zhong, Qifang Sun, Baoping Ren, Chang Yu, Shunhua Zhou, Qing Gao, Xiaojuan Wang, Chengzhi Yuan, Jing Lu, Qinghua Peng, Meiyan Zeng, Houpan Song","doi":"10.1097/MD.0000000000041137","DOIUrl":"10.1097/MD.0000000000041137","url":null,"abstract":"<p><strong>Background: </strong>The aim of this network meta-analysis (NMA) was to compare the effectiveness and safety of different Chinese patent medicines (CPMs) combined with Western medicines (WMs) regimen versus WMs alone in the treatment of Helicobacter pylori-related gastric ulcer (GU).</p><p><strong>Methods: </strong>A comprehensive search was conducted on databases from their inception to May 31, 2023, to identify all randomized controlled trials (RCTs) that investigated the efficacy of CPMs in combination with conventional WMs in the treatment of patients with H pylori-related GU. Using Cochrane risk of bias assessment tool, we evaluated the methodological quality of RCTs. R version 4.2.3 and Stata version 15.1 software were cross-merged to conduct pairwise NMA.</p><p><strong>Results: </strong>A total of 35 studies involving 4667 patients and 11 CPMs were identified. Eleven CPMs were analyzed, including Pingwei Capsule (PWC), Kangfuxin Solution (KFXS), Shugan Jieyu Capsule (SGJYC), Weisu Granule (WSG), Qiwei Weitong Capsule (QWWTC), Beiling Weitong Granule (BLWTG), Anweiyang Capsule (AWYC), Jinghua Weikang Capsule (JHWKC), Weifuchun Tablet (WFCT), Wenweishu Capsule (WWSC), and Weidean Capsule (WDAC). Results showed that the combination of CPM and WM was more effective relative to the WM regimen alone. NMA revealed that WWSC combined with the WM yielded superior results in enhancing clinical outcomes and mitigating GU recurrence rates. PWC combined with the WM showed the best performance in improving the H pylori eradication rate. WFCT combined with the WM had the most optimal performance in controlling gastrin (GAS) and motilin (MTL) levels. KFXS combined with the WM showed the best results in terms of reducing the incidence of adverse events.</p><p><strong>Conclusion: </strong>Our NMA findings indicate that the combination of WWSC, PWC, WFCT, and KFXS with WM may be more effective and advantageous outcomes compared to other CPMs. Due to the limitations of this study, future research should employ larger sample sizes and multicenter RCTs to conduct real-world clinical studies.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 6","pages":"e41137"},"PeriodicalIF":1.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391187","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, prevalence, and association of different forms of hair loss among individuals with anxiety disorder: Systematic review and meta-analysis.","authors":"Almuntsrbellah Almudimeegh, Ahmed Hamad Alajlan, Abdulelah Ibrahim Alrasheed, Mansour Ibrahim Alrasheed, Abdullah Khalid Alqahtani, Reem Bin Idris, Muhannad Abdullah Alomar, Shaden Ahmad Alobaid, Nouf Ali Alotaibi","doi":"10.1097/MD.0000000000041457","DOIUrl":"10.1097/MD.0000000000041457","url":null,"abstract":"<p><strong>Background: </strong>Hair loss is a serious health concern, with individuals having to bear the associated psychological impact of the condition. Alopecia has been linked to emotional and psychological anguish in relationships, career, and personal life.</p><p><strong>Objective: </strong>This study aimed to elucidate the intricate association, prevalence, and impact of hair loss with anxiety disorders, distinguished from other psychological impacts of alopecia.</p><p><strong>Methods: </strong>The current review and meta-analysis were performed in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) framework. A comprehensive search was performed using the Cochrane, PubMed, and Google Scholar electronic databases studies published in English and conducted between January 2014 and September 2024. Statistical analysis was performed using STATA version 16.0 (StataCorp LLC), and the Newcastle-Ottawa Scale and RoB 2 tools were used for critical quality appraisal.</p><p><strong>Results: </strong>A total of 24 eligible articles were included in the current study, with a cumulative of 5553 patients presenting with 1 or more forms of hair loss. Anxiety disorder was significantly prevalent among patients with alopecia event rate (ER) 0.47 (95% CI: 0.39-0.54). Anxiety severity analysis also showed a significant relationship between anxiety and hair loss, with ERs of 0.35 (95% CI: 0.10-0.60), 0.15 (95% CI: 0.01-0.29), and 0.05 (95% CI: 0.03-0.29), respectively. Statistical significance was also demonstrated by a mean HADS-A score of 7.87 (95% CI: 6.85-8.88). However, considerable heterogeneity was observed in various statistical analyses.</p><p><strong>Conclusion: </strong>In summary, our study showed that among people with hair loss-related diseases, alopecia was substantially linked to anxiety disorders, with the frequency of anxiety among those affected being noticeably higher.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 6","pages":"e41457"},"PeriodicalIF":1.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391233","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":"Clinical research progress of umbilical cord blood mesenchymal stem cells in Knee articular cartilage repair: A review.","authors":"ZhongKai Liao","doi":"10.1097/MD.0000000000041402","DOIUrl":"10.1097/MD.0000000000041402","url":null,"abstract":"<p><p>Umbilical cord blood mesenchymal stem cells (UCB-MSCs) are a type of adult stem cell with multipotent differentiation potential and immunoregulatory functions, primarily found in neonatal cord blood. Due to their noninvasive collection method, abundance, and ease of preservation, UCB-MSCs represent a promising biological material. This review examines the clinical research on UCB-MSCs in knee articular cartilage repair, highlighting their regenerative potential for treating knee joint cartilage defects. Our aim is to provide insights into current applications and propose directions for future research, focusing on optimizing clinical use and enhancing patient outcomes.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 6","pages":"e41402"},"PeriodicalIF":1.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391244","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":"Building a cancer risk and survival prediction model based on social determinants of health combined with machine learning: A NHANES 1999 to 2018 retrospective cohort study.","authors":"Shiqi Zhang, Jianan Jin, Qi Zheng, Zhenyu Wang","doi":"10.1097/MD.0000000000041370","DOIUrl":"10.1097/MD.0000000000041370","url":null,"abstract":"<p><p>The occurrence and progression of cancer is a significant focus of research worldwide, often accompanied by a prolonged disease course. Concurrently, researchers have identified that social determinants of health (SDOH) (employment status, family income and poverty ratio, food security, education level, access to healthcare services, health insurance, housing conditions, and marital status) are associated with the progression of many chronic diseases. However, there is a paucity of research examining the influence of SDOH on cancer incidence risk and the survival of cancer survivors. The aim of this study was to utilize SDOH as a primary predictive factor, integrated with machine learning models, to forecast both cancer risk and prognostic survival. This research is grounded in the SDOH data derived from the National Health and Nutrition Examination Survey dataset spanning 1999 to 2018. It employs methodologies including adaptive boosting, gradient boosting machine (GradientBoosting), random forest (RF), extreme gradient boosting, light gradient boosting machine, support vector machine, and logistic regression to develop models for predicting cancer risk and prognostic survival. The hyperparameters of these models-specifically, the number of estimators (100-200), maximum tree depth (10), learning rate (0.01-0.2), and regularization parameters-were optimized through grid search and cross-validation, followed by performance evaluation. Shapley Additive exPlanations plots were generated to visualize the influence of each feature. RF was the best model for predicting cancer risk (area under the curve: 0.92, accuracy: 0.84). Age, non-Hispanic White, sex, and housing status were the 4 most important characteristics of the RF model. Age, gender, employment status, and household income/poverty ratio were the 4 most important features in the gradient boosting machine model. The predictive models developed in this study exhibited strong performance in estimating cancer incidence risk and survival time, identifying several factors that significantly influence both cancer incidence risk and survival, thereby providing new evidence for cancer management. Despite the promising findings, this study acknowledges certain limitations, including the omission of risk factors in the cancer survivor survival model and potential biases inherent in the National Health and Nutrition Examination Survey dataset. Future research is warranted to further validate the model using external datasets.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 6","pages":"e41370"},"PeriodicalIF":1.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391253","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":"Epidemiological investigation on an outbreak of food-borne disease caused by nitrite poisoning.","authors":"Peng Li, Ming-Yu Wu, Heng Wang, Hao-Di Xu, Yan Chen, Cheng-Ji Chen, Yu-Chao Wang, An Tang, Jian-Bo Yan, Chen Wu, Zhen-Dong Tong","doi":"10.1097/MD.0000000000041464","DOIUrl":"10.1097/MD.0000000000041464","url":null,"abstract":"<p><p>Sodium nitrite, often mistaken for common table salt or sugar due to its similar appearance, has resulted in poisoning incidents. This report details a cluster of sodium nitrite poisoning stemming from a dinner gathering on a maintenance ship. The epidemiological investigation aims to uncover the incident's cause, provide clinical insights, and offer preventive recommendations for similar events in the future. Individual interviews were conducted with all suspected cases, capturing basic information, clinical symptoms and onset times, dining history, and food exposure. Gathering organizer and food preparer was interviewed to gather potential leads regarding the poisoning incident. Blood samples from cases were collected for methemoglobin testing, and samples of vomit, leftovers, and the dining environment were collected for sodium nitrite detection. A total of 11 people participated in the dinner party, and 6 of them developed symptoms, with an attack rate of 54.55%. Clinical presentations mainly included dizziness, weakness, nausea, vomiting, and cyanosis of the lips, with elevated methemoglobin levels. The shortest incubation period was 0.5 hours, the longest was 3 hours, with a median of 2 hours. All cases showed rapid symptom relief after treatment with the specific antidote methylene blue. A retrospective cohort study showed that the incidence rate among those who consumed vegetable and tofu soup was 85.71% (6/7), which was higher than that of nonconsumers (0/4), and the difference was statistically significant (relative risk = 7.000, 95% confidence interval = 1.140-42.969). Sodium nitrite concentrations in vomit samples ranged from 5.40 to 37.17 mg/kg, while leftovers showed levels of 170.88 mg/kg in a vegetable and tofu soup, 55.65 mg/kg in goose meat, and 9.17 mg/kg in other leftovers. Furthermore, environmental samples from the suspected condiment storage area tested positive for sodium nitrite. This cluster of sodium nitrite poisoning was due to the inadvertent use of sodium nitrite in cooking, mistaken for table salt. Public awareness campaigns on food safety should be intensified across multiple platforms, and enhanced oversight of nitrite usage is crucial to prevent similar poisoning incidents.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 6","pages":"e41464"},"PeriodicalIF":1.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391271","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":"Hemosuccus pancreaticus post-EUS-FNA in multicystic pancreatic tail formation: A case report.","authors":"Goran Bokan, Eva Mislej, Borut Štabuc, Darko Siuka","doi":"10.1097/MD.0000000000041453","DOIUrl":"10.1097/MD.0000000000041453","url":null,"abstract":"<p><strong>Rationale: </strong>Hemosuccus pancreaticus (HP) is a rare but serious cause of gastrointestinal bleeding, characterized by hemorrhage from the papilla of Vater via the pancreatic duct. It is typically associated with vascular or pancreatic pathologies, including pancreatic cysts, tumors, or pseudoaneurysms involving adjacent arteries such as the splenic or gastric artery.</p><p><strong>Patient concerns: </strong>A 68-year-old male patient was evaluated for a pancreatic tail cyst detected on magnetic resonance cholangiopancreatography (MRCP). The lesion was described as a 20-mm multilocular cystic formation with septations, raising suspicion of malignancy.</p><p><strong>Diagnosis: </strong>HP was diagnosed following an episode of gastrointestinal bleeding after endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of the pancreatic tail cystic lesion.</p><p><strong>Interventions: </strong>The patient underwent EUS-FNA via a transgastric approach to obtain a tissue sample for further evaluation.</p><p><strong>Outcomes: </strong>The procedure was complicated by gastrointestinal bleeding and later confirmed to be HP. The bleeding was managed conservatively, and the patient remained hemodynamically stable with spontaneous resolution of symptoms.</p><p><strong>Lessons: </strong>This case underscores a rare but significant complication of EUS-FNA. Given the limited number of reported cases, further research is needed to establish the incidence, risk factors, and preventive measures for HP in similar clinical scenarios.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 6","pages":"e41453"},"PeriodicalIF":1.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11812990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391301","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":"Hypercalcemia in children with APL caused by interactions between voriconazole and all-trans retinoic acid: A case report and literature review.","authors":"Namei Wu, Zhihang Lin, Shuquan Zhuang, Shuifa Wu, Zhiming Cai, Xiaofang Wang","doi":"10.1097/MD.0000000000041426","DOIUrl":"10.1097/MD.0000000000041426","url":null,"abstract":"<p><strong>Rationale: </strong>All-trans retinoic acid (ATRA) and voriconazole (VRZ) are pivotal drugs for the treatment of acute promyelocytic leukemia (APL) and invasive fungal infections, respectively. When ATRA is co-administered with VRZ, clinically significant drug interactions may occur due to alterations in drug metabolism and clearance.</p><p><strong>Patient concerns: </strong>We report a case of hypercalcemia caused by the interaction between ATRA and VRZ in a child with APL.</p><p><strong>Diagnoses and interventions: </strong>A 14-year-old boy received arsenictrioxide (ATO) for APL and VRZ for invasive fungal infections, followed by planned maintenance therapy with ATRA monotherapy and combination of ATRA and ATO. He experienced no adverse reactions during the concurrent use of ATO and VRZ, while on the 12th day of combined ATRA and VRZ administration, his blood calcium levels significantly increased, accompanied by a series of symptoms. Following the discontinuation of VRZ and continuation of ATRA monotherapy, and subsequent maintenance chemotherapy with ATRA and ATO, his blood calcium levels decreased and remained within the normal range.</p><p><strong>Outcomes: </strong>We reviewed the published literature and excluded primary hyperparathyroidism or ectopic parathyroid hormone secretion as the cause of hypercalcemia in the child. He did not use other cytochrome inhibitors that may affect ATRA metabolism other than VRZ. Multiple measurements of VRZ trough concentrations ranged from 1.2 to 3 μg/mL. According to the Drug Interaction Probability Scale (5 points) and Naranjo Probability Scale (4 points), the drug interaction between VRZ and ATRA is probable. The hypercalcemia and other clinical manifestations may be caused by the inhibition of ATRA metabolism by VRZ.</p><p><strong>Lessons: </strong>During clinical use of ATRA, it is necessary to closely monitor the adverse drug interactions such as hypercalcemia and limit the use of drugs that may affect cytochrome P450 enzyme such as VRZ.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 6","pages":"e41426"},"PeriodicalIF":1.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11812993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391316","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":"Molecular mechanism of the effect of BixiezelanYin on knee osteoarthritis based on network pharmacology and molecular docking.","authors":"Renkun Huang, Jiehua Lu, Xueyi Yang, Guanyun Sheng, Fangyi Qin, Xiongwu Yang","doi":"10.1097/MD.0000000000041459","DOIUrl":"10.1097/MD.0000000000041459","url":null,"abstract":"<p><p>The BixizelanYin (BXZLY) is a traditional herbal formula for treating damp-heat type knee osteoarthritis (KOA). This study aimed to investigate the potential therapeutic effects of BXZLY on KOA by using network pharmacology and molecular docking. Active ingredients and their corresponding targets of BXZLY were screened through the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform. The known disease targets of KOA were retrieved from GeneCards and the Online Mendelian Inheritance in Man database. The effective targets of BXZLY for treating KOA were obtained with the Venny platform. A drug-component-target network diagram was constructed using Cytoscape 3.7.2 software, and a protein-protein interaction network was established via the STRING database. The protein-protein interaction network was visualized by Cytoscape 3.7.2 software. The biological functions of the targets wereanalyzed through Gene Ontology and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis with the DAVID database. The Gene Ontology enrichment and KEGG pathway visualization bubble charts were generated using the OmicShare online platform to explore the biological functions of BXZLY in treating KOA. The main signaling pathways of BXZLY in treating KOA were investigated by KEGG pathway enrichment analysis. Finally, AutoDockTools software was used for molecular docking validation of the key molecules of the drug and the key proteins of the disease. A total of 108 active compounds and 280 target proteins of BXZLY were identified. There were 2816 disease-related targets related to KOA, among which 99 were targeted by BXZLY for KOA treatment. Key compounds included β-sitosterol, stigmasterol, campesterol, quercetin, and dioscin. Core target proteins consisted of STAT3, ESR1, EGFR, JUN, and PTGS2. The pathways mainly involved the advanced glycation end products - receptor for advanced glycation end products, estrogen, HIF-1, and relaxin signal pathways. Molecular docking showed a strong binding affinity between active ingredients and core target proteins. Docking candidates were selected based on oral bioavailability ≥ 30%, drug-likeness ≥ 0.18, and degree values in Cytoscape. This strategy ensured a reliable selection of compounds with high therapeutic relevance. BXZLY provides a comprehensive therapeutic strategy for KOA treatment by regulating cell proliferation and alleviating inflammation through its multi-component, multi-target, and multi-pathway effects.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 6","pages":"e41459"},"PeriodicalIF":1.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391380","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}