Medicine最新文献

{"title":"Venlafaxine-induced thrombocytopenia: A case report and literature review.","authors":"Shi Lijun, Ma Zhongrui, Wei Li, Feng Lei, Jiang Wei, Yu Xia, Pan Yaning","doi":"10.1097/MD.0000000000043413","DOIUrl":"10.1097/MD.0000000000043413","url":null,"abstract":"<p><strong>Rationale: </strong>Drug-induced thrombocytopenia (DITP) is an adverse drug effect mediated by drug-dependent antibodies. Although several cases of thrombocytopenia induced by antidepressants and antianxiety drugs have been reported at home and abroad, reports of venlafaxine hydrochloride-induced thrombocytopenia are rare.</p><p><strong>Patient concerns: </strong>In this study, we report a case of an anxiety patient who developed severe thrombocytopenia and subcutaneous bleeding after 1 week of treatment with a venlafaxine-containing regimen.</p><p><strong>Diagnoses: </strong>DITP was considered after other secondary factors were excluded.</p><p><strong>Interventions: </strong>The patient's platelet count returned to normal after treatment with glucocorticoids combined with recombinant human thrombopoietin, and antianxiety drugs without venlafaxine were administered for continued treatment.</p><p><strong>Outcomes: </strong>Three months after discharge, repeated routine blood monitoring indicated that the platelet count remained normal.</p><p><strong>Lessons: </strong>In combination with the cases and related literature, we would like to emphasize that venlafaxine may rarely cause thrombocytopenia, and clinicians should pay attention to and inform patients of rare adverse reactions that may occur if they encounter venlafaxine in their clinical practice. Once DITP is considered, the drug should be discontinued and relevant treatment measures should be taken. Based on this case and a review of the literature, we suggest that all cases with myelodysplastic tumor characteristics should undergo screening for BCR/ABL genes or Ph chromosomes to exclude chronic myeloid leukemia to mitigate the risk of misdiagnosis and ensure timely initiation of appropriate treatment.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 30","pages":"e43413"},"PeriodicalIF":1.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732307","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 and safety of Gegen Qinlian decoction combined with mesalazine for the treatment of UC: A meta-analysis and systematic review.","authors":"Yanjie Chen, Ruoqi Li, Yuping Yuan, Haomin He, Wei Yang, Cheng Yuan, Jinyin Xiao, Yile Qin, Min Lian, Zhouyu Yang","doi":"10.1097/MD.0000000000042266","DOIUrl":"10.1097/MD.0000000000042266","url":null,"abstract":"<p><strong>Background: </strong>To systematically evaluate the clinical efficacy and safety of a Gegen Qinlian decoction combined with mesalazine for the treatment of ulcerative colitis (UC).</p><p><strong>Methods: </strong>Chinese (CNKI, CSPD, CCD, and CBM) and foreign databases (PubMed, Web of Science, Cochrane Library, and Embase) were searched for randomized controlled trials related to the treatment regimen used in this study. The risk of bias of the included studies was evaluated using the Cochrane assessment tool. Revman5.0 and Stata17.0 were used for the meta-analysis and sensitivity analysis. Trial sequential analysis was used for sequential analysis. Gradepro3.6 was used to evaluate the level of evidence quality of outcome indicators.</p><p><strong>Results: </strong>Fifteen studies involving 1428 patients were included. The results of meta-analysis showed that the intervention group in the treatment of UC improved the total clinical effective rate (P < .001, relative risk = 1.22, 95% confidence interval (CI) [1.16-1.28]), the main clinical symptoms (P < .001, standard mean difference [SMD] = 1.58, 95% CI [1.86, 1.30]), intestinal mucosal barrier function (P < .001, SMD = 1.02, 95% CI [1.20, 0.84]), reduce the incidence of adverse reactions (P = .05, relative risk = 0.59, 95% CI [0.35, 1.00]), modified Mayo score (P < .001, SMD = 1.53, 95% CI [2.17, 0.89]), Baron endoscopic score (P < .001, SMD = 0.93, 95 CI [1.18, 0.68]), regulate immune function (P < .001, SMD = 0.69, 95% CI [0.47, 0.90]), inflammatory factor levels (P < .001, SMD = 0.69, 95% CI [0.47, 0.90]), intestinal flora (P = .004, SMD = 1.42, 95% CI [0.44, 2.39]), the intervention group were better than the comparison group. But there was no significant difference in oxidative stress index (P = .54, SMD = -0.44, 95% CI [-1.82, 0.95]).</p><p><strong>Conclusion: </strong>Gegen Qinlian decoction combined with mesalazine has definite clinical efficacy and safety for the treatment of UC. Owing to the limited methodological quality of the included studies, high-quality randomized controlled trials are still needed for verification in the future.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 30","pages":"e42266"},"PeriodicalIF":1.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732228","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 systematic review and meta-analysis of floating needle in the treatment of primary dysmenorrhea.","authors":"Yuan Luo, Song Zhang, Xiao Chen, Xiaocong Shen, Li Chen, Liyue Zhang, Shuqiang Li","doi":"10.1097/MD.0000000000043265","DOIUrl":"10.1097/MD.0000000000043265","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the clinical effect of floating needle on primary dysmenorrhea.</p><p><strong>Methods: </strong>Wanfang database, Chinese Journal Full-text database, VIP database, PubMed, Embase, OVID, and Cochrane library were searched by computer to collect randomized controlled studies on floating acupuncture in the treatment of primary dysmorrhea published during the period from establishment to November 2023. Two researchers independently screened the literature, conducted multilevel screening, quality evaluation, extracted relevant data, and used Revman5.3 software and stata 17.0 software to conduct meta-analysis of the collected literature data.</p><p><strong>Results: </strong>A total of 16 randomized controlled studies were included, with a total of 1278 patients. The results of meta-analysis showed: overall effective rate (relative risk [RR] = 1.20, 95% confidence interval [CI] [1.15, 1.26], P < .00001), apparent rate (RR = 1.38, 95% CI [1.28,1.50], P < .00001), visual analog scale (VAS) score after treatment (mean difference [MD] = -1.07, 95%CI [-1.51, -0.63], P < .0001), VAS score after 30 minutes of treatment (MD = -1.94, 95% CI [-2.31, -1.57]), VAS score after 12 hours of treatment (MD = -1.31, 95%CI [-1.93, -0.69], P < .001), symptom score (MD = -2.93, 95% CI [-4.22, -1.65], P < .00001) and cox menstrual symptom scale score (MD = -4.53, 95% CI [-6.51, -2.55], P < .00001) were better than the control group, and the difference was statistically significant.</p><p><strong>Conclusion: </strong>The effect of floating acupuncture on primary dysmenorrhea is remarkable, which can significantly reduce the pain of patients.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 30","pages":"e43265"},"PeriodicalIF":1.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732156","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":"Advances in research on unphosphorylated STAT3: A review.","authors":"Lei Zhang, Wei Guo, Na Lu, Yuqing Tian, Jinghua Yang, Liang Wang","doi":"10.1097/MD.0000000000043476","DOIUrl":"10.1097/MD.0000000000043476","url":null,"abstract":"<p><p>Signal transducer and activator of transcription 3 (STAT3), a member of the STAT family, is a pivotal player in multiple cellular processes including proliferation, migration, differentiation, angiogenesis, programmed cell death, inflammatory response, and immune activation. As a transcription factor, the regulation of STAT3 activity is incredibly complicated as it is implicated signaling pathways in many distinct types of cells and under a diverse array of conditions. The activation of STAT3 commonly depends on the phosphorylation of specific residues in response to numerous growth factors and cytokines. With the discovery of STAT3 mediating gene expression in the absence of tyrosine/serine phosphorylation, a growing number of investigations related to unphosphorylated signal transducer and activator of transcription 3 (U-STAT3) demonstrated that U-STAT3 possess distinct features in regulation of gene expression. Herein, we summarize the current research progress in the roles of U-STAT3 in transcription and try to provide a basis for better understanding the complicated STAT3 activity regulation and its diverse functions.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 30","pages":"e43476"},"PeriodicalIF":1.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732159","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 bibliometric analysis of the published studies in ciprofol research.","authors":"Wei Wu, Yanting Sun, Zhaoting Li, Yuntai Yao","doi":"10.1097/MD.0000000000043567","DOIUrl":"10.1097/MD.0000000000043567","url":null,"abstract":"<p><strong>Objective: </strong>Ciprofol (HSK-3486), a novel intravenous anesthetic with structural similarities to propofol, has shown promising pharmacokinetic (PK) and pharmacodynamic (PD) profiles; however, clinical data regarding its efficacy and safety remain limited. Because research on ciprofol is still in its infancy, this study uses bibliometric methods to examine the published literature and to highlight research trends, key topics, and future directions for its clinical applications.</p><p><strong>Methods: </strong>We searched the Web of Science Core Collection (WoSCC) for English-language articles and reviews on ciprofol published from 2017 - the year it was first reported - through August 28, 2024. Two authors independently screened titles and abstracts for eligibility, discrepancies were resolved in consultation with a senior reviewer. The data, including publication details and citation metrics, were extracted and organized for analysis. We visualized the results with CiteSpace, GraphPad Prism, and Microsoft Excel.</p><p><strong>Results: </strong>A total of 62 studies were included. Annual publications rose by 50% from 2021 to 2022 and by 83% from 2022 to 2023. China dominated the field, contributing 59 articles (95.16% of the total). Sichuan University and Liu X. were the most prolific institution and author, respectively. BMC Anesthesiology, Drug Design, Development and Therapy, Frontiers in Pharmacology, and Journal of Clinical Anesthesia were the 4 leading journals publishing ciprofol research. Frontiers in Pharmacology received the most citations (n = 71) and achieved an H-index of 4. Anesthesiology carried the highest 2022 impact factor (9.1), whereas Anesthesia and Analgesia accrued 48 citations. Safety, pharmacokinetics, and anesthesia were the most frequently studied aspects, whereas \"critically ill patients,\" \"injection,\" and \"pain\" emerged as recent research hotspots. Temporal analysis showed that key terms shifted from \"pharmacokinetics\" in 2021 to \"general anesthesia\" by 2022, while themes such as \"critically ill patients\" remained consistently relevant.</p><p><strong>Conclusion: </strong>This bibliometric analysis provides a comprehensive overview of ciprofol research, identifies key contributors, and reveals critical insights and gaps in the literature. Our findings underscore ciprofol's safety, efficacy, and optimal clinical use while highlighting current hotspots and challenges that should guide future research.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 30","pages":"e43567"},"PeriodicalIF":1.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case report of pancreaticoduodenectomy with en bloc celiac axis resection.","authors":"Mengna Zhang, Bin Zhang, Ying'an Zhao, Anle Wu, Jiyun Zhu, Xuanlei Ren, Jianbo Zheng, Siming Zheng","doi":"10.1097/MD.0000000000042233","DOIUrl":"10.1097/MD.0000000000042233","url":null,"abstract":"<p><strong>Objective: </strong>To summarize the clinical experience of a case report of pancreaticoduodenectomy (PD) with en bloc celiac axis (CA) resection for locally advanced pancreatic cancer.</p><p><strong>Methods: </strong>We retrospectively analyzed the clinical data of a patient with locally advanced pancreatic cancer who underwent PD with en bloc CA resection after neoadjuvant chemotherapy and embolization of the proper hepatic artery at the Department of Hepatopancreatobiliary Surgery of the First Affiliated Hospital of Ningbo University in May 2023. This study was approved by the ethics committee of the Ningbo First Hospital.</p><p><strong>Results: </strong>This case was operated on smoothly with an operative time of 535 minutes and intraoperative bleeding of approximately 800 mL. Only short-term elevation of hepatic aminotransferase appeared in the postoperative period, which was improved by hepatoprotective and symptomatic treatments. The patient was discharged from the hospital 20 days postoperatively, and no tumor recurrence occurred in the follow-up period.</p><p><strong>Conclusion: </strong>In patients with locally advanced pancreatic cancer with simultaneous invasion of the celiac trunk, common hepatic artery, and hepatic innominate artery, total PD with en bloc CA resection is safe and feasible in cases where neoadjuvant chemotherapy is effective and after establishing hepatic collateral circulation by preoperative embolization of the hepatic innominate artery. Meanwhile, more cases from more centers are needed to validate this conclusion.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 30","pages":"e42233"},"PeriodicalIF":1.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732181","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":"Asymptomatic young male with ectopia cordis interna: A rare case report.","authors":"Hashim Talib Hashim, Mohammedbaqer Ghuraibawi, Fatimah Abdullah Sulaiman, Batool S Al-Aboudi, Zainab Ahmed Lateef, Ashraf Fhed Mohammed Basalilah, Bashar Hadi Shalan","doi":"10.1097/MD.0000000000043626","DOIUrl":"10.1097/MD.0000000000043626","url":null,"abstract":"<p><strong>Rationale: </strong>Ectopia cordis interna is a rare congenital condition that occurs when the heart is found within the abdominal cavity.</p><p><strong>Patient concerns: </strong>A 22-year-old Iraqi male with a chest infection presented to the clinic with a chest infection, during which the anomaly was incidentally discovered.</p><p><strong>Diagnoses: </strong>Although there are no clear symptoms, the anomaly can lead to potential risks during any abdominal procedures.</p><p><strong>Interventions: </strong>The patient got a chest X-ray for his infection, which revealed the anomaly.</p><p><strong>Outcomes and lessons: </strong>The case highlights the importance of early detection of this condition through imaging modalities and the need for focused research into its long-term implications and management strategies.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 30","pages":"e43626"},"PeriodicalIF":1.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732191","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":"Diagnostic and therapeutic challenges of Candida albicans infection post-lumbar surgery in a rheumatoid arthritis patient: A case report and review of the literature.","authors":"Yulei Wang, Fanzhe Feng, Zhongzheng Yu, Jinlong Liang, Yongqing Xu, Tianhua Zhou, Nengqi Shao, Wenhao Xu, Yi Cui","doi":"10.1097/MD.0000000000042970","DOIUrl":"10.1097/MD.0000000000042970","url":null,"abstract":"<p><strong>Rationale: </strong>Postoperative Candida albicans infections are exceedingly rare in urban populations, especially among patients on long-term immunosuppressive therapy. To date, there have been no reported cases of rheumatoid arthritis (RA) patients developing C albicans infections following spinal surgery. This report aims to highlight this rare occurrence and share insights on management strategies.</p><p><strong>Patient concerns: </strong>A 53-year-old Han Chinese male patient was admitted with severe pain in the right lower limb. He had a 3-year history of RA and was on continuous antirheumatic medication. The postoperative course was complicated by the development of a C albicans infection, which was confirmed after multiple diagnostic measures.</p><p><strong>Diagnoses: </strong>The patient was diagnosed with postoperative C albicans infection based on intraoperative sampling and laboratory confirmation 79 days after spinal surgery.</p><p><strong>Interventions: </strong>The patient underwent targeted antifungal therapy, including an 8-week intravenous course followed by a 3-month oral itraconazole regimen. Supportive measures included meticulous perioperative management, nutritional support, and physical rehabilitation.</p><p><strong>Outcomes: </strong>The infection was successfully controlled, leading to the complete resolution of symptoms. The patient achieved a clinical cure, demonstrating the efficacy of combined antifungal therapy and comprehensive perioperative care.</p><p><strong>Lessons: </strong>This case underscores the importance of vigilant perioperative management in RA patients, especially those with immunosuppression. Individualized treatment strategies, close monitoring of nutritional and functional status, and timely antifungal intervention are essential for preventing and managing such rare infections. Furthermore, a review of literature since 1980 has enhanced our understanding of risk factors, diagnosis, and treatment of postoperative C albicans infections, informing better clinical practice.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 30","pages":"e42970"},"PeriodicalIF":1.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732211","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":"Postoperative radiotherapy enhances survival in NSCLC patients with moderate lymph node metastases following surgery: A SEER-based population cohort study.","authors":"Xuyang Chen, Zeliang Ma, Yinghong Ren, Ya Che, Genxiang Chen, Qian Liu, Xinhan Zhao","doi":"10.1097/MD.0000000000043367","DOIUrl":"10.1097/MD.0000000000043367","url":null,"abstract":"<p><p>The role of postoperative radiotherapy (PORT) for non-small cell lung cancer (NSCLC) is still debated. A nonlinear relationship may exist between the number of positive lymph nodes (PLN) and the benefits of PORT. Our study seeks to identify patient subgroups that could benefit from PORT by stratifying them based on PLN counts. We enrolled patients with pathologic N2 NSCLC who underwent surgery and adjuvant chemotherapy between January 2004 and December 2015 from the surveillance, epidemiology, and end results (SEER) database. Overall survival (OS) and lung cancer-specific survival (LCSS) were compared between patients receiving PORT and those not receiving PORT. The restricted cubic spline analysis model was applied to investigate the relationship between PLNs and survival. The Kaplan-Meier method was used to generate survival curves, and the log-rank test was applied to compare survival outcomes between the PORT and non-PORT groups. Cox proportional hazard models were employed to calculate adjusted hazard ratios and their corresponding 95% confidence intervals. A total of 4048 patients were eligible, with a median follow-up time of 103 months. PORT had a negative impact on OS (HR = 1.08, 95% CI = 1.01-1.17, P = .03) and showed no association with LCSS (HR = 1.06, 95% CI = 0.98-1.15, P = .14). The restricted cubic spline analysis analysis indicated that PLN counts could modify the effects of PORT on survival. Patients were categorized into 3 risk subgroups according to their PLN counts: low-risk (1-4 PLNs), moderate-risk (5-6 PLNs), and high-risk (over 6 PLNs). In the low-risk subgroup, PORT exhibited an adverse effect on OS (HR = 1.17, 95% CI = 1.00-1.28, P < .01). Conversely, in the moderate-risk subgroup, PORT improved OS (HR = 0.72, 95% CI = 0.60-0.87, P < .01). In the high-risk subgroup, PORT had no impact on OS (HR = 1.00, 95% CI = 0.86-1.16, P = 1.00). Analysis in LCSS showed consistent results. While PORT does not universally improve survival outcomes for all patients with pN2 NSCLC, it improves survival for those with a moderate number of PLNs.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 30","pages":"e43367"},"PeriodicalIF":1.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732244","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":"Unveiling the effect of diet-derived circulating antioxidants on brain cortical structure: New insights from Mendelian randomization.","authors":"Yin Xu, Menglong Zou, Jia Fu, Zhan Yi, Ying Zhu","doi":"10.1097/MD.0000000000043380","DOIUrl":"10.1097/MD.0000000000043380","url":null,"abstract":"<p><p>The brain, which contains high levels of catecholamines and unsaturated lipids, is particularly susceptible to oxidative damage. Against this background, increasing antioxidant levels through diet seems to be a potential approach to the prevention of neurodegenerative diseases. A recent innovative study suggests that the shape of the brain itself, rather than just the neural pathways, can have a significant impact on our cognitive processes. Here, we investigated the causal relationship between diet-derived circulating antioxidants and surface area (SA) and thickness (TH) of brain cortical structure using Mendelian randomization (MR). Published studies were used to identify instrumental variables related to absolute levels of circulating antioxidants like lycopene, retinol, ascorbate, and β-carotene, as well as antioxidant metabolites such as ascorbate, retinol, α-tocopherol, and γ-tocopherol. Outcome data on brain cortical structure were obtained from the ENIGMA consortium, which included a total of 51,665 participants. Following the guidelines of the Desikan-Killiany atlas, the cortical structure was divided into 34 regions, resulting in 70 phenotypes covering both the global and regional aspects of SA and TH. Inverse variance weighted or Wald ratio was chosen as the main method for MR analysis based on the number of single nucleotide polymorphisms. Furthermore, we performed sensitivity analyses to confirm the reliability of the findings. At the global level, absolute circulating levels of ascorbate were found to increase SA of the full cortex (β = 2244.536 mm2, 95% CI: 921.172 mm2 to 3567.901 mm2, P = .001) but had no causal relationship with TH of the full cortex (β = -0.008 mm, 95% CI: -0.020 mm to 0.005 mm, P = .228). For the levels of functional parcellation analysis, we found that circulating ascorbate metabolite significantly reduced the SA of the inferior parietal (β = -110.917 mm2; 95% CI: -176.543 mm2 to -45.292 mm2; P = .00092) and absolute circulating retinol significantly reduced the TH of the precuneus (β = -0.045 mm; 95% CI: -0.073 mm to -0.017 mm; P = .00146). No heterogeneity, pleiotropy or outliers were found. MR estimates suggest that absolute circulating levels of ascorbate increase the SA of the whole cortex. There were also 2 significant negative correlations between circulating antioxidants and cortical structure. These results provide important insights into how circulating antioxidants influence structural changes within specific cortical areas and remind us of the potential adverse consequences of supplementation with circulating antioxidants.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 30","pages":"e43380"},"PeriodicalIF":1.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732303","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}