Open Medicine最新文献

{"title":"Impact of multimodal health education and preoperative ocular fixation training on psychological stress and postoperative complications in patients undergoing pterygium surgery.","authors":"Shi-Jie Zhang","doi":"10.1515/med-2026-1480","DOIUrl":"10.1515/med-2026-1480","url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluated the effects of multimodal health education combined with preoperative ocular fixation training on patients undergoing pterygium surgery.</p><p><strong>Methods: </strong>A cohort of 88 patients who underwent pterygium surgery at Xining First People's Hospital from April 2025 to September 2025 were selected and randomly assigned to a control group (n=44) and an intervention group (n=44) using a random number table. The control group received routine high-quality nursing, and the intervention group received multimodal health education and preoperative ocular fixation training in addition to routine care. Disease uncertainty, psychological stress scores, and postoperative complications were compared between the two groups.</p><p><strong>Results: </strong>Following the intervention, patients in the intervention group had significantly lower Mishel Uncertainty in Illness Scale (MUIS) scores compared with the control group (p<0.05). Psychological resilience scores were significantly higher in the intervention group (p<0.05). The incidence rates of eye pain (11.36 %), infection (0), and dry eye (0) in the intervention group were lower than those observed in the control group (79.55 , 13.64, and 15.91 %, respectively) (p<0.05).</p><p><strong>Conclusions: </strong>Multimodal health education combined with preoperative ocular fixation training markedly reduced psychological stress and illness uncertainty in patients undergoing pterygium surgery and was associated with lower postoperative complication rates.</p>","PeriodicalId":19715,"journal":{"name":"Open Medicine","volume":"21 1","pages":"20261480"},"PeriodicalIF":1.8,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13340829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148405468","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":"Comparing outcomes of TAVI and SAVR in low or intermediate risk symptomatic severe aortic stenosis: a systematic review and meta-analysis.","authors":"Khalid Rashid, Ahmedyar Hasan, Mustafa Javaid, Farrukh Ansar, Yahya Khan, Muhammad Hazqeel Kazmi, Taimur Farid, Faraz Waheed, Leena Ali, Salah Ali Saleh, Raza Ali Akbar, Muhammad Aamir Waheed","doi":"10.1515/med-2026-1466","DOIUrl":"10.1515/med-2026-1466","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the mortality and clinical outcomes of transcatheter aortic valve implantation (TAVI) versus surgical aortic valve replacement (SAVR) in patients with low- or intermediate-risk symptomatic severe aortic stenosis through an updated systematic review and meta-analysis of randomized controlled trials.</p><p><strong>Methods: </strong>This systematic review was performed using PubMed, Medline, Embase, and Cochrane databases for RCTS between 2017 and 2024 which evaluated mortality outcomes in patients with low to intermediate risk AS who received TAVI vs. SAVR. Relative risks (RRs) with 95 % confidence intervals (CIs) were pooled using random effects models.</p><p><strong>Results: </strong>TAVI showed a numerically lower but statistically insignificant mortality risk compared to SAVR (RR: 0.88, 95 % CI: 0.62-1.25, p=0.49). TAVI was associated with a higher risk of PPM insertion (RR: 2.19, 95 % CI: 1.55-3.16, p<0.001, i2: 80 %), aortic valve re-intervention (RR: 2.51, 95 % CI: 1.40-4.51, p<0.001; I²=0 %), new-onset bundle branch block (RR: 2.10, 95 % CI: 1.21-3.67, p<0.01; I²=84 %), and vascular site complications (RR: 4.77, 95 % CI: 2.11-10.81, p<0.001; I²=62 %). Atrial fibrillation incidence was lower with TAVI (RR: 0.29, 95 % CI: 0.23-0.38, p<0.001; I²=73). There was no significant difference in the rates of post-procedural myocardial infarction, stroke and endocarditis between TAVI and SAVR.</p><p><strong>Conclusions: </strong>TAVI has mortality outcomes comparable to SAVR in low to intermediate risk patients. TAVI offers advantages in atrial fibrillation reduction, but is associated with increased risk of PPM insertion, vascular complications, new-onset bundle branch block, aortic valve re-intervention. Individualized treatment decisions remain important for optimizing outcomes in low to intermediate risk patients.</p><p><strong>Prospero registration number: </strong>CRD42024547882.</p>","PeriodicalId":19715,"journal":{"name":"Open Medicine","volume":"21 1","pages":"20261466"},"PeriodicalIF":1.8,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13340834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148405418","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 triglyceride-glucose index and sarcopenia in older adults without either dysglycemia or central obesity: a cross-sectional study from CHARLS.","authors":"Jiaojiao Lin, Zhaozhao Zhu","doi":"10.1515/med-2026-1487","DOIUrl":"10.1515/med-2026-1487","url":null,"abstract":"<p><strong>Objectives: </strong>This study investigated the association between the triglyceride-glucose (TyG) index and sarcopenia in a metabolically healthier older population.</p><p><strong>Methods: </strong>This cross-sectional study utilized data from China Health and Retirement Longitudinal Study (CHARLS), involving 1,544 participants aged ≥60 years who were free of both dysglycemia (i.e., diabetes or prediabetes) and central obesity. Logistic regression was used to evaluate the association between the TyG index and sarcopenia.</p><p><strong>Results: </strong>Participants with sarcopenia had a significantly lower TyG index than those without sarcopenia (8.29 [8.01-8.59] vs. 8.38 [8.07-8.69]; p=0.001), and the prevalence of sarcopenia declined progressively across TyG quartiles (Q1-Q4: 54.3 %, 53.4 %, 47.4 %, 43.8 %; p for trend=0.001). After adjustment for significant covariates, a higher TyG index was independently associated with lower odds of sarcopenia (per quartile: OR = 0.826, 95 % CI: 0.720-0.947; per unit: OR = 0.714, 95 % CI: 0.517-0.985). Compared with the lowest quartile, participants in the highest quartile had a 44.8 % lower odds of sarcopenia (OR = 0.552, 95 % CI: 0.357-0.852).</p><p><strong>Conclusion: </strong>Among older adults without either dysglycemia or central obesity, a higher TyG index was independently associated with a lower odds of sarcopenia.</p>","PeriodicalId":19715,"journal":{"name":"Open Medicine","volume":"21 1","pages":"20261487"},"PeriodicalIF":1.8,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13340828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148405453","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":"Complementary mNGS and traditional testing for bloodstream infections.","authors":"Dongjuan Chen, Xuemei Li, Zhenhui Wang, Liping Huang, Liu Qin","doi":"10.1515/med-2026-1494","DOIUrl":"10.1515/med-2026-1494","url":null,"abstract":"<p><p>Bloodstream infections (BSIs) require rapid and accurate etiological diagnosis to guide timely antimicrobial therapy. Conventional diagnostic approaches, particularly blood culture, remain indispensable for antimicrobial susceptibility testing; however, they are limited by prolonged turnaround time and reduced sensitivity, especially following prior antibiotic exposure. Metagenomic next-generation sequencing (mNGS) has emerged as a culture-independent and hypothesis-free diagnostic tool capable of detecting a broad spectrum of pathogens directly from clinical samples. This approach is particularly advantageous for identifying rare, fastidious, and polymicrobial infections, as well as infections in immunocompromised patients. However, its clinical application remains constrained by challenges in distinguishing infection from colonization, interpreting antimicrobial resistance signals, and variability in bioinformatics pipelines. Thus, in the era of integrated diagnosis, mNGS does not replace but powerfully complements traditional methods. Furthermore, we propose a dynamic evidence-weighted integrated diagnostic framework to guide real time clinical decision and improve the clinical applicability of mNGS in bloodstream infections.</p>","PeriodicalId":19715,"journal":{"name":"Open Medicine","volume":"21 1","pages":"20261494"},"PeriodicalIF":1.8,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13340825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148405430","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":"Serum levels of SIRT3 in elderly patients undergoing general anesthesia and its relationship with postoperative delirium.","authors":"Linfeng Li, Huai Zhang, Rong Qian, HuiJuan Wang, Min Zhang, Lu Tang, Min Liao","doi":"10.1515/med-2025-1359","DOIUrl":"10.1515/med-2025-1359","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate whether serum SIRT3 levels can predict postoperative delirium (POD) in elderly patients undergoing general anesthesia.</p><p><strong>Methods: </strong>A prospective observational study was conducted on 118 elderly patients who underwent general anesthesia from January 2021 to December 2023. POD was assessed using the Confusion Assessment Method (CAM) within 72 h post-surgery. Serum SIRT3, IL-6, IL-1β, IL-17, and CRP levels were measured by ELISA. Clinical data including surgical time, anesthesia time, and blood loss were recorded. Statistical analysis was performed using SPSS 25.0 (p<0.05 considered significant).</p><p><strong>Results: </strong>Compared to non-POD patients, those with POD had longer surgery and anesthesia durations, lower hemoglobin and albumin levels, significantly lower serum SIRT3, and higher IL-6, IL-1β, and IL-17 levels. Serum SIRT3 was inversely correlated with IL-1β and IL-17. ROC analysis suggested SIRT3 as a potential predictive biomarker for POD. Logistic regression identified low SIRT3, low albumin, and elevated IL-1β and IL-17 as risk factors.</p><p><strong>Conclusions: </strong>Serum SIRT3 is significantly reduced in elderly POD patients and may serve as a predictive biomarker and potential therapeutic target for POD.</p>","PeriodicalId":19715,"journal":{"name":"Open Medicine","volume":"21 1","pages":"20251359"},"PeriodicalIF":1.8,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13340832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148405443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of the relationship between serum LAMC2, TROAP and clinical stages and prognosis of non-muscle invasive bladder cancer.","authors":"Xiaolong He, Haiqin Zhu, Yongming Huang, Xiaolin Deng, Jianrong Huang","doi":"10.1515/med-2026-1481","DOIUrl":"10.1515/med-2026-1481","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the relationship between serum LAMC2 and TROAP levels and clinical stage and prognosis in non-muscle invasive bladder cancer (NMIBC) patients.</p><p><strong>Methods: </strong>Serum LAMC2 and TROAP levels were measured in 102 NMIBC patients and 104 healthy controls. NMIBC patients were followed up and grouped by survival status. Correlations, prognostic factors, and diagnostic value were analyzed.</p><p><strong>Results: </strong>The serum levels of LAMC2 and TROAP in the research group were higher than those in the control group, and the two were positively correlated (r=0.303, p=0.002). The proportion of patients with high serum expression of LAMC2 and TROAP in stages III-IV was higher than that in patients with low expression (p<0.05). The 3-year survival rate of patients with high expression of LAMC2 and TROAP was lower than that of patients with low expression of both (p<0.05). Elevated levels of serum LAMC2 and TROAP, as well as TNM stages III-IV, were risk factors for mortality in NMIBC patients (p<0.05). The combined diagnosis of serum LAMC2 and TROAP showed better AUC than single diagnosis (Z=2.234, 2.864, p<0.05).</p><p><strong>Conclusions: </strong>Elevated serum LAMC2 and TROAP are linked to advanced stage and poor prognosis in NMIBC. Their combination improves prognostic diagnostic value.</p>","PeriodicalId":19715,"journal":{"name":"Open Medicine","volume":"21 1","pages":"20261481"},"PeriodicalIF":1.8,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13336265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148437123","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 adjuvant chemotherapy in patients with late-onset stage II/III colon cancer: a retrospective cohort study.","authors":"Peng Song, Yongjie Zhao, Wencong Tian, Jia Zhao, Yanhong Liu, Chuntao Wang, Lei Cao","doi":"10.1515/med-2026-1442","DOIUrl":"10.1515/med-2026-1442","url":null,"abstract":"<p><strong>Objectives: </strong>Studies providing more evidence to guide adjuvant chemotherapy decisions in colon cancer patients aged 50 years and older are expected.</p><p><strong>Methods: </strong>Eligible patients were recruited from the Surveillance, Epidemiology and End Results (SEER) database between 2010 and 2015. The cancer-specific survival (CSS) rate was analyzed using the Kaplan-Meier method, and comparisons of survival difference between different subgroups were performed using the log-rank test. Multivariate Cox proportional hazards regression models were built to assess hazard ratios (HRs) of different variables with 95 % confidence intervals (95 % CIs).</p><p><strong>Results: </strong>In stage II colon cancer patients aged 50 years or older, the Kaplan-Meier survival analysis showed that the 5-year CSS rates of chemotherapy and no chemotherapy groups were 83.5 % and 85.6 %, respectively (p=0.0047). Patients with chemotherapy receipt were associated with a higher cancer-specific mortality rate (HR=1.134, 95 % CI: 1.027-1.252, p=0.013); however, further subgroup analyses indicated that this finding is highly likely driven by unmeasured confounding and selection bias rather than direct treatment-related harm. For stage III patients of the same age group, 5-year CSS was 74.2 % (chemotherapy) vs. 56.4 % (no chemotherapy, p<0.0001), and chemotherapy was linked to a 49.3 % lower cancer-specific mortality (HR=0.507, 95 % CI: 0.482-0.534, p<0.001).</p><p><strong>Conclusions: </strong>Adjuvant chemotherapy should be considered during the treatment of stage III colon cancer patients aged 50 years or older. For stage II patients, a generalized survival advantage from chemotherapy was not observed, which highlights the profound impact of selection bias in observational data and strongly emphasizes the necessity of precise, individualized risk stratification before administering treatment.</p>","PeriodicalId":19715,"journal":{"name":"Open Medicine","volume":"21 1","pages":"20261442"},"PeriodicalIF":1.8,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13336266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148437150","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":"Pericentric inversion in chromosome 2 and their fertility issues: three cases report and literature review.","authors":"Wenjie Tian, Ranwei Li, Xiuyan Wang","doi":"10.1515/med-2026-1408","DOIUrl":"10.1515/med-2026-1408","url":null,"abstract":"<p><strong>Objectives: </strong>Genetic counseling remains challenging for carriers of chromosomal inversions due to variable reproductive outcomes. This study aims to characterize the clinical features of three male carriers with chromosome 2 inversion.</p><p><strong>Methods: </strong>All participants underwent comprehensive assessment, including karyotype analysis and semen examination. Relevant cases were retrieved via PubMed, and candidate genes at chromosome 2 breakpoints were analyzed.</p><p><strong>Results: </strong>xCytogenetic analysis identified three karyotypes: 46,XY,inv(2)(p15q13), 46,XY,inv(2)(p13q11), and 46,XY,inv(2)(p11.2q13). A total of 22 previously reported cases were included for comparative analysis. inv(2)(p11q13) and inv(2)(p11.2q13) were the most prevalent karyotypes. Breakpoints at 2p11, 2p11.2, and 2q13 appeared to have minimal impact on spermatogenesis, while breakpoints at 2p13 and 2q11 may impair spermatogenesis by disrupting the structure and function of relevant genes located at 2p23, 2p13, 2q11, and 2q33.</p><p><strong>Conclusions: </strong>Detailed characterization of inversion breakpoints is essential for providing precise genetic counseling to carriers of chromosome 2 inversion.</p>","PeriodicalId":19715,"journal":{"name":"Open Medicine","volume":"21 1","pages":"20261408"},"PeriodicalIF":1.8,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13336267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148437392","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":"Effect of navigated transcranial magnetic stimulation for glioma surgery outcomes: a systematic review and meta-analysis.","authors":"Zhipeng Xu, Jinrong Wang, Wenming Wang, Hua Liu","doi":"10.1515/med-2025-1326","DOIUrl":"10.1515/med-2025-1326","url":null,"abstract":"<p><strong>Objectives: </strong>Gliomas are the most common primary brain tumors in adults, often linked to poor prognosis despite advances in treatment. Navigated transcranial magnetic stimulation (nTMS) is a non-invasive preoperative mapping technique that may improve glioma surgery outcomes by enhancing tumor resection and preserving neurological function. This meta-analysis evaluates the impact of nTMS on glioma resection outcomes.</p><p><strong>Methods: </strong>A literature search was conducted in PubMed, Embase, Cochrane Library, and Web of Science up to September 2024 for cohort or case-control studies comparing nTMS-guided surgery with conventional planning, with or without subcortical fibre-guided tractography (SFG) and intra-operative neurophysiological monitoring (IONM). Data on extent of resection, motor function, quality of life (Karnofsky Performance Status), and complications were extracted. Statistical analysis was performed using RevMan 5.3. This study was registered at PROSPERO (registration number CRD42025641788).</p><p><strong>Results: </strong>Five studies with 736 patients were included. The nTMS group showed significantly higher rates of gross total resection (GTR) and lower rates of subtotal resection (STR) compared to the non-nTMS group. No significant differences were found in postoperative motor function or quality of life. Two studies comparing nTMS + SFG + IONM with IONM alone demonstrated higher GTR rates (absolute increase 12-18 %) and reduced permanent motor paresis (3-6 % vs. 9-14 %); one reached statistical significance for neurological outcomes.</p><p><strong>Conclusions: </strong>Pre-operative nTMS significantly improves the anatomical radicality of glioma resection without increasing early neurological morbidity. Integration of nTMS with SFG-based tractography and IONM may confer additional functional protection, highlighting the value of a multimodal mapping strategy for tumors abutting motor-eloquent cortex. Further studies are needed to confirm these findings.</p>","PeriodicalId":19715,"journal":{"name":"Open Medicine","volume":"21 1","pages":"20251326"},"PeriodicalIF":1.8,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13321228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148369399","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":"Procalcitonin neutralization in sepsis: unresolved effects on mononuclear phagocytes.","authors":"Franz J Wiedermann, Wolfgang Lederer, Norbert Mutz, Christian J Wiedermann","doi":"10.1515/med-2026-1470","DOIUrl":"10.1515/med-2026-1470","url":null,"abstract":"","PeriodicalId":19715,"journal":{"name":"Open Medicine","volume":"21 1","pages":"20261470"},"PeriodicalIF":1.8,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13313139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148353015","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}