Postgraduate Medical Journal最新文献

{"title":"Therapeutic targets for gastrointestinal diseases: proteome-wide Mendelian randomization and colocalization analyses.","authors":"Daqin Zhan, Zhihao Yang, Pengcheng Li, Jun Pan","doi":"10.1093/postmj/qgae140","DOIUrl":"10.1093/postmj/qgae140","url":null,"abstract":"<p><strong>Purpose: </strong>This study was aimed to identify serum proteins linked with gastrointestinal diseases by proteome-wide Mendelian randomization analysis.</p><p><strong>Methods: </strong>We determined the casual relationship between 732 kinds of circulating proteins and the 24 kinds of gastrointestinal diseases via Mendelian randomization analysis.</p><p><strong>Results: </strong>Four circulating proteins (FCGR3B, IL-12B, MAPKAPK2, and IL-23R) were associated with the occurrence of ulcerative colitis (UC), and IL23R was also correlated with risk of Crohn's disease (CD). Genetically predicted levels of IL23R were strongly correlated with the risk of UC and CD based on the high supporting evidence of colocalization analysis. Five circulating proteins (NOV, EFEMP1, ADGRE2, LCT, and SEMA3G) were associated with the risk of diverticulosis disease. With high supporting evidence of colocalization, genetically predicted levels of NOV and SEMA3G were inversely correlated with the risk of diverticulosis disease. Five circulating proteins (FUT3, FUT5, CRHBP, SULT2A1, and QPCTL) were associated with the occurrence of cholelithiasis. With high supporting evidence of colocalization, genetically predicted levels of FUT3 and CRHBP were inversely correlated with the risk of cholelithiasis.</p><p><strong>Conclusions: </strong>The proteome-wide Mendelian randomization investigation identified several circulating proteins associated with the risk of UC, CD, diverticular disease and cholelithiasis, which reinforced the understanding of molecular pathogenesis and design of therapeutic targets.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"283-290"},"PeriodicalIF":3.6,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142472940","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":"Long-term trends analysis of the incidence and mortality in patients with ovarian cancer: a large sample study based on SEER database.","authors":"Hongwei Zhao, Yu Zhang, Qianyong Zhu","doi":"10.1093/postmj/qgae143","DOIUrl":"10.1093/postmj/qgae143","url":null,"abstract":"<p><strong>Background: </strong>To analyze long-term trends of the incidence and mortality of ovarian cancer in the United States.</p><p><strong>Methods: </strong>Patients diagnosed with ovarian cancer were obtained from the Surveillance, Epidemiology, and End Results (SEER) database between 2000 and 2017. Joinpoint regression analysis was used to analyze the incidence and mortality trend, and the changes were reported as average annual percentage change (AAPC) with a 95% confidence interval (CI). Kaplan-Meier survival curve and Cox regression analyses were utilized for survival analysis.</p><p><strong>Results: </strong>A total of 74 682 patients were included, among whom 49 491 (66.27%) died and 44 487 (59.57%) died from ovarian cancer. The mean age was 61.95 ± 15.23 years. The incidence of ovarian cancer showed a decreased trend from 2000 to 2017 with an AAPC of -1.9 (95%CI: -2.0, -1.7). Both the overall mortality and cancer-specific mortality for ovarian cancer decreased from 2000 to 2017, with AAPCs of -5.0 (95%CI: -5.7, -4.2) and -4.6 (95%CI: -5.4, -3.8), respectively. There was a significant decrease in the incidence and mortality of patients with the distant SEER stage, histological subtypes of serous and malignant Brenner carcinoma, and grades II and III from 2000 to 2017. Older age, Black race, histological subtypes of carcinosarcoma, higher tumor grade, and radiotherapy were associated with poorer overall survival and cancer-specific survival, whereas higher income, histological subtype of endometrioid, and surgery were associated with better survival.</p><p><strong>Conclusion: </strong>This study provided evidence of a statistically significant decrease in the incidence and mortality of ovarian cancer from 2000 to 2017. Key message What is already known on this topic?  Ovarian cancer is one of the most common tumors in women, with high morbidity and mortality. However, trends in long-term morbidity and mortality of patients with ovarian cancer have not been reported. What this study adds  Overall incidence and mortality for ovarian cancer showed a decreased trend from 2000 to 2017, and trends in incidence and mortality varied by stage, histological subtype, and tumor grade. Factors associated with overall survival and cancer-specific survival also differ. How this study might affect research, practice, or police  This study provides evidence of long-term trends in ovarian cancer incidence and mortality from 2000 to 2017.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"302-312"},"PeriodicalIF":3.6,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546944","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":"LLMs may improve medical communication: social science perspective.","authors":"Shuo Wang, Tianyu Liu, Shotaro Kinoshita, Hiromi M Yokoyama","doi":"10.1093/postmj/qgae101","DOIUrl":"10.1093/postmj/qgae101","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"384-385"},"PeriodicalIF":3.6,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141913736","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 introduction to anatomical pathology.","authors":"Jack D Hywood, Albert H Yin","doi":"10.1093/postmj/qgae160","DOIUrl":"10.1093/postmj/qgae160","url":null,"abstract":"<p><p>Our experience in the Australian context is that medical students and clinicians receive minimal exposure to anatomical pathology throughout the course of their training. In this paper, we bring this topic to light by describing the process of converting an intact specimen into glass slides for microscopic analysis. We also explain how a pathological report is composed, along with brief discussions about ancillary tests, such as immunohistochemistry, special stains, and molecular testing. Our main goal is to familiarize clinicians with anatomical pathology in order to improve communication between clinicians and pathologists, as well as improve the quality of testing and patient care.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"366-370"},"PeriodicalIF":3.6,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695760","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":"Association between asthma and depression: results from the NHANES 2005-2018 and Mendelian randomization analysis.","authors":"Yikun Guo, Jun Yan","doi":"10.1093/postmj/qgae147","DOIUrl":"10.1093/postmj/qgae147","url":null,"abstract":"<p><strong>Objective: </strong>Asthma is a common respiratory disease that is believed to be associated with mental disorders. This study aims to assess the correlation and causal relationship between asthma and depression by combining observational and Mendelian randomization (MR) approaches.</p><p><strong>Methods: </strong>We collected relevant data from the National Health and Nutrition Examination Survey (NHANES) and employed multivariable logistic regression to evaluate the correlation between asthma and depression. Additionally, a two-sample MR analysis was conducted using inverse variance-weighted (IVW) method, along with multiple sensitivity analyses.</p><p><strong>Results: </strong>The observational study included a total of 23 648 participants, and the results showed that asthma patients had an increased risk of developing depression compared to non-asthma individuals (OR 1.26; 95% CI 1.04-1.57; P < 0.01). The IVW-MR results from two datasets indicated a potential causal relationship between asthma and depression (EBI dataset: OR 1.141; 95% CI 1.051-1.239; P = 0.01; UKB dataset: OR 1.009; 95% CI 1.005-1.013; P < 0.01). These findings suggest that asthma may be a risk factor for the onset of depression, increasing the risk of developing depression.</p><p><strong>Conclusion: </strong>There is a significant correlation and potential causal relationship between asthma and depression, with asthma being a risk factor for the onset of depression. These findings warrant further research for validation and exploration of preventive and therapeutic measures for depression in asthma patients. Key messages What is already known on this topic-There are some potential associations between asthma and depression based on observational studies, but the results of observational studies are often biased. This study aims to further explore the relationship between asthma and depression through a combination of observational studies and Mendelian randomization (MR) analysis. What this study adds-The observational study results from the National Health and Nutrition Examination Survey database and MR analysis are consistent, indicating that after adjusting for multiple covariates and confounding factors, asthma increases the risk of depression and is a risk factor for depression, with similar results obtained at the genetic level. How this study might affect research, practice or policy-Asthma patients not only need active medication treatment, but also need timely psychological attention, and psychological treatment is more important to a certain extent.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"291-301"},"PeriodicalIF":3.6,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546914","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":"Over-the-scope clips for Nonvariceal upper gastrointestinal bleeding: a systematic review and meta-analysis of randomized studies.","authors":"Yuanzhi Ni, Kamran Ali, Penghao Tang, Khizar Hayat, Zhiwen Cheng, Benfeng Xu, Zhiwen Qin, Wu Zhang","doi":"10.1093/postmj/qgae155","DOIUrl":"10.1093/postmj/qgae155","url":null,"abstract":"<p><strong>Background & aims: </strong>Nonvariceal upper gastrointestinal bleeding (NVUGIB) is a common and potentially life-threatening condition. Over-the-scope clips (OTSCs) have emerged as a promising endoscopic treatment option for NVUGIB. We aimed to analyze the efficacy and safety of OTSCs compared to standard endoscopic treatments (ST) in patients with NVUGIB.</p><p><strong>Methods: </strong>We conducted a comprehensive search of PubMed, Embase, Scopus, and Cochrane Library databases from inception to June 2024 for randomized controlled trials (RCTs) comparing OTSCs with ST for NVUGIB. The primary outcomes were initial hemostasis and persistent bleeding. Secondary outcomes included rebleeding rates, mortality, hospital stays and others. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random/fixed-effects models.</p><p><strong>Results: </strong>Six RCTs involving 621 patients were included in the meta-analysis. OTSCs demonstrated significantly higher initial hemostasis (OR 4.80, 95% CI 1.78-12.96; P = 0.002) and lower persistent bleeding rates (OR 0.17, 95% CI 0.05-0.56; P = 0.003) compared to ST group. The rebleeding rate was significantly lower in the OTSC group 7-days re-bleeding (OR 0.27, 95% CI 0.14-0.53; P = 0.001); 30-days rebleeding (OR 0.40, 95%CI 0.22, 0.70; P = 0.002). No significant differences were observed in mortality (OR 0.65, 95% CI 0.31-1.33; P = 0.38) and hospital stay (mean difference 0.79 days 95%CI -0.57, 2.15) between the two groups.</p><p><strong>Conclusions: </strong>OTSCs are more effective than ST for achieving hemostasis and preventing rebleeding in patients with NVUGIB, without increasing mortality. Key message What is Already Known  Previous studies have shown that nonvariceal upper gastrointestinal bleeding (NVUGIB) is a serious medical condition that needs effective endoscopic interventions. The success rates of standard treatments for achieving hemostasis and preventing rebleeding are not consistent. What This Study Adds  According to this study, over-the-scope clips (OTSCs) have the same mortality rate as standard endoscopic treatments, but they significantly improve initial hemostasis and lower rebleeding rates. Impact on Research, Practice, or Policy  The findings support the use of OTSCs as a preferred intervention for NVUGIB, which could affect clinical guidelines and encourage additional research focused on improving endoscopic techniques and patient outcomes in the management of gastrointestinal bleeding.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"351-359"},"PeriodicalIF":3.6,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583935","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":"Academic misconduct by Chinese medical staff.","authors":"Hong Zhang","doi":"10.1093/postmj/qgae098","DOIUrl":"10.1093/postmj/qgae098","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"383"},"PeriodicalIF":3.6,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889944","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":"Screening doctors in training for dyslexia: the benefits of an inclusive screening approach.","authors":"Sadhbh O'Dwyer, Glynis Lavington, Jane Miller, Chris Elfes, Antonia Calogeras, Fatima El-Bakri","doi":"10.1093/postmj/qgae162","DOIUrl":"10.1093/postmj/qgae162","url":null,"abstract":"<p><p>There is a lack of suitable screeners for dyslexia for doctors in training, as the typical adult screeners do not cater for the needs of capable medical graduates. The aim of this research is to create an inclusive screening and training process for doctors with undiagnosed dyslexia. This involved working with doctors to co-create a new dyslexia screener tool. We designed an innovative holistic dyslexia screening, assessment, and support system as part of a 3-year longitudinal study. Qualitative data was collected through the use of a dyslexia screener and case-study interviews with trainees in general practice and psychiatry. Interviews were thematically analyzed to explore dyslexic trainees' experiences of an inclusive approach to dyslexia screening and assessment. Out of the 103 trainees that were screened, 10 were found to have dyslexia, one dyspraxia, and another ADHD trait. Dyslexia-specific coaching, exam, and workplace accommodations were beneficial in dispelling stigma about dyslexia as well as supporting examination success. International Medical Graduate (IMG) trainees were also supported in this process. The case study participants' progression was tracked over 3 years, and all subsequently passed their examinations. We recommend that all trainees are given access to this inclusive, holistic, medical-focused dyslexia screening process. Specifically, this can enable newly diagnosed trainees to access support and exam accommodation. In particular, greater understanding of dyslexia helps dispel stigma and enable better support, which has a positive impact on trainee well-being as well as progression.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"360-365"},"PeriodicalIF":3.6,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667766","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":"Inflammatory cytokines, metabolites, and rheumatoid arthritis.","authors":"Zhou Peilin, Wang Wenqiang, Liu Yongzhen, Chen Xiang, Mo Yongjun, Su Hongjie, Nie Xinyu, Hua Qikai","doi":"10.1093/postmj/qgae146","DOIUrl":"10.1093/postmj/qgae146","url":null,"abstract":"<p><strong>Background: </strong>Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by persistent inflammation and joint destruction. Although the roles of inflammatory cytokines and metabolites in RA pathogenesis have caught a lot of attention, there is a lack of systematic studies, and their causal relationships remain unclear.</p><p><strong>Methods: </strong>We conducted a two-step mendelian randomization analysis utilizing genetic data from genome-wide association studies (GWAS) of inflammatory cytokines, metabolites, and RA. The first step assessed the causal effect of 91 inflammatory cytokines and 1400 metabolites on RA risk using inverse variance weighted method, complemented by MR-Egger, weighted median, simple mode and MR-PRESSO to ensure robustness and assess pleiotropy. The second step evaluated the mediation effects of selected metabolites on the relationship between cytokines and RA.</p><p><strong>Results: </strong>The analysis identified 9 inflammatory cytokines, including IL-1α and IL-10, which significantly increase RA risk, while TNF-β exhibited a protective effect. Additionally, 6 metabolites were associated with increased RA risk, including 1-(1-enyl-palmitoyl)-2-arachidonoyl-GPE and arachidonate (20:4n6). Conversely, 5 metabolites, such as docosatrienoate (22:3n3) and Cholesterol, were found to reduce RA risk. The mediation analysis revealed that TNF-β may exerts its protective effect through its influence on specific metabolites, and X-24949, which accounted for a -2.58% mediated effect in the TNF-β-RA causal pathway.</p><p><strong>Conclusion: </strong>This study explores the complex interplay between inflammatory cytokines, metabolites, and RA. The findings suggest potential biomarkers for early diagnosis and novel therapeutic targets, particularly those related to lipid metabolites and specific cytokines like TNF-β. Key message What is already known on this topic  Inflammatory factors and metabolites are considered to be related to the onset and progression of RA. What this study adds  We conducted a MR analysis to identify all inflammatory factors and metabolites associated with RA and calculated the mediation effect of inflammatory cytokines on RA through metabolites. This study contributes to a comprehensive understanding of the pathophysiological processes of RA. How this study might affect research, practice or policy  This has laid the groundwork for developing early diagnosis methods and future treatments.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"313-320"},"PeriodicalIF":3.6,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546943","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":"What should you have in your little black bag? A letter to a young doctor.","authors":"Ami Schattner","doi":"10.1093/postmj/qgae174","DOIUrl":"10.1093/postmj/qgae174","url":null,"abstract":"<p><p>Rather than looking at which instruments to put in the traditional physician's black bag, the changing face of medicine suggests that some virtual assets assume prime importance. With a solid background of core knowledge and skills acquired through medical school but continuously developed and updated, several habitual attitudes are advocated-each aiming to address a different facet of concerns in today's time-constrained, often impersonal, fast-changing, information-overloaded, and highly technological practice. They include humility, curiosity, \"red flag\" identification, and reflexive database consultation-each with myriad, diverse advantages.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"386-388"},"PeriodicalIF":3.6,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829661","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}