Tzu Chi Medical Journal最新文献

{"title":"Immune thrombocytopenia: Evolving mechanistic understanding and clinical development of new therapies.","authors":"Sheng-Chuan Huang, Chih-Lung Shen, Yi-Feng Wu","doi":"10.4103/tcmj.TCMJ-D-25-00206","DOIUrl":"10.4103/tcmj.TCMJ-D-25-00206","url":null,"abstract":"<p><p>Immune thrombocytopenia (ITP) is an acquired autoimmune disorder characterized by isolated thrombocytopenia resulting from increased platelet destruction, impaired platelet production, or both. Once viewed primarily as a benign, antibody-mediated condition, ITP is now recognized as a heterogeneous immune dysregulation syndrome involving autoreactive lymphocytes, innate immune activation, complement engagement, and megakaryocytic dysfunction. Although corticosteroids, intravenous immunoglobulin, anti-D immunoglobulin, rituximab, splenectomy, and thrombopoietin receptor agonists have constituted the therapeutic foundation for decades, these approaches remain limited by transient responses, toxicity, and insufficient disease modification. Advances in immunopathology have catalyzed the development of targeted therapeutics designed to interrupt discrete mechanisms underlying platelet destruction or impaired thrombopoiesis. Bruton tyrosine kinase (BTK) inhibitors (rilzabrutinib and orelabrutinib) modulate B-cell activation and macrophage effector pathways; spleen tyrosine kinase inhibitors (fostamatinib) block Fcγ receptor-mediated phagocytosis, neonatal Fc receptor inhibitors (efgartigimod and rozanolixizumab) accelerate IgG catabolism and rapidly reduce pathogenic autoantibody burden; and complement inhibition (sutimlimab) provides a rational strategy for patients in whom classical pathway activation contributes to refractory disease. Collectively, these agents represent the most significant expansion of the ITP treatment landscape in decades, offering steroid-sparing options and enabling more durable, individualized disease control. As ITP management transitions toward mechanism-based, biomarker-informed approaches, understanding the immunologic underpinnings of emerging therapies will be essential for optimizing treatment sequencing, improving long-term outcomes, and advancing personalized care for patients with this complex autoimmune disorder.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"38 3","pages":"300-311"},"PeriodicalIF":2.4,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13367604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148450025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fatty acid profile, vitamin D, and iodine status in Taiwanese vegans, vegetarians, and omnivores.","authors":"Kian Yuan Lim, Hui-Min Su, Ning-Sing Shaw, Anren Hu, Tina H T Chiu","doi":"10.4103/tcmj.TCMJ-D-25-00058","DOIUrl":"10.4103/tcmj.TCMJ-D-25-00058","url":null,"abstract":"<p><strong>Objectives: </strong>Vegan diet - the exclusion of all animal products, even eggs and dairy - ranked the most climate-friendly diet, but concerns persist regarding its nutritional adequacy, particularly for omega-3 fatty acids, vitamin D, and iodine. This study compares the nutritional status of fatty acids, vitamin D, and iodine, among Taiwanese vegans, vegetarians, and omnivores.</p><p><strong>Materials and methods: </strong>This cross-sectional study included 45 omnivores, 46 lacto-ovo vegetarians, and 24 vegans. Blood and urine samples were collected to analyze nutritional biomarkers, including erythrocyte fatty acid profiles, plasma vitamin D, and urinary iodine.</p><p><strong>Results: </strong>Vegans had the lowest median percentage of saturated fatty acids, trans-fatty acids, and omega-3 fatty acids, including EPA and DHA, but the highest levels of omega-6 fatty acids. The medians (P25-P75) of omega-3 index values were 2.6 (2.4-2.8), 3.7 (3.2-4.5), and 5.8 (5.0-6.5) for vegans, vegetarians, and omnivores, respectively. Vitamin D deficiency was most prevalent among vegans (75%), followed by omnivores (36%) and vegetarians (24%). Iodine insufficiency was also more common in vegans (76%) than in vegetarians (57%) and omnivores (56%).</p><p><strong>Conclusion: </strong>Taiwanese vegan diets may be advantageous in lowering saturated fatty acids and trans-fatty acid status but may be associated with a higher risk of deficiency for omega-3 fatty acids, vitamin D, and iodine. Strategies to enhance the adequacy of these nutrients may be needed to improve the quality of vegan diets.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"38 3","pages":"407-414"},"PeriodicalIF":2.4,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13367610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148449973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human leukocyte antigen study on a cohort of 149 Vietnamese umbilical cord blood samples.","authors":"Kuo-Liang Yang, Chi-Dung Phu, Shee-Ping Chen, Shu-Hui Wen, Py-Yu Lin","doi":"10.4103/tcmj.TCMJ-D-25-00100","DOIUrl":"10.4103/tcmj.TCMJ-D-25-00100","url":null,"abstract":"<p><strong>Objectives: </strong>We here report the distribution of the human leukocyte antigen (HLA)-A, -B, -C, -DRB1, and -DQB1 alleles among 149 units of Vietnamese umbilical cord blood samples and deduced their most probable HLA haplotypes for HLA-A/B loci, HLA-B/C loci, HLA-DRB1/DQB1 loci, HLA-A/C/B loci, HLA-A/C/B/DRB1 loci, and HLA-A/C/B/DRB1/DQB1 loci. Our objective is to reveal the unprecedented information on the distribution of HLA alleles in the Vietnamese cord blood and to find out the most probable HLA haplotypes associated with the various HLA alleles detected in the cohort of 149 cord blood specimens.</p><p><strong>Materials and methods: </strong>The material for this study was umbilical cord blood samples, preserved in acid citrate dextrose anticoagulants. The blood donors were umbilical cord blood donors whose parents voluntarily donated their newborn baby's cord blood to the Blood Transfusion and Hematology Hospital, Ho Chi Minh City, Vietnam. DNA sequence-based typing of the Sanger's sequencing method was performed for the HLA allelic typing. Target exon sequence amplifications were achieved by polymerase chain reaction (PCR), and the resulting amplicons were sequenced by BigDye Terminator Cycle Sequencing Ready Reaction Kit, according to the manufacturer's protocols.</p><p><strong>Results: </strong>In the total number of 149 randomized cord blood samples studied, we detected distinctive 22 HLA-A alleles, 23 HLA-C alleles, 44 HLA-B alleles, 27 HLA-DRB1 alleles, and 15 HLA-DQB1 alleles. In addition, we determined the most probable HLA haplotypes for the alleles detected.</p><p><strong>Conclusion: </strong>Our findings in this study are useful in research for the comprehensive understanding of the distribution of HLA alleles and their associated HLA haplotypes in Vietnamese cord blood. Further, the cord blood with HLA typing determined is now ready for matching search purpose for patients who are looking for suitable hematopoietic stem cell donations for transplantation therapeutic applications.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"38 2","pages":"197-202"},"PeriodicalIF":2.4,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13167076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insights into the role of the shock index and its derivatives in triage.","authors":"Da-Sen Chien, Tsung-Hsien Wu, Chi-Yuan Liu, Chien-Hsing Wang, Chia-Hung Tsai, Giou-Teng Yiang, Meng-Yu Wu","doi":"10.4103/tcmj.TCMJ-D-25-00124","DOIUrl":"10.4103/tcmj.TCMJ-D-25-00124","url":null,"abstract":"<p><p>Trauma is a considerable global public health concern. In Taiwan, the Taiwan Trauma Registry was established in 2005 through collaboration between the Formosa Association for the Surgery of Trauma and the government. However, the registry has not yet achieved full national integration, which limits its utility for research and policymaking. To address this gap, we integrated data from the four hospitals of the Tzu Chi Medical Foundation, which are located in northern, central, southern, and eastern Taiwan. This newly developed Tzu Chi Trauma Registry reflects the diverse characteristics of regional emergency medical service systems and provides a foundation for optimizing trauma care models and developing targeted injury prevention and clinical intervention programs. This review summarizes current tools for prehospital and in-hospital triage, focusing on the shock index and its derivatives. This review also discusses the predictive value of combining hemodynamic indices with neurological assessment tools with respect to clinical outcomes in patients with trauma, including predicting the need for transfusion, the need for massive transfusion protocol activation, and mortality. By performing a retrospective analysis of the Tzu Chi Trauma Registry, we aim to improve the accuracy of triage decision-making by reducing overtriage and undertriage, thereby enhancing the quality of trauma care and improving patient outcomes.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"38 2","pages":"174-180"},"PeriodicalIF":2.4,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13167078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acetazolamide in hydrocephalus management: Mechanistic insights and clinical challenges.","authors":"Li-Jin Chen, Sheng-Tzung Tsai, Guo-Fang Tseng","doi":"10.4103/tcmj.TCMJ-D-25-00108","DOIUrl":"10.4103/tcmj.TCMJ-D-25-00108","url":null,"abstract":"<p><p>Hydrocephalus is a heterogeneous neurological disorder characterized by impaired cerebrospinal fluid (CSF) dynamics, resulting in ventriculomegaly, neurological dysfunction, and substantial morbidity across pediatric and adult populations. Surgical CSF diversion remains the standard treatment but risks infection, shunt malfunction, and lifelong dependency, underscoring the need for potential nonsurgical adjuncts. Acetazolamide, a carbonic anhydrase inhibitor, has been investigated as a pharmacological approach to reduce CSF production, lower intracranial pressure, and modulate cerebral blood flow. More recently, acetazolamide has also been implicated in regulating aquaporin-mediated water transport and enhancing brain glymphatic clearance function mechanisms, particularly relevant to the pathophysiology of idiopathic normal pressure hydrocephalus. These emerging mechanistic insights have renewed interest in evaluating its potential in hydrocephalus management. Experimental studies and selective clinical applications suggest possible benefits; however, conclusive evidence remains at large across hydrocephalus subtypes. Beyond exploratory treatment strategies, acetazolamide has also been applied diagnostically, including in cerebrovascular reactivity testing and as a predictor of CSF shunt responsiveness. This review appraises the critical mechanistic rationale, experimental findings, and clinical evidence regarding acetazolamide in hydrocephalus management, highlighting current uncertainties and limitations. Well-designed, subtype-specific clinical trials are needed to clarify whether the modulation of CSF and glymphatic pathway functions can be translated into safe, consistent, and durable clinical benefit.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"38 2","pages":"137-144"},"PeriodicalIF":2.4,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13167087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the antidepressant effects of tirzepatide on unpredictable chronic mild stress-induced depression in Swiss Albino mice.","authors":"Jay Maradia, Shirish Shashikant Joshi, Paresh Koli, Manoj Radhakrishnan, Chitra Athavale","doi":"10.4103/tcmj.TCMJ-D-25-00078","DOIUrl":"10.4103/tcmj.TCMJ-D-25-00078","url":null,"abstract":"<p><strong>Objectives: </strong>Depression, diabetes, and obesity often coexist, forming a complex \"metabolic-mood syndrome\" characterized by inflammation, impaired neuroplasticity, and neuroendocrine dysregulation. Conventional antidepressants show limited efficacy in such cases and may worsen metabolic profiles. Tirzepatide, a dual glucagon-like peptide-1/glucose-dependent insulinotropic polypeptide receptor agonist approved for diabetes and obesity, may offer neuropsychiatric benefits. The objective of this study was to evaluate its antidepressant-like effects in an unpredictable chronic mild stress (UCMS)-induced depression model of Swiss Albino mice.</p><p><strong>Materials and methods: </strong>Forty male Swiss Albino mice were randomly divided into five groups (<i>n</i> = 8): normal control, disease control (DC) (UCMS + saline), positive control (UCMS + fluoxetine 10 mg/kg), and two test groups (UCMS + tirzepatide at 50 μg/kg and 120 μg/kg). UCMS was induced over 28 days. Behavioral assessments were conducted using forced swim test (FST) and tail suspension test (TST). After that, \"hippocampal brain-derived neurotrophic factor (BDNF)\" and \"whole brain interleukin (IL-6) and serotonin\" levels were analyzed using the enzyme-linked immunosorbent assay method.</p><p><strong>Results: </strong>Duration of immobility was significantly reduced in both FST and TST, in the high-dose group compared to the DC group. Hippocampal BDNF levels were significantly elevated in the high-dose group, suggesting enhanced neuroplasticity. While IL-6 and serotonin levels showed no statistically significant changes, the directional trends point toward possible anti-inflammatory effect and serotonergic modulation.</p><p><strong>Conclusion: </strong>This study provides preclinical evidence for the antidepressant-like effects of tirzepatide, likely mediated through neurotrophic and anti-inflammatory pathways. Tirzepatide holds promise as a novel therapeutic option for managing depression in patients with comorbid metabolic conditions.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"38 2","pages":"190-196"},"PeriodicalIF":2.4,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13167083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic performance of neutrophil-to-lymphocyte ratio in periprosthetic joint infection: A systematic review and meta-analysis.","authors":"Tzu-Rong Peng, Hung-Hong Lin, Tai-Yung Yi, Ta-Wei Wu","doi":"10.4103/tcmj.tcmj_60_25","DOIUrl":"10.4103/tcmj.tcmj_60_25","url":null,"abstract":"<p><strong>Objectives: </strong>Periprosthetic joint infection (PJI) is one of the most severe complications following joint replacement surgery, leading to significant morbidity, mortality, and healthcare burden. The neutrophil-to-lymphocyte ratio (NLR) has emerged as a potential biomarker for diagnosing PJI due to its simplicity and cost-effectiveness. However, the diagnostic utility of NLR remains unclear, warranting a systematic review and meta-analysis.</p><p><strong>Materials and methods: </strong>This study systematically reviewed 23 studies involving 11,657 patients, of whom 2061 had PJI. The pooled sensitivity, specificity, diagnostic odds ratio, and area under the summary receiver operating characteristic curve (AUC) were calculated to evaluate the diagnostic performance of NLR. Subgroup analyses were conducted based on the type of arthroplasty (total knee or hip replacement) and PJI classification (acute or chronic). Publication bias was assessed using Deeks' funnel plot.</p><p><strong>Results: </strong>The pooled sensitivity and specificity of NLR for diagnosing PJI were 0.71 (95% confidence interval [CI]: 0.66-0.76) and 0.70 (95% CI: 0.65-0.75), respectively. The AUC was 0.76, demonstrating moderate diagnostic accuracy. Subgroup analyses revealed consistent findings across acute and chronic PJI cases, as well as total knee and hip arthroplasties. NLR cutoff values ranged from 2.1 to 3.82 across studies, reflecting a lack of standardization.</p><p><strong>Conclusion: </strong>NLR is a promising biomarker for diagnosing PJI, offering moderate diagnostic accuracy and practical advantages due to its accessibility and cost-effectiveness. However, standardization of NLR thresholds and further validation in prospective studies are needed to optimize its clinical utility.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"38 2","pages":"248-255"},"PeriodicalIF":2.4,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13167091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147933750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of patient narrative interview training on medical students' narrative competence - A randomized controlled trial.","authors":"Hung-Che Wang, Chi-Wei Lin, Bang-Yuan Kuo, Meei-Ju Lin, Yu-Che Chang, Shao-Yin Chu","doi":"10.4103/tcmj.tcmj_134_25","DOIUrl":"10.4103/tcmj.tcmj_134_25","url":null,"abstract":"<p><strong>Objectives: </strong>Medical students' narrative competence was trained primarily through reflective writing, literature reading, patient stories, film viewing, music listening, and art appreciation. This study aimed to explore the impact of patient narrative interview training on medical students' narrative competence.</p><p><strong>Materials and methods: </strong>A randomized controlled pre-posttest design was employed with 63 5^th- and 6^th-year MSs (32 experimental and 31 control groups). The experimental group received training in patient narrative interview guide and conducted narrative interviews with 32 patients with significant or chronic illnesses. Both groups completed the narrative competence scale pre- and postintervention. The narrative competence scale includes four dimensions: narrative horizon, narrative construction, medical relationship, and medical care. A mixed-methods approach incorporated quantitative analysis via one-way multivariate analysis of covariance (MANCOVA) and qualitative data from questionnaires and postexperiment interview guides.</p><p><strong>Results: </strong>MANCOVA revealed significant differences between experimental and control groups (Wilks' λ = 0.64, <i>F</i> [4, 54] = 7.068, <i>P</i> < 0.05). The experimental group showed significant improvements in narrative construction (<i>F</i> [1, 57] = 29.39, <i>η²</i> = 0.34), medical relationship (<i>F</i> [1, 57] = 22.25, <i>η²</i> = 0.28), and medical care (<i>F</i> [1, 57] = 19.77, <i>η²</i> = 0.26), all <i>P</i> < 0.0125. All subdimensions of these three domains also showed significant improvements (<i>P</i> < 0.0125). Findings from the qualitative feedback questionnaires and postexperiment patient interviews further supported the quantitative results, demonstrating enhancements in medical students' narrative competencies.</p><p><strong>Conclusion: </strong>Compared to the control group peers, patient narrative interview training significantly enhanced medical students' narrative competence, especially in narrative construction, medical relationship, and medical care.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"38 2","pages":"256-261"},"PeriodicalIF":2.4,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13167084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long noncoding RNA LOC441461 drives cancer growth and is associated with poor clinical outcomes.","authors":"Ching-Feng Cheng, Ya-Ting Tu, Yi-Ru Chen, Ming-Cheng Lee, Hui-Chen Ku, Kuo-Wang Tsai","doi":"10.4103/tcmj.TCMJ-D-25-00032","DOIUrl":"10.4103/tcmj.TCMJ-D-25-00032","url":null,"abstract":"<p><strong>Objectives: </strong>The role of LOC441461, a long noncoding RNA, differs in different cancer types, and its role in lung cancer remains unclear.</p><p><strong>Materials and methods: </strong>We investigated the clinical significance of LOC441461 expression in lung cancer using bioinformatics analyses. To explore the biological function of LOC441461, we performed siRNA-mediated knockdown in lung cancer cells and evaluated its effects on cell proliferation, colony formation, apoptosis, and cell cycle progression.</p><p><strong>Results: </strong>LOC441461 was found to be significantly overexpressed in lung adenocarcinoma (LUAD), and LOC441461 overexpression was significantly associated with poor prognosis in patients with LUAD. LOC441461 knockdown significantly inhibited cell growth and induced a modest but statistically significant increase in apoptosis in lung cancer cells. According to a cell cycle analysis, LOC441461 knockdown induced G0/G1 arrest in A549 cells; increased p21 and p27 expression; and reduced the levels of CDK4 and the cyclins A2, B1, and D1, similar to p53-dependent regulation. By contrast, H1299 cells exhibited G2/M accumulation with no change in p21 and p27 levels<b>,</b> suggesting a p53-independent mechanism.</p><p><strong>Conclusion: </strong>Our findings indicate that high LOC441461 expression is correlated with worse prognosis in LUAD. These results support the potential of LOC441461 as a novel therapeutic and prognostic target in LUAD.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"38 1","pages":"75-82"},"PeriodicalIF":1.6,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12885466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vaginal septum in women: A review of diagnosis, management, and obstetric outcomes.","authors":"Ya-Chu Wu, Pei-Chen Li, Dah-Ching Ding","doi":"10.4103/tcmj.TCMJ-D-25-00041","DOIUrl":"10.4103/tcmj.TCMJ-D-25-00041","url":null,"abstract":"<p><p>Congenital anomalies of the female genital tract, such as vaginal septa, arise from disruptions in Müllerian ducts and urogenital sinus development. Vaginal septa, including longitudinal and transverse types, are rare and often remain undiagnosed due to asymptomatic presentation. However, they can lead to significant complications such as dyspareunia, infertility, and obstructed labor. This narrative review aims to provide a detailed overview of the clinical presentation, diagnosis, and management of vaginal septum, with a particular focus on the challenges encountered during pregnancy and labor. A systematic search of PubMed, Web of Science, Scopus, and Embase identified 34 relevant articles, including 16 case reports detailing labor outcomes in women with vaginal septum. The review highlights that timely diagnosis through pelvic examination and imaging, such as magnetic resonance imaging or ultrasound, can prevent labor complications. Management options range from conservative observation in asymptomatic cases to surgical resection, which can be performed intrapartum or before delivery to facilitate vaginal birth. The presence of associated anomalies, including uterine malformations and renal agenesis, underscores the need for thorough evaluation. Postoperative outcomes are generally favorable, though careful surgical planning is essential to avoid complications such as restenosis or infection. Clinicians should remain highly vigilant for women with unexplained infertility, menstrual abnormalities, or labor obstruction. Early identification and individualized management of vaginal septum can optimize obstetric outcomes and preserve reproductive function. Future research should aim to improve early detection methods, refine surgical techniques, and investigate the genetic and embryological basis of these rare anomalies.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"38 1","pages":"40-47"},"PeriodicalIF":1.6,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12885464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}