Tzu Chi Medical Journal最新文献

{"title":"Bacterial co-infection and secondary infection in critically ill patients with acute respiratory failure of coronavirus disease 2019.","authors":"Yi-Ting Chen, Ya-Ju Wu, Li-Liang Chuang, Hui-Sheng Wang, Yuan-Chieh Chang","doi":"10.4103/tcmj.tcmj_255_24","DOIUrl":"10.4103/tcmj.tcmj_255_24","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of the study is to understand the prevalence of bacterial co-infection and secondary infection in severe coronavirus disease 2019 (COVID-19) pneumonia in a tertiary hospital intensive care unit (ICU), the spectrum of pathogens, and the impact of these infections on clinical outcomes.</p><p><strong>Materials and methods: </strong>Retrospective analysis of all patients with COVID-19 with acute hypoxemic respiratory failure who were admitted to the ICU requiring invasive mechanical ventilation (IMV) or high-flow nasal cannula (HFNC) from January 2021 to August 2022.</p><p><strong>Results: </strong>Of the 123 cases, 59.3% had culture-confirmed bacterial co-infection, mostly lower respiratory tract infections (LRTIs). Patients with bacterial co-infection had higher 30-day mortality (28.8% vs. 12%, hazard ratio [HR] = 2.96, %95 confidence interval [CI] =1.1-7.99; adjusted HR [aHR] = 1.34, %95 CI = 0.43-4.17). <i>Klebsiella pneumoniae, Staphylococcus aureus, and Pseudomonas aeruginosa</i> were the most common co-infection pathogens. Of the 108 cases who stayed in the ICU for >2 days, 34 (31.5%) cases developed secondary bacterial infections within 30 days, of whom all cases had LRTI, 4 had bacteremia, and 8 had urinary tract infections. IMV users had a higher 1-month incidence of secondary bacterial infections than HFNC users (47.5% vs. 8.9%, <i>P</i> < 0.0001). Patients with secondary bacterial infections had higher 60-day mortality (32.4% vs. 11.2% HR = 3.45, 95% CI = 1.27-9.4; aHR = 2.29, %95 CI =0.8-6.67). The most common secondary infection pathogens were <i>Acinetobacter</i> species, <i>P</i>. <i>aeruginosa, Stenotrophomonas maltophilia</i>, and <i>K</i>. <i>pneumoniae</i>. At the 30-day follow-up, 54 events of ICU-acquired secondary bacterial LRTI were noted in 34 patients, 18 (33.3%) events, and 15 (44%) patients were infected by carbapenem-resistant Gram-negative bacilli.</p><p><strong>Conclusion: </strong>The high incidence of bacterial co-infection and secondary infection in critically ill patients with COVID-19 might associated with increased mortality. Infection by drug-resistant pathogens may develop during the treatment course.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"37 3","pages":"304-310"},"PeriodicalIF":1.6,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754781","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":"Comparison of survival between open and minimally invasive radical hysterectomies for stage IB1 cervical cancer (≤2 cm): A systematic review and meta-analysis.","authors":"Wing Lam Tsui, Guang-Hong Deng, Tsung-Cheng Hsieh, Pei-Chen Li, Dah-Ching Ding","doi":"10.4103/tcmj.tcmj_268_24","DOIUrl":"10.4103/tcmj.tcmj_268_24","url":null,"abstract":"<p><strong>Objectives: </strong>Cervical cancer remains a leading cause of death among women globally, with surgery being a key treatment for early-stage disease. However, the survival outcomes (disease-free survival [DFS] and overall survival [OS]) of patients with early-stage cervical cancer treated using different surgical methods remain controversial. This systematic review and meta-analysis aimed to evaluate the survival outcomes of laparoscopic radical hysterectomy (LRH) versus open radical hysterectomy (ORH) for treating early-stage cervical cancer (tumor ≤2 cm).</p><p><strong>Materials and methods: </strong>A comprehensive search of the PubMed, Web of Science, and Cochrane databases from 1960 to 2022 identified 12 retrospective cohort studies for inclusion. The primary outcome included DFS and OS. The pooled hazard ratio (HR) with 95% confidence intervals (CI) was calculated to compare DFS and OS. The <i>I</i> ² statistic was used to estimate the heterogeneity of the included studies. A funnel plot was used to examine publication bias. Review Manager version 5.4 software was used for the analysis. <i>P</i> < 0.05 was statistically significant.</p><p><strong>Results: </strong>The results showed no significant difference between LRH and ORH in a 5-year OS (HR = 1.25; 95% CI, 0.82-1.86; <i>P</i> = 0.3) or 5-year DFS (HR = 1.03; 95% CI, 0.67-1.57; <i>P</i> = 0.9), with minimal publication bias in DFS.</p><p><strong>Conclusion: </strong>LRH is a safe and effective alternative to ORH for early-stage cervical cancer, with similar survival outcomes. The results may encourage further research into optimizing minimally invasive techniques, potentially influencing the clinical guidelines and promoting the broader adoption of LRH in treating cervical cancer.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"37 4","pages":"430-436"},"PeriodicalIF":1.6,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12574987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145432560","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 best pooling strategy to reduce polymerase chain reaction tests during the coronavirus disease-19 pandemic at low prevalence.","authors":"Chen-Lun Chu, Tai-Yin Wu, Sheng-Mou Hou, Kao-Shang Shih, Yo-Lun Chu, Cheng-Kuang Chen, Li-Wei Hung, Hao-Wei Hsu, Chen-Kun Liaw","doi":"10.4103/tcmj.tcmj_244_24","DOIUrl":"10.4103/tcmj.tcmj_244_24","url":null,"abstract":"<p><strong>Objectives: </strong>Pooling can reduce reverse transcriptase polymerase chain reaction (RT-PCR) tests during the coronavirus disease-19 (COVID-19) pandemic. Pooling strategy is a complex issue. Recent advances in computer science may provide a better strategy.</p><p><strong>Materials and methods: </strong>We developed our algorithm which can help healthcare workers set up their pooling policy during the COVID-19 pandemic.</p><p><strong>Results: </strong>Comparing with three other strategies, naming single pooling, array pooling, and hypercube pooling, our multiple pooling shows to be the best with minimal RT-PCR tests per patient.</p><p><strong>Conclusion: </strong>We hope clinicians in COVID-19 pandemic regions can use our algorithm to reduce both RT-PCR tests and time and hence save more lives.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"37 3","pages":"299-303"},"PeriodicalIF":1.6,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754791","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":"Benefits of bladder point-of-care ultrasound for acute ischemic stroke and application of AGN3 criteria.","authors":"Cheng-Lun Hsiao, Wan-Ling Chang, Pei-Ya Chen, Shinn-Kuang Lin","doi":"10.4103/tcmj.tcmj_294_24","DOIUrl":"10.4103/tcmj.tcmj_294_24","url":null,"abstract":"<p><strong>Objectives: </strong>We investigated the benefits of bladder point-of-care ultrasound (POCUS) during acute ischemic stroke (AIS) by applying AGN3 criteria.</p><p><strong>Materials and methods: </strong>Three groups of inpatients with AIS were retrospectively enrolled. Group A (between January 2011 and March 2014) comprised 1104 patients who did not undergo bladder POCUS. Group B (between May 2014 and February 2017) comprised 824 patients for whom relaxed bladder POCUS criteria were applied. Group C (between July 2021 and October 2023) comprised 920 patients for whom AGN3 criteria were applied (i.e., age ≥75 years, female gender, National Institutes of Health Stroke Scale [NIHSS] total score ≥5, NIHSS conscious score ≥1, and NIHSS leg score ≥2).</p><p><strong>Results: </strong>The proportions of patients who met the AGN3 criteria were 76%, 73%, and 72% in Groups A, B, and C, respectively. Only 33% of Group B and 50% of Group C patients who met the AGN3 criteria underwent bladder POCUS. The incidence of urinary tract infection (UTI) was highest in Group A (6.9%), followed by Groups B (4%) and C (2.1%). The optimal cutoff postvoid residual urine volume for predicting UTI was ≥100 mL. The hospital length of stay (LOS) was longer in Group A (13.6 days) than in Groups B and C (11.9 and 12.1 days, respectively). A C-statistic of 0.814 was estimated using the AGN3 criteria. AGN3 score ≥2 was the optimal cutoff value for predicting UTI.</p><p><strong>Conclusion: </strong>Bladder POCUS is beneficial for reducing the incidence of UTI and shortening hospital LOS. Patients with AGN3 score ≥2 were at higher risk of UTI and required bladder POCUS studies.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"38 1","pages":"97-103"},"PeriodicalIF":1.6,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12885448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158665","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":"Allogeneic human umbilical cord blood for acute ischemic stroke: Phase I clinical trial.","authors":"Raymond Y Lo, Yuncin Luo, Shu-Cin Chen, Jen-Hung Wang, Chen-Yu Ko, Ying-Jie Chen, Yu-Chin Su, Tong-Young Lee, Jonas C Wang, Shinn-Zong Lin","doi":"10.4103/tcmj.tcmj_249_24","DOIUrl":"10.4103/tcmj.tcmj_249_24","url":null,"abstract":"<p><strong>Objectives: </strong>Transplantation of human umbilical cord blood cells (hUCB) may enhance neuroprotection, and thus, the intravenous (IV) infusion of hUCB in patients with acute ischemic stroke (AIS) is being tested for its safety and efficacy.</p><p><strong>Materials and methods: </strong>We conducted a 12-month, open-label, and single-center, phase I trial of hUCB treatment in AIS patients at the age of 45-80 years, with magnetic resonance imaging evidence of acute infarction in the internal carotid artery supplied territory and the National Institute of Health Stroke Scale (NIHSS) score between 6 and 18. Eligible participants received a single-dose IV infusion of hUCB followed by the two doses of mannitol infusion within 9 days after the onset of stroke symptoms. The primary endpoint was the incidence of adverse events (AEs) and the secondary endpoints were the changes in NIHSS, Barthel index (BI), and Berg Balance Scale (BBS) scores.</p><p><strong>Results: </strong>Six patients (Male: Female = 3: 3) were enrolled with a mean age at 65.8 years. A total of 40 AEs occurred in six participants during this study, which included nine serious adverse events. Only transient erythema multiforme and hematuria were probably and possibly related to hUCB infusion, respectively. The mean NIHSS score was 11.5 at baseline and it significantly improved at 1, 3, 6, 9, and 12 months after treatment (mean change from baseline: -4.0, -5.3, -6.8, -7.0, and -7.3). The mean BI score was 22.5 at baseline and it significantly increased at 3 and 6 months after treatment (mean change from baseline: 26.7 and 42.5, respectively). The BBS score increased numerically but did not reach statistical significance. The changes in cytokine levels and spleen size were unremarkable.</p><p><strong>Conclusion: </strong>The IV hUCB was safe and well tolerated in AIS patients, and the preliminary efficacy results demonstrated its therapeutic potential, supporting the conduct of a randomized, placebo controlled, phase II clinical trial in future.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"37 3","pages":"321-327"},"PeriodicalIF":1.6,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754780","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":"Therapeutic peptides and their delivery using lipid-based nanoparticles.","authors":"Jui-Hung Yen, Chun-Chun Chang, Tien-Yuan Wu, Chin-Hao Yang, Hao-Jen Hsu, Je-Wen Liou","doi":"10.4103/tcmj.tcmj_321_24","DOIUrl":"10.4103/tcmj.tcmj_321_24","url":null,"abstract":"<p><p>Therapeutic peptides have become an intensively anticipated research field for novel drug discovery and design owing to their high specificity, efficacy, and biocompatibility. The advances in computer technology and structural biology, together with the invention of chemical peptide synthesis methods, have led to tremendous progress in this research field. Over the years, more than 100 peptide-based therapeutics have been approved for clinical use, and many others are currently under clinical trials. However, the <i>in vivo</i> application of therapeutic peptides is hindered by intrinsic disadvantages of peptides, such as poor stability against enzymatic degradations, short <i>in vivo</i> half-life, and low oral bioavailability. Therefore, strategies for efficiently protecting the peptides inside the body and facilitating the delivery of peptides to their targets are required. Lipid-based nanoparticles are considered a versatile class of carriers for drug delivery. Their biocompatibility, biodegradability, and ability to interact with biological membranes make them ideal platforms for <i>in vivo</i> delivery of peptides. Here, by leveraging examples, we aim to provide a comprehensive review of the current status of therapeutic peptide developments and lipid-based nanoparticles as drug carriers. Recent attempts to utilize lipid-based nanoparticles as platforms for the oral delivery of therapeutic peptides are also discussed.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"37 3","pages":"223-234"},"PeriodicalIF":1.6,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754793","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":"Gut-derived uremic toxins and cardiovascular health in chronic kidney disease.","authors":"Ming-Chun Chen, Chiu-Huang Kuo, Yu-Li Lin, Bang-Gee Hsu","doi":"10.4103/tcmj.tcmj_293_24","DOIUrl":"10.4103/tcmj.tcmj_293_24","url":null,"abstract":"<p><p>Uremic toxins (UTs) are bioactive compounds that accumulate in chronic kidney disease (CKD) due to impaired renal clearance, exacerbating disease progression and cardiovascular (CV) complications. These toxins originate from endogenous metabolism, gut microbiota, and dietary intake and include protein-bound UTs such as p-cresyl sulfate, indoxyl sulfate, and indole acetic acid, as well as small, water-soluble toxins such as trimethylamine-N-oxide and phenylacetylglutamine. Their accumulation promotes oxidative stress, inflammation, and endothelial dysfunction, contributing to vascular damage and associated with CV risk. Current management strategies focus on dietary interventions, prebiotics, probiotics, oral sorbents, emerging pharmacological approaches, and advanced dialysis techniques, but clinical outcomes remain inconsistent. Recent trials have demonstrated the potential of agents such as sevelamer, high-amylose-resistant starch, and AST-120 to reduce UT levels and improve certain vascular markers. However, more robust, long-term studies are necessary to fully establish the therapeutic efficacy and optimize treatment strategies to mitigate the impact of gut-derived UTs on CKD and CV health.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"37 3","pages":"264-274"},"PeriodicalIF":1.6,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754784","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":"A comprehensive review of surgical techniques for chronic Achilles tendon rupture.","authors":"Kuang-Ting Yeh, Wen-Tien Wu, Chia-Ming Chang, Tzai-Chiu Yu, Ing-Ho Chen, Chen-Chie Wang","doi":"10.4103/tcmj.tcmj_250_24","DOIUrl":"10.4103/tcmj.tcmj_250_24","url":null,"abstract":"<p><p>Chronic Achilles tendon rupture (CATR) represents a significant clinical challenge, often necessitating surgical intervention to restore function, alleviate pain, and prevent long-term complications. The complex nature of CATR, characterized by tendon retraction, scar formation, and poor tissue quality, requires a tailored, evidence-based approach. This review comprehensively examines current surgical strategies for managing CATR, focusing on their indications, advantages, outcomes, and associated complications. A detailed literature search of 20 studies published between 2010 and 2023 identified key surgical techniques, including end-to-end repair, tendon transfers, autografts, synthetic grafts, and allografts. Surgical recommendations were stratified by defect size and patient factors. Small defects (<2 cm) are effectively managed with end-to-end repair or tendon transfers, offering rapid recovery and restoration of tendon continuity. Medium defects (2-5 cm) benefit from techniques such as V-Y plasty or semitendinosus autografts, providing additional length and biomechanical stability. Larger defects (>5 cm) often necessitate advanced procedures, including free tendon grafts, synthetic materials, or allografts, particularly for older patients or those with poor tissue quality. Minimally invasive techniques, such as endoscopic flexor hallucis longus transfer, have shown promise in reducing recovery times and complications. A structured decision-making framework is proposed to guide surgical choices, ensuring patient-specific, optimal outcomes. Emerging techniques further expand the possibilities for managing this challenging condition, emphasizing the need for innovation and individualized care in CATR treatment.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"37 3","pages":"247-254"},"PeriodicalIF":1.6,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754779","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":"Nucleolar immunohistochemical expression of H3K27me3 in a pediatric cerebellar lesion: A true or false positive?","authors":"Gabriele Gaggero, Chiara Trambaiolo Antonelli, Gianluca Piatelli, Claudia Milanaccio","doi":"10.4103/tcmj.tcmj_289_24","DOIUrl":"10.4103/tcmj.tcmj_289_24","url":null,"abstract":"","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"38 1","pages":"123-124"},"PeriodicalIF":1.6,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12885447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158690","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":"Reciprocal regulation between B lymphoma Mo-MLV insertion region 1 homolog and type I insulin-like growth factor receptor in pemetrexed-resistant lung cancer cells.","authors":"Huan-Ting Shen, Peng-Ju Chien, Gwo-Tarng Sheu, Bing-Yen Wang, Wen-Wei Chang","doi":"10.4103/tcmj.tcmj_288_24","DOIUrl":"10.4103/tcmj.tcmj_288_24","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this study was to investigate the role of type I insulin-like growth factor receptor (IGF-1R) in pemetrexed-resistant lung cancer cells and its interaction with B lymphoma Mo-MLV insertion region 1 homolog (BMI1), previously identified as a key resistance gene.</p><p><strong>Materials and methods: </strong>The study started with the analysis of the activation of IGF-1R in pemetrexed-resistant A549 (A400) lung cancer cells by Western blot analysis of its form of phosphorylation. Cancer stem cell (CSC) activity was assessed by tumor sphere culture. IGF-1R inhibition was performed by picropodophyllin (PPP), an IGF-1R inhibitor, or by shRNA-mediated RNA silencing. A Nonobese diabetic/severe combined immunodeficiency (NOD/SCID) mouse xenograft model was used to access <i>in vivo</i> pemetrexed sensitivity. To further understand the relationship between IGF-1R and BMI1, both BMI1 knockdown and overexpression experiments were performed to assess IGF-1R phosphorylation by western blot.</p><p><strong>Results: </strong>Increased IGF-1R phosphorylation was found in A400 cells, and subsequent IGF-1R inhibition resulted in a reduction in CSC activity in these resistant cells. In the <i>in vivo</i> studies, PPP treatment effectively suppressed tumor growth and reduced BMI1 expression in A400 tumor tissue. Further investigation showed that BMI1 knockdown in A400 cells resulted in decreased IGF-1R phosphorylation, whereas BMI1 overexpression in A549 cells resulted in increased IGF-1R phosphorylation, indicating an interaction between these two proteins.</p><p><strong>Conclusion: </strong>A novel reciprocal regulatory relationship between IGF-1R and BMI1 has been identified in lung cancer cells, suggesting potential therapeutic strategies to combat pemetrexed resistance in lung cancer patients.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"37 3","pages":"285-292"},"PeriodicalIF":1.6,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12310109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754789","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}