Annals of medicine最新文献

{"title":"Musculoskeletal disorders in women of childbearing age: global trends, socio-demographic disparities, and future projections.","authors":"Liang Luo, Xīn Gào, Junting Yang, Xuewu Zhang, Zhike Liu, Chun Li","doi":"10.1080/07853890.2025.2532860","DOIUrl":"10.1080/07853890.2025.2532860","url":null,"abstract":"<p><strong>Background: </strong>Musculoskeletal (MSK) disorders are a leading cause of disability worldwide, particularly prevalent among women of childbearing age (WCBA). Our aim is to comprehensively assess the global, regional, and national burden of MSK disorders in WCBA, and examine the burden of MSK disorders among WCBA at varying levels of the Socio-demographic Index (SDI), then to project the burden of these disorders through to 2045.</p><p><strong>Methods: </strong>This study utilized data from the Global Burden of Disease (GBD) 2021 project, focusing on MSK disorders among WCBA (15-49 years). Age-standardized rate was calculated using the World Standard Population proportions. Descriptive analysis was conducted at global, regional, and national levels. SDI associations were explored using smoothing spline models. Projections to 2045 employed age-period-cohort models using R software.</p><p><strong>Results: </strong>In 2021, the estimated global age-standardized incidence, prevalence, deaths, Years of Life Lost, Years Lived with Disability, and Disability-Adjusted Life Years (DALYs) rates per 100 000 population of MSK disorders in WCBA were 4933.9 (95% UI 3683.7-6454.4), 20145.9 (17 082.6-23 564.4), 0.7 (0.6-0.8), 40.7 (34.1-45.7), 2090.4 (1414.8-2896.2), and 2131.1 (1455.8-2936.8), respectively. From 1990 to 2021, a total of 183 countries exhibited an increase in prevalence rate and 166 countries showed an upward trend in DALYs rate. Between 1990 and 2021, there was a positive association between the SDI and age-standardized DALYs rate for MSK disorders in WCBA, both globally and regionally. By 2045, the age-standardized number of DALYs for MSK disorders in WCBA is expected to reach 48.8 million, with an age-standardized DALYs rate of 2160 per 100,000 population.</p><p><strong>Conclusion: </strong>The burden of MSK disorders among WCBA is already substantial and is expected to increase further in the future. Despite the observed decline in age-standardized incidence rate of MSK disorders among WCBA in half of the regions and countries globally, the age-standardized prevalence and DALYs rates have shown an adverse increasing trend. By 2045, the global number of DALYs for MSK disorders in WCBA is projected to exceed 48 million. To mitigate the future burden of MSK disorders in WCBA, stratified and targeted healthcare strategies are essential to improve early diagnosis and treatment.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2532860"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676796","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":"Development and performance of female breast cancer incidence risk prediction models: a systematic review and meta-analysis.","authors":"Liyuan Liu, Peng Zhou, Lijuan Hou, Chunyu Kao, Ziyu Zhang, Di Wang, Lixiang Yu, Fei Wang, Yongjiu Wang, Zhigang Yu","doi":"10.1080/07853890.2025.2534522","DOIUrl":"10.1080/07853890.2025.2534522","url":null,"abstract":"<p><strong>Introduction: </strong>Accurate breast cancer risk prediction is essential for early detection and personalized prevention strategies. While traditional models, such as Gail and Tyrer-Cuzick, are widely utilized, machine learning-based approaches may offer enhanced predictive performance. This systematic review and meta-analysis compare the accuracy of traditional statistical models and machine learning models in breast cancer risk prediction.</p><p><strong>Methods: </strong>A total of 144 studies from 27 countries were systematically reviewed, incorporating genetic, clinical, and imaging data. Pooled C-statistics were calculated to assess model discrimination, while observed-to-expected (O/E) ratios were used to evaluate calibration. Subgroup and sensitivity analyses were conducted to examine heterogeneity and assess the influence of study bias across various populations.</p><p><strong>Results: </strong>Machine learning-based models demonstrated superior performance, with a pooled C-statistic of 0.74, compared to 0.67 for traditional models. Models that integrated genetic and imaging data showed the highest levels of accuracy, although performance varied by population. Sensitivity analyses excluding high-bias studies showed improved discrimination in models incorporating genetic factors, with the pooled C-statistic increasing to 0.72. Traditional models, such as Gail, exhibited notably poor predictive accuracy in non-Western populations, as evidenced by a C-statistic of 0.543 in Chinese cohorts.</p><p><strong>Conclusion: </strong>Machine learning models provide significantly greater predictive accuracy for breast cancer risk, particularly when incorporating multidimensional data. However, issues related to model generalizability and interpretability remain, particularly in diverse populations. Future research should focus on developing more interpretable models and expanding global validation efforts to improve model applicability across different demographic groups.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2534522"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676792","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":"Efficacy and safety of different acupuncture therapies in treating sleep apnea syndrome: a systematic review and network meta-analysis.","authors":"Yun Li, Ling Gao, Xiyan Gao, Wenming Chu, Boyu Zhang","doi":"10.1080/07853890.2025.2527356","DOIUrl":"10.1080/07853890.2025.2527356","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate and rank the efficacy and safety of different acupuncture (AP) therapies in treating sleep apnea syndrome (SAS).</p><p><strong>Methods: </strong>We searched PubMed, Web of Science, Cochrane Library, Embase, Wanfang Data, CNKI, CBM, and VIP for randomized controlled trials (RCTs) studying AP for SAS until April 25, 2024. Effectiveness required a >25% decrease in apnea-hypopnea index (AHI) and a >1/3 reduction in symptom scores after treatment. Secondary outcomes included AHI, lowest oxygen saturation (LSaO₂), longest apnea time (LAT), Epworth Sleepiness Scale (ESS) score, and adverse events (AEs). We performed standard pairwise meta-analyses and network meta-analyses (NMA) using Stata15.1 and RStudio4.2.3, assessed evidence quality (GRADE), and ranked treatments using SUCRA values.</p><p><strong>Results: </strong>Network meta-analysis of 43 randomized trials (3402 SAS patients) revealed distinct efficacy profiles: Electroacupuncture (EA) was the best intervention for reducing apnea-hypopnea index (AHI) (SUCRA=86.0%), while acupoint catgut embedding (ACE) ranked highest for both shortening longest apnea time (LAT) (SUCRA=98.7%) and improving lowest oxygen saturation (LSaO₂) (SUCRA = 89.7%). For reducing daytime sleepiness (ESS), manual acupuncture combined with Chinese herbal decoction (MA+OCHD) was most effective (SUCRA = 87.6%). In terms of overall clinical effectiveness rate, manual acupuncture plus Western medicine (MA+WM) performed best (SUCRA = 79.8%). Safety analysis showed Chinese herbal decoction (OCHD) alone was associated with the fewest adverse events (SUCRA = 93.4%).</p><p><strong>Conclusion: </strong>AP therapies are effective and safe for SAS. EA or ACE best improves breathing parameters, MA+OCHD best reduces sleepiness, and MA+WM yields the highest overall effectiveness. These findings guide SAS treatment selection.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2527356"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676793","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":"Ultrasound therapy inhibits knee osteoarthritis progression in rabbits by activating the PPARs pathway: a pilot study.","authors":"Qinglu Luo, Ruike Zhang, Zhizhao Liang, Yanhua Wen, Yi Zhang, Jinyi Liu, Zhongmin Ouyang, Hongbo Wu","doi":"10.1080/07853890.2025.2537348","DOIUrl":"10.1080/07853890.2025.2537348","url":null,"abstract":"<p><strong>Background: </strong>Ultrasound (US) is effective in knee osteoarthritis (KOA), but its therapeutic mechanism is unclear, particularly the interaction between US and peroxisome proliferator-activated receptors (PPARs). This study aims to elucidate the therapeutic mechanism of US through PPARs signaling.</p><p><strong>Methods: </strong>A surgically induced KOA rabbit model evaluated the therapeutic effects of Sham US, US, Fenofibrate (PPAR-α agonist), and Rosiglitazone (PPAR-γ agonist) via MRI. Cartilage and synovium tissues were collected for immunohistochemistry, RT-PCR, and western blotting. Synovial fluid inflammatory factors were analyzed. We also developed an <i>in vitro</i> cultured KOA chondrocyte model to investigate the effects of US therapy on PPARs-related signaling pathways and extracellular matrix cytokines. The mechanism by which US therapy inhibits KOA was studied using GW6471 (PPAR-α antagonist) and Mifobate (PPAR-γ antagonist).</p><p><strong>Results: </strong>MRI revealed that US therapy slowed cartilage thinning and improved cartilage structure in the KOA model. Concurrently, US therapy effectively reduced chondrocyte damage and degradation <i>via</i> modulating mRNA and protein levels of PPARs-related signaling pathways in both cartilage and synovial tissues. Additionally, US therapy suppressed synovial inflammation by downregulating pro-inflammatory cytokines such as interleukin-6, interleukin-1β, and tumor necrosis factor-α, while promoting extracellular matrix homeostasis through the upregulation of aquaporin 7 and Collagen II levels <i>in vivo</i> and <i>in vitro</i>. By maintaining cartilage-chondrocyte equilibrium, US therapy prevented GW6471 or Mifobate's KOA-promoting impact.</p><p><strong>Conclusion: </strong>Our results show that US therapy could arrest the progression of KOA by reducing synovial inflammation, delaying cartilage degradation, and decreasing extracellular matrix degradation <i>via</i> PPARs-related signaling pathways.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2537348"},"PeriodicalIF":4.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12302468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710249","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":"Psychometric validation of the Physician Well-Being Index-Expanded (ePWBI) among physician educators in Hong Kong.","authors":"Linda Chan, Paul Po Ling Chan, Xiaoai Shen, Emma Victoria Marianne Bilney, Tai Pong Lam, Julie Yun Chen, George L Tipoe, Fraide A Ganotice","doi":"10.1080/07853890.2025.2532121","DOIUrl":"10.1080/07853890.2025.2532121","url":null,"abstract":"<p><strong>Introduction: </strong>Physician educators' distress and well-being are of emerging concern in academic medicine. The Physician Well-Being Index-Expanded (ePWBI) is known for measuring physician distress and well-being, yet its psychometric properties in Asian contexts, including Hong Kong (HK), remain unexamined. This study evaluated the reliability and validity of the ePWBI in determining the distress and well-being of HK physician educators.</p><p><strong>Method: </strong>This cross-sectional validation study recruited 333 physician educators using convenience sampling at a HK medical school from October 2020 to January 2021, during the COVID-19 pandemic. Participants voluntarily completed the 9-item ePWBI and 5-item World Health Organization Well-Being Index (WHO-5) instruments in an online survey. Psychometric validation included within-network analyses (confirmatory factor analysis [CFA], one-way ANOVA, independent <i>t</i>-tests), and between-network analyses (ROC curves and correlational analyses with the WHO-5).</p><p><strong>Results: </strong>Using data from 333 physician educators, the ePWBI demonstrated excellent construct validity. CFA results indicated good data fit to the a priori model: Comparative Fit Index=0.99, Tucker-Lewis Index=0.99, Standardized Root Mean Square Residual=0.05, and Root Mean Square Error of Approximation=0.02 [90% CI 0.00-0.05]. Most factor loadings ranged from 0.36 to 0.69 and were statistically significant (<i>p</i><0.05). Significant age differences in distress levels were found [<i>F</i>(4,328)=5.39, <i>p</i><0.001], with younger educators (aged 20-39) experiencing greater distress. However, no gender differences were observed [<i>t</i>(328)=-1.16, <i>p</i>=0.247]. Between-network analyses revealed significant correlations between the ePWBI and WHO-5 scores (-0.09 to -0.42), along with satisfactory ROC results, indicating acceptable internal consistency and good discriminatory power.</p><p><strong>Conclusion: </strong>The ePWBI appears to be a valid and reliable instrument for assessing the distress and well-being of HK physician educators. It shows promise as a tool for identifying those at higher risk of distress who could benefit from early tailored interventions and in practice, it could thereby strengthen mental health support systems in academic medical institutions.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2532121"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12269091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644331","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":"Cell biomechanics on muscle atrophy: from intricate mechanisms to therapeutic frontiers.","authors":"Yilin Wang, Jingyuan Meng, Jiechao Zhang, Lichao Tian, Wenrui Wei, Xiaoye Tang, Qian Zhang, Daofang Ding, Xuepeng Wang, Zicheng Guo, Yong He","doi":"10.1080/07853890.2025.2540598","DOIUrl":"10.1080/07853890.2025.2540598","url":null,"abstract":"<p><strong>Background: </strong>Muscle atrophy-the decline of skeletal muscle volume and function-is pervasive in chronic disease, aging, and inactivity. As the primary driver of human mobility and metabolic health, skeletal muscle loss diminishes quality of life and increases healthcare burden. Atrophy impairs recovery and prognosis by reducing metabolic capacity, accelerating systemic protein catabolism, and compromising the biomechanical support necessary for movement and respiration. Although core molecular pathways and cellular changes are well characterized, the role of mechanical cues in modulating these mechanisms remains underexplored.</p><p><strong>Main findings: </strong>Our review reveals five convergent atrophy drivers-mechanical unloading, ECM alterations, mitochondrial dysfunction/oxidative stress, inflammation, and endocrine imbalance-that converge on inhibited mTORC1 signaling, activated FoxO/UPS/autophagy, and impaired satellite-cell function. Quantitative data show that axial stretch preserves PI3K/Akt/mTOR activity, with phosphorylated Akt levels increasing by two- to three-fold and fiber cross-sectional area expanding by 10%-20%; low-intensity compression activates AMPK and autophagy, with AMPK phosphorylation rising by 1.5-fold without triggering excessive protein breakdown; and shear stress enhances VEGF and Nrf2-mediated angiogenesis and antioxidant defenses, doubling VEGF expression and reducing ROS levels by 25% to mitigate neurogenic atrophy. Moreover, stem-cell myogenic differentiation is optimized on 3D biomimetic substrates with stiffness from 11 to 17 kPa under physiological loading, and advances in biomaterials and tissue engineering enable more accurate muscle-tissue models.</p><p><strong>Future directions: </strong>Translating these biomechanical insights into tailored clinical interventions-combining stretch, compression, and shear modalities with biomaterials, stem-cell technologies, and personalized exercise programs- holds promise for preventing and reversing muscle atrophy across diverse patient populations.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2540598"},"PeriodicalIF":4.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762648","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 efficacy of ultrasound for plantar fasciitis, a systematic review and meta-analysis.","authors":"Xuan Li, Jiao Yang, Shuhan Li, Liuxin Yang, Dianhuai Meng","doi":"10.1080/07853890.2025.2543056","DOIUrl":"10.1080/07853890.2025.2543056","url":null,"abstract":"<p><strong>Background: </strong>Ultrasound (US) has been widely used in the treatment of plantar fasciitis (PF); however, its therapeutic effect remains unclear.</p><p><strong>Objective: </strong>This meta-analysis aimed to investigate the effects of ultrasound (US) on pain intensity and foot function in patients with PF.</p><p><strong>Methods: </strong>PubMed, Web of Science, Cochrane Library, and other databases were systematically searched from inception to July 2024. Meta-analysis was performed using RevMan 5.3.</p><p><strong>Results: </strong>Thirteen trials were performed. There was no difference in pain relief between US alone and no treatment, as was US plus conventional physical exercises (CPE) compared with CPE alone. In the comparison between the US plus CPE group and the other interventions plus CPE group, there was a statistically significant difference in pain intensity (MD = 0.78, 95%CI= 0.12 to 1.44, <i>p</i> = 0.02), except in the case where extracorporeal shock wave therapy (ESWT) acted as an \"other intervention\" (MD = 0.75, 95%CI= -0.28 to 1.78, <i>p</i> = 0.15). The foot function measured in the Foot Function Index (FFI) showed a statistically significant difference between the two groups (MD =9.20, 95%CI = 0.77 to 17.63, <i>p</i> = 0.03), while the American Orthopaedic Foot showed no statistically significant difference.</p><p><strong>Conclusion: </strong>Whether applied alone or in combination with CPE, US cannot reduce pain intensity in patients with PF. However, US in combination with CPE may improve foot function.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2543056"},"PeriodicalIF":4.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12340940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818635","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":"Effects of proprioceptive training intervention on knee function in patients with anterior cruciate ligament reconstruction: a systematic review and meta-analysis.","authors":"Shiwei Chen, Jinfa Gu, Shazlin Shaharudin","doi":"10.1080/07853890.2025.2542441","DOIUrl":"10.1080/07853890.2025.2542441","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to systematically evaluate the impact of proprioceptive training on the rehabilitation of patients after anterior cruciate ligament reconstruction (ACLR) including subjective knee functional scores, knee proprioception, knee range of motion, flexion strength and single-leg hopping ability.</p><p><strong>Methods: </strong>PubMed, Web of Science, Cochrane Library, Embase, and China National Knowledge Infrastructure were searched for randomized controlled trials (RCTs) on proprioceptive training for ACLR patients from the inception of the databases to December 2, 2024. The Cochrane Risk of Bias tool was used to assess, Grading of Recommendations Assessment, Development and Evaluation evaluated evidence levels, and the effect size combination, subgroup analysis, and sensitivity analysis were performed using Stata 17.</p><p><strong>Results: </strong>Thirteen studies with a total of 529 patients were included. The meta-analysis indicated that proprioceptive training significantly improved subjective knee functional scores (Hedge's <i>g</i> = 0.58, 95% CI: 0.26 to 0.9, <i>p</i> = 0.00), single-leg hopping ability (Hedge's <i>g</i> = 0.44, 95% CI: 0.15 to 0.72, <i>p</i> = 0.00), and knee proprioception (Hedge's <i>g</i> = -0.8, 95% CI: -1.33 to -0.28, <i>p</i> = 0.00) in ACLR patients. However, proprioceptive training did not have a significant effect on knee range of motion or flexion strength.</p><p><strong>Conclusion: </strong>Proprioceptive training improves subjective knee functional scores, single-leg hopping ability and proprioception but does not significantly enhance knee range of motion or flexion strength in ACLR patients.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2542441"},"PeriodicalIF":4.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769368","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":"Clinical characteristics of pulmonary sarcoidosis in China: a retrospective, multicenter study.","authors":"Kaige Wang, Linhui Yang, Zhen Kang, Zhuang Luo, Dan Liu, Fen Tan, Weimin Li","doi":"10.1080/07853890.2025.2540017","DOIUrl":"10.1080/07853890.2025.2540017","url":null,"abstract":"<p><strong>Background: </strong>Patients with pulmonary sarcoidosis or intrathoracic lymph node tuberculosis (TB) may present with comparable clinical manifestations that pose challenges in differentiation. This study aims to improve the diagnostic accuracy of pulmonary sarcoidosis.</p><p><strong>Methods: </strong>A retrospective analysis of patients diagnosed with pulmonary sarcoidosis or intrathoracic lymph node TB within the past decade at four tertiary hospitals in China was conducted. According to the inclusion and exclusion criteria, a total of 968 patients were ultimately enrolled in the study, comprising 477 individuals diagnosed with pulmonary sarcoidosis and 491 individuals diagnosed with intrathoracic lymph node TB. The analysis focused on general information, clinical manifestations, and auxiliary examination results, with a comparative analysis between the two groups.</p><p><strong>Results: </strong>The median age of onset for pulmonary sarcoidosis was 50 years, with females accounting for 68.94% of the patients. Common symptoms of pulmonary sarcoidosis included cough, sputum production, dyspnea, and chest pain, while approximately 34.12% of patients were asymptomatic. Fever, fatigue, and night sweats occurred less frequently in pulmonary sarcoidosis patients than in those with intrathoracic lymph node TB. Uveitis and myocardial sarcoidosis were observed exclusively in pulmonary sarcoidosis patients. The median time from symptom onset to the diagnosis of pulmonary sarcoidosis was up to three months. Approximately 47.29% of pulmonary sarcoidosis patients had reduced peripheral blood lymphocyte counts, and 94.12% exhibited symmetric enlargement of hilar lymph nodes on chest CT. Both pulmonary sarcoidosis and intrathoracic lymph node TB showed granulomatous inflammation, with 64.36% of intrathoracic lymph node TB cases presenting necrotic foci. Bronchoscopy was the primary method for biopsy, and only 11.06% of pulmonary sarcoidosis patients had multiple nodules in the tracheal or bronchial mucosa, with a low positivity rate for pathogen tests.</p><p><strong>Conclusion: </strong>Pulmonary sarcoidosis predominantly affects middle-aged and young women and can be differentiated from intrathoracic lymph node TB by the presence of uveitis and myocardial sarcoidosis, although these manifestations are rare. A significant proportion of pulmonary sarcoidosis patients experience a reduction in their peripheral blood lymphocyte count. Chest CT scans often reveal symmetric bilateral enlargement of hilar lymph nodes, and in some cases, multiple nodules in the tracheal or bronchial mucosa. Both pulmonary sarcoidosis and intrathoracic lymph node TB show granulomatous inflammation, but tuberculosis lesions are more likely to necrose.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2540017"},"PeriodicalIF":4.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12322989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777224","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":"Unlocking the potential: advancements and applications of gene therapy in severe disorders.","authors":"Rahul G Ingle, Gehan M Elossaily, Mohd Nazam Ansari, Shivani Makhijani","doi":"10.1080/07853890.2025.2516697","DOIUrl":"10.1080/07853890.2025.2516697","url":null,"abstract":"<p><strong>Introduction: </strong>Several severe disorders, such as inherited diseases (e.g. cystic fibrosis and beta thalassemia), genetic diseases (e.g. malignant tumors and diabetes), and infectious diseases (e.g. HIV) are pose significant challenges to human health.</p><p><strong>Background: </strong>Over the past few decades, researchers have been working on gene therapies, and currently, terrible dreams have come true. To date, the Food and Drug Administration (FDA) has approved multiple gene therapies such as Kynamro for familial hypercholesterolaemia, Exondys51 for duchenne muscular dystrophy, Spinraza for spinal muscular atrophy, etc., rest for cancer, infectious diseases, and rare diseases.</p><p><strong>Discussion: </strong>The authors have summarized recent advances in gene therapy, its background, molecular basis (e.g. viral and non-viral vectors), gene-editing techniques (e.g. CRISPR/Cas9, TALEN, ZFN), and its foremost applications in severe disorders, such as cancer, monogenic disorders (e.g. spinal muscular atrophy), polygenic disorders (e.g. autism), neurogenic disorders (e.g. Parkinson disease and Alzheimer's disease), and infectious diseases (e.g. HIV).</p><p><strong>Challenges: </strong>In addition, we explored the major challenges faced by gene therapies during targeted delivery, immunogenicity, efficacy, and safety.</p><p><strong>Conclusion: </strong>To date, most of the promising approaches, such as different vectors, target cell populations, and both <i>in vivo</i> and <i>ex vivo</i> have paved the foundation for applications of gene therapies. Additionally, advances in enhancing the immune system that would certainly lower the healthcare costs. This review highlights the translatory potential of gene therapy in revolutionizing the treatment landscape for severe disorders.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2516697"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12175193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318943","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}