Journal of the Chinese Medical Association : JCMA最新文献

{"title":"Endoscopic variceal ligation versus cyanoacrylate injection for acute variceal bleeding from the cardia to the lesser curvature.","authors":"Yu-Fu Chen, Tsung-Chieh Yang, Ping-Han Hsieh, Yu-Jen Chen, Hsiao-Sheng Lu, Kuei-Chuan Lee, Hui-Chun Huang, Jiing-Chyuan Luo, Ming-Chih Hou","doi":"10.1097/JCMA.0000000000001393","DOIUrl":"10.1097/JCMA.0000000000001393","url":null,"abstract":"<p><strong>Background: </strong>Current guidelines recommend endoscopic variceal ligation (EVL) and endoscopic cyanoacrylate injection (ECI) for esophageal and fundal variceal bleeding, respectively. However, the optimal strategy for treating acute variceal bleeding (AVB) from the cardia to the lesser curvature remains undefined. This study compared the efficacy of EVL and ECI for AVB in this region.</p><p><strong>Methods: </strong>We retrospectively analyzed patients with AVB from the cardia to the lesser curvature treated with EVL or ECI. Varices were classified as type 1 gastroesophageal varices-cardiac varices (GOV1-CVs; 0-2 cm below the gastroesophageal junction) or conventional GOV1s (2-5 cm below). Outcomes, including 5-day treatment failure, 6-week rebleeding, and 6-week survival, were compared using Kaplan-Meier analysis. Independent predictors of rebleeding and mortality were identified via Cox regression and subgroup analyses by variceal location.</p><p><strong>Results: </strong>We enrolled 129 patients (EVL: 59; ECI: 70) between 2006 and 2024. Both modalities achieved high hemostasis rates, with no significant differences in 5-day treatment failure (3.4% vs 4.3%; p = 1.000), 6-week rebleeding (10.2% vs 12.9%; p = 0.630), or 6-week survival (76.3% vs 77.1%; p = 0.956). On multivariable analysis, portal vein thrombosis (hazard ratio [HR]: 5.4; p = 0.020) and clinically significant bleeding (HR: 4.4; p = 0.016) predicted 6-week rebleeding, whereas Child-Pugh class C (HR: 4.3; p < 0.001) and creatinine >1.3 mg/dL (HR: 2.5; p = 0.024) predicted 6-week mortality. EVL demonstrated lower 6-week rebleeding than ECI for GOV1-CVs (9.8% vs 40.0%, p = 0.011), but not GOV1s ( p = 0.408). In the GOV1-CVs subgroup, EVL (HR: 0.2; p = 0.030) was the only independent predictor of rebleeding.</p><p><strong>Conclusion: </strong>EVL and ECI demonstrated comparable efficacy for AVB from the cardia to the lesser curvature. Notably, EVL is superior to ECI in reducing 6-week rebleeding in GOV1-CVs, supporting EVL as the preferred approach and underscoring the importance of precise variceal classification.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"497-507"},"PeriodicalIF":2.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148229811","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":"Incidence of Jarisch-Herxheimer reaction after syphilis treatment and the role of awareness effect.","authors":"Yoshihiro Ono, Yoshiyuki Miyazawa, Seiji Arai, Yoshitaka Sekine","doi":"10.1097/JCMA.0000000000001400","DOIUrl":"10.1097/JCMA.0000000000001400","url":null,"abstract":"","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"554"},"PeriodicalIF":2.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148274313","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 utility of preoperative lymphocyte-albumin-neutrophil ratio for prognostication in patients with oral cancer undergoing surgery.","authors":"Hung-Hua Chen, Yu-Tsai Lin, Hui-Ching Chuang, Chih-Yen Chien, Chao-Hui Yang, Fu-Min Fang, Hui Lu, Ming-Hsien Tsai","doi":"10.1097/JCMA.0000000000001395","DOIUrl":"10.1097/JCMA.0000000000001395","url":null,"abstract":"<p><strong>Background: </strong>Systemic inflammation and nutritional status are key determinants of prognosis in oral squamous cell carcinoma (OSCC). The neutrophil-to-lymphocyte ratio and serum albumin in peripheral blood are established markers reflecting host immune response and nutritional condition, respectively. The lymphocyte-albumin-neutrophil ratio (LANR), a composite index integrating these parameters, has emerged as a potential prognostic biomarker in several cancers; however, its role in OSCC remains unclear. This study aimed to evaluate the prognostic value of preoperative LANR in OSCC.</p><p><strong>Methods: </strong>We retrospectively analyzed OSCC patients who underwent radical surgery between 2007 and 2017, randomly dividing them into training and validation cohorts by a 2:1 ratio. LANR was calculated by multiplying the absolute lymphocyte count by the serum albumin level and dividing by the absolute neutrophil count. The primary outcomes were 5-year overall survival (OS) and disease-free survival (DFS). Survival-associated factors were identified through univariate and multivariate Cox regression analyses, serving as the foundation for constructing a predictive nomogram model.</p><p><strong>Results: </strong>This study included a total of 660 patients, with 440 assigned to the training cohort and 220 to the validation cohort. A LANR cutoff value of 18.7 effectively stratified patients into distinct prognostic groups, demonstrating significant differences in survival outcomes. A low LANR independently predicted worse OS (hazard ratio [HR]: 1.54, 95% CI: 1.04-2.28; p = 0.03) and DFS (HR: 1.54, 95% CI: 1.08-2.19; p = 0.017). The LANR-based nomogram demonstrated strong predictive performance, with concordance indices of 0.75 and 0.71 in the training and validation cohorts, respectively.</p><p><strong>Conclusion: </strong>Preoperative LANR serves as an independent prognostic marker in patients with OSCC. Incorporating LANR into risk models may enhance patient stratification and guide treatment strategies.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"534-543"},"PeriodicalIF":2.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254932","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":"Biologics reduced infections in ankylosing spondylitis and psoriatic arthritis under immunosuppressants.","authors":"Hsiang-Yuen Tung, Hsien-Tzung Liao, Chung-Ching Wang, Wei-Liang Chen, Chang-Youh Tsai","doi":"10.1097/JCMA.0000000000001392","DOIUrl":"10.1097/JCMA.0000000000001392","url":null,"abstract":"<p><strong>Background: </strong>Biologic disease-modifying antirheumatic drugs (bDMARDs) alleviate inflammation but may have immunocompromising effects. Previous studies evaluating infection risks in spondyloarthritis (SpA) have yielded inconsistent conclusions. We investigated infection risk in patients with ankylosing spondylitis (AS) and psoriatic arthritis (PsA) receiving bDMARDs compared with that of those receiving only conventional synthetic disease-modifying antirheumatic drugs.</p><p><strong>Methods: </strong>Using the database at Taipei Veterans General Hospital (from January 1, 2011, to September 30, 2018), we retrospectively identified eligible SpA patients and applied a two-step verification process to confirm serious infections requiring hospitalization. Time-to-event outcomes were analyzed using multivariable Cox regression adjusted for age, sex, comorbidities, and concomitant medications. Site-specific analyses characterized infection patterns.</p><p><strong>Results: </strong>We included 5568 patients with SpA (4,784 AS, 784 PsA), with a mean age of 42.1 years and male predominance (68.4%). bDMARD prescription was associated with a reduced risk of first serious infection in the overall SpA cohort (adjusted hazard ratio [aHR] = 0.247, p = 2.4782 × 10 -7 ), as well as in AS (aHR = 0.253, p = 4.73 × 10 -4 ) and PsA (aHR = 0.207, p = 6.69 × 10 -4 ). bDMARD prescription was also associated with significantly lower risks of skin and soft tissue infection in PsA (aHR = 0.252, p = 1.1905 × 10 -2 ) and pneumonia/gastrointestinal infections in SpA. Sulfasalazine (SSZ) was independently associated with an increased infection risk (aHR = 1.630, p = 2 .6276 × 10 Sulfasalazine 2 ); nonsteroidal anti-inflammatory drugs were associated with a reduced risk in AS.</p><p><strong>Conclusion: </strong>Adjunctive bDMARD therapy was associated with a substantially reduced risk of serious infection in AS, PsA, and the overall SpA cohort, potentially because of effective systemic inflammation suppression in SpA and restoration of the skin barrier in PsA. The elevated risk associated with SSZ in AS may reflect channeling bias in refractory patients. Early and appropriate use of bDMARDs in SpA may achieve disease control without compromising immune defense against infections.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"508-516"},"PeriodicalIF":2.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145771","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":"Respiratory syncytial virus infection in adults: Clinical manifestations, outcomes, and vaccines.","authors":"Ching-Hao Hsu, Yi-Tien Hsuan, Yu-Jiun Chan, Hsin-Pai Chen","doi":"10.1097/JCMA.0000000000001398","DOIUrl":"10.1097/JCMA.0000000000001398","url":null,"abstract":"<p><p>Respiratory syncytial virus (RSV) is an RNA virus transmitted via droplets and affects individuals across all age groups. Although RSV is increasingly being recognized as a key pathogen in adults, differentiating RSV infection from other acute viral infections solely on the basis of clinical features is challenging. Polymerase chain reaction is the gold standard for RSV detection. Notably, RSV accounts for 2% to 10% of all hospitalizations due to respiratory tract infections in adults. Among hospitalized adults with RSV infection, 18.9% require intensive care, experiencing a disease burden similar to that of influenza. Severe RSV infection disproportionately affects older adults with multiple comorbidities, such as chronic heart failure and chronic obstructive pulmonary disease. This review focused on the manifestations and outcomes of RSV infection and on advances in the development of RSV vaccines. We comprehensively searched PubMed for relevant studies published between 1991 and 2024. Evidence specific to RSV treatments remains limited, with supportive care being the mainstay of management. In 2023, two protein subunit vaccines were approved for individuals aged ≥60 years; in addition, an mRNA-based vaccine that exerts substantial protective effects against severe RSV disease received approval in the United States. The development of novel antiviral therapies and vaccines holds promise for mitigating the burden of RSV infection. However, further research is required to evaluate the real-world effectiveness of vaccines, particularly in high-risk hospitalized patients requiring intensive care or mechanical ventilation, to optimize implementation strategies.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"489-496"},"PeriodicalIF":2.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148274311","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":"Advances in body composition imaging for diagnosis and monitoring: From radiologic assessment to precision medicine.","authors":"Fu-Shun Ko, Guan-Yu Su, Chii-Min Hwu, Ching-Lan Wu","doi":"10.1097/JCMA.0000000000001391","DOIUrl":"10.1097/JCMA.0000000000001391","url":null,"abstract":"<p><p>Body composition (BC) is a key determinant of metabolic risk, treatment tolerance, and long-term outcomes. The distribution of skeletal muscle, visceral adipose tissue (VAT), and ectopic fat provides greater prognostic information than total body weight alone. However, conventional anthropometric measures, such as body mass index, cannot distinguish among different tissue compartments, including skeletal muscle, VAT, and ectopic fat, potentially obscuring clinically relevant phenotypes such as sarcopenia, myosteatosis, and sarcopenic obesity. This review addresses the \"BMI paradox\" by evaluating how different imaging modalities identify high-risk phenotypes, such as sarcopenic obesity, that are not detected by standard anthropometric measures. Radiological imaging enables high-precision quantification by using validated metrics. In Asian populations, clinical interpretation requires population-specific thresholds. For example, the Asian Working Group for Sarcopenia 2019 criteria define low muscle mass as an appendicular skeletal muscle index of <7.0 kg/m 2 for men and <5.4 kg/m 2 for women. Computed tomography is the reference standard for BC assessment, and Hounsfield units are used to identify myosteatosis, typically within a range of -29 to +150 HU for skeletal muscle. Magnetic resonance imaging enables scanner-independent quantification of ectopic fat through proton density fat fraction and through longitudinal monitoring of metabolic interventions. Studies report a substantial reduction in VAT within 12 months after metabolic surgery. Artificial intelligence has changed the workflow of BC analysis by reducing manual segmentation time from 15-30 minutes per case to only a few seconds, while maintaining high concordance with manual methods. This improvement enables opportunistic screening using existing diagnostic scans without additional radiation exposure or cost. Integration of radiologic assessment with quantitative biomarkers supports the use of BC imaging as a structured \"metabolic report,\" which can guide therapeutic decision-making and support proactive health risk management.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"483-488"},"PeriodicalIF":2.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145748","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":"Prognostic indicators and microbial landscape of post-radiation nasopharyngeal necrosis in nasopharyngeal carcinoma patients.","authors":"Yi-Fan Chang, Wei-Hsin Wang, Yu-Wen Huang, Li-Ting Hung, Yun-Ting Chao, Chien-Fu Yeh, Ming-Ying Lan","doi":"10.1097/JCMA.0000000000001384","DOIUrl":"10.1097/JCMA.0000000000001384","url":null,"abstract":"<p><strong>Background: </strong>Post-radiation nasopharyngeal necrosis (PRNN) is a serious complication in patients with nasopharyngeal carcinoma (NPC) treated with radiotherapy, and is often accompanied by infections such as sinusitis, otitis media, or central nervous system infections. This study retrospectively examined the clinical features, microbial profiles, treatment approaches, and prognostic factors of patients with PRNN to improve clinical management.</p><p><strong>Methods: </strong>Patients with NPC diagnosed with PRNN at Taipei Veterans General Hospital between September 2005 and April 2021 were reviewed. The data included demographics, cancer staging, treatment history, complications, and PRNN management. Microbial cultures from necrotic tissues were analyzed. Patients were categorized as cured or uncured based on post-treatment mucosal healing. Statistical analysis identified predictors of uncured or persistent PRNN.</p><p><strong>Results: </strong>During the study period, 872 patients with NPC were treated, of whom 30 (24 males and six females; mean age, 60.6 years) developed PRNN, with an incidence of 3.4%. Fourteen (46.7%) patients underwent reirradiation, and 14 (46.7%) had local recurrence. Sinusitis occurred in 19 patients (63.3%), otitis media in 13 (43.4%), and central nervous system infections in 4 (13.3%). Microbiological cultures were available for 26 patients. Polymicrobial infections were identified in 17 patients (65.4%), predominantly involving aerobic bacteria (80.8%), most commonly Staphylococcus spp. (53.8%), followed by Klebsiella spp. and Pseudomonas aeruginosa (26.9% each). Fungi and anaerobic bacteria were detected in 9 patients (34.6%). Sixteen patients (53.3%) underwent surgical debridement, and 11 (36.7%) required endovascular treatment for carotid blowout syndrome (CBS). Complete mucosal healing was achieved in 10 (33.3 %) patients. CBS and reirradiation significantly predicted refractory PRNN (adjusted odds ratio 9.6, p = 0.034).</p><p><strong>Conclusion: </strong>Patients with NPC and PRNN present with diverse pathogens and management challenges. Reirradiation and CBS are key predictors of poor outcomes, underscoring the need for vigilant care in high-risk patients.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"423-430"},"PeriodicalIF":2.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13286453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147871100","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":"Analysis of prognosis and medical resource utilization in elderly patients with trauma: A retrospective cohort study in one trauma center.","authors":"Lung-Yun Kang, Hu-Yu Hua","doi":"10.1097/JCMA.0000000000001194","DOIUrl":"10.1097/JCMA.0000000000001194","url":null,"abstract":"<p><strong>Background: </strong>Trauma is consistently among the top 10 causes of death worldwide. The aging population, constituting 15.21% of adults aged over 65 in Taiwan as of November 2019, has significantly impacted healthcare expenditures. This study aimed to explore the prognosis and resource utilization in patients with geriatric trauma.</p><p><strong>Methods: </strong>This retrospective analysis included emergency room admissions between January 2015 and December 2017 at a level I trauma center in southern Taiwan. Comparisons between the age groups assessed medical resource use, patient characteristics, trauma profiles, and management. Outcomes examined included mortality, complications, length of hospital stay (LOS), duration of intensive care unit (ICU) stay, and costs.</p><p><strong>Results: </strong>Of the 5185 eligible patients, 1743 were elderly. Elderly patients, predominantly women, exhibit more blunt injuries often resulting from accidental falls. They experienced longer hospital stays and higher medical expenses, as well as increased complication and mortality rates. Mortality predictors included age, Glasgow Coma Scale (GCS) score, trauma severity score (≥16), complications, surgery, and initial hypotension.</p><p><strong>Conclusion: </strong>Elderly patients experienced longer LOS, higher mortality and complication rates, and greater total medical costs compared to younger individuals. These findings highlight the increased healthcare resource utilization and heightened mortality risks faced by elderly trauma patients. Thus, tailored healthcare approaches and resource allocation strategies are essential to meet the needs of this aging population in trauma care.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"431-436"},"PeriodicalIF":2.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13286340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962556","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":"Integrative gene ontology-driven analysis of the eutopic endometrium reveals key dysregulated functionomes and pathways in endometriosis.","authors":"Jyun-Cheng Ke, Chia-Ming Chang, Peng-Hui Wang, Yu-Chi Wang, Ping-Lin Hsieh, Kuo-Min Su","doi":"10.1097/JCMA.0000000000001382","DOIUrl":"10.1097/JCMA.0000000000001382","url":null,"abstract":"<p><strong>Background: </strong>Endometriosis is a chronic estrogen-dependent inflammatory disorder associated with pelvic pain, infertility, and an increased risk of endometriosis-associated ovarian cancer. Despite extensive research, its molecular mechanisms remain incompletely understood. This study aimed to identify dysregulated biological functions and potential molecular signatures in the eutopic endometrium of women with endometriosis using an integrative functionome-based approach.</p><p><strong>Methods: </strong>An integrative gene ontology-driven functionome analysis was conducted using publicly available transcriptomic datasets. A modified Differential Rank Conservation algorithm was applied to reconstruct sample-specific Gene Set Regularity (GSR) indices across 10 192 gene ontology (GO)-defined gene sets. Statistical analyses, exploratory factor analysis, and support vector machine (SVM)-based machine learning were used to identify dysregulated functionomes, dysfunctional pathways, and key differentially expressed genes (DEGs).</p><p><strong>Results: </strong>The analysis included 196 patients with endometriosis and 246 healthy controls. Functionome profiling revealed widespread dysregulation of immune, metabolic, angiogenic, and extracellular matrix-related pathways. Among the top 50 dysregulated functionomes, eight were related to copper ion transport and homeostasis. Integrative analysis identified a recurrent four-gene copper-regulatory signature consisting of ATP7A , ATP7B , ATOX1 , and SLC31A1 ( p < 0.05), suggesting coordinated disruption of copper homeostasis in endometriosis.</p><p><strong>Conclusion: </strong>Dysregulation of copper ion homeostasis and cuproptosis-related pathways may represent a previously underappreciated molecular feature of endometriosis. Although causal relationships cannot be established from this comparative analysis, the identified copper-regulatory signature provides a reproducible transcriptomic framework for future mechanistic and translational studies.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"415-422"},"PeriodicalIF":2.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13286419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793262","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":"Experimental study on the effect of warm acupuncture on the healing of bone nonunion in rats.","authors":"Yongliang Mei, Chao Song, Yun Gao, Daqian Zhou, Silong Gao, Kang Cheng, Daru Guo, Weiye Cai, Fei Yu, Zongchao Liu","doi":"10.1097/JCMA.0000000000001386","DOIUrl":"10.1097/JCMA.0000000000001386","url":null,"abstract":"<p><strong>Background: </strong>Bone nonunion is a challenging clinical issue that hinders fracture healing. Warm acupuncture, as a traditional Chinese medicine therapy, has shown potential in promoting tissue repair, but its effect on bone nonunion healing and the underlying mechanism remain unclear. This study aims to investigate the effect of warm acupuncture on the healing of bone nonunion in rats and predict its potential mechanism.</p><p><strong>Methods: </strong>Sprague-Dawley (SD) rats were randomly divided into a blank control group (BC group), a tibial bone nonunion model group (M group), and a warm acupuncture treatment group (WA group). The BC group was not treated. Bone nonunion modeling was performed on M and WA groups. After modeling, M group was tied up. The WA group was treated with warm acupuncture after restraint, once a day for 4 weeks. After treatment, collected blood samples, performed digital radiography (DR), micro-computed tomography (micro-CT), hematoxylin-eosin staining (HE staining), and assess the bone morphogenetic protein 2 (BMP-2) protein expression by Western blot.</p><p><strong>Results: </strong>After treatment, the phosphorus (P), calcium (Ca), and alkaline phosphatase (ALP) levels and the BMP-2 protein expression level were significantly higher in WA group than in BC group and M group. The difference between WA group and M group in terms of fracture scab measurement was statistically significant. The recovery of fracture structure in WA group was better than that in M group. WA group was better than M group in bending strength, bending stiffness, bending load, bending deflection, bending moment, and deflection. Bone volume fraction, trabecular thickness, and number of trabeculae were higher in WA group than in M group.</p><p><strong>Conclusion: </strong>Warm acupuncture can enhance the serum Ca, ALP, and P concentrations and increase the expression of BMP-2 in rats, thus improving bone scab production, promoting the healing of fractures, and increasing the biomechanical strength in rats.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"470-479"},"PeriodicalIF":2.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13286385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147871059","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}