The American journal of the medical sciences最新文献

{"title":"Association between vitamin E and 28-day mortality in adult sepsis patients: A retrospective cohort analysis.","authors":"Yili He, Yang Li, Qifang Lao, Tao Qin, Xianlong Xie, Wenyan Jiang","doi":"10.1016/j.amjms.2025.04.020","DOIUrl":"10.1016/j.amjms.2025.04.020","url":null,"abstract":"<p><strong>Background: </strong>Currently, there is no definitive conclusion on the impact of standalone use of vitamin E in adult sepsis patients in the ICU on the 28-day mortality rate. This study hypothesizes that vitamin E can improve the prognosis of adult sepsis patients.</p><p><strong>Methods: </strong>We analyzed adult sepsis patients (According to the international diagnostic criteria of sepsis 3.0) from the Medical Information Mart for Intensive Care IV Database (MIMIC-IV). A multivariate regression, propensity score analysis, and interaction effects were used to determine the associations between vitamin E intake and 28-day mortality rates in ICU.</p><p><strong>Results: </strong>There was no significant reduction in 28-day mortality among patients who used vitamin E (treatment group) compared to those who did not use it (control group) in the preliminary observation and univariate analysis (hazard ratio = 0.89, 95 % confidence interval = 0.7-1.14, p = 0.361). After adjusting for all the covariates in multivariate Cox regression analysis, the hazard ratio is 0.75(95 % CI: 0.59∼0.95, p = 0.019). We also established two additional models for the relationship between vitamin E and mortality by adjusting different covariates. The adjusted HR values in model 1 and model 2 were 0.77 (95 % CI: 0.61-0.98, p = 0.035) and 0.75 (95 % CI: 0.59-0.96, p = 0.021), respectively. In the propensity score matching (PSM) model, we observed that the Multivariable-Adjusted, Propensity Score-adjusted, Weighted SMRW, Weighted PA, and Weighted Ow all have HR values <1, with p-values <0.05, and consistent trends in all results.</p><p><strong>Conclusions: </strong>In a general population of critically ill patients with adult sepsis, the use of vitamin E is associated with reduced 28-day mortality in ICU.</p>","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144877704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Place of death from asthma among adults aged 65 and Older, 1999-2023.","authors":"Guodong Ding, Changgen Li, Angela Vinturache, Yongjun Zhang","doi":"10.1016/j.amjms.2025.08.011","DOIUrl":"10.1016/j.amjms.2025.08.011","url":null,"abstract":"","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"BUB1B promotes gemcitabine resistance in lung adenocarcinoma and activates the PI3K/AKT signaling pathway.","authors":"Qi-Feng Zeng, Yi-Jing Chen, Ji-Peng Yang, Li-Ping Zheng, Xiao Ye, Yun Xie","doi":"10.1016/j.amjms.2025.08.010","DOIUrl":"10.1016/j.amjms.2025.08.010","url":null,"abstract":"<p><strong>Purpose: </strong>Lung adenocarcinoma (LUAD) exhibits aggressive biological behavior and a poor prognosis. Gemcitabine is the first-line chemotherapy drug for advanced LUAD but has a low response rate. This study aims to explore the effect of BUB1B on gemcitabine resistance in LUAD.</p><p><strong>Methods: </strong>The data in the cancer genome atlas (TCGA) database was analyzed to clarify the expression of BUB1B in lung cancer and its relationship with clinical features. LUAD samples were collected to confirm BUB1B expression in lung cancer by qRT-PCR and Western Blot. The effects of gemcitabine on cell proliferation, apoptosis, and invasiveness were explored by overexpressing and silencing BUB1B in vitro and in vivo. Changes in PI3K/AKT were detected by Western Blot.</p><p><strong>Results: </strong>BUB1B had higher expression in tumor tissues than in normal tissues and was associated with a worse prognosis (P < 0.05). The GSEA results showed that the G2m checkpoint and the PI3K / AKT pathway were differentially enriched in the LUAD samples. Inhibition of BUB1B expression affected proliferation activity, clone formation ability, and invasion ability of tumor cells. Meanwhile, inhibition of BUB1B expression increased tumor cell apoptosis rate and increased lung cancer cell sensitivity to gemcitabine among inhibition of the PI3K / AKT pathway. Furthermore, inhibition of BUB1B expression increased the sensitivity of lung cancer cells to gemcitabine, which was further validated in vivo.</p><p><strong>Conclusions: </strong>BUB1B may be a potentially useful prognostic molecular biomarker associated with poor survival in patients with LUAD and could regulate the sensitivity of lung cancer cells to gemcitabine and activates the PI3K/AKT pathway.</p>","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in right heart load in patients with ARDS and the benefits of prone ventilation.","authors":"Xiaonan Du, Taipu Guo, Shuaijie Pei, Yue Yang, Keliang Xie","doi":"10.1016/j.amjms.2025.08.007","DOIUrl":"10.1016/j.amjms.2025.08.007","url":null,"abstract":"<p><p>Acute respiratory distress syndrome (ARDS) often occurs in the intensive care unit, and patients with ARDS have a poor prognosis due to severe hypoxemia caused by bilateral pulmonary oedema. Moreover, circulatory problems in patients with ARDS are a major concern for intensive care unit physicians. Due to increased pulmonary circulatory resistance, patients with acute respiratory distress syndrome usually exhibit increased right heart afterload, and patients with right heart failure usually develop Acute cor pulmonale(ACP). Prone ventilation is a common treatment for moderate-to-severe acute respiratory distress syndrome, and the prone position not only improves the patient's oxygenation index but also reduces pulmonary circulatory resistance and relieves circulatory pressure through multiple pathways. This article summarises the factors that increase pulmonary circulatory resistance in patients with ARDS and the circulatory benefits of prone ventilation. The purpose of this study was to provide assistance in the management of patients with ARDS.</p>","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding sodium balance: the Edelman formula and its significance: a narrative review of the literature.","authors":"Jackeline Flores, Camilo Pena, Kenneth Nugent","doi":"10.1016/j.amjms.2025.08.005","DOIUrl":"10.1016/j.amjms.2025.08.005","url":null,"abstract":"<p><p>Clinicians have long faced challenges and decisions regarding sodium management in their patients. Clinicians must have a good understanding of the physiology of sodium, its metabolism, distribution in the body, and the consequences of an increase or decrease in its normal level since changes in sodium levels occur frequently in different settings of patient care and across different specialties. Multiple studies and several formulas are currently available to help manage cases with abnormal sodium levels. These tools require a detailed focus to benefit patients in the short and long term and to avoid consequences due to poor decisions resulting in osmotic demyelination syndrome. This review will consider different aspects of sodium metabolism, the role sodium has in patients with edema, the evolution sodium management has had since the development of the Edelman formula and different variations of his formula, and other considerations regarding sodium storage in the skin are currently relevant for a more in-depth approach to the management of patients with dysnatremias.</p>","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144786313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The new ReDS system for fluid management: The clinical application status and prospect.","authors":"Mingyue Xu, Junpeng Kan, Yunli Xing, Qing Ma, Ying Sun","doi":"10.1016/j.amjms.2025.07.003","DOIUrl":"10.1016/j.amjms.2025.07.003","url":null,"abstract":"<p><p>Volume assessment is a critical and challenging clinical skill, especially in cardiology, emergency departments, and intensive care units. The right heart catheterization is the only gold standard to evaluate the volume, and there is currently a lack of rapid, non-invasive, and accurate methods to quantify pulmonary congestion. The remote dielectric sensing system (ReDS) is a non-invasive technique based on electromagnetic energy, which can quantify the percentage of lung fluid concentration in the body within one minute. Although ReDS technology was created 10 years ago, it has been only in the past 3 years that ReDS technology has gradually become more widely used in the clinic. Many patients with heart failure, lung infections, and perioperative have benefited. The purpose of this article is to introduce the new technology of ReDS and its current clinical application and prospects. It is hoped that it can provide more research ideas for clinicians and provide basis for further research on more diseases.</p>","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144786311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute asymptomatic C-reactive protein rise predicts short-term adverse events in peritoneal dialysis patients.","authors":"Margarita Kunin, Sharon Mini, Nabil Abu-Amer, Pazit Beckerman","doi":"10.1016/j.amjms.2025.08.001","DOIUrl":"10.1016/j.amjms.2025.08.001","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;C-reactive protein (CRP) is an acute inflammatory protein that increases in association with acute and chronic inflammation due to a range of causes, including infectious diseases and noninfectious inflammatory disorders and also in metabolic stresses. The purpose of this work was to determine whether acute CRP elevations above the baseline level in asymptomatic peritoneal dialysis (PD) patients could be associated with future short-term adverse events.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Medical records of chronic PD patients between the years 2012-2022 were reviewed retrospectively. Cases of acutely increased serum CRP during regular patient visits without a clinical picture of inflammation or infection were collected. Follow-up analysis of each such elevated serum CRP test was performed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Overall 122 cases of acute increased CRP level were identified in patients who presented at regular visits in PD clinics without a clinical picture of infection or inflammation. Thirty-five patients (28.7%) developed an adverse event during the following month. CRP elevations that were associated with adverse events during the following month reached higher values compared to CRP elevations without adverse events, for any event - 58.97 ± 58.29 mg/l versus 31.67 ± 24.57 mg/l (p = 0.004), for severe event - 70.28 ± 62.26 mg/l versus 31.16 ± 24.67 mg/l (p = 0.001), for peritonitis - 54.95 ± 28.28 mg/l versus 37.81 ± 39.96 mg/l (p = 0.024) for hospitalization - 81.03 ± 72.27 mg/l versus 35.79 ± 32.91 mg/l (p = 0.010), and for the need for antibiotic treatment 70.40 ± 64.66 mg/l versus 33.07 ± 27.96 mg/l (p = 0.001). The area under the receiver operating characteristics (ROC) curve for serum CRP was 0.737 (range 0.606-0.869) for prediction of PD-related peritonitis (p = 0.007); 0.771 (range 0.639-0.902) for hospitalization (p = 0.005); 0.665 (range 0.552-0.778) for any adverse event (p = 0.005); 0.768 (range 0.664-0.873) for a severe adverse event (0.000) and 0.749 (range 0.631-0.868) for the need for antibiotic treatment (p = 0.000). Acute asymptomatic CRP elevations to a value above 50 mg/l were associated with increased risk of adverse events: Odd ratio was 3.119 (1.423, 6.836) p = 0.004 for any event, 4.727 (2.049, 10.904) p = 0.000 for severe event, 3.091 (1.064, 8.984) p = 0.038 for PD-related peritonitis, 5.023 (1.333, 18.931) p = 0.017 for hospitalization, and 3.698 (1.606, 8.518) p = 0.002 for antibiotic treatment. Multivariate analysis demonstrated that acutely elevated serum CRP above 50 mg/l was independently associated with any adverse event and severe adverse event during the next month after the elevation. Odd ratio was 2.769 (1.209, 6.343) p = 0.016 for any event and 4.065 (1.669, 9.902) p = 0.002 for severe adverse event.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Acute increase of serum CRP above 50 mg/l among asymptomatic PD patients was associated with future short-term adverse event. Therefor","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144786308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic role of the pulmonary artery-to-aorta ratio and the N-terminal of prohormone brain natriuretic peptide in patients hospitalized with bronchiectasis exacerbation.","authors":"Hyewon Seo, Seung-Ick Cha, Jongmin Park, Jae-Kwang Lim, Ji-Eun Park, Sun Ha Choi, Yong Hoon Lee, Seung-Soo Yoo, Shin-Yup Lee, Jaehee Lee, Chang-Ho Kim, Jae-Yong Park","doi":"10.1016/j.amjms.2025.08.002","DOIUrl":"10.1016/j.amjms.2025.08.002","url":null,"abstract":"<p><strong>Background: </strong>Information regarding the role of the N-terminal of prohormone brain natriuretic peptide (NT-proBNP) and the ratio of the diameter of the pulmonary artery to the diameter of the aorta (PA:A ratio) on computed tomography in predicting prognosis in patients with bronchiectasis exacerbation is limited.</p><p><strong>Methods: </strong>Retrospectively, patients with bronchiectasis exacerbation were classified into survivors and non-survivors based on 1-year mortality. Clinical, laboratory, and radiological variables were compared between the two groups.</p><p><strong>Results: </strong>Based on 1-year mortality, patients (n = 389) were classified as non-survivors (67 [17.2 %]) or survivors (322 [82.8 %]). Age, body mass index <18.5 kg/m², ≥3 exacerbations in the previous year, NT-proBNP >404 pg/mL, and PA:A ratio >1 were independent predictors of 1-year mortality in patients hospitalized with bronchiectasis exacerbation. In terms of the prognostic performance of various factors for predicting 1-year mortality using receiver operating characteristic curves, NT-proBNP had the highest area under the curve, followed by PA:A ratio. Furthermore, the prognostic performance of the Bronchiectasis Severity Index, FACED score, NT-proBNP, and PA:A ratio in predicting 1-year mortality was assessed in 198 patients with spirometry results. Among these variables, the Bronchiectasis Severity Index exhibited the highest area under the curve, followed by NT-proBNP and PA:A ratio.</p><p><strong>Conclusions: </strong>PA:A ratio and NT-proBNP may be valuable biomarkers for predicting 1-year mortality in patients with bronchiectasis exacerbation.</p>","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144786309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to \"Associations between psoriasis, psoriatic arthritis and gout or hyperuricemia: A systematic review and meta-analysis\" [Am J Med Sci. 369 (2025) 671-678].","authors":"Zixia Liu, Xieli Ma, Tian Chang, Chuanhui Yao, Mengge Song, Shang Biyue, Fuyuan Zhang, Jiameng Liu, Quan Jiang","doi":"10.1016/j.amjms.2025.07.014","DOIUrl":"10.1016/j.amjms.2025.07.014","url":null,"abstract":"","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The closed loop of the circCLIP2/miR-361-3p/STAT2 signaling axis regulates the progression of cervical cancer.","authors":"Qian Zhang, Wang Cai","doi":"10.1016/j.amjms.2024.08.002","DOIUrl":"https://doi.org/10.1016/j.amjms.2024.08.002","url":null,"abstract":"<p><strong>Background: </strong>Circular RNAs (circRNAs) are involved in tumorigenesis and the progression of cancer through various pathways. However, the detailed regulatory mechanisms of circRNAs in cervical cancer are not fully understood. The present study was designed to explore the biological functions and potential mechanisms of circCLIP2 (has_circ_0001717) in cervical cancer.</p><p><strong>Methods: </strong>The expression profiles of circRNAs in cancerous and adjacent normal tissues of cervical cancer patients were examined using RNA sequencing. Gain- and loss-of-function experiments were carried out to determine the biological functions of circCLIP2 in the proliferation, invasion, migration and apoptosis of cervical cancer cells. qRT-PCR was also used to evaluate the expression of circCLIP2, miR-361-3p and STAT2 in cervical cancer cells. The protein levels of STAT2 were determined by western blotting.</p><p><strong>Results: </strong>CircCLIP2 was identified as the most down-regulated molecule in the cancerous tissues of cervical cancer patients compared to the adjacent normal tissues. Moreover, the levels of circCLIP2 was decreased in cervical cancer patients with metastasis and advanced tumour stage, and patients with high-circCLIP2-expression exhibited poorer survival rate. In addition, over-expression of circCLIP2 suppressed the proliferation, invasion and migration of cervical cancer cells, whereas cell apoptosis was enhanced. Moreover, down-regulated circCLIP2 functioned as the sponge of miR-361-3p, which reduced the expression of STAT2. Furthermore, knockdown of STAT2 inhibited the expression of circCLIP2 at the transcriptional level.</p><p><strong>Conclusion: </strong>The circCLIP2/miR-361-3p/STAT2 signalling could mediate the progression of cervical cancer. CircCLIP2 may become a novel target for the diagnosis and treatment of cervical cancer.</p>","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}