The Journal Of International Medical Research[JOURNAL]
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200 papers
Upper gastrointestinal hemorrhage due to splenic artery pseudoaneurysm combined with pancreatic pseudocyst recurrence: A case report.
Liu J, Liang M, Pan Y … +3 more , Xu Z, Shi D, Yu J
J Int Med Res · 2026 Jun · PMID 42371404 · Full text
Intracapsular hemorrhage occurs occasionally in acute pancreatitis complicated with pseudocyst that can be managed using laparoscopic gastric cyst anastomosis and drainage. However, cyst recurrence many years later and s...
Intracapsular hemorrhage occurs occasionally in acute pancreatitis complicated with pseudocyst that can be managed using laparoscopic gastric cyst anastomosis and drainage. However, cyst recurrence many years later and secondary splenic artery pseudoaneurysm rupture and hemorrhage leading to bloody vomiting and syncope are uncommonly reported. A woman in her late 40s was admitted for bloody vomiting, melena, anemia, and syncope. She underwent laparoscopic gastric cyst anastomosis and drainage for severe acute pancreatitis 3 years ago. Gastroscopy identified a bleeding gastric vascular malformation. Metal clips were used for endoscopic hemostasis. Abdominal enhanced computed tomography revealed a cystic lesion in the tail of the pancreas (4.2 × 3.9 cm) connected with the stomach wall and a splenic artery pseudoaneurysm in the cyst. Splenic artery pseudoaneurysm embolization was performed. The patient remains asymptomatic 2 years after embolization. Percutaneous selective embolization of a splenic artery pseudoaneurysm may be the preferred choice for patients with a pancreatic pseudocyst complicated by rupture and hemorrhage of the splenic artery pseudoaneurysm in the pancreatic pseudocyst. Clinicians should be alert regarding the possibility of recurrence after prior drainage, highlighting the importance of long-term follow-up.
Sleep quality and psychological interactions in endurance and ultra-endurance trail runners: A prospective cross-sectional study.
Saborosa GP, Guilherme LQ, Scheer V … +6 more , Matos JP, Brandão MLDS, Martins PR, Knechtle B, Kravchychyn ACP, de Sá Souza H
J Int Med Res · 2026 Jun · PMID 42370814 · Full text
IntroductionEndurance and ultra-endurance running impose substantial physical and psychological demands, leading athletes to experience intense emotional states before, during, and after competitions. Accordingly, there...
IntroductionEndurance and ultra-endurance running impose substantial physical and psychological demands, leading athletes to experience intense emotional states before, during, and after competitions. Accordingly, there is a paucity of evidence comparing mood profiles between endurance and ultra-endurance runners competing in trail and mountain events.ObjectiveThe aim of this study was to characterize the mood profile of endurance and ultra-endurance runners participating in La Misión Brasil 2024 and to analyze its relationship with sleep quality.MethodsThis prospective cross-sectional study included 193 runners, divided into an endurance group (n = 118; men = 75; women = 43) and an ultra-endurance group (n = 75; men = 60; women = 15), who participated in the same competition according to the proposed distances. La Misión Brasil is a trail running event with race distances ranging from 25 to 80 km and substantial elevation gain. One week prior to the competition, participants completed questionnaires assessing mood state, anxiety, psychological health, and sleep quality. Comparisons between groups (endurance group vs. ultra-endurance group) and sexes were performed using independent -tests, Mann-Whitney tests, and generalized linear models, whereas associations were examined using Spearman's correlation.ResultsThe results indicated higher vigor levels in the ultra-endurance group (p = 0.020) and greater overall fatigue in the endurance group (p = 0.027). Regarding sex differences, men exhibited higher vigor (p = 0.004), whereas women presented higher total mood disturbance and anxiety scores (trait anxiety and state anxiety; p < 0.05). Correlational analyses revealed that poorer sleep quality scores were moderately associated with higher total mood disturbance (r = 0.45) and anxiety levels (trait anxiety: r = 0.47; state anxiety: r = 0.48). Additionally, strong correlations were observed between negative mood states, total mood disturbance, and anxiety (r > 0.50).ConclusionsOverall, endurance and ultra-endurance runners demonstrated a favorable mood profile; however, the psychological demands of these modalities are associated with relevant interactions between sleep, mood, and anxiety.
Therapeutic effect of N-acetylcysteine in severe or critical coronavirus disease 2019 pneumonia: A retrospective cohort study.
Jin X, Zhao Y, Jiang X
J Int Med Res · 2026 Jun · PMID 42363800 · Full text
BackgroundSevere or critical coronavirus disease 2019 pneumonia is associated with a high mortality rate and considerable treatment cost. Although a few reports have shown that N-acetylcysteine may shorten recovery time...
BackgroundSevere or critical coronavirus disease 2019 pneumonia is associated with a high mortality rate and considerable treatment cost. Although a few reports have shown that N-acetylcysteine may shorten recovery time in patients with severe acute respiratory syndrome coronavirus 2 infection, its effect on mortality or disease progression in patients with severe or critical coronavirus disease 2019 pneumonia has not been investigated. This study aimed to evaluate the effect of N-acetylcysteine on mortality or disease progression, hospital stay, and hospitalization costs in patients with severe or critical coronavirus disease 2019 pneumonia.MethodsThis single-center, retrospective cohort study included 221 patients with severe or critical coronavirus disease 2019 pneumonia who were hospitalized at the Department of Respiratory and Critical Care Medicine, Huashan Hospital from December 2022 to January 2023. After 1:1 propensity score matching, 176 patients were divided into two groups based on whether oral N-acetylcysteine was administered for at least 3 days. Binary logistic regression was used to analyze the effect of N-acetylcysteine on mortality or disease progression, whereas its effect on 28- or 90-day mortality was analyzed using Cox regression.ResultsBinary logistic regression analysis showed that N-acetylcysteine was associated with a reduced risk of the composite endpoint of mortality or disease progression during hospitalization (odds ratio = 0.288, 95% confidence interval: 0.147-0.793, = 0.011). However, N-acetylcysteine was not significantly associated with hospitalization costs, length of hospital stay, or the use of high-flow oxygen or mechanical ventilation. In addition, no significant association was observed between N-acetylcysteine use and 28- or 90-day mortality. Given the retrospective design and potential residual confounding, these findings should be interpreted as exploratory.ConclusionsIn this retrospective cohort study, treatment with N-acetylcysteine for at least 3 days was associated with a possible reduction in mortality or disease progression during hospitalization in patients with severe or critical coronavirus disease 2019 pneumonia. Prospective studies are needed to confirm these observations.
Monitoring and analysis of drug therapy in a patient with drug reaction with eosinophilia and systemic symptoms syndrome caused by pantoprazole: A case report.
Chen GH, Lei HB, Liu X … +1 more , Zheng YH
J Int Med Res · 2026 Jun · PMID 42363799 · Full text
Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe T-cell-mediated adverse cutaneous reaction characterized by rash, fever, and visceral involvement following prolonged drug use. It is rar...
Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe T-cell-mediated adverse cutaneous reaction characterized by rash, fever, and visceral involvement following prolonged drug use. It is rarely induced by proton pump inhibitors, with no prior reports documenting pharmacist-identified pantoprazole-related DRESS syndrome and subsequent intervention. A female in her early 60s (Han Chinese ethnicity) was admitted to the intensive care unit of Xiangtan Central Hospital (Xiangtan, China) in mid-2024 for thoracoabdominal pain caused by a fall, and pantoprazole was initiated for stress ulcer prophylaxis on the hospital day 2. Twenty-six days after pantoprazole initiation, the patient developed diffuse macular erythema with desquamation, and her eosinophil percentage increased from 0.5% to 7.8% after 2 days of rash onset. The clinical pharmacist initially suspected meropenem hypersensitivity and recommended discontinuation of this agent; however, 5 days after the onset of rash, leucopenia was observed with the eosinophil percentage peaking at 18.4%, and subsequent discontinuation of pantoprazole resulted in defervescence within 48 h, gradual resolution of the rash, and normalization of blood counts within approximately 10 days of drug cessation. Despite the complex pathophysiology and diagnostic challenges associated with DRESS syndrome, the pharmacist's identification of the suspected drug and targeted intervention achieved favorable outcomes, providing clinical reference for further research on DRESS syndrome.
Small-incision, point-by-point debridement combined with double-cannula negative-pressure irrigation and drainage for granulomatous mastitis: A single-center retrospective cohort study.
Li L, Jia H
J Int Med Res · 2026 Jun · PMID 42363797 · Full text
ObjectiveTo evaluate the efficacy of small-incision, point-by-point debridement combined with double-cannula negative-pressure irrigation and drainage in the treatment of granulomatous mastitis.MethodsThis single-center,...
ObjectiveTo evaluate the efficacy of small-incision, point-by-point debridement combined with double-cannula negative-pressure irrigation and drainage in the treatment of granulomatous mastitis.MethodsThis single-center, retrospective matched cohort study included 118 patients with granulomatous mastitis who were treated at the Third People's Hospital of Mianyang between January 2022 and December 2024. Patients with comparable clinical characteristics were matched in a 1:1 ratio and assigned to either the treatment or control group, with 59 patients in each group. Patients in the treatment group underwent small-incision, point-by-point debridement of necrotic tissue combined with double-cannula continuous negative-pressure irrigation and drainage, whereas those in the control group underwent conventional incision and drainage combined with negative-pressure drainage. Postoperative drainage volume, time to drain removal, frequency of dressing changes, wound healing time, primary healing rate, recurrence rate, and breast shape score were compared between the two groups.ResultsCompared with the control group, the treatment group had a significantly lower postoperative drainage volume, fewer dressing changes, shorter time to drain removal, and shorter wound healing time. The recurrence rate was significantly lower in the treatment group than in the control group (χ = 5.221, < 0.05). The primary healing rate was significantly higher in the treatment group than in the control group (χ = 4.140, < 0.05). In addition, breast shape scores were significantly higher in the treatment group. All between-group differences were statistically significant.ConclusionSmall-incision, point-by-point debridement combined with double-cannula negative-pressure irrigation and drainage may promote wound recovery, reduce recurrence, and better preserve breast appearance in selected patients with granulomatous mastitis requiring surgical treatment. Further prospective studies are warranted to confirm these findings.
Immediate versus delayed dexamethasone implantation during vitrectomy for diabetic macular edema with secondary epiretinal membrane: A retrospective comparative study.
Chen J
J Int Med Res · 2026 Jun · PMID 42363796 · Full text
ObjectiveTo compare outcomes between immediate intraoperative dexamethasone implantation and scheduled 1-month postoperative dexamethasone implantation in pseudophakic eyes undergoing vitrectomy for diabetic macular edem...
ObjectiveTo compare outcomes between immediate intraoperative dexamethasone implantation and scheduled 1-month postoperative dexamethasone implantation in pseudophakic eyes undergoing vitrectomy for diabetic macular edema with secondary epiretinal membrane.MethodsThis retrospective comparative study included 80 pseudophakic eyes with diabetic macular edema and secondary epiretinal membrane. All eyes underwent 25-gauge vitrectomy with epiretinal membrane and internal limiting membrane peeling. The Immediate Group received dexamethasone implantation at the end of vitrectomy, and the Delayed Group received the first dexamethasone implant 1 month postoperatively. From month 3, both groups followed the same pro re nata retreatment protocol. Best-corrected visual acuity, central macular thickness, intraocular pressure, and dexamethasone injection frequency were assessed for 12 months.ResultsBoth groups showed improvement in best-corrected visual acuity and reduction in central macular thickness, but early recovery was faster in the Immediate Group. At 1 month, best-corrected visual acuity was 0.55 ± 0.08 versus 0.78 ± 0.11 logarithm of the minimum angle of resolution, and central macular thickness was 315.5 ± 28.6 versus 520.2 ± 35.4 μm, respectively (both P < 0.001). Mixed-effects models showed significant time effects and significant group × time interactions at earlier visits, supporting greater early improvement in the Immediate Group. At 12 months, best-corrected visual acuity remained better in the Immediate Group (0.36 ± 0.08 vs. 0.43 ± 0.10 logarithm of the minimum angle of resolution, P = 0.001). Although central macular thickness remained lower in the Immediate Group, the group × time interaction for central macular thickness was no longer significant, indicating that the anatomical advantage became less pronounced over time. The Immediate Group showed numerically fewer dexamethasone injections, but without statistical significance. Intraocular pressure elevation was controlled medically, and no serious ocular or systemic adverse events were documented.ConclusionImmediate intraoperative dexamethasone implantation was associated with faster early anatomical recovery and earlier visual improvement. The anatomical advantage became less pronounced over time, and the potential effect on retreatment burden requires confirmation in prospective randomized studies.
Regional versus general anesthesia for femur and hip fracture surgery: A meta-analysis of postoperative outcomes and complications.
Li P, Han L, Lv L
J Int Med Res · 2026 Jun · PMID 42363795 · Full text
ObjectiveHip and femur fractures in older adults are linked to high morbidity, mortality, and socioeconomic costs. This meta-analysis compares regional anesthesia and general anesthesia for these surgeries, focusing on p...
ObjectiveHip and femur fractures in older adults are linked to high morbidity, mortality, and socioeconomic costs. This meta-analysis compares regional anesthesia and general anesthesia for these surgeries, focusing on perioperative safety and outcomes.MethodsFifteen studies (6829 participants) from 2009 to 2024 were analyzed. Primary outcomes included 30-day mortality, postoperative delirium, and cardiovascular events; secondary outcomes covered intraoperative blood loss, hospital stay, and pain. Pooled effect sizes were calculated using random-effects models with odds ratios and 95% confidence intervals. Heterogeneity was assessed using the I statistic. Risk of bias was evaluated with Risk of Bias 2.0 (randomized controlled trials) and Risk Of Bias In Nonrandomized Studies of Interventions (observational studies). Certainty of evidence was rated using the Grading of Recommendations Assessment, Development and Evaluation approach.ResultsPooled analysis showed no significant difference in 30-day mortality between regional anesthesia and general anesthesia (odds ratio = 0.89 (0.72-1.10), p = 0.28, I = 34%). Regional anesthesia was associated with significantly lower hypotension rates (odds ratio = 0.28 (0.18-0.43), p < 0.001, I = 52%). There was a nonsignificant trend toward lower postoperative delirium with regional anesthesia (odds ratio = 0.78 (0.60-1.01), p = 0.06, I = 46%). Pain management favored general anesthesia in one large trial (severe pain: 28.8% vs. 42.3%, p < 0.01), but other studies showed no difference. No significant differences were found in long-term mortality or functional recovery (p > 0.05 for all). Substantial heterogeneity (I > 50%) was noted for some outcomes because of variations in age, fracture type, and study design.ConclusionRegional anesthesia may offer perioperative benefits, including reduced hypotension and a possible (but not statistically confirmed) reduction in postoperative delirium. General anesthesia provides better early pain control in some patients and remains suitable for complex cases. Individualized anesthesia plans are recommended. Future research should prioritize standardized outcomes and larger trials.
Correlation of vitamin D and diabetic peripheral neuropathic pain: A cross-sectional study.
Yao C, Wang L, Zhang H … +7 more , Yang W, Zhong Y, Han W, Xu J, Chen Y, Wang P, Zhang S
J Int Med Res · 2026 Jun · PMID 42363794 · Full text
ObjectiveAlthough ample evidence exists on the association between vitamin D deficiency and diabetic peripheral neuropathy, only a few studies have distinguished between painful and painless forms. This study compared se...
ObjectiveAlthough ample evidence exists on the association between vitamin D deficiency and diabetic peripheral neuropathy, only a few studies have distinguished between painful and painless forms. This study compared serum vitamin D levels in type 2 diabetes patients with and without painful neuropathy.MethodsWe enrolled 46 patients with diabetes (painless diabetic peripheral neuropathy, n = 15; painful diabetic peripheral neuropathy, n = 16; non-neuropathy, n = 15) and 15 healthy controls. Assessments included neurologic exams, Michigan Neuropathy Screening Instrument, electrophysiology, skin biopsy, and serum 25(OH)D measurements.ResultsThe level of 25(OH)D was significantly lower in painful diabetic peripheral neuropathy (23.00 ± 7.97) patients versus controls (44.48 ± 6.77), non- diabetic peripheral neuropathy (31.22 ± 6.14) patients, and painless diabetic peripheral neuropathy patients (36.91 ± 6.22; P < 0.01). Multivariate analysis identified vitamin D as an independent factor for painful diabetic peripheral neuropathy (P = 0.007). The 25(OH)D level was significantly correlated with sural amplitude (r = 0.377), peroneal amplitude (r = 0.434), vibration threshold (r = -0.393), and Michigan Neuropathy Screening Instrument score (r = -0.456).ConclusionsSerum 25(OH)D levels were significantly lower in painful diabetic peripheral neuropathy, suggesting the potential role of vitamin D deficiency in the pathogenesis of diabetic peripheral neuropathy.
Hepatic portal venous gas in severe neurocritical illness after intracranial surgery: Two case reports and literature review.
Li S, Liu G, Shen Z … +1 more , Zhang Y
J Int Med Res · 2026 Jun · PMID 42363432 · Full text
Hepatic portal venous gas is an uncommon radiologic finding that has been rarely reported in neurocritical care settings. This article presents two clinically instructive case reports of severe neurological disorders com...
Hepatic portal venous gas is an uncommon radiologic finding that has been rarely reported in neurocritical care settings. This article presents two clinically instructive case reports of severe neurological disorders complicated by HPVG. Both patients presented with abdominal distension, absent bowel sounds, and septic shock following neurological surgery, and abdominal imaging confirmed the presence of hepatic portal venous gas. These cases provide valuable clinical references for the abdominal management of patients in neurocritical care.
Long-term mortality trends and disparities in renal failure across the United States, 1999 to 2024: A nationwide population-based ecological time-trend study.
Wang Y, Leng X
J Int Med Res · 2026 Jun · PMID 42359812 · Full text
ObjectiveAlthough renal failure is an important cause of death in the United States, recent mortality trends and subgroup differences remain insufficiently characterized. This nationwide ecological time-trend study exami...
ObjectiveAlthough renal failure is an important cause of death in the United States, recent mortality trends and subgroup differences remain insufficiently characterized. This nationwide ecological time-trend study examined renal failure mortality among adults in the United States from 1999 to 2024 by sex, age, race and ethnicity, region, state, urbanization level, and renal failure subtype.MethodsDeaths among adults aged ≥25 years with renal failure as the underlying cause of death were identified from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database. Renal failure was defined using International Classification of Diseases, Tenth Revision codes N17 to N19. Primary measures were age-adjusted mortality rate and average annual percent change. Subtype analyses were performed for acute, chronic, and unspecified renal failure.ResultsFrom 1999 to 2024, 1,192,598 deaths were attributed to renal failure. Annual deaths increased from 34,456 to 53,848, whereas age-adjusted mortality rate changed only modestly from 19.57 to 19.05 per 100,000 population, with an average annual percent change of -0.16 (95% confidence interval, -0.62 to 0.30). In 2024, males had a higher age-adjusted mortality rate than females (22.72 vs. 16.26), and non-Hispanic Black individuals exhibited the highest age-adjusted mortality rate (37.53). Adults aged 45-54 years showed a significant long-term increase. Subtype analyses revealed increasing chronic renal failure, a nonsignificant increase in acute renal failure, and markedly declining unspecified renal failure.ConclusionsAlthough overall renal failure age-adjusted mortality rate remained largely stable from 1999 to 2024, this pattern masked divergent subtype trends and persistent subgroup disparities. Higher rates among males, non-Hispanic Black individuals, and nonmetropolitan populations suggest that gaps have not narrowed sufficiently, likely reflecting unequal cardiometabolic risk burden, delayed detection, and uneven access to kidney care. Prevention strategies should prioritize high burden communities and improve early chronic kidney disease recognition, risk factor control, and access to nephrology care.
Diabetes knowledge and attitudes among non-diabetic adults in Iraq: A cross-sectional study of awareness, risk perception, and preventive understanding.
Al-Qerem WA, Alsajri AH, Jarab AS … +8 more , Eberhardt J, Subhi SB, Dahaam FS, Jasim SA, Mohamed TW, Al-Hashaki DK, Alkhawwam NM, Sawaftah LF
J Int Med Res · 2026 Jun · PMID 42359810 · Full text
ObjectiveTo assess diabetes mellitus-related knowledge, attitudes, risk perception, and preventive understanding among non-diabetic adults in Iraq.MethodsThis cross-sectional study used convenience, voluntary sampling to...
ObjectiveTo assess diabetes mellitus-related knowledge, attitudes, risk perception, and preventive understanding among non-diabetic adults in Iraq.MethodsThis cross-sectional study used convenience, voluntary sampling to recruit adults aged 18 years or older without a prior diagnosis of diabetes mellitus from different regions of Iraq between June and October 2025. Participants completed a culturally adapted questionnaire assessing sociodemographic characteristics, diabetes mellitus knowledge, attitudes, information sources, and beliefs regarding prevention. Descriptive statistics, Mann-Whitney U tests, quantile regression, and binary logistic regression were used.ResultsThe study included 874 participants. Nearly half (48.4%) reported a family history of diabetes mellitus. Common symptoms, such as frequent urination (89.9%) and excessive thirst (84.2%), were widely known, whereas less obvious symptoms, such as unexpected weight loss, were less well recognized. Awareness of some complications, such as loss of consciousness (94.2%) and amputation (93.8%), was high, while awareness of others, such as kidney damage (69.5%) and eye disorders (78.3%), was moderate. Quantile regression analysis showed significantly lower knowledge scores among participants without a medical background (β = -4.214, p < 0.001). In addition, higher knowledge scores were significantly associated with more positive attitudes toward diabetes mellitus (odds ratio = 1.179, 95% confidence interval: 1.108-1.255, p < 0.001), whereas older age was associated with less favorable attitudes (odds ratio = 0.545, p < 0.001).ConclusionsAdults without diabetes in Iraq demonstrated a good basic understanding of diabetes mellitus; however, important gaps remain in knowledge of symptoms, complications, and key risk factors. These findings highlight the need for practical, evidence-based public health education to support prevention efforts and reduce the future burden of diabetes mellitus.
Clinical features of dentatorubral-pallidoluysian atrophy: A survey of Chinese patients.
Zheng N, Li M, Wang YX … +1 more , Yao GE
J Int Med Res · 2026 Jun · PMID 42359808 · Full text
ObjectiveWe aimed to characterize the clinical, magnetic resonance imaging, and genetic features of Chinese patients with dentatorubral-pallidoluysian atrophy.MethodsIn this retrospective case-series and literature-revie...
ObjectiveWe aimed to characterize the clinical, magnetic resonance imaging, and genetic features of Chinese patients with dentatorubral-pallidoluysian atrophy.MethodsIn this retrospective case-series and literature-review study, we analyzed three affected members belonging to the same family diagnosed at our institution. We also reviewed genetically confirmed Chinese dentatorubral-pallidoluysian atrophy cases reported in the China National Knowledge Infrastructure, Wanfang, and PubMed databases up to 31 May 2025 and included additional 42 patients from separate families. Cases with available age at onset, initial symptoms, and CAG repeat size were included; cases without magnetic resonance imaging data were excluded only from imaging-specific analyses. Thus, the final cohort included 45 Chinese dentatorubral-pallidoluysian atrophy patients.ResultsForty-five patients were analyzed. The median CAG repeat count was 62 (range, 53-79), and mean age at onset was 28.22 ± 17.48 (range, 2-69) years. Seizures (46.7%) and gait instability (42.2%) were the most common initial manifestations. Multiple clinical manifestations frequently co-occurred, including gait instability (88.9%), cognitive impairment (73.3%), speech impairment (66.7%), seizures (64.4%), and involuntary movements (48.9%). Patients with seizure onset had larger CAG expansions and younger age at onset than those with gait-instability onset. Age at onset negatively correlated with CAG repeat count in the overall cohort and seizure-onset subgroup, but not in the gait-instability subgroup.ConclusionsLarger CAG repeat expansions may be associated with earlier onset, especially in seizure-predominant dentatorubral-pallidoluysian atrophy. Magnetic resonance imaging commonly shows cerebellar atrophy and white-matter or brainstem involvement. After excluding common causes, dentatorubral-pallidoluysian atrophy should be considered in patients presenting with unexplained combinations of seizures, ataxia, cognitive impairment, and a compatible family history.
Remission of Immunoglobulin A nephropathy following sequential tonsillectomy and appendectomy: A case report.
Zheng P, Lin G, Weng X … +5 more , Xu W, Qiu M, Zhong Y, Ouyang J, Chen J
J Int Med Res · 2026 Jun · PMID 42343655 · Full text
Immunoglobulin A nephropathy is a common glomerular disease associated with mucosal immune dysregulation. We report the case of a young woman diagnosed with biopsy-proven immunoglobulin A nephropathy who achieved sustain...
Immunoglobulin A nephropathy is a common glomerular disease associated with mucosal immune dysregulation. We report the case of a young woman diagnosed with biopsy-proven immunoglobulin A nephropathy who achieved sustained clinical remission following sequential tonsillectomy and appendectomy performed for standard clinical indications. Tonsillectomy was associated with improvement in hematuria, whereas proteinuria persisted. Four years later, appendectomy for chronic appendicitis was followed by complete resolution of the proteinuria. The temporal association between these interventions and changes in disease activity is notable; however, causality cannot be established. This case highlights the potential relevance of extrarenal mucosal inflammatory conditions in selected patients with immunoglobulin A nephropathy and underscores the complexity of disease activity assessment. These observations should be considered hypothesis-generating and require further investigation.
Integration of single-cell cis-expression quantitative trait locus and Mendelian randomization analyses identifies a Treg-specific gene for precision therapy in rheumatoid arthritis, gonarthrosis, and gouty arthritis.
Ren T, Shen Y, Li J … +4 more , Zhang Z, Liu Z, Bao L, Li X
J Int Med Res · 2026 Jun · PMID 42343651 · Full text
ObjectiveArthritis, including rheumatoid arthritis, gonarthrosis, and gouty arthritis, poses a substantial public health challenge. Regulatory T cells are critical for immune homeostasis, and their dysfunction contribute...
ObjectiveArthritis, including rheumatoid arthritis, gonarthrosis, and gouty arthritis, poses a substantial public health challenge. Regulatory T cells are critical for immune homeostasis, and their dysfunction contributes to arthritis pathogenesis; however, the specific gene regulatory programs causally influencing disease susceptibility remain elusive. We aimed to identify regulatory T cell-specific therapeutic targets using single-cell cis-expression quantitative trait locus and Mendelian randomization.MethodsWe integrated single-cell regulatory T cell cis-expression quantitative trait locus data with genome-wide association study results from FinnGen R12 (16,314 rheumatoid arthritis, 61,356 gonarthrosis, and 12,342 gouty arthritis cases). Two-sample Mendelian randomization was employed to infer causality, using the inverse-variance weighted method, with rigorous sensitivity analyses conducted to ensure robustness.ResultsThe analysis revealed distinct causal associations. In rheumatoid arthritis, upregulation of DexD/H-box helicase 60 like ( significantly increased the disease risk (odds ratio = 2.10), whereas expression served as a protective factor (odds ratio = 0.65). For gonarthrosis, again demonstrated a protective effect (odds ratio = 0.897), whereas janus kinase and microtubule interacting protein 2 ( was identified as a modest risk factor (odds ratio = 1.019). Conversely, no significant regulatory T cell-specific causal signals were observed for gouty arthritis.Conclusions is a cross-disease regulatory T cell protector, whereas and are disease-specific risk amplifiers. Engineering high-OAS1/low-DDX60L/low-JAKMIP2 regulatory T cells offers a genetically grounded blueprint for rheumatoid arthritis and gonarthrosis but not for gouty arthritis.
Network pharmacology and bioinformatics analysis-based strategy for exploring the mechanisms of luteolin in the treatment of five types of cancer: A retrospective computational study.
Xu H, Qiu W, Zhu C … +2 more , Zhao N, Sha J
J Int Med Res · 2026 Jun · PMID 42343650 · Full text
ObjectiveLuteolin, a natural flavonoid, exhibits anticancer effects; however, its mechanisms of action are unclear.MethodsThis retrospective computational study combined network pharmacology, molecular docking, and molec...
ObjectiveLuteolin, a natural flavonoid, exhibits anticancer effects; however, its mechanisms of action are unclear.MethodsThis retrospective computational study combined network pharmacology, molecular docking, and molecular dynamics simulation to explore luteolin's anticancer mechanisms in five types of cancers, including breast, lung, colorectal, gastric, and liver cancers. Network pharmacology helps uncover multi-target interactions in complex diseases. Public databases were used to build compound-target, target-disease, and protein-protein interaction networks. Molecular docking and dynamics simulations validated luteolin's binding to AKT1. The Clinical Proteomic Tumor Analysis Consortium dataset and Human Protein Atlas database were used to assess AKT1 expression in cancer versus normal tissues.ResultsTopological analysis identified (a PI3 K/AKT pathway kinase) as a hub gene linked to apoptosis, cell cycle, and tumor suppression. Molecular studies confirmed strong luteolin-AKT1 binding. Clinical Proteomic Tumor Analysis Consortium and Human Protein Atlas data showed that compared with normal tissues, higher AKT1 expression was present in lung, gastric, and breast cancers and lower expression was observed in liver and colorectal cancers.ConclusionThe anticancer effects exerted by luteolin may involve AKT1 signaling modulation. Network pharmacology aids in revealing multi-target mechanisms of natural compounds, supporting further research on the therapeutic potential of luteolin.
Timing of surgical excision for burn wounds: A systematic evaluation and meta-analysis comparing early and delayed excision.
Wang H, Wang D, Wu Y … +1 more , Liu J
J Int Med Res · 2026 Jun · PMID 42343617 · Full text
BackgroundThe optimal timing of burn wound excision remains controversial. We updated the evidence base by synthesizing data from comparative studies published from 1 January 2010 to 11 March 2024 that compared the outco...
BackgroundThe optimal timing of burn wound excision remains controversial. We updated the evidence base by synthesizing data from comparative studies published from 1 January 2010 to 11 March 2024 that compared the outcomes of early and delayed excision in patients with thermal burns.MethodsThe PubMed, Embase, Cochrane Library, and Web of Science Core Collection databases were searched. Two reviewers independently screened studies, extracted data, and assessed the risk of bias. Random-effects meta-analysis was performed. Mortality was pooled as risk difference, and continuous outcomes were pooled as standardized mean differences with 95% confidence intervals. Prespecified subgroup analyses considered study design, country income group, and the operational definition of early excision. This systematic review and meta-analysis was formally registered in the International Prospective Register of Systematic Reviews (PROSPERO) on 3 December 2024 (CRD42024621585).ResultsTen comparative studies (8 observational studies and two randomized controlled trials) involving 5070 patients fulfilled the eligibility criteria. Early excision was not associated with lower mortality than delayed excision (5 studies; risk difference: -0.01, 95% confidence interval: -0.06 to 0.03; = 0.52; = 79%). Early excision was associated with a shorter duration of hospitalization (8 studies; standardized mean difference: -0.64, 95% confidence interval: -0.93 to -0.35; < 0.001; = 94%). There were no statistically significant differences in the hospital cost (3 studies; standardized mean difference: -0.45, 95% confidence interval: -1.72 to 0.81; = 0.48) or graft success rate (3 studies; standardized mean difference: 0.63, 95% confidence interval: -1.03 to 2.29; = 0.46) between early and late excision. Sensitivity analyses did not materially change the direction of the main findings; however, there was substantial heterogeneity for several outcomes.ConclusionsEarly excision may shorten the duration of hospitalization for selected burn patients; however, no consistent mortality benefit was demonstrated. The available evidence for costs and graft success remains limited and highly heterogeneous; therefore, decisions pertaining to excision timing should be individualized within the broader perioperative burn-care pathway.
Diagnostic performance of point-of-care ultrasound for pediatric skull fractures: A systematic review and meta-analysis.
Wang X, Rao G, Yang G … +8 more , Ye Y, Jiang X, Lin J, Tang M, Chen L, Pan L, Chen W, Wu X
J Int Med Res · 2026 Jun · PMID 42339785 · Full text
ObjectivePediatric head trauma is common, but computed tomography exposes children to ionizing radiation. This systematic review and meta-analysis evaluated the diagnostic accuracy of point-of-care ultrasound for pediatr...
ObjectivePediatric head trauma is common, but computed tomography exposes children to ionizing radiation. This systematic review and meta-analysis evaluated the diagnostic accuracy of point-of-care ultrasound for pediatric skull fractures and clarified its role as an adjunct to clinical assessment rather than a replacement for computed tomography when intracranial injury is suspected.MethodsWe conducted a systematic review and bivariate random-effects diagnostic test meta-analysis guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement and registered in the International Prospective Register of Systematic Reviews (Registration Number: CRD420251139217). PubMed, Embase, the Cochrane Library, and Web of Science were searched from inception through 3 September 2025. Two reviewers independently screened studies, extracted 2 × 2 diagnostic data, and assessed risk of bias using the Quality Assessment of Diagnostic Accuracy Studies-2 tool.ResultsNine studies conducted in emergency department settings met the inclusion criteria. Point-of-care ultrasound demonstrated a pooled sensitivity of 0.90 (95% confidence interval: 0.84-0.94), specificity of 0.98 (95% confidence interval: 0.94-0.99), and an area under the summary receiver operating characteristic curve of 0.96 (95% confidence interval: 0.94-0.97). The summary positive likelihood ratio was 41.73 (95% confidence interval: 15.85-109.87), and the negative likelihood ratio was 0.10 (95% confidence interval: 0.07-0.17). Deeks' funnel plot showed no evidence of small-study effects (P = 0.80).ConclusionsPoint-of-care ultrasound shows high diagnostic accuracy for detecting pediatric skull fractures and may support bedside risk stratification in selected children with low- or intermediate-risk mild head trauma. However, most isolated linear skull fractures are managed conservatively, and point-of-care ultrasound does not evaluate intracranial injury. Computed tomography decisions should therefore remain anchored in neurological status, injury mechanism, validated pediatric head injury decision rules, and clinician judgment.
Impact of uncomplicated cataract surgery on central retinal thickness changes in diabetic patients: A short-term analysis.
Smoljanovic Skocic S, Burgic SS, Algorinees RM … +1 more , Alahmed SK
J Int Med Res · 2026 Jun · PMID 42339781 · Publisher ↗
ObjectiveThe study aimed to evaluate the short-term changes in central retinal thickness after uncomplicated cataract surgery in diabetic patients and assess the influence of diabetic retinopathy severity on postoperativ...
ObjectiveThe study aimed to evaluate the short-term changes in central retinal thickness after uncomplicated cataract surgery in diabetic patients and assess the influence of diabetic retinopathy severity on postoperative retinal response.MethodsIn total, 102 eyes of 102 type 2 diabetic patients undergoing cataract surgery were divided into two groups: Group I (n = 51) comprised eyes without diabetic retinopathy and Group II (n = 51) included eyes with diabetic retinopathy. Central retinal thickness was assessed at baseline and postoperative weeks 1, 6, and 12 using spectral-domain optical coherence tomography. Changes in central retinal thickness of ≥10, ≥29, and ≥50 µm were analyzed.ResultsCentral retinal thickness significantly increased at 6 weeks postoperatively (Group I: median 263 µm; Group II: median 270 µm; = 0.001). No significant differences in best-corrected visual acuity loss were observed between the two groups ( = 0.265). In Group II, the increase in central retinal thickness was highest in patients with severe diabetic retinopathy.ConclusionThe severity of diabetic retinopathy is correlated with the magnitude of retinal thickening, peaking at 6 weeks postoperatively. Despite an increase in the central retinal thickness, visual acuity remained stable during the study period. Duration of diabetes and elevated glycosylated hemoglobin levels were identified as systemic risk factors. These findings underscore the importance of optical coherence tomography-based monitoring and diabetic retinopathy staging in perioperative diabetic care.
Percutaneous pedicle screw combined with percutaneous kyphoplasty for osteoporotic vertebral compression fractures with endplate depression: A randomized controlled trial.
Zha D, Yao X, Xu M … +3 more , Zhang X, Ying X, Ma C
J Int Med Res · 2026 Jun · PMID 42334329 · Full text
ObjectiveThis study investigated the efficacy of a combined technique involving percutaneous pedicle screw fixation and percutaneous kyphoplasty in treating osteoporotic vertebral compression fractures with endplate depr...
ObjectiveThis study investigated the efficacy of a combined technique involving percutaneous pedicle screw fixation and percutaneous kyphoplasty in treating osteoporotic vertebral compression fractures with endplate depression.MethodsA prospective cohort of 120 patients with osteoporotic vertebral compression fractures with endplate depression was classified into Group A (n = 58, percutaneous pedicle screw fixation + percutaneous kyphoplasty) and Group B (n = 62, percutaneous kyphoplasty). Radiographic parameters, visual analog scale score, and Oswestry Disability Index were systematically compared between the two groups postoperatively.ResultsGroup A demonstrated significantly better Cobb angle correction than Group B 0.05). Both percentage of the anterior and central vertebral height of the injured vertebra were significantly higher in Group A across all time points 0.05). Group A exhibited significantly less secondary loss of Cobb correction angle and percentage of secondary loss of vertebral height 0.05). The Oswestry Disability Index was significantly lower in Group A from postoperative 3 months to 2 years 0.05).ConclusionsThe application of percutaneous pedicle screw fixation + percutaneous kyphoplasty demonstrates significant advantages in treating osteoporotic vertebral compression fractures with endplate depression, including enhanced reduction efficacy, reduced postoperative secondary loss of correction, and decreased risk of implant failure. This approach represents a safe and effective therapeutic strategy. Chinese Clinical Trial Registry (No. ChiCTR2500104911).
TriDermCancerNet: A hybrid deep learning framework for skin cancer classification.
Fiaz B, Khan MA, Zafar A … +4 more , Alsenan S, Alnsour Y, Yang Z, Nam Y
J Int Med Res · 2026 Jun · PMID 42334317 · Full text
ObjectiveSkin cancer diagnosis via automated image analysis remains a challenging task due to poor image contrast, visual similarity among lesion classes, and class imbalance in available datasets. To address these issue...
ObjectiveSkin cancer diagnosis via automated image analysis remains a challenging task due to poor image contrast, visual similarity among lesion classes, and class imbalance in available datasets. To address these issues, this study proposes a novel Tri Model Dermatology Cancer Neural Network (TriDermCancerNet) for classifying skin cancer from dermoscopic images.MethodsTwo publicly available datasets are used in this work: the International Skin Imaging Collaboration 2018 and 2019 datasets, which contain multiple classes of cancer types. In the proposed model framework, a contrast enhancement technique was applied to improve image quality, followed by data augmentation to balance the datasets. The proposed TriDermCancerNet architecture is designed based on the key challenges of this work, including dataset variability, interclass similarity, and model explainability. The proposed architecture integrates three modules: a 105-layer Inception module, a 186-layer Inverted Bottleneck Residual module, and the Dense-177 module. Each module was integrated into the proposed network in parallel rather than in series. Thereafter, each module was trained, and features were extracted and fused using a depth concatenation approach. During training, several important hyperparameters were selected using Bayesian optimization, and the final model was used for classification in the testing phase.ResultsThe fused TriDermCancerNet achieved 98.6% accuracy, 98.6% sensitivity, 98.6% F1-score, and an area under the curve of 1.0 on the International Skin Imaging Collaboration 2018 dataset and 99.7% accuracy, 99.6% sensitivity, 99.6% F1-score, and an area under the curve of 1.0 on the International Skin Imaging Collaboration 2019 dataset. Statistical significance testing confirmed that the fusion model outperforms each branch (p < 0.05).ConclusionThe proposed hybrid TriDermCancerNet approach enhances the precision and robustness of skin cancer classification frameworks, providing clinicians with a valuable diagnostic aid for early detection.
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