The Journal Of International Medical Research[JOURNAL]
Sun
200 papers
The real diagnostic value of serum iron in iron deficiency anemia among patients with inflammatory bowel disease: A retrospective study.
Tang JT, Wang X, Chen H … +1 more , He GB
J Int Med Res · 2026 May · PMID 42087743 · Full text
ObjectiveThe diagnostic utility of serum iron in identifying iron deficiency anemia among patients with inflammatory bowel disease remains underreported. This study aimed to evaluate the true diagnostic value of serum ir...
ObjectiveThe diagnostic utility of serum iron in identifying iron deficiency anemia among patients with inflammatory bowel disease remains underreported. This study aimed to evaluate the true diagnostic value of serum iron.MethodsA total of 160 patients with iron deficiency anemia from a grade-A general hospital in Sichuan Province between January 2022 and January 2025 were enrolled. Eighty patients with inflammatory bowel disease and iron deficiency anemia were included in the test group, while 80 patients with iron deficiency anemia without inflammation were included in the control group. Iron metabolism parameters, including serum iron and serum ferritin, complete blood count indices, and biochemical markers, were collected and compared. Differences in diagnosing iron deficiency anemia using serum iron and serum ferritin among patients with inflammatory bowel disease were compared using the chi-square test. Spearman correlation analysis was performed among serum iron, serum ferritin, and other indicators. Meanwhile, potential factors affecting serum iron levels were investigated using linear regression, and the significance of serum iron in diagnosing inflammatory bowel disease with iron deficiency was evaluated using the receiver operating characteristic curve.ResultsAmong patients with inflammatory bowel disease, ulcerative colitis and Crohn's disease showed no significant differences in serum iron and serum ferritin levels. The real clinical results showed that when using 1-6.6 times the lower limit of normal of serum ferritin as a threshold to diagnose patients with inflammatory bowel disease and iron deficiency anemia, a statistically significant difference was observed compared with the serum iron lower limit of 1 time (p0.01). The positivity rate of iron deficiency anemia was 88.75% (71/80) for serum iron and 61.25% (49/80) for 3.3-time serum ferritin. Correlation analysis revealed that serum iron was positively correlated with serum ferritin (=0.263, p=0.018) and negatively correlated with most inflammatory parameters (p<0.05). Multiple linear regression analysis showed that when serum iron was used as the dependent variable, the optimal regression model with the independent variables serum ferritin, hemoglobin, platelet count, and monocyte-to-lymphocyte ratio had regression coefficients () of 0.246, 0.231, -0.405, and -0.187, respectively, all of which were significantly different (p<0.05). Moreover, according to the European Crohn's and Colitis Organization diagnostic criteria for iron deficiency, patients with inflammatory bowel disease were divided into an iron deficiency group involving 41 patients and a non-iron deficiency group involving 39 patients. By comparing the parameters of the two groups and constructing the receiver operating characteristic curve, serum iron alone yielded the highest Youden index and the largest area under the curve for diagnosing iron deficiency (area under the curve = 0.764, p<0.001). However, when the false-positive rate was controlled at 20%, the sensitivity of serum iron for diagnosing iron deficiency was 62.00%.ConclusionsIn patients with inflammatory bowel disease, serum iron is inversely associated with inflammation and appears to be more sensitive than serum ferritin in detecting iron deficiency anemia. These findings suggest that combined measurement of serum iron and serum ferritin may enhance the diagnosis of iron deficiency anemia in clinical practice.
Bracketless three-dimensional orthodontic treatment using coated nickel-titanium E-wires for mild-moderate anterior crowding: A case report with 6-month follow-up.
Alqaisi NN, Hadad RA, Alsilq MN
J Int Med Res · 2026 May · PMID 42082448 · Full text
In recent years, interest in esthetics has increased considerably, resulting in a growing demand for invisible orthodontic appliances, particularly among adolescents and adults. Bracketless orthodontic treatment is an ad...
In recent years, interest in esthetics has increased considerably, resulting in a growing demand for invisible orthodontic appliances, particularly among adolescents and adults. Bracketless orthodontic treatment is an advanced orthodontic approach that uses coated archwires and composite resin, applied with precision using three-dimensional technology. This method may offer an effective alternative to conventional bracket-based systems in certain cases. This single-case report described a clinical case of skeletal and dental Class I malocclusion characterized by moderate lower dental crowding (4.5 mm); midline shift; a dental crossbite involving teeth 14, 15, and 25; and an increased mandibular incisor inclination (lower incisor to mandibular plane = 104°). This condition was managed using the three-dimensional bracketless orthodontic treatment technique. This technique represents an advanced esthetic approach designed for individuals who prioritize dental appearance. It may reduce anterior teeth proclination by acting from the lingual side and may shorten treatment duration in cases of mild to moderate crowding, ensuring faster and more efficient outcomes.
Development of a nomogram for predicting the risk of potentially inappropriate medication use in older adults: A retrospective cross-sectional study.
Qi W, Zhang W, Tong J … +1 more , Chen Z
J Int Med Res · 2026 May · PMID 42082428 · Full text
ObjectiveTo analyze the prevalence of potentially inappropriate medication use in older adults and develop a nomogram for predicting the individualized risk for potentially inappropriate medication use.MethodsA retrospec...
ObjectiveTo analyze the prevalence of potentially inappropriate medication use in older adults and develop a nomogram for predicting the individualized risk for potentially inappropriate medication use.MethodsA retrospective cross-sectional study was conducted using prescription data from older adults who visited the Hefei Third People's Hospital between May 2022 and May 2024. The 2019 Beers Criteria and Chinese criteria for Determining Potentially Inappropriate Medication Use in Older Adults in China were used to identify potentially inappropriate medication use. We conducted univariate and multivariate logistic regression analyses to identify the factors associated with potentially inappropriate medication use and developed a nomogram model to predict the individualized risk of potentially inappropriate medication use.ResultsAmong the 475 older adults included, 195 (41.05%) had at least one incidence of potentially inappropriate medication use (total 288 occurrences). Medications considered as potentially inappropriate were most commonly used (88.72%), followed by medications to be used with caution (6.67%), potentially inappropriate drug-drug interactions (1.54%), and medications potentially inappropriate for patients with certain diseases or syndromes (2.05%). Benzodiazepines, rapid/short-acting insulin, proton pump inhibitors, and amitriptyline were the most frequently used potentially inappropriate medications. Independent risk factors for potentially inappropriate medication use included: (a) age ≥70 years; (b) diabetes mellitus; (c) hypertension; (d) coronary heart disease; (e) sleep disorders; (f) ≥3 comorbidities; and (g) use of ≥4 medications. The nomogram showed moderate discriminative ability (concordance index =0.738) with good calibration and minimal overfitting.ConclusionAdvanced age, multiple chronic conditions, and polypharmacy are key predictors of potentially inappropriate medication in older adults. Enhanced monitoring and personalized medication management may help reduce the risk of potentially inappropriate medication use in this population.
Clinical, imaging characteristics, and outcomes of neuropsychiatric lupus patient admitted to a referral neurology hospital in Bangladesh: A prospective study.
Been Sayeed SKJ, M M, Mahmud R … +3 more , Rahman S, Jannat T, Mm R
J Int Med Res · 2026 May · PMID 42082427 · Full text
ObjectiveThis study aimed to describe the clinical and neuroimaging characteristics and 120-day outcomes in neuropsychiatric systemic lupus erythematosus patients.MethodsThis prospective study involved 32 patients with s...
ObjectiveThis study aimed to describe the clinical and neuroimaging characteristics and 120-day outcomes in neuropsychiatric systemic lupus erythematosus patients.MethodsThis prospective study involved 32 patients with systemic lupus erythematosus who presented with neuropsychiatric symptoms. The Systemic Lupus Erythematosus Disease Activity Index 2000 was used to evaluate disease activity. Standard treatments were administered, and patients were followed up for 120 days. Outcomes were assessed in terms of remission, partial remission, and mortality.ResultsThe most prevalent neuroimaging characteristics were microhemorrhage in eight patients (25%), hemorrhagic infarct in four patients (12%), and ischemic infarct in four patients (12%). Additionally, magnetic resonance angiography of the cerebral artery revealed a beaded appearance in the middle cerebral artery or its branches in nine patients (28%). Magnetic resonance venography showed a filling defect, narrowing, and irregularity of the superior sagittal and transverse sinus in five patients (16%). Upon admission, the mean Systemic Lupus Erythematosus Disease Activity Index 2000 score was 24 (SD = 9). After receiving standard treatment, complete remission occurred in 24 patients (75%) and partial remission in 7 patients (22%), with a median Systemic Lupus Erythematosus Disease Activity Index 2000 score of 2 (interquartile range = 1-4.5) at 120 days, = 0.02.ConclusionMagnetic resonance angiography of cerebral vessels helps confirm vasculitis. Patients generally experience satisfactory outcome with standard treatment at 4 months.
Body composition indices align with thyroid variation in euthyroid Saudi adults: A cross-sectional study.
Alrajhi DS, Ai-Musharaf S, Mazi TA … +3 more , Aldhwayan M, Abolmeaty M, Aljuraiban GS
J Int Med Res · 2026 May · PMID 42082426 · Full text
ObjectiveAlthough associations between obesity and thyroid function have been widely reported, few studies have examined euthyroid (clinically normal) adults using both bioelectrical impedance-derived body composition me...
ObjectiveAlthough associations between obesity and thyroid function have been widely reported, few studies have examined euthyroid (clinically normal) adults using both bioelectrical impedance-derived body composition measures and clinically accessible central adiposity markers in the same analysis, particularly Saudi adults in sex-stratified models. We examined the associations between thyroid function (evaluated using thyroid-stimulating hormone, free thyroxine, and free triiodothyronine) and body composition in Saudi adults, considering sex-specific patterns.MethodsWe conducted a cross-sectional analysis including 551 euthyroid adults (aged ≥18 years, 59% men). Anthropometric characteristics and body composition parameters were evaluated. Serum thyroid-stimulating hormone, free triiodothyronine, and free thyroxine levels were measured. Correlations and logistic regression analyses were used to assess associations. Participants were categorized as having high thyroid-stimulating hormone, low free thyroxine, or low free triiodothyronine levels for an assessment of their obesity risk.ResultsLow free thyroxine levels were associated with higher odds of obesity, as classified using body mass index (odds ratio = 1.85; 95% confidence interval, 1.09-3.10) and waist circumference (odds ratio = 2.68; 95% confidence interval, 1.21-6.20). High thyroid-stimulating hormone levels alone demonstrated a limited association to obesity risk. However, in women, high thyroid-stimulating hormone levels were strongly associated with central obesity. In men, low free thyroxine level was the more prominent predictor, associated with increased odds of elevated waist circumference. Free triiodothyronine levels were positively correlated with lean body mass and negatively with fat percentage, as indicated by higher free triiodothyronine levels in individuals with more muscle and less fat.ConclusionsGreater adiposity was associated with higher thyroid-stimulating hormone and lower free thyroxine levels in our population. These relationships differed by sex; the association of elevated thyroid-stimulating hormone levels with adiposity was more pronounced in women, whereas a stronger inverse free thyroxine-obesity link was observed in men.
Quality of life impairment in vitiligo: A comprehensive review of psychosocial and clinical determinants.
Da Costa AF, Ashkanani H, Ferreira C … +1 more , Torres T
J Int Med Res · 2026 May · PMID 42082425 · Full text
Vitiligo is a chronic depigmenting disorder that imposes a substantial psychological, social, and economic burden, extending beyond its physical manifestations. This narrative review synthesizes and critically evaluates...
Vitiligo is a chronic depigmenting disorder that imposes a substantial psychological, social, and economic burden, extending beyond its physical manifestations. This narrative review synthesizes and critically evaluates current evidence on the determinants of quality of life impairment among individuals with vitiligo. A review of the published literature was conducted, focusing on studies evaluating health-related quality of life, psychosocial outcomes, stigma, psychiatric comorbidities, and validated quality of life assessment instruments in patients with vitiligo. Evidence from systematic reviews, cohort studies, cross-sectional analyses, and instrument validation studies was examined to identify the clinical, demographic, and sociocultural factors associated with disease burden. Across studies, vitiligo was consistently associated with significant impairment in psychological and social domains of quality of life. Disease visibility, particularly involvement of the face or genital regions; greater body surface area involvement; active disease progression; and longer disease duration emerged as key clinical factors associated with worse outcomes. Several demographic and sociocultural characteristics, including female sex, younger age, darker skin phototype, unmarried status, and residence in highly stigmatizing cultural environments, were also associated with greater quality of life impairment. Depression and anxiety were more frequently reported in individuals with vitiligo than in the general population, with pediatric and adolescent patients demonstrating particularly high vulnerability. Although dermatology-specific instruments such as the Dermatology Life Quality Index are commonly used in research and clinical practice, vitiligo-specific tools may more accurately capture stigma, social participation limitations, and disease-specific psychosocial impact. Overall, the available evidence indicates that vitiligo imposes a profound psychosocial burden that often exceeds the objective clinical severity of depigmentation. Quality of life impairment appears to be driven primarily by lesion visibility, sociocultural context, and psychological comorbidity rather than symptom severity alone. These findings underscore the importance of incorporating validated quality of life assessment tools into routine clinical care, screening for psychiatric comorbidities, and adopting culturally sensitive and patient-centered approaches to vitiligo management.
Emergency nephrectomy for fulminant emphysematous pyelonephritis mimicking gastroenteritis: A case report.
Chu W, Wang G, Yan S … +4 more , Deng J, Liao M, Bi L, Fu X
J Int Med Res · 2026 May · PMID 42082424 · Full text
Emphysematous pyelonephritis is a rare, life-threatening necrotizing infection that is typically characterized by classic urinary symptoms. However, it is exceptionally rare for emphysematous pyelonephritis to manifest w...
Emphysematous pyelonephritis is a rare, life-threatening necrotizing infection that is typically characterized by classic urinary symptoms. However, it is exceptionally rare for emphysematous pyelonephritis to manifest with predominant gastrointestinal symptoms, a deceptive mimicry that often masks the underlying renal pathology and leads to significant diagnostic delays. We report the case of a woman in her 60s with type 2 diabetes whose initial presentation was limited to vomiting and diarrhea, suggesting acute gastroenteritis. In the absence of typical urological distress, her condition rapidly worsened, and she developed septic shock and altered mental status within 48 h. Computed tomography confirmed Huang-Tseng class 3B emphysematous pyelonephritis with extensive destruction of the right renal parenchyma. Recognizing the irreversible tissue necrosis and failure of medical therapy, a decisive transition to emergency nephrectomy was performed. This timely surgical intervention successfully arrested the fulminant progression, leading to hemodynamic stabilization and recovery. This case underscores that emphysematous pyelonephritis rarely masquerades as gastroenteritis; in diabetic patients, such atypical manifestations followed by rapid clinical deterioration necessitate immediate computed tomography evaluation. Furthermore, when imaging reveals extensive gas formation and clinical stability is lost, prompt and resolute surgical source control is a critical, life-saving measure for ensuring patient survival.
Lipoprotein(a) and acute myocardial infarction: Differential risk across age and sex subgroups.
Liu Z, Li H, Chang W … +3 more , Geng B, Wu L, Chen Z
J Int Med Res · 2026 Apr · PMID 42059449 · Full text
ObjectiveLipoprotein(a) is an identified risk factor for acute myocardial infarction; however, its role in specific subgroups is inconclusive. This case-control study examined whether classical risk factors modify the as...
ObjectiveLipoprotein(a) is an identified risk factor for acute myocardial infarction; however, its role in specific subgroups is inconclusive. This case-control study examined whether classical risk factors modify the association between lipoprotein(a) levels and acute myocardial infarction across subgroups.MethodsOur study involved 2946 patients with initial acute myocardial infarction and 14,571 controls. Data were processed using multiple imputation and propensity score-based matching. Binary logistic regression, stratification, and sensitivity analyses were performed to explore associations.ResultsThe acute myocardial infarction group had a significantly greater proportion of men, smokers, and alcohol consumers as well as higher lipoprotein(a) levels. After risk factor adjustment in Model 2, the odds ratios and 95% confidence intervals for lipoprotein(a) (Quartile 2-Quartile 4) were 1.11 (0.97, 1.28), 1.24 (1.07, 1.42), and 1.45 (1.26, 1.66), respectively. In older patients, the adjusted odds ratio for acute myocardial infarction in Quartile 4 (vs. Quartile 1) was 2.15 (1.76-2.63)-higher than that in younger patients. Among female participants, the odds ratio for Quartile 4 was 2.61 (1.98-3.45), exceeding that in men. Compared with the younger/male group, the older/female group exhibited escalating acute myocardial infarction risks (adjusted odds ratios: Quartile 2 = 1.48 (1.00-2.18); Quartile 3 = 1.97 (1.38-2.81); and Quartile 4 = 2.88 (2.04-4.05)), culminating in a 2.88-fold elevation in Quartile 4. Repeat analyses of the complete dataset yielded the same results.ConclusionsHigh lipoprotein(a) levels independently increased the risk of initial acute myocardial infarction in older women, suggesting its role as a lipid-lowering therapy target in this population.
Angiotensin-(1-7) suppresses pyroptosis in cerebral endothelium to decrease blood-brain barrier permeability and cognitive impairments in sepsis.
Han Y, Ding H, Chen Y … +5 more , Wen Y, Zhu H, Su Z, Tang J, Zeng H
J Int Med Res · 2026 Apr · PMID 42055817 · Full text
ObjectiveThis study aimed to explore the influence of the angiotensin-(1-7)/Mas receptor and angiotensin II/angiotensin II type 1 receptor pathways on pyroptosis during sepsis and their subsequent effects on cognitive fu...
ObjectiveThis study aimed to explore the influence of the angiotensin-(1-7)/Mas receptor and angiotensin II/angiotensin II type 1 receptor pathways on pyroptosis during sepsis and their subsequent effects on cognitive function.MethodsAdult C57BL/6 mice were subjected to cecal ligation and puncture to induce sepsis. Brain microvascular endothelial cells were treated with angiotensin II and angiotensin-(1-7) to evaluate their impact on pyroptotic processes. Cognitive performance was assessed using the Morris water maze method, and blood-brain barrier permeability was quantified using Evans blue staining.ResultsCompared with the sham group, sepsis induced sustained activation of the angiotensin II/angiotensin II type 1 receptor pathway, whereas the angiotensin-(1-7)/Mas receptor pathway was progressively suppressed. Genetic ablation of cysteine-dependent aspartate protease-1 significantly attenuated pyroptosis in brain endothelial cells, decreased blood-brain barrier permeability, and enhanced cognitive function in septic mice compared with that in the cecal ligation and puncture group. Angiotensin-(1-7) treatment improved cognitive function in septic mice and significantly suppressed angiotensin II-induced pyroptosis, with these effects reversed by the Mas receptor antagonist A-779.ConclusionsThis study identified a novel mechanism in which angiotensin-(1-7) selectively suppresses angiotensin II-induced pyroptosis in brain endothelial cells, consequently ameliorating cognitive deficits during sepsis.
Association between appendicular lean mass-to-body weight ratio and metabolic syndrome in community-dwelling older adults in Taiwan: A cross-sectional study.
Chang CY, Chu NF, Wu DM … +3 more , Liang WC, Yeh SC, Chuang CH
J Int Med Res · 2026 Apr · PMID 42055816 · Full text
ObjectiveMetabolic syndrome increases the risk of cardiovascular diseases and diabetes. This study examined the associations of body mass index and the appendicular lean mass-to-body weight ratio with metabolic syndrome...
ObjectiveMetabolic syndrome increases the risk of cardiovascular diseases and diabetes. This study examined the associations of body mass index and the appendicular lean mass-to-body weight ratio with metabolic syndrome in Taiwanese older adults.MethodsA cross-sectional study of 3739 participants from community surveys (2017-2019) was conducted. Anthropometric measurements, blood pressure, handgrip strength, and biochemical markers were assessed. Appendicular lean mass-to-body weight ratio was calculated using a validated equation. Lifestyle factors and comorbidities were evaluated using questionnaires.ResultsThe prevalence of metabolic syndrome was 47.1% in males and 50.0% in females. Participants with metabolic syndrome had higher body mass index and waist circumference but lower appendicular lean mass-to-body weight ratio. Higher appendicular lean mass-to-body weight ratio was inversely associated with metabolic syndrome (odds ratio = 0.877 in males; odds ratio = 0.885 in females).ConclusionsHigher body mass index was positively associated with metabolic syndrome, whereas higher appendicular lean mass-to-body weight ratio was inversely associated with metabolic syndrome. Maintaining greater muscle mass relative to body weight may help reduce the risk of metabolic syndrome in older adults.
Prediction of recurrence in patients with non-acute atherosclerotic middle cerebral artery occlusion: A longitudinal study using computed tomography perfusion and magnetic resonance imaging.
Zhang X, Zhang Y, Zou R … +5 more , Zhang H, Duan G, Chen Z, Luo Y, Li J
J Int Med Res · 2026 Apr · PMID 42055815 · Full text
ObjectiveThis study aimed to assess the performance of time to maximum concentration (Tmax) using computed tomography perfusion for predicting stroke recurrence in patients with symptomatic non-acute atherosclerotic midd...
ObjectiveThis study aimed to assess the performance of time to maximum concentration (Tmax) using computed tomography perfusion for predicting stroke recurrence in patients with symptomatic non-acute atherosclerotic middle cerebral artery occlusion.MethodsThis retrospective monocentric study enrolled 138 patients diagnosed with non-acute atherosclerotic middle cerebral artery occlusion. In addition to conventional computed tomography angiography or digital subtraction angiography, all patients underwent head computed tomography perfusion and magnetic resonance imaging 7-14 days after stroke and repeat head magnetic resonance imaging at 3-6 weeks. Volume of time to maximum concentration >4 s was considered the hypoperfusion area. The association between imaging characteristics, new ischemic lesion or lesion size increase on magnetic resonance imaging, and patient prognosis was assessed.ResultsIncreased number/area of infarct lesion was observed in 52/138 (37.7%) patients on diffusion weighted imaging 3-6 weeks after the first stroke. The volume of time to maximum concentration >4 s at baseline was strongly associated with infarct lesion development (odds ratio = 1.22 per 10-mL increase, 95% confidence interval: 1.10-1.34, < 0.001). Volume of time to maximum concentration >4 s exhibited high discriminative ability for poor prognosis (area under the curve = 0.84, 95% confidence interval: 0.78-0.91, < 0.001) with volume of time to maximum concentration >4 s larger than 99.8 mL being an optimal cutoff (odds ratio = 14.31, 95% confidence interval: 5.84-40.89, < 0.001, sensitivity = 0.88 and specificity = 0.65).ConclusionsThe risk of stroke recurrence in patients with symptomatic non-acute atherosclerotic middle cerebral artery occlusion gradually increases with the volume of time to maximum concentration >4 s. Patients with volume of time to maximum concentration >4 s larger than 99.8 mL may have a significantly higher risk of stroke. Volume of time to maximum concentration >4 s on computed tomography perfusion can be used to predict the prognosis in patients with symptomatic non-acute atherosclerotic middle cerebral artery occlusion.
Malignant transformation in a patient with type 1 neurofibromatosis: A case report.
Li S, Hao W, Xue Y
J Int Med Res · 2026 Apr · PMID 42055814 · Full text
Neurofibromatosis is an autosomal dominant disease. The most common skin manifestation of type 1 neurofibromatosis is plexiform neurofibromas. Malignant peripheral nerve sheath tumors are rare and aggressive malignancies...
Neurofibromatosis is an autosomal dominant disease. The most common skin manifestation of type 1 neurofibromatosis is plexiform neurofibromas. Malignant peripheral nerve sheath tumors are rare and aggressive malignancies that predominantly arise from peripheral nerves and various nerve sheath cells. This report presents the case of a male patient in his late 50s who was diagnosed with malignant transformation of type 1 neurofibromatosis and treated surgically. The clinical manifestations, histopathological characteristics, treatment, and outcomes of this rare clinical case provide insights for subsequent diagnostic evaluation and clinical decision-making.
Third-generation sequencing technology in the prevention and control of thalassemia: Applications and advances.
Tang J, Lv M, Zhang H … +4 more , Qin M, Yan J, Zhang Y, He J
J Int Med Res · 2026 Apr · PMID 42055813 · Full text
With the rapid advancement of sequencing technology, third-generation sequencing, particularly single-molecule real-time sequencing and nanopore sequencing, has opened new avenues for the precise prevention and control o...
With the rapid advancement of sequencing technology, third-generation sequencing, particularly single-molecule real-time sequencing and nanopore sequencing, has opened new avenues for the precise prevention and control of genetic diseases. It offers distinct advantages, including long-read lengths, minimal requirement for extensive polymerase chain reaction amplification, and real-time sequencing capability. This narrative review summarizes and critically evaluates recent advances in the application and latest progress of third-generation sequencing in thalassemia. It focuses on the technical advantages and application status of this technology in detecting complex structural variations, large-scale carrier screening, prenatal diagnosis, and preimplantation genetic testing. The review further analyzes the considerable potential of this technology in improving diagnostic accuracy, shortening detection cycles, and reducing technical costs. Additionally, it discusses the challenges currently faced in data interpretation, standardized processes, and clinical translation. Finally, this review provides insights into future development directions, with the aim of providing new technical perspectives and a theoretical basis for optimizing the prevention and control strategies of thalassemia.
Association between blood cadmium and the likelihood of developing human papillomavirus infection: A combination of NHANES and clinical study.
He Q, Zhao X, He W … +1 more , Yang Y
J Int Med Res · 2026 Apr · PMID 42055812 · Full text
ObjectiveTo determine whether blood cadmium levels are associated with the likelihood of developing human papillomavirus infection in women aged 20-59 years.MethodsIn this cross-sectional study, we analyzed data from 781...
ObjectiveTo determine whether blood cadmium levels are associated with the likelihood of developing human papillomavirus infection in women aged 20-59 years.MethodsIn this cross-sectional study, we analyzed data from 7815 women in the 2005-2016 National Health and Nutrition Examination Survey. The nonlinear association was examined using generalized weighted models and smoothed curves, with subgroup analyses by age, body mass index, and other covariates. An independent validation cohort of 50 human papillomavirus-positive patients and 50 human papillomavirus-negative controls from Yuejianglou Community Health Center under the Medical Alliance of The Second Hospital of Nanjing was also used.ResultsHuman papillomavirus-positive individuals exhibited higher average blood cadmium levels (0.6 ± 0.74 μg/L) than human papillomavirus-negative individuals (0.48 ± 0.53 μg/L). A positive, nonlinear relationship was found. Subgroup analysis revealed that each unit increase in blood cadmium levels increased the risk of human papillomavirus infection by 34% in women aged 46-59 years with a body mass index of 25-30 kg/m. The validation cohort confirmed significantly higher cadmium levels in human papillomavirus-positive patients.ConclusionsOur research indicates a potential link between blood cadmium levels and human papillomavirus infection status, warranting further investigation.
The evidence for the use of peripheral blood indices in the diagnosis of breast cancer.
Zhou Z, Zhou Y, Liang L … +3 more , Wang B, Zhang X, Fu Y
J Int Med Res · 2026 Apr · PMID 42055811 · Full text
Diagnosis at early stages is critical for achieving favorable outcomes in patients with breast cancer. However, early breast cancer is characterized by atypical clinical and imaging manifestations, which are misdiagnosed...
Diagnosis at early stages is critical for achieving favorable outcomes in patients with breast cancer. However, early breast cancer is characterized by atypical clinical and imaging manifestations, which are misdiagnosed as benign breast disease. This misdiagnosis may affect the choice of treatment, delay the patient's condition, and affect survival. Therefore, identifying an effective and simple screening method to supplement existing screening methods is of considerable importance for improving diagnostic efficacy. Peripheral blood indices are simple, economical, and readily accessible that include routine blood indices, lipid indices, and coagulation indices. With in-depth research on tumor pathogenesis, the relationships between these indices and tumor development have been gradually revealed, suggesting their potential as diagnostic factors for breast cancer. This narrative review explores the development of peripheral blood indices for diagnosing breast cancer and their potential use in early diagnosis.
A novel low-metabolism strategy combined with multimodal detoxification for successful management of high-dose diquat-paraquat mixed poisoning: A comprehensive therapeutic analysis.
Li Z, Cen Z, Wei J … +9 more , Huang G, Mo K, Yan H, Liang L, Du H, Mai X, Yang S, Wei S, Wang W
J Int Med Res · 2026 Apr · PMID 42055808 · Full text
Combined diquat and paraquat poisoning is a rare but clinically significant form of poisoning, associated with severe oxidative stress and multiorgan failure. Historical case series have reported high case fatality, part...
Combined diquat and paraquat poisoning is a rare but clinically significant form of poisoning, associated with severe oxidative stress and multiorgan failure. Historical case series have reported high case fatality, particularly following high-dose exposure. The absence of specific antidotes and standardized treatment protocols for mixed poisoning necessitate innovative therapeutic approaches. We present the case of an adolescent girl in her early teens who ingested 100 mL of a commercially obtained but illegally formulated diquat-paraquat mixture (200 g/L). A novel low-metabolism strategy was implemented, comprising low-concentration oxygen therapy (fraction of inspired oxygen (21%-30%), targeted sedation/analgesia, β-blockade, temperature management, and multimodal detoxification). Plasma toxin levels decreased by >97% within 20 h. Despite complications including anuria, cerebral edema, and respiratory failure, the patient achieved complete recovery after 49 days. Low-metabolism strategy reduced cellular oxygen consumption, mitigated oxidative damage, and enabled effective elimination of toxins. Dynamic monitoring guided tailored organ support. The integration of low-metabolism strategy timely and multimodal detoxification may represent a promising, albeit resource-intensive, approach for severe bipyridinium herbicide poisoning. This strategy warrants further validation in controlled studies and offers a potential framework for cases with severe poisoning.
Advances in the management of gout: From current strategies to emerging therapies.
Zhao Q, Dai X
J Int Med Res · 2026 Apr · PMID 42050917 · Full text
Gout is a form of inflammatory arthritis caused by disordered uric acid metabolism, characterized by severe joint pain and inflammatory reactions, which significantly impair patients' quality of life. With changes in lif...
Gout is a form of inflammatory arthritis caused by disordered uric acid metabolism, characterized by severe joint pain and inflammatory reactions, which significantly impair patients' quality of life. With changes in lifestyle and dietary habits, the incidence of gout has been rising globally, making it a critical public health concern. Current research primarily focuses on short- and long-term management strategies, including pharmacological therapies, lifestyle interventions, and patient education. Short-term management typically comprises nonsteroidal anti-inflammatory drugs and colchicine to alleviate acute attacks, while long-term management focuses on uric acid control and recurrence prevention through urate-lowering drugs. Although existing management strategies can effectively control symptoms, challenges such as poor patient adherence and insufficient individualized treatment persist. Emerging therapies, including biologics and gene-based treatments, have demonstrated promising potential and may offer more effective and personalized therapeutic solutions for patients with gout. This narrative review aims to provide a comprehensive synthesis of existing literature to inform clinical practice and explore future directions in gout management.
A multidimensional nomogram integrating immune, inflammatory, and coagulation markers for personalized prognosis in bladder cancer.
Li Y, Wei W, Liu C … +8 more , Lu H, Chen R, Wu S, Lin Y, Xie H, Ban C, Yi X, Tang Y
J Int Med Res · 2026 Apr · PMID 42050916 · Full text
ObjectiveTo develop and validate an integrated prognostic model based on tumor immune microenvironmental, systemic inflammatory, and coagulation markers to improve prognostic stratification and personalize management for...
ObjectiveTo develop and validate an integrated prognostic model based on tumor immune microenvironmental, systemic inflammatory, and coagulation markers to improve prognostic stratification and personalize management for bladder cancer patients undergoing surgery.MethodsThis retrospective study analyzed 140 patients who underwent radical or partial cystectomy at our institution between 2013 and 2021. Cutoff values for continuous variables were determined using receiver operating characteristic analysis. Independent prognostic factors for overall survival were identified using univariate and multivariate Cox regression analyses. A nomogram was subsequently developed and validated using time-dependent receiver operating characteristic curves, calibration plots, and decision curve analysis.ResultsMultivariate analysis confirmed that tertiary lymphoid structure density, hemoglobin level, D-dimer level, platelet-to-lymphocyte ratio, and clinical stage are independent predictors of overall survival. The constructed nomogram demonstrated high predictive accuracy for 1-, 3-, and 5-year overall survivals, with area under the curve values of 0.868, 0.880, and 0.894, respectively. Calibration and decision curve analyses confirmed the model's excellent consistency and clinical utility. Risk stratification based on the nomogram revealed significant survival differences between the groups ( < 0.001).ConclusionWe developed and validated a novel nomogram that integrates multidimensional immune microenvironmental, systemic inflammatory, and coagulation biomarkers. This model provides a practical tool for prognostic assessment and risk stratification in bladder cancer patients following surgery.
Blue rubber bleb nevus syndrome complicated with esophageal squamous carcinoma: A case report with robotic-assisted resection and literature review.
Pan Y, Zhu Z, Cai J
J Int Med Res · 2026 Apr · PMID 42050915 · Full text
Blue rubber bleb nevus syndrome is a rare congenital vascular malformation disease characterized by venous malformations affecting multiple organs throughout the body. Cases complicated with esophageal cancer are exceedi...
Blue rubber bleb nevus syndrome is a rare congenital vascular malformation disease characterized by venous malformations affecting multiple organs throughout the body. Cases complicated with esophageal cancer are exceedingly uncommon. In April 2025, Sir Run Run Shaw Hospital, affiliated with Zhejiang University School of Medicine, admitted a patient with blue rubber bleb nevus syndrome complicated with esophageal cancer. The patient was treated using da Vinci robotic-assisted surgery. This system may provide a new solution for such complex cases due to its precision and minimally invasive capabilities.
Emerging therapies for type 1 diabetes: Immunotherapy and gene editing advances.
Zhao M, Yao Z
J Int Med Res · 2026 Apr · PMID 42050914 · Full text
Type 1 diabetes is a chronic autoimmune disease involving the specific destruction of pancreatic β-cells and consequent absolute insulin deficiency. Although exogenous insulin replacement aids in hyperglycemic management...
Type 1 diabetes is a chronic autoimmune disease involving the specific destruction of pancreatic β-cells and consequent absolute insulin deficiency. Although exogenous insulin replacement aids in hyperglycemic management, it does not cure the disease and increases the risks of hypoglycemia. Recent breakthroughs in disease-modifying therapies aim to delay, halt, or reverse disease progression via immune modulation or cell replacement. This narrative review systematically summarizes key therapeutic advances from 2023 to 2025. In immunotherapy, anti-CD3 monoclonal antibodies such as teplizumab have become the first Food and Drug Administration-approved agents to delay clinical onset in high-risk individuals. Inhibitors targeting pathways such as Janus kinase-STAT and engineered cell therapies such as chimeric antigen receptor-Tregs have also demonstrated potential for preserving residual β-cell function. For gene therapy and cell replacement, clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated protein 9 (Cas9) editing has generated "hypoimmune" stem cell-derived β-cells, with early clinical trials reporting instances of insulin independence without immunosuppression. Encapsulation technologies further provide a physical immune barrier for transplanted cells. Collectively, these advances mark a paradigm shift from symptomatic control to addressing core disease mechanisms through immune repair and functional restoration. Although challenges in long-term efficacy, safety, and accessibility persist, the ongoing development of combination strategies and precision medicine contributes to long-term remission and potentially a cure within reach.
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