The Journal Of International Medical Research[JOURNAL]
Sun
200 papers
Dual-specificity phosphatase 14 inhibits the growth of cervical cancer cells by regulating the transforming growth factor-beta-activated kinase 1 and NOD-like receptor pyrin domain containing 3 inflammatory pathways.
Zhang Y, Zhuo Q, Abuduwufu S … +1 more , Wushouer A
J Int Med Res · 2026 Apr · PMID 42050913 · Full text
ObjectiveThis study investigated the role and mechanism of dual-specificity phosphatase 14 in cervical cancer.MethodsIn this experimental study, clinical samples from five patients with cervical squamous cell carcinoma a...
ObjectiveThis study investigated the role and mechanism of dual-specificity phosphatase 14 in cervical cancer.MethodsIn this experimental study, clinical samples from five patients with cervical squamous cell carcinoma and five with chronic cervicitis were analyzed. Dual-specificity phosphatase 14 was overexpressed in HeLa and SiHa cells. Gene and protein expression levels were analyzed using real-time quantitative polymerase chain reaction and western blot analysis. Cell viability, apoptosis, and migration were assessed using cell counting kit-8, flow cytometry as well as Transwell and wound healing assays. Cytokine levels were measured using enzyme-linked immunosorbent assay.ResultsDual-specificity phosphatase 14 expression was significantly downregulated in cervical cancer tissues and cell lines compared with that in their respective controls ( < 0.05). Dual-specificity phosphatase 14 overexpression markedly inhibited cell viability and induced apoptosis in HeLa and SiHa cells ( < 0.05). Furthermore, it significantly suppressed cell migration ( < 0.05). At the molecular level, dual-specificity phosphatase 14 upregulation decreased messenger ribonucleic acid levels of transforming growth factor-beta-activated kinase 1, NOD-like receptor pyrin domain containing 3, interleukin-1 beta, and tumor necrosis factor-alpha; reduced protein levels of phosphorylated transforming growth factor-beta-activated kinase 1 and NOD-like receptor pyrin domain containing 3; and diminished secretion of interleukin-1 beta and tumor necrosis factor-alpha cytokines ( < 0.05).ConclusionDual-specificity phosphatase 14 acts as a tumor suppressor in cervical cancer by inhibiting proliferation and migration, promoting apoptosis, and suppressing the transforming growth factor-beta-activated kinase 1/NOD-like receptor pyrin domain containing 3 inflammatory pathway, highlighting its potential as a novel therapeutic target and biomarker.
Risk factors for intraoperative hypothermia in patients undergoing thoracic spinal surgery: A retrospective cohort study.
Wang Y, Yin X, Pan A … +3 more , Jiang F, Zhang X, Lin X
J Int Med Res · 2026 Apr · PMID 42050912 · Full text
ObjectiveThe present study aimed to develop a clinical prediction model for intraoperative hypothermia in patients undergoing thoracic spinal surgery, with the objective of supporting decision-making in clinical care and...
ObjectiveThe present study aimed to develop a clinical prediction model for intraoperative hypothermia in patients undergoing thoracic spinal surgery, with the objective of supporting decision-making in clinical care and anesthesia management.MethodsA total of 600 patients were enrolled in this retrospective cohort study. The dataset was randomly divided into training (70% of all data) and validation (30% of all data) sets using sample function in R language. Based on the results of the multivariable binary logistic regression analysis, a nomogram was developed and evaluated using R language. Calibration was performed by comparing the predicted and actual probability curves using the 'rms' package. The 'ggDCA' package was used to construct decision analysis curves for evaluating clinical utility.ResultsA least absolute shrinkage and selection operator binary logistic regression model was constructed to identify 5 potential risk factors from the 14 variables previously identified. These five risk factors, including duration of anesthesia, preoperative body temperature, body mass index, number of diseased vertebrae, and reason for surgery, were then validated using logistic regression models. The concordance index was calculated as 0.919.ConclusionsTumor-related spinal surgery, multilevel procedures, prolonged surgical duration, low preoperative temperature, and low body mass index were associated with a higher risk of intraoperative hypothermia. These factors may help guide targeted warming strategies in patients undergoing thoracic spinal surgery.
Exploring the causal effect of genetically predicted blood and cerebrospinal fluid metabolites and metabolic pathways on intracranial aneurysm.
Ding L, Cao W, Zhou Z … +4 more , Mei Z, Chen B, Lu X, Chen W
J Int Med Res · 2026 Apr · PMID 42050911 · Full text
ObjectivePrevious studies have identified significant alterations in metabolites in patients with intracranial aneurysm. This study aimed to evaluate the causal relationships of metabolites in both blood and cerebrospina...
ObjectivePrevious studies have identified significant alterations in metabolites in patients with intracranial aneurysm. This study aimed to evaluate the causal relationships of metabolites in both blood and cerebrospinal fluid with intracranial aneurysm at the genetic level using bidirectional Mendelian randomization analysis.MethodsGenetic instrumental variables for 1400 blood metabolites were obtained from a genome-wide association study analysis involving 8299 individuals, while 338 cerebrospinal fluid metabolites were sourced from another genome-wide association study involving 291 individuals. Outcome data for intracranial aneurysm were retrieved from the International Stroke Genetics Consortium, and validation data were retrieved from the FinnGen study. The primary analysis employed the inverse-variance weighted method, supported by sensitivity analysis to address pleiotropy and enhance robustness. Replication analysis and meta-analysis were performed to enhance the robustness of the findings. Colocalization analysis was used to assess the potential shared genetic architecture between metabolites and intracranial aneurysm, and metabolic pathway analysis was performed using MetaboAnalyst 6.0.ResultsFollowing false discovery rate correction, four and five genetically predicted blood metabolites showed inversely causal associations with intracranial aneurysms and subarachnoid hemorrhage, respectively, in the discovery group, while no cerebrospinal fluid metabolites showed significant causal associations with three intracranial aneurysm phenotypes. After performing a meta-analysis incorporating the results from the replication data, we identified 1-arachidonoyl-GPC (20:4n6) (odds ratio: 0.90) and 1-palmitoyl-2-arachidonoyl-GPC (16:0/20:4n6) (odds ratio: 0.92) as potential protective factors against intracranial aneurysms as well as (N(1) + N(8))-acetylspermidine (odds ratio: 0.83) as a potential protective factor against subarachnoid hemorrhage.ConclusionsOur findings establish a potential causal link between blood/cerebrospinal fluid metabolites and intracranial aneurysm. Furthermore, the identified metabolites and pathways provide valuable insights into the pathogenic mechanisms and progression of intracranial aneurysm.
A metabolic-inflammatory phenotype of pelvic floor dysfunction: A machine learning-based cross-sectional study in a nationally representative US population.
Yang J, Zhao D, Wang L
J Int Med Res · 2026 Apr · PMID 42050910 · Full text
ObjectiveTo analyze pelvic floor dysfunction heterogeneity by identifying distinct clinical subtypes using unsupervised machine learning in a nationally representative cohort.MethodsThis cross-sectional study analyzed 72...
ObjectiveTo analyze pelvic floor dysfunction heterogeneity by identifying distinct clinical subtypes using unsupervised machine learning in a nationally representative cohort.MethodsThis cross-sectional study analyzed 7291 women from the National Health and Nutrition Examination Survey (NHANES 2005-2012). K-means clustering was applied to pelvic floor dysfunction-positive women to identify latent subtypes based on physiological features. Supervised machine learning models were subsequently developed to predict subtype membership, with SHapley Additive exPlanation analysis used to identify key predictors.ResultsTwo distinct subtypes emerged. Phenotype 1 ("metabolic-inflammatory") was characterized by severe central obesity (mean body mass index, 36.1 kg/m), diabetes, and hypertension. Conversely, Phenotype 2 ("metabolically-healthy") revealed pelvic floor dysfunction symptoms but maintained a healthy metabolic profile indistinguishable from the controls. A neural network model accurately differentiated these groups (area under the curve = 0.848), identifying waist circumference as the primary predictive factor.ConclusionsPelvic floor dysfunction is not a single disorder but includes a distinct "metabolic-inflammatory" phenotype strongly associated with systemic metabolic disease. This data-driven classification challenges traditional paradigms, suggesting "subtype-specific" strategies for precision management.
Plasma heat shock protein 90α shows a concentration-dependent, threshold association with pulmonary nodules in asymptomatic males >40 years undergoing low-dose computed tomography.
Du J, Niu J, Zheng S … +1 more , Wang S
J Int Med Res · 2026 Apr · PMID 42050909 · Full text
ObjectiveHeat shock protein 90α is involved in tumorigenesis; however, its concentration-dependent relationship and threshold with pulmonary nodules remain unclear. This study aimed to explore the association and critica...
ObjectiveHeat shock protein 90α is involved in tumorigenesis; however, its concentration-dependent relationship and threshold with pulmonary nodules remain unclear. This study aimed to explore the association and critical threshold of plasma heat shock protein 90α levels with the prevalence of pulmonary nodules in males aged ≥40 years.MethodsThis study included 968 male participants (aged ≥40 years) undergoing low-dose computed tomography and plasma heat shock protein 90α measurement from January 2022 to June 2024. Restricted cubic splines and segmented logistic regression were used to identify were the inflection point of the concentration-response relationship. Multivariable models were adjusted for age, smoking index, high-density lipoprotein cholesterol, triglycerides, and family history of lung cancer.ResultsPulmonary nodules were detected in 40.2% (389/968) of participants. The prevalence of pulmonary nodules increased from 28.7% to 51.0% across heat shock protein 90α quartiles (P for trend <0.001). A threshold was identified at 89.5 ng/mL (95% confidence interval: 87.2-93.1). Above this level, each 1 ng/mL increase in the heat shock protein 90α levels was associated with a 3% higher prevalence of pulmonary nodules (adjusted odds ratio = 1.03, 95% confidence interval: 1.01-1.05). The adjusted odds ratio for the highest versus lowest quartile was 1.88 (95% confidence interval: 1.26-2.80).ConclusionsElevated plasma heat shock protein 90α levels are associated with an increased prevalence of pulmonary nodules in asymptomatic males aged ≥40 years, with a critical threshold of 89.5 ng/mL.
Endothelial activation and stress index links to cardiovascular disease in postmenopausal women mediated by arterial stiffness: A cross-sectional study of National Health and Nutrition Examination Survey 1999-2018.
Long H, Guo R, Zhou J … +3 more , Liu G, Chen H, Lin Y
J Int Med Res · 2026 Apr · PMID 42050908 · Full text
ObjectiveTo investigate the association between the endothelial activation and stress index and cardiovascular disease prevalence among postmenopausal women and to evaluate whether arterial stiffness, assessed by estimat...
ObjectiveTo investigate the association between the endothelial activation and stress index and cardiovascular disease prevalence among postmenopausal women and to evaluate whether arterial stiffness, assessed by estimated pulse wave velocity, statistically accounts for part of this association.MethodsWe conducted a cross-sectional analysis of 9877 postmenopausal women from the National Health and Nutrition Examination Survey (1999-2018). Endothelial activation and stress index was log-transformed (LnEASIX), and arterial stiffness was assessed using estimated pulse wave velocity. Logistic regression was used to evaluate associations with cardiovascular disease after adjusting for demographic, lifestyle, and clinical factors. Nonlinear trends were explored using restricted cubic splines, and mediation analysis were performed to assess the contribution of estimated pulse wave velocity.ResultsHigher LnEASIX was associated with greater cardiovascular disease prevalence (adjusted odds ratio per unit = 1.62, 95% confidence interval: 1.35-1.95). Risk increased sharply above an LnEASIX threshold of -0.97 (endothelial activation and stress index of approximately 0.38; odds ratio = 2.16, 95% confidence interval: 1.71-2.72). Estimated pulse wave velocity statistically accounted for 4.82% of this association. Associations were stronger in women with diabetes.ConclusionElevated endothelial activation and stress index is associated with increased cardiovascular disease risk in postmenopausal women, with arterial stiffness partially mediating this relationship. These findings highlight the potential utility of endothelial activation and stress index as a practical biomarker for cardiovascular risk assessment and prevention.
Explainable artificial intelligence-driven ensemble learning for asthma risk prediction using machine and deep learning.
Druvo MMR, Islam A, Chowdhury A … +1 more , Mohi Uddin KM
J Int Med Res · 2026 Apr · PMID 42050907 · Full text
ObjectiveAsthma, a chronic respiratory condition characterized by airway inflammation and constriction, affects millions of individuals worldwide, resulting in high healthcare expenses and a lower quality of life. Early...
ObjectiveAsthma, a chronic respiratory condition characterized by airway inflammation and constriction, affects millions of individuals worldwide, resulting in high healthcare expenses and a lower quality of life. Early prediction and control of asthma risk are critical for avoiding exacerbations and improving outcomes.MethodsIn this study, we describe a comprehensive asthma prediction model that uses machine learning and deep learning techniques to estimate asthma risk based on a variety of health and environmental parameters. Recursive feature elimination and Extra Trees Classifier were used to choose features, and the synthetic minority over-sampling approach was used to balance the dataset to overcome class imbalance. Hyperparameter tuning was used to optimize performance for 12 machine learning models such as extreme gradient boosting, Random Forest, and support vector machine as well as deep learning models, including multilayer perceptrons, convolutional neural networks, recurrent neural network, and artificial neural network.ResultsAfter hyperparameter adjustment, ensemble approaches that used both hard and soft voting were evaluated. When hyperparameter adjustment was used, the soft voting ensemble that combined XGBoost and CatBoost achieved the highest accuracy (93.61%). Shapley additive explanations and local interpretable model-agnostic explanations were employed to make predictions interpretable, providing information on feature contributions and boosting clinician confidence. A Flask server and web interface were also deployed, enabling real-time user interaction where patients and medical professionals could enter data and obtain asthma risk estimations immediately.ConclusionsThis study presents an accurate and explainable asthma risk prediction framework using ensemble machine and deep learning models, achieving 93.61% accuracy with real-time clinical applicability.
Neurodevelopmental treatment needs after severe acute respiratory syndrome coronavirus 2 infection in young children: A cohort study.
Michael D, Matan L, Tal P … +1 more , Nadav R
J Int Med Res · 2026 Apr · PMID 42050906 · Full text
ObjectiveThis cohort study examined whether documented coronavirus disease 2019 in young children affects the need for neurodevelopmental treatment and its association with developmental diagnoses and other medical condi...
ObjectiveThis cohort study examined whether documented coronavirus disease 2019 in young children affects the need for neurodevelopmental treatment and its association with developmental diagnoses and other medical conditions.MethodsChildren with and without coronavirus disease 2019 were compared before and after an index date, defined as the first confirmed severe acute respiratory syndrome coronavirus 2 infection for participants with an infection and a matched reference date for controls. Data were obtained from a large health maintenance organization.ResultsThe study included 227,728 children born between 1 January 2017 and 31 January 2022 who were followed up from birth until 1 January 2024. Before the index date, there was no significant difference in the neurodevelopmental treatment between the two groups. After diagnosis, the affected children received significantly more treatments than those without an infection. Diagnosed children also exhibited higher rates of ear, nose, and throat; respiratory; and gastrointestinal conditions both before and after diagnosis. Emotional difficulties, including anxiety and acute stress reactions, were more common post-infection, whereas no increase in developmental diagnoses, such as developmental delay and autism spectrum disorder, was observed.ConclusionObservations on the same cohort before and after severe acute respiratory syndrome coronavirus 2 exposure suggest that the infection rather than adverse neurodevelopmental outcomes prompted greater parental concern and increased therapeutic support.
Impact of coronavirus disease 2019 nonpharmaceutical interventions on influenza epidemiology: A retrospective analysis in Hebei Province, China from 2019 to 2023.
Zhao P, Zhang Y, Wang J … +3 more , Li Y, Zhao M, Zhang X
J Int Med Res · 2026 Apr · PMID 42050905 · Full text
BackgroundIn this study we retrospectively analyzed the influenza virus antigen detection data from Hebei General Hospital for the period from 2019 to 2023, focusing on the impact of coronavirus disease 2019 nonpharmaceu...
BackgroundIn this study we retrospectively analyzed the influenza virus antigen detection data from Hebei General Hospital for the period from 2019 to 2023, focusing on the impact of coronavirus disease 2019 nonpharmaceutical interventions on the epidemiology of influenza.MethodsA retrospective analysis was conducted on 45,956 records of patients with influenza-like illness retrieved from the Laboratory Information System of Hebei General Hospital between January 2019 and December 2023. Nasal and pharyngeal swab samples from these patients were tested for influenza A and influenza B virus antigens using colloidal gold immunochromatographic assay.ResultsCompared with the pre-pandemic period, both number of influenza cases and positive detection rates declined substantially during the coronavirus disease 2019 pandemic. Notably, this decline coincided with the peak implementation of nonpharmaceutical interventions aimed at mitigating coronavirus disease 2019 spread. The cases of influenza surged significantly following the relaxation of coronavirus disease 2019 restrictions in 2023 and even approached or exceeded the pre-coronavirus disease 2019 levels.ConclusionsOur findings provide strong evidence that comprehensive nonpharmaceutical interventions implemented to control the transmission of severe acute respiratory syndrome coronavirus-2 also profoundly suppressed seasonal influenza epidemics. The sharp rebound of influenza activity after the relaxation of restrictions underscores the need for integrated preparedness strategies to manage concurrent threats from multiple respiratory viruses.
Nodular fasciitis of the masseter muscle: Radiologic and pathologic correlation of a rare benign lesion.
Joni SS, Motiei M, Akbari M
J Int Med Res · 2026 Apr · PMID 42050904 · Full text
Nodular fasciitis rarely arises from the masseter muscle and is frequently misdiagnosed as soft tissue sarcoma. A 43-year-old male presented with a rapidly enlarging, painless swelling below the right mandibular angle ov...
Nodular fasciitis rarely arises from the masseter muscle and is frequently misdiagnosed as soft tissue sarcoma. A 43-year-old male presented with a rapidly enlarging, painless swelling below the right mandibular angle over 2 months. Clinical examination revealed a firm, mobile mass without skin fixation or lymphadenopathy. Ultrasound and magnetic resonance imaging were performed, followed by fine-needle aspiration cytology and excisional biopsy. Ultrasound demonstrated a well-defined, hypoechoic lobulated lesion (23 × 13 × 8 mm) within the superficial masseter, showing mild internal vascularity and no bone involvement. Magnetic resonance imaging revealed an iso- to slightly hypointense T1 signal, hyperintense T2/ short tau inversion recovery signal, and homogeneous postcontrast enhancement with smooth margins, features suggestive of a benign myofibroblastic lesion. Excisional biopsy confirmed the diagnosis of nodular fasciitis. This case indicates that masseteric nodular fasciitis, a rare benign lesion, may present with imaging features of small size, smooth margins, homogeneous enhancement, and mild vascularity in the context of trauma history. Recognition of this self-limited myofibroblastic proliferation can prevent unnecessary radical surgery and guide conservative management.
Association between anthropometric indices and mortality risk among individuals with depression: A population-based cohort study.
Kong X, Xiao N, Zhou Q … +2 more , Chen Y, Zhao X
J Int Med Res · 2026 Apr · PMID 42050903 · Full text
BackgroundFew studies have explored the associations of body mass index and waist circumference with mortality risk in patients with depression. In particular, the emergence of the obesity paradox in recent years has dra...
BackgroundFew studies have explored the associations of body mass index and waist circumference with mortality risk in patients with depression. In particular, the emergence of the obesity paradox in recent years has drawn renewed attention to the potential relationship between overweight or obesity and mortality across different populations.ObjectiveThis study aimed to investigate the associations of body mass index and waist circumference with mortality risk in individuals with depression.MethodsThis was a population-based retrospective cohort study, and participants with a body mass index <18.5 kg/m (underweight) were excluded from the analyses. Weighted Cox regression analyses were conducted to examine the associations of body mass index and waist circumference with mortality risk in individuals with depression. Restricted cubic spline models were applied to evaluate the dose-response relationships of body mass index and waist circumference with mortality. Subgroup analyses were further conducted to explore variations in these associations across different populations, along with interaction tests to assess potential effect modification.ResultsWeighted Cox regression analysis showed that compared with individuals with a normal body mass index, those who were overweight or obese had a 53% (Model 3: hazard ratio = 0.47, 95% confidence interval: 0.29-0.76, = 0.002) and 58% (hazard ratio = 0.42, 95% confidence interval: 0.27-0.67, < 0.001) lower risk of all-cause mortality, respectively. Similar results were observed when waist circumference was used as the covariate for analysis, with participants in the abdominal obesity group showing a significantly lower risk of mortality than those with normal waist circumference (Model 3: hazard ratio = 0.58, 95% confidence interval: 0.37-0.89, = 0.01). In the combined analysis of body mass index and waist circumference, compared with participants with normal values for these parameters, those who were overweight and had a high waist circumference had a 55% lower mortality risk (hazard ratio = 0.45, 95% confidence interval: 0.26-0.80, = 0.01). Similarly, participants who were obese and had a high waist circumference had a 59% lower mortality risk (hazard ratio = 0.41, 95% confidence interval: 0.25-0.69, < 0.001).ConclusionsWe found that both body mass index and waist circumference were inversely associated with mortality risk in individuals with depression, and this inverse association remained robust even when body mass index and waist circumference were jointly analyzed according to their respective categories.
Effects of probiotic supplementation on glycemic control in children with type 1 diabetes: A systematic review and meta-analysis.
Su Y, Sun M, Huang Q … +5 more , Xu L, Zhao C, Xu F, Tao N, Yang Y
J Int Med Res · 2026 Apr · PMID 42050902 · Full text
BackgroundThis study aimed to evaluate the effects of probiotic supplementation on glycemic control in children with type 1 diabetes, as measured using glycated hemoglobin level, fasting blood glucose level, and insulin...
BackgroundThis study aimed to evaluate the effects of probiotic supplementation on glycemic control in children with type 1 diabetes, as measured using glycated hemoglobin level, fasting blood glucose level, and insulin requirements.MethodsA systematic search was conducted across four databases (PubMed, Web of Science, Embase, and Scopus) to identify eligible randomized controlled trials. The Cochrane Risk of Bias tool was used to assess methodological quality. Meta‑analyses were performed using random‑effects models, with subgroup analysis conducted by probiotic strain. The study was registered with the Research Registry (reviewregistry2089).ResultsSix randomized controlled trials (483 children) were included. Probiotic supplementation significantly reduced glycated hemoglobin levels (weighted mean difference: -0.54%; 95% confidence interval: -0.90% to -0.18%; = 0.003; I = 19.65%) and insulin requirements (weighted mean difference: -0.082 U/kg/day; 95% confidence interval: -0.147 to -0.017; = 0.013; I = 0%). Fasting blood glucose levels showed a non‑significant reduction (mean difference: -10.54 mg/dL; 95% confidence interval: -23.25 to 2.17; = 0.104; I = 0%). Subgroup analysis revealed that the De Simone formulation explained 70.32% of the between‑study variance. No publication bias was detected.ConclusionProbiotic supplementation, particularly specific formulations, may reduce glycated hemoglobin levels and insulin needs in children with type 1 diabetes, supporting probiotics supplementation as an adjunctive therapy; however, larger trials are needed to confirm these findings.
Association between blood type and pulmonary thromboembolism in patients with gastric cancer: A retrospective cohort study.
Lee J, Jang Y, Pack K … +5 more , Yang T, Won Y, Ha KE, Kim YS, Moon J
J Int Med Res · 2026 Apr · PMID 42010806 · Full text
ObjectiveGastric cancer is associated with an increased risk of pulmonary thromboembolism. Although the ABO blood group system is a known thrombotic risk factor, its role in gastric cancer-associated pulmonary thromboemb...
ObjectiveGastric cancer is associated with an increased risk of pulmonary thromboembolism. Although the ABO blood group system is a known thrombotic risk factor, its role in gastric cancer-associated pulmonary thromboembolism remains unclear.MethodsThis retrospective study analyzed 1488 gastric cancer patients to assess the association between ABO blood type and pulmonary thromboembolism. Cox proportional hazards models were used to identify independent predictors, and Kaplan-Meier analysis was used to compare cumulative incidence.ResultsPulmonary thromboembolism incidence was highest in the AB group (5.49%), while that in non-AB groups was 1.81% ( < 0.01). Multivariate analysis confirmed AB blood type (hazard ratio: 2.42, 95% confidence interval: 1.09-5.39, = 0.03), age >65 years (hazard ratio: 2.75, 95% confidence interval: 1.30-5.82, = 0.01), and metastasis (hazard ratio: 4.03, 95% confidence interval: 1.69-9.62, < 0.01) as significant independent predictors. Kaplan-Meier analysis confirmed a higher cumulative pulmonary thromboembolism incidence in the AB group (log-rank test, < 0.01). However, the O versus non-O group showed no significant differences in Kaplan-Meier analysis (log-rank test, = 0.35).ConclusionsAB blood type is an independent risk factor for pulmonary thromboembolism in gastric cancer patients. This finding, distinct from the traditional non-O group risk model, suggests that identifying AB blood type can improve risk stratification.
Retraction notice.
J Int Med Res · 2026 Apr · PMID 41992660 · Full text
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Intravitreal foscarnet is an effective adjunct after systemic therapy failure in pediatric antiviral-resistant cytomegalovirus retinitis.
Amiri I, Shah P, Soleimani M … +1 more , Zhang AY
J Int Med Res · 2026 Apr · PMID 41986961 · Full text
This report describes the case of a school-aged male child with T-cell acute lymphoblastic leukemia who developed cytomegalovirus retinitis despite systemic antiviral therapy. The patient had a history of cytomegalovirus...
This report describes the case of a school-aged male child with T-cell acute lymphoblastic leukemia who developed cytomegalovirus retinitis despite systemic antiviral therapy. The patient had a history of cytomegalovirus viremia that improved with intravenous foscarnet and oral maribavir; however, routine ophthalmic screening revealed new retinal whitening and hemorrhages in the right eye. Anterior chamber paracentesis confirmed intraocular cytomegalovirus DNA. Although systemic viral loads declined, the retinal lesions progressed toward the macula, prompting initiation of intravitreal foscarnet. Treatment was initiated with a 1.2 mg/0.05 mL injection under anesthesia, followed by 2.4 mg/0.1 mL injections administered twice weekly at the clinic. The regimen was well tolerated and resulted in stabilization and regression of retinitis without central involvement, with fundus photography demonstrating fading whitening and vascular sclerosis.This case highlights the importance of close ophthalmic monitoring in immunosuppressed pediatric patients with cytomegalovirus viremia and emphasizes intravitreal foscarnet as an effective adjunct when systemic therapy fails. Furthermore, it demonstrates the feasibility of administering multiple intravitreal injections in the pediatric population, underscoring the role of local antiviral delivery in preserving vision in cases of antiviral-resistant cytomegalovirus retinitis.
Association between serum uric acid levels and adverse pregnancy outcomes: A prospective cohort study.
Ho HTT, Tran DM, Nguyen LT … +2 more , Nguyen SPH, Nguyen HH
J Int Med Res · 2026 Apr · PMID 41986890 · Full text
BackgroundEmerging evidence suggests that elevated serum uric acid levels may be associated with adverse pregnancy outcomes.ObjectivesTo investigate the association between serum uric acid levels and adverse pregnancy ou...
BackgroundEmerging evidence suggests that elevated serum uric acid levels may be associated with adverse pregnancy outcomes.ObjectivesTo investigate the association between serum uric acid levels and adverse pregnancy outcomes among pregnant women.Materials and methodsA prospective cohort study was conducted among 200 pregnant women attending Vinh Long General Hospital, including 100 women with hyperuricemia and 100 without hyperuricemia. Hyperuricemia was defined as a serum uric acid level >360 µmol/L. Pregnancy-, delivery-, and postpartum-related complications were recorded and compared between the two groups.ResultsThe mean maternal age was 25.06 ± 5.79 years. In the hyperuricemia group, 45.0% were primigravida, whereas 22.0% had multiple pregnancies. Adverse pregnancy outcomes were more frequent in women with hyperuricemia than in those without hyperuricemia (28.0% vs. 15.0%; odds ratio = 2.20; 95% confidence interval: 1.09-4.44). Within the hyperuricemia group, smoking was more common among women who developed complications than among those without complications (42.9% vs. 18.1%), along with lower platelet counts and higher creatinine levels (p < 0.05). Multivariable logistic regression analysis identified alcohol consumption (odds ratio = 3.85), serum creatinine (odds ratio = 1.19), and hyperuricemia (odds ratio = 1.65) as independent predictors of adverse pregnancy outcomes (p < 0.05).ConclusionHyperuricemia was independently associated with an increased risk of adverse pregnancy outcomes.
Middle ear lymphoepithelioma-like carcinoma with cerebellopontine angle invasion misdiagnosed as meningioma: A case report and literature review.
Deng D, Yang Y, Cheng B … +3 more , Fan C, Wang W, Zhao H
J Int Med Res · 2026 Apr · PMID 41986889 · Full text
Lymphoepithelioma-like carcinoma typically arises in the nasopharynx. Primary occurrence in the middle ear with subsequent intracranial extension remains exceedingly rare, and its diagnosis is often challenging owing to...
Lymphoepithelioma-like carcinoma typically arises in the nasopharynx. Primary occurrence in the middle ear with subsequent intracranial extension remains exceedingly rare, and its diagnosis is often challenging owing to the paucity of detailed clinicoradiological data. Herein, we describe a case of an 82-year-old male presenting with a 2-year history of left-sided hearing loss, a 3-year history of left facial asymmetry (including mouth deviation and eyelid insufficiency), and a 10-day history of nausea/vomiting. His medical history included chronic otitis media. Imaging studies revealed a left cerebellopontine angle mass and chronic left otomastoiditis. Subtotal tumor resection was performed, and pathological analysis confirmed the diagnosis of lymphoepithelioma-like carcinoma. The patient received only supportive care and survived for 23 months. This case report aimed to emphasize the need for clinicians consider atypical cerebellopontine angle tumors in patients with chronic otitis media from Epstein-Barr virus-endemic regions and highlight the importance of a comprehensive diagnostic and therapeutic approach.
Vascular endothelial cell-derived small extracellular vesicles: A protective role against cardiomyocyte apoptosis in ischemia-reperfusion injury through miR410-3p-modulated pathway.
Liu X, Ge Y, Xing X … +6 more , Liu J, Chen H, Wang D, Ni H, Li W, Wang F
J Int Med Res · 2026 Apr · PMID 41986888 · Full text
ObjectiveReperfusion therapy is essential for preserving cardiac tissue in patients with acute myocardial infarction. However, ischemia-reperfusion exacerbates cardiac damage. Vascular endothelial cell-derived small extr...
ObjectiveReperfusion therapy is essential for preserving cardiac tissue in patients with acute myocardial infarction. However, ischemia-reperfusion exacerbates cardiac damage. Vascular endothelial cell-derived small extracellular vesicles play a pivotal role in ischemia-reperfusion injury; although the underlying mechanisms remain poorly understood. Therefore, this study aimed to elucidate the mechanisms of vascular endothelial cell-derived small extracellular vesicles and investigate their potential therapeutic roles.MethodsSmall extracellular vesicles derived from vascular endothelial cells were isolated using ultracentrifugation, and their characteristics were confirmed using transmission electron microscopy, nanoparticle tracking analysis, and western blotting. Their effects on myocardial injury was evaluated in vivo using a mouse myocardial ischemia-reperfusion model, and their role was further examined in vitro using a cellular hypoxia/reoxygenation model. The key micro ribonucleic acid in small extracellular vesicles was screened via high-throughput sequencing, and its regulatory effect on cardiomyocyte apoptosis was verified in vitro through intervention experiments. The key gene was predicted using miRanda and TargetScan, and the related interaction was verified by a dual-luciferase reporter assay and ribonucleic acid immunoprecipitation.ResultsOur in vivo study revealed that small extracellular vesicles significantly attenuated ischemia-reperfusion-induced cardiomyocyte apoptosis and improved cardiac function. We also analyzed micro ribonucleic acid expression in small extracellular vesicles and found that miR410-3p was highly expressed and associated with cellular apoptosis. In vitro experiments demonstrated that small extracellular vesicles increased miR410-3p expression in cardiomyocytes and that miR410-3p effectively inhibited cardiomyocyte apoptosis in a cellular ischemia-reperfusion model. Conversely, miR410-3p inhibition attenuated the protective effect of small extracellular vesicles. Moreover, we found that SMAD family member 7 is one of the target messenger ribonucleic acids of miR410-3p and affects cellular apoptosis by modulating nuclear factor kappa-light-chain-enhancer of activated B cells. Cellular experiments verified that the antiapoptotic effect of miR410-3p was neutralized by SMAD family member 7 overexpression.ConclusionsThese results revealed that vascular endothelial cell-derived small extracellular vesicles attenuate ischemia-reperfusion-induced cardiomyocyte apoptosis via the miR410-3p/SMAD family member 7 axis. This study provides valuable insights into the molecular mechanisms underlying ischemia-reperfusion-induced myocardial damage and highlights potential therapeutic opportunities for mitigating it.
Accuracy of ChatGPT and DeepSeek in answering clinical questions from the 2025 Society for Cardiovascular Angiography & Interventions/Heart Rhythm Society left atrial appendage occlusion guidelines.
Jin Y, Feng C, Zhao J … +2 more , Lin W, Li B
J Int Med Res · 2026 Apr · PMID 41975575 · Full text
ObjectiveTo evaluate the accuracy of ChatGPT and DeepSeek in answering guideline-based clinical questions in cardiology.MethodsIn August 2025, responses generated from four large language models to eight clinical questio...
ObjectiveTo evaluate the accuracy of ChatGPT and DeepSeek in answering guideline-based clinical questions in cardiology.MethodsIn August 2025, responses generated from four large language models to eight clinical questions based on the 2025 Society for Cardiovascular Angiography & Interventions/Heart Rhythm Society guidelines were evaluated. Three cardiologists independently rated accuracy using a six-point Likert scale: (a) completely incorrect; (b) more incorrect than correct; (c) nearly equally correct and incorrect; (d) more correct than incorrect; (e) nearly all correct; and (f) completely correct. Reproducibility (Fleiss' kappa coefficient, five repeated queries) and inter-rater reliability (intraclass correlation coefficient) were assessed.ResultsThe median (interquartile range) accuracy scores were 5.5 (5, 6) for ChatGPT-5, 6 (5, 6) for ChatGPT-4o, and 5 (4, 6) for both DeepSeek-R1 and DeepSeek-V3, with a significant overall difference (p < 0.001). Pairwise comparisons showed significantly higher accuracy for ChatGPT models than for DeepSeek models (all p < 0.001), whereas no significant differences were observed between ChatGPT-5 and ChatGPT-4o (p = 0.518) or between DeepSeek-R1 and DeepSeek-V3 (p = 0.812). Reproducibility (Fleiss' kappa coefficient) was excellent for ChatGPT-5 (0.803) and good for ChatGPT-4o (0.574), DeepSeek-R1 (0.577), and DeepSeek-V3 (0.618). Overall inter-rater reliability was moderate (intraclass correlation coefficient = 0.463).ConclusionsChatGPT and DeepSeek demonstrated high accuracy and reproducibility but moderate inter-rater reliability, necessitating further validation for educational use.
Vogt-Koyanagi-Harada disease recurrence after laser treatment: A case report.
Muto T, Sakamoto M, Machida S … +2 more , Imaizumi S, Sekiryu T
J Int Med Res · 2026 Apr · PMID 41968085 · Full text
This study reports two cases of Vogt-Koyanagi-Harada disease recurrence after laser treatment. Case 1 involved a woman in her late 70s with Vogt-Koyanagi-Harada disease that was controlled by adalimumab and steroid eye s...
This study reports two cases of Vogt-Koyanagi-Harada disease recurrence after laser treatment. Case 1 involved a woman in her late 70s with Vogt-Koyanagi-Harada disease that was controlled by adalimumab and steroid eye solution therapy. She presented with uveitis recurrence 4 weeks after undergoing neodymium:yttrium aluminum garnet laser posterior capsulotomy in both eyes. She was immediately treated with sub-Tenon triamcinolone acetonide injection in both eyes, which provided palliative relief. During the following year, she experienced further recurrences every 3-5 months. Case 2 involved a woman in her 40s with Vogt-Koyanagi-Harada disease and untreated type 2 diabetes. She had undergone pulse steroid therapy 3 months ago. She was prescribed insulin and oral diabetic medicine. The sudden glycemic control caused progression of her diabetic retinopathy, which was treated with retinal photocoagulation of the left eye. Three days later, there was recurrence of bilateral serous retinal detachment. She was immediately treated with sub-Tenon triamcinolone acetonide injection in both eyes, which improved serous detachment. Additional retinal photocoagulation was performed in both eyes 18 months later. These cases suggest that laser treatment triggers recurrence of Vogt-Koyanagi-Harada disease. Further investigation of this association is warranted.
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