International Journal Of General Medicine[JOURNAL]
Sun
200 papers
Quantitative CT Pulmonary Angiography and Echo Cardiography Analysis for Enhanced Cardiovascular Assessment of Right Ventricular Failure in Pulmonary Hypertension.
Hajiahmadi S, Mirdamadi A, Tajmirriahi M … +4 more , Fadavi S, Moradi M, Rasti S, Elhaie M
Int J Gen Med · 2026 · PMID 42299232 · Full text
BACKGROUND: Pulmonary hypertension (PH) with concomitant right ventricular (RV) dysfunction presents major clinical challenges. Computed tomography pulmonary angiography (CTPA) is a widely available, non-invasive tool fo...
BACKGROUND: Pulmonary hypertension (PH) with concomitant right ventricular (RV) dysfunction presents major clinical challenges. Computed tomography pulmonary angiography (CTPA) is a widely available, non-invasive tool for PH assessment. This study evaluated the diagnostic performance of selected CTPA-derived metrics for detecting RV dysfunction and severe PH. METHODS: A cross-sectional study included 39 adults (mean age 51.46 ± 2.71 years; 53.8% female) with newly diagnosed non-cardiogenic PH (World Health Organization groups 1, 3, 4, and 5). Key CTPA parameters were entered into backward stepwise logistic regression to predict RV dysfunction and severe PH (systolic pulmonary artery pressure >60 mmHg), using echocardiography as the reference standard. Adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were calculated; statistical significance was set at P<0.05. RESULTS: RV dysfunction was present in 28 patients (71.8%) and severe PH in 20 (51.3%). Independent predictors of RV dysfunction were anteroposterior right atrial (AP RA) diameter (OR 1.135; 95% CI 1.032-1.248; P=0.009) and short-axis ascending aortic (AA) diameter (OR 0.723; 95% CI 0.572-0.915; P=0.007), achieving combined sensitivity 92.9%, specificity 72.7%, and accuracy 87.2% (95% CI 76.7-97.7). Contrast medium reflux into the inferior vena cava or hepatic veins was the only independent predictor of severe PH (OR 6.857; 95% CI 1.627-28.899; P=0.009; accuracy 71.8%). CONCLUSION: CTPA-derived AP RA and AA diameters are useful markers for RV dysfunction in non-cardiogenic PH, while contrast reflux reliably indicates severe disease. Larger prospective studies and right atrial shape analysis are warranted to confirm and refine these findings.
Erratum: Discovering Novel Biomarkers Associated with the Pathogenesis of Psoriasis: Evidence from Bioinformatic Analysis [Corrigendum].
Int J Gen Med · 2026 · PMID 42293119 · Full text
[This corrects the article DOI: 10.2147/IJGM.S354985.].
[This corrects the article DOI: 10.2147/IJGM.S354985.].
Neurological and Cardiac Determinants of Hyperbaric Oxygen Therapy in Carbon Monoxide Poisoning: A Retrospective Cohort Study.
Yüceer Ö
Int J Gen Med · 2026 · PMID 42293118 · Full text
INTRODUCTION: Carbon monoxide (CO) poisoning remains a major global cause of morbidity and mortality. Although normobaric oxygen therapy (NBOT) is the standard initial treatment, hyperbaric oxygen therapy (HBOT) is often...
INTRODUCTION: Carbon monoxide (CO) poisoning remains a major global cause of morbidity and mortality. Although normobaric oxygen therapy (NBOT) is the standard initial treatment, hyperbaric oxygen therapy (HBOT) is often considered in patients with severe neurological or cardiac involvement. This study aimed to evaluate clinical, biochemical, electrocardiographic, and imaging factors associated with the selection of HBOT in patients presenting to the emergency department with CO poisoning. METHODS: This retrospective cohort study included 272 adult patients diagnosed with CO poisoning between January 2020 and January 2025. Of these, 169 patients (62.1%) received NBOT and 103 patients (37.9%) received HBOT. Demographic characteristics, laboratory parameters (COHb, lactate, troponin, creatine kinase-MB [CK-MB]), Glasgow Coma Scale (GCS) scores, electrocardiographic (ECG) findings, and magnetic resonance imaging (MRI) results were analyzed. Multivariable logistic regression and receiver operating characteristic (ROC) analyses were performed. RESULTS: Patients receiving HBOT had significantly lower GCS scores, higher cardiac biomarkers, and more frequent ischemic ECG findings. In multivariable analysis, lower GCS (OR 0.66, 95% CI 0.57-0.76, p<0.001), ischemic ECG findings (OR 7.31, 95% CI 1.56-34.30, p=0.012), and lactate levels (OR 0.81, 95% CI 0.65-0.99, p=0.043) were independently associated with HBOT selection. Lactate and COHb demonstrated limited discriminative ability (AUC 0.554 and 0.599, respectively). CONCLUSION: HBOT selection in CO poisoning is primarily associated with neurological status and cardiac involvement rather than biochemical parameters alone. These findings support a multidimensional clinical approach in emergency settings.
Therapeutic Potential of in Glioblastoma: Evidence from in vitro and in vivo Studies.
Lee CC, Kung WM, Yeh YC … +8 more , Chen YL, Chang CH, Chien CC, Wei KC, Chuang CC, Hsu PW, Hwang TL, Huang YC
Int J Gen Med · 2026 · PMID 42293117 · Full text
BACKGROUND: Glioblastoma (GB) is a highly aggressive and invasive brain tumor characterized by a poor prognosis. The Danshen ( Bunge) crude extract (DCE) demonstrated effective anticancer effects against glioblastoma. Th...
BACKGROUND: Glioblastoma (GB) is a highly aggressive and invasive brain tumor characterized by a poor prognosis. The Danshen ( Bunge) crude extract (DCE) demonstrated effective anticancer effects against glioblastoma. This study investigated the in vitro and in vivo efficacy of DCE on GB and explored its potential mechanisms of action. MATERIALS AND METHODS: Cell viability and migration were assessed using 3-(4, 5-dimethyl-2-thiazolyl)-2, 5-diphenyl-2H-tetrazolium bromide and wound healing assays, respectively. The cell cycle and apoptosis were evaluated using flow cytometry. The in vivo effect of DCE was determined using a U87-MG GB xenograft model in BALB/c-nude mice. The gene expression profile of DCE-treated tumor tissue was assessed using RNA sequencing, with validation of key genes by using quantitative reverse transcription polymerase chain reaction (qRT-PCR). RESULTS: DCE treatment significantly reduced cell viability in both the U87-MG and DBTRG-05MG GB cell lines. Additionally, DCE notably induced G0/G1 cell cycle arrest and promoted apoptosis in both cell lines. Furthermore, DCE effectively inhibited cell migration in both GB cell lines. The in vivo results revealed that DCE significantly suppressed tumor growth in the GB xenograft mouse model. qRT-PCR analysis indicated that the anticancer activity of DCE is associated with the downregulation of , and gene expression. CONCLUSION: DCE effectively suppressed the progression of GB in both in vitro and in vivo models, likely through modulation of modulating pro-inflammatory signaling pathways. These findings highlight DCE as a promising candidate for therapeutic development against GB.
The Gut-Brain Axis in Comorbidity of Inflammatory Bowel Disease and Anxiety/Depression: Mechanisms, Controversies, and Future Directions.
Cui Y, Huang Y
Int J Gen Med · 2026 · PMID 42281655 · Full text
Inflammatory bowel disease (IBD), including Crohn's disease (CD), ulcerative colitis (UC), and IBD unclassified (IBD-U), frequently cooccurs with anxiety and depression, a comorbid pattern that severely impairs patients'...
Inflammatory bowel disease (IBD), including Crohn's disease (CD), ulcerative colitis (UC), and IBD unclassified (IBD-U), frequently cooccurs with anxiety and depression, a comorbid pattern that severely impairs patients' quality of life and has thus attracted increasing attention in clinical practice. The gut-brain axis (GBA)-an intricate bidirectional communication network encompassing neural, immune, endocrine, and microbial pathways-serves as a key framework for unraveling the biological underpinnings of this comorbidity. This review systematically synthesizes existing literature to dissect the GBA mechanisms driving IBD-anxiety/depression comorbidity, focusing on four core inflammatory pathways: immune inflammation, gut microbiota-metabolite interactions, neural signaling, and the hypothalamic-pituitary-adrenal (HPA) axis. We also critically examine ongoing research controversies in inflammopharmacology and propose future breakthrough directions grounded in current evidence. Our synthesis reveals that these four pathways form a self-reinforcing inflammatory vicious cycle: intestinal inflammation may disrupt central nervous system (CNS) function through proinflammatory factors, microbiota-derived metabolites, and neural signals, thereby contributing to emotional disorders. Conversely, psychological stress and negative emotions may exacerbate intestinal inflammation via neural and endocrine pathways. Key controversies include unresolved causal relationships between IBD and emotional disorders, debates over dominant regulatory mechanisms, poor reproducibility of gut microbiota studies, and variable efficacy of single-target anti-inflammatory interventions. Moving forward, future research should leverage longitudinal cohort designs, advanced omics technologies, and artificial intelligence tools to deepen mechanistic insights. Developing multi-target anti-inflammatory interventions and robust biomarker systems will facilitate integrated gastroenterological and psychiatric care, enabling precise diagnosis and treatment to enhance patients' physical and mental rehabilitation.
Advances in the Application of Musculoskeletal Ultrasound in the Diagnosis of Rheumatoid Arthritis: A Review.
Zhang H
Int J Gen Med · 2026 · PMID 42273531 · Full text
Rheumatoid arthritis (RA) is a chronic autoimmune disorder that primarily targets the joints, causing persistent inflammation, progressive joint destruction, and functional disability. Early and accurate diagnosis is ess...
Rheumatoid arthritis (RA) is a chronic autoimmune disorder that primarily targets the joints, causing persistent inflammation, progressive joint destruction, and functional disability. Early and accurate diagnosis is essential for initiating timely treatment and improving patient outcomes. Musculoskeletal ultrasound (MSUS), a non-invasive and real-time imaging technique, has attracted considerable interest for its high-resolution visualization and ability to assess joints dynamically. This narrative review synthesizes current literature on the role of MSUS in the diagnosis of RA, with particular emphasis on its unique value in the early detection of subclinical synovitis and in supporting the diagnosis of seronegative RA, where conventional serological markers are absent. MSUS enables sensitive detection of synovial hypertrophy, tenosynovitis, joint effusion, increased vascularity on power Doppler imaging, and early bone erosions, facilitating timely recognition of inflammatory activity and structural damage. Despite these advantages, limitations such as operator dependence and variability in standardization remain. Recent advances-including consensus-based EULAR-OMERACT definitions and scoring systems, standardised scanning protocols, and emerging artificial intelligence applications-have broadened the clinical value of MSUS, indicating promising opportunities for its incorporation into routine RA management. This article aims to synthesize existing evidence, address ongoing challenges, and explore future directions to further enhance the diagnostic and monitoring capabilities of MSUS in patients with RA.
Prognostic Models for Small Hepatocellular Carcinoma Using Inflammatory Indices and Machine Learning: A Propensity Score-Matched Study.
Cong Y, Gou Y, Ma Z … +5 more , Huang W, Zhang L, Guo Q, Aji T, Shao Y
Int J Gen Med · 2026 · PMID 42273530 · Full text
BACKGROUND: The prognosis for patients with small hepatocellular carcinoma (HCC) after curative resection is variable. Early recurrence (within 2 years) remains a significant clinical challenge, closely associated with p...
BACKGROUND: The prognosis for patients with small hepatocellular carcinoma (HCC) after curative resection is variable. Early recurrence (within 2 years) remains a significant clinical challenge, closely associated with poor long-term outcomes. Although inflammatory biomarkers have shown prognostic value, integrated models for predicting both early recurrence and long-term survival are lacking. This study developed and validated prognostic models for overall survival (OS) and recurrence-free survival (RFS) in HCC patients post-resection, employing propensity score matching (PSM) to control for confounders between small (≤3 cm) and non-small HCC, with an emphasis on assessing model performance within the small HCC subgroup. METHODS: A retrospective analysis of HCC patients who underwent hepatectomy was performed. PSM (1:1 nearest-neighbor with replacement) was applied to balance baseline characteristics between small and non-small HCC groups. After matching, a balanced cohort was used for survival analysis. Independent prognostic factors were identified through Cox regression. A traditional nomogram and risk score models were developed and compared against three machine learning models (LASSO-Cox, Random Forest, XGBoost) using time-dependent AUC. RESULTS: Following PSM, 165 patients (90 with small HCC and 75 with non-small HCC) were included. Small HCC patients demonstrated significantly better OS and RFS (both p < 0.01). Multivariate analysis identified tumor size, SII, and AAR as independent predictors for OS, and tumor size, PAR, NLR, and GPR for RFS. The LASSO-Cox model exhibited the best overall performance, achieving the highest accuracy for early recurrence (2-year RFS AUC = 0.727) and competitive accuracy for long-term survival (5-year OS AUC = 0.698). The nomogram retained good interpretability (5-year OS AUC = 0.691). CONCLUSION: This study establishes a comprehensive prognostic framework for small HCC, integrating tumor size with systemic inflammation (SII, NLR), liver function (AAR, GPR), and nutritional-coagulation status (PAR). The LASSO-Cox model is recommended for predicting both early recurrence and long-term survival, offering refined risk stratification to guide postoperative management.
Clinical Significance of the C-Reactive Protein-Triglyceride-Glucose Index in Cardiovascular Disease, Stroke, Cardiovascular-Kidney-Metabolic Syndrome, Cancer, Diabetes, and Osteoporosis: A Narrative Review.
Yang S, Yao X, Chai J … +5 more , Lu H, Tang W, Wu Z, He W, Xie Y
Int J Gen Med · 2026 · PMID 42273529 · Full text
OBJECTIVE: This narrative review aimed to summarize and critically appraise current evidence on the clinical significance of CTI in cardiovascular disease, stroke, cardiovascular-kidney-metabolic syndrome, cancer, diabet...
OBJECTIVE: This narrative review aimed to summarize and critically appraise current evidence on the clinical significance of CTI in cardiovascular disease, stroke, cardiovascular-kidney-metabolic syndrome, cancer, diabetes, and osteoporosis. METHODS: PubMed and Web of Science databases were searched from January 2022, when CTI was first proposed, to January 2026. Search terms combined "C-reactive protein-triglyceride glucose index", "CTI", "CRP-TyG", "insulin resistance", "inflammation", and disease-specific terms including cardiovascular disease, coronary heart disease, heart failure, stroke, cardiovascular-kidney-metabolic syndrome, cancer, diabetes, osteoporosis. Eligible studies reported CTI-specific clinical associations, prognostic performance, or relevant mechanistic evidence. Because this was a narrative review, no meta-analysis was performed. RESULTS: Current evidence is dominated by observational studies. Elevated CTI is consistently associated with higher cardiometabolic risk and poorer outcomes in cardiovascular disease, coronary heart disease, heart failure, stroke, cardiovascular-kidney-metabolic syndrome, cancer, and diabetes. Emerging data also suggest a potential relationship between higher CTI and reduced bone mineral density or osteoporosis, particularly among patients with type 2 diabetes mellitus. However, reported associations differ by glycometabolic status, disease stage, sex, age, and study design, and standardized CTI thresholds remain unavailable. CONCLUSION: CTI is a simple, accessible index that may help characterize the inflammatory-metabolic burden underlying several chronic diseases. Its clinical value is most plausible as a complementary risk-stratification tool rather than a stand-alone diagnostic marker. Future studies should validate disease-specific thresholds, test whether CTI improves established prediction models, and determine whether interventions that reduce CTI translate into better clinical outcomes.
Lipoprotein(a) in Residual Cardiovascular Risk: Measurement Challenges, Assay Standardisation, and Clinical Implications.
Lu Y, Jiang D, Zhang J … +1 more , Liang Y
Int J Gen Med · 2026 · PMID 42266446 · Full text
Lipoprotein(a) [Lp(a)] is a largely genetically determined, independent contributor to residual atherosclerotic cardiovascular disease (ASCVD) risk, but its clinical interpretation is constrained by measurement complexit...
Lipoprotein(a) [Lp(a)] is a largely genetically determined, independent contributor to residual atherosclerotic cardiovascular disease (ASCVD) risk, but its clinical interpretation is constrained by measurement complexity. Variation in apolipoprotein(a) [apo(a)] KIV2 copy number, glycosylation, lipid composition, and isoform co-expression complicates mass-based reporting and may cause isoform-sensitive bias in immunoassays. This review examines how these metrological limitations affect Lp(a) reporting, assay comparability, LDL-C estimation, and clinical risk stratification. Current evidence supports preferential use of validated molar reporting (nmol/L) and discourages fixed conversion between mg/dL and nmol/L. Automated immunoassays remain practical for screening and population studies, whereas ELISA and LC-MS/MS have complementary roles in assay validation, reference-method development, and standardisation. Clinically, high Lp(a) may distort calculated LDL-C, and fixed 30% Lp(a)-cholesterol correction can misclassify risk or treatment response. Harmonised molar measurement, ancestry-inclusive validation, and clearer distinction between intact Lp(a) particles and free apo(a) are essential for improving risk assessment and implementing Lp(a)-targeted therapies.
Association of Serum Fetuin-B with Large-Artery Atherosclerotic Acute Ischemic Stroke and Functional Outcome.
Deng X, Hu T, Zhou K … +1 more , Deng Q
Int J Gen Med · 2026 · PMID 42266445 · Full text
OBJECTIVE: This study investigated the association of serum fetuin-B with large-artery atherosclerotic acute ischemic stroke (LAA-AIS) and poor functional outcome after stroke. METHODS: We retrospectively enrolled 216 co...
OBJECTIVE: This study investigated the association of serum fetuin-B with large-artery atherosclerotic acute ischemic stroke (LAA-AIS) and poor functional outcome after stroke. METHODS: We retrospectively enrolled 216 consecutive LAA-AIS patients from September 2023 to December 2024 and 194 age- and sex-matched healthy controls. Serum fetuin-B was measured via ELISA. Multivariable logistic regression and restricted cubic spline (RCS) analyses were used to assess the relationships between fetuin-B and the presence of LAA-AIS or poor functional outcome (modified Rankin Scale > 2). Predictive performance was evaluated using C-index, net reclassification index (NRI), integrated discrimination improvement (IDI), calibration plots, and decision curve analysis (DCA). Internal validation was performed via 1000 bootstrap resamples. RESULTS: Serum fetuin-B was significantly higher in patients with LAA-AIS than in controls (2.68 vs 1.79 µg/mL, < 0.001) and correlated positively with total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), glycated hemoglobin (HbA1c), and C-reactive protein (CRP). Multivariable regression showed higher fetuin-B independently associated with the presence of LAA-AIS (OR = 2.433, < 0.001) and poor functional outcome (OR = 1.903, < 0.001). Fetuin-B tertiles showed a graded increase in both risks (all for trend <0.05). Incorporating fetuin-B to the basic model significantly improved the C-index for LAA-AIS risk (from 0.827 to 0.871) and poor functional outcome (from 0.749 to 0.806), supported by significant NRI and IDI (all < 0.01). Calibration curves and DCA indicated good consistency and clinical net benefit. RCS analysis further revealed a non-linear association between fetuin-B and the presence of LAA-AIS, as well as an approximately linear association with poor functional outcome. CONCLUSION: Elevated serum fetuin-B measured after stroke onset was independently associated with LAA-AIS status and poor functional outcome.
Serum CAPN1 and CLEC2 as Biomarkers for Hearing Loss Severity and Internal Auditory Artery Narrowing in Sudden Sensorineural Hearing Loss.
Ye S, Sun H, Yang C … +1 more , Lu F
Int J Gen Med · 2026 · PMID 42266444 · Full text
BACKGROUND: The pathogenesis of sudden sensorineural hearing loss (SSNHL) remains unclear, with inner ear microcirculatory disturbance being an important mechanism. However, serum biomarkers for evaluating this mechanism...
BACKGROUND: The pathogenesis of sudden sensorineural hearing loss (SSNHL) remains unclear, with inner ear microcirculatory disturbance being an important mechanism. However, serum biomarkers for evaluating this mechanism are inadequately studied. This study investigated the expression of calpain-1 (CAPN1) and C-type lectin-like receptor 2 (CLEC2) and their correlations with hearing loss severity and inner ear artery diameters in SSNHL patients. METHODS: In this prospective study, we consecutively enrolled 150 patients with SSNHL admitted between March 1, 2021, and June 1, 2025, and 150 healthy controls undergoing routine physical examination. Serum CAPN1 and CLEC2 concentrations were measured using enzyme-linked immunosorbent assay (ELISA). Vascular measurements were based on MRI-derived large artery caliber (including the internal auditory artery, basilar artery, and anterior inferior cerebellar artery). Pearson correlation analysis was used to evaluate the relationship between CAPN1, CLEC2 and these arterial diameter parameters. Logistic regression analysis was performed to identify risk factors for SSNHL. Receiver operating characteristic (ROC) curves were used to evaluate the discriminative efficacy of CAPN1 and CLEC2. RESULTS: CAPN1 and CLEC2 levels were significantly elevated in the SSNHL group and increased with the severity of hearing loss (P < 0.001). All three arterial diameters were significantly smaller than those in the healthy group and were negatively correlated with CAPN1 and CLEC2 levels (P < 0.001). Multivariable logistic regression analysis showed that elevated WBC count, neutrophil count, CAPN1, and CLEC2 were independent risk factors, whereas increased arterial diameter was a protective factor (P < 0.05). The AUCs for CAPN1 alone, CLEC2 alone, and both combined were 0.804, 0.793, and 0.863, respectively, demonstrating good discriminative performance. CONCLUSION: Elevated serum CAPN1 and CLEC2 levels correlated with reduced diameters of arteries supplying the inner ear and severity of hearing loss in patients with SSNHL, suggesting their potential value as novel biomarkers for evaluation of inner ear microcirculatory disturbance and prediction of SSNHL. However, external validation and longitudinal outcome studies are warranted to establish their clinical applicability.
Multifactor Analysis of Electric Bicycle-Related Road Traffic Injuries in Wenzhou and Construction of a Prediction Model Based on Data from a Tertiary Trauma Center.
Ye T, Jin Q, Meng W … +2 more , Shen X, Huang X
Int J Gen Med · 2026 · PMID 42266443 · Full text
OBJECTIVE: To investigate the multifactorial determinants of electric bicycle-related road traffic injuries in Wenzhou based on data from a tertiary hospital trauma center, and to develop a risk prediction model for seve...
OBJECTIVE: To investigate the multifactorial determinants of electric bicycle-related road traffic injuries in Wenzhou based on data from a tertiary hospital trauma center, and to develop a risk prediction model for severe injury. METHODS: We retrospectively analyzed data from 249 electric bicycle riders treated at The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University between January 2020 and June 2023. Demographic characteristics, injury severity, safety-related factors, environmental factors, accident-related factors, and vehicle-related factors were collected. Univariate and multivariate logistic regression analyses were performed to identify independent variables associated with injury severity. A risk prediction model was constructed and visualized using a nomogram, and its discrimination and predictive performance were evaluated using the Hosmer-Lemeshow goodness-of-fit test and receiver operating characteristic (ROC) curve analysis. RESULTS: Among the 249 enrolled riders (168 males, 81 females; mean age: 33.2 ± 12.2 years), 70 (28.1%) sustained severe injuries. Multivariate analysis revealed that junior high school education or above was protective (OR=0.513), while riding speed >25 km/h (OR=3.182), poor road lighting (OR=2.777), collision with a motor vehicle (OR=23.377), and accidents on unpaved roads (OR=5.888) were significant risk factors (all P<0.05). The model demonstrated good calibration (Hosmer-Lemeshow test P=0.879) and discrimination, with an ROC curve area of 0.873 (95% CI: 0.823-0.922), yielding 71.43% sensitivity and 87.71% specificity. CONCLUSION: Rider education level, riding speed, road lighting, collision counterpart, and road type are significantly associated with the severity of electric bicycle-related road traffic injuries. The model constructed from these variables demonstrates good discriminative ability and has favorable performance for predicting severe injuries in electric bicycle riders.
Gut Microbiota and Hypertension: Mechanisms, Drug Interactions, and Translational Directions for Individualized Therapy.
Sun G, Shen H, Xiao Z … +1 more , Yang C
Int J Gen Med · 2026 · PMID 42266442 · Full text
Hypertension remains a major global health challenge, with suboptimal treatment and blood pressure (BP) control rates and apparent or confirmed resistant hypertension (RHT) affecting approximately 10-20% of treated patie...
Hypertension remains a major global health challenge, with suboptimal treatment and blood pressure (BP) control rates and apparent or confirmed resistant hypertension (RHT) affecting approximately 10-20% of treated patients. Increasing evidence suggests that the gut microbiota may contribute to BP regulation through interconnected metabolic, immune-inflammatory, intestinal barrier, gut-brain, and gut-kidney pathways. Short-chain fatty acids (SCFAs) may support vasodilation, renal sodium handling, epithelial barrier integrity, and anti-inflammatory signaling through receptor- and tissue-specific mechanisms, whereas trimethylamine N-oxide (TMAO) has been associated with adverse vascular and cardio-renal phenotypes but may function either as a pathogenic mediator or as a biomarker of altered microbial-host metabolism or impaired renal clearance. Beyond the SCFA-TMAO axis, bile acid metabolism, tryptophan/indole derivatives, phenylacetylglutamine, uremic toxins, and the nitrate-nitrite-nitric oxide pathway provide additional mechanistic links between microbial ecology and BP phenotypes. This review synthesizes mechanistic, pharmacological, clinical, and translational evidence on microbiota-hypertension interactions, with particular emphasis on drug-microbiota bidirectionality. We propose a three-layer framework in which bacterial enzymatic transformation, host metabolic regulation, and epithelial transport/barrier functions jointly shape antihypertensive drug exposure and response. Human interventional evidence remains preliminary: colon-targeted acetylated and butyrylated high-amylose maize starch increased circulating SCFAs and reduced 24-hour systolic BP by approximately 5-6 mmHg in a small, short-duration trial of untreated essential hypertension, whereas probiotics and prebiotics generally show modest BP reductions of approximately 1-3 mmHg systolic and 1-2 mmHg diastolic in meta-analyses. These findings support microbiota-informed hypertension research and risk stratification, but clinical implementation, particularly in well-defined RHT populations, remains investigational.
Therapeutic Effect Comparisons of Cyclophosphamide and Methotrexate in Immune-Mediated Necrotizing Myopathy.
Li Q, Zhou J, Huang W … +1 more , Tang L
Int J Gen Med · 2026 · PMID 42266441 · Full text
BACKGROUND: Immune-mediated necrotizing myopathy (IMNM) is a rapidly progressing autoimmune muscle disease that severely affects the proximal, respiratory, and cardiac muscles. There is no globally unified consensus on t...
BACKGROUND: Immune-mediated necrotizing myopathy (IMNM) is a rapidly progressing autoimmune muscle disease that severely affects the proximal, respiratory, and cardiac muscles. There is no globally unified consensus on treatment. Here, we compare the effects of cyclophosphamide (CTX) and methotrexate (MTX) in IMNM to provide evidence for treatment strategies. METHODS: This is a retrospective single-center study. Patients were assigned into a CTX group or an MTX group based on the type of immunosuppressant. Statistical analyses were compared using SPSS 23.0. RESULTS: A total of 35 patients were included-19 in the CTX group, and 16 in the MTX group. Before treatment, the aspartic transaminase (AST) levels were significantly higher in the CTX group than in the MTX group (P < 0.05). All patients received high-dose glucocorticoids as basic therapy. After inductive treatments, the proportion of patients whose creatine kinase (CK) decreased by more than 50% was higher in the CTX group (18 cases, 94.7%) than in the MTX group (10 cases, 62.5%; P < 0.05). The descent degree of laboratory indicators were analyzed further. Reductions in CK (6919.1 U/L vs. 3245.3 U/L), lactate dehydrogenase (LDH, 964.0 U/L vs. 318.5 U/L), and AST (225 U/L vs. 52.5 U/L) were also greater in the CTX group than in the MTX group (P < 0.05). CONCLUSION: In this cohort of IMNM patients, CTX achieved greater improvements in CK, LDH, and AST levels compared to MTX. CTX may be more beneficial than MTX for disease inductive treatment in IMNM patients. This finding provides evidence for selecting clinical treatment schemes.
Association of Umbilical Cord Blood P-Selectin and PTX3 Levels with Early-Onset Sepsis in Preterm Infants with Premature Rupture of Membranes.
Luo Y, Li M, Liu W … +1 more , Xiu W
Int J Gen Med · 2026 · PMID 42261343 · Full text
OBJECTIVE: To investigate the relationship between umbilical cord blood P-selectin and pentraxin 3 (PTX3) levels and early-onset sepsis (EOS) in preterm neonates with premature rupture of membranes (PROM). METHODS: A tot...
OBJECTIVE: To investigate the relationship between umbilical cord blood P-selectin and pentraxin 3 (PTX3) levels and early-onset sepsis (EOS) in preterm neonates with premature rupture of membranes (PROM). METHODS: A total of 148 preterm neonates with PROM duration >12 h admitted from September 2024 to September 2025 were included as the experimental group, including 22 with EOS and 126 without EOS. Fifty healthy preterm neonates born to mothers without PROM were enrolled as controls. Umbilical cord blood P-selectin and PTX3 levels were measured by ELISA. Pathogens were identified using an automated bacterial identification system. Pearson correlation analysis and ROC curve analysis were performed. RESULTS: Umbilical cord blood P-selectin and PTX3 levels were higher in the experimental group than in controls (P<0.05). Among the 22 neonates with EOS, 6 (27.3%) had positive blood cultures, yielding 6 pathogenic strains. Gram-negative bacteria predominated (66.67%), mainly Escherichia coli (33.33%). Compared with the non-sepsis group, the sepsis group had higher CRP, PCT, P-selectin, and PTX3 levels (P<0.05). P-selectin was positively correlated with PTX3 in neonates with EOS (r=0.639, P<0.05). The AUCs (95% CI) of P-selectin and PTX3 for evaluating EOS were 0.876 (0.814-0.937) and 0.883 (0.830-0.935), respectively. Their combined AUC was 0.911 (0.862-0.960), with sensitivity of 79.2% and specificity of 96.1%, outperforming CRP and PCT. CONCLUSION: Gram-negative bacteria were the main pathogens of EOS in preterm neonates with PROM. Umbilical cord blood P-selectin and PTX3 levels showed good value for evaluating EOS in this population.
Efficacy of Intestinal Obstruction Catheter Combined with Modified Dachengqi Decoction in Elderly Patients with Early Postoperative Inflammatory Intestinal Obstruction: A Randomised Study.
Liu J, Zhong Y, Deng Q … +5 more , Peng Y, Wang X, Long C, Ji Y, Duan C
Int J Gen Med · 2026 · PMID 42261342 · Full text
OBJECTIVE: This study aimed to evaluate the efficacy of a combined therapy integrating a nasointestinal decompression catheter with a modified Dachengqi Decoction (mDQD) for elderly patients diagnosed with early postoper...
OBJECTIVE: This study aimed to evaluate the efficacy of a combined therapy integrating a nasointestinal decompression catheter with a modified Dachengqi Decoction (mDQD) for elderly patients diagnosed with early postoperative inflammatory intestinal obstruction (EPIIO) following gastrointestinal emergency surgery. METHODS: We conducted a prospective, randomized controlled trial involving 62 elderly EPIIO patients. Participants were randomly assigned to an experimental group (n=31) or a conventional group (n=31). Both groups received standard nasointestinal catheter decompression and conventional Western medical therapy. The experimental group received additional treatment with mDQD administered through the catheter. Outcomes included recovery times (symptom resolution, first flatus, hospital stay), inflammatory markers (white blood cell count, C‑reactive protein, interleukin‑6), and intestinal barrier function (D‑lactate, diamine oxidase), measured before treatment and at 7 and 14 days post‑treatment. RESULTS: The experimental group showed statistically significant improvements in several recovery metrics, including shorter time to symptom resolution, first flatus, and hospital discharge, compared with the conventional group (all P < 0.05). In addition, the experimental group had greater reductions in systemic inflammatory markers and better restoration of intestinal barrier function at days 7 and 14 (P < 0.05). No major adverse events were reported in either group. CONCLUSION: The combined therapy of an intestinal obstruction catheter and modified Dachengqi Decoction was associated with improved recovery outcomes in elderly patients with early postoperative inflammatory intestinal obstruction, including reduced inflammation and enhanced intestinal barrier function. However, these findings should be interpreted with caution owing to the small sample size and single‑center design. Larger, multicenter randomized trials are needed to confirm the efficacy of this integrated approach.
Prevalence of HSV-1, HSV-2, EBV, and HHV-8 Co-Infections Among HPV-Positive Women: A Cross-Sectional Study from Iran.
Safarnezhad Tameshkel F, Salimi Jeda A, Sadat Ghaemi M … +6 more , Ataei-Pirkooh A, Motamedaria P, Hemmasi G, Motevasselian M, Panahi Z, Karbalaie Niya MH
Int J Gen Med · 2026 · PMID 42261341 · Full text
BACKGROUND: Interactions between human papillomavirus (HPV) and co-infecting herpesviruses remain incompletely understood. This study assessed the prevalence of HSV-1, HSV-2, Epstein-Barr virus (EBV), and HHV-8 among HPV...
BACKGROUND: Interactions between human papillomavirus (HPV) and co-infecting herpesviruses remain incompletely understood. This study assessed the prevalence of HSV-1, HSV-2, Epstein-Barr virus (EBV), and HHV-8 among HPV-positive women in Iran, and evaluated associations with HPV genotypic risk groups and genotype multiplicity. METHODS: This cross-sectional study analyzed 303 residual cervical cytology samples from HPV-positive women. Herpesviruses were detected using multiplex real-time PCR. Associations between herpesvirus positivity and HPV variables were examined using Logistic regression, Fisher's Exact Test and nonparametric statistics. RESULTS: Co-infection of HPV with herpesviruses were detected in 20 of 303 samples (6.6%; 95% CI: 4.1-10.0), including HSV-1 in 2 samples (0.7%), HSV-2 in 10 samples (3.3%), EBV in 8 samples (2.6%), and HHV-8 in none of the samples. No significant associations were found between herpesvirus positivity and HPV risk group or HPV genotype multiplicity (p>0.05). Multivariable models did not identify independent predictors; analyses were limited by the low number of herpesvirus-positive cases and wide confidence intervals. CONCLUSION: Co-infection of HPV with herpesviruses were uncommon among HPV-positive women and were not measurably associated with HPV genotype patterns. The low event frequency and cytology-based sampling likely contributed to nondetection of associations. Studies using tissue-based sampling, HPV-herpesvirus viral load, and high-grade lesions are needed to clarify potential viral synergism.
TyG Index is Associated with Major Adverse Cardiovascular Events in HIV-Infected Individuals with Cardiovascular Disease: A Single-Center Retrospective Cohort Study.
Chen L, Fan G, Yuan Q … +2 more , Guo G, Zhou J
Int J Gen Med · 2026 · PMID 42261340 · Full text
OBJECTIVE: To explore the correlation between triglyceride-to-glucose (TyG) ratio and major adverse cardiovascular events (MACE) risk in coronary artery disease complicated with human immunodeficiency virus (CAD-HIV) pat...
OBJECTIVE: To explore the correlation between triglyceride-to-glucose (TyG) ratio and major adverse cardiovascular events (MACE) risk in coronary artery disease complicated with human immunodeficiency virus (CAD-HIV) patients, and assess its predictive value. METHODS: A single-center retrospective cohort study was conducted. A total of 103 CAD-HIV patients admitted to the First Affiliated Hospital of Xinjiang Medical University from January 2020 to June 2025 were enrolled, with a follow-up of 5-49 months (median 22.00 months). Patients were grouped by MACE occurrence. Baseline data and TyG index were collected, with MACE as the primary endpoint. Cox regression, restricted cubic spline (RCS), ROC curve and subgroup analysis were performed. RESULTS: Forty-one patients (39.81%) developed MACE, with significantly higher TyG index in the MACE group (P < 0.001). Multivariate Cox analysis showed each 0.1-unit elevation in TyG index increased MACE risk by 42% (HR = 1.42, 95% CI: 1.16-1.74, P < 0.001). Compared with Q1, Q3 and Q4 had 4.42-fold (95% CI: 1.17-16.68, P = 0.028) and 6.17-fold (95% CI: 1.77-21.54, P = 0.004) higher risk. RCS verified linear positive correlation (P for overall = 0.006, P for nonlinear = 0.387). AUC for 1-year and 3-year MACE prediction was 0.745 and 0.805, respectively. The association was stronger in non-smokers (P for interaction = 0.006). CONCLUSION: TyG index is linearly associated with MACE risk in CAD-HIV patients and shows favorable predictive performance for 1-year and 3-year MACE, which can be used as a simple biomarker for cardiovascular risk stratification.
Construction and Analysis of ceRNA Regulatory Networks Reveal the Core Genes Associated with Rheumatoid Arthritis.
Zhang C, Chen X, Yu H … +3 more , Huang M, Wang Y, Wang Y
Int J Gen Med · 2026 · PMID 42246038 · Full text
BACKGROUND: Circular RNAs (circRNAs), microRNAs (miRNAs), and transcription factors (TFs) participate in the immune dysregulation that drives rheumatoid arthritis (RA), but their integrated regulatory architecture in per...
BACKGROUND: Circular RNAs (circRNAs), microRNAs (miRNAs), and transcription factors (TFs) participate in the immune dysregulation that drives rheumatoid arthritis (RA), but their integrated regulatory architecture in peripheral blood remains incompletely defined. We therefore constructed a circRNA-miRNA-TF-mRNA competing endogenous RNA (ceRNA) network and performed experimental validation in a collagen-induced arthritis (CIA) model. METHODS: Publicly available RA datasets were retrieved from the Gene Expression Omnibus, including GSE189338 (circRNA), GSE124373 (miRNA), and GSE17755 (mRNA). Differentially expressed transcripts were identified with limma. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses were used to characterize the differentially expressed mRNAs. TF-mRNA pairs were obtained from TRRUST v2, experimentally supported miRNA-target interactions were obtained from miRTarBase, and circRNA-miRNA interactions were predicted with CircBank. Candidate genes were cross-checked in the Comparative Toxicogenomics Database. Selected network components were validated by quantitative real-time PCR (RT-qPCR) using peripheral blood from CIA rats. RESULTS: We identified 920 differentially expressed mRNAs, 282 differentially expressed miRNAs, and 980 differentially expressed circRNAs. Functional enrichment linked the mRNA signature to leukocyte adhesion, apoptosis-related processes, focal adhesion, and immune-inflammatory pathways relevant to RA. Integration of TF, miRNA, and circRNA layers yielded an initial network containing 6 circRNAs, 4 miRNAs, 4 TFs, and 24 mRNAs. For biological verification, we prioritized 6 circRNAs, 4 miRNAs, 3 TFs, and 8 mRNAs for RT-qPCR. Most candidates showed expression changes consistent with the discovery datasets, whereas miR-195-5p did not differ significantly between groups. After excluding the unsupported branch, the refined network comprised 5 circRNAs, 3 miRNAs, 3 TFs, and 8 mRNAs. CONCLUSION: This study defines a blood-based circRNA-miRNA-TF-mRNA regulatory framework in RA and nominates a focused set of candidate biomarkers for subsequent mechanistic and clinical validation. The findings should be interpreted as hypothesis-generating rather than definitive evidence of causal ceRNA regulation.
Unaddressed Biases in a Retrospective Study of Anticoagulant Prophylaxis in Trauma Patients [Response to Letter].
Chen S, Zou M, Chen M … +2 more , Feng M, Wan P
Int J Gen Med · 2026 · PMID 42238360 · Full text
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