International Journal Of General Medicine[JOURNAL]
Sun
200 papers
Risk Factors for Cardiac Rupture After Acute Myocardial Infarction and Development of a Risk Prediction Model.
Gao J, Jia P, Hong Z … +3 more , Liu Y, Liang L, Zhang L
Int J Gen Med · 2026 · PMID 42057923 · Full text
AIM: To investigate the influencing factors for acute myocardial infarction (AMI) complicated by cardiac rupture (CR),evaluate the predictive value of the systemic inflammation response index (SIRI), and construct a clin...
AIM: To investigate the influencing factors for acute myocardial infarction (AMI) complicated by cardiac rupture (CR),evaluate the predictive value of the systemic inflammation response index (SIRI), and construct a clinically practical risk prediction model. METHODS: A total of 53 AMI patients complicated with CR admitted to Tianshui First People's Hospital from January 2013 to December 2023 were enrolled as the CR group.During the same period, 159 AMI patients without CR were selected as the control group at a 1:3 ratio, matched for age and sex.Baseline data, clinical indicators, and laboratory test results of patients in both groups were collected, and SIRI was calculated. Lasso regression was used to screen core variables, multivariate Logistic regression analysis was performed to identify independent influencing factors, a nomogram prediction model was constructed based on key variables, and the receiver operating characteristic (ROC) curve was used to evaluate the model's efficacy. RESULTS: Multivariate Logistic regression analysis showed that admission heart rate (OR = 1.050,95% CI = 1.024-1.075, P < 0.001), Killip classification (OR = 2.092,95% CI = 1.460-2.997, P < 0.001) and SIRI (OR = 1.105,95% CI = 1.022-1.196, P = 0.012) were independent risk factors for CR in AMI patients. Primary PCI (OR = 0.239,95% CI = 0.097-0.589, P = 0.002) and taking ACEI / ARB drugs within 24 hours (OR = 0.173,95% CI = 0.060-0.500, P = 0.001) were protective factors. The ROC curve model constructed based on the above five indicators has an area under the curve (AUC) of 0.885. CONCLUSION: Admission heart rate, Killip classification, and systemic inflammatory response index are independent risk factors for AMI with CR. Primary PCI and the administration of ACEI/ARB within 24 hours of admission were identified as protective factors against CR. The nomogram model demonstrated good predictive value for the occurrence of cardiac rupture in patients with AMI.
Multidimensional Mechanisms of Hypertension and Advances in Diagnosis and Integrated TCM-Based Treatment: A Review.
Chen A, Chen R, Zhang Y … +2 more , Yang W, Wang R
Int J Gen Med · 2026 · PMID 42057922 · Full text
BACKGROUND: Hypertension is a major chronic cardiovascular disorder and a leading contributor to cardiovascular, cerebrovascular, and renal morbidity worldwide. Its development is influenced by the interaction of metabol...
BACKGROUND: Hypertension is a major chronic cardiovascular disorder and a leading contributor to cardiovascular, cerebrovascular, and renal morbidity worldwide. Its development is influenced by the interaction of metabolic abnormalities, environmental exposure, lifestyle factors, and genetic susceptibility, resulting in substantial heterogeneity across populations. MAIN FINDINGS: This review summarizes current evidence on the multidimensional mechanisms of hypertension, including vascular dysfunction, endocrine imbalance, and neural dysregulation, as well as recent advances in diagnosis such as ambulatory and home blood pressure monitoring. It also examines the role of Traditional Chinese Medicine (TCM) in hypertension management. Available experimental and clinical studies suggest that TCM interventions, including herbal formulas, acupuncture, and integrated TCM-Western medicine approaches, may contribute to blood pressure reduction, vascular protection, and improvement of inflammatory and metabolic status through multi-target effects. At the same time, the current evidence base remains limited by small sample sizes, methodological heterogeneity, and insufficient standardization. CONCLUSION: Hypertension management requires a more comprehensive and individualized approach that integrates advances in modern diagnostics, precision medicine, and digital health with more rigorous evaluation of TCM-based and integrative treatment strategies. Strengthening methodological quality and standardization will be essential for clarifying the clinical value of TCM in hypertension care.
Exploring Influencing Factors Including CYP2C19 Genotypes, and Developing a Machine Learning-Based Predictive Model for Clopidogrel Resistance in Chinese Patients with Ischemic Stroke.
Xu B, Gu L, Lin G … +3 more , Ni H, Shi H, Chen B
Int J Gen Med · 2026 · PMID 42051361 · Full text
BACKGROUND: Clopidogrel resistance (CR) may diminish its antiplatelet effect, thereby increasing the risk of cardiovascular and cerebrovascular events. The cause of CR remains unclear, and it may be related to pharmacoge...
BACKGROUND: Clopidogrel resistance (CR) may diminish its antiplatelet effect, thereby increasing the risk of cardiovascular and cerebrovascular events. The cause of CR remains unclear, and it may be related to pharmacogenomics and coagulation markers. Machine learning is a novel approach to investigate the correlations among various factors. This study aimed to investigate the factors influencing CR in Chinese patients with ischemic stroke and to develop a precise and reliable predictive model for CR using machine learning. METHODS: Thromboelastography (TEG), a standard technique for assessing platelet inhibition, was used to measure the adenosine diphosphate (ADP)-induced platelet inhibition rate. CR was defined as an ADP-induced platelet inhibition rate of less than 30%. Genotypes of and were identified using fluorescence in situ hybridization. The relationships between genotypes, laboratory indicators, and ADP-induced platelet inhibition rates or CR were examined. An extreme gradient boosting (XGBoost) machine learning method was applied to predict the occurrence of CR. Adaptive Synthetic technique was used for reliable data augmentation and the predictive model was internally validated via nested cross-validation. RESULTS: A total of 208 patients were enrolled in the study. Participants were categorized into the CR group (n=14) and the non-CR group (n=194). The CR group exhibited significantly lower activated partial thromboplastin time (APTT) levels compared with the non-CR group (P<0.05). Carriers of at least one loss-of-function (LOF) allele of had a significantly higher risk of CR than individuals without LOF alleles. Other risk factors for ischemic stroke, such as age, sex, and body weight, did not significantly affect platelet inhibition rates or CR. Based on the XGBoost model, genotype, D-dimer levels, platelet count, and total bilirubin were major contributors to the prediction of CR in Chinese patients with ischemic stroke. The area under the receiver operating characteristic curve was 0.9925±0.0067. The model's accuracy and sensitivity was 97.44% and 91.82%, respectively. CONCLUSION: Genetic polymorphisms in are the primary factors influencing CR. A machine learning model may be useful for early prediction of CR and for guiding the rational use of clopidogrel.
Temporal Dynamic Machine Learning Prediction of Postoperative Gastrointestinal Dysfunction Duration in Esophageal Cancer: Integrating Preoperative and Perioperative Routine Blood Temporal Data and Dynamic Ultrasonic Features.
Jin L, Chang Y, Liu H … +1 more , Guo J
Int J Gen Med · 2026 · PMID 42051360 · Full text
OBJECTIVE: Gastrointestinal dysfunction following esophageal cancer surgery represents a prevalent postoperative complication. This study aims to develop a time-dynamic machine learning model to predict the duration of p...
OBJECTIVE: Gastrointestinal dysfunction following esophageal cancer surgery represents a prevalent postoperative complication. This study aims to develop a time-dynamic machine learning model to predict the duration of postoperative gastrointestinal dysfunction (POGID) by integrating preoperative and perioperative continuous blood data with dynamic ultrasound characteristics, thereby facilitating early clinical intervention. METHODS: A retrospective cohort of 826 patients who underwent radical esophagectomy between 2017 and 2024 was enrolled and stratified into a training set (70%), a validation set (15%), and a test set (15%). Predictive variables encompassed baseline demographic and clinical data, blood routine parameters at five distinct time points, and ultrasound features at three time points. Four machine learning models were constructed: Long Short-Term Memory (LSTM), Gated Recurrent Unit (GRU), Temporal Convolutional Network (TCN), and Random Forest (RF). Model performance was evaluated using Mean Absolute Error (MAE), Root Mean Square Error (RMSE), Coefficient of Determination (R), and Mean Absolute Percentage Error (MAPE). Feature importance was assessed via SHapley Additive exPlanations (SHAP) analysis. RESULTS: The LSTM model demonstrated superior predictive performance on the test set, achieving an MAE of 1.23 ± 0.31 days, an RMSE of 1.56 ± 0.42 days, an of 0.78 ± 0.06, and an MAPE of 12.3% ± 3.1%, significantly outperforming the RF model (all P < 0.001). The top five influential predictors were postoperative day 1 white blood cell count, preoperative day 1 antral cross-sectional area, postoperative day 3 platelet count, Tumor Node Metastasis (TNM) stage, and postoperative day 2 intestinal peristalsis frequency. Subgroup analyses confirmed the model's robust predictive capability, with values ranging from 0.72 to 0.83. CONCLUSION: The time-dynamic LSTM model, which integrates continuous blood data, ultrasound features, and baseline characteristics, accurately predicts POGID duration and identifies actionable intervention targets. This model can be integrated into clinical decision support systems to optimize perioperative management and enhance postoperative recovery.
The Relationship Between Magnetic Resonance Diffusion Tensor Imaging Parameters and Muscle Dysfunction in Patients with Osteoporosis: A Cross-Sectional Retrospective Study.
Wang H, Yang Y, Cui J … +4 more , Wang Y, Zhang C, Guo Z, Zheng D
Int J Gen Med · 2026 · PMID 42051359 · Full text
OBJECTIVE: To explore the relationship between magnetic resonance (MR) diffusion tensor imaging (DTI) parameters and muscle dysfunction in patients with osteoporosis (OP), and provide a basis for clinical diagnosis and t...
OBJECTIVE: To explore the relationship between magnetic resonance (MR) diffusion tensor imaging (DTI) parameters and muscle dysfunction in patients with osteoporosis (OP), and provide a basis for clinical diagnosis and treatment. METHODS: A retrospective study was conducted on 100 patients with osteoporosis treated in Ninth Medical Center of PLA General Hospital from January 2021 to January 2024. All patients underwent DTI examination and evaluated according to the Lovett muscle strength grading system (0-5 levels). Patients with muscle strength grades 0-3 were defined as the group with poor muscle function (n=31) and good muscle function (grades 4-5, n=69). The affecting factors were analyzed through logistic regression model. Pearson model was used to analyze the correlation. RESULTS: The fraction anisotropy (FA) values of the gluteus maximus, gracilis, rectus femoris, adductor femoris, and long adductor femoris in the poor group were all lower than the good group (all P<0.05). The apparent diffusion coefficient (ADC) values of the gracilis muscle (1.02 ± 0.34 mm/s vs 1.74 ± 0.41 mm/s), adductor femoris muscle (1.07 ± 0.33 mm/s vs 1.76 ± 0.38 mm/s), and long adductor femoris muscle (1.04 ± 0.34 mm/s vs 1.68 ± 0.34 mm/s) were all lower than the good group (all P<0.05). FA decrease and ADC increase in the adductor major and adductor longus muscles were independent factors affecting thigh muscle dysfunction (P<0.05). The weakening of OP muscle function was positively correlated with the decrease of muscle FA and ADC (P<0.05). The AUC predicted by the combination of FA and ADC was 0.722 (95% CI: 0.6239-0.821), higher than those predicted by a single parameter (P<0.05). CONCLUSION: There is a correlation between DTI parameters FA and ADC in different muscle parts and the occurrence of muscle dysfunction, and they have potential predictive value for muscle dysfunction in OP patients.
Comparison of Open Visiting and Restricted Visiting in ICU Chronic Critical Patients: Effects on Negative Emotions and Delirium.
Xu C, Zhao C, Deng C … +1 more , Jin Z
Int J Gen Med · 2026 · PMID 42046752 · Full text
OBJECTIVE: To compare the effects of open visiting versus restricted visiting on negative emotions and delirium in ICU chronic critical patients. METHODS: A retrospective analysis was conducted on 264 chronic critical pa...
OBJECTIVE: To compare the effects of open visiting versus restricted visiting on negative emotions and delirium in ICU chronic critical patients. METHODS: A retrospective analysis was conducted on 264 chronic critical patients admitted to a tertiary hospital ICU between January 2025 and January 2026. Patients were divided into a restricted visiting control group (n=132) and an open visiting study group (n=132) based on the implementation of open visiting in December 2025. The open group received 24-hour access, while the control group received 1 hour daily. Clinical outcomes, psychological status, and delirium incidence were compared. RESULTS: The study group had significantly shorter mechanical ventilation time (15.44±1.28 vs. 18.88±3.47 days), ICU stay (12.17±3.33 vs. 15.91±3.78 days), and total hospital stay (20.22±3.16 vs. 25.11±5.11 days) compared to the control group (all P<0.05). Treatment compliance was higher in the study group (89.39% vs. 75.45%, P<0.05). At discharge, the study group showed lower HADS scores (11.22±1.96 vs. 14.78±2.25 points), as well as lower family state anxiety (44.23±2.17 vs. 56.89±2.88) and trait anxiety scores (44.18±1.89 vs. 57.54±3.11) (all P<0.05). Delirium incidence was significantly reduced in the study group (11.36% vs. 25.76%, P<0.05). No significant difference in ICU air quality was observed between groups (P>0.05). CONCLUSION: Open visiting mode is superior to restricted visiting in improving psychological outcomes, reducing delirium, and enhancing clinical recovery in ICU chronic critical patients, supporting its clinical promotion.
Erratum: The Diagnosis and Prognosis Value of Exosomal MascRNA in Patients with Acute Coronary Syndrome [Corrigendum].
Int J Gen Med · 2026 · PMID 42046751 · Full text
[This corrects the article DOI: 10.2147/IJGM.S538127.].
[This corrects the article DOI: 10.2147/IJGM.S538127.].
Short-Term Efficacy and Safety of Haizao Yuhu Decoction Plus Methimazole versus Methimazole Monotherapy for Graves' Disease: A Prospective Study Using Propensity Score-Matching.
Huang W, Cheng F, Liu X … +7 more , Li X, Zhou S, Lin R, Zhu F, Mao X, Liu C, Xu S
Int J Gen Med · 2026 · PMID 42046750 · Full text
OBJECTIVE: To investigate the efficacy and safety of the early addition of Haizao Yuhu Decoction (HYD) with methimazole (MMI) versus the monotherapy of MMI in treating Graves' disease (GD). METHODS: This was a prospectiv...
OBJECTIVE: To investigate the efficacy and safety of the early addition of Haizao Yuhu Decoction (HYD) with methimazole (MMI) versus the monotherapy of MMI in treating Graves' disease (GD). METHODS: This was a prospective observational study. A total of 198 patients with GD were assigned to either the HYD combined with MMI group or the MMI monotherapy group according to clinical judgment and patient preference. To minimize confounding bias, propensity score matching (PSM) was performed to balance baseline characteristics between the two groups. Primary (thyroid function, MMI dose) and secondary outcomes (general conditions, thyrotrophin receptor antibody [TRAb], thyroid size, peak systolic velocity of the superior thyroid artery [STA-PSV], the Thyroid-related Patient-Reported Outcome 39 [ThyPRO39] scores, traditional Chinese medicine [TCM] syndrome scores, and safety) were measured at 0 (V), 4 (V), 8 (V) and 12 weeks of treatment (V). RESULTS: Each group consisted of 54 GD patients after a 1:1 PSM. A greater decline in free thyroxine (FT4) (16.67 [7.64, 24.43] pmol/L vs 9.82 [3.49, 19.02] pmol/L, = 0.018) and free triiodothyronine (FT3) (5.32 [3.10, 10.33] pmol/L vs 3.46 [1.16, 7.63] pmol/L, = 0.043) was observed at V in the combination group than in the MMI group. The cumulative dose of MMI during the 12-week treatment was significantly lower in the combination group than in the MMI group (814.20 [600.00, 1050.00] mg vs 1007.10 [782.10, 1125.00] mg, P = 0.004). The combination group showed more pronounced reductions in the STA-PSV, TCM syndrome scores, and ThyPRO scores ( = 0.032, 0.010, and 0.044, respectively). The cumulative incidence of adverse events in the combination group was significantly lower than that in the MMI group (5.56% [3/54] vs 18.52% [10/54], = 0.038). CONCLUSION: The combination of HYD and MMI serves as an effective and safe treatment of GD, accelerating thyroid function recovery, reducing thyroid hormone levels and ATD dosage, alleviating hyperthyroid symptoms, and lowering the risk of adverse events.
Comparative Prognostic Value of ASPECTS and CTP Core Infarct Volume in Acute Ischemic Stroke Patients Undergoing Endovascular Therapy.
Wang Z, Zhang L, Wang X … +4 more , Yu X, Tang J, Dai X, Qiu T
Int J Gen Med · 2026 · PMID 42046749 · Full text
BACKGROUND: Rapid and accurate imaging assessment is critical for selecting acute ischemic stroke (AIS) patients for endovascular therapy. While CT perfusion (CTP) provides quantitative evaluation of infarct core, the AS...
BACKGROUND: Rapid and accurate imaging assessment is critical for selecting acute ischemic stroke (AIS) patients for endovascular therapy. While CT perfusion (CTP) provides quantitative evaluation of infarct core, the ASPECTS score based on non-contrast CT (NCCT) is widely used for its speed and simplicity. However, their comparative predictive value and consistency in clinical practice remain unclear. OBJECTIVE: To evaluate the prognostic value of NCCT-based ASPECTS and CTP-derived core infarct volume in AIS patients undergoing endovascular treatment, and to explore their correlation and clinical implications. METHODS: In this retrospective single-center study, we analyzed 82 patients with acute ischemic stroke who underwent endovascular therapy within 24 hours of symptom onset. Preoperative ASPECTS scores and CTP-defined core infarct volumes (processed via Shukun software) were recorded. Prognostic outcome was defined by the 90-day modified Rankin Scale (mRS). Statistical analysis included logistic regression, ROC curve analysis, and Spearman correlation. RESULTS: Patients with poor outcomes had significantly larger CTP-derived infarct core volumes and lower ASPECTS scores (both P<0.001). In the overall cohort, CTP (AUC=0.74) and ASPECTS (adjusted AUC=0.71) demonstrated comparable predictive performance, with no statistically significant difference. In subgroup analyses stratified by onset-to-treatment time, both modalities remained predictive, and no significant differences in predictive accuracy were observed between ASPECTS and CTP in either the ≤6-hour or 6-24-hour groups. A moderate negative correlation was observed between ASPECTS and core infarct volume (r=-0.61, P<0.001). CONCLUSION: Both ASPECTS and CTP-derived core infarct volume predict functional outcomes in AIS patients undergoing endovascular therapy, with comparable performance. ASPECTS offers a rapid assessment, whereas CTP provides quantitative evaluation. The two modalities may serve complementary roles in clinical decision-making.
Clinical Presentation, Angiographic Characteristics, and In-Hospital Outcomes of Young Adults Undergoing Coronary Angiography in a Resource-Limited Sub-Saharan Setting.
Abdi IA, Aydın MZ, Mohamud MFY
Int J Gen Med · 2026 · PMID 42046748 · Full text
BACKGROUND: Premature coronary artery disease is increasingly observed in low- and middle-income countries; however, data on young adults undergoing invasive coronary evaluation in resource-limited settings remain scarce...
BACKGROUND: Premature coronary artery disease is increasingly observed in low- and middle-income countries; however, data on young adults undergoing invasive coronary evaluation in resource-limited settings remain scarce. This study assessed clinical presentation, angiographic findings, system-related delays, and in-hospital outcomes among young adults undergoing coronary angiography in a Sub-Saharan catheterization center. METHODS: We retrospectively analyzed consecutive patients aged ≤45 years who underwent coronary angiography, with or without percutaneous coronary intervention, for acute coronary syndromes (ST-elevation myocardial infarction [STEMI], non-ST-elevation myocardial infarction [NSTEMI], or unstable angina) and stable coronary artery disease between June 2021 and June 2025. Demographic data, cardiovascular risk factors, angiographic characteristics, and in-hospital outcomes were collected. The primary outcome was in-hospital mortality. RESULTS: A total of 121 patients were included (median age 41 years; 77.7% male). Acute coronary syndromes predominated, with ST-elevation myocardial infarction in 45.5%. Smoking (55.4%) and khat use (39.7%) were the most prevalent risk factors. System delays were substantial, with a median door-to-balloon time of 355 minutes and 79.3% exceeding 180 minutes. The left anterior descending artery was the most common culprit vessel, and multivessel disease was present in 36.4%. In-hospital mortality was 9.9% and was associated with cardiogenic shock, severely reduced left ventricular ejection fraction, no-reflow/slow-flow phenomena, khat use, and prolonged door-to-balloon time (p <0.05). CONCLUSION: Young adults with acute coronary syndromes in resource-limited settings experience substantial early mortality associated with delayed reperfusion, high-risk presentation, and region-specific risk factors. Improving STEMI systems of care and targeting modifiable exposures such as smoking and khat use may help improve outcomes.
Whole Exome Sequencing Reveals Potential Single Nucleotide Polymorphisms and Copy Number Variations in 26 Sporadic Patients with Immature Teratoma.
Liu Y, Jia Y, Du N … +3 more , Li Y, Wang C, Kang S
Int J Gen Med · 2026 · PMID 42038264 · Full text
BACKGROUND: Immature teratoma is a malignant tumor and accounts for 1%-3% of ovary teratoma. The objective of this study was to find the potential single nucleotide polymorphisms (SNPs), copy number variations (CNVs) and...
BACKGROUND: Immature teratoma is a malignant tumor and accounts for 1%-3% of ovary teratoma. The objective of this study was to find the potential single nucleotide polymorphisms (SNPs), copy number variations (CNVs) and drug targets in the immature teratoma. MATERIAL AND METHODS: Genomic DNA was extracted from peripheral blood of 26 sporadic immature teratoma patients for whole exome sequencing (WES) analysis to detect germline variants. SNPs and CNVs were identified, followed by the analysis of physical/chemical properties and conserved domain of mutated genes. Functional enrichment and protein-protein interaction (PPI) analysis of mutated genes was performed, followed by pharmacogenomic analysis. Finally, SNPs, CNVs and mRNA expression of mutated genes were investigated in ovarian cancer by using the online databases. RESULTS: A total of 24 common mutated genes were identified in 26 patients. Among which, 5 common mutated genes with common mutation sites were identified, including 2 frameshift mutant genes (MYPOP and FRG2C) and 3 nonsynonymous mutant genes (CNTNAP3, GPRIN2 and MUC3A). After mutation, molecular weight of MYPOP, FRG2C, CNTNAP3, GPRIN2 and MUC3A changed slightly. In the PPI network, MUC12 (with the highest degree) interacted with GALNT12, MUC3A and FCGBP. Based on the pharmacogenomic analysis, MUC2 was predicted to be a potential drug target of CHEMBL35482, FLUOROURACIL and DECITABINE. According to the functional analysis, MUC3A, MUC2 and MUC12 were involved in biological processes of activation of the innate immune response. The mutation frequency of FCGBP and CNTNAP3 was rare and had a higher amplification frequency in ovarian cancer. In addition, 2 common CNVs (deletion state) were screened out, which involving 6 genes, such as RP11. CONCLUSION: This study identified some potential SNPs and CNVs, which may contribute to clarifying the pathogenesis of immature teratoma and provide potential biomarkers and drug targets for this disease.
Machine Learning Identification of Metabolism-Related Biomarkers with Diagnostic Potential for Gastric Cancer: Multi-Dimensional Transcriptomic Validation.
Kong W, Wang J, Zhang K … +2 more , Wang X, Zhang J
Int J Gen Med · 2026 · PMID 42038263 · Full text
BACKGROUND: An increasing body of evidence suggests an association between metabolic syndrome and gastric cancer. However, the shared genetic signatures and underlying molecular mechanisms between them remain to be eluci...
BACKGROUND: An increasing body of evidence suggests an association between metabolic syndrome and gastric cancer. However, the shared genetic signatures and underlying molecular mechanisms between them remain to be elucidated. METHODS: We obtained transcriptomic data for gastric cancer and metabolic syndrome from the GEO, TCGA, and GTEx databases. Using the Limma and WGCNA algorithms respectively, we identified differential genes and co-expression module genes related to metabolic syndrome and gastric cancer. Lasso and SVM were employed to further screen for hub genes, while XGBoost was utilized to enhance the diagnostic value of these hub genes. CIBERSORT and GSVA were applied to assess the correlation among hub genes for immune infiltration and metabolic scores. Single-cell and spatial transcriptomic analyses were conducted to explore cell subpopulations and tissue distribution of hub genes in gastric cancer. We used qPCR experiments to detect expression differences of hub genes between gastric cancer tissues and normal tissues. RESULTS: CSE1L, IL32, and CCDC86 were identified as shared hub genes between metabolic syndrome and gastric cancer. These genes were significantly associated with immune cell infiltration and dysregulated metabolic pathways. Single-cell analysis revealed elevated glycolysis across gastric cancer cell subpopulations, accompanied by enhanced cell-cell interactions. Spatial transcriptomic analysis confirmed the upregulation of hub genes in tumor regions. qPCR further verified significantly higher mRNA expression levels of these genes in gastric cancer tissues than in adjacent normal tissues. CONCLUSION: CSE1L, IL32, and CCDC86 may represent potential metabolism-related biomarkers associated with gastric cancer and metabolic syndrome. These findings provide additional insight into the molecular links between the two conditions and may support future mechanistic studies and larger-scale clinical validation.
Prevalence and Predictors of Poor Sleep Quality Among Adolescents in Central Sudan: The Role of Depression, Anxiety, and Gender.
Omar SM, Al-Nafeesah A, Alwabili AA … +2 more , AlEed A, Adam I
Int J Gen Med · 2026 · PMID 42038262 · Full text
BACKGROUND: Sleep is crucial for adolescent health; however, there is a scarcity of data on adolescent sleep in Sudan, which has a major sociopolitical disruption. Thus, this study aimed to determine the prevalence of po...
BACKGROUND: Sleep is crucial for adolescent health; however, there is a scarcity of data on adolescent sleep in Sudan, which has a major sociopolitical disruption. Thus, this study aimed to determine the prevalence of poor sleep quality and the factors associated with it among adolescents who returned after internal displacement in Central Sudan. METHODS: A multi-stage, stratified random sampling approach was used in a community-based, cross-sectional study conducted in East Gezira, Central Sudan. Data from 365 adolescents were collected on sociodemographic factors, body mass index (BMI), and mental health. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. The Patient Health Questionnaire (PHQ)-9 was used to measure symptoms of depression, and anxiety symptoms were measured using the Generalized Anxiety Disorder (GAD-7) questionnaire. Multivariate binary logistic regression was performed to identify factors associated with poor sleep quality, defined as a PSQI score > 5. RESULTS: A total of 365 adolescents were enrolled (52.1% were females; 47.9% were males). The median (interquartile range [IQR]) age and BMI were 14 (12‒16) years and 16.2 (14.7‒18.1) kg/m, respectively. The median (IQR) depression and anxiety scores were 2 (0‒4) and 2 (1‒5), respectively. Thirty-five (9.6%) of the 365 adolescents had poor sleep quality. A multivariate binary analysis showed that poor sleep quality was positively associated with depression scores (adjusted odds ratio [AOR] =1.20; 95% confidence interval [CI] = 1.04‒1.37) and anxiety scores (AOR = 1.20; 95% CI = 1.05‒1.38). Female adolescents were found to be at higher risk of poor sleep quality than males (AOR = 3.94; 95% CI = 1.18‒13.07). CONCLUSION: This study indicates that the prevalence of poor sleep quality (9.6%) among adolescents in Central Sudan is lower than reported in the existing literature. Poor sleep quality is significantly associated with mental health conditions, particularly depression and anxiety, as well as being female. These results highlight the need for mental health support to improve adolescent sleep health in the region.
Prognostic Value of the HALP Score Compared with Other Inflammatory and Nutritional Indices in IgA Nephropathy.
Benlioglu BN, Korkut G, Girtine E … +4 more , Celebioglu Pekiner M, Sarsik Kumbaraci B, Şen S, Sezis M
Int J Gen Med · 2026 · PMID 42038261 · Full text
PURPOSE: IgA nephropathy (IgAN) is the most common primary glomerulonephritis and is characterized by highly variable renal outcomes. Conventional prognostic factors, including proteinuria, hypertension, estimated glomer...
PURPOSE: IgA nephropathy (IgAN) is the most common primary glomerulonephritis and is characterized by highly variable renal outcomes. Conventional prognostic factors, including proteinuria, hypertension, estimated glomerular filtration rate (eGFR), and the MEST-C classification, provide limited predictive accuracy. This study aimed to evaluate the prognostic value of inflammatory and nutritional indices, particularly the Hemoglobin-Albumin-Lymphocyte-Platelet (HALP) score, in patients with IgAN. PATIENTS AND METHODS: This retrospective cohort included 204 patients with biopsy-proven IgAN. Baseline demographic, clinical, laboratory, and histopathological data were collected. Inflammatory and nutritional indices (HALP, Systemic Immune-Inflammation Index [SII], Neutrophil-to-Lymphocyte Ratio [NLR], Platelet-to-Lymphocyte Ratio [PLR], Glasgow Prognostic Score [GPS/mGPS], and Controlling Nutritional Status [CONUT]) were calculated from routine laboratory parameters. Associations with renal outcomes, particularly progression to end-stage kidney disease (ESKD), were analyzed using Cox regression, Kaplan-Meier survival, and receiver operating characteristic (ROC) analyses. RESULTS: During a median follow-up of 39.5 months, 17.1% of patients progressed to ESKD. Higher HALP scores were significantly associated with better renal survival, whereas other indices showed no consistent prognostic value. In multivariate analysis, HALP remained an independent predictor of renal outcome (hazard ratio = 0.13; < 0.001). ROC analysis confirmed its prognostic performance (AUC = 0.65; 95% CI: 0.56-0.74; < 0.001) with an optimal cut-off value of 42.4 (sensitivity: 72.7%; specificity: 55.0%). CONCLUSION: The HALP score is a strong and independent prognostic biomarker in IgAN, outperforming other inflammatory and nutritional indices. Incorporating HALP into current risk-stratification models may enhance prognostic assessment and guide clinical management.
Research Progress on Pathology, Molecular Mechanisms, and Intervention Strategies of Cognitive Dysfunction Associated with Type 2 Diabetes.
Zhou H, Ran Y, Jiang Y … +1 more , Li R
Int J Gen Med · 2026 · PMID 42038260 · Full text
Type 2 diabetes-associated cognitive dysfunction (DACD) is a major neurological complication of type 2 diabetes mellitus (T2DM). Against the backdrop of global population aging and the rising prevalence of T2DM, DACD pos...
Type 2 diabetes-associated cognitive dysfunction (DACD) is a major neurological complication of type 2 diabetes mellitus (T2DM). Against the backdrop of global population aging and the rising prevalence of T2DM, DACD poses a substantial challenge to public health. The pathogenesis of DACD involves the interplay of multiple signaling pathways and pathological processes, which remain incompletely understood. This review aims to systematically delineate the interconnections and regulatory networks among core mechanisms in DACD, including glucose transporter dysfunction, the oxidative stress-mitochondrial dysfunction-neuroinflammation axis, ferroptosis, the microbiota-gut-brain axis, autophagy, and epigenetic modifications. By integrating recent research advances in these mechanisms, this review provides a comprehensive understanding of the pathology of DACD and proposes multi-target intervention strategies from an integrated perspective, thereby offering insights for the development of future therapeutic approaches. This integrated framework is expected to provide new theoretical perspectives for clinicians and translational medicine researchers, to promote the development of diagnostic tools integrating multi-omics biomarkers, and to offer references for optimizing combination treatment strategies targeting key nodes across multiple mechanisms. The primary limitation of this review is that the conclusions are based predominantly on preclinical evidence; future clinical translation will require further validation through large-scale studies.
Prognostic Nutritional Index is Independently Associated with Major Adverse Cardiovascular Events in Patients with Triple - Vessel Disease: A Retrospective Cohort Study.
Wang M, Lei Y, Xue Y
Int J Gen Med · 2026 · PMID 42028556 · Full text
OBJECTIVE: Current evidence indicates that nutrition plays an important role in cardiovascular disease risk monitoring and prognosis assessment. Therefore, this study aimed to evaluate the correlation between the prognos...
OBJECTIVE: Current evidence indicates that nutrition plays an important role in cardiovascular disease risk monitoring and prognosis assessment. Therefore, this study aimed to evaluate the correlation between the prognostic nutritional index (PNI) and major adverse cardiovascular events (MACE) in patients with triple - vessel coronary heart disease (TV - CHD). METHODS: In this single - center retrospective cohort study, 547 patients with TV - CHD admitted to Liaocheng People's Hospital from January 2020 to January 2023 were enrolled. Univariate and multivariate Cox regression analyses, subgroup and sensitivity analyses, receiver operating characteristic (ROC) curve analysis, and Kaplan - Meier survival analysis were performed to assess the association between PNI and time to first MACE. RESULTS: During a median follow - up period of 38.5 months, 176 MACE events occurred (32.2%). Multivariate Cox regression analysis showed that after adjusting for all confounding factors, each one - unit increase in PNI was associated with a 2.9% reduction in MACE risk (HR 0.971, 95% CI 0.947-0.997, P = 0.026). Compared with the T1 group, the T3 group had a 34.5% lower risk of MACE (HR 0.655, 95% CI 0.447-0.960, P = 0.030). Multiple subgroup and sensitivity analyses further confirmed the robustness of the results. Time - dependent ROC analysis indicated that PNI had modest predictive value for MACE risk (overall population: time=dependent AUC at 12, 24, and 36 months were 0.588, 0.575, and 0.562). Kaplan - Meier survival curves demonstrated significant differences in cumulative MACE risk among PNI tertiles, with the T1 group having the poorest prognosis (Log - rank P = 0.010). CONCLUSION: Lower PNI levels are independently associated with an increased risk of MACE in TV - CHD patients. Given its modest discriminatory ability, PNI should be considered a readily available, cost - effective supplementary biomarker that may provide adjunctive prognostic value in the comprehensive assessment of this high - risk population.
Development and Validation of a Prediction Model for Intensive Care Unit-Acquired Weakness in Adult Patients with Sepsis: A Prospective, Observational, Single-Center Study.
Wang B, Liu Y, He G … +5 more , Sun S, Han J, Zhang M, He L, Meng S
Int J Gen Med · 2026 · PMID 42016800 · Full text
PURPOSE: This study aimed to develop and validate a clinical prediction model for intensive care unit-acquired weakness (ICU-AW) in sepsis patients, in order aid the early identification of high-risk patients and enable...
PURPOSE: This study aimed to develop and validate a clinical prediction model for intensive care unit-acquired weakness (ICU-AW) in sepsis patients, in order aid the early identification of high-risk patients and enable targeted intervention measures. PATIENTS AND METHODS: This prospective observational study was a single-center study conducted in a tertiary hospital in Shenzhen, China. Eligible inpatients diagnosed with sepsis between January 2023 and June 2024 were enrolled. The least absolute shrinkage and selection operator (LASSO) regression model was used to optimize the feature selection for the risk prediction model for ICU-AW in sepsis patients. Multivariable logistic regression analysis was applied to build a predicting model that incorporated the features selected in the LASSO regression model. Receiver operating characteristic (ROC) and calibration curves, and decision curve analysis (DCA) were applied to assess the model. RESULTS: A total of 344 patients were included in the present study. Among these patients, 257 and 87 patients were assigned to the modeling and validation groups, respectively. Six independent predictors were identified: age, multiple organ dysfunction syndrome (MODS), use of neuromuscular blocking agents (NMBAs), duration of mechanical ventilation, duration of sedation, and Acute Physiology and Chronic Health Evaluation II (APACHE II) score. The nomogram revealed good performance, with an area under the ROC curve (AUC) of 0.905 (95% CI: 0.871-0.940) for the modeling group and 0.861 (95% CI: 0.784-0.939) for the validation group. The calibration curves indicated a good agreement between the predicted and observed outcomes. The DCA demonstrated a broad benefit threshold and good clinical effectiveness. CONCLUSION: The risk prediction model constructed in the present study demonstrated good predictive performance, providing a valuable reference for clinical practitioners to identify the risk of ICU-AW in patients with sepsis and implement prompt intervention.
Network Pharmacology-Serum Metabolomics Integration Identifies Key Targets, Biomarkers and Mechanism of Sendeng-4 in Rheumatoid Arthritis Therapy.
Zhou F, Li J, Zhou Y … +6 more , Zhang X, Luo J, Li X, Sun W, Zhang Q, Li M
Int J Gen Med · 2026 · PMID 42016799 · Full text
PURPOSE: Rheumatoid arthritis (RA) is characterized by chronic inflammatory synovitis and immunometabolic dysregulation, necessitating safer multi-target therapies. Sendeng-4 (SD-4) is a traditional Mongolian medicinal f...
PURPOSE: Rheumatoid arthritis (RA) is characterized by chronic inflammatory synovitis and immunometabolic dysregulation, necessitating safer multi-target therapies. Sendeng-4 (SD-4) is a traditional Mongolian medicinal formula composed of four botanical ingredients ( Bunge, Ellis, , and ) traditionally used for RA. However, its circulating material basis and mechanisms remain unclear. This study aimed to elucidate the pharmacodynamic constituents and potential mechanisms of SD-4 in RA. METHODS: An integrative approach combining serum pharmacochemistry, network pharmacology, molecular docking, in vivo pharmacodynamics, and non-targeted serum metabolomics was employed. Absorbable constituents of SD-4 were identified by HPLC-Q-Exactive-Orbitrap-MS. Key targets and pathways were explored using network analysis, and therapeutic efficacy and metabolomic biomarkers were evaluated in a collagen-induced arthritis mouse model. RESULTS: Twenty absorbable constituents were detected, with SRC, PIK3CA, and PIK3R1 emerging as key targets involved in PI3K-AKT and HIF-1 signaling. SD-4 treatment significantly reduced arthritis scores (by up to 45% in high-dose mice), paw thickness, and serum pro-inflammatory cytokines (TNF-α, IL-6, IL-1β decreased by 30-55%, all P < 0.05). Serum metabolomics identified 46 disease-associated metabolites reversed by SD-4, particularly involving tryptophan metabolism and glycolysis/gluconeogenesis. Correlation analyses suggest these metabolic changes are associated with modulation of inflammatory pathways. CONCLUSION: SD-4 alleviates arthritis in mice, likely through modulation of the PI3K/SRC network and partial rebalancing of glycolysis-tryptophan metabolic crosstalk, restoring immunometabolic homeostasis. These findings support the potential clinical application of SD-4 for RA and provide a mechanistic framework for its multi-target actions.
Machine Learning-Based Ultrasound Radiomics Signature: A Retrospective Analysis for Differentiating Benign from Malignant Non-Mass Lesions in Dense Breasts.
Chen W, Xiong Y, Ke Z
Int J Gen Med · 2026 · PMID 42016798 · Full text
OBJECTIVE: The purpose of this study is to establish and validate a machine learning based ultrasound radiomics feature that combines clinical and ultrasound features, which can be used to identify benign and malignant n...
OBJECTIVE: The purpose of this study is to establish and validate a machine learning based ultrasound radiomics feature that combines clinical and ultrasound features, which can be used to identify benign and malignant non mass lesions (NML) of dense breast and evaluate its diagnostic value. METHODS: This study is a retrospective single center study. We included 619 patients with dense breast NML diagnosed by ultrasound from January 2017 to January 2023. The patients were randomly divided into training group (n=434) and validation group (n=185) according to the ratio of 7:3. About 848 radiomics features were extracted from two-dimensional ultrasound images and screened by lasso regression. The clinical model, ultrasound model, radiomics model and combined model were established. The diagnostic performance was evaluated by ROC curve, correction curve and decision curve analysis (DCA), and the model differences were compared by Delong test. RESULTS: There were 304 cases of malignant lesions and 315 cases of benign lesions confirmed by postoperative pathology. Multivariate logistic regression analysis showed that age, lesion length, microcalcification, surrounding structure distortion and blood flow were independent predictors of malignancy. Twelve non-zero coefficient radiomics features were selected to construct the radiomics features. The AUC of the combined model was the highest, the training set was 0.89 (95% CI: 0.86-0.92), and the validation set was 0.83 (95% CI: 0.78-0.89). Delong test showed that there were significant differences between the combined model and the other three single models (all p<0.05). The calibration curve showed good consistency in predicting the actual pathology, and DCA verified its best clinical application value. CONCLUSION: We successfully combine ultrasound imaging, clinical and ultrasound features to build a prediction model, which has a good diagnostic effect on the differentiation of benign and malignant breast dense non-small cell lymphoma, and provides a reliable basis for clinical treatment decision-making of breast cancer.
Methodological Considerations for CAUTI Risk Prediction in Stroke Patients [Letter].
Liu M, Liu Y
Int J Gen Med · 2026 · PMID 42016797 · Full text
Abstract loading — click title to view on PubMed.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe