International Journal Of General Medicine[JOURNAL]
Sun
200 papers
Olfactory Decline in Elderly at High Altitudes: A Narrative Review.
Chen X, Guo Y
Int J Gen Med · 2026 · PMID 42016796 · Full text
Olfactory dysfunction is highly prevalent in the elderly population, severely affecting nutritional status, environmental safety perception, and quality of life, and is recognized as an early warning marker of neurodegen...
Olfactory dysfunction is highly prevalent in the elderly population, severely affecting nutritional status, environmental safety perception, and quality of life, and is recognized as an early warning marker of neurodegenerative diseases. Compared with populations living at low altitudes, residents at high altitudes are chronically exposed to combined extreme environmental conditions including hypoxia, low temperature, and low humidity, which may lead to more complex and severe degenerative changes in the olfactory system. However, existing evidence remains fragmented, and a systematic synthesis is lacking. This narrative review aims to systematically integrate the epidemiological characteristics, pathophysiological mechanisms, diagnostic assessment tools, intervention strategies, and health risks associated with olfactory decline in elderly residents at high altitudes. Epidemiological evidence shows a significant negative correlation between altitude and olfactory function, and the effects of aging are substantially amplified under high-altitude conditions. The underlying mechanisms primarily involve chronic hypoxia interacting with aging and genetic susceptibility through damage to olfactory ensheathing cells, suppression of olfactory neurogenesis, and remodeling of synaptic plasticity in olfactory-related brain regions. Olfactory behavioral testing combined with functional magnetic resonance imaging and emerging biomarkers provides multidimensional tools for early diagnostic stratification. Although oxygen therapy, olfactory training, and environmental management have shown potential efficacy, evidence-based data specific to this population remain limited. The core value of this review lies in adopting an integrated perspective of "environment-aging" interactions to systematically elucidate the combined effects of high-altitude stress and age-related degenerative changes on the olfactory system, revealing the unique patterns and intervention targets for olfactory dysfunction in this vulnerable population. Future research urgently needs large-scale longitudinal cohort studies, establishment of altitude-specific normative olfactory assessment tools, and development of precision interventions targeting hypoxic injury to improve overall health outcomes in this population.
In-Hospital Mortality and Predictors Among People with Diabetes in Lubumbashi, Democratic Republic of the Congo: A Prospective Observational Study.
Kamalo BMK, Musung JM, Yumba GN … +3 more , Kakisingi CN, Mukuku O, Mwamba CM
Int J Gen Med · 2026 · PMID 42016795 · Full text
BACKGROUND: Diabetes mellitus (DM) is a growing public health challenge in sub-Saharan Africa, where limited diagnostic capacity and delayed care contribute to high morbidity and mortality. However, data on in-hospital m...
BACKGROUND: Diabetes mellitus (DM) is a growing public health challenge in sub-Saharan Africa, where limited diagnostic capacity and delayed care contribute to high morbidity and mortality. However, data on in-hospital mortality determinants among people with diabetes in the Democratic Republic of the Congo (DRC) are scarce. This study assessed in-hospital mortality and predictors among people with diabetes admitted to tertiary hospitals in Lubumbashi. METHODS: A prospective observational cohort study was conducted over 20 months (January 2022-August 2023) in three hospitals in Lubumbashi. A total of 324 adults (≥18 years) with confirmed DM were enrolled and prospectively followed from hospital admission until discharge or death. Sociodemographic, clinical, laboratory, and treatment-related data were collected using standardised forms. The primary outcome was in-hospital mortality within 60 days of admission. Kaplan-Meier analysis was performed to estimate 60-day survival, and the Log rank test was used to compare survival distributions. Cox proportional hazards regression identified independent predictors of mortality, with adjusted hazard ratios (aHRs) and 95% confidence intervals (95% CIs) reported. RESULTS: Of the 324 hospitalised people with diabetes, 41 deaths occurred, yielding an in-hospital mortality rate of 12.7%. The deceased patients had a mean time to death of 4.9±4.1 days. The overall restricted mean survival time for the cohort was 53.0±1.0 days. Several factors were independently associated with increased mortality: older age (aHR=1.05; 95% CI: 1.03-1.09; p<0.001), stroke (aHR=4.53; 95% CI: 1.64-12.55; p=0.004), hyperosmolar hyperglycemic state (aHR=3.15; 95% CI: 1.16-8.60; p=0.025), meningoencephalitis (aHR=5.84; 95% CI: 1.60-21.24; p=0.007), chronic kidney disease (aHR=5.20; 95% CI: 1.43-18.89; p=0.012), and sepsis (aHR=5.85; 95% CI: 2.57-13.34; p<0.001). CONCLUSION: In-hospital mortality among people with diabetes in Lubumbashi is substantial and comparable to rates reported in other African settings. Mortality is strongly associated with advanced age, acute neurological events, severe metabolic derangements, infectious complications, and chronic kidney disease.
Peripheral Blood HIST1H2AE is a Candidate Epigenetic Biomarker for Coronary Artery Disease: A Multi-Dataset Discovery and Comparative Validation Study.
Xu L, Wang Y, Ji H … +7 more , Shan Y, Zhang J, Yang L, Du W, Jiang J, Chen J, Cao R
Int J Gen Med · 2026 · PMID 42011357 · Full text
OBJECTIVE: To identify peripheral blood biomarker candidates for coronary artery disease (CAD) and to test whether bioinformatically prioritized genes replicate in an angiography-confirmed cohort, with emphasis on HIST1H...
OBJECTIVE: To identify peripheral blood biomarker candidates for coronary artery disease (CAD) and to test whether bioinformatically prioritized genes replicate in an angiography-confirmed cohort, with emphasis on HIST1H2AE as an epigenetically relevant marker. METHODS: Differentially expressed genes (DEGs) were identified from three GEO datasets (GSE42148, GSE98583, GSE12288) after within-dataset normalization; DEGs were then intersected across datasets to prioritize robust candidates while avoiding direct cross-study merging and associated batch effects. Enrichment analysis and protein-protein interaction network prioritization were performed, followed by independent in silico evaluation in GSE20681 using receiver operating characteristic (ROC) analysis. HIST1H2AE and CXCL14 were then tested by qPCR in peripheral blood from 20 participants (10 angiography-confirmed CAD; 10 non-CAD controls). Immune cell proportions in GSE20681 were estimated with CIBERSORTx, and correlations with hub-gene expression were assessed. RESULTS: Eight DEGs were consistently shared across the three discovery datasets, and HIST1H2AE and CXCL14 were prioritized as hub candidates. In GSE20681, ROC analysis suggested discriminatory ability for both genes (AUC=0.711 for HIST1H2AE; AUC=0.878 for CXCL14). In the angiography-confirmed qPCR cohort, CXCL14 was not consistently different between groups, whereas HIST1H2AE was significantly downregulated in CAD. HIST1H2AE expression showed no significant correlation with estimated immune cell proportions. CONCLUSION: This multi-dataset discovery and comparative validation framework prioritizes HIST1H2AE as a peripheral blood biomarker candidate for CAD with an immune-independent expression profile in the analyses performed. Given the small qPCR cohort, these findings are preliminary and require confirmation in larger, independent cohorts and mechanistic studies of chromatin-level regulation.
METTL16 Promotes Cerebral Ischemia-Reperfusion Injury via mA-Dependent Upregulation of TIPARP.
Xiang M, Han J, Ye Z … +2 more , Chen B, Wang H
Int J Gen Med · 2026 · PMID 42004240 · Full text
BACKGROUND: Ischemic stroke leads to severe cerebral ischemia/reperfusion (I/R) injury, resulting in neuronal death and neurological deficits. The N-methyladenosine (mA) methyltransferase METTL16 has emerged as a key reg...
BACKGROUND: Ischemic stroke leads to severe cerebral ischemia/reperfusion (I/R) injury, resulting in neuronal death and neurological deficits. The N-methyladenosine (mA) methyltransferase METTL16 has emerged as a key regulator of RNA metabolism, but its specific role and mechanism in ischemic stroke remain unclear. METHODS: A transient middle cerebral artery occlusion (MCAO) model was established in adult male C57BL/6J mice. METTL16 was knocked down via intracerebroventricular injection of shRNA-expressing lentivirus at 6 hours post-reperfusion. Cerebral infarct volume (TTC staining), neurological function (mNSS, adhesive removal, corner-turning, and rotarod tests), histopathology (H&E, TUNEL, Nissl, NeuN), and apoptosis-related protein expression were evaluated. Primary cortical neurons and astrocytes were subjected to oxygen-glucose deprivation (OGD). Cell apoptosis, LDH release, inflammatory cytokines (TNF-α, IL-1β), and synaptic protein (Synapsin-1, PSD-95) expression were assessed. The METTL16-TIPARP interaction and mA modification were analyzed by RIP and mA-RIP-qPCR. Protein stability was determined using cycloheximide chase assay. Rescue experiments were performed by overexpressing TIPARP in METTL16-depleted cells. RESULTS: METTL16 knockdown significantly reduced infarct volume, attenuated neuronal apoptosis and inflammation, and improved sensorimotor and coordination functions after MCAO. In vitro, METTL16 depletion protected neurons and astrocytes from OGD-induced apoptosis, cytokine release, and synaptic damage. Mechanistically, METTL16 directly bound to TIPARP mRNA and enhanced its mA modification, thereby stabilizing TIPARP transcripts and upregulating TIPARP protein expression. Critically, TIPARP overexpression completely abolished the protective effects of METTL16 knockdown against OGD-induced apoptosis and synaptic impairment. CONCLUSION: METTL16 promotes cerebral I/R injury by stabilizing TIPARP mRNA via mA methylation, leading to elevated TIPARP expression. The METTL16-mA-TIPARP axis represents a novel pathogenic mechanism and a potential therapeutic target for ischemic stroke.
Chinese Patent Medicines for Cervical Spondylosis: A Comprehensive Review and Current Status of Clinical Research.
Fan Y, Sun Y, Lou H … +5 more , Ji Y, Chang T, Cui Y, Yao J, Shang Q
Int J Gen Med · 2026 · PMID 42004239 · Full text
In this study, an overview review method was employed to systematically categorize proprietary Chinese patent medicines (CPM) for cervical spondylosis listed in the national authoritative drug catalogues and assess their...
In this study, an overview review method was employed to systematically categorize proprietary Chinese patent medicines (CPM) for cervical spondylosis listed in the national authoritative drug catalogues and assess their current clinical research status. Literature management and data extraction were performed by searching the databases (updated until January 26, 2025) using EndNote and Excel, and the results were presented visually. A total of 31 proprietary CPMs were included in the study, with activation of blood circulation and removal of blood stasis being the most common therapeutic effects. Involving 112 medicinal ingredients, Pueraria lobata Radix is the most commonly used Chinese medicine ingredient. A total of 130 articles were screened from the literature, with the highest number of studies focusing on Jingtong granules (tablets) (24.62%). The number of studies peaked in 2023, with 77.69% of the studies being randomized controlled trials. Among these, 126 were clinical trial studies, with a maximum sample size of 528 participants. The most common intervention regimen involved CPM combined with western medicines versus western medicines alone (17.46%). The intervention duration was 4 weeks (25.40%), with the main outcome measure being the "Total Effective Rate (TER)" (86.51%). This study demonstrates that CPM has strong potential for treating cervical spondylosis. However, issues remain, such as incomplete information in some drug instructions and the lack of standardization in clinical studies, which require further improvement.
The "Dilution Effect" of Augmented Renal Clearance on the Prognostic Utility of NT-proBNP in Patients with Severe Traumatic Brain Injury.
Dong J, Zhang Q, Huang M … +3 more , Zhou J, Zhou S, Zhu D
Int J Gen Med · 2026 · PMID 42004238 · Full text
BACKGROUND: Augmented renal clearance (ARC) constitutes a prevalent phenomenon in patients with severe traumatic brain injury (sTBI). Although N-terminal pro-B-type natriuretic peptide (NT-proBNP) serves as a valuable pr...
BACKGROUND: Augmented renal clearance (ARC) constitutes a prevalent phenomenon in patients with severe traumatic brain injury (sTBI). Although N-terminal pro-B-type natriuretic peptide (NT-proBNP) serves as a valuable prognostic biomarker, its renal clearance may be accelerated in the presence of ARC, theoretically compromising its predictive accuracy. The present study aimed to quantify this "dilution effect" and construct an ARC-adjusted nomogram to optimize mortality prediction. METHODS: This retrospective cohort study enrolled 352 patients with sTBI admitted to the Geriatrics ICU between June 2020 and June 2024. ARC defined as creatinine clearance >130 mL/min/1.73 m. Patients were stratified into ARC and Non-ARC cohorts. To mitigate baseline demographic confounders, propensity score matching (PSM) was employed. The primary endpoint was 28-day mortality. The impact of ARC on serum NT-proBNP concentrations and its subsequent prognostic value was evaluated using receiver operating characteristic (ROC) curves, logistic regression, and decision curve analysis (DCA). NT-proBNP values were log-transformed and included the continuous NRI value to quantify the incremental predictive power of the new model. RESULTS: Within the original cohort, 141 patients (40.1%) exhibited ARC. In the matched cohort (n=186), patients with ARC demonstrated significantly lower serum NT-proBNP levels compared to the Non-ARC group (P=0.0089), suggesting a distinct biomarker dilution effect. Multivariate analysis identified ARC status as an independent protective factor for mortality, whereas elevated NT-proBNP persisted as a risk factor. Consequently, the predictive accuracy of NT-proBNP was markedly attenuated in the ARC group (AUC=0.637) relative to the Non-ARC group (AUC=0.833). A novel nomogram integrating ARC status, Age, log-NT-proBNP, APACHE II, and Hypertension was developed. This ARC-adjusted model exhibited improved risk stratification capabilities (continuous NRI=0.590) and yielded a higher net clinical benefit than the baseline model. CONCLUSION: ARC is associated with significantly depressed serum NT-proBNP levels in sTBI patients, suggesting a "dilution effect" driven by enhanced renal elimination. Clinicians should interpret NT-proBNP levels with caution in this population, as reliance on standard cutoff values may lead to an underestimation of mortality risk.
Phosphatidylethanolamine Alleviates Osteoarthritis Progression by Inhibiting Oxidative Stress-Induced Chondrocyte Ferroptosis in a Lysosomal-Dependent Manner.
Zheng H, Zhu Z, Zhu J … +3 more , Chen D, Ruan R, Ning R
Int J Gen Med · 2026 · PMID 42004237 · Full text
PURPOSE: Lysosomal dysfunction and chondrocyte ferroptosis are pivotal drivers of osteoarthritis (OA) pathogenesis, yet their interlinked molecular mechanisms remain poorly defined. This study investigates the associatio...
PURPOSE: Lysosomal dysfunction and chondrocyte ferroptosis are pivotal drivers of osteoarthritis (OA) pathogenesis, yet their interlinked molecular mechanisms remain poorly defined. This study investigates the associations between lysosomal dysfunctions and ferroptosis in OA chondrocytes, aiming to identify actionable therapeutic targets. PATIENTS AND METHODS: Human OA cartilage samples were categorized into intact and damaged groups based on structural integrity. Lysosomal fractions were isolated from both groups for comparative lipidomic profiling and functional assays. A rat OA model was established via anterior cruciate ligament transection, followed by histopathological evaluation using hematoxylin-eosin (HE) staining, Safranin-O Fast Green scoring, and immunohistochemical analysis to quantify cartilage repair and degeneration. RESULTS: The damaged groups displayed significantly increased lysosomal membrane permeability (LMP) and ferroptosis activation compared to intact groups. Lysosomal lipidomics revealed oxidative stress-induced down-regulation of phosphatidylethanolamine (PE), a key membrane-stabilizing phospholipid, in chondrocytes. Functional studies demonstrated that PE supplementation rescued chondrocyte viability (CCK-8 assay) and attenuated LMP-driven ferroptosis by restoring lysosomal integrity and suppressing lipid peroxidation. In vivo, intra-articular PE administration markedly reduced OA progression, as evidenced by improved cartilage histology scores, and downregulated ferroptosis markers. CONCLUSION: PE supplementation restores lysosomal PE levels, reduces LMP, and alleviates ferroptotic phenotypes in preclinical models, suggesting therapeutic potential. These findings significantly increase our understanding of the pathogenesis of OA and reveal potential therapeutic targets for its management.
Metabolic Regulatory Networks in Ferroptosis During Alzheimer's Disease, Mechanisms of Glial Cell Action, and Pathological Correlations with Neuritic Plaques.
Zhang B, Zhang M
Int J Gen Med · 2026 · PMID 42004236 · Full text
Alzheimer's disease (AD) is a neurodegenerative disease with a complex pathological mechanism, which is still poorly understood. Ferroptosis is a type of non-apoptotic programmed cell death. Many recent studies have foun...
Alzheimer's disease (AD) is a neurodegenerative disease with a complex pathological mechanism, which is still poorly understood. Ferroptosis is a type of non-apoptotic programmed cell death. Many recent studies have found that ferroptosis is closely related to the occurrence and development of AD. This article explains the main theoretical basis of ferroptosis in the pathological development of AD, and systematically analyzes the synergistic pathological network of multiple pathways caused by iron metabolism disorder, abnormal lipid peroxidation, and abnormal amino acid metabolism. This article mainly focuses on the dual regulation mechanism and molecular mechanism of microglia, astrocytes, and oligodendrocytes in the process of ferroptosis. This article studies the two-way relationship between neuritic plaques (NP) and ferroptosis, and the relationship between NP and dystrophic neurites, inflammatory response, and abnormal tau phosphorylation. Based on the existing research, we propose several unanswered questions and possible targeted research directions to provide a theoretical reference for the study of AD pathogenesis and the exploration of intervention strategies.
Laboratory Biomarker Profiles and Phenotypic Discrimination in Coronary Artery Disease with Metabolic and Renal Comorbidities: A Cross-Sectional Study.
Lai X, Zhong S, Lin C … +2 more , Cheng Z, Li H
Int J Gen Med · 2026 · PMID 42004235 · Full text
BACKGROUND: Coronary artery disease (CAD) frequently coexists with metabolic and renal comorbidities, including type 2 diabetes mellitus (T2DM), hyperuricemia (HUA), and chronic kidney disease (CKD), which may influence...
BACKGROUND: Coronary artery disease (CAD) frequently coexists with metabolic and renal comorbidities, including type 2 diabetes mellitus (T2DM), hyperuricemia (HUA), and chronic kidney disease (CKD), which may influence laboratory biomarker profiles. This study aimed to characterize haematological, biochemical, and urinary parameters across CAD phenotypes and identify laboratory predictors associated with these comorbidity patterns. METHODS: A retrospective cross-sectional study was conducted at Guangzhou Liwan Central Hospital between January 1 and December 31, 2024, including 544 adult patients with CAD. Diagnoses of CAD, T2DM, HUA, and CKD were defined according to established clinical criteria documented in hospital electronic medical records. Patients were stratified into seven phenotypic subgroups based on the presence of T2DM, HUA, and CKD. Demographic characteristics and laboratory parameters-including haematological indices, biochemical markers, and urinary findings-were extracted from electronic records. Between-group comparisons were performed using ANOVA and chi-square tests, and multivariable logistic regression was used to identify laboratory predictors associated with CAD comorbidity phenotypes. RESULTS: Significant differences in demographic and laboratory parameters were observed across CAD phenotypes. Gender distribution differed significantly between groups (p = 0.004). The CAD+HUA group had the highest mean age (84.7 ± 10.1 years), whereas the CAD+T2DM+CKD group had the lowest (76.4 ± 11.0 years; p = 1.77 × 10 ). Multivariable logistic regression identified leukocyte esterase positivity (OR 2.41, 95% CI 1.38-4.19), β2-microglobulin (OR 1.52, 95% CI 1.16-2.01), potassium (OR 1.37, 95% CI 1.08-1.74), glucosuria (OR 0.58, 95% CI 0.35-0.96), nitrite positivity (OR 1.89, 95% CI 1.07-3.34), and serum calcium (OR 0.73, 95% CI 0.55-0.96) as significant predictors of CAD comorbidity phenotypes. CONCLUSION: Haematological, biochemical, and urinary biomarkers differ across CAD phenotypes with metabolic and renal comorbidities. These laboratory indicators show moderate discriminatory potential for identifying CAD comorbidity patterns, although further validation in larger prospective cohorts is required.
Determinants of Suboptimal INR Control in Eritrean Post-Cardiac Surgery Patients: Insights from a Low-Resource Setting.
Mengistu ST, Siyum DH, Teklemariam HM … +8 more , Gebremedhin H, Habteab BN, Yeshitila ET, Kidane MM, Negash SA, Berhe NT, Weldu LG, Seyoum Y
Int J Gen Med · 2026 · PMID 41994589 · Full text
BACKGROUND: Warfarin remains the mainstay of long-term anticoagulation in low-resource settings; however, maintaining optimal international normalized ratio (INR) control is challenging, particularly in countries with li...
BACKGROUND: Warfarin remains the mainstay of long-term anticoagulation in low-resource settings; however, maintaining optimal international normalized ratio (INR) control is challenging, particularly in countries with limited follow-up services. In Eritrea, patients requiring lifelong anticoagulation often undergo cardiac surgery abroad yet face barriers to consistent INR monitoring upon return. OBJECTIVE: To identify demographic, clinical, and treatment-related factors associated with poor anticoagulation control among Eritrean patients on long-term warfarin following cardiac surgery. METHODS: We conducted a retrospective observational cohort study of Eritrean adults (≥18 years) who underwent cardiac surgery at the Salam Centre for Cardiac Surgery in Sudan and returned to Eritrea for follow-up. Data were collected from patients followed between February 2020 and July 2021 (median follow-up: 60 days, IQR: 24-120 days). INR control was assessed using Time in Therapeutic Range (TTR) via the Rosendaal method. Linear mixed-effects modeling identified predictors of INR variability. RESULTS: Ninety-three patients (37.5% male, median age 45 years) met inclusion criteria. Median TTR was 47.8% (IQR: 33.2-62.9%), with only 25% achieving optimal control (TTR ≥60%). Valvular heart disease was the leading indication (62%), with 67% having metallic valve replacement. Mixed-effects modeling identified mechanical valve replacement (exp(β)=1.26, 95% CI: 1.17-1.37), higher therapeutic target (exp(β)=1.21), COPD/asthma (exp(β)=0.71), and specific co-medications (aspirin, digoxin, enalapril) as significant determinants of INR variability. CONCLUSION: In this cohort, anticoagulation control was suboptimal for the majority. Mechanical valve replacement, therapeutic targets, and specific co-medications were significant determinants of INR variability. These findings, while limited by sample size and single-center design, suggest that targeted medication review and individualized therapeutic targets may improve anticoagulation outcomes in similar low-resource settings.
Nasotracheal Versus Orotracheal Intubation in Critically Ill COVID-19 Patients: A Retrospective Study.
Zhang YL, Zou HD, Dai RP … +1 more , Luo RY
Int J Gen Med · 2026 · PMID 41994588 · Full text
BACKGROUND: This study aimed to compare the clinical efficacy of nasotracheal intubation (NTI) versus orotracheal intubation (OTI) in severe COVID-19 pneumonia patients requiring mechanical ventilation. METHODS: In this...
BACKGROUND: This study aimed to compare the clinical efficacy of nasotracheal intubation (NTI) versus orotracheal intubation (OTI) in severe COVID-19 pneumonia patients requiring mechanical ventilation. METHODS: In this retrospective, propensity score-matched cohort study, we consecutively enrolled 45 critically ill adults with COVID-19 who underwent NTI. These patients were matched 1:1 by age and sex with 45 controls who received OTI. Data on sedative, analgesic, and neuromuscular blocking agent (NMBA) usage, tracheotomy incidence, intubation-related complications, and ICU length of stay were extracted from medical records. Multivariable logistic regression was performed to assess the independent association between intubation route and tracheotomy risk. RESULTS: Patients in the NTI group had significantly lower requirements for continuous infusion of sedatives, analgesics, and NMBAs compared with the OTI group (all P < 0.001). The incidence of tracheotomy was significantly lower in the NTI group (6.7% vs. 26.7%, P = 0.011). Multivariable logistic regression analysis, adjusted for age, sex, BMI, PaO/FiO, and SOFA score confirmed that NTI was independently associated with a reduced risk of tracheotomy (adjusted OR = 0.19, 95% CI: 0.04-0.78, P = 0.022). The incidence of oral ulcers was lower (P = 0.002). No significant differences were observed in other complications, including ventilator-associated pneumonia. CONCLUSION: In this retrospective study of patients with severe COVID-19 pneumonia, NTI was associated with reduced sedative, analgesic, and NMBA requirements, a lower risk of tracheotomy, and fewer oral complications, without increasing other major adverse events. Given the observational design, these findings should be considered hypothesis-generating, and prospective randomized trials are needed to confirm causality.
Non-Invasive Tests for the Detection of MASLD: Biomarkers and Imaging for Staging Steatosis, MASH, and Fibrosis.
Wang L, Wang Y
Int J Gen Med · 2026 · PMID 41987810 · Full text
Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) has become the predominant cause of liver diseases, with a rising incidence globally, has gained considerable attention. As a heterogeneous disease, it imp...
Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) has become the predominant cause of liver diseases, with a rising incidence globally, has gained considerable attention. As a heterogeneous disease, it imposes a significant economic burden on society and can progress to severe outcomes like cirrhosis, hepatocellular carcinoma (HCC) and even death. However, awareness, attention, and early intervention for MASLD are lacking, as the disease often starts insidiously and remains asymptomatic in its initial stages. The traditional diagnostic approaches, including liver biopsy and routine laboratory tests, are limited by their invasiveness, acceptance, and specificity. Similarly, imaging methods struggle with high costs and insufficient sensitivity. Early diagnosis and management of MASLD are critical to preventing the onset and decelerating the progression of liver fibrosis, thereby improving liver health. These challenges have prompted considerable efforts to develop non-invasive tests for diagnosing and managing MASLD. Using serum alone or in combination with imaging technology has the potential to improve early diagnostic accuracy, allowing clinicians to better assess and classify the disease. This article offers a comprehensive overview of the current state of non-invasive assessments for MASLD, discussing their applicability and exploring their potential in diagnosing and staging steatosis, MASH, and fibrosis, thereby enhancing patient management and care.
Impact of Clinical and Treatment Factors on Clinical Pregnancy and Live Birth in IVF/ICSI-ET: A Retrospective Cohort Study.
Xu J, Ni R, Shen K
Int J Gen Med · 2026 · PMID 41982819 · Full text
OBJECTIVE: This study aimed to evaluate the impact of clinical, hormonal, and embryologic factors on clinical pregnancy and live birth outcomes in in vitro fertilization/intracytoplasmic sperm injection and embryo transf...
OBJECTIVE: This study aimed to evaluate the impact of clinical, hormonal, and embryologic factors on clinical pregnancy and live birth outcomes in in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET). METHODS: This retrospective cohort analysis included Clinical, endocrine, and embryological data in 178 IVF/ICSI-ET cycles performed at a single reproductive medicine center from January 2020 to December 2024. Clinical pregnancy and live birth served as the primary outcomes. Statistical analyses included univariate and multivariate logistic regression and ROC curve analysis assessing the discriminative abilityof male age. RESULTS: Among the 139 IVF/ICSI-ET cycles meeting inclusion criteria, the clinical pregnancy rate was 51.8%, with a live birth rate of 38.1%. The pregnancy group exhibited significantly younger male age, lower basal AMH, shorter infertility duration, and more double-embryo transfers (all p < 0.05). Multivariate analysis identified male age as the sole independently associated factor of clinical pregnancy (OR = 0.85). ROC analysis indicated moderate discriminative abilityat a cut-off of 31.5 years (AUC = 0.620). Among pregnant patients, live birth was associated with younger female and male age, lower gonadotropin doses, and double-embryo transfer in univariate analysis (p < 0.05), but no independently associated factors were confirmed on multivariate analysis (p > 0.05). CONCLUSION: Male age appears to play a significant role in clinical pregnancy outcomes in IVF/ICSI-ET, highlighting the importance of incorporating paternal factors into fertility assessments.
Construction of a Risk Prediction Model for Stroke Occurrence in Septic Shock Patients: A Combined Analysis Using LASSO and Multivariate Logistic Regression.
Lai Z, Zhang H
Int J Gen Med · 2026 · PMID 41982818 · Full text
BACKGROUND: This study aimed to develop and validate a risk prediction model for stroke within 90 days in patients with septic shock and to identify independent risk factors. METHODS: A retrospective, single-center study...
BACKGROUND: This study aimed to develop and validate a risk prediction model for stroke within 90 days in patients with septic shock and to identify independent risk factors. METHODS: A retrospective, single-center study was performed, including 2127 septic shock patients admitted to Dongyang City People's Hospital from June 2016 to December 2024. Clinical variables were selected using LASSO regression, and the prediction model was established by multivariate logistic regression. Internal validation was conducted using nomogram, calibration curves, ROC curves, and decision curve analysis (DCA). RESULTS: Seven variables (age, hypertension, ALB, TC, Cr, TBIL, and WBC) were screened by LASSO regression. Multivariate analysis confirmed that age, hypertension, ALB, TC, and TBIL were independent risk factors. These factors may reflect age-related vascular vulnerability, chronic hypertension-related cerebrovascular damage, and metabolic or hepatic dysfunction associated with stroke risk in septic shock. The model showed good predictive performance, with AUCs of 0.754 and 0.76 in the modeling and testing cohorts, respectively. Calibration and DCA curves confirmed satisfactory discrimination, calibration, and clinical utility. CONCLUSION: This prediction model demonstrates favorable performance for stroke risk stratification in septic shock patients. It may allow early identification of high-risk individuals, enabling timely intervention to reduce stroke-related mortality and disability.
Deep Learning-Based Assessment of the Value of Vertebral Structural Parameters in Predicting Osteoporotic Vertebral Compression Fractures on Opportunistic CT Scans.
Qin J, Li J, Liang Y … +5 more , Yu M, Ran Z, Yao Q, Noor Shafini M, Ramli I
Int J Gen Med · 2026 · PMID 41982817 · Full text
BACKGROUND: Osteoporotic vertebral compression fractures are common fragility fractures in older adults and are associated with substantial disability and healthcare burden. Opportunistic CT may provide a practical no-ex...
BACKGROUND: Osteoporotic vertebral compression fractures are common fragility fractures in older adults and are associated with substantial disability and healthcare burden. Opportunistic CT may provide a practical no-extra-radiation pathway for fracture-risk assessment, but quantitative vertebral structural parameters, especially cortical parameters, remain insufficiently studied. PURPOSE: To evaluate the value of vertebral structural parameters derived from opportunistic CT in identifying osteoporotic vertebral compression fractures and to develop a nomogram for individualized risk estimation. METHODS: This retrospective single-center study included 298 patients aged 45 years or older who underwent chest or abdominal CT at the Second Affiliated Hospital of Shandong First Medical University between January 2020 and May 2024. Osteoporotic vertebral compression fracture status on sagittal CT was determined by two readers (one radiology resident and one senior physician) by consensus. A high-resolution 3D Dense-U-Net was used for automated vertebral segmentation and extraction of L1 structural parameters. Group comparisons were performed with t tests, one-way analysis of variance, and chi-squared tests as appropriate. Independent predictors were identified with univariate and multivariate logistic regression, and the nomogram was evaluated with receiver operating characteristic and calibration analyses. RESULTS: Of the 298 participants (182 men and 116 women; mean age, 62.33 ± 9.56 years), 134 had osteoporotic vertebral compression fractures and 164 did not. In multivariate analysis, L1 cortical average area (OR, 0.99; 95% CI, 0.99-1.00; = 0.002) and L1 cortical average thickness (OR, 0.22; 95% CI, 0.13-0.38; < 0.001) were independent predictors. The nomogram achieved an area under the curve of 0.867 (95% CI, 0.817-0.918) in the training cohort and 0.804 (95% CI, 0.709-0.899) in the validation cohort. CONCLUSION: Quantitative vertebral structural parameters derived from opportunistic CT, particularly cortical parameters, showed good performance for identifying osteoporotic vertebral compression fracture risk in this single-center cohort. These findings support the potential value of deep learning-assisted quantitative assessment for opportunistic screening, although external validation is still required before broader clinical implementation.
Machine Learning Analysis of Risk Factors for Catheter-Associated Urinary Tract Infections in Stroke Patients and Their Impact on Healthcare Quality.
Lu L, Li X, Cai D … +3 more , Mei C, Hong X, Xie J
Int J Gen Med · 2026 · PMID 41978636 · Full text
PURPOSE: Catheter-associated urinary tract infections (CAUTIs) represent a common complication among hospitalised stroke patients, exacerbating clinical outcomes and increasing healthcare burdens. This study aims to iden...
PURPOSE: Catheter-associated urinary tract infections (CAUTIs) represent a common complication among hospitalised stroke patients, exacerbating clinical outcomes and increasing healthcare burdens. This study aims to identify key risk factors for CAUTI in stroke patients using a random forest algorithm, construct and validate a clinical prediction model, and investigate the impact of CAUTIs on healthcare quality. METHODS: Data were retrospectively collected from 7486 stroke patients with indwelling urinary catheters at Guangdong Provincial Second Hospital of Traditional Chinese Medicine between January 2020 and December 2024. Patients were categorised into infection and non-infection groups based on CAUTI occurrence. Healthcare quality indicators including length of stay and hospitalisation costs were compared between groups. Random forest algorithm screening identified variables influencing infection, with a decision tree model constructed. Model performance was assessed using area under Receiver Operating Characteristiccurve (AUC), calibration curve, and decision curve analysis (DCA). RESULTS: Among 7486 patients, 248 developed CAUTI. Hospitalisation duration and costs were significantly higher in the infection group. Random forest identified three potential predictors: age, days of catheter use (DaysCAU), and time from admission to catheter insertion (TTCAU). Multivariate logistic regression confirmed ageand DaysCAU as independent risk factors for CAUTI. The constructed nomogram model demonstrated an AUC of 0.794 in the training cohort and 0.778 in the validation cohort. Calibration curves indicated good agreement between predicted and actual values, while DCA confirmed significant clinical net benefit within the 5-20% risk interval. CONCLUSION: Secondary CAUTI in stroke patients significantly prolongs hospital stays and increases healthcare costs. The predictive model based on age and catheterisation duration demonstrates favourable discriminatory performance and generalisability. It provides a practical tool for clinicians to identify high-risk patients early and formulate individualised prevention strategies, holding significant implications for enhancing healthcare quality.
Diabetic Neuropathy: From Etiopathogenesis to Integrative Therapeutic Strategies with Traditional Chinese Medicine.
Hu B, Aruna, Bao S … +2 more , Bao G, Aowuliji
Int J Gen Med · 2026 · PMID 41978635 · Full text
Diabetic neuropathy is a common and disabling complication of diabetes leading to numbness, pain, sensory loss and reduced quality of life. This review summarizes its diagnosis, epidemiology, genetic basis, pathophysiolo...
Diabetic neuropathy is a common and disabling complication of diabetes leading to numbness, pain, sensory loss and reduced quality of life. This review summarizes its diagnosis, epidemiology, genetic basis, pathophysiological mechanisms and current treatment strategies, with a focus on the role of traditional Chinese medicine (TCM). Its current common diagnostic methods include nerve conduction studies and corneal confocal microscopy. The development of diabetic neuropathy has been closely linked to chronic hyperglycemia, metabolic disorders, oxidative stress, inflammation, and mitochondrial dysfunction, and the current treatment mainly relies on glycemic control, neuroprotective agents, pain relief, exercise, and physical therapy, despite clinical benefits remain limited in many patients. TCM has shown potential value through herbal formulas, active natural compounds, acupuncture, moxibustion, and external therapies such as herbal foot baths, which have shown efficacies in relieving symptoms and protecting nerve function through antioxidant, anti-inflammatory, and autophagy-related effects, as well as regulation of gut microbiota. This review also highlights current research gaps, including uneven study quality, insufficient mechanistic evidence, and lack of standardized evaluation. Overall, we integrate recent basic and clinical evidence to provide a clearer framework for future research and more standardized development of TCM-based strategies for diabetic neuropathy.
Humoral Immune Response to SARS-CoV-2 in Children with Idiopathic Nephrotic Syndrome: A Cross-Sectional Exploratory Study.
Sandokji I, Abdullah S, Eskembaji M … +8 more , Fallatah AA, Hajjar M, Almutairi F, Alarabi AA, Syrafi MH, Imery M, Alshengeti A, Mahallawi W
Int J Gen Med · 2026 · PMID 41971034 · Full text
BACKGROUND: Children with idiopathic nephrotic syndrome face a high risk of infections due to an abnormal antibody response. This study aims to evaluate the humoral immunity in children with nephrotic syndrome against SA...
BACKGROUND: Children with idiopathic nephrotic syndrome face a high risk of infections due to an abnormal antibody response. This study aims to evaluate the humoral immunity in children with nephrotic syndrome against SARS-CoV-2. METHODS: This cross-sectional study assessed anti-spike SARS-CoV-2 IgG levels in children with nephrotic syndrome and compared them with those in the control group. Data on COVID-19 exposure and vaccination were collected from caregivers. Statistical analyses were performed using appropriate parametric and non-parametric tests, with a significance level set at p < 0.05. RESULTS: Thirty-five children (10 with nephrotic syndrome and 25 controls) were enrolled. Seropositivity rates were 60% in children with nephrotic syndrome versus 32% in controls (p = 0.15). Mean antibody levels were comparable between groups (0.74 ± 0.68 vs 0.89 ± 1.24, p = 0.64), with no statistically significant differences observed in children receiving steroid therapy. CONCLUSION: The humoral response to COVID-19 was similar in children with idiopathic nephrotic syndrome compared to control children, suggesting that routine vaccination schedules remain appropriate in this group. These findings suggest preserved antibody responses in this population; however, due to the exploratory nature of this study, larger studies are needed before clinical recommendations can be modified.
The Diagnostic Value of sdLDL-C for Acute Coronary Syndrome with Coexisting Hypertension and Carotid Atherosclerosis in Northeast China.
Li J, Dong Z, Wang D … +1 more , Cui J
Int J Gen Med · 2026 · PMID 41953379 · Full text
BACKGROUND: Current cardiovascular risk assessment relies heavily on conventional lipid parameters, which inadequately capture residual risk for acute coronary syndrome (ACS). Small dense low-density lipoprotein choleste...
BACKGROUND: Current cardiovascular risk assessment relies heavily on conventional lipid parameters, which inadequately capture residual risk for acute coronary syndrome (ACS). Small dense low-density lipoprotein cholesterol (sdLDL-C) exhibits heightened atherogenicity due to its unique physicochemical properties, yet its diagnostic utility for ACS in high-risk populations with multiple comorbidities remains undefined. Furthermore, population-specific evidence, particularly from Northeast China where cardiovascular disease prevalence is high, is limited. METHODS: This retrospective study enrolled 456 ACS patients and 100 healthy controls. Patients were stratified by hypertension (HT) grade and carotid intima-media thickness (CIMT). Receiver operating characteristic (ROC) analysis was performed to evaluate diagnostic efficacy and determine optimal cut-off values. An independent validation cohort (4 groups, n=100 each) was used to calculate positive predictive value (PPV) and negative predictive value (NPV). RESULTS: sdLDL-C levels were significantly higher in ACS patients vs. controls [0.78 vs. 0.42 mmol/L, < 0.001], showing an increasing trend with disease burden and peaking in the ACS with HT and abnormal CIMT group (ACS+HT+ACIMT). Multivariate logistic regression revealed the strongest association between sdLDL-C and the ACS+HT+ACIMT group, odds ratio (OR)=119.341. ROC analysis demonstrated the highest diagnostic efficacy for this group (area under the curve (AUC)=0.903), with an optimal cut-off of 0.621 mmol/L (sensitivity 88.70%, specificity 83.00%). In the validation cohort, the ACS+HT+ACIMT group achieved PPV of 89.36% and NPV of 84.91%, with narrower confidence intervals, indicating improved predictive accuracy. CONCLUSION: sdLDL-C exhibits significant diagnostic value in ACS patients, with efficacy increasing alongside disease burden, particularly in high-risk populations with HT and carotid atherosclerosis. The phenotype-specific cut-off (0.621 mmol/L) may serve as an effective risk stratification tool.
Using the Systemic Inflammatory Response Index and the Prognostic Nutritional Index in Predicting Subsequent Bone Metastases in Patients with Non-Small Cell Lung Cancer.
Wang P, Yan X, Yan G … +2 more , Li D, Ma L
Int J Gen Med · 2026 · PMID 41947979 · Full text
OBJECTIVE: This study aimed to identify the risk factors for Bone Metastases (BM) in patients with non-small cell lung cancer (NSCLC) and develop a scoring system combining the systemic inflammatory response index (SIRI)...
OBJECTIVE: This study aimed to identify the risk factors for Bone Metastases (BM) in patients with non-small cell lung cancer (NSCLC) and develop a scoring system combining the systemic inflammatory response index (SIRI) and prognostic nutritional index (PNI) to predict subsequent bone metastases in patients with NSCLC. METHODS: A retrospective analysis of patients with NSCLC treated at our hospital between February 2019 and January 2025 was conducted. Based on the occurrence of BM during follow-up, patients were stratified into the BM or the non-BM group. After their preoperative SIRI and PNI values were calculated, receiver operating characteristic (ROC) curve analysis was used to determine the optimal cut-off values for SIRI and PNI, which were used to establish the SIRI-PNI scoring system. The SIRI-PNI scores were compared between the groups, and univariate and multivariate logistic regression analyses were performed to identify factors influencing BM development. RESULTS: Among the 418 patients included with a mean follow-up of 11.91 ± 0.88 months (range: 9-14 months), 142 were diagnosed with BM (33.97%). ROC analysis determined an optimal threshold of 539.0 for the SIRI (area under the curve [AUC] = 0.877; 95% confidence interval [CI]: 0.807-0.947) and 44.8 for the PNI (AUC = 0.801; 95% CI: 0.689-0.912). An SIRI-PNI scoring system was established, with scores ranging from 0 to 2. Clinical stage, lymph node metastasis, and SIRI-PNI score significantly differed between the BM and non-BM groups (P < 0.05). Multivariate analysis identified clinical stage IV (odds ratio = 11.91, P < 0.0001) and a SIRI-PNI score of 2 (P < 0.0001) as independent risk factors for BM. CONCLUSION: Advanced clinical stage (IV) and a high SIRI-PNI score (2 points) are significant prognostic indicators for BM development in patients with NSCLC. The preoperative SIRI-PNI scoring system may facilitate early identification of high-risk patients.
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