Category: Nevin Manimala

Clin Transl Sci. 2026 Mar;19(3):e70517. doi: 10.1111/cts.70517.

ABSTRACT

Type 2 diabetes mellitus (T2DM) is becoming increasingly prevalent worldwide, especially in developing countries such as Vietnam; however, data on diabetes knowledge and medication adherence among Vietnamese high-risk T2DM patients, particularly those living in the rural areas, remains scarce. This study aimed to evaluate the levels of diabetes knowledge and medication adherence, along with their relationship, among high-risk T2DM patients in a rural area of Vietnam. A cross-sectional study was conducted at Quang Thanh General Hospital, a tertiary care hospital in Nghe An Province, Vietnam, between May and July 2024. Diabetes knowledge and adherence were assessed using the Vietnamese versions of the Spoken Knowledge in Low Literacy Patients with Diabetes (SKILLD) and the General Medication Adherence Scale (GMAS), respectively. Binary logistic regression was used to assess the association between diabetes knowledge and medication adherence. A total of 230 high-risk, T2DM patients met the inclusion criteria and were included in the study. The mean age was 67.9 ± 6.6 years, while 43.9% were male. The mean SKILLD score was 36.7 ± 20.03, with 82.6% classified as having low diabetes knowledge. For medication adherence, the mean GMAS score was 30.4 ± 3.07, with 16.1% of patients classified as being non-adherent. Binary logistic regression showed that better knowledge significantly increased the likelihood of medication adherence (OR = 8.3, 95% CI: 1.1-64.8, p = 0.043). In conclusion, diabetes knowledge was low among Vietnamese high-risk T2DM patients. A strong relationship existed between high diabetes knowledge and better medication adherence.

PMID:41796060 | DOI:10.1111/cts.70517

Clin Transl Sci. 2026 Mar;19(3):e70494. doi: 10.1111/cts.70494.

ABSTRACT

Circulating serum biomarkers have prognostic value in patients with advanced NSCLC, yet their potential still remains underappreciated at present. This review discusses classical approaches of biomarker data analysis, highlighting gaps, and summarizing current methodologies to evaluate the relationship between serum biomarkers and clinical outcome in advanced NSCLC. Showcased for serum biomarker data exploitation of a phase III study in advanced NSCLC patients, this review also promotes and offers perspectives on how to analyze and interpret longitudinal biomarker data using pharmacometric approaches for potential implementation into clinical practice.

PMID:41796056 | DOI:10.1111/cts.70494

Addiction. 2026 Mar 8. doi: 10.1111/add.70345. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Social anxiety is associated with disparate alcohol-related outcomes among young people. This meta-analysis synthesised the literature to determine what factors (e.g. impulsivity) may account for variance in these outcomes.

METHODS: Empirical studies reporting the correlation of social anxiety with alcohol use and/or alcohol-related problems (ARPs) among young people (aged 13-29 years) were identified through a systematic literature search. Five random-effects meta-analyses were performed for ARPs, problematic alcohol use, frequency, quantity and quantity by frequency index measures of alcohol use. Seventy studies were included with 233 effect sizes extracted. The average age was 20 years (n = 38 517; 66.2% female).

RESULTS: Social anxiety was negatively associated with index alcohol use [number of studies (k) = 28, r = -0.05, 95% confidence interval (CI) = -0.08 to -0.03, t = -4.04, P < 0.001] but statistically non-significant with quantity (k = 21, r = 0.00, 95% CI = -0.04 to 0.05, t = 0.18, P = 0.86) or frequency (k = 18, r = -0.01, 95% CI = -0.06 to 0.05, t = -0.29, P = 0.78) of alcohol use. Social anxiety was statistically significantly positively associated with ARPs (k = 45, r = 0.13, 95% CI = 0.10-0.16, t = 9.93, P < 0.001) and problematic alcohol use (k = 23, r = 0.06, 95% CI = 0.01-0.11, t = 2.68, P = 0.01). Impulsivity was a statistically significant moderator, such that, as the correlation of impulsivity with social anxiety increased, the association of social anxiety with index alcohol use positively increased. Subgroup analyses for ARPs measure used were also statistically significant.

CONCLUSION: Young people with elevated social anxiety appear to drink less alcohol than their peers, but report more problematic alcohol use and alcohol-related problems. Impulsivity may clarify unexpected patterns of lower alcohol consumption, although conclusions remain tentative due to methodological constraints.

PMID:41796042 | DOI:10.1111/add.70345

Fa Yi Xue Za Zhi. 2025 Dec 25;41(6):585-592. doi: 10.12116/j.issn.1004-5619.2024.141001.

ABSTRACT

OBJECTIVES: To analyze the factors contributing to inconsistent opinions on assessments of mental disability degrees caused by traumatic brain injury (TBI).

METHODS: A retrospective analysis was conducted on 50 cases of re-assessment of mental disability caused by TBI at Forensic Medicine Center of Sun Yat–sen University from 2018 to 2019. General demographic information of the assessed individuals, TBI conditions, and initial and re-assessment opinions were collected. Descriptive statistics, Spearman correlation analysis and generalized estimating equations were used to analyze the differences in mental disorder diagnosis and disability degrees between initial and re-assessment. The reasons for inconsistent opinions were analyzed.

RESULTS: The inconsistency rate for two mental disability assessment opinions was 70.0% (including only mental disorder diagnosis were inconsistent, only disability degrees were inconsistent and both inconsistent). The responses to questioning, memory, intelligence, emotional activities, volitional behavior activities, and self-awareness during the assessment were correlated with the location of the cerebral malacia foci caused by TBI. There were significant differences between the two assessments in the degree of impairment to some mental symptoms and the living ability.

CONCLUSIONS: The reasons for the inconsistent opinions on the two assessments may be: (1) depending on different brain imaging information (including changes in brain imaging information in the recent three months, and the location of cerebral malacia foci); (2) examiners have different understandings of the degree of damage caused by mental disorders; (3) examiner’s assessment of the degree of impairment in living ability varies.

PMID:41796032 | DOI:10.12116/j.issn.1004-5619.2024.141001

Fa Yi Xue Za Zhi. 2025 Dec 25;41(6):552-558. doi: 10.12116/j.issn.1004-5619.2023.431205.

ABSTRACT

OBJECTIVES: To explore the method of postmortem submersion interval (PMSI) estimation for bodies from the Jingzhou reach of the Yangtze River, utilizing an aquatic decomposition score.

METHODS: A total of 105 cases of known PMSI bodies recovered from the Jingzhou reach of the Yangtze River were collected from the cases handled by the Jingzhou Branch of Yangtze River Shipping Public Security Bureau from 2018 to 2022. Considering the average monthly temperature, these cases were categorized into summer and winter groups, with the threshold set at 20 ℃. For each case, the total aquatic decomposition score (TADS) was assessed using the aquatic decomposition score table. The relationship between TADS and PMSI was explored using statistical approach, and two regression equations were established respectively through the natural logarithmic transformation of PMSI. Six bodies recovered in 2023 from the Jingzhou reach of the Yangtze River were selected to verify the equations.

RESULTS: In both summer and winter groups, PMSI was positively correlated with TADS (R²>0.70). The regression equation of summer group was TADS=5.117+4.825×ln(PMSI), and for the winter group, it was TADS=3.191+3.967×ln(PMSI).

CONCLUSIONS: The decomposition degree of the bodies can be used to estimate PMSI combined with the feature of water temperature of the Jingzhou reach of the Yangtze River.

PMID:41796028 | DOI:10.12116/j.issn.1004-5619.2023.431205

Zhonghua Yi Xue Za Zhi. 2026 Mar 10;106(9):848-856. doi: 10.3760/cma.j.cn112137-20250708-01661.

ABSTRACT

Objective: To explore the mechanism of vitamin K2 (VitK2) regulating matrix Gla protein (MGP) in inhibiting tumor growth in inflammation-associated colorectal cancer (CAC) model mice. Methods: Twenty-six C57BL/6 male mice, 6-8 weeks old and weighing 20-25 g, were divided into 4 groups according to the random number table method (each group received different treatments): normal group (treated with olive oil gavage and physiological saline intraperitoneal injection) (n=5), model group [treated with olive oil gavage, azoxymethane (AOM) intraperitoneal injection, and dextran sulfate sodium (DSS) solution drinking treatment)] (n=5), 30 mg group (treated with 30 mg·kg^-1·d^-1 of vitamin K2 gavage, AOM intraperitoneal injection, and DSS solution drinking treatment) (n=8), and 60 mg group (treated with 60 mg·kg^-1·d^-1 of vitamin K2 gavage, AOM intraperitoneal injection, and DSS solution drinking treatment) (n=8). The mice were sacrificed at the end of the 12th week, and the number and length diameter of colon tumors in each group were compared. The expression level of nuclear proliferation antigen (Ki-67) in colon tissues was assessed by immunohistochemistry (IHC), while the levels of MGP protein and Smad1/5 pathway-associated proteins were determined by Western blotting (WB). Additionally, the expression of MGP mRNA was quantified using real-time quantitative PCR (RT-qPCR). According to different treatment methods, colon cancer epithelial cell line SW480 cells were divided into control group [treated with dimethyl sulfoxide (DMSO)], 100 μmol/L group (treated with 100 μ mol/L VitK2), 200 μmol/L group (treated with 200 μ mol/L VitK2), 400 μmol/L group (treated with 400 μ mol/L VitK2), empty vector group (SW480 cells were transfected with empty plasmid) and MGP overexpressing group (SW480 cells were transfected with MGP overexpressing plasmid). After 48 hours of treatment, the expression of MGP protein, changes in the Smad1/5 pathway, and cell proliferation at different time points (24, 48, 72, and 96 hours) after treatment were detected. Results: All mice in the model group, 30 mg group, and 60 mg group developed colorectal tumors, with a tumorigenesis rate of 100% (17/17). There was no significant difference in the number of colon tumors between the 30 mg and 60 mg groups and the model group (both P>0.05), but the long diameter of tumors in the 30 mg or 60 mg groups was smaller than those in the model group (both P<0.05). There was no significant difference in tumor number or long diameter between the 30 mg and 60 mg groups (both P>0.05). The Ki-67 protein expression levels in the 30 mg and 60 mg groups were both lower than those in the model group (both P<0.05). Meanwhile, the MGP protein expression levels and pSmad1/5 protein expression levels in the 30 mg and 60 mg groups were both higher than those in the model group (all P<0.05). There was no statistically significant difference in MGP mRNA levels between the 30 mg and 60 mg groups and the model group (both P>0.05). Furthermore, there was no statistically significant difference in the expression levels of Ki-67 protein, MGP protein, pSmad1/5 protein, or MGP mRNA between the 30 mg and 60 mg groups (all P>0.05). In the cell experiments, the MGP and pSmad1/5 protein expression levels in the 100 μmol/L group showed no statistically significant difference compared to the control group (both P>0.05). The MGP and pSmad1/5 expression levels in the 200 μmol/L and 400 μmol/L groups were both higher than those in the control group (both P<0.001). After 72 and 96 hours, the cell proliferation capacity in the 200 μmol/L and 400 μmol/L groups was both lower than that in the control group (both P<0.001). The pSmad1/5 protein expression level in the MGP overexpression group was higher than that in the empty vector group (P<0.001). After 24, 48, 72, and 96 hours, the cell proliferation capacity in the MGP overexpression group was lower than that in the empty vector group (all P<0.001). Conclusion: VitK2 can inhibit the growth of CAC model mice by promoting MGP expression and activating Smad1/5 pathway.

PMID:41796008 | DOI:10.3760/cma.j.cn112137-20250708-01661

Zhonghua Yi Xue Za Zhi. 2026 Mar 10;106(9):834-840. doi: 10.3760/cma.j.cn112137-20250722-01813.

ABSTRACT

Objective: To investigate the distribution patterns of vertebral bone density in degenerative lumbar scoliosis (DLS) patients with different coronal imbalance classifications. Methods: A retrospective study was conducted on 154 patients with DLS who underwent long-segment spinal fusion surgery at Nanjing Drum Tower Hospital between January 2017 and December 2022. The patients were classified according to the Nanjing Drum Tower coronal imbalance classification of DLS: Type A, coronal balance distance (CBD) <3 cm; Type B, CBD ≥3 cm and C₇ plumb line (C₇PL) located on the concave side; Type C, CBD ≥3 cm and C₇PL located on the convex side. The major curve Cobb angle and CBD were measured on preoperative standing full-spine radiographs. Preoperative assessments also included L_1-4 T-scores and femoral neck T-scores obtained from dual-energy X-ray absorptiometry (DXA). Additionally, overall vertebral body bone density and Hounsfield unit (HU) values on the concave and convex sides were measured using preoperative CT scans. The patients with L_{1 HU} value <110 were diagnosed with osteoporosis (OP). Comparative analyses included OP prevalence and coronal plane bone mass distribution patterns among the different coronal classifications. Results: A total of 154 patients were included in this study, comprising 21 males and 133 females, with an average age of (62.9±6.6) years. Among them, 99 patients were classified as Type A, 30 as Type B, and 25 as Type C. The prevalence of OP was 48.7% (75/154), with the prevalence in Type C (72.0%, 18/25) patients being higher than that in Types A (44.4%, 44/99) and B (43.3%, 13/30) (both P<0.05). The mean HU value of the S₁ vertebra for all patients was 140.8±63.1, it was the lowest in Type C patients (108.2±53.4), which was statistically significantly lower than that in Types A and B patients (150.2±66.0 and 137.1±52.0, respectively, both P<0.05). For all the patients, the HU values on the concave side of the main curve were all greater than those on the convex side (all P<0.005), with the greatest asymmetry observed at the apex vertebra. The asymmetry ratios of the concave to convex sides of the S₁ vertebra in Type B and Type C patients were higher than those in Type A patients (1.25±0.24, 1.23±0.24, and 1.11±0.22, respectively; P<0.01). Conclusions: Patients with DLS exhibit a high prevalence of OP, with Type C patients showing the highest OP prevalence and the lowest bone density at the S₁ vertebral body. Based on these findings, it is recommended that, for type C patients, distal internal fixation be performed using iliac screws or S₂ sacroiliac screws to reduce the risk of internal fixation failure.

PMID:41796006 | DOI:10.3760/cma.j.cn112137-20250722-01813

Zhonghua Yi Xue Za Zhi. 2026 Mar 10;106(9):828-833. doi: 10.3760/cma.j.cn112137-20250810-02022.

ABSTRACT

Objective: To explore the relationship between preoperative thyroglobulin (Tg) levels and recurrence risk as well as treatment response in patients with differentiated thyroid cancer (DTC). Methods: A retrospective analysis was conducted on the clinical data of 604 patients with DTC who underwent total thyroidectomy at Shanghai Renji Hospital from January 1, 2020, to December 31, 2024. The postoperative recurrence status of patients was recorded, with follow-up ending on June 30, 2025. Determine the cut-off value of preoperative Tg for predicting patient prognosis using the maximum selected rank statistic method. Multivariate Cox proportional hazards regression model was used to analyze the risk factors for postoperative recurrence in DTC patients. Survival curves were plotted using the Kaplan-Meier method, and the log-rank test was used to evaluate the differences in postoperative disease-free survival rates and treatment response among DTC patients with different preoperative Tg levels. Results: Among the 604 patients, 417 were female and 187 were male, with the age of 45.0(36.0, 57.0) years. The preoperative Tg was 20.2 (10.4, 44.3) μg/L, and the follow-up period was 1.40 (0.85, 2.84) years. Multivariate Cox proportional hazards regression model analysis revealed that preoperative Tg levels≥36.2 μg/L (HR=14.180, 95%CI:1.745-115.200) was a risk factor for postoperative recurrence in DTC. Patients with the preoperative Tg level of<36.2 μg/L had a higher 3-year disease-free survival rate compared to those with the preoperative Tg level of≥36.2 μg/L (99.8% vs 92.3%, P<0.001). The proportion of patients with the favorable treatment response was lower among those with the preoperative Tg level of≥36.2 μg/L compared to those with the preoperative Tg level of<36.2 μg/L, whereas the proportions of patients with biochemical incomplete, structural incomplete, and indeterminate responses were higher among those with the preoperative Tg level of≥36.2 μg/L (all P<0.05). Conclusions: Preoperative Tg levels are significantly associated with the recurrence risk and treatment response in DTC patients. The Tg level of≥36.2 μg/mL indicates a high recurrence risk and poor treatment response.

PMID:41796005 | DOI:10.3760/cma.j.cn112137-20250810-02022

Zhonghua Yi Xue Za Zhi. 2026 Mar 10;106(9):813-818. doi: 10.3760/cma.j.cn112137-20250807-02000.

ABSTRACT

Objective: To compare the therapeutic effects of hemithyroidectomy (HT) versus total thyroidectomy (TT) on sporadic medullary thyroid carcinoma (sMTC). Methods: Clinical data of sMTC patients firstly treated in Tianjin Medical University Cancer Institute and Hospital from January 2011 to December 2019 were reviewed retrospectively. The patients were categorized into the HT group and the TT group based on the extents of primary tumor resection. The differences in clinical characteristics between the two groups were compared. A 1∶1 matching of variables including tumor stage and mulifocality was performed using propensity score matching (PSM) to balance the baseline differences between the two groups. Subsequently, the differences in biochemical cure rate, biochemical recurrence rate, and structural recurrence rate between the two groups were compared. Survival curves were plotted using the Kaplan-Meier method, and the log-rank test was utilized to compare the differences in progression-free survival and overall survival between the two groups. Results: A total of 199 patients with sMTC were included in the study, comprising 80 males and 119 females, with the age [M(Q₁,Q₃)] of 51.0 (42.0,59.0) years. Before PSM, 117 patients were in HT group and 82 patients were in TT group. There were statistically significant differences in preoperative calcitonin, N stage, TNM stage, and the number of lesions between the two groups (all P<0.05). After PSM, 63 patients were in HT group and 63 patients were in TT group. There was no statistically significant difference in all clinicopathological characteristics between the two groups (all P>0.05). Before PSM, the biochemical cure rate in the HT group was higher than that in the TT group [76.4% (81/106) vs 60.5% (46/76), P=0.021]. There were no statistically significant differences in the biochemical recurrence rate and structural recurrence rate between the HT group and the TT group [4.7% (5/106) vs 7.9% (6/76), 8.5% (10/117) vs 15.9% (13/82), both P>0.05]. The progression-free survival of the HT group was longer than that of the TT group [(137.26±3.53) vs (114.12±5.98) months, P=0.025]. There was no statistically significant difference in overall survival between the HT group and the TT group [(142.12±2.91) vs (126.92±5.15) months, P=0.140]. After PSM, there were no statistically significant differences between the HT group and the TT group in terms of biochemical cure rate [66.7% (40/60) vs 77.2% (44/57)], biochemical recurrence rate [5.0% (3/60) vs 7.0% (4/57)], structural recurrence rate [12.7% (8/63) vs 17.5% (11/63)], progression-free survival [(130.69±5.07) vs (112.19±6.91) months], and overall survival [(136.05±4.04) vs (124.71±6.83) months] (all P>0.05). Conclusions: The therapeutic effects of HT and TT on sMTC are comparable. With careful preoperative evaluation, selective performance of HT is safe and feasible.

PMID:41796003 | DOI:10.3760/cma.j.cn112137-20250807-02000

Zhonghua Gan Zang Bing Za Zhi. 2026 Feb 20;34(2):161-169. doi: 10.3760/cma.j.cn501113-20251017-00440.

ABSTRACT

Objective: To investigate the effect of antinuclear antibodies on the clinicopathological characteristics, short-term treatment response, and long-term prognosis of primary biliary cholangitis. Methods: A retrospective analysis was performed on 690 cases with primary biliary cholangitis who were treated in eight medical centers, including Nanjing Second Hospital, from January 2017 to October 2023, and were divided into a negative group (96 cases) and a positive group (594 cases) according to antinuclear antibody status. Propensity score matching (1∶1) was used to balance age and gender factors. The laboratory indicators, liver histological characteristics, short-term biochemical responses, and the occurrence of decompensated event conditions were compared between the two groups. An independent sample t-test was used for comparison between groups of continuous variables that conformed to normal distribution. The Mann-Whitney U test was used for comparison between groups of continuous variables with non-normal distribution. The χ² test or Fisher’s exact test was used for comparison of categorical variables between the two groups. The Mann-Whitney U test was used for rank data.The log-rank test was employed to compare the differences between groups in the Kaplan-Meier survival analysis.The Cox proportional hazards model was used to analyze the risk factors affecting prognosis. The cut-off value of the numerical variable was determined by the receiver operating characteristic curve. Results: There were 96 cases following matching in each group. The levels of aspartate aminotransferase (88.10 U/L vs. 71.55 U/L), γ-glutamyl transferase (278.61 U/L vs. 144.00 U/L), alkaline phosphatase (229.98 U/L vs. 159.68 U/L), and immunoglobulin G (19.90 U/L vs. 17.73 U/L) were significantly increased (P <0.05). The proportion of patients with positive anti-gp210 antibodies and/or anti-SP100 antibodies was significantly higher than that of the anti-nuclear antibody-negative group (21.43% vs. 5.26%, P=0.005). Liver histology showed that the detection rate of epithelioid granuloma was higher in the anti-nuclear antibody positive group (37.50% vs. 22.92%, P=0.028), while the degree of interface inflammation (none/mild/moderate/severe:2.08%/8.33%/63.54%/26.04% vs. 18.75%/23.96%/36.46%/20.83%, P<0.001) and Nakanuma-hepatitis activity score (HA0/HA1/HA2/HA3: 2.08%/4.17%/58.33%/35.42% vs. 23.96%/18.75%/35.42%/21.88%, P<0.001) were significantly higher in the anti-nuclear antibody-negative group. There was no statistically significant difference in the 1-year biochemical response rate and the incidence rate of decompensation between the two groups (P>0.05). Multivariate Cox regression analysis showed that platelet count ≤0.3× upper limit of normal value, albumin count ≤0.6×upper limit of normal value, and fibrosis stage S≥S3 were independent risk factors for decompensation of cirrhosis in patients with primary biliary cholangitis. Conclusions: Patients with antinuclear antibody-positive primary biliary cholangitis exhibit a phenotype of “high inflammatory burden,” suggesting that antinuclear antibody status may serve as a potential serological marker of disease activity, and its value in long-term prognosis and treatment decision-making needs to be further verified by prospective studies.

PMID:41795975 | DOI:10.3760/cma.j.cn501113-20251017-00440