AMERICAN JOURNAL OF THE MEDICAL SCIENCES美国医学科学杂志
AMERICAN JOURNAL OF THE MEDICAL SCIENCES(英文缩写 AM J MED SCI),ISSN 0002-9629,eISSN 1538-2990,中文译名:美国医学科学杂志 是一本学术期刊。本页汇总该期刊的最新影响因子、分区信息以及最新收录于 PubMed 的文献,帮助您快速了解期刊全貌。
发文量统计区间：2025-09-27 至 2026-09-27，按本站收录文献的发表日期统计。
期刊介绍
历年影响因子趋势
| JCR 数据年份 | 影响因子 | JCR 分区 |
|---|---|---|
| 2021 | 3.462 | Q2 |
| 2022 | 3.100 | Q2 |
| 2023 | 2.300 | Q2 |
| 2024 | 1.800 | Q2 |
| 2025 | 2.400 | Q2 |
AMERICAN JOURNAL OF THE MEDICAL SCIENCES 最新收录文献
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1. Diffuse alveolar hemorrhage in ANCA-associated vasculitis: Current evidence and multimodal treatment approaches.
PMID:日期:2026-10-01Diffuse alveolar hemorrhage (DAH) is a rare but life-threatening complication of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), with management largely extrapolated from broader AAV and ARDS literature. We conducted a review of studies published between 2000 and 2025 evaluating treatments and outcomes in AAV-associated DAH, synthesizing evidence across immunosuppressive, plasmapheresis, hemostatic, respiratory and hemodynamic, and infection prevention strategies. Glucocorticoids combined with rituximab or cyclophosphamide induce remission in most patients, although optimal steroid tapering and comparative efficacy in severe, ventilated DAH remain uncertain. Avacopan improves sustained remission and renal recovery in severe AAV and appears to be a feasible steroid-sparing adjunct in early DAH series. Large randomized trials demonstrate no survival benefit of plasma exchange. Local hemostatic therapies may provide rapid bleeding control, but evidence is limited. Respiratory outcomes are driven by hypoxemia severity and need for invasive ventilation or extracorporeal support. Lastly, infection prevention measures are strongly supported.
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2. Radiological changes, pulmonary function, and systemic inflammation in pneumoconiosis: A retrospective cohort study.
PMID:日期:2026-10-01Despite advances in occupational health, pneumoconiosis remains an important public health problem. This study aimed to describe changes in pulmonary function tests and systemic inflammatory markers in patients with pneumoconiosis and to evaluate their relationship with radiological stage changes during follow-up. This retrospective cohort study included 109 patients with pneumoconiosis followed between 2007 and 2024. Spirometry, carbon monoxide diffusing capacity (DLCO), ILO pneumoconiosis categories, and hemogram parameters obtained at baseline and follow-up were analyzed. Associations between exposure duration, inflammatory markers, pulmonary function changes, and radiological stage changes were assessed using non-parametric methods and multivariable linear regression analyses. Radiological progression was observed in 20.2% of patients. Progression occurred in 16.9% of patients with category 1 disease, 34.6% of those with category 2 disease, and 75% of those with category 3 disease. A significant annual decline was observed in FEV₁ (p = 0.003) and FEV₁/FVC (p = 0.005). The annual decline in DLCO was more pronounced among patients with radiological progression (p < 0.05). Inflammatory markers showed an overall increase during follow-up, exposure duration was positively correlated with neutrophil-to-lymphocyte ratio values (r = 0.223; p = 0.020). Pulmonary function decline and changes in inflammatory markers were observed during follow-up in patients with pneumoconiosis, with greater DLCO reduction among those showing radiological progression. These findings highlight the value of evaluating radiological findings together with functional and laboratory parameters to better characterize disease burden. Further prospective studies are needed to clarify the clinical significance of these associations.
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3. Effects of CTLA4-Ig, rituximab, and rapamycin on rat-to-mouse cardiac xenograft survival.
PMID:日期:2026-10-01Xenotransplantation addresses the critical shortage of human organs and tissues; however, innate immune responses and acute humoral rejection (AHR) limit xenograft survival, the regimen of combined medication remains to be further explored. This study aimed to determine whether a clinically applicable immunosuppressive regimen consisting of CTLA4-Ig, rituximab, and rapamycin could synergistically prolong xenograft survival. Hearts were harvested from Sprague-Dawley (SD) rats and transplanted into C57BL/6 mice. Recipient animals were randomly divided into three groups: an untreated control group, a CTLA4-Ig monotherapy group, or a combination therapy group receiving the triple immunosuppressive regimen. In the control group, cardiac xenografts were rejected within 10 days, characterized by cell-mediated rejection and AHR. In contrast, the combination therapy significantly prolonged xenograft survival and suppressed immune rejection in the treated recipients. Notably, infiltration of T cells, B cells, dendritic cells, macrophages, and natural killer (NK) cells was markedly reduced, complement deposition was decreased, and the production of xeno-reactive antibodies and proinflammatory cytokines were lowered. Furthermore, we confirmed that the combination therapy confers enhanced protection against xenograft injury via inhibition of the PI3K/mTOR signaling pathway. These findings strongly support the rationale for administering CTLA4-Ig, rituximab, and rapamycin to constrain innate immune responses and alleviate AHR in xenotransplantation.
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4. When headache signals hypoglycemia: Clinical recognition and management.
PMID:日期:2026-10-01Headache is an underrecognized manifestation of hypoglycemia in individuals with diabetes. Although hypoglycemia is well known to produce autonomic and neuroglycopenic symptoms, headache is frequently overlooked as a potential indicator of low glucose, which may lead to unnecessary diagnostic evaluation and missed opportunities to prevent recurrent episodes. A landmark pre-CGM study reported hypoglycemia-related headache in 43% of insulin-treated individuals experiencing hypoglycemia, although contemporary prevalence estimates remain uncertain. Recognition of the temporal relationship between headache episodes and glucose fluctuations is essential for accurate diagnosis. Continuous glucose monitoring can help identify symptomatic and asymptomatic hypoglycemia associated with headache and support prevention through real-time alerts and pattern recognition. This review summarizes the pathophysiology, clinical presentation, diagnostic evaluation, and management of hypoglycemia-related headache and provides a practical clinical approach, including a diagnostic algorithm, to assist clinicians in evaluating headache complaints in patients with diabetes.
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5. Dual role of T cell subsets in renal injury.
5. T细胞亚群在肾损伤中的双重作用PMID:日期:2026-10-01T cells and their subsets play dual roles in the pathogenesis, progression, and repair of kidney injury, acting as both drivers of inflammation and fibrosis and regulators of immune homeostasis and tissue repair. Although previous research has predominantly focused on the role of T cells in classic immune-mediated kidney diseases such as lupus nephritis and glomerulonephritis, with relatively less emphasis on their involvement in broader kidney injury contexts, emerging evidence reveals a more extensive and spatiotemporally specific regulatory network of T-cell subsets in acute kidney injury (AKI), chronic kidney disease (CKD), and transplant kidney injury. Within the pathological processes of kidney injury, distinct T-cell subsets contribute to disease progression through specific mechanisms. For instance, Th17 cells exacerbate acute and chronic inflammation and fibrosis via IL-17-dependent pathways, yet may contribute to repair in later injury phases. This review primarily outlines the impact of different T-cell subsets on kidney injury and explores strategies for their therapeutic targeting.
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6. Resting heart rate, electrocardiographic markers of atrial cardiopathy, and all-cause mortality.
PMID:日期:2026-10-01Elevated resting heart rate (HR) and atrial cardiopathy are each linked to higher mortality risk, yet their interrelationship and joint prognostic value remain unclear. We analyzed 7326 adults (mean age 59.0 ± 13 years) without cardiovascular disease from the Third National Health and Nutrition Examination Survey with available electrocardiograms. Atrial cardiopathy was defined by electrocardiogram as abnormal P-wave axis or deep terminal P-wave negativity in V1. Multivariable logistic regression assessed cross-sectional associations between HR categories and atrial cardiopathy. Cox proportional hazard models evaluated independent and joint associations of HR categories and atrial cardiopathy with all-cause mortality. Atrial cardiopathy was present in 1833 participants (25.0%). After adjustment, sinus tachycardia ((≥100 bpm) was associated with higher odds of atrial cardiopathy (OR 1.76, 95% CI 1.06-2.92), whereas sinus bradycardia (≤50 bpm) was associated with lower odds (OR 0.61, 95% CI 0.43-0.84). Each 10-bpm HR increase corresponded to 25% higher odds of atrial cardiopathy. Over a median 13.8-year follow-up, 2415 deaths (33.0%) occurred. Sinus tachycardia (HR 3.58, 95% CI 2.61-4.91) and atrial cardiopathy (HR 1.27, 95% CI 1.16-1.39) were independently associated with mortality. Individuals with both conditions had the highest risk (HR 4.11, 95% CI 2.63-6.41). Associations varied by age and race. Elevated resting HR is associated with higher odds of atrial cardiopathy, and their coexistence confers markedly increased mortality risk. Integrating resting HR into atrial cardiopathy metrics may enable granular population-level risk profiling.
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7. Uncovering the evidence frontier beyond the lipid-lowering effects of PCSK9 inhibitors in heart transplantation.
PMID:日期:2026-10-01Cardiac allograft vasculopathy (CAV) is a major cause of long-term complications in heart transplant (HTx) recipients, with dyslipidemia playing a key role in its development. While statins are the standard therapy, their effectiveness can be limited by side effects, insufficient lipid-lowering response, or drug interactions. This scoping review examines the emerging role of proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) as an alternative strategy, emphasizing their positive effects on lipid profiles, especially low-density lipoprotein cholesterol (LDL-c), in slowing CAV progression. Recent preclinical studies using a heterotopic murine heart transplant model have identified a novel finding: the PCSK9i "alirocumab" may protect against transplant rejection through mechanisms independent of lipid-lowering, possibly by modulating hepatic immune responses. These findings reveal a significant evidence frontier and highlight the need for clinical research to further explore the immunomodulatory properties of PCSK9i in the context of heart transplantation.
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8. Auricular hematoma in antiquity: Possible surgical drainage in the hellenistic boxer at rest.
PMID:日期:2026-10-01Injuries of the external ear caused by blunt trauma are among the most characteristic lesions of contact sports and have likely accompanied athletic competition since antiquity. Auricular hematoma is a well-recognized consequence of blunt trauma to the external ear and remains a common injury in modern contact sports. If untreated, subperichondrial blood accumulation may lead to cartilage ischemia and permanent auricular deformity, commonly known as cauliflower ear. Evidence of this condition may already appear in ancient artistic representations. The Hellenistic bronze statue known as the Boxer at Rest (late fourth-third century BCE) depicts an athlete with pronounced bilateral auricular deformities consistent with chronic auricular hematoma. In addition to these features, both ears display short, sharply defined linear lesions accentuated by copper inlays suggestive of active bleeding. This study reexamines these markings from a clinical and anatomical perspective. Their morphology, symmetry, and anatomical location closely correspond to sites commonly used in modern surgical drainage of auricular hematomas. This raises the possibility that the sculpture depicts not merely traumatic injury but a therapeutic intervention. Although classical medical texts do not explicitly describe the treatment of auricular hematoma, incision and evacuation of pathological fluid collections were well established in ancient medicine. The statue may therefore represent one of the earliest visual depictions of the management of sports-related ear trauma. This interpretation highlights the continuity of traumatic injuries associated with contact sports and their medical consequences across more than two millennia.
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9. Frailty and heart failure: Clinical impact, biomarkers, and phenotypic differences.
PMID:日期:2026-10-01Frailty is a multidimensional geriatric syndrome characterized by reduced physiologic reserve and increased vulnerability to stressors. Its prevalence is particularly high among patients with heart failure (HF), reflecting the interplay between aging, multimorbidity, and chronic cardiovascular disease. Frailty independently predicts poor outcomes, including higher hospitalization rates, mortality, and impaired quality of life. The Fried Frailty Phenotype defines frailty as the presence of three or more of the following five criteria: unintentional weight loss, exhaustion, weakness (grip strength), slow walking speed, and low physical activity. In this review, we explore the complex relationship between frailty and HF, with a focus on pathophysiology, clinical outcomes, biomarkers, and therapeutic considerations. We highlight differences across HF phenotypes-heart failure with reduced ejection fraction (HFrEF), preserved ejection fraction (HFpEF), and mildly reduced ejection fraction (HFmrEF)-underscoring the importance of tailored, phenotype-specific approaches. We also discuss emerging biomarkers including the stress hyperglycemia ratio (SHR) in HFpEF. Finally, we address limitations of current evidence and future directions for integrating frailty assessment into HF management.
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10. Positive airway pressure therapy in the prevention of obstructive sleep apnea associated cardiovascular disease: Controversy.
PMID:日期:2026-10-01Obstructive sleep apnea (OSA) is a highly prevalent and heterogeneous disorder strongly associated with cardiovascular morbidity and mortality. This review examines the pathophysiological mechanisms linking OSA to cardiovascular disease, and evaluates current evidence regarding the impact of positive airway pressure (PAP) therapy on cardiovascular outcomes and mortality. OSA is an independent risk factor for hypertension, coronary artery disease, heart failure, arrhythmias, stroke, and metabolic dysfunction, mediated by mechanisms including intermittent hypoxia, sympathetic activation, oxidative stress, endothelial dysfunction, and systemic inflammation. Although PAP therapy improves symptoms, apnea-hypopnea index, and intermediate cardiometabolic parameters-particularly among adherent patients-randomized controlled trials have yielded inconsistent results for reducing cardiovascular events and mortality. Emerging evidence indicates that treatment adherence, disease severity, and distinct OSA phenotypes and endotypes substantially influence cardiovascular risk. Methodological limitations, population heterogeneity, and inadequate long-term follow-up continue to fuel controversy, highlighting the need for individualized, phenotype-driven research approaches.