MEDICINE医学
MEDICINE(英文缩写 MEDICINE),ISSN 0025-7974,eISSN 1536-5964,中文译名:医学 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：2025-09-01 至 2026-08-31，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 | 1.817 | Q3 |
| 2022 | 1.600 | Q3 |
| 2023 | 1.300 | Q2 |
| 2024 | 1.400 | Q2 |
| 2025 | 2.000 | Q2 |
MEDICINE 最新收录文献
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1. Optimizing isolated limb perfusion in malignant melanoma and sarcoma: Key factors influencing postoperative outcomes and complications.
PMID:日期:2026-09-25Isolated hyperthermic limb perfusion (ILP) is a limb-salvage technique used in the treatment of malignant melanoma and soft tissue sarcomas with in-transit or locally advanced disease. ILP allows regional administration of high-dose chemotherapy with minimal systemic toxicity. This study aims to evaluate postoperative complications and identify predictive factors influencing outcomes in patients undergoing ILP. We retrospectively analyzed 49 patients with malignant melanoma or extremity soft tissue sarcoma who underwent ILP at a single tertiary center between 2014 and 2024. Complications were classified using the Clavien-Dindo system; toxicity was graded via the Wieberdink scale. Logistic regression and univariate analyses were used to evaluate clinical, surgical, and laboratory parameters predictive of severe complications, toxicity, and mortality. Of the patients, 32 (65.3%) experienced complications, primarily within the first 3 postoperative days. Severe complications (Clavien-Dindo grade ≥ 3) occurred in 11 patients (22.4%). Severe regional toxicity (Wieberdink grade ≥ 4) was observed in 6.1%. Early mortality occurred in 3 cases. Preoperative and postoperative albumin levels, along with C-reactive protein levels on postoperative days 3 and 5, were significantly associated with severe complications. No significant relationship was found between modified Systemic Inflammation Scores and postoperative outcomes. ILP remains a valuable regional treatment option for carefully selected patients with advanced melanoma and extremity soft tissue sarcoma. Preoperative nutritional status and early postoperative inflammatory markers, particularly albumin and C-reactive protein, may serve as valuable predictors for adverse outcomes. Optimization of these parameters could improve postoperative recovery and treatment planning.
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2. Post-marketing safety assessment of tetrandrine based on the WHO-VigiAccess database.
PMID:日期:2026-09-25Tetrandrine, a bisbenzylisoquinoline alkaloid extracted from Stephania tetrandra S. Moore, is clinically used in the treatment of silicosis and rheumatoid arthritis. Despite its demonstrated efficacy, systematic safety evaluations remain limited. This study represents the first effort to identify adverse event (AE) signals associated with tetrandrine meglumine using the World Health Organization VigiAccess database. Global AE reports for tetrandrine were extracted up to July 6, 2025. The collected data included demographic variables such as age group and gender, as well as regional distribution. Additionally, data on adverse drug reaction-related disease systems and symptoms were compiled from adverse drug reaction annual reports and reports submitted to the World Health Organization. Disproportionality analyses were conducted using the reporting odds ratio (ROR) and the Bayesian confidence propagation neural network. A total of 265 reports were included, documenting 448 AEs. The most commonly affected systems were gastrointestinal disorders (38.39%), skin and subcutaneous tissue disorders (16.96%), and nervous system disorders (16.07%). Frequently reported adverse reactions included nausea, dizziness, pruritus, vomiting, rash, abdominal pain, diarrhea, and abnormal hepatic function. Strong association signals were observed for oral anesthesia (ROR 241.19, 95% confidence interval [CI] 79.74-729.58), abnormal hepatic function (ROR 20.31, 95% CI 12.27-33.63), hypoaesthesia (ROR 10.47, 95% CI 4.66-23.54), pollakiuria (ROR 9.53, 95% CI 3.04-29.83), and abdominal pain (ROR 8.94, 95% CI 5.96-13.41). Additionally, potential adverse reactions not listed in the product labeling, including pruritus, rash, abnormal hepatic function, chest pain, palpitations, hypoaesthesia, edema, pyrexia, insomnia, pollakiuria, and dyspnea, were identified. This study comprehensively characterized the AE profile of tetrandrine and identified novel adverse effects. These findings underscore the importance of ongoing drug safety monitoring and patient management, and highlight the need for clinicians to use this medication more appropriately, tailoring treatment regimens based on the identified adverse effect profiles.
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3. Outcome of navigated laser photocoagulation for persistent macular edema in branch retinal vein occlusion: A retrospective observational study.
PMID:日期:2026-09-25To evaluate the clinical efficacy of navigated laser photocoagulation (Navilas®) for persistent macular edema (ME) secondary to branch retinal vein occlusion (BRVO), and to determine whether angiographic microaneurysm (MA) morphology, including clustered MAs, telangiectatic capillaries (TelCaps), and MAs within collateral vessels, is associated with successful discontinuation of anti-vascular endothelial growth factor (VEGF) therapy. This retrospective observational study included eyes with persistent BRVO-associated ME treated with Navilas® at Nagoya City University Hospital between June 2014 and February 2022 and followed for at least 3 months. Clinical data and multimodal imaging findings were retrospectively reviewed. Outcomes included changes in best-corrected visual acuity and central subfield thickness, changes in anti-VEGF injection frequency, and successful discontinuation of anti-VEGF therapy. Angiographic MA morphology was assessed using fluorescein angiography and indocyanine green angiography. Logistic regression analysis was performed to identify morphological predictors of treatment discontinuation. Best-corrected visual acuity remained stable throughout follow-up after Navilas®. Approximately 60% of eyes achieved successful discontinuation of anti-VEGF therapy. Discontinuation was achieved in 63% (5 out of 8) of eyes with TelCaps, 33% (2 out of 6) of eyes with MAs within collateral vessels, and 27% (3 out of 11) of eyes with clustered MAs. In eyes that required continued anti-VEGF therapy, the injection frequency was significantly reduced compared with the pretreatment period. Logistic regression analysis demonstrated that the presence of clustered MAs was significantly associated with failure to discontinue anti-VEGF therapy. Navilas® appears to be an effective adjunctive treatment for persistent BRVO-associated ME, maintaining visual function while reducing the burden of anti-VEGF therapy. The presence of clustered MAs may serve as a useful angiographic biomarker of suboptimal response to navigated laser treatment, potentially reflecting severe localized hyperpermeability and extensive capillary nonperfusion. Angiographic assessment of MA morphology may therefore help refine patient selection and guide individualized treatment strategies.
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4. Mobile phone bacterial contamination among students and staff at Haramaya University, Eastern Ethiopia: A cross-sectional study.
PMID:日期:2026-09-25Mobile phones are used by most of the global population, particularly by college and university students and healthcare professionals. Despite their benefits, potential health risks associated with mobile-phone contamination may be overlooked. Therefore, this study aimed to determine bacterial contamination, associated factors, and antimicrobial susceptibility patterns of bacterial isolates from mobile phones among students and employees of Haramaya University College of Health and Medical Sciences, Harar, Eastern Ethiopia. An institution-based cross-sectional study was conducted among 238 students and employees from July 1 to August 30, 2022. Participants were selected using stratified sampling techniques. A structured questionnaire was used to collect the data. A swab sample was collected from each participant's mobile phone using a sterilized cotton swab and transported to the laboratory within 2 hours for microbiological investigation. Bacterial isolates were identified using colony morphology, gram staining, and biochemical tests. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method. Bivariable and multivariable logistic regression analyses were used to identify factors associated with bacterial contamination. Bacterial contamination was detected on 89.5% (95% confidence interval [CI]: 87-92) of sampled mobile phones. A total of 235 bacterial isolates were recovered, of which Staphylococcus epidermidis was the predominant isolate (70.6%), followed by Staphylococcus saprophyticus (14.9%) and Staphylococcus aureus (6.4%). Among the bacterial isolates tested for antimicrobial susceptibility, susceptibility was highest to gentamicin and chloramphenicol (94.0% each), followed by clindamycin (83.4%). Resistance was highest to ampicillin (98.7%), kanamycin (88.2%), cefotaxime (71.5%), cefoxitin (54.9%), and ciprofloxacin (52.8%). Overall, 181 (77.02%) isolates were multidrug-resistant, and 25 (10.64%) were extensively drug-resistant. Male sex (adjusted odds ratio [AOR]: 3.92, 95% CI: 1.364-11.282), lack of regular mobile-phone cleaning (AOR: 7.25, 95% CI: 2.161-24.336), and lack of awareness about mobile-phone bacterial contamination (AOR: 4.25, 95% CI: 1.293-13.970) were independently associated with bacterial contamination. This study demonstrated a high level of bacterial contamination of mobile phones among students and employees. S epidermidis was the predominant bacterial isolate. High levels of antimicrobial resistance were observed, particularly to ampicillin, kanamycin, and cefotaxime. The findings support the need to promote regular mobile-phone cleaning and improve awareness of mobile-phone hygiene.
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5. Factors associated with occult acute rib fractures on chest CT after negative radiography in older fall patients: A retrospective observational study.
PMID:日期:2026-09-25In older patients with fall-related injuries, chest computed tomography (CT) can detect acute rib fractures after chest radiography (CXR) showed no evidence of acute fracture. We evaluated clinical factors associated with CT-reported acute rib fracture within this clinician-selected imaging pathway. In this single-center retrospective observational study, we included patients aged ≥65 years who presented to the emergency department after a slip or fall between February 2021 and January 2024 and underwent same-visit chest CT after initial CXR without a definite, possible, or suspected acute rib fracture. The primary multivariable logistic model included age category (65-74, 75-84, or ≥85 years), male sex, fall from an elevated surface, non-alert mental status, head trauma, and localized chest wall pain. Covariates were entered simultaneously without automated selection, and all 739 patients were included. Sensitivity analyses examined alternative age specifications, sparse focal findings, and selectively ordered laboratory testing. Among 739 patients, 224 (30.3%) had a CT-reported acute rib fracture. Relative to ages 65 to 74 years, adjusted odds ratios (aORs) were 2.236 (95% confidence interval [CI], 1.443-3.465) for ages 75 to 84 years and 8.391 (95% CI, 4.354-16.172) for ages ≥85 years. Male sex (aOR, 1.791; 95% CI, 1.187-2.701), fall from an elevated surface (aOR, 2.415; 95% CI, 1.561-3.734), non-alert mental status (aOR, 1.891; 95% CI, 1.017-3.514), and localized chest wall pain (aOR, 11.541; 95% CI, 7.584-17.562) were also associated with acute rib fracture. Head trauma was not significantly associated with acute rib fracture. A 3-knot restricted cubic spline sensitivity analysis showed no evidence of departure from a linear age effect (P = .875); the estimate for non-alert mental status was attenuated when age was modeled continuously (P = .068). Within this clinician-selected CT pathway, older age, male sex, fall from an elevated surface, and localized chest wall pain were associated with CT-reported acute rib fracture after adjustment in the primary full-cohort model; the association with non-alert mental status was less stable across age specifications. These findings do not define a CT decision rule or support routine CT after negative CXR.
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6. Associations among grazing behavior, emotional eating, and psychological well-being in university students: A cross-sectional study.
PMID:日期:2026-09-25This study aimed to examine the associations among grazing behavior, emotional eating, and psychological well-being and to identify variables statistically associated with emotional eating among university students. A descriptive, cross-sectional, and correlational design was employed. Data were collected from 540 students between May and July 2025 through face-to-face interviews using a personal information form, the Grazing Questionnaire, the Emotional Eating Scale, and the Psychological Well-Being Scale. Descriptive statistics, including frequencies, percentages, means, and standard deviations, were calculated. Sociodemographic differences were analyzed using independent samples t-tests and 1-way analysis of variance, while relationships between scales were examined with Pearson correlation analysis. Multiple linear regression analysis was conducted to identify variables statistically associated with emotional eating. Of the participants, 71.9% (n = 388) were female. On average, students reported low levels of grazing behavior, exhibited emotional eating behaviors, and demonstrated moderate levels of psychological well-being according to scale scores. A significant positive correlation was found between grazing behavior and emotional eating, whereas psychological well-being was significantly negatively correlated with emotional eating. In the regression model, grazing behavior showed the strongest positive association with emotional eating. The model including grazing behavior, psychological well-being, body mass index, and gender explained 36.6% of the variance in total emotional eating scores. These findings suggest that university-based counseling programs, public health initiatives, and psychological support interventions may help address grazing and emotional eating behaviors among students.
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7. Macrophage pyroptosis in lupus nephritis - Novel insights into renal pathogenesis and clinical correlates: A cross-sectional study.
7. 狼疮性肾炎中的巨噬细胞焦亡——肾脏发病机制与临床相关性的新见解：一项横断面研究PMID:日期:2026-09-25Pyroptosis is a form of programmed cell inflammatory death. Macrophage pyroptosis has been implicated in the development of various immune diseases, yet its role in lupus nephritis (LN) remains poorly understood. This study examined macrophage pyroptosis in LN and its clinical correlations. This was a cross-sectional observational study. Renal tissues and clinical data were collected from 49 LN patients and 20 minimal change disease (MCD) patients. Macrophage pyroptosis was detected using immunofluorescence (cluster of differentiation 68 [CD68]/gasdermin D [GSDMD] co-staining), and serum inflammatory markers were analyzed via ELISA. Hierarchical regression analyses were performed to identify clinical parameters significantly associated with macrophage pyroptosis. A comparative analysis between the LN cohort (41 females, 8 males; mean age 32.6 ± 12.1 years) and MCD controls revealed significantly elevated levels of blood urea nitrogen, C-reactive protein, uric acid, and anti-double-stranded DNA antibodies (P < .05), accompanied by decreased complement component 3 (C3), complement component 4 (C4), estimated glomerular filtration rate (eGFR), and total cholesterol. Immunofluorescence demonstrated a marked increase in CD68/Cleaved GSDMD double-positive cells within both glomerular and interstitial compartments of LN patients (P < .001). LN patients with chronic kidney disease (CKD) stages 5 exhibited significantly interstitial macrophage pyroptosis (P < .05). This study is the first to report the presence of macrophage pyroptosis in LN renal tissues, with the extent of interstitial pyroptosis showing a significant cross-sectional association with CKD stage (by eGFR). This observation suggests a potential link between macrophage pyroptosis and disease severity in LN, meriting further investigation.
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8. Public knowledge and misconceptions regarding antibiotic use and resistance in Jordan: A cross-sectional study.
PMID:日期:2026-09-25Studying public knowledge regarding antibiotic use and resistance is beneficial in providing effective interventions to encourage responsible use of antibiotics. This study aimed to examine antibiotic misuse among Jordanian citizens and their awareness of the risks that this problem can cause. Between February 14, 2025, and May 13, 2025, an online cross-sectional survey study using Qualtrics software was conducted in Jordan. This study utilized a previously developed questionnaire tool to examine antibiotic and antibiotic resistance knowledge developed by the World Health Organization. A total of 654 participants were included in this research. The most commonly misunderstood conditions were sore throat and cold and flu, with 75.5% and 67.3% incorrectly believing they can be treated by antibiotics. The total mean score of antibiotic knowledge was 5.9 ± 2.2 out of 12 and 4.40 ± 1.3 for antibiotic resistance, indicating a moderate level of knowledge of both antibiotic use and resistance. Participants with a bachelor's degree had significantly lower odds of antibiotic knowledge (adjusted odds ratio [AOR] = 0.52, 95% confidence interval [CI] = 0.29-0.91, P = .02). Participants who used antibiotics in the last 6 months or last year also demonstrated significantly lower odds of antibiotic knowledge (AOR = 0.49, 95% CI = 0.32-0.74, P = .001) and (AOR = 0.50, 95% CI = 0.28-0.89, P = .02), respectively. Participants with an income between 500 and 1000 had a significantly higher odds of possessing antibiotic resistance knowledge (AOR = 1.59, 95% CI = 1.01-2.51, P = .04). Participants who worked in the medical field and were university students had a significantly higher odd of antibiotic resistance knowledge (AOR = 4.54, 95% CI = 1.74-11.84, P = .002) and (AOR = 2.98, 95% CI = 1.09-8.13, P = .03), respectively. Participants who obtained their antibiotics from a doctor or nurse the last time had a significantly higher odd of possessing antibiotic resistance knowledge (AOR = 2.26, 95% CI = 1.46-3.49, P < .001). This study indicates a moderate level of knowledge of both antibiotic use and resistance among Jordanian citizens. The public has several misconceptions regarding antibiotic use, resistance, obtaining, and prescribing. Comprehensive public education programs that consider these factors and the identified misconceptions are recommended to enhance understanding regarding antibiotic use and resistance among the Jordanian public.
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9. Bidirectional causal associations between Sjögren syndrome and gastrointestinal disorders: A two-sample Mendelian randomization study.
PMID:日期:2026-09-25As a systemic autoimmune disorder, Sjögren syndrome (SS) often has symptoms related to the gastrointestinal manifestations. Nevertheless, the causal relationships between SS and gastrointestinal disorders remain incompletely understood. We implemented bidirectional Mendelian randomization (MR) framework to examine causal links between SS and 7 gastrointestinal diseases, including gastric ulcer (GU), duodenal ulcer (DU), irritable bowel syndrome (IBS), Crohn disease (CD), ulcerative colitis (UC), noninfectious gastroenteritis (NGE), and constipation (CP). The inverse-variance weighted approach served as the primary analytical tool while additional techniques used include MR-Egger, weighted median and weighted mode methods. Sensitivity analyses were carried out to determine if there was any evidence of pleiotropy and heterogeneity. Genetic liability for SS was linked with an increased risk of GU (odds ratio [OR] = 1.055, 95% CI = 1.013-1.100) and a reduced risk of IBS (OR = 0.970, 95% CI = 0.948-0.993). Reverse MR analysis indicated that NGE increases the risk of SS (OR = 1.347, 95% CI = 1.118-1.622). Causative relations were not shown between SS and DU, CD, UC, or CP. Sensitivity testing showed stability of the results. This MR analysis presents genetic evidence suggesting that SS increases the risk of GU and decreases the risk of IBS whereas NGE appears to increase the chance of having SS. No causative links with DU, CD, UC, and CP were discovered. These findings support the stratified gastrointestinal monitoring of SS and emphasize the importance of managing gut inflammatory processes within the context of reducing autoimmune risk. However, the protective effect of SS against IBS needs to be investigated.
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10. A case report on the management of sepsis complicated by eroded mixed hemorrhoids following breast cancer chemotherapy.
PMID:日期:2026-09-25Sepsis is a life-threatening complication in breast cancer patients undergoing chemotherapy, particularly when compounded by anorectal conditions. The management of eroded mixed hemorrhoids in the setting of severe chemotherapy-induced neutropenia and septicemia presents a clinical dilemma, as standard surgical interventions carry prohibitive risks. This case report details a successful conservative, multimodal approach to this rare and critical scenario. A 51-year-old female with stage IIIA human epidermal growth factor receptor 2-positive breast cancer developed a high fever (40.1°C) 1 week after her first cycle of neoadjuvant TCHP (docetaxel, carboplatin, trastuzumab, and pertuzumab) chemotherapy. She presented with severe bone marrow suppression and constipation, which led to the manual reduction of prolapsed hemorrhoids, resulting in an eroded, inflamed perianal mass. The patient was diagnosed with septicemia (confirmed by Escherichia coli bacteremia), chemotherapy-induced grade IV bone marrow suppression (white blood cell count 0.17 × 109/L, platelet count 6 × 109/L), and mixed hemorrhoids with erosion and secondary perianal infection. Given the high risk of surgery due to critical thrombocytopenia and neutropenia, a conservative strategy was implemented. This included broad-spectrum systemic antibiotics (meropenem, vancomycin, amikacin, amphotericin B sequentially), aggressive hematologic support (granulocyte colony-stimulating factor, blood transfusions), and meticulous multimodal local wound care. The local regimen comprised saline cleansing, infrared therapy, recombinant human epidermal growth factor gel, zinc oxide ointment, compound borneol ester suppositories, and the topical application of a self-prepared traditional Chinese medicine, "Liuhe Dan." After 30 days of treatment, the patient became afebrile, and her perianal swelling and inflammation completely resolved. The eroded hemorrhoid healed entirely, allowing for a successful transfer to a lower-level hospital for continued supportive care. This case demonstrates that in severely neutropenic and thrombocytopenic patients, a conservative, integrated approach combining systemic anti-infective therapy with advanced local wound care and traditional Chinese medicine can successfully manage life-threatening sepsis originating from eroded hemorrhoids. It underscores the critical importance of perianal hygiene, prompt management of chemotherapy-induced constipation and bone marrow suppression, and the potential of nonsurgical strategies in high-risk surgical candidates.