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：2025-09-28 至 2026-09-28，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. Unraveling the intricate molecular mechanisms of sex hormones' roles in breast cancer pathogenesis. A review: Erratum.
PMID:日期:2026-09-18该文献暂无摘要。
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2. Association of blood parameters and ratios with aseptic loosening after total knee arthroplasty: A retrospective cohort study.
PMID:日期:2026-09-18This study aimed to evaluate the association of blood parameters and ratios with knee prosthesis loosening in patients after knee arthroplasty. A total of 221 patient files having knee prosthesis attempting to our clinic between 2018 and 2022 were retrospectively examined. Patients were divided into 2 groups as loosening (n = 108; 48.9%) and not loosening (n = 113; 51.1%) groups. Monocyte/high-density lipoprotein (HDL) ratio monocyte-to-HDL ratio (MHR), Neutrophil/lymphocyte ratio, Albumin/ C-reactive protein (CRP) ratio, albumin-to-C-reactive protein ratio (ACR), Eosinophile-to- lymphocyte ratio, mean platelet volume /PLT ratio mean platelet volume-to-platelet ratio, Monocyte -to-lymphocyte ratio, Platelet/lymphocyte ratio (PLR) and Hemoglobin/Platelet ratio (HPR) parameters of patients were evaluated. HDL, albumin, hemoglobin, ACR, PLR and HPR levels were significantly higher in loosening patients (P < .05). CRP, neutrophile, lymphocyte, monocyte and MHR means were significantly higher in no-loosening patients (P < .05). Loosening was significantly correlated with gender (R = 0.141; P < .05), HDL (R = 0.474; P < .01), albumin (R = 0.349; P < .01), CRP (r = -0.466; P < .01), neutrophile (r = -0.167; P < .05), lymphocyte (r = -0.240; P < .01), monocyte (r = -0.380; P < .01), hemoglobin (R = 0.254; P < .01), MHR (r = -0.513; P < .01), ACR (R = 0.496; P < .01), PLR (R = 0.142; P < .05) and HPR (R = 0.204; P < .01). Binary logistic regression analysis showed that MHR (B = -0.415; P < .01), ACR (B = 0.048; P < .01), and HPR (B = 30.640; P < .05) were significantly associated with knee prosthesis loosening at the multivariate level. ROC analysis demonstrated statistically significant discriminative performance for MHR, area under the curve ([AUC] = 0.798; P < .01), ACR (AUC = 0.786; P < .01), and HPR (AUC = 0.618; P < .01). For MHR 6.2481 cutoff level, sensitivity was 72.2% and specificity was 10.6%. For ACR 8.6380 cutoff level, sensitivity was 84.3% and specificity was 59.3%. For HPR 0.0506 cutoff level, sensitivity was 63.9% and specificity was 54.0%. MHR, ACR, and HPR were significantly associated with aseptic loosening after total knee arthroplasty and may be considered potential associated markers rather than definitive predictors.
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3. Development and validation of a blood-based diagnostic model for pulmonary tuberculosis combining GBP5 expression and routine laboratory indicators.
PMID:日期:2026-09-18WHO reports that only 54% of tuberculosis (TB) patients received rapid diagnostic tests at their initial presentation. Conventional laboratory methods in TB detection have high specificity (>90%) but low sensitivity (<50%). This means a large number of tuberculosis patients are missed. A better diagnostic approach is essential to decrease the TB burden. Studies on multi-indicator blood-based models for rapid TB diagnosis remain limited. We developed a rapid, non-sputum-based model to improve the efficiency of TB diagnosis. This was a retrospective case-control study including 301 patients with active tuberculosis (ATB) and 191 patients with other pulmonary diseases (OPD) who were evaluated at the Department of Pulmonary Medicine of the Affiliated Infectious Diseases Hospital of Soochow University between May 2023 and May 2024. A composite clinical diagnosis served as the gold standard for ATB diagnosis, including either a clinical diagnosis or bacteriological confirmation. The diagnostic outcome of ATB (ATB vs OPD) was defined as the dependent variable, while guanylate-binding protein 5 (GBP5) expression levels and routine laboratory indicators (including blood cell counts and plasma protein measurements) were defined as independent variables. Univariate and multivariate logistic regression analyses were performed to identify key predictors, and an AdaBoost algorithm was used to construct a TB diagnostic model. The performance of the model was compared with traditional laboratory-based TB tests. DeLong's Test was used to evaluate the statistical difference of AUC between AdaBoost and traditional methods. Through univariate and multivariate logistic regression analyses, the GBP5 gene, white blood cell (WBC) count, platelet (PLT) count, and prothrombin time (PT) were selected to construct an ATB diagnosis model using the AdaBoost algorithm. The AdaBoost model achieved an AUC of 0.808 in the training set and 0.805 in the test set, while the AUC of smear microscopy, MTB culture, Xpert MTB/RIF, and IGRA were 0.67, 0.59, 0.63 and 0.75 respectively. Therefore, our model demonstrated better diagnostic performance than conventional methods. This study preliminarily demonstrates that our AdaBoost diagnostic model based on GBP5 gene expression and routine blood indicators could serve as a potential tool for the clinical diagnosis of ATB. However, to be applied to the clinic, large samples are needed to validate the performance of the model.
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4. Arthroscopic partial meniscectomy should be performed carefully for medial meniscus tear with the anteromedial meniscofemoral ligament.
4. 伴前内侧半月板股骨韧带的内侧半月板撕裂应谨慎行关节镜下半月板部分切除术PMID:日期:2026-09-18The clinical relevance of the anteromedial meniscofemoral ligament (AMMFL) in medial meniscus (MM) tears remains unclear. This study investigated whether arthroscopic partial meniscectomy (APM) for MM tears with AMMFL is associated with joint degeneration. Among 2568 patients who underwent arthroscopic surgery in 2003 to 2017, 10 with AMMFL and ≥2 years of magnetic resonance imaging follow-up were selected for this retrospective comparative study. Five underwent APM for MM tears (excluding subtotal meniscectomy), while the other 5 did not. Procedures involving the lateral meniscus were excluded from group classification. Pre- and postoperative cartilage statuses and subchondral bone marrow lesions were assessed based on magnetic resonance imaging Osteoarthritis Knee Score criteria. The sum of cartilage and bone marrow lesion scores of the medial femoral condyle and tibial plateau was compared between the groups. Clinical outcomes were evaluated using the Lysholm score. Over a mean 50.4-month follow-up (range, 28-88), statistically significant chondral wear was noted in both the femoral condyle and tibial plateau (P = .011 and P = .042, respectively). The 2 groups showed statistically significant differences in postoperative femoral and tibial cartilage statuses (P = .048 and P = .008, respectively) and tibial cartilage score change (P = .008). There were no inter-group differences in the Lysholm score. APM for MM tears with AMMFL may accelerate cartilage degeneration in the medial compartment. The AMMFL should not be resected indiscriminately, and efforts should be made to preserve it when possible. Considering the difference between MM with the AMMFL and typical MM, surgical intervention on the former should be performed more carefully. These findings should be interpreted with caution given the small sample size included in this study.
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5. Mortality trends in digestive system malignancies among US adults aged 45 years or older, 1999 to 2023: A CDC WONDER time-trend analysis.
5. 1999年至2023年美国45岁及以上成年人消化系统恶性肿瘤死亡率趋势：一项CDC WONDER时间趋势分析PMID:日期:2026-09-18Digestive system malignancies remain a major cause of cancer mortality in the United States (US). Updated evidence through 2023 is needed to characterize recent trends, disparities, and cancer-site heterogeneity among adults aged 45 years or older. We conducted an ecological time-trend secondary analysis of publicly available, deidentified, aggregate mortality data from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) Underlying Cause of Death database. US residents aged ≥ 45 years who died from digestive system malignancies (International Classification of Diseases, 10th Revision [ICD-10] C15-C26) during 1999 to 2023 were included. Age-adjusted mortality rates (AAMRs) per 1,00,000 were directly standardized to the 2000 US standard population, whereas age-group analyses used crude rates. Joinpoint regression estimated annual percent changes (APCs) and average annual percent changes (AAPCs), with Benjamini-Hochberg (BH) adjustment for multiple comparisons. Between 1999 and 2023, the number of deaths increased from 1,25,353 to 1,66,045, whereas the national AAMR declined from 131.59 to 108.28 per 1,00,000 population (AAPC = -0.89%; 95% confidence interval: -0.98 to -0.79; q < 0.001). The annual decline was smaller after 2008. Men consistently had higher AAMRs than women, and non-Hispanic Black adults had the highest mortality rate but the most rapid long-term decline (AAPC = -1.55%; q < 0.001). Recent numerical changes among women, non-Hispanic White adults, and adults aged 45 to 54 years were not statistically significant after BH adjustment. In 2023, state-level AAMRs ranged from 92.31 in Colorado to 133.42 per 1,00,000 in Mississippi. Under the consistent 2013 National Center for Health Statistics (NCHS) classification, the 2020 AAMR was higher in nonmetropolitan than metropolitan areas (117.23 vs 105.67 per 1,00,000). Cancer-site-specific patterns were heterogeneous: the largest absolute reductions in AAMRs occurred for colorectal and stomach cancers, whereas AAMRs increased for liver and intrahepatic bile duct, pancreatic, anal and anal canal, and small-intestinal cancers. Despite a modest long-term decline in age-adjusted mortality from digestive system malignancies, the absolute number of deaths increased, and substantial demographic, geographic, and cancer-site-specific heterogeneity persisted. Continued site-specific and equity-focused surveillance is needed to guide prevention, early detection, and resource allocation.
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6. Emergency surgical management of acute Stanford type A aortic dissection in a primigravida at 29 weeks gestation: A case report.
PMID:日期:2026-09-18Acute aortic dissection during the 3rd trimester of pregnancy is a catastrophic cardiovascular emergency. The management is complex, requiring a multidisciplinary strategy to balance the competing risks of aortic rupture and fetal prematurity, as well as the conflict between surgical anticoagulation and postpartum hemorrhage. We report a case of a 34-year-old primigravida (29 weeks and 3 days of gestation) presenting with sudden, severe chest and back pain lasting over 7 hours following physical exertion. She had a history of developmental dysplasia of the left hip and thalassemia. Computed tomography angiography confirmed acute Stanford type A aortic dissection involving the ascending aorta and aortic arch branches and extending to the bilateral common iliac arteries, with severe true-lumen compression. Given the life-threatening nature of the dissection and fetal viability, a multidisciplinary team performed an emergency coordinated sequential combined procedure. Cesarean delivery was undertaken 1st. Because of initial uterine atony and the requirement for subsequent full systemic heparinization for cardiopulmonary bypass, a Bakri intrauterine balloon was inserted to secure uterine hemostasis. After abdominal closure, the patient underwent aortic valve commissural resuspension, total arch replacement, and frozen elephant trunk implantation. A viable preterm female infant weighing 1320 g was delivered and survived to neonatal intensive care unit discharge after respiratory support. Maternal uterine hemostasis was maintained during systemic heparinization, with estimated surgical blood loss of approximately 600 mL. Despite the patient's underlying thalassemia, no allogeneic red blood cell transfusion was required; transfusion was limited to 1 therapeutic unit of irradiated apheresis platelets. The mother recovered without neurological deficits. This case illustrates a coordinated cesarean-delivery-followed-by-aortic-repair strategy that avoided fetal exposure to cardiopulmonary bypass. Bakri balloon tamponade provided an organ-sparing means of securing uterine hemostasis before systemic heparinization. In young patients with thoracic aortic disease and possible syndromic features, structured genetic evaluation and family surveillance may be considered when feasible.
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7. Analysis, evaluation of hemodynamic differences and treatment strategy recommendations for multiple paraclinoid aneurysms.
PMID:日期:2026-09-18Multiple paraclinoid aneurysms of the internal carotid artery present distinct clinical and anatomical challenges compared with other aneurysms. This study aimed to investigate the hemodynamic characteristics of the parent artery adjacent to these lesions and to provide evidence-based suggestions for clinical treatment. We retrospectively reviewed digital subtraction angiography images of 57 patients treated between 2020 and 2024, including 18 cases with multiple paraclinoid aneurysms, 19 with a single paraclinoid aneurysm, and 20 with normal vascular anatomy. Parameters including peak systolic flow velocity and wall shear stress were derived from reconstructed hemodynamic models. We compared hemodynamic profiles among groups and evaluated the effects of simulated aneurysm obliteration on the distal vessel wall proximal to the carotid bifurcation. Four real-world follow-up cases were also analyzed for morphological and hemodynamic changes after treatment. The multiple-aneurysm group exhibited greater variability and instability in wall shear stress and flow velocity than the single-aneurysm and normal groups. Simulated aneurysm elimination showed no significant hemodynamic effect on distal vessels (P > .05). In clinical follow-up, however, noticeable morphological and hemodynamic alterations were observed following stent deployment. Multiple paraclinoid aneurysms induce more prominent hemodynamic disturbances in the parent artery. Aneurysm obliteration appears to have minimal immediate impact on the distal vessel wall, but stent placement may produce favorable long-term vascular remodeling, including straightened curvature and improved mild stenosis.
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8. The outcome of chemical synovectomy with Rifampicin in chronic hemophilic synovitis: The Syrian experience.
PMID:日期:2026-09-18Chronic arthropathy is the most common complication of moderate to severe hemophilia. Chemical synovectomy with Rifampicin offers a cost-effective alternative to radioactive synovectomy, especially in resource-limited settings like Syria. A retrospective study was conducted at the Syrian Hemophilia Society (2020-2024), involving 50 patients (69 target joints) with hemophilic synovitis. Outcomes were assessed using the Hemophilia Joint Health Score visual analogue scale (VAS) for pain, range of motion (ROM), Arnold-Hilgartner classification, and annual bleeding rate,pre- and post-intervention. Participants were predominantly young (mean age 18.99 ± 6.51 years), with hemophilia A (80%). A significant delay was noted between target joint onset and intervention (mean 40.30 months). The knees were most affected (72%), with moderate joint involvement (Arnold-Hilgartner Class II-III). Regional disparities emerged: Damascus patients showed better outcomes (HJHS: 2.33 vs 7.04; VAS: 1.11 vs 3.27, P < .001). Most patients improved significantly (P < .05), except those with mild phenotypes (no HJHS/VAS improvement), ankle involvement (no ROM improvement), and Arnold score 0 (no ROM improvement). Findings underscored inequities in care access across regions. Rifampicin-based chemical synovectomy is a viable, accessible treatment for hemophilic synovitis in low-resource settings. It led to significant improvements in pain, bleeding episodes, joint health, and mobility. However, regional healthcare disparities and delayed interventions remain key challenges affecting outcomes.
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9. Impact of a standardized oral care protocol on oral mucositis severity in leukemia patients receiving induction chemotherapy.
PMID:日期:2026-09-18This study aimed to evaluate whether a standardized oral care protocol is associated with reduced oral mucositis (OM) severity among leukemia patients receiving induction chemotherapy. Baseline characteristics were comparable between groups. Severe OM occurred in 17/90 (18.9%) in the protocol group versus 30/90 (33.3%) with usual care (odds ratio 0.46; P = .027); the association remained significant after adjustment (adjusted odds ratio 0.50; P = .044). OM duration was shorter with the protocol (median 6 vs 8 days; P = .003), with faster time to resolution (14 vs 16 days; P = .04). The protocol group reported lower maximum pain (median 3 vs 5; P < .001), less opioid use (44.4% vs 60.0%; P = .036), lower morphine milligram equivalents (60 vs 120 mg; P = .006), and reduced parenteral nutrition use (13.3% vs 24.4%; P = .049). Febrile neutropenia, blood culture positivity, intensive care unit transfer, and length of stay did not differ significantly. A standardized oral care protocol was associated with reduced severe OM and meaningful improvements in OM duration and symptom burden during leukemia induction chemotherapy. Prospective studies are warranted to confirm effectiveness and implementation fidelity. We conducted a single-center retrospective cohort study including adult leukemia inpatients receiving induction chemotherapy. Patients were grouped by exposure to a standardized oral care protocol with per-shift documentation versus usual care (90 vs 90). OM was graded each shift using the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) v5.0 from induction day 1 to hospital discharge. The primary outcome was peak OM severity; severe OM was defined as CTCAE grade ≥ 3. Secondary outcomes included OM incidence (CTCAE ≥ 1), time to onset, duration, time to resolution, maximum oral pain score (0-10 Numeric Rating Scale), opioid use and cumulative morphine milligram equivalents, parenteral nutrition use, febrile neutropenia (temperature > 38.3°C with neutropenia), blood culture positivity, intensive care unit transfer, and length of stay. Group comparisons used Pearson χ2/Fisher exact tests and appropriate parametric/nonparametric tests. Multivariable logistic regression assessed the association between protocol exposure and severe OM.
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10. Association between COVID-19 and exacerbation of allergic skin diseases: A retrospective questionnaire-based cross-sectional study in Western China.
PMID:日期:2026-09-18Coronavirus disease 2019 (COVID-19) has been linked to systemic immune dysregulation and various cutaneous manifestations, but its association with chronic allergic skin diseases, including atopic dermatitis (AD) and chronic urticaria (CU), remains unclear. This retrospective questionnaire-based cross-sectional study enrolled patients with AD and/or CU from a tertiary dermatology outpatient center in Western China. Self-administered questionnaires collected data on COVID-19 infection status, clinical characteristics, medication use, and self-reported changes in disease status within 14 days of COVID-19 symptom onset or diagnosis. Outcomes were self-reported rather than based on validated severity scores, and no prospective longitudinal follow-up was performed. Multivariable logistic regression analyses were conducted to identify factors associated with self-reported exacerbation. Covariates were selected a priori based on clinical relevance, and no missing data were present. A total of 509 patients with AD and/or CU were included. Compared with the non-COVID-19 group, participants with COVID-19 more frequently reported current alcohol consumption, pre-COVID-19 antihistamine use, insomnia, allergic rhinitis, and discontinuation of dermatological medications. COVID-19 infection was associated with self-reported exacerbation of allergic skin diseases in both the baseline-adjusted model (odds ratio [OR] = 4.611, 95% confidence interval [CI] = 2.268-9.377) and the fully adjusted model (OR = 4.445, 95% CI = 2.159-9.151). Among participants with COVID-19, fever, headache, fatigue, taste loss, reported use of antipyretics and antibiotics, and nervousness differed between the exacerbation and non-exacerbation groups. After multivariable adjustment, fatigue (OR = 1.601, 95% CI = 1.049-2.443), taste loss (OR = 1.654, 95% CI = 1.004-2.723), and the reported use of antibiotics (OR = 1.609, 95% CI = 1.036-2.499) and antipyretics (OR = 1.575, 95% CI = 1.037-2.392) were associated with self-reported exacerbation, although the medication-related associations likely reflected confounding by indication. Sensitivity analyses yielded consistent results. In this retrospective questionnaire-based cross-sectional study conducted during the omicron wave, COVID-19 infection was associated with self-reported exacerbation of AD and CU within 14 days of symptom onset or diagnosis. Because the outcome was based on participants' recall of symptom change rather than objective clinical assessment, the findings should be interpreted with caution, and their generalizability is limited by the single-center, omicron-period design. Associations with antipyretics and antibiotics likely reflect confounding by indication rather than direct pharmacological effects. Prospective multicenter studies with standardized outcome measures are needed to validate these findings.