Advances in Clinical and Experimental Medicine临床与实验医学进展
Advances in Clinical and Experimental Medicine(英文缩写 ADV CLIN EXP MED),ISSN 1899-5276,eISSN 2451-2680,中文译名:临床与实验医学进展 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 | 1.736 | Q4 |
| 2022 | 2.100 | Q4 |
| 2023 | 2.100 | Q3 |
| 2024 | 1.900 | Q3 |
| 2025 | 2.500 | Q3 |
Advances in Clinical and Experimental Medicine 最新收录文献
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1. EQ-5D-5L quality of life scores predict long-term outcomes in kidney transplant recipients.
PMID:期刊:日期:2026-09-17Kidney transplantation is the optimal method of renal replacement therapy. The EQ-5D-5L is a widely used instrument for assessing health-related quality of life (HRQoL) across different populations. This study aimed to assess HRQoL in kidney transplant recipients (KTRs) compared with the general population and to identify factors associated with impaired HRQoL. A total of 156 KTRs (58 women and 98 men) participated in this prospective observational study. All participants completed the EQ-5D-5L questionnaire. Demographic and laboratory data were collected, and physical performance tests were performed. Statistical analyses were conducted using Statistica. Of the 156 participants, 54 (34.62%) had an EQ-5D-5L health state of 11111, whereas 102 (65.38%) reported impairment in HRQoL in at least 1 domain. No significant differences in sex, age, or Charlson Comorbidity Index (CCI) were observed between the analyzed groups. Compared with Polish population reference values for the EQ-5D-5L, KTRs had similar HRQoL, with a median utility score of 0.970 [Q1-Q3: 0.916-1.000]. In the multivariable Cox regression model, the EQ-5D-5L utility score independently predicted mortality in KTRs (hazard ratio (HR) = 0.007; 95% confidence interval (95% CI): 0.000-0.134; *p* = 0.001). The EuroQol Visual Analogue Scale (EQ VAS) score also independently predicted adverse outcomes (HR = 0.966; 95% CI: 0.935-0.997; p = 0.030). Assessment of HRQoL should be an integral component of the holistic management of KTRs. HRQoL assessment is associated with long-term outcomes in KTRs. Self-rated HRQoL measured on a 0-100 VAS may help identify patients at increased risk of adverse outcomes.
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2. Machine learning identifies autophagy biomarkers driving microvascular injury in cardiac ischemia/reperfusion.
PMID:期刊:日期:2026-09-17Ischemic heart disease (IHD) remains a leading global cause of mortality. While reperfusion is essential for treating ischemic cardiomyopathy, it paradoxically induces myocardial ischemia/reperfusion (I/R) injury targeting the microvascular endothelium. The link between autophagy and microvascular damage in myocardial I/R requires clarification. This study aimed to identify autophagy-related biomarkers of myocardial I/R injury using integrated bioinformatics and experimental validation, characterize the associated molecular and immune features, and evaluate the role of Myc in cardiac microvascular endothelial injury. Bioinformatics analysis of Gene Expression Omnibus (GEO) multi-chip datasets intersected autophagy-related genes (HADb) with differentially expressed genes (DEGs) to identify signature biomarkers using machine-learning algorithms. Diagnostic efficacy was validated using a nomogram. Mechanistic exploration through gene set enrichment analysis (GSEA) and immune profiling revealed I/R subtypes. Biomarker expression was externally validated in the GSE168610 dataset. Myocardial I/R models were assessed using echocardiography (cardiac function), Evans blue/TTC staining (infarction area), and ink perfusion (microvascular density). Hub gene expression was quantified using quantitative polymerase chain reaction (qPCR), western blot (WB), and immunohistochemistry (IHC). In vitro, c-Myc-knockout cardiac endothelial cells underwent hypoxia/reoxygenation (H/R), followed by analysis of autophagy (WB), apoptosis (TUNEL), and autophagic vacuoles (transmission electron microscopy (TEM)). Seven autophagy-related DEGs were identified and linked to muscle proliferation, protease activation, and oncogenesis. Four signature genes (Casp4, Cdkn1a, Myc, and Rgs19) were identified by 3 machine-learning algorithms, with diagnostic validation. In the development cohort, the AUCs ranged from 0.756 to 0.876. In the external-validation cohort, the AUC was 1.000 for Casp4, Myc, and Rgs19 and 0.875 for Cdkn1a. GSEA linked these genes to tricarboxylic acid cycle (TCA) dysregulation and immune infiltration. Unsupervised clustering identified 2 molecular subtypes. C1 exhibited higher expression of 6 of the 7 autophagy-related DEGs, whereas C2 showed higher proportions of mast cells and activated dendritic cells and enrichment of mitochondrial and energy-metabolism pathways. c-Myc knockout reduced endothelial apoptosis and autophagic injury. c-Myc emerged as a critical driver linking excessive autophagy to microvascular damage, providing a promising diagnostic and therapeutic target for reperfusion injury management.
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3. Prospective analysis of risk factors in pediatric tic disorders: A clinical observational study.
PMID:期刊:日期:2026-09-17Tic disorders (TD) are common neuropsychiatric conditions in children, often accompanied by anxiety and depression. Understanding the associated risk factors and their relationship with TD severity is crucial for effective management. This study investigated risk factors for TD in children and examined the relationship between anxiety, depression, and TD severity using the Screen for Child Anxiety Related Emotional Disorders (SCARED) and the Depression Self-Rating Scale for Children (DSRSC). A prospective observational study was conducted in 113 children diagnosed with TD at our hospital between January 2021 and January 2024. Tic disorder severity was evaluated using the Yale Global Tic Severity Scale (YGTSS). Anxiety and depression were assessed using SCARED and DSRSC, respectively. Demographic and clinical characteristics, as well as comorbidities, were analyzed using IBM SPSS v. 25.0. Children with TD had significantly higher rates of febrile seizures, family history of TD, recurrent respiratory infections, and comorbid attention-deficit/hyperactivity disorder (ADHD). Patients with TD exhibited elevated SCARED and DSRSC scores, which were significantly higher in moderate-to-severe cases than in mild cases. Yale Global Tic Severity Scale scores were positively correlated with both SCARED and DSRSC scores. Key risk factors associated with TD and with moderate-to-severe disease included a family history of TD, higher DSRSC scores, and higher SCARED scores. This study highlights a strong association between anxiety, depression, and TD severity, with higher SCARED and DSRSC scores observed in moderate-to-severe cases. A family history of TD, along with elevated anxiety and depression scores, were identified as significant associated factors. These findings underscore the importance of psychological assessment and tailored interventions for children with TD.
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4. Pancytopenia and isolated cytopenias as hematological complications of SLE: A narrative review.
4. 全血细胞减少症和单一血细胞减少症作为SLE的血液学并发症：一项叙述性综述PMID:期刊:日期:2026-09-14Pancytopenia is a significant hematological complication in patients with systemic lupus erythematosus (SLE), with an estimated prevalence of 10-40%. It is defined as a simultaneous decrease in red blood cells, white blood cells, and platelets. Although isolated cytopenias are more common, pancytopenia may indicate severe disease activity or secondary complications, such as bone marrow suppression or hemophagocytic syndromes. This review aims to summarize and synthesize current knowledge on the etiology, pathophysiology, diagnostic approach, and treatment strategies for pancytopenia in SLE, as well as its differentiation from other causes of bone marrow failure. The pathogenesis of pancytopenia in SLE is multifactorial and includes drug-induced bone marrow suppression, hypersplenism, myelofibrosis, macrophage activation syndrome (MAS), and autoimmune bone marrow failure. The diagnostic evaluation includes hematologic assessment, bone marrow examination, and exclusion of alternative diagnoses, such as aplastic anemia and paroxysmal nocturnal hemoglobinuria. Therapeutic management depends on the underlying cause. We also summarize published case reports comparing treatment approaches and clinical outcomes. The role of rituximab (RTX) in the management of pancytopenia and isolated cytopenias associated with SLE is discussed in detail. Particular attention is given to its mechanisms of action, safety profile and mixed clinical outcomes, documented in multicenter retrospective cohort studies, meta-analyses, and case series. Early recognition of pancytopenia remains a clinical challenge and requires well-structured diagnostic and therapeutic strategies. A thorough understanding of its underlying mechanisms and clinical manifestations is essential to avoid delays in treatment and prevent complications.
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5. Changes in hip joint anatomical shape as a predictor of osteoarthritis.
PMID:期刊:日期:2026-09-14Hip osteoarthritis (HOA) is one of the leading causes of musculoskeletal disability worldwide, yet its etiology remains incompletely understood. Its pathogenesis is multifactorial, involving systemic factors and biomechanical alterations of the hip joint that trigger degenerative changes. The aim of this study was to identify the most informative radiographic views and the key acetabular and proximal femoral parameters for detecting structural abnormalities of the hip joint that may contribute to the development of HOA. This observational case-control study included 156 patients older than 55 years who underwent total hip arthroplasty for HOA (osteoarthritis (OA) group) and 61 age-matched controls without clinical HOA, recruited from a single center between 2019 and 2022. Patient demographics, clinical history, and hip-specific functional scores were collected. Standardized anteroposterior (AP), frog-leg lateral (LL), and Dunn 45° radiographs were obtained, and multiple radiographic parameters were measured. Asymptomatic contralateral hips in patients with OA had significantly more cam-type deformities (higher alpha angles, lower head-neck offset ratios, and a higher prevalence of pistol-grip deformity) than those in the control group (p < 0.001). In contrast, pincer-type features were more common in the control group. Logistic regression analysis identified higher alpha angles, greater femoral neck diameter, and lower head-neck offset ratios as predictors of OA, whereas a larger femoral head diameter was identified as a protective factor (model area under the curve (AUC) = 0.90). Bone quality was superior in the control group, with longer femoral neck axis lengths and higher Singh indices (p < 0.001). Radiographic markers of cam-type femoroacetabular impingement (FAI) are significantly more prevalent in patients with HOA and may serve as early indicators of disease risk. Dunn and LL views are optimal for detecting these abnormalities. A larger femoral head diameter, as measured on both AP and LL radiographic views, appears to be a protective factor against the development of HOA. Understanding these morphological differences may facilitate earlier diagnosis and support preventive strategies for HOA.
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6. Awareness and acceptance of respiratory syncytial virus (RSV) vaccination among pregnant women in Poland: Results of an internet-based survey.
PMID:期刊:日期:2026-09-14Respiratory syncytial virus (RSV) is a major cause of severe lower respiratory tract infections in infants, particularly among vulnerable groups such as preterm newborns and infants with underlying medical conditions. The approval of the RSVpreF vaccine for use during pregnancy offers a new strategy for reducing RSV-related morbidity in newborns. This study aimed to assess RSV vaccination coverage among pregnant women in Poland, identify factors influencing vaccine hesitancy, and evaluate knowledge regarding the benefits of RSV vaccination. A Computer-Assisted Web Interview (CAWI) survey was conducted among 668 respondents in Poland. An anonymous questionnaire consisting of 23 questions was distributed via social media platforms between July 25 and August 1, 2024. Participants were recruited through Facebook groups and Instagram and included women who had recently given birth or were currently pregnant. Respondents with medical backgrounds more frequently provided correct answers to questions regarding RSV than those without medical training. For example, when asked about methods of treating RSV infection, 109 medical professionals (74.15%) answered correctly, compared with 251 non-medical respondents (48.18%; p < 0.001). Individuals with medical backgrounds and those who received information about vaccination from their physician were more likely to receive the RSV vaccine during pregnancy. In addition, women vaccinated against other diseases, such as influenza and pertussis, were more likely to choose RSV vaccination. Vaccination against RSV during pregnancy is an important strategy for protecting newborns against severe RSV infection and should be promoted as a public health measure. Our findings highlight the need for targeted educational initiatives and public health campaigns to increase awareness and improve vaccination coverage among pregnant women.
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7. Clinical characteristics and risk factors for carbapenem-resistant Pseudomonas aeruginosa infection.
PMID:期刊:日期:2026-09-14Pseudomonas aeruginosa (PA) is a major opportunistic pathogen responsible for nosocomial infections, particularly those affecting the lower respiratory tract. The emergence of carbapenem-resistant PA (CRPA) poses a significant global therapeutic challenge, as increasing resistance rates complicate clinical management. To investigate the clinical characteristics and antimicrobial resistance profiles of CRPA infections, identify associated risk factors among patients at The Affiliated Hospital of North Sichuan Medical College, and provide evidence for the development of effective prevention and control strategies. A retrospective case-control study was conducted involving 94 patients with CRPA infection (study group) and 50 patients with CSPA infection (control group) between January 2021 and December 2022. Clinical characteristics and risk factors were analyzed using univariate analyses and multivariable logistic regression. Variable selection for the primary model was performed using best-subset selection based on the Bayesian information criterion (BIC). Carbapenem-resistant PA isolates were primarily recovered from lower respiratory tract secretions (77.66%) and were most frequently identified in the intensive care unit (ICU) (41.49%). Compared with CSPA strains, CRPA exhibited significantly higher resistance rates to aztreonam, ciprofloxacin, levofloxacin, and cephalosporins (p < 0.05). Multivariable logistic regression using best-subset selection identified prior exposure to carbapenems (adjusted odds ratio (aOR) = 6.914, 95% confidence interval (95% CI): 2.765-17.290, p < 0.001) and aminoglycosides (aOR = 6.209, 95% CI: 1.701-22.668, p = 0.006) as independent risk factors for CRPA infection. Carbapenem-resistant PA infection imposes a considerable burden in our hospital, particularly among ICU patients. Prior exposure to carbapenems and aminoglycosides significantly increases the risk of CRPA infection. The BIC-selected model identified the same main risk factors as the fully adjusted sensitivity analysis, supporting the consistency of the findings. Strengthening antimicrobial stewardship and tailoring empirical therapy according to local antimicrobial susceptibility patterns are essential to curb resistance and improve clinical outcomes.
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8. Integrated single-cell transcriptomics, Mendelian randomization, and machine learning identify CEBPZ as an immune-related biomarker in oral lichen planus.
8. 整合单细胞转录组学、孟德尔随机化和机器学习识别CEBPZ作为口腔扁平苔藓的免疫相关生物标志物PMID:期刊:日期:2026-09-14Oral lichen planus (OLP) is a chronic, immune-mediated oral mucosal disease with complex pathophysiology and potential for malignant transformation. Understanding its molecular basis is critical for the development of precise diagnostic and therapeutic strategies. We aimed to identify key immune-related biomarkers and characterize cellular dynamics in OLP, with a particular focus on the role of CEBPZ in disease pathogenesis. We analyzed single-cell RNA sequencing (scRNA-seq) data from OLP lamina propria samples (GSE211630) to identify disease-specific T-cell subpopulations using high-dimensional weighted gene co-expression network analysis (hdWGCNA) for oxidative stress-related gene modules.-data-based Mendelian randomization (SMR) integrated FinnGen genome-wide association study (GWAS; 342,499 Europeans) data with Genotype-Tissue Expression (GTEx) expression quantitative trait loci (eQTL) data to identify causal genes. Machine learning (ML) models (least absolute shrinkage and selection operator (LASSO) and convolutional neural network (CNN)) were developed using bulk RNA-seq datasets (GSE52130 and GSE38616) for diagnostic purposes. We identified OLP-specific T-cell populations (clusters 0, 3, 5, 7, 13, and 15) with enhanced migration inhibition factor (MIF) pathway signaling toward B cells and monocytes. Two oxidative stress-associated modules contained hub genes, including CEBPZ. Summary-data-based Mendelian randomization analysis identified 231 OLP-associated genes, with CEBPZ uniquely intersecting LASSO-selected markers (odds ratio (OR) = 1.057, 95% confidence interval (95% CI) = 1.013-1.102, p = 0.010). Machine learning models achieved area under the curve (AUC) values ranging from 0.653 to 0.745, with the CNN model reaching a validation accuracy of 0.735. CEBPZ showed elevated expression in OLP T cells and correlated with enhanced MIF-(CD74+CXCR4) signaling. This integrative approach identifies CEBPZ as a pivotal biomarker linking genetic susceptibility, oxidative stress, and immune dysregulation in OLP. Our diagnostic models offer promising tools for OLP management.
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9. Enhancing European governance for health crisis management: A proposal for the effective integration of primary healthcare systems into emergency preparedness and response plans.
PMID:期刊:日期:2026-09-08Primary healthcare (PHC) facilities are fundamental components of health systems across Europe, serving as the first point of contact and ensuring continuity of care. However, the COVID-19 pandemic exposed significant gaps in their preparedness for large-scale health crises. Although emergency preparedness frameworks developed by the World Health Organization (WHO) and the European Union existed, they often lacked adequate integration of PHC into comprehensive public health (PH) emergency preparedness and response plans (EPRPs). To identify regulatory and operational gaps in the integration of PHC into existing European health EPRPs; to evaluate challenges related to governance and health information system (HIS) interoperability between PHC and PH authorities; and to develop a multilevel governance model to harmonize the role of PHC across the continuum of health crisis management in future PH emergencies. The EURODATA research group conducted a comprehensive analysis of the role of primary care during the COVID-19 pandemic. The study included a review of international and European health policies and emergency preparedness frameworks. The analysis followed the health EPRP framework and focused on regulations, governance structures, HIS interoperability, and the role of PHC. Based on these findings, recommendations were developed to strengthen EPRPs for European PHC systems. The analysis identified limited regulatory guidance on coordination between PHC and PH authorities, insufficient interoperability of HIS, and gaps in local coordination. The proposed EPRP framework addresses these shortcomings by promoting improved governance, integration of information systems, and harmonization of the role of PHC within coordinated health crisis management. Strengthening the role of PHC in health emergency preparedness is essential for building resilient health systems. The proposed EPRP provides actionable strategies to address the identified gaps and improve the integration of PHC into health crisis management. Implementation of these recommendations may enhance the capacity of European PHC systems to respond effectively to both acute and chronic health needs during future crises.
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10. Digitally supported physical cancer rehabilitation during and after systemic treatment in South Baltic countries: Protocol for the AMBeR eRehab feasibility study.
PMID:期刊:日期:2026-09-08Research in exercise oncology has consistently provided evidence supporting the integration of exercise into all phases of cancer care. However, less is known about how this can be implemented across different patient populations and healthcare settings. This study aims to generate knowledge about the equitable implementation of digitally supported physical rehabilitation during and after systemic cancer treatment through feasibility testing in 5 South Baltic countries. Methodology. This study is part of the gAMBeRh project (Advanced Modeling of Baltic E-cancer caRe) and is an international, multicenter, prospective study with a hybrid implementation-effectiveness design. It includes 2 single-arm feasibility trials, each aiming to enroll 30 patients undergoing systemic treatment and 30 patients who have completed systemic treatment or are receiving long-term or life-prolonging treatment at each participating site, for a total of 300 adult cancer patients. All tumor groups are eligible, and participants must be .18 years of age. We will use the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework to structure data collection and reporting. Additionally, Group Concept Mapping will be used to evaluate determinants of participation among patients and determinants of intervention delivery among healthcare professionals (HCPs). Enrollment began in September 2024 and is expected to be completed by December 2026. Discussion. While digital solutions have the potential to overcome barriers to integrating exercise into oncology care, inequitable implementation may inadvertently exacerbate disparities in cancer rehabilitation if these innovations remain inaccessible to patients with fewer resources. By evaluating reach, effectiveness, adoption, implementation, and maintenance, as well as the determinants of participation among patients and HCPs, this study will contribute to the evidence base on the implementation of digitally supported physical rehabilitation in cancer care. Findings from the AMBeR eRehab study will inform future efforts to digitize cancer rehabilitation while ensuring that inequities are not reproduced.