Med
Med(英文缩写 MED-CAMBRIDGE),ISSN 2666-6359,eISSN 2666-6340 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：2025-10-01 至 2026-09-30，按本站收录文献的发表日期统计。
期刊介绍
Med 最新收录文献
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1. GLP-1 receptor agonist exposure in the periconceptional period and adverse obstetric outcomes: A systematic review and meta-analysis.
PMID:日期:2026-09-29This systematic review and meta-analysis assesses whether exposure to glucagon-like peptide-1 receptor agonists (GLP-1 RAs) during pregnancy or the periconceptional period is associated with adverse maternal and perinatal outcomes. Medline, Embase, and the Cochrane Library were searched for observational studies comparing pregnancies exposed and unexposed to GLP-1 RAs within 6 months before a positive pregnancy test. Outcomes included miscarriage, intrauterine death, congenital anomalies, preterm birth (PTB), hypertensive disorders of pregnancy (HDP), gestational diabetes mellitus (GDM), fetal growth restriction (FGR), small for gestational age (SGA), large for gestational age (LGA), and excess gestational weight gain. Random-effects meta-analyses and subgroup analyses by indication were performed. Ten studies included 2,118,215 women, of whom 8,325 were exposed and 2,109,890 were unexposed. Pooled estimates did not show a clearly detectable increase in miscarriage or intrauterine death, congenital anomalies, preterm birth, HDP, gestational diabetes, abnormal fetal growth, or excess gestational weight gain. A lower pooled estimate for preeclampsia was observed (odds ratio [OR]: 0.87, 95% confidence interval [CI]: 0.78-0.98; p = 0.02), but this was based on two datasets and should be interpreted cautiously. Subgroup analyses showed no clearly detectable differences by indication. The exposure-window sensitivity analysis, covering 90 days before conception through the end of the first trimester, used the same four studies as the primary congenital-malformation analysis and therefore was not independent. Available observational evidence did not identify a clearly detectable increase in adverse maternal or perinatal outcomes following periconceptional exposure to GLP-1 RAs. However, these findings do not establish safety because of heterogeneity, residual confounding, and limited datasets. None.
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2. Pregnancy-associated cardiac complications.
PMID:日期:2026-09-18Cardiovascular disease has become the most common cause of maternal mortality in the United States and non-obstetric cause of maternal mortality worldwide. Pregnancy profoundly alters maternal physiology and creates multiple maternal vulnerabilities, especially but not uniquely in women with preexisting cardiac disease. Common cardiac conditions represented in this patient population include arrhythmias, cardiomyopathies, and valvular heart disease, putting women at risk for numerous adverse events of pregnancy, including pre-eclampsia, heart failure, preterm delivery, and small-for-gestational-age babies. These complications often foretell long-term maternal cardiovascular risks and are also highly influenced by socioeconomic circumstances. To address these issues, cardio-obstetrics has emerged as a diverse and growing field spanning multiple medical specialties. Due to the breadth of pathology, a multidisciplinary Cardio-Obstetrics management team strategy is crucial. We review here common cardiac pathologies and their management throughout the peripartum period.
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3. Mucoadhesive recombinant human catalase for dry eye disease: From protein engineering to first-in-human study.
PMID:日期:2026-09-18Oxidative stress caused by excess reactive oxygen species (ROS) plays a key role in the progression of dry eye disease (DED), yet no approved DED therapy directly eliminates ROS. Here, we develop an antioxidant biologic with enhanced ocular-surface retention by thiol engineering of recombinant human catalase (hCAT) as a new ROS-scavenging eye drop therapy for DED. Thiolated hCAT (hCAT-SH) was characterized for activity, stability, mucin interaction, and ocular retention. Efficacy, mechanism, and safety were evaluated in mouse, rabbit, and rat studies, followed by a randomized, double-blind, placebo-controlled first-in-human trial in 30 patients with DED. With formulation optimization, hCAT-SH maintained enzymatic activity and formulation stability, while exhibiting enhanced mucin binding and prolonged corneal retention. In mouse DED models, hCAT-SH reduced oxidative stress, accelerated epithelial repair, restored tear secretion, and modulated inflammatory and barrier-repair pathways distinct from cyclosporine. In rabbits, exposure remained predominantly ocular with favorable repeated-dose tolerability. Clinically, 0.1 mg/mL hCAT-SH significantly improved corneal fluorescein staining, reduced tear cytokine levels and corneal dendritic cell density versus placebo, and raised no treatment-related safety concerns. hCAT-SH is a carrier-free, long-retained HO-scavenging biologic, with integrated preclinical and first-in-human evidence supporting further development as a new DED drug. National Natural Science Foundation of China; National Technology Innovation Center for Biopharmaceuticals; Jiangsu Key R&D Program; National Key R&D Program of China; Shanghai "Dawn" Program; Shanghai Science and Technology Innovation Action Plans; Shanghai Municipal Commission of Health; Shanghai High-Quality Development Plan for Science and Technology Industry; and Macao FDCT.
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4. Deep learning-enabled screening of chronic kidney disease from echocardiography.
PMID:日期:2026-09-18Chronic kidney disease (CKD) affects nearly 850 million individuals globally. The prevalence of undiagnosed CKD is over 60%. Taking advantage of the relationship between CKD and cardiovascular disease, we developed a deep learning (DL) model to detect CKD from parasternal long-axis (PLAX) videos, using 325,377 PLAX videos from 62,818 patients at Cedars-Sinai Medical Center (CSMC). We externally validated our model in two independent cohorts of 2,762 patients at Stanford Healthcare (SHC) and 41,611 patients at Kaiser-Permanente Northern California (KPNC). In a held-out test cohort at CSMC, our model detected any stage of CKD with an area under the curve (AUC) of 0.756 (95% confidence interval: 0.749-0.763), with consistently strong performance in the KPNC (AUC: 0.718 [0.714-0.723]) and SHC (AUC: 0.719 [0.704-0.735]) cohorts. Our model performed well across subgroups with and without metabolic comorbidities, suggesting that it learned imaging features specific to CKD. Our DL echo model detected CKD with robust performance at two external clinical sites, thus offering an avenue for noninvasive screening and improved detection rates. This work was supported by the Sarnoff Cardiovascular Research Foundation, the American Heart Association (25POST1357984 and 25AHAI1487693), and the National Institutes of Health (R00HL157421, R01HL173487, and R01HL173526).
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5. An adult proteomic signature associated with very low birth weight and chronic disease risk.
PMID:日期:2026-09-16Adults born at very low birth weight (VLBW, <1.5 kg) have elevated risks of chronic disease, but it is unclear whether adult plasma proteomics contains a detectable signature associated with recalled VLBW. We analyzed 2,923 plasma proteins in 26,061 UK Biobank participants (median sampling age 56.4 years) with recalled birth weight, including 368 with VLBW and 25,693 with normal birth weight. We derived a machine learning proteomic prematurity index (PPI) distinguishing these groups and evaluated associations with 425 adult diagnoses, discrimination relative to birth weight and electronic health record (EHR) information, incident diseases after proteomic sampling, and exploratory biological interpretation. The PPI was associated with recalled VLBW (odds ratio [OR], 7.32; 95% confidence interval [95% CI], 4.01-13.42) and remained independently associated after adjustment for EHR-derived VLBW probability (OR, 5.82; 95% CI, 3.99-8.47). Recalled VLBW was associated with adult disease burden, and PPI showed higher discrimination than birth weight for 370 of 425 diseases. Incident-only analyses preserved the cross-disease hazard ratio patterns, while fewer events and adult factor adjustment attenuated some associations. Exploratory biological annotations paralleled the disease patterns. Among participants with normal birth weight, higher PPI was associated with disease burden and subsequent disease risk, indicating that PPI is not VLBW specific. Adult plasma proteomics identifies a signature associated with recalled VLBW that provides information about adult disease risk beyond birth weight and EHR-derived measures. These findings are hypothesis generating and do not establish a direct molecular consequence of prematurity. External validation is required before clinical application. The March of Dimes, the Alfred E. Mann Foundation, the Universe of Mind, and the Bill & Melinda Gates Foundation (INV-037517 and INV-076306).
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6. N-of-1 investigational study of a novel antisense oligonucleotide drug in CHCHD10-related ALS shows early signs of efficacy.
PMID:日期:2026-09-14Pathogenic CHCHD10 variants cause a rare, dominantly inherited form of amyotrophic lateral sclerosis (ALS). Non-allele-selective CHCHD10 knockdown may mitigate a toxic gain-of-function mechanism. We evaluated nL-CHCHD-001 in one participant with the p.Arg15Leu variant. In this open-label N-of-1 study, 320-gapmer antisense oligonucleotides (ASOs) were screened, and a lead candidate was selected according to specificity and non-clinical safety criteria. Six intrathecal doses were administered over 12 months (three 50-mg doses followed by three 75-mg doses). Prespecified primary outcomes were 12-month changes in functional, cognitive, quality-of-life, respiratory, neurofilament light (NfL), and survival measures; secondary outcomes assessed were safety and tolerability. Analyses were descriptive. No serious adverse events occurred. Post-dose headache and fatigue were mild to moderate, and cerebrospinal fluid safety results were unremarkable. Plasma NfL decreased by approximately 50% from a mildly elevated pretreatment baseline and entered the laboratory reference range. The Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised score increased from 33 to 36, vital capacity increased from 48% to 55% (as predicted), cognitive and quality-of-life scores remained stable, and the participant was alive at 12 months. Individualized CHCHD10-directed treatment was feasible and well tolerated and was temporally associated with biomarker and clinical stability or improvement. This N-of-1 study demonstrates the feasibility of developing individualized ASO therapy for CHCHD10-related ALS and provides preliminary evidence of biomarker and clinical benefit. These findings support further evaluation of nL-CHCHD-001 and highlight NfL as a practical treatment-response biomarker for personalized therapeutics in ALS. gov: NCT06392126. This study was supported by the n-Lorem Foundation, National Institutes of Health grants U01NS134684 and KL2 TR002379, and the Kevin Merszei Career Development Award.
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7. Prenatal exposure to the plasticizer DEHP increases the likelihood of early-life autism and ADHD symptoms through epigenetic programming.
PMID:日期:2026-09-11Growing evidence implicates prenatal exposure to di-(2-ethylhexyl) phthalate (DEHP), a common endocrine-disrupting plasticizer, in the development of autism and attention-deficit/hyperactivity disorder (ADHD). Yet underlying mechanisms remain unclear. Here, we examined whether cord blood DNA methylation, a key epigenetic marker, mediates the association between prenatal DEHP exposure and autism and ADHD symptoms in 847 children from the Barwon Infant Study. Autism and ADHD are complex phenotypes driven by alterations in higher-level gene networks and neuronal circuits, where diverse genetic and environmental risk factors converge. Accordingly, rather than a gene-by-gene approach, we employed a data-driven strategy to elucidate broader functional epigenetic signatures of autism and ADHD elicited by DEHP exposure. This included (1) a methylation profile score for DEHP exposure (MPS), and (2) a targeted analysis of DEHP-associated co-methylated gene networks. Causal mediation analysis showed that both MPS and a network of 531 co-methylated genes mediated the effect of DEHP on increased autism and ADHD symptoms at ages 2 and 4 years (proportion mediated: 0.21-0.80). The co-methylation network was enriched for neural cell-type markers, autism and ADHD risk genes (including FOXP1, SHANK2, and PLXNB1), and targets of endocrine receptors previously linked to DEHP (including estrogen and glucocorticoid receptors), providing biological plausibility. We validated key results in independent blood (n = 66) and postmortem brain (n = 40) DNA methylation datasets. These findings provide mechanistic evidence linking DEHP to adverse neurodevelopment and reinforce mounting concerns regarding the risks of prenatal exposure. Funding was obtained from the NHMRC, the Minderoo Foundation, and additional sources (detailed in acknowledgments).
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8. Pancreatic ductal adenocarcinoma: Clinical trials to watch.
PMID:日期:2026-09-11The treatment of PDAC is transitioning from uniform cytotoxic chemotherapy toward precision strategies guided by molecular identity and disease stage. RAS and PARP inhibitors and personalized neoantigen vaccination have created new options across metastatic and resectable disease. Chemotherapy timing relative to surgery and post-resection surveillance represent other important axes of precision oncology. Seven trials addressing these dimensions may collectively redefine PDAC treatment.
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9. The fear in the waiting room.
PMID:日期:2026-09-11In this Backstory, the authors describe the journey from a basic science laboratory to the first randomized clinical trial of an anti-inflammasome drug for an eye disease, told through the lives of the patients whose situation made the question impossible to ignore.
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10. Pomalidomide plus bortezomib and dexamethasone for newly diagnosed multiple myeloma with renal impairment: Randomized phase II study (POM-MM-003).
10. 泊马度胺联合硼替佐米和地塞米松用于新诊断伴肾功能损害的多发性骨髓瘤：随机II期研究（POM-MM-003）PMID:日期:2026-09-09POM-MM-003 study compared pomalidomide-bortezomib-dexamethasone (PVd) with Vd in newly diagnosed multiple myeloma (NDMM) patients with RI. POM-MM-003 was open-label, randomized, phase II study done at eight centers in China (ClinicalTrials.gov: NCT05432414). Patients with symptomatic NDMM with RI (creatinine clearance ≥15 to <60 mL/min) were randomly 2:1 to PVd and Vd groups for two 21-day induction cycles, followed by additional 2-cycle same treatment when achieving minor response. Primary endpoint was very good partial response or better (≥VGPR) after 4-cycle induction. Between January 18, 2023 and December 2, 2024, 82 patients were randomized to PVd (n = 58) and Vd (n = 24) groups. After 4-cycle induction, PVd resulted in a significantly higher ≥ VGPR rate (72.4% [42/58; 95% CI: 59.1-83.3] vs. 20.8% [5/24; 95% CI: 7.1-42.2]; p < 0.001) and renal response rate (75.9% [44/58; 95% CI: 62.8-86.1] vs. 45.8% [11/24; 95% CI: 25.6-67.2]; p = 0.009) versus Vd after 4-cycle induction. Median progression-free survival (PFS) and overall survival (OS) in both groups were not reached. Grade 3-4 treatment-related adverse events (TRAEs) occurred in 41.4% (24/58) of patients with PVd and 29.2% (7/24) with Vd. Only one case in the PVd group died of treatment-related ileus. PVd may represent a potential treatment option for this patient population. This trial was sponsored by Chia Tai Tianqing Pharmaceutical Group Co., Ltd. (2021072900001) and was funded by the National Natural Science Foundation of China (no. 82370203), the Beijing Natural Science Foundation (no. 7264339), and the Peking University People's Hospital Scientific Research Development Funds (RDJP2025-06).