医学最新文献

Objective: To analyze and evaluate the efficacy of different blue light therapy methods and provide evidence-based recommendations for their selection in clinical practice.

Methods: Clinical randomized controlled trials (RCTs) evaluating the efficacy of various blue light therapy methods for neonatal jaundice were retrieved from both domestic and international databases. The search period covered the inception of each database until November 2023. After screening, the quality of the included studies was assessed using the Cochrane Risk of Bias tool. Literature management was conducted with NoteExpress 3.2, while data collection and extraction were performed using Excel 2003. Statistical analysis was carried out using RevMan 5.4.1. Heterogeneity was assessed using the Q test (p value), and the OR value of the combined effect was calculated using either a fixed-effects or random effects model, depending on the presence of heterogeneity. A forest plot was generated to visualize the results. Sensitivity analysis was performed by excluding the largest-weighted study, and the potential for bias in outcome indicators was assessed using a funnel plot.

Results: A total of 652 articles were retrieved, with 16 clinical RCTs meeting the inclusion criteria. The meta-analysis results indicated that, compared to continuous blue light therapy in the control group, intermittent blue light therapy achieved a higher total effective rate (OR = 1.82, 95%CI (1.25-2.64), p = .002), significantly lower serum bilirubin levels post-treatment (OR = -14.59, 95%CI (-26.11 to -3.08), p = .01), and a shorter time to jaundice resolution (OR = -2.35, 95%CI (-3.83 to -0.87), p = .002). Additionally, the incidence of adverse reactions was lower in the intermittent therapy group compared to the control group (OR = 0.27, 95%CI (0.19-0.36), p < .00001). Sensitivity analysis confirmed that the combined effect size was stable and reliable (OR (95%CI) = -16.23 (-28.67 to -3.79), p = .01). The funnel plot suggested potential publication bias.

Conclusions: Intermittent blue light therapy is effective and demonstrates significant clinical benefits, making it a valuable treatment option for neonatal jaundice in clinical practice.

Globally, there are over 3 million severe cases of influenza each year, leading to up to half a million deaths. This study provides a comprehensive analysis of the current status of children's influenza vaccine research over the past 20 years and explores potential future research trends, including improvements in vaccine coverage and strategies to address vaccine hesitancy. We extracted all research data on children's influenza vaccines from 2004 to 2024 using the Web of Science Core Collection (WOSCC). The contributions of various countries/regions, institutions, authors, and journals in this field were assessed, and research hotspots as well as promising future trends were predicted through keyword analysis using CiteSpace and VOSviewer. A total of 2,598 related publications from 2004 to 2024 were identified and collected for analysis. The United States (USA) and England emerged as the leading contributors with the highest number of published papers. AstraZeneca was identified as a key leader among research institutions, and Ambrose Christopher S was recognized as the most productive author in this field. The journals Vaccine and Human Vaccines & Immunotherapeutics stood out as the most prominent publications in this area. The keyword analysis highlighted that international research collaboration maybe a promising strategy for bridging global gaps; Addressing vaccine hesitancy could potentially increase vaccination coverage; Live attenuated vaccines, intranasal administration and universal vaccines are promising directions for future development. These insights highlight potential avenues for improving influenza vaccine coverage and inform strategies to mitigate vaccine hesitancy, crucial for protecting children and enhancing public health.

Preeclampsia is a complex condition characterized by elevated blood pressure and organ damage involving kidneys or liver, resulting in significant morbidity and mortality for both the mother and the fetus. Increasing evidence suggests that oxidative stress, often caused by mitochondrial dysfunction within fetal trophoblast cells may play a major role in the development and progression of preeclampsia. Oxidative stress occurs as a result of an imbalance between the production of reactive oxygen species (ROS) and the capacity of antioxidant defenses, which can lead to placental cellular damage and endothelial cell dysfunction. Targeting oxidative stress appears to be a promising therapeutic approach that has the potential to improve both short- and long-term maternal and fetal outcomes, thus reducing the global burden of preeclampsia. The purpose of this review is to provide a comprehensive account of the mechanisms of oxidative stress in preeclampsia. Furthermore, it also examines potential interventions for reducing oxidative stress in preeclampsia, including natural antioxidant supplements, lifestyle modifications, mitochondrial targeting antioxidants, and pharmacological agents.A better understanding of the mechanism of action of proposed therapeutic strategies targeting oxidative stress is essential for the identification of companion biomarkers and personalized medicine approaches for the development of effective treatments of preeclampsia.

Regulatory T cells (Tregs) contribute significantly to the immunosuppressive nature of the tumor microenvironment which is a main barrier for immunotherapies of solid cancers. Reducing Treg numbers enhances anti-tumor immune responses but current depletion strategies also impair effector T cells (Teffs), potentially leading to reduced anti-tumor immunity and/or autoimmune diseases. CD137 has been identified as the most differentially expressed gene between peripheral Tregs and intratumoral Tregs in virtually all solid cancers. Further, CD137 is expressed by malignant cells of certain cancers, making it a potential target for tumor immunotherapy. Here, we report the development of a fully human anti-human CD137 antibody of the IgG1 isotype, clone P1A1, that induces antibody-dependent cell-mediated cytotoxicity (ADCC) in CD137⁺ Tregs and cancer cells. P1A1 cross-reacts with murine CD137 which allowed testing murine chimeric P1A1 in syngeneic murine tumor models where P1A1 significantly reduced the number of CD137⁺ Tregs and inhibited tumor growth in a murine hepatocellular carcinoma (HCC) and a melanoma lung metastasis model. P1A1 can also be internalized thus enabling it as a carrier for drugs to target CD137⁺ Tregs and cancer cells. These anti-cancer properties suggest a translation of P1A1 to human immunotherapy.

Background: The body composition of National Collegiate Athletic Association (NCAA) athletes is well documented but no such data exist for university club sports athletes. Additionally, the majority of norms for NCAA athletes were created from individual methods requiring assumptions.

Objective: This study used a four-component (4C) model to measure the body composition of university club sports athletes.

Methods: Data were collected on club athletes participating in baseball, climbing, cycling, figure skating, gymnastics, ice hockey, lacrosse, pickleball, powerlifting, racquetball, rodeo, rugby, soccer, swimming, ultimate, and volleyball. The 4C model consisted of body volume, total body water, and bone mineral content measured by air displacement plethysmography, bioimpedance spectroscopy, and dual-energy x-ray absorptiometry, respectively. Percentile ranks were created for body fat percentage (%BF) and fat-free mass index (FFMI). Mean differences across teams were quantified with Cohen's d.

Results: In total, 225 athletes (137 men, 88 women) completed data collection. Athletes varied in competitive experience (1 to 22 y) and body mass index (16.9 to 36.4 kg·m^-2). The density of the FFM was significantly greater than the assumed value of 1.100 g·cm^-3 for both men (p = .043) and women (p = .011). The %BF ranged from 4.9% to 35.7% (14.3 ± 5.8% BF) for men and from 15.5% to 42.8% (25.2 ± 6.0% BF) for women. FFMI ranged from 15.6 kg·m^-2 to 26.8 kg·m^-2 (30.0 kg·m^-2 outlier removed) for men and from 14.1 kg·m^-2 to 22.6 kg·m^-2 for women. Differences across sports in %BF and FFMI were considered large-sized effects (d ≥ 0.80) for both men and women. Weight-sensitive sports (e.g. cycling and climbing) had the lightest athletes and were among the leanest, whereas power athletes (e.g. powerlifting and rugby) were among the heaviest athletes and had the highest FFMI.

Conclusions: Differences in %BF and FFMI are evident across sports. Due to the small sample size, use caution when interpreting the data as reference values for club sports athletes.

Background: In Egypt, there were 150,578 new cancer cases and 95,275 cancer deaths in 2022, indicating a substantial burden on patients and the healthcare system. The analysis aims to support decision-making related to investments in cancer prevention and new treatments, by highlighting the economic burden associated with five types of cancer.

Methods: The human capital approach was used to estimate productivity losses from premature mortality due to liver, lung, breast, bladder, and cervical cancer in Egypt in 2019 by calculating years of life lost (YLL), years of productive life lost (YPLL), and present value of future lost productivity (PVFLP). Mortality data were sourced from the World Health Organization (WHO), while life expectancy, retirement age, gross domestic product (GDP) per capita, and labor force participation rates were obtained from the World Bank. Income data, such as annual earnings and minimum wage were sourced from the Wage Indicator database. Deterministic sensitivity analysis (DSA) assessed the sensitivity of results to input variations.

Results: In 2019, Egypt had a total of 45,114 deaths, from liver, lung, breast, cervical, and bladder cancers, resulting in a productivity loss of $430,086,636. Liver cancer led to the most male deaths (17,745) and breast cancer to the most female deaths (6,754), with PVFLP of $232,663,468 and $130,745,592, respectively. The five cancers resulted in 551,336 YLL and 235,415 YPLL in Egypt. The total PVFLP was estimated at $217,224,178 for females and $212,862,458 for males, with a total PVFLP/death of $9,533. The DSA showed that the PVFLP was most sensitive to changes in the retirement age.

Conclusion: In conclusion, there is a substantial economic burden relating to premature cancer mortality in Egypt, highlighting that policies and treatment advances to decrease cancer are working, however, there is need for continuous prioritization of awareness programs, cancer screening and treatment advancements.

Healthcare in low- and middle-income countries is becoming problematic due to the emergence of multidrug-resistant bacteria causing serious morbidity and mortality. Klebsiella variicola carrying multiple antimicrobial resistance (AMR) genes were found significantly among sepsis patients in a study done between October 2019 and September 2020 at four Ethiopian hospitals located in the central (Tikur Anbessa and Yekatit 12), southern (Hawassa), and northern (Dessie) parts. Among 1416 sepsis patients, 74 K. variicola isolates were identified using MALDI-TOF, most of them at Dessie (n = 44) and Hawassa (n = 28) hospitals. Whole genome sequencing showed that K. variicola strains identified at Dessie Hospital displayed phylogenetic clonality, carried an IncM1 plasmid and the majority were ST3924. Many K. variicola identified at Hawassa Hospital were clonally clustered and the majority belonged to novel STs and carried IncFIB(K) and IncFII(K) plasmids concurrently. Fifty K. variicola carried ESBL genes while 2 isolates harboured AmpC. Other frequently found genes were aac(3)-lla, bla_CTX-M-15, bla_TEM-1B, bla_LEN2, bla_OXA-1, bla_SCO-1, catB3, dfrA14, QnrB1, aac(6')-lb-cr and sul2. Virulence genes detected at both sites were mrk operons for biofilm formation and siderophore ABC transporter operons for iron uptake. Capsular alleles varied, with wzi 269 at Dessie and wzi 582 at Hawassa. The isolation of multidrug-resistant K. variicola as an emerging sepsis pathogen calls for strong infection prevention strategies and antimicrobial stewardship supported by advanced bacterial identification techniques.

Therapeutic option for treating methicillin-resistant Staphylococcus aureus (MRSA) infection is urgently required since its resistance to a broad spectrum of currently available antibiotics. Here, we report that isoniazid is able to potentiate the killing efficacy of tigecycline to MRSA. The combination of isoniazid and tigecycline reduces the minimal inhibitory concentration of clinic MRSA strains to tigecycline. The killing activity of tigecycline is further confirmed by killing experiments and murine infection model. We further demonstrate the mechanism that isoniazid increases intracellular accumulation of tigecycline by promoting the influx but limiting the efflux of tigecycline through proton motive force. We also show that isoniazid and tigecycline synergize to increase the abundance of isoniazid-NAD adduct, which in turn damage cell membrane, possibly contributing to the disruption of PMF. Whereas phosphatidylethanolamine and cardiolipin are able to abrogate the synergistic effect of isoniazid plus tigecycline. Thus our study provides a new perspective that antibiotics, e.g. isoniazid, once recognized only to target Mycobacterium tuberculosis, can be repurposed as antibiotic adjuvant to tigecycline, expanding our choice of antibiotic-antibiotic combinations in treating bacterial infectious diseases.