Clinics最新文献

Objective: TRIB3 has been confirmed to participate in and regulate biological metabolic activities in head and neck tumors such as nasopharyngeal carcinoma and oropharyngeal carcinoma, so the purpose of this study was to explore whether there is a correlation between TRIB3 and Laryngeal Squamous Cell Carcinoma (LSCC) and to preliminarily explore the biological characteristics of TRIB3 in LSCC.

Methods: TRIB3 expression in the LSCC was analyzed based on The Cancer Genome Atlas (TCGA) database. CCK-8 assay, Colony Formation Assay, wound healing assay, and Transwell assay were performed to investigate the roles of TRIB3 in the proliferation, invasion and metastasis of LSCC. The Protein-Protein Interaction (PPI) network of TRIB3 was analyzed based on the STRING database. Western blotting and qRT-PCR were employed to detect the protein and mRNA expression of TRIB3.

Results: TRIB3 over-expressed in the LSCC, which was related to the poor prognosis of LSCC. Patients with methylation related to high TRIB3 expression had a poorer prognosis. Knock-down of TRIB3 expression suppresses the growth, invasion and migration of LSCCs via PI3K / AKT / mTOR. TIME analysis, surface checkpoint analysis, and prediction model indicated that TRIB3 related risk model displayed a poor prognosis.

Conclusion: This study investigates the role of TRIB3 in the biological characteristics of LSCC, and preliminarily concludes that TRIB3 may be a potentially promising prognostic biomarker for LSCC. TRIB3 may facilitate the growing, invasive and migrating LSCC, leading to a poor prognosis.

Background: Individuals with severe obesity and type 2 diabetes mellitus have reduced secretion of incretins by L cells. Studies suggest an increase in L cell activity according to the length of the Biliopancreatic Loop (BPL).

Objective: Compare the effect of biliopancreatic loop extension on the number and expression of L cells in patients undergoing RYGB METHODS: Subjects (n = 13) undergoing RYGB with a BPL of 100 cm (G1) or 200 cm (G2). Intestinal biopsies were done before (T1) and 6 months after (T2) RYGB in 3 segments: gastro-enteric anastomosis (A), entero-enteric anastomosis (B) and terminal ileum (C). Analyzes of intestinal biopsies by immunohistochemistry and qRT-PCR.

Results: There was an increase (p < 0.0001) in L cells marked by PYY and GLP1 between T1 (17 ± 10.5) and T2 (23.5 ± 10.7) only at point C. There was no difference in L cells expression between groups G1 and G2 at points A (A1: 17.3 ± 2.9; A2: 19.9 ± 1.9; p = 0.09), B (B1: 13.7 ± 6.6; B2: 14.1 ± 4.9; p = 0.89) and C (C1: 13.2 ± 2.2; C2: 11.4 ± 3.4; p = 0.32) in PYY and GLP1 gene expression (A1: 20.8 ± 4, 1; A2: 23.7 ± 3.6; p = 0.2), B (B1:14.3 ± 7.9; B2: 22.7 ± 11.8; p = 0.1), (C1: 17±4.1; C2: 21.1 ± 4.8; p = 0.2).

Conclusions: Both techniques lead to an increase in the number of active L cells.

Background: The common drugs used for the treatment of Newly Diagnosed Multiple Myeloma (NDMM) include bortezomib and lenalidomide, but the adverse effects of lenalidomide cannot be ignored, especially when it is used in the initial therapy.

Methods: This retrospective study evaluated the efficacy and safety of a modified DVD regimen (pegylated liposomal doxorubicin, bortezomib, and dexamethasone) followed by lenalidomide in the treatment of NDMM. A total of 40 NDMM patients were treated with a reduced dose of pegylated liposomal doxorubicin (20 mg/m²) on day 1, subcutaneous bortezomib (1.3 mg/m²) on days 1, 4, 8, and 11, and dexamethasone (20 mg) on days 1, 2, 3, 4, 8, 9, 11, and 12 (20 days for each course). When patients failed to achieve partial or better response after 2 courses of treatment, a regimen containing lenalidomide was administered. After the induction therapy, 15 eligible patients received Peripheral Blood Stem Cells (PBSC) mobilization and transplantation followed by maintenance therapy with lenalidomide.

Results: The response rate (≥ very good partial response) was 55% and 80% after 2 and 4 courses, respectively. The 18-month Progression Free Survival (PFS) and Overall Survival (OS) were 78.6% and 83.4%, respectively. Grade 3 or 4 hematologic toxicity occurred in less than 10% of patients. In addition, all 15 transplant-eligible patients successfully mobilized PBSC (median CD34⁺cells = 4.59 × 10⁶/kg) and underwent autologous PSBC transplantation.

Conclusions: This study suggests that the modified DVD regimen followed by lenalidomide is an effective and well-tolerated regimen, and has little influence on the PBSC collection and transplantation for patients with NDMM.

Introduction: The OSCE has been a robust tool for assessing clinical skills in medical education, adaptable across various clinical domains and stages. The COVID-19 pandemic, however, posed significant challenges to traditional assessment methods. This led to the development of the OSVE as an alternative.

Objective: This study aimed to correlate OSVE results with MCT scores and Grade Point Average (GPA) of clerkship.

Methods: This cross-sectional study involved 129 clerkships. It compared two OSVEs and two MCTs, covering content from the 5th and 6th years of the curriculum, against final graduation grades.

Results: The score of GPA was 8.13 ± 0.43. The authors compared OSVE-5th (7.13 ± 0.93) and OSVE-6th (7.23 ± 0.83, NS), MCT-5th (7.08 ± 0.91) vs. MCT-6th (7.68 ± 1.21, p < 0.001), OSVE-5th (7.13 ± 0.93) and MCT-5th (7.08 ± 0.91, NS), OSVE-6th (7.23 ± 0.83) and MCT-6th (7.68 ± 1.21, p < 0.001) OSVE-5th (7.13 ± 0.93) and MCT-6th (7.68 ± 1.21, p < 0.001), OSVE-6th (7.23 ± 0.83) and MCT-5th (7.08 ± 0.91, NS), OSVE-5th (7.13 ± 0.93) and GPA (8.13 ± 0.43, p < 0.001), OSVE-6th (7.23 ± 0.83) and GPA (8.13 ± 0.43, p < 0.001), MCT-5th (7.08 ± 0.91) and GPA (8.13 ± 0.43, p < 0.001), and MCT-6th (7.68 ± 1.21) and GPA (8.13 ± 0.43, p < 0.001). There were positive correlations between OSVE-5th and OSVE-6th (R = 0.418, p < 0.05), OSVE-5th and MCT-5th (R = 0.475, p < 0.05), MCT-5th, OSVE-6th and MCT-6th (R = 0,180, p < 0.05), MCT-6th (R = 0.227, p < 0.05), with OSVE-6th and MCT-5th (R = 0.478, p < 0.05), OSVE-5th and GPA (R = 0.481, p < 0.05), OSVE-6th and GPA (R = 0,439, p < 0.05), MCT-5th and GPA (R = 0.681, p < 0.05) and MCT-6th and GPA (R = 0.195, p < 0.05), no correlation was found between OSVE-6th and MCT-6th (R = 0.070, NS).

Conclusions: The correlations between the assessments revealed mild to moderate, suggesting that the assessments can be used interchangeably in the context of formative assessment. These results indicate the feasibility of using both OSVE and multiple-choice tests as effective tools to enhance intern training and monitoring.

Purpose: This study aimed to evaluate the accuracy and quality of healing of main corneal incisions in femtosecond laser procedures in cataract surgery.

Methods: It was a prospective, non-randomized, investigator-masked study. A total of 37 eyes of 37 patients with indication for cataract surgery were separated into two groups in this prospective, nonrandomized study: Femto group, with incisions automated by femtosecond laser (18 eyes), and Phaco group, with incisions made using a keratome (19 eyes). The planned incisions were 2.2 mm wide and 1.65 mm long. The length of the incision and prevalence of endothelial gap, endothelial misalignment, and localized Descemet Membrane Detachment (DMD) were compared.

Results: The mean incision length was statistically higher in the Femto group in two examinations: 1.64 mm ± 0.16 vs. 1.43 mm ± 0.30 (p = 0.001) in Exam 1 (between 2 and 4 days) and 1.58 mm ± 0.22 vs. 1.27 mm ± 0.34 (p < 0.0001) in Exam 2 (between 1 and 3 months). No eye presented an endothelial gap in Exam 2. The endothelial gap was higher in the Femto group in Exam 1. In the two examinations, endothelial misalignment was lower in the Femto group, whereas the incidence of DMD was lower in the Femto group in the two examinations.

Conclusions: Automated incisions with femtolaser presented a higher mean length and lower DMD prevalence compared to manual incisions with a keratome.

Background: Communication barriers make it difficult for deaf women to access information about contraceptive methods, making them vulnerable to unplanned pregnancies.

Objective: To identify knowledge and attitudes of deaf women in relation to contraceptive methods.

Method: The authors conducted a systematic review of the literature, PROSPERO registry (CRD42021277635), conducted from August 2021 to April 2024. The included studies focused on knowledge and attitudes about contraception among women with deafness.

Results: Twelve articles were included, with a total of 2,641 participants and those reported low knowledge about contraceptive methods. Nine studies showed withdrawal, condoms, and oral contraceptives as the best methods that deaf women know. Five studies showed low knowledge about intrauterine devices and subdermal implants. The main reasons given for abandoning the method were reproductive desire and fear of side effects. The use of hormonal contraceptives was higher among adult women and, two studies showed that among teenagers the practice of withdrawal was higher than the use of condoms. The barriers most mentioned in the eight articles for the use of contraceptives were those of communication.

Conclusion: Knowledge of contraceptives among deaf women was low; however, the attitude of acceptance of the use of contraceptive methods was favorable, despite the little access to more effective methods, especially among adolescents. The factor associated with low knowledge evidenced in the systematic review was communication barriers.

Background and objective: The aim of this retrospective observational case-control study was to examine the significance of different renal Doppler marker variations within the initial 24-hour period as potential predictors of Acute Kidney Injury (AKI) in patients with sepsis.

Methods: A total of 198 sepsis patients were enrolled and categorized into two groups: the AKI group (n = 136) and the non-AKI group (n = 62). Three renal Doppler indices, Renal Resistive Index (RRI), Power Doppler Ultrasound (PDU) score and Renal Venous Stasis Index (RVSI), were measured within 6h (T0) and at 24h (T1) after ICU admission.

Results: The AKI group had more hypertension patients than the non-AKI group (p = 0.047). The cases of the AKI group showed higher levels of CRP (p = 0.001), PCT (p < 0.001), lactate (p < 0.001), AST (p = 0.003), ALT (p = 0.049), total bilirubin (p = 0.034), BNP (p = 0.019) and cTnI (p = 0.012). The RRI at T1 was significantly higher in the AKI group (p = 0.037). AKI group exhibited a lower incidence of reduced RRI at T1 compared with non-AKI group (p < 0.001). After controlling for age, sex, and BMI through partial correlation analysis, the results indicated significant associations between SA-AKI and CVP (r = -0.473), SOFA score (r = 0.425), lactate (r = 0.378), and RRI reduction (r = -0.344) in sepsis patients. The multivariate logistic regression analysis showed that variables including CVP, SOFA score, CRP, lactate, VIS, and RRI not reduced following 24h of ICU treatment were predictive indicators for early detection of SA-AKI in sepsis patients.

Conclusion: CVP, SOFA score, CRP, lactate, VIS, and RRI not reduction following 24h of ICU treatment can be utilized as predictive indicators for early detection of SA-AKI in sepsis patients.

Objectives: Mild Traumatic Brain Injury (mTBI) is quite prevalent in the elderly population, and the authors performed a retrospective analysis regarding the predictive value of frailty assessing tools regarding the prognosis of elderly mTBI patients.

Methods: All the patients underwent assessment of frailty upon admission using five tools including Frailty Phenotype (FP), FRAIL Scale (FS), Edmonton Frailty Scale (EFS), Groningen Frailty Indicator (GFI), and Clinical Frailty Scale (CFS). The predicting potential of tools was analyzed against the prognosis defined by the extended Glasgow Outcome Scale (GOSE).

Results: The incidence of frailty in elderly patients varies widely among the tools. Multivariate logistic regression analysis showed that only frail conditions defined by FP (p-value = 0.014) and FS (p-value = 0.004) could be employed for predicting unfavorable prognosis defined by GOSE, while frailty defined by CFS (p-value = 0.683), EFS (p-value = 0.301) and GFI (p-value = 0.925) could not. The ROC further showed that FP (AUC = 73.2 %) and FS (AUC = 76.2 %) had moderate power in predicting unfavorable conditions, while CFS (AUC = 46.1 %), EFS (AUC = 55.6 %), and GFI (AUC = 51.5 %) only had low or even no power.

Conclusions: FP and FS could be used to predict the unfavorable prognosis associated with mTBI in the elderly population.