European Journal of Medical Research最新文献

Purpose: The objective of this study is to examine the impact of administering remimazolam and estazolam in alleviating preoperative anxiety on the recovery of gastrointestinal function in patients undergoing laparoscopic cholecystectomy surgery.

Materials and methods: A total of 140 patients who were scheduled for elective laparoscopic cholecystectomy surgery were randomly divided into four groups using random number table: remimazolam group (group R, n = 35), estazolam group (group E, n = 35), remimazolam combined with estazolam group (group RE, n = 35), and control group (group C, n = 35). Group R received an intravenous injection of remimazolam before the administration of anesthesia, group E was orally administered estazolam on the night before surgery and intravenously injected with normal saline before induction of anesthesia, group RE received both estazolam orally on the night before surgery and intravenous injection of remimazolam before induction of anesthesia, and group C was given normal saline before induction of anesthesia. The visual analogue scale for anxiety (VAS-A) scores were documented during the preoperative visit, following entry into the operating room, and 10 min after intravenous remimazolam or normal saline. Time to the first postoperative exhaust and defecation, occurrence of nausea and vomiting within 24 h after surgery, sleep quality scores on the night before surgery and two nights after surgery as per Numerical Rating Scale (NRS), postoperative patient satisfaction, and occurrence of adverse reactions were also recorded.

Results: In contrast to group C, time to the first postoperative exhaust and defecation of groups R, E, and RE were significantly reduced (P < 0.05); the VAS-A scores of groups E and RE exhibited a significant decrease upon entering the operating room, and the VAS-A scores of groups R, E, and RE decreased significantly 10 min after intravenous remimazolam or normal saline (P < 0.05); sleep quality scores of groups R, E, and RE were significantly higher on the first night after surgery (P < 0.05). There was no significant difference in the occurrence of nausea and vomiting among the four groups within 24 h after surgery. No adverse reactions such as wound bleeding, infection, and severe abdominal distension occurred in the four groups.

Conclusions: The utilization of remimazolam and estazolam, either singularly or in combination, before laparoscopic cholecystectomy surgery, has shown considerable efficacy in alleviating preoperative anxiety, and thus expediting the recovery of postoperative gastrointestinal function in patients. Moreover, the combination of both agents can improve the patient's postoperative sleep quality, thereby elevating patient satisfaction.

Objective: To assess the feasibility and safety of a novel closure technique, namely the parallel closure technique (Par-CT), in which the sheath is placed parallel to the ProGlide system during veno-arterial extracorporeal membrane oxygenation (VA-ECMO) to enhance the efficiency of percutaneous vascular haemostasis.

Methods: The abdominal aortas of goats were punctured with a 17F sheath to simulate arterial cannula vascular access for VA-ECMO, and the Par-CT was used to achieve vascular haemostasis. In five goats, the abdominal aorta was punctured with a 17F sheath and then a 6 to 10F vascular sheath was introduced. This resulted in a smaller vascular rupture area and successful closure of the aortic rupture using the Par-CT.

Results: If the sheath tube that was introduced was < 8 F, the puncture site could not be closed and would therefore have to be resutured and the Par-CT would have to be repeated. However, the puncture site could be sutured appropriately if the sheath tube that was introduced was ≥ 8F.

Conclusions: This study suggested that the Par-CT is both safe and effective for haemostasis after weaning from VA-ECMO.

Objectives: To investigate the influence of MEK5/ERK5 pathway on mitophagy in osteosarcoma (OS), as well as the involved molecular mechanisms.

Methods: The overlapped genes of mitophagy-related genes from MSigDB database and DEGs between metastatic and primary OS groups from GSE32981 were identified. GSVA of mitophagy-related pathways between the metastatic and primary groups were analyzed. The relationships between Nur77 and mitophagy-related pathways, prognosis, immune infiltrating cells, immune response gene sets were investigated. Quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) and western blotting were utilized to assess the expression levels of MEK5, ERK5, Nur77, PINK1, and Parkin. Cellular behaviors and mitochondrial potential were evaluated via CCK-8, Transwell assay and JC-1 staining.

Results: Total 4 overlapped genes were obtained as mitophagy-related DEGs, including GABARAPL1, HIF1A, PINK1, and RB1CC1. The activity scores of 3 mitophagy-related pathways exhibited significant differences between metastatic and primary groups. Importantly, Nur77 was significantly negatively correlated with a mitophagy-related pathway (GOBP MITOPHAGY: R = - 0.48, P = 0.02). The Nur77 expression in metastatic group was remarkedly higher than that in the primary group (P < 0.001). Patients with high Nur77 expression had poor prognosis, with AUC values all above 0.615 in predicting 1-, 3-, and 5-year survival. In addition, Nur77 was closely related to numerous immune cells, including activated dendritic cells, activated mast cells and M0 macrophages, and immune response gene sets chemokines and cytokines (all P < 0.05). In addition, MEK5/ERK5 pathway is activated in OS, and Nur77 is overexpressed in OS, and MEK5/ERK pathway promotes Nur77 expression, tumorigenesis and mitochondrial function in U2OS cells. Cytosporone B implement significantly increased the tumorigenesis of U2OS cells in sh-MEK5 group, and inhibited the weaken in mitochondrial membrane potential caused by MEK5 downregulation, and reversed the protein levels of mitophagy markers PINK1 and Parkin in sh-MEK5 group.

Conclusions: MEK5-ERK5 pathway mediates mitophagy by regulating Nur77 to promote tumorigenesis of OS cells. These findings offered promising therapeutic targets for OS.

Background: Our research aims to explore the effect of salmon calcitonin (sCT) combined with three calcium antagonists (CCA), verapamil, nifedipine and diltiazem, on calcium and phosphorus ion metabolism in the blood of osteoporotic female rats following ovarian removal. To explore a method of combination medication suitable for postmenopausal women with osteoporosis.

Methods: We first carried out the combined drug experiment on rats, and then carried out the combined drug experiment on osteoporosis rats. Blood samples were collected at 1, 2, 4, 8 and 12 h post-administration, and then we measured the concentration of calcium and phosphorus ions in serum.

Results: Osteoporotic rats were divided into eight groups, with 6 rats in each group, with an average weight of 350 g. By studying changes in the concentration of calcium and phosphorus ions in the blood over a period of time, we found that the effect of sCT combined with nifedipine and verapamil in reducing serum calcium and phosphorus was better than that of single drug; the effect of sCT combined with diltiazem in reducing serum calcium was better than that of single drug, and the effect of reducing blood phosphorus was not as good as that of single drug.

Conclusions: We have studied and found that the group of sCT combined with nifedipine group has the most significant effect on reducing calcium and phosphorus in the blood of osteoporotic rats. The effect was significantly better than salmon calcitonin alone. That provided a new medication method for postmenopausal women with osteoporosis.

Clinical trial number: Not applicable.

Background: Research has demonstrated that circular RNAs (circRNAs) play important roles in acute ischemic stroke (AIS). However, the functions of circRNA-mediated competitive endogenous RNA (ceRNA) in AIS-related immunological inflammation are not well understood. In our study, we aimed to construct a circRNA-mediated immune-related ceRNA network and identify diagnostic circRNAs for AIS.

Methods: R software was used to analyze the microarray data obtained from the GEO database. The bioinformatics database was then used to develop the circRNA-mediated ceRNA network. A topological property study of the ceRNA network was performed to identify new circRNAs. Subsequently, we validated the potential circRNAs in both mice middle cerebral artery occlusion (MCAO) model and clinical samples obtained from our center with quantitative real-time polymerase chain reaction (qRT-PCR).

Results: An AIS immune-related ceRNA (AISIRC) network was constructed, comprising immune-related genes (IRGs), circRNAs, and miRNAs. A subnetwork was then extracted from the AISIRC network and we identified seven circRNAs associated with immune response. The qRT-PCR assays were conducted to validate the circRNAs candidate using blood samples from MCAO mice. The results demonstrated that circulating circOXCT1 and circSLC8A1 were significantly up-regulated in AIS patients. Receiver-operating characteristic (ROC) curve analyses and logistic regression demonstrated the perfect predictive and discriminative features of these two circRNAs biomarkers in AIS. Longitudinal analysis of circRNA expression after AIS indicated the promising potential of circSLC8A1 for monitoring AIS progression and dynamics.

Conclusion: We successfully constructed circRNA-mediated immune-related ceRNA network and identified two circulating circRNAs (circOXCT1 and circSLC8A1), which showed high diagnostic sensitivity for AIS.

Background: Breast cancer is a highly prevalent tumor worldwide. Mitochondrial permeability transition (MPT)-driven necrosis is a novel type of cell death induced by mitochondrial membrane disruption. The roles of MPT-driven necrosis in breast cancer remain unclear.

Methods: Gene expression and clinicopathologic features were extracted from The Cancer Genome Atlas and Gene Expression Omnibus. We performed a genome landscape analysis of MPT-driven necrosis (MPTdn)-related genes, and a consensus clustering analysis was conducted to construct MPTdn clusters. Next, a risk model was established based on the differentially expressed genes related to MPTdn. We grouped and used external data sets to verify the stability of the model. Subsequently, immune correlation analysis, clinical correlation assessment and drug sensitivity analysis were conducted. Finally, candidate genes were validated in the protein and mRNA levels.

Results: A total of 39 MPTdn-related genes were identified in our analysis. Most MPTdn-related genes had different expression levels and somatic mutations in breast cancer, and a close interaction was noted among them. A risk model composed of BCL2A1, SCUBE2, NPY1R and CLIC6 was constructed. The low-risk group had better overall survival and higher immune infiltration levels. All three external data sets achieved excellent predictive efficacy. Finally, the immunohistochemistry results indicated that BCL2A1, SCUBE2, NPY1R and CLIC6 were expressed at significantly lower levels in breast cancer tissues, and the transcriptome sequencing results revealed that BCL2A1 and SCUBE2 mRNA expression levels were greater in the nonrecurrence group.

Conclusions: We developed a risk model with excellent predictive efficacy based on MPTdn and revealed that BCL2A1, SCUBE2, NPY1R and CLIC6 could be used as the biomarkers, laying a solid foundation for investigations of therapeutic targets of breast cancer.

Background: Stroke is a prevalent neurological disorder globally, often resulting in post-stroke depression (PSD). The cardiometabolic index (CMI) is a novel marker for assessing cardiovascular and metabolic health, but its association with PSD has not been adequately investigated. This study aims to explore the relationship between CMI and PSD, providing a basis for clinical prevention and treatment.

Methods: We utilized data from the 2007-2018 National Health and Nutrition Examination Survey (NHANES) in this cross-sectional analysis. Multivariable logistic regression and restricted cubic spline (RCS) models were applied to assess the independent and linear relationships between CMI and PSD. To minimize confounding, propensity score matching (PSM) was employed. Subgroup analyses and interaction tests were also conducted to further explore potential effect modifications.

Results: A total of 1082 participants were included, with 18.67% diagnosed with PSD. Higher CMI levels were positively associated with PSD in stroke patients. In the fully adjusted model, the association between CMI and PSD remained significant (OR = 1.06; 95% CI 1.01-1.12). RCS analysis indicated a linear relationship between CMI and PSD (nonlinearity P = 0.334). Subgroup analyses showed that this association persisted across different groups (all P for trend > 0.05). After covariate balance through PSM, the positive association between CMI and PSD was further supported.

Conclusion: This study demonstrates a positive association between CMI and PSD. CMI may serve as a useful tool for evaluating the risk of depressive symptom in stroke patients, potentially aiding in targeted clinical interventions.

Background: Early assessment and intervention are crucial for improving survival in septic shock. This study aimed to address the shortcomings of existing scoring systems in predicting the risk of early death, particularly in identifying patient populations that require more precise prognostic assessments.

Methods: This retrospective study included 143 patients with septic shock admitted to the intensive care unit of a tertiary hospital between January 1, 2019, and June 30, 2024. Patients were stratified by 28-day survival status. Binary logistic regression analysis identified independent predictors of early mortality and developed a prognostic model, which was validated using receiver operating characteristic curves.

Results: Among the patients, 106 survived, whereas 37 died. Multi-factor binary logistic regression analysis identified the sequential organ failure assessment (SOFA) score and the C-reactive protein-albumin-lymphocyte (CALLY) index as significant independent predictors of 28-day mortality (p < 0.05), culminating in the formulation of the "SOFAplusCALLY" model. This model showed superior predictive accuracy compared to other Scoring systems (area under the curve: 0.90, p < 0.01) and was validated for robustness in both training and validation cohorts.

Conclusions: The CALLY index and SOFA score independently forecast 28-day mortality in adults with septic shock, offering substantial clinical utility for forecasting patient prognosis. The SOFAplusCALLY model, synthesized from both indices, comprehensively assesses the clinical status of patients with septic shock and enhances prognostic accuracy, which is crucial for clinical decision-making and resource allocation.

Background: Walking on an incline demands specific neuronal control because the vestibular system may alter gait patterns to maintain balance with respect to self-orientation to gravity. A previous study confirms the aforementioned hypothesis that walking on inclines with bilateral vestibular disruptions altered spatial-temporal gait parameters in anterior-posterior and vertical directions. This study extended the current knowledge to investigate bilateral mastoid vibration's effect on the Margin of Stability (MoS) while walking on inclines.

Methods: Eighteen healthy young adults participated in this study. Participants were randomly assigned to eight treadmill trials, encompassing walking at their preferred walking speed on inclines of 0%, 3%, 6%, and 9% with and without bilateral mastoid vibrations. The dependent variables were MoS in both the anterior-posterior (MoSap) and medial-lateral (MoSml) directions, the variability of MoS in both AP (MoSVap) and ML (MoSVml) directions, step length, step length variability, step width, and step width variability.

Results: We found the significantly greater MoSap (3%: p = 0.005, 6%: p = 0.002, 9%: p < 0.001) and the significantly larger step length (3%: p = 0.008, 6%: p = 0.025, 9%: p < 0.001) while walking on different inclines with bilateral mastoid vibration than without vestibular stimulation. We also noticed MoSml (F_{1, 17} = 14.24, p = 0.002) was significantly smaller while walking with bilateral mastoid vibration than walking without vestibular stimulation.

Discussion: These results revealed that bilateral mastoid vibrations impact the margin of stability in both directions, and walking on inclines requires adjustment of MoS. This result may facilitate future clinical implications for patients with compromised vestibular functions.