Journal of Investigative Medicine最新文献

Cardiovascular diseases, especially ischemic heart diseases, are the leading cause of death globally, highlighting the need for improved diagnostic tools for vulnerable plaques. This study aimed to evaluate the potential of soluble Talin-1 (sTalin-1) and Pentraxin-3 (PTX-3) as biomarkers in patients with ST-elevation myocardial infarction (STEMI). Conducted as a single-center observational study, it included 40 STEMI patients and 30 controls with normal coronary arteries. Serum levels of sTalin-1 and PTX-3 were measured using enzyme-linked immunosorbent assays (ELISA), and disease severity was assessed with SYNTAX and Gensini scores. Results showed that STEMI patients had significantly lower levels of sTalin-1 and higher levels of PTX-3 compared to controls. ROC curve analysis revealed an area under the curve (AUC) of 0.785 for sTalin-1 and 0.702 for PTX-3 in differentiating between STEMI patients and controls. While sTalin-1 demonstrated high specificity but low sensitivity, PTX-3 exhibited moderate sensitivity and specificity. Talin-1 levels negatively correlated with SYNTAX and Gensini scores, suggesting its role in assessing disease severity. These findings suggest that decreased serum levels of sTalin-1 and increased levels of PTX-3 in STEMI patients could serve as potential biomarkers for identifying vulnerable plaques and assessing disease severity. The study supports the potential use of sTalin-1 and PTX-3 in the diagnostic and prognostic evaluation of acute coronary syndromes.

Despite the significant progress of DNA profiling in forensic science, the extraction of DNA from challenging samples remains a formidable obstacle in forensic laboratories. Particularly, hard tissues (bones, teeth, hair, and nails), formalin-fixed tissues, and contaminated samples pose considerable difficulties. DNA extraction from such samples is often complicated, resulting in scanty, degraded, and contaminated DNA. Moreover, the presence of inhibitors from the surrounding environment further hinders DNA quantification and amplification, presenting additional challenges. This review article delves into the molecular basis of these challenges and examines the mechanistic principles underlying standard DNA extraction protocols. To overcome these obstacles, skilled efforts and additional pre-processing techniques are generally required before organic or silica column-based DNA extraction. Such techniques may involve scraping the waste, sample cleaning with detergents, disinfecting, demineralization of bones and teeth, long proteolytic enzyme treatment, in some cases, harsh methods like hot alkali treatment, tailored to the specific sample type. By addressing these challenges and understanding the molecular intricacies involved in DNA extraction, forensic scientists can improve the reliability and success rate of DNA analysis from difficult forensic samples. This review serves as a comprehensive resource for understanding the complexities of DNA extraction and offers potential solutions for recovering the DNA from highly challenging samples.

Acute myeloid leukemia (AML) presents varying prognoses in pediatric and adult patients, with dysregulated N6-methyladenosine (m6A)-related genes playing a pivotal role in its pathogenesis. Through an analysis of single-cell RNA sequencing data from the Gene Expression Omnibus, we uncovered distinct patterns of m6A gene expression specific to pediatric AML (pAML) cases. Additionally, we devised a LASSO risk regression model to evaluate prognosis within different AML subsets, showcasing the clinical utility of m6A-related genes in predicting AML outcomes. Our study underscores the unique and significant m6A gene expression profiles observed in pAML, emphasizing their potential relevance in prognostic assessment. The demonstrated effectiveness of the LASSO risk regression model further underscores the importance of m6A-related genes as valuable predictors of AML outcomes. These findings not only unveil novel insights into the prognostic implications of m6A-related genes in pAML but also advocate for their application as prognostic markers to enhance personalized treatment strategies in both pAML and adult AML populations.

Metformin, an oral hypoglycemic agent, is commonly used in patients with type II diabetes mellitus. Studies have shown its use is associated with a reduction in major cardiovascular events (MACE) in patients with type 2 diabetes such as hospitalization for acute myocardial infarction, stroke, transient ischemic attack, or cardiovascular death. There is also a suggestion that metformin may have effects beyond those relating to lowering of blood sugar. The goal of this review is to assess the effects of metformin in coronary artery disease (CAD), but more importantly, its effects on disease states other than CAD.

Accurate knowledge of fibrosis levels is essential for effective treatment decisions and prognostication in chronic hepatitis B (CHB) infection. Current guidelines recommend liver biopsy and elastography as the most reliable methods for assessing fibrosis in CHB patients. However, these methods are not widely implemented due to the limited availability, high costs, and invasiveness of liver biopsy. Thus, we aimed to identify simple clinical predictors of significant liver fibrosis in CHB patients in daily practice. We prospectively recruited CHB patients to undergo shear wave elastography (SWE), abdominal ultrasound, and blood tests. In parallel, we extracted data on patient demographics, habits, medical backgrounds, medications, and CHB status and treatment. Multivariate logistic regression analyses were used to determine predictors of significant fibrosis. Of the 173 patients included in the final analysis, 40 (23.0%) had evidence of significant fibrosis on two-dimensional SWE. Age > 50 years (odds ratio (OR): 3.53; 95% confidence interval (CI): 1.34-9.25; p = 0.001), alanine aminotransferase > 40 (OR: 8.16; 95% CI: 4.6-15.3; p = 0.001), hepatitis B virus DNA> 2000 (OR: 9.20; 95% CI: 3.4-19.0; p < 0.001), concomitant diabetes mellitus (OR: 3.58; 95% CI: 1.89-5.49; p = 0.040), moderate-to-severe steatosis on ultrasound (OR: 4.50; 95% CI: 2.35-9.95; p = 0.014), and heavy smoking were independent predictors of significant fibrosis. In conclusion, we identified clinical and laboratory variables that may effectively identify CHB patients at high risk of significant fibrosis. These can aid in resource allocation in daily practice with limited resources.

Since the onset of the coronavirus disease 2019 (COVID-19) pandemic, there have been nearly seven million deaths associated with COVID-19 and over thirteen billion total vaccine doses administered worldwide. This study aimed to evaluate the patient demographics and laboratory values that might help predict individuals at risk of having a deep vein thrombosis (DVT) formation while hospitalized with COVID-19. Focusing on the four major strains alongside the associated vaccination availability periods in the United States to devise risk stratification and management algorithms. This retrospective cohort study analyzed 4429 COVID-19-positive patients admitted to a single, tertiary care institution from March 2020 to February 2024 who underwent venous duplex ultrasound due to clinical suspicion. It was found that active chemotherapy treatment, higher weight (77.0 vs 84.0 kg), and longer LOS to first duplex (5 vs 10 days) were independent predictors of mortality. In addition, men, older age (68 vs 70 years old), medical history of DVTs, and longer LOS to first duplex (5 vs 8 days) were prognostic for DVT formation. More importantly, the prevalence of DVT was not statistically different between each COVID-19 wave, despite diminished mortality and morbidity over time. This study also demonstrated many non-predictive variables including COVID-19 as the principal diagnosis, BMI, smoking status, history of atrial fibrillation, stroke, CAD, vaccination status, and traditional laboratory values. Helping establish a critical foundation to analyze trends of anticoagulant and systemic corticosteroid use in this COVID-19 patient population.

Systemic lupus erythematosus (SLE) is linked with an increased risk of cancers, particularly hematologic malignancies. Cancer mortality among patients with SLE in the United States remains unclear. Our cross-sectional study sought to measure trends in cancer mortality among patients with SLE in the last two decades. Cancer deaths among patients with SLE from 1999 to 2020 were analyzed from the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER). Age-adjusted mortality rates (AAMRs) per 1,000,000 individuals were measured. We used joinpoint trend analysis to determine the average annual percent change (AAPC) in AAMR trends. From 1999 to 2020, there were 2481 cancer deaths with comorbid SLE. Overall, the AAMRs of cancer among patients with SLE increased from 0.71 in 1999 to 1.19 per 1,000,000 individuals in 2020, with the AAPC at +1.19. Women had a higher AAMR from cancer death with comorbid SLE than men (1.39 vs 0.29 per 1,000,000 individuals). The highest AAMR was observed among African Americans (1.23 per 1,000,000 individuals), followed by Hispanics (0.61 per 1,000,000 individuals), Whites (0.58 per 1,000,000 individuals), and Asians (0.36 per 1,000,000 individuals). Those who lived in the West region and the rural region had the highest AAMR, respectively (0.69 vs 0.70 per 1,000,000 individuals). The three most common causes of cancer deaths were lung cancer (28.70%), breast cancer (8.83%), and non-Hodgkin lymphoma (4.96%). Cancer mortality in SLE patients has risen, with higher rates among African Americans, highlighting the need for targeted interventions.