Journal of Investigative Medicine最新文献

To investigate the differences in relative mRNA expression levels of the novel iron regulatory erythroid factors FAM210B, CCDC115, HO-1, PCBP1, PCBP2, NCOA4, and Nrf2 in children with β-thalassemia major (β-TM) before and after transfusion therapy. A total of 98 children with transfusion-dependent β-thalassemia were recruited from the First Affiliated Hospital of Guangxi Medical University between October 2022 and May 2023. The children were classified based on their hemoglobin (Hb) levels: 57 cases with Hb ≤ 90 g/L and 41 cases with Hb > 90 g/L. Real-time fluorescence quantitative PCR was employed to assess the relative mRNA expression between the groups. The mRNA expression levels of FAM210B, HO-1, and NCOA4 were significantly higher in the Hb ≤ 90 g/L group compared to the Hb > 90 g/L group (p < 0.05). Moreover, higher relative expression levels of FAM210B and NCOA4 correlated with an increased likelihood of requiring blood transfusions in β-TM children. The differences in the remaining factors did not reach statistical significance. FAM210B and NCOA4 may serve as indicators of erythropoiesis and the degree of anemia in children with β-TM. Further research is warranted to explore their potential as therapeutic targets for β-thalassemia and other erythropoietic disorders.

Peripheral frequency of inducible T cell co-stimulator (ICOS) + CD4 T cells is associated with early response to immunotherapy and prognosis in gastric cancer (GC); however, limited studies have clarified its association with chemotherapy response. This was a prospective, pilot study. A total of 120 participants with newly diagnosed GC were recruited; 50 advanced GC patients (T3-4N1-3M0-1) underwent curative surgery followed by platinum-based chemotherapy, and their prognosis and survival were assessed. The frequency of ICOS + CD4 T cells in the peripheral blood of each patient was examined using flow cytometry. The frequency of ICOS+CD4 T cells in stage III GC patients was significantly higher than that of stages I and II combined (p = 0.0204) and stage IV GC patients (p = 0.0117). In xenograft GC animals, a positive correlation was noted between the peripheral frequency of ICOS + CD4 and the tumor volume in mice (p = 0.0496). Co-culture experiments showed that the presence of GC cells increased the ratio of ICOS + CD4 T cells derived from peripheral blood in a dose-dependent manner. The initial peripheral frequency of ICOS + CD4 T cells in the GC progression-group was significantly lower than that in the stable-group after 3 months of platinum-based chemotherapy (p = 0.0318). High frequency of peripheral ICOS + CD4 was significantly positively correlated with peripheral IFN-γ concentration in tumor-bearing mice. The frequency of ICOS + CD4 serves as an index reflecting the tumor burden of GC. It effectively predicts the short-term progression risk for resectable advanced GC under platinum-based chemotherapy, primarily because it can reflect the basal immune status of the body.

Methamphetamine use is associated with a range of cardiovascular conditions, including hypertension and heart failure. Beta-blocker use is commonly avoided when treating patients intoxicated with methamphetamines due to a fear of inducing unopposed alpha stimulation and worsening hypertension. We performed a retrospective review of medical records in a county hospital in California with a high prevalence of methamphetamine users. We included adults who tested positive for methamphetamines on urine toxicology, subjects who received beta-blockers within 48 h of their arrival were assigned to the case group, and those who received a non-beta-blocker antihypertensive or no antihypertensive were assigned to the control group. We compared the length of stay (LOS), readmission rate within 30 days, and systolic blood pressure (SBP) and diastolic blood pressure (DBP) between the groups at admission and 24 h. There was no significant difference between LOS and 30-day readmission rates between subjects who received beta-blockers and subjects who did not. Subjects who received carvedilol were compared to subjects in the control group who received another antihypertensive. SBP was significantly higher in the carvedilol group at admission, but there was no significant difference between groups after 24 h, and there was no significant difference in LOS. Treatment with beta-blockers in the case group did not increase LOS or readmission rates compared to the control group, and treatment with carvedilol effectively reduced SBP in patients with hypertension and methamphetamine-induced cardiomyopathy. Our results indicate that beta-blockers, particularly carvedilol, are an effective treatment modality in methamphetamine users.

This trial evaluated the effects of insulin aspart (IAsp) combined with insulin detemir and metformin on islet function in newly diagnosed type 2 diabetes mellitus (T2DM).Newly diagnosed T2DM patients (n = 96) were randomly divided into the control group and study group, 48 cases in each group, and treated with insulin detemir + metformin or insulin detemir + metformin + IAsp, respectively. Clinical effect was assessed, and blood glucose, body mass index (BMI), fasting insulin (FINS), insulin dosage, and blood glucose standard time were recorded. The insulin resistance index (homeostasis model assessment of insulin resistance) and insulin function index (homeostasis model assessment-β) were calculated. Adverse reactions were recorded, and quality of life and sleep quality were assessed.The total effective rate of the study group was 95.83%, which was higher than that of the control group 79.17%. The study group had lower blood glucose, BMI, and FINS, less insulin dosage, and shorter blood glucose standard time. Moreover, the study group had lower insulin resistance index and higher insulin function index, as well as better quality of life and sleep quality. The incidence of adverse reactions exhibited no difference between the two groups.Insulin detemir + metformin + IAsp is effective in the treatment of T2DM, which can effectively improve insulin function and blood glucose index, reduce BMI and insulin dosage without increasing adverse reactions, and improve quality of life and sleep quality.

After completing medical school in the United States, most students apply to residency programs to progress in their training. The residency application process contains numerous writing sections, including the personal statement, curriculum vitae, and "impactful experiences" section. This study's purpose is to investigate the perception of third and fourth-year medical students on generative artificial intelligence (GenAI) and its influence on the residency application process. We developed a 13-question survey using the REDCap application to explore participants' educational background, year in school, preferred medical specialty, and perception of current or potential use of GenAI within residency applications. More than half of the responders have already used or plan to use GenAI for assistance in developing their personal statements for their applications. A considerable percentage (43.3%) will use GenAI to edit/modify a draft of the personal statement. More than half of survey participants believe that in the future, GenAI may alter the significance program directors place on letters of recommendation (LORs) in their selection criteria for deciding who to interview and select. Our survey results indicate that a number of students are either using or are receptive to the idea of using GenAI to draft or refine certain components of their residency application, such as the personal statement and impactful experiences section. As the application of GenAI expands, in-person interactions in the evaluation of candidates may become increasingly critical, and although personal statements and LORs are currently significant components of the residency application, their future roles remain a question.