Open Medicine最新文献

Background: It is unclear how the estimated glucose disposal rate (eGDR) index relates to osteoarthritis (OA). The goal of this research is to explore the possible link between the eGDR index and the likelihood of OA development.

Methods: The study encompassed 9,051 individuals from the National Health and Nutrition Examination Survey (2011-2018). Participants were divided into quartiles according to their eGDR, calculated with the equation: eGDR (mg/kg/min) = 21.158 - (0.09 × waist circumference) - (3.407 × hypertension) - (0.551 × glycosylated hemoglobin). We assessed the independent correlation between the eGDR metric and the incidence of OA through weighted multivariate regression, stratified analysis, and threshold effect evaluation.

Results: The study encompassed 9,051 participants, who had an average eGDR of 7.09. Participants with OA had lower eGDR levels compared to those without OA (6.27 ± 0.09 vs 7.31 ± 0.06, P < 0.001). The odds ratios (ORs) for OA associated with the eGDR index in the logistic regression models were 0.87 (95% confidence interval [CI]: 0.84, 0.89) in the unadjusted model I and 0.87 (95% CI: 0.84, 0.91) in model II (adjusted for all covariates). Higher eGDR index was associated with a reduced risk of OA when compared to the lowest quartile (Q1). A restricted cubic spline analysis indicated a linear negative relationship between eGDR and OA risk.

Conclusion: An increased eGDR index is inversely related to the risk of OA. The eGDR may serve as a valuable biomarker for the detection of OA and offers a new perspective for the assessment and management of the condition.

Background: Macrophage accumulation found in biopsy specimens of patients with dilated cardiomyopathy (DCM) has been thought to reflect chronic myocarditis. However, it is unsettled whether they are responsible for the active or persistent phase of the disease.

Objective: The aim of this study was to count the number of macrophages in relation to plasma concentrations of cardiac troponin T (cTnT).

Methods: We studied the biopsies of 181 patients with DCM by immunohistochemistry using anti-CD68(+) antibodies. The total number of CD68(+) and the number of CD68(+) cells attached to injured cardiomyocytes were counted and presented as the number of cells/mm².

Results: Two expression patterns of CD68(+) macrophages were observed: those localized freely in the interstitial space only, and the cells attached to injured cardiomyocytes. As regards macrophages adhered to injured cardiomyocytes, 72 out of 181 (39.8%) patients presented these cells in the biopsy sections. Both the total number of CD68(+) macrophages and the number of CD68(+) cells directly adhered correlated negatively with cTnT in the serum of DCM patients (Spearman's rho, r = -0.45, P < 0.001 and r = -0.31, P = 0.009, respectively).

Conclusion: Macrophages attached to injured cardiomyocytes may reflect chronic (ongoing) inflammation in the myocardium.

Background & aims: There was considerable debate regarding the effect of statins administration on the outcome of septic patients. This retrospective study aimed to assess the association between statins administration and mortality in sepsis patients and investigate whether this association differed according to the types of statins.

Methods: We performed a retrospective study based on the electronic ICU Collaborative Research Database, Medical Information Mart for Intensive Care Database, and the Amsterdam University Medical Centers Database. The participants with sepsis were divided as two groups, statins group and non-statins group. The primary endpoint was the all-cause mortality. We utilized logistic regression, propensity score matching (PSM), and sub-analysis to assess the association between statins administration and outcome in patients with sepsis.

Results: A total of 19,327 sepsis patients were enrolled. Among these, 3,721 patients were prescribed statins. Pooled analyses of three databases showed that statin users had a decreased risk of mortality in sepsis as compared with nonusers (OR 0.73, 95% CI 0.66-0.80, P < 0.001). Sub-analysis of statin showed that atorvastatin had the most distinct effectiveness in decreasing mortality (OR 0.67, 95% CI 0.59-0.76, P = 0.035), whereas pravastatin, simvastatin, and rosuvastatin were not. PSM analysis confirmed these findings for statins (OR 0.75, 95% CI 0.67-0.84, P < 0.001) and atorvastatin (OR 0.70, 95% CI 0.59-0.82, P < 0.001).

Conclusions: The use of statins could decrease the risk of mortality in patients with sepsis during the hospital period. Among different types of statins, atorvastatin showed the most significant trend to reduce the risk of mortality in patients with sepsis.

Objective: To investigate how lathyrol affects aggressive behaviors and related proteins of the androgen receptor (AR) 786-O cells.

Methods: 786-O cells were cultured in vitro and divided into these groups at random: the dimethylsulfoxide (DMSO) control group (A group), negative control group (B group), and experimental group (C group). Cells in A group were grown in DMSO working medium (contained RPMI 1640 medium and 1% DMSO), B group cells were cultured in nilutamide working medium (contained DMSO working medium and 325 μg/mL nilutamide), while those in C group were cultured in lathyrol working medium (contained DMSO working medium and 300 μg/mL lathyrol). Cell proliferation was measured via CCK-8 assays, and cell apoptosis was examined through terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling staining. Scratch tests and Transwell invasion tests were used to evaluate cell movement and penetration. The expression information about p-AR, AR, p-Akt, ki67, caspase3, cleaved-caspase3, Bcl-2, Bax, caspase9, cleaved-caspase9, and GAPDH proteins was investigated through western blotting. Immunocytochemistry was used to identify the 786-O cells' secretion level of matrix metalloproteinase 2 (MMP2), MMP9, and prostate-specific antigen (PSA) proteins.

Results: The negative control and experimental groups' cells exhibited reduced proliferation, migration, and invasion and increased apoptosis after 24 h treatment. Furthermore, these two group cells exhibited a notable reduction in the status of Ki67, Bcl-2, MMP2, MMP9, and p-Akt (P < 0.05) and significantly increased the expressions of AR, p-AR, Bax, cleaved-caspase3, and cleaved-caspase9 (P < 0.05). There was no statistical distance in PSA, caspase3, and caspase9 expressions among the three groups (P > 0.05).

Conclusion: In vitro, lathyrol and nilutamide exert notable anticancer effects by effectively suppressing the proliferation, migration, and invasion of 786-O cells while also inducing apoptosis.

Background: The highly infectious coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2, the seventh coronavirus. It is the longest pandemic in recorded history worldwide. Many countries are still reporting COVID-19 cases even in the fifth year of its emergence.

Objective: The performance of various machine learning (ML) and deep learning (DL) models was studied for image-based classification of the lungs infected with COVID-19, pneumonia (viral and bacterial), and normal cases from the chest X-rays (CXRs).

Methods: The K-nearest neighbour and logistics regression as the two ML models, and Visual Geometry Group-19, Vision transformer, and ConvMixer as the three DL models were included in the investigation to compare the brevity of the detection and classification of the cases.

Results: Among the investigated models, ConvMixer returned the best result in terms of accuracy, recall, precision, F1-score and area under the curve for both binary as well as multiclass classification. The pre-trained ConvMixer model outperformed the other four models in classifying. As per the performance observations, there was 97.1% accuracy for normal and COVID-19 + pneumonia-infected lungs, 98% accuracy for normal and COVID-19 infected lungs, 82% accuracy for normal + bacterial + viral infected lungs, and 98% accuracy for normal + pneumonia infected lungs. The DL models performed better than the ML models for binary and multiclass classification. The performance of these studied models was tried on other CXR image databases.

Conclusion: The suggested network effectively detected COVID-19 and different types of pneumonia by using CXR imagery. This could help medical sciences for timely and accurate diagnoses of the cases through bioimaging technology and the use of high-end bioinformatics tools.

Background: Early-stage breast cancer requires effective surgical interventions. This meta-analysis compares the therapeutic efficacy of endoscopic minimally invasive surgery (EMIS) with traditional surgery, such as modified radical mastectomy.

Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and the Patient, Intervention, Comparison, Outcome model, we systematically searched PubMed, Embase, Web of Science, and the Cochrane Library until July 19, 2023. We included comparative trials, focusing on randomized controlled trials, retrospective, and prospective studies. Metrics analyzed included operative time, blood loss, postoperative drainage volume, and lymph node harvest using Stata version 17.

Results: Out of 943 studies, six met the inclusion criteria. Endoscopic surgery had a longer operative time (weighted mean difference [WMD] = 1.03, P < 0.01) but significantly less blood loss (WMD = -1.48, P < 0.01). No significant differences were noted in drainage volume and lymph node harvest.

Conclusions: EMIS reduces intraoperative blood loss but requires more time than traditional surgeries. Both methods show comparable outcomes in postoperative drainage and lymph node harvest, supporting their efficacy in treating early-stage breast cancer.

Background: Radical gastrectomy is generally prefered for gastric cancer but has postoperative complications. The objectives of the study are to evaluate the effectiveness of three different models of preoperative counseling and postoperative follow-up care in patients who underwent radical gastrectomy for gastric cancer.

Methods: In retrospective medical record analyses, patients received nurse-led preoperative counseling and postoperative follow-up care (NC cohort, n = 105) or surgeon-led preoperative counseling and surgeon-led follow-up (SC cohort, n = 140), or did not receive counseling and aftercare (RC cohort, n = 160).

Results: Patients had a postoperative intensive care unit (PICU) stay of 24 (26-22) h/patient and postoperative pain of 6 (6-5)/ patient. The frequencies of nausea, vomiting, medical intensive care unit admission(s), dizziness, length of PICU stay, and intensity of postoperative pain were lower among patients in the NC cohort, followed by those in the SC and RC cohorts. A higher number of patients in the RC cohort died when compared to the NC (25 [16%) vs 2 [2%], p = 0.0458) and the SC (25 [16%] vs 11 [8%], p = 0.0001) cohorts in follow-up.

Conclusion: Patients who undergo radical gastrectomy for gastric cancer require healthcare professional-led preoperative counseling and postoperative aftercare. Nurse-led preoperative counseling and postoperative aftercare, could improve outcome measures in patients who underwent radical gastrectomy for gastric cancer.

Background: Anti-angiogenesis or inhibition of blood vessel formation is the best way to prevent the growth and metastasis of tumors. Natural sources like plants are currently being explored for its antiangiogenic activity as they are factories of various phytochemicals. The goal of the current study is to investigate the antiangiogenic potential of Elaeagnus umbellata (E. umbellata) by using chorioallantoic membrane (CAM) assay and molecular docking.

Methods: Based on our previous research, the antiangiogenic activity was carried out using active fractions including crude methanol (Eu-Met), ethyl acetate (Eu-EtAc), and chloroform (Eu-Chf) extracts using CAM assay. Furthermore, to understand the binding mechanism of identified compounds, molecular docking was performed against vascular endothelial growth factor receptor 2 (VEGFR-2) using AutoDock vina as docking software. VEGFR-2 is overexpressed in pathological angiogenesis.

Results: In CAM assay, Eu-Met, Eu-EtAc, and Eu-Chf extracts showed antiangiogenic activities but notable antiangiogenic activities were exhibited by Eu-Chf with IC₅₀ value of 65.02 μg/mL. In molecular docking, five compounds, catechin, catechin hydrate, morin, quercetin, and rutin, reported in the extract and active fractions (Eu-Met, Eu-EtAc, and Eu-Chf) of E. umbellata showed strong interactions with VEGFR-2 with binding affinities of -9.4, -9.3, -9.9, -10.2, and -9.4 kcal/mol.

Conclusion: Based on our results, we can claim that E. umbellata possess antiangiogenic activity which needs to be explored further.

Purpose: This study aims to investigate the role and mechanism of p-hydroxyl cinnamaldehyde (CMSP) in triggering ferroptosis of small cell lung cancer (SCLC) cells.

Methods: The impact of CMSP on ferroptosis in H1688 and SW1271 cells was assessed through cell experiments and biological information analysis. Moreover, the expression of heme oxygenase 1 (HMOX1) in SCLC tissue was examined.

Results: Following CMSP treatment, a concentration-dependent increase in cell death was observed, and differentially expressed genes were found to be associated with ferroptosis. CMSP notably facilitated ferroptosis events, such as elevated levels of reactive oxygen species (ROS), Fe²⁺, malondialdehyde (MDA), transferrin receptor 1 (TFR1), divalent metal transporter 1 (DMT1), and decreased levels of glutathione (GSH), solute carrier family 7 member 11 (SLC7A11), and glutathione peroxidase 4 (GPX4). Furthermore, CMSP promoted mitochondrial dysfunction, manifested as reduced mitochondrial volume, increased membrane density, elevated mitochondrial ROS, and decreased mitochondrial membrane potential. Consistently, the mitochondrial-targeted antioxidant Mito-TEMPO reversed CMSP-induced ferroptosis. Expression of the HMOX1 gene was markedly increased under CMSP treatment, while lower expression was observed in cancer tissue compared to adjacent tissue.

Conclusion: CMSP triggers mitochondrial dysfunction via HMOX1 activation, leading to ferroptosis in SCLC cells, underscoring its potential as a therapeutic agent for SCLC.

Objective: This study investigated the clinical significance of plasma sB7-H3 and YKL-40 levels in children with refractory Mycoplasma pneumoniae pneumonia (RMPP).

Methods: A total of 182 RMPP patients (103 general Mycoplasma pneumoniae patients and 79 RMPP patients) were included. sB7-H3, YKL-40, and other inflammatory factors were measured. Independent factors associated with the early diagnosis of RMPP were determined. The value of each independent risk factor in predicting RMPP was evaluated.

Results: The RMPP group reported significantly longer hospital stays and total fever durations. Levels of C-reactive protein, D-dimer, IL-13, IL-6/-10, sB7-H3, and YKL-40 were higher in the RMPP group. sB7-H3 was positively correlated with IL-13, IL-6, and IL-4, whereas YKL-40 was positively correlated with all of the above indicators (IL-5 was also included). sB7-H3 and YKL-40 were independent risk factors for RMPP. The critical values for sB7-H3 and YKL-40 were 3.525 and 313.3 ng/mL, respectively. sB7-H3 and YKL-40 had areas under the curve of 0.734 and 0.859, respectively. YKL-40 had high sensitivity and specificity of 88.61 and 87.38%, respectively. Both indicators had predictive value, YKL-40 had the highest predictive ability for RMPP.

Conclusion: Detection of sB7-H3 and YKL-40 levels in the plasma may be useful in diagnosing RMPP early in the disease process.