Open Medicine最新文献

Objectives: This review explores the application value of fluorescence micro-optical sectioning tomography (fMOST) in diabetes-related cognitive dysfunction research, emphasizing its unique capacity to resolve microstructural alterations in neural circuits and vascular networks, thereby offering novel insights into the pathogenesis of type 2 diabetic cognitive impairment.

Methods: Existing literature was analyzed to evaluate fMOST's principles and capabilities, including its achievement of whole-brain three-dimensional imaging at sub-micron resolution, simultaneous acquisition of neuronal morphology (soma, dendritic spines, axonal terminals) and vascular networks, and integration with fluorescent labeling to trace prefrontal cortical pyramidal neuron projections under pathological conditions.

Results: fMOST technology revealed the critical role of neurovascular coupling dysfunction in diabetic cognitive impairment, demonstrating that interactive damage between neurons and vasculature collectively drives disease progression. In type 2 diabetic models, it identified abnormal synaptic structures in prefrontal/hippocampal pyramidal neurons, vascular network remodeling, and disrupted brain connectivity. Compared to conventional imaging (magnetic resonance imaging/positron emission tomography), fMOST enables concurrent quantitative analysis of synaptic-level neural circuits and microangiopathy, overcoming the resolution limitations of macroscopic imaging.

Conclusion: fMOST serves as an indispensable high-precision, multi-scale imaging tool for investigating diabetic cognitive impairment. Future priorities include elucidating dynamic neurovascular unit interactions in diabetic encephalopathy, developing neural circuit-targeted interventions, and advancing interdisciplinary integration to accelerate clinical translation.

Objective: Autophagy serves as a protective mechanism in response to mechanical stress during OTM. However, the role of ATG7, a key regulatory gene in autophagy, in modulating periodontium remodeling during OTM remains unclear. This study aims to investigate the potential modulation of periodontium remodeling by ATG7 under compression force.

Materials and methods: HPDLSCs and a rat OTM model were used as in vitro and in vivo systems to study the effect of compressive stress on autophagy and osteoclast-related markers. To investigate the role of ATG7, hPDLSCs with ATG7 knockdown and ATG7^+/- rats were used in this study.

Results: Compression force activates autophagy and increases the RANKL/OPG ratio. ATG7 knockdown significantly suppresses autophagy in hPDLSCs, while the RANKL/OPG ratio is markedly elevated. Under compression stress, hPDLSCs-siATG7 markedly enhanced RANKL/OPG expression. In the rat OTM model, autophagy was significantly activated in the periodontium on the compression side. Compared to wild-type SD rats, ATG7^+/- rats exhibit reduced autophagy-related protein expression, an increased RANKL/OPG ratio, and accelerated tooth movement.

Conclusions: Under compression force, inhibition of ATG7 expression significantly increases the RANKL/OPG ratio both in vivo and in vitro, which is accompanied by an increased rate of orthodontic tooth movement.

Objective: This study aimed to review the rates of physical frailty and sarcopenia, as well as associated risk factors, among adults aged 60 and older living in the community.

Methods: A systematic literature search was conducted in PubMed, Wiley Library, Embase, Web of Science, and Cochrane Library for articles published from January 2000 to December 2024. The review followed PRISMA guidelines for meta-analysis.

Results: Sixteen studies with 41,765 participants were included in the meta-analysis. The pooled prevalence of frailty/sarcopenia was 27% (95% CI: 19-35%). Specifically, the pooled prevalence of frailty was 25% (95% CI: 16-38%) and that of sarcopenia was 23% (95% CI: 13-37%). Age, malnutrition, depression, falls, and hypertension were identified as significant risk factors for frailty/sarcopenia.

Conclusion: Nearly 30% of older adults in the community are affected by frailty/sarcopenia. Early identification of these risk factors is crucial for the prevention and management of frailty/sarcopenia. Further research is needed to determine effective interventions and strategies to reduce the incidence of frailty/sarcopenia.

Background and aim: The aim of this study is to investigate whether certain clinical nomograms influencing the success of extracorporeal shock wave lithotripsy (ESWL) also play a role in determining the number of treatment sessions required in patients who achieved stone-free status following ESWL.

Methods: The data of 354 patients with successful ESWL outcomes were analyzed. Patients were evaluated 4-6 weeks post-ESWL using X-ray, ultrasound, or computed tomography. The presence of residual stones larger than 4 mm was considered a treatment failure. Data recorded included age, gender, laterality of stone localization (right/left), stone location (renal pelvis, mid calyx, upper calyx, proximal ureter, mid ureter, distal ureter), stone size (maximum longitudinal dimension), body mass index (BMI), and stone Hounsfield unit (HU) values. Patients were categorized into two groups: single-session and multiple-session treatment.

Results: In the univariate model, factors such as age, BMI, distal ureter, renal pelvis, mid-calyx stone localization, stone size, and stone HU value showed a significant (p < 0.05) effect in distinguishing between single-session and multiple-session groups. Stone size and HU values were significantly higher (p < 0.05) in the multiple-session group compared to the single-session group. In the multivariate model, age, stone size, and HU value emerged as significant independent factors (p < 0.05) in differentiating between single-session and multiple-session treatments.

Conclusion: Several factors influencing the success of ESWL also affect the number of sessions required. BMI, age, stone size, stone HU value, and certain stone locations are key determinants of the number of ESWL sessions.

Background: Acute cholecystitis (AC) is a common condition in emergency departments (EDs), where timely diagnosis and severity assessment are critical for treatment decisions and outcome prediction.

Methods: This study included 194 patients with AC to evaluate the diagnostic and severity-grading performance of procalcitonin (PCT) and C-reactive protein (CRP). Receiver operating characteristic (ROC) curve analysis was used to determine optimal cut-off values for discriminating between severity grades according to the Tokyo Guidelines.

Results: Elevated levels of PCT and CRP were observed in 73.2 and 67% of cases, respectively. PCT demonstrated a sensitivity of 75.6% and specificity of 64.8% at a cut-off value of ≤ 0.595 ng/mL for distinguishing grade I from grades II to III. For differentiating grade III from grades I to II, PCT showed a sensitivity of 62.5% and specificity of 92.1% at a cut-off value of ≥5.095 ng/mL. Similarly, CRP had a sensitivity of 82.9% and specificity of 64.8% at a cut-off value of ≤78 mg/L for grade I versus grades II to III, and a sensitivity of 62.5% and specificity of 69.7% at a cut-off value of ≥82.5 mg/L for grade III versus grades I to II.

Conclusion: Both PCT and CRP are valuable biomarkers for diagnosing AC and assessing its severity.

Scleroderma is an autoimmune disorder characterized by vasculopathy, progressive skin fibrosis, and dysfunction of internal organs. Esophageal involvement is seen in most scleroderma patients. There is no specific treatment for dysphagia caused by scleroderma. FLIP technology is a novel diagnostic and therapeutic modality to assess the tightness of esophageal sphincters and esophageal motility and also provide therapeutic dilation. We describe the case of a patient with scleroderma who presented with dysphagia. Upper endoscopy was unremarkable. Esophageal manometry revealed aperistalsis with normal upper and lower esophageal sphincter (LES) relaxation. Barium esophagram demonstrated poor esophageal motility and hold-up of the barium tablet at the gastroesophageal junction. EndoFLIP test during sedated upper endoscopy revealed normal LES distensibility and absent peristalsis of the esophageal body. Due to dysphagia, the LES was dilated with a 30 mm EsoFLIP. A barium esophagram following the dilation revealed a significant reduction in esophageal body diameter, normalization of barium tablet transit, and symptomatic improvement in dysphagia. Our case is the first report of the use of EsoFLIP to help improve dysphagia in a scleroderma patient. It illustrates the importance of multi-modal functional testing in patients with dysphagia and suggests the utility of EsoFLIP in the treatment of dysphagia in these patients.

Background: Diabetic retinopathy (DR), as a frequent complication of diabetes mellitus, is a common cause of vision impairment and blindness. Microglial activation plays an important role in the pathological cascade of DR, and novel potential therapeutics is needed to interfere with this process. Petunidin (PET) is one of the most abundant natural anthocyanins with the biological activities of anti-inflammation, anti-cancer, and anti-microbial.

Objective: The purpose of this study is to investigate the effect of PET against lipopolysaccharide (LPS)-induced retinal microglia inflammatory response as well as the underpinning mechanism.

Methods: Cell viability was determined using MTT assay. Cytokines secretion was determined using ELISA assay. iTRAQ-based proteomic analysis was used for the identification of differentially expressed proteins. Western blot analysis, Co-IP and immunofluorescence analysis were applied in the study.

Results: The results showed that PET pre-treatment significantly reduced LPS-induced cytokines secretion in BV2 cells and primary retinal microglia, as well as lipocalin 2 (LCN2) upregulation in BV2 cells by suppressing activation of O-GlcNAc modification and activation of NF‑κB. Further study revealed that PET inactivated NF‑κB by down-regulating OGT in BV2 cells, indicating that the protective effect of PET against LPS-induced retinal microglia inflammatory response was achieved by regulating OGT/NF-κB/LCN2 axis.

Conclusion: Our findings may contribute to the potential clinical use of PET in treating DR and suggest OGT/NF-κB/LCN2 axis may be the potential therapeutic target of this disease.

Background: Laparoscopic adrenalectomy (LA) is the gold standard technique for well-selected patients with an adrenal mass. The surgical team's experience is an essential factor in the surgical outcome.

Objective: The aim of this study was to assess the outcomes of patients who underwent lateral transperitoneal LA to remove their adrenal mass.

Methods: In this case-series study, 20 consecutive patients with adrenal mass were enrolled in Sulaimani Teaching Hospital, Sulaimaniyah, Iraq, from March 2019 to March 2022. Patients underwent lateral transperitoneal LA under general anaesthesia. Then, the type of LA, operation time, mass size, hospital stay, histopathological finding, and postoperative complications were assessed.

Results: Most patients were females (65%), underwent left-sided LA (55%), had a nonfunctioning mass (55%), and had no postoperative complications (85%). The mean operation time was 95 ± 2.0 min, and the mean hospital stay was 3.2 ± 1.5 days. Most patients were detected incidentally through radiology (55%), while others were detected after biochemical tests were done, including cases of pheochromocytoma (25%), hypercortisolism (10%), and hyperaldosteronism (10%). Most patients had benign cortical adenoma (45%), followed by benign medullary pheochromocytoma (25%), myelolipoma (15%), oncocytoma, adrenal hyperplasia, and ganglioneuroma (5.0% each).

Conclusions: LA seems to be a safe and feasible option for selected cases in this locality.

Background: Rapid application of transcatheter valve replacement for valve diseases has promoted the development of biological valves. Different efforts have been made to improve the surface properties of valves. We developed a new method using arginine-glycine-aspartate (RGD) peptide and epoxy chloropropane (EC). Our goal was to evaluate and detect the surface biological characteristics of valve materials using RGD and EC treatments.

Methods: The surfaces of the valve materials used in the GA-EC and RGD-EC groups were smooth and relatively dense, as observed using a scanning electron microscope.

Results: More MSCs adhered to and grew on the samples in the GA-EC and RGD-EC groups than in the GA group. The apoptosis rate of MSCs was markedly decreased, whereas the expression of vimentin was elevated in the GA-EC and RGD-EC groups (P < 0.05). The adherent ability of MSCs in the RGD-EC and GA-EC groups was significantly higher than that in the GA group (P < 0.05).

Conclusions: The new treatment method using RGD and EC improves the biological properties of the surface of the biological valve materials.

Background and objective: The World Health Organization (WHO) appeal of January 15, 2024, stated "The current number, size and concurrence of multiple outbreaks, the spread to areas free of cholera for decades and alarmingly high mortality rates present a major threat to global health security." The current state is extremely worrying, considering the difficulties of countries in dealing with cholera epidemics due to the lack of funding and the difficulty in oral cholera vaccine production and administration. This study aims to analyse the past and current influence of anthropization on cholera onset.

Methods: We analysed the literature, particularly of the last 5 years, on the influence of human actions that impact the spread of cholera.

Results: The epidemiological data published by WHO and the available literature highlight a strong impact of human actions on the epidemic spread of cholera, the government's difficulty in making decisions on epidemic prevention or containment, and the fear of the population.

Conclusions: Cholera should be considered an anthropogenic disaster, considering the historical health analysis of the cholera epidemics in Italy in the last two centuries and in southern Italy and in Naples in 1973.