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miR-145-5p regulates hepatocellular carcinoma malignant advancement and immune escape via down-regulation of AcylCoA synthase ACSL4. miR-145-5p通过下调酰基辅酶a合成酶ACSL4调控肝癌恶性进展和免疫逃逸。
0 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-12-07 DOI: 10.17305/bb.2024.11209
Dingxue Wang, Wenqi Huang, Gao Li

Hepatocellular carcinoma (HCC) exhibits a subtle onset, high incidence rates, and low survival rates, becoming a substantial threat to human health. Hence, it is crucial to discover fresh biomarkers and treatment targets for the early detection and management of HCC. CCK-8, scratch-wound, and transwell assays were used to evaluate the biological properties of HCC cell lines (Huh-7 and Hep3B). Bioinformatics analysis identified the downstream target mRNA of miR-145-5p as acyl-CoA synthetase long-chain family member 4 (ACSL4). RT-qPCR was used to test miR-145-5p and ACSL4 levels. Transwell chambers were used to co-incubate purified CD8+ T cells and HCC cells for 48 h, and the effect of CD8+ T cells on apoptosis in HCC cells was detected by flow cytometry. A subcutaneous graft tumor model was constructed, and ELISA kits were used to assess cytokine levels and CD8+ T cell activation markers. HCC cells showed a decline in miR-145-5p levels and a rise in ACSL4 levels. Overexpression of miR-145-5p hindered HCC cell proliferation, migration, and invasion, while stimulating CD8+ T cell activation. Conversely, overexpression of ACSL4 enhanced the malignant biological properties of HCC cells and reduced the effect of CD8+ T cells, while silencing ACSL4 had the opposite effect. miR-145-5p targeted and downregulated ACSL4, while overexpression of miR-145-5p weakened the promotion of HCC malignant progression caused by ACSL4 overexpression. Additionally, overexpression of miR-145-5p and silencing ACSL4 were effective in inhibiting tumor growth in vivo. In conclusion, miR-145-5p targets and downregulates ACSL4, leading to the inhibition of HCC malignant progression and preventing immune escape in HCC cells.

肝细胞癌(HCC)发病轻、发病率高、生存率低,已成为人类健康的重大威胁。因此,发现新的生物标志物和治疗靶点对于HCC的早期发现和治疗至关重要。采用CCK-8、划伤法和transwell法评估HCC细胞系(Huh-7和Hep3B)的生物学特性。生物信息学分析鉴定miR-145-5p的下游靶mRNA为酰基辅酶a合成酶长链家族成员4 (ACSL4)。RT-qPCR检测miR-145-5p和ACSL4水平。采用Transwell腔将纯化的CD8+ T细胞与HCC细胞共孵育48 h,流式细胞术检测CD8+ T细胞对HCC细胞凋亡的影响。建立皮下移植瘤模型,采用ELISA试剂盒检测细胞因子水平和CD8+ T细胞活化标志物。HCC细胞miR-145-5p水平下降,ACSL4水平升高。miR-145-5p过表达抑制HCC细胞增殖、迁移和侵袭,同时刺激CD8+ T细胞活化。相反,过表达ACSL4会增强HCC细胞的恶性生物学特性,降低CD8+ T细胞的作用,而沉默ACSL4则会产生相反的效果。miR-145-5p靶向并下调ACSL4,而过表达miR-145-5p减弱了ACSL4过表达对HCC恶性进展的促进作用。此外,过表达miR-145-5p和沉默ACSL4在体内可有效抑制肿瘤生长。综上所述,miR-145-5p靶向并下调ACSL4,从而抑制HCC细胞的恶性进展并阻止HCC细胞的免疫逃逸。
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引用次数: 0
Morroniside ameliorates sevoflurane anesthesia-induced cognitive dysfunction in aged mice through modulating the TLR4/NF-κB pathway. 莫罗尼苷通过调节TLR4/NF-κB途径改善七氟醚麻醉诱发的老年小鼠认知功能障碍
0 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-12-06 DOI: 10.17305/bb.2024.11433
Jianxing Chen, Bo Peng, Wenqian Lin, Yinjun Mao, Yongsheng Wang

Morroniside (Mor) is a bioactive compound in Cornus officinalis with anti-inflammatory, neuroprotective and antioxidant properties. Prolonged use of the anesthetic sevoflurane (Sev) has been connected to the development postoperative cognitive dysfunction (POCD). This research aims to elucidate the mechanism of action of Mor to improve cognitive impairment. A model of cognitive dysfunction induced by Sev was established in aged mice and tested for behavioral analysis using the water maze experiment. Histopathological changes and neuronal apoptosis in mouse hippocampus were observed by hematoxylin and eosin (HE) staining, Nissl staining, and TUNEL staining. ELISA and qRT-PCR determined the levels of inflammatory factors. Phenotypic transformation of microglia in hippocampal tissue was assessed by immunofluorescence, flow cytometry, and qRT-PCR. The interaction between Mor and TLR4 was analyzed using molecular docking. Western blot identified the levels of apoptosis-related proteins, synapse-related proteins, and TLR4/NF-κB pathway proteins. Inhalation of Sev caused a notable reduction in learning and spatial memory in old mice, which was dose-dependently ameliorated by Mor. Mor inhibited neuroinflammation, modulated the polarization state of hippocampal microglia, promoted their polarization to M2 type, alleviated Sev-induced hippocampal tissue damage and neuronal apoptosis. Notably, Mor can bind well with TLR4 and reduce TLR4-positive expression. Mor blocked Sev-induced TLR4/NF-κB pathway activation in hippocampal tissues, and the TLR4 agonist CRX-527 attenuated the effect of Mor. In conclusion, Mor blocked the TLR4/NF-κB pathway, reducing hippocampal tissue damage and neuroinflammation caused by Sev, which in turn improving cognitive impairment in aged mice.

山茱萸内酯(Morroniside, Mor)是山茱萸中的一种生物活性化合物,具有抗炎、神经保护和抗氧化作用。长期使用麻醉剂七氟醚(Sev)与术后认知功能障碍(POCD)的发展有关。本研究旨在阐明Mor改善认知功能障碍的作用机制。建立Sev致老年小鼠认知功能障碍模型,并采用水迷宫实验进行行为学分析。采用苏木精伊红(HE)染色、尼氏染色、TUNEL染色观察小鼠海马组织病理变化及神经元凋亡情况。ELISA和qRT-PCR检测炎症因子水平。采用免疫荧光、流式细胞术和qRT-PCR技术评价海马组织小胶质细胞的表型转化。通过分子对接分析了Mor与TLR4的相互作用。Western blot检测凋亡相关蛋白、突触相关蛋白、TLR4/NF-κB通路蛋白水平。吸入Sev可显著降低老年小鼠的学习和空间记忆能力,Mor可剂量依赖性地改善这一现象。Mor抑制神经炎症,调节海马小胶质细胞极化状态,促进其向M2型极化,减轻sev诱导的海马组织损伤和神经元凋亡。值得注意的是,Mor可以很好地与TLR4结合,降低TLR4阳性表达。Mor阻断了sev诱导的海马组织TLR4/NF-κB通路的激活,TLR4激动剂CRX-527减弱了Mor的作用。综上所述,Mor阻断TLR4/NF-κB通路,减轻Sev引起的海马组织损伤和神经炎症,从而改善老年小鼠的认知功能障碍。
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引用次数: 0
Red cell distribution width to albumin ratio and mortality in acute pulmonary thromboembolism. 急性肺血栓栓塞症患者的红细胞分布宽度与白蛋白比率和死亡率。
0 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-12-06 DOI: 10.17305/bb.2024.10791
Berrin Zinnet Eraslan, Sumeyye Kodalak Cengiz, Ozlem Saniye İçmeli, Seda Beyhan Sagmen, Sevda Şener Cömert

The red cell distribution width (RDW)/albumin ratio (RAR) is an inflammation-based prognostic biomarker. To date, its prognostic value in patients with pulmonary thromboembolism (PTE) has been investigated in only one study. This study aimed to assess the effect of RAR on mortality in patients with PTE. Patients admitted for PTE between 2017 and 2023 were retrospectively reviewed. The data collected included demographic information, comorbidities, clinical findings, RDW, albumin, troponin, D-dimer levels, and in-hospital and 30-day mortality outcomes. RAR was calculated by dividing the RDW by albumin. A total of 190 patients were included in the study, of whom 83 (43.7%) were male. The mean age was 63 years (range: 23-89), and the mean RAR was 4.48% ± 1.68% /g/dL. A positive correlation was observed between RAR and both age and troponin level, whereas inverse correlations were noted with systolic blood pressure (sBP), diastolic blood pressure (dBP), and oxygen saturation (SpO2). Using a cutoff value of 5.294 determined by ROC analysis, patients with RAR ≥ 5.294 had a significantly shorter mean survival time than those with RAR value < 5.294 (16.310 months vs 35.163 months; log-rank test, P < 0.001). Multivariate Cox regression analysis identified malignancy (hazard ratio [HR], 4.213; 95% confidence interval [CI], 1.103-16.090; P = 0.035) and RAR (HR: 1.295, 95% CI: 1.035-1.621, P = 0.024) as independent predictors of survival. In conclusion, an RAR value ≥ 5.294 was associated with significantly shorter survival, underscoring its potential utility as a prognostic marker in clinical practice for non-massive PTE.

红细胞分布宽度(RDW)/白蛋白比值(RAR)是一种基于炎症的预后生物标志物。迄今为止,只有一项研究调查了它在肺血栓栓塞症(PTE)患者中的预后价值。本研究旨在评估RAR对PTE患者死亡率的影响。对2017年至2023年间因PTE入院的患者进行了回顾性研究。收集的数据包括人口统计学信息、合并症、临床表现、RDW、白蛋白、肌钙蛋白、D-二聚体水平以及院内和30天死亡率结果。RAR的计算方法是用RDW除以白蛋白。研究共纳入了 190 名患者,其中 83 名(43.7%)为男性。平均年龄为 63 岁(范围:23-89),平均 RAR 为 4.48% ± 1.68% /g/dL。RAR 与年龄和肌钙蛋白水平呈正相关,而与收缩压 (sBP)、舒张压 (dBP) 和血氧饱和度 (SpO2) 呈反相关。根据 ROC 分析确定的 5.294 临界值,RAR ≥ 5.294 的患者的平均生存时间明显短于 RAR 值 < 5.294 的患者(16.310 个月 vs 35.163 个月;log-rank 检验,P < 0.001)。多变量 Cox 回归分析发现,恶性肿瘤(危险比 [HR],4.213;95% 置信区间 [CI],1.103-16.090;P = 0.035)和 RAR(HR:1.295,95% CI:1.035-1.621,P = 0.024)是生存期的独立预测因素。总之,RAR 值≥ 5.294 与明显较短的存活期相关,突出了其在临床实践中作为非重度 PTE 预后标志物的潜在作用。
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引用次数: 0
Plasma extracellular vesicle neurofilament light chain as the biomarkers of the progression of Parkinson's disease. 血浆细胞外囊泡神经丝轻链作为帕金森病进展的生物标志物。
0 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-12-03 DOI: 10.17305/bb.2024.11502
Chien-Tai Hong, Chen-Chih Chung, Yi-Chen Hsieh, Lung Chan

Parkinson's disease (PD) is a common neurodegenerative disorder characterized by progressive symptoms, underscoring the urgent need for predictive blood biomarkers. Plasma extracellular vesicles (EVs) offer a promising platform for biomarker development, with neurofilament light chain (NfL) emerging as a potential candidate for neurological diseases. This study evaluated plasma EV NfL as a biomarker for disease progression in a PD cohort.A total of 55 patients with PD (PwP) and 58 healthy controls (HCs) were followed, with PwP completing an average of 3.96 visits and HCs 2.25 visits. Plasma EVs were isolated and validated, and EV NfL levels were measured using an immunomagnetic reduction assay. Generalized estimating equations and Spearman correlations assessed relationships between clinical symptom progression and biomarkers. Although no significant differences in plasma EV NfL levels were observed between PwP and HCs over time, changes in plasma EV NfL significantly correlated with motor symptom progression, specifically with adjusted-total and akinetic-rigidity subscores of the Unified PD Rating Scale (UPDRS) Part III. Additionally, changes in UPDRS Part II scores were significantly associated with plasma EV NfL levels. These findings suggest that plasma EV NfL reflects motor symptom progression in PwP, highlighting its potential as a valuable biomarker for monitoring disease progression and guiding clinical trials in PD.

帕金森病(PD)是一种常见的以进行性症状为特征的神经退行性疾病,迫切需要预测性血液生物标志物。血浆细胞外囊泡(EVs)为生物标志物的开发提供了一个很有前途的平台,神经丝轻链(NfL)成为神经系统疾病的潜在候选者。该研究评估了血浆EV NfL作为PD队列疾病进展的生物标志物。共随访55例PD患者(PwP)和58例健康对照(hc), PwP平均完成3.96次就诊,hc平均完成2.25次就诊。分离并验证血浆EV,并使用免疫磁还原法测量EV NfL水平。广义估计方程和Spearman相关性评估了临床症状进展与生物标志物之间的关系。虽然血浆EV NfL水平在PwP和hc之间随时间没有显著差异,但血浆EV NfL的变化与运动症状进展显著相关,特别是与统一PD评定量表(UPDRS)第三部分的调整总评分和动力刚性评分相关。此外,UPDRS第二部分评分的变化与血浆EV NfL水平显著相关。这些发现表明血浆EV NfL反映了PwP的运动症状进展,突出了其作为监测疾病进展和指导PD临床试验的有价值的生物标志物的潜力。
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引用次数: 0
Epidemiological survey on prevalence and subtypes distribution of Blastocystis sp. in Southern Guizhou, China. 黔南囊虫流行病学调查及亚型分布。
0 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-12-02 DOI: 10.17305/bb.2024.11303
Xiaoyin Fu, Jiayin Lyu, Yunliang Shi, Bingying Cao, Dengyu Liu, Xi Yang, Lin Huang, Qiuguo Liang, Dejun Liao, Shanshan He

Blastocystis sp. is one of the most common intestinal protozoan parasites of humans worldwide and often has genetic polymorphisms. Due to its high prevalence and the possibility of potential transmission to humans, this study was carried out to investigate the prevalence of Blastocystis sp. and characterize its subtypes (genotypes) in southern Guizhou, China. A total of 548 fecal samples were collected from hospital patients for culture-based diagnosis. PCR products were sequenced and phylogenetically analyzed to identify subtypes and analyze their distribution. 43 positive cases of infection with Blastocystis sp. were detected, resulting in an overall prevalence of 7.85% (43/548). Seven subtypes were identified: ST3 (55.81%), ST1 (25.58%), ST7 (6.98%), ST5 (4.65%), ST2 (2.33%), ST4 (2.33%), and ST15 (2.33%). ST3 demonstrated the lowest intra-ST diversity, followed by ST1. Blastocystis sp. infection in southern Guizhou was caused by seven subtypes (ST1-ST5, ST7 and ST15) of the parasite, in which ST3 was the most common subtype, followed by ST1. The lowest intra-ST diversity of ST3 may be associated with substantial interhuman transmission in Guizhou. ST15 was found for the first time in humans, suggesting that it has the potential to be a zoonotic parasite. These findings have enhanced our understanding of the epidemiology and transmission of Blastocystis sp. in Southern Guizhou, China.

囊虫(Blastocystis sp.)是人类最常见的肠道原生动物寄生虫之一,通常具有遗传多态性。鉴于囊虫在贵州南部地区的高流行率和传播给人类的可能性,本研究旨在调查囊虫在贵州南部地区的流行情况,并对其亚型(基因型)进行特征分析。收集住院患者粪便样本548份,进行培养诊断。对PCR产物进行测序和系统发育分析,以确定其亚型并分析其分布。检出囊虫感染阳性43例,检出率为7.85%(43/548)。共鉴定出7种亚型:ST3(55.81%)、ST1(25.58%)、ST7(6.98%)、ST5(4.65%)、ST2(2.33%)、ST4(2.33%)、ST15(2.33%)。st内多样性最低的是ST3,其次是ST1。黔南地区囊虫感染主要由ST1- st5、ST7和ST15 7个亚型引起,其中以ST3亚型最为常见,其次为ST1亚型。ST3的最低st内多样性可能与贵州大量的人际传播有关。ST15首次在人类中被发现,这表明它有可能是一种人畜共患寄生虫。这些发现增加了我们对黔南囊虫流行病学和传播的认识。
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引用次数: 0
The association between plasma levels of Sestrin2 and risk factors of cardiovascular diseases in healthy and diabetic adults: A study of Qatar Biobank data. 健康和糖尿病成人血浆中Sestrin2水平与心血管疾病危险因素之间的关系:卡塔尔生物银行数据的研究
0 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-11-29 DOI: 10.17305/bb.2024.11418
Shahenda Abdelsalam, Muhammad Ammar Zahid, Hicham Raïq, Hanan Abunada, Ahad Elsayed, Aijaz Parray, Abdelali Agouni

This study examines the association between serum Sestrin2 (SESN2) levels and cardiovascular disease (CVD) risk factors in healthy and diabetic adults, using data from the Qatar Biobank (QBB). A total of 844 participants were included, with 518 in the diabetic cohort and 326 in the healthy cohort. Clinical characteristics, cardiometabolic markers, and SESN2 levels were measured, and binomial logistic regression analyses were conducted to assess the associations between SESN2 and various health indices. Diabetic patients had significantly lower SESN2 levels compared to healthy controls (5.49 ± 5.94 vs 8.25 ± 7.57 ng/mL, P < 0.001). A significant negative correlation was observed between SESN2 and HbA1c (-0.19, P = 0.0006), insulin (-0.19, P = 0.0006), HOMA-IR (-0.17, P = 0.0024), C-peptide (-0.18, P = 0.0012), triglycerides (TG)/HDL ratio (-0.12, P = 0.0283), and the pulsatility index (PI) (-0.15, P = 0.006). In healthy individuals, higher SESN2 levels were associated with lower odds of elevated HbA1c (adjusted odds ratio [AOR] = 0.33, P = 0.00), insulin (AOR = 0.23, P = 0.00), HOMA-IR (AOR = 0.58, P = 0.06), C-peptide (AOR = 0.56, P = 0.04), and TG (AOR = 0.37, P = 0.03). In contrast, diabetic patients showed a positive correlation between SESN2 and insulin (0.15, P = 0.0005), HOMA-IR (0.11, P = 0.0106), and C-peptide (0.12, P = 0.0048). Participants in the highest SESN2 tertile had increased risks for high BMI (AOR = 1.96, P = 0.05), high TG (AOR = 1.57, P = 0.04), high NT-proBNP (AOR = 7.27, P = 0.01), and high fibrinogen (AOR = 1.92, P = 0.03). These findings suggest that while high SESN2 levels are cardioprotective in healthy individuals, they may indicate higher cellular stress in diabetics. Determining optimal SESN2 levels could help assess CVD risk, particularly in diabetic patients.

本研究利用卡塔尔生物银行(QBB)的数据,研究了健康和糖尿病成年人血清Sestrin2 (SESN2)水平与心血管疾病(CVD)危险因素之间的关系。共纳入844名参与者,其中518人属于糖尿病组,326人属于健康组。测量临床特征、心脏代谢标志物和SESN2水平,并进行二项logistic回归分析,以评估SESN2与各种健康指标之间的相关性。糖尿病患者的SESN2水平明显低于健康对照组(5.49±5.94 vs 8.25±7.57 ng/mL, P < 0.001)。SESN2与HbA1c (-0.19, P = 0.0006)、胰岛素(-0.19,P = 0.0006)、HOMA-IR (-0.17, P = 0.0024)、c肽(-0.18,P = 0.0012)、甘油三酯(TG)/HDL比值(-0.12,P = 0.0283)、脉搏指数(PI) (-0.15, P = 0.006)呈显著负相关。在健康人群中,较高的SESN2水平与较低的HbA1c升高的几率相关(校正优势比[AOR] = 0.33, P = 0.00)、胰岛素(AOR = 0.23, P = 0.00)、HOMA-IR (AOR = 0.58, P = 0.06)、c肽(AOR = 0.56, P = 0.04)和TG (AOR = 0.37, P = 0.03)。糖尿病患者SESN2与胰岛素(0.15,P = 0.0005)、HOMA-IR (0.11, P = 0.0106)、c肽(0.12,P = 0.0048)呈正相关。SESN2水平最高的参与者出现高BMI (AOR = 1.96, P = 0.05)、高TG (AOR = 1.57, P = 0.04)、高NT-proBNP (AOR = 7.27, P = 0.01)和高纤维蛋白原(AOR = 1.92, P = 0.03)的风险增加。这些发现表明,虽然高SESN2水平在健康个体中具有心脏保护作用,但它们可能表明糖尿病患者的细胞应激更高。确定最佳SESN2水平有助于评估心血管疾病风险,尤其是糖尿病患者。
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引用次数: 0
Risk factors and a nomogram for predicting valproic acid-induced liver injury : A nested case-control study. 预测丙戊酸引起的肝损伤的危险因素和nomogram:巢式病例对照研究。
0 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-11-29 DOI: 10.17305/bb.2024.11258
Yue Chen, Yadong Wang, Runan Xia, Yi Chen, Xuefeng Xie

The risk factors for liver injury induced by valproic acid (VPA) are not well understood, and no predictive tool currently exists to identify patients at risk. This study aims to explore these risk factors and develop a predictive model. We collected medical data from patients treated with VPA between January 1, 2020, and October 31, 2023. Prescription sequence analysis was used to identify patients with suspected VPA-induced liver injury, and the Roussel Uclaf Causality Assessment Method was applied to confirm the diagnosis. Risk factors were analyzed using logistic regression, and a nomogram model was developed and evaluated. A total of 256 cases were included in the study: 64 in the VPA-induced liver injury group and 192 in the control group. The incidence of liver injury was 5.3%. Multivariate logistic regression analysis revealed that dysglycemia (odds ratio [OR] = 5.171; 95% confidence interval [CI]: 1.254-21.325), hyperlipidemia (OR = 4.903; 95% CI: 1.400-17.173), surgery (OR = 10.020; 95% CI: 1.737-57.805), and hypokalemia (OR = 10.407; 95% CI: 2.398-45.173) were significant independent risk factors for VPA-induced liver injury. The area under the receiver operating characteristic curve was 0.904 (95% CI: 0.860-0.947), indicating excellent model performance. The Hosmer-Lemeshow test yielded a P value of 0.2671, and the calibration plot slope was close to one, further supporting the model's accuracy. The findings suggest that patients with dysglycemia, hyperlipidemia, a history of surgery, and hypokalemia are at higher risk for VPA-induced liver injury. The nomogram model provides a reliable method for predicting the likelihood of liver injury in these patients.

丙戊酸(VPA)引起肝损伤的危险因素尚不清楚,目前也没有预测工具来识别有风险的患者。本研究旨在探讨这些风险因素,并建立预测模型。我们收集了2020年1月1日至2023年10月31日期间接受VPA治疗的患者的医疗数据。采用处方序列分析对疑似vpa所致肝损伤患者进行鉴定,采用Roussel - Uclaf因果关系评价法进行诊断。采用logistic回归分析危险因素,建立模型并进行评价。本研究共纳入256例:vpa肝损伤组64例,对照组192例。肝损伤发生率为5.3%。多因素logistic回归分析显示血糖异常(优势比[OR] = 5.171;95%可信区间[CI]: 1.254-21.325)、高脂血症(OR = 4.903;95% CI: 1.400-17.173),手术(OR = 10.020;95% CI: 1.737-57.805)和低钾血症(OR = 10.407;95% CI: 2.398 ~ 45.173)是vpa所致肝损伤的重要独立危险因素。受试者工作特征曲线下面积为0.904 (95% CI: 0.860-0.947),表明模型性能良好。Hosmer-Lemeshow检验的P值为0.2671,校正图斜率接近1,进一步支持模型的准确性。研究结果表明,患有血糖异常、高脂血症、手术史和低钾血症的患者发生vpa诱导的肝损伤的风险更高。nomogram模型为预测这些患者发生肝损伤的可能性提供了可靠的方法。
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引用次数: 0
Enhancing clinical decision-making in closed pelvic fractures with machine learning models. 用机器学习模型增强闭合性骨盆骨折的临床决策。
0 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-11-29 DOI: 10.17305/bb.2024.10802
Dian Wang, Yongxin Li, Li Wang

Closed pelvic fractures can lead to severe complications, including hemodynamic instability (HI) and mortality. Accurate prediction of these risks is crucial for effective clinical management. This study aimed to utilize various machine learning (ML) algorithms to predict HI and death in patients with closed pelvic fractures and identify relevant risk factors. The retrospective study included 208 patients diagnosed with pelvic fractures and admitted to Suning Traditional Chinese Medicine Hospital between 2019 and 2023. Among these, 133 cases were identified as closed PFs. Patients with closed fractures were divided into a training set (n = 115) and a test set (n = 18). The training set was further stratified into two groups based on hemodynamic stability: Group A (patients with HI) and Group B (patients with hemodynamic stability). A total of 40 clinical variables were collected, and multiple machine learning algorithms were employed to develop predictive models, including logistic regression (LR), C5.0 Decision Tree (DT), Naive Bayes (NB), support vector machine (SVM), K-nearest neighbors (KNN), random Forest (RF), and artificial neural network (ANN). Additionally, factor analysis was performed to assess the interrelationships between variables. The RF and LR algorithms outperformed traditional methods-such as central venous pressure (CVP) and intra-abdominal pressure (IAP) measurements-in predicting HI. The RF model achieved an average under the ROC (AUC) of 0.92, with an accuracy of 0.86, precision of 0.81, and an F1 score of 0.87. The LR model had an average AUC of 0.82 but shared the same accuracy, precision, and F1 score as the RF model. Key risk factors identified included TILE grade, heart rate (HR), creatinine (CR), white blood cell count (WBC), fibrinogen (FIB), and lactic acid (LAC), with LAC levels >3.7 and an injury severity score (ISS) >13 as significant predictors of HI and mortality. In conclusion, the RF and LR algorithms are effective in predicting HI and mortality risk in patients with closed PFs, enhancing clinical decision-making and improving patient outcomes.

闭合性骨盆骨折可导致严重的并发症,包括血流动力学不稳定(HI)和死亡。准确预测这些风险对于有效的临床管理至关重要。本研究旨在利用各种机器学习(ML)算法来预测闭合性骨盆骨折患者的HI和死亡,并确定相关的危险因素。该回顾性研究包括2019年至2023年间苏宁市中医院收治的208例骨盆骨折患者。其中133例被确定为闭合PFs。闭合性骨折患者分为训练组(n = 115)和测试组(n = 18)。根据血流动力学稳定性将训练集进一步分为两组:A组(HI患者)和B组(血流动力学稳定性患者)。共收集40个临床变量,采用logistic回归(LR)、C5.0决策树(DT)、朴素贝叶斯(NB)、支持向量机(SVM)、k近邻(KNN)、随机森林(RF)、人工神经网络(ANN)等多种机器学习算法建立预测模型。此外,进行因子分析以评估变量之间的相互关系。RF和LR算法在预测HI方面优于传统方法,如中心静脉压(CVP)和腹内压(IAP)测量。该模型在ROC (AUC)下的均值为0.92,准确率为0.86,精密度为0.81,F1得分为0.87。LR模型的平均AUC为0.82,但准确度、精密度和F1评分与RF模型相同。确定的关键危险因素包括TILE分级、心率(HR)、肌酐(CR)、白细胞计数(WBC)、纤维蛋白原(FIB)和乳酸(LAC),其中乳酸水平bbb3.7和损伤严重程度评分(ISS) >13是HI和死亡率的重要预测因素。综上所述,RF和LR算法可有效预测闭合性PFs患者的HI和死亡风险,增强临床决策并改善患者预后。
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引用次数: 0
Dapagliflozin and Sirtuin-1 interaction and mechanism for ameliorating atrial fibrillation in a streptozotocin-induced rodent diabetic model. 达格列净和Sirtuin-1的相互作用及其改善链脲佐菌素诱导的啮齿动物糖尿病模型心房颤动的机制
0 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-11-28 DOI: 10.17305/bb.2024.11361
Wei-Chieh Lee, Yu-Wen Lin, Jhih-Yuan Shih, Zhih-Cherng Chen, Nan-Chun Wu, Wei-Ting Chang, Ping-Yen Liu

The incidence of atrial fibrillation (AF) increases with age and is particularly high in individuals with diabetes. Sodium-glucose cotransporter-2 inhibitors (SGLT2i), such as dapagliflozin, show promise in treating heart failure (HF) and reducing the risk of AF. Sirtuin 1 (SIRT1), a key enzyme in metabolic regulation, may be influenced by SGLT2i and play a role in the development of AF. This study investigates the relationship between dapagliflozin therapy and atrial tachyarrhythmia in diabetic cardiomyopathy, with a focus on the role of SIRT1. A streptozotocin (STZ)-induced diabetes mellitus (DM) rat model was used to assess AF across four groups: sham, STZ, STZ with dapagliflozin, and STZ with dapagliflozin + sirtinol (a SIRT1 inhibitor). Additionally, HL-1 cardiomyocytes were cultured under high glucose (HG) conditions and treated with dapagliflozin, with or without sirtinol. In the rat model, dapagliflozin improved atrial fibrosis and reduced AF inducibility and duration-effects that were partially reversed by sirtinol. These findings suggest that dapagliflozin may alleviate cardiac fibrosis and atrial arrhythmia by modulating SIRT1. In HL-1 cells under HG conditions, dapagliflozin reduced apoptosis, restored autophagy and mitophagy, and improved calcium channel activity. However, sirtinol negated these protective effects. Dapagliflozin helped normalize autophagy, mitophagy, and calcium handling, while sirtinol diminished its protective effects, highlighting the key role of SIRT1 in regulating calcium handling under HG conditions. Overall, SIRT1 plays a protective role in diabetic cardiomyopathy by reducing apoptosis, regulating autophagy and mitophagy, and modulating calcium channel activity. Dapagliflozin reduces AF duration and inducibility in the STZ model, likely through SIRT1 upregulation and calcium channel modulation.

心房颤动(AF)的发病率随着年龄的增长而增加,在糖尿病患者中尤其高。钠-葡萄糖共转运蛋白-2抑制剂(SGLT2i),如达格列清,在治疗心力衰竭(HF)和降低房颤风险方面显示出希望。SIRT1是代谢调节的关键酶,可能受到SGLT2i的影响,并在房颤的发展中发挥作用。本研究探讨了达格列清治疗与糖尿病心肌病心房性心动过速的关系,重点研究了SIRT1的作用。采用链脲佐菌素(STZ)诱导的糖尿病(DM)大鼠模型评估四组房颤:假手术组、STZ组、STZ组联合达格列净组、STZ组联合达格列净+ sirtinol (SIRT1抑制剂)组。此外,在高糖(HG)条件下培养HL-1心肌细胞,并使用达格列净(含或不含sirtinol)处理。在大鼠模型中,达格列净改善了心房纤维化,降低了心房颤动的诱导性和持续时间效应,而这一效应被sirtinol部分逆转。这些发现表明,达格列净可能通过调节SIRT1减轻心脏纤维化和心房心律失常。在HG条件下的HL-1细胞中,达格列净减少凋亡,恢复自噬和有丝分裂,提高钙通道活性。然而,sirtinol抵消了这些保护作用。达格列净有助于自噬、有丝分裂和钙处理的正常化,而sirtinol则降低了其保护作用,突出了SIRT1在HG条件下调节钙处理的关键作用。综上所述,SIRT1通过减少细胞凋亡、调节自噬和线粒体自噬以及调节钙通道活性在糖尿病心肌病中发挥保护作用。达格列净在STZ模型中减少AF持续时间和诱导性,可能是通过SIRT1上调和钙通道调节。
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引用次数: 0
The MHC-I-dependent neoantigen presentation pathway predicts response rate to PD-1/PD-L1 blockade. MHC-I依赖性新抗原呈递途径可预测PD-1/PD-L1阻断疗法的反应率。
0 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-11-26 DOI: 10.17305/bb.2024.11069
Yuchen Zhang, Chen Yang, Yanchao Xu, Xiang Jiang, Jiajun Shi, Binghua Li, Decai Yu

Immune checkpoint inhibitors produce durable antitumor effects in various cancers, but not all patients respond. High tumor mutational burden (TMB) is a known predictor of clinical benefit. In this study, we focused on the MHC-I-dependent neoantigen presentation pathway to enhance predictive capabilities beyond TMB. Using pan-cancer immunogenomic analyses of somatic mutation data from The Cancer Genome Atlas (TCGA) and The International Cancer Genome Consortium (ICGC), we analyzed 33 cancer types. Objective response rates (ORRs) to PD-1/PD-L1 inhibitors were evaluated in relation to immune characteristics, including TMB, neoantigen load, MHC-I gene expression, and CD8+ T cell fraction. Spearman’s rank correlation was used to assess these relationships. TMB showed the strongest correlation with ORR (r = 0.783, P = 2.17 × 10⁻⁵). However, integrating TMB, HLA-A expression, and CD8+ T cell fraction significantly improved predictive accuracy (r = 0.865, P = 1.80 × 10⁻⁶). Validation in external cohorts confirmed these findings, revealing notable differences in MHC-I pathway activity between responders and non-responders to immunotherapy. Our results demonstrate that the MHC-I antigen presentation pathway is strongly associated with response to PD-1/PD-L1 inhibitors. Importantly, combining antigen expression, processing, presentation, and recognition features provides superior predictive power compared to TMB alone. This integrated approach could improve treatment outcome predictions and advance personalized immunotherapy strategies.

免疫检查点抑制剂可对多种癌症产生持久的抗肿瘤效果,但并非所有患者都能产生反应。高肿瘤突变负荷(TMB)是已知的临床获益预测指标。在这项研究中,我们重点研究了依赖于 MHC-I 的新抗原呈递途径,以增强 TMB 以外的预测能力。通过对癌症基因组图谱(TCGA)和国际癌症基因组联盟(ICGC)的体细胞突变数据进行泛癌症免疫基因组学分析,我们分析了 33 种癌症类型。评估了PD-1/PD-L1抑制剂的客观反应率(ORR)与免疫特征的关系,包括TMB、新抗原负荷、MHC-I基因表达和CD8+T细胞比例。评估这些关系时使用了斯皮尔曼等级相关性。TMB与ORR的相关性最强(r=0.783,P=2.17×10-⁵)。然而,整合 TMB、HLA-A 表达和 CD8+ T 细胞比例可显著提高预测准确性(r=0.865,P=1.80×10-⁶)。在外部队列中的验证证实了这些发现,揭示了免疫疗法应答者和非应答者之间在 MHC-I 通路活性上的明显差异。我们的研究结果表明,MHC-I抗原递呈途径与PD-1/PD-L1抑制剂的反应密切相关。重要的是,将抗原表达、处理、呈递和识别特征结合在一起比单独使用 TMB 具有更高的预测能力。这种综合方法可以改善治疗结果预测并推进个性化免疫疗法策略。
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引用次数: 0
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Biomolecules & biomedicine
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