Advances in Clinical and Experimental Medicine最新文献

This review summarizes the latest advancements in stem cell (SC) mitochondrial proteomics. With the rapid development of biotechnology, mitochondrial proteomics has emerged as a pivotal area in SC research. The research methods used in mitochondrial proteomics include mass spectrometry (MS), with pre-MS sample processing, MS data acquisition employing both qualitative and quantitative approaches, and bioinformatics analysis to annotate and explore protein functions. In recent years, mitochondrial proteomics research has contributed to the establishment and expansion of our understanding of the roles of various mitochondrial proteins involved in regulating SC differentiation, metabolism and aging, including Drp1, Mfn1/2, OPA1, SIRT3, Bcl-2, YME1L, and PGC-1α. This multidisciplinary approach, combining qualitative and quantitative proteomics with bioinformatics, sheds light on the intricate regulatory mechanisms of mitochondrial proteins in SC. These findings provide a scientific basis for developing novel therapeutic targets and strategies, thereby advancing the field of regenerative medicine and personalized treatment paradigms.

Bacterial pneumonia is a cause of HIV-associated morbidity and mortality. Recurrent pneumonia, defined as 2 or more episodes within a 12-month period, is an AIDS-defining illness. The prevalence of bacterial pulmonary infections in HIV-infected patients has been decreasing with the introduction and widespread use of antiretroviral therapy. In well-developed settings, the frequency of bacterial pneumonia in people living with HIV is comparable to that in the general population. Studies have shown that the cumulative incidence of pneumonia is higher in HIV-infected patients with advanced immunosuppression, airflow limitation, smoking, intravenous drug use, or in those from underdeveloped countries and urban areas. In HIV-infected patients with community-acquired bacterial pneumonia, Streptococcus pneumoniae and Haemophilus species are the most frequently isolated pathogens. However, in untreated or poorly adherent HIV-infected individuals, opportunistic infections may occur. Although the incidence of opportunistic infections among HIV-infected patients has declined in well-developed settings due to the widespread use of antiretroviral therapy, tuberculosis remains a serious threat and a major cause of morbidity and mortality among HIV-infected individuals worldwide. Early diagnosis of HIV infection, timely initiation of antiretroviral therapy with good adherence, and promotion of vaccination remain priorities. This editorial provides an overview of community-acquired pneumonia in HIV-infected patients and discusses recent changes in its epidemiology and etiology.

Background: Research documenting the results of liver trauma surgery revealed a connection between prophylactic drainage (PD) and escalating infections or septic consequences.

Objectives: Meta-analysis research was conducted to review the wound complications (WCs) frequency of PD in liver resections (LRs).

Material and methods: Up until June 2024, comprehensive literature study was completed, and 757 related studies were reviewed. The 10 selected studies included 5,459 LRs at the beginning; 2,918 of them were drained and 2,541 were not. The dichotomous approaches and a fixed or random model were used to assess the WCs frequency of PD in LRs using odds ratios (ORs) and 95% confidence intervals (95% CIs).

Results: Prophylactic drainage had significantly higher surgical site wound infection rate (OR = 1.97; 95% CI: 1.09-3.55, p = 0.02) compared to non-PD in in LR patients, though no significant difference was found among PD and non-PD in LR patients in infected intra-abdominal collections (IIACs; OR = 3.17; 95% CI: 0.93-10.80, p = 0.07).

Conclusion: Prophylactic drainage had a considerably greater surgical site wound infection rate, and there was no discernible difference between IIACs and non-PD in LR individuals. Nevertheless, because there were not many studies nominated for comparison in the meta-analysis, care must be used when working with its outcomes, and further research is warranted to confirm these findings.

Background: Breast cancer (BC) is now the most common malignancy in women. Early detection and precise diagnosis are essential for improving survival.

Objectives: To develop an integrated computer-aided diagnosis (CAD) system that automatically detects, segments and classifies lesions in mammographic images, thereby aiding BC diagnosis.

Material and methods: We adopted YOLOv5 as the object-detection backbone and used the Curated Breast Imaging Subset of the Digital Database for Screening Mammography (CBIS-DDSM). Data augmentation (random rotations, crops and flips) increased the dataset to 5,801 images, which were randomly split into training, validation and test sets (7 : 2 : 1). Lesion-classification performance was evaluated with the area under the receiver operating characteristic (ROC) curve (AUC), precision, recall, and mean average precision at a 0.5 confidence threshold (mAP@0.5).

Results: The CAD system yielded an mAP@0.5 of 0.417 and an F1-score of 0.46 for lesion detection, achieved an AUC of 0.90 for distinguishing benign from malignant lesions, and processed images at 65 fps.

Conclusions: The integrated CAD system combines rapid detection and classification with high accuracy, underscoring its strong clinical value.

Background: Amiodarone is the most commonly used class III antiarrhytmic drug with antiarrhytmic and vasodilator properties. Adenosine triphosphate (ATP) serves as a crucial source of intracellular energy, while resveratrol is known for its potent antioxidant activity.

Objectives: This study aimed to biochemically, histopathologically and immunohistochemically evaluate the effects of ATP, resveratrol and their combination on potential liver damage and dysfunction induced by amiodarone in rats.

Material and methods: The rats were divided into 6 groups: healthy control (HG), amiodarone alone (ADG), amiodarone + ATP at 2 mg/kg (AAG-2), amiodarone + ATP at 5 mg/kg (AAG-5), resveratrol + amiodarone (RAG), and resveratrol + amiodarone + ATP at 2 mg/kg (RAA-2). Amiodarone (50 mg/kg, orally), ATP (2 mg/kg and 5 mg/kg, intraperitoneally) and resveratrol (25 mg/kg, orally) were administered once daily for 14 days. Following treatment, liver tissues were excised for biochemical analysis. Oxidative stress was assessed by measuring malondialdehyde (MDA) levels, while antioxidant status was evaluated through total glutathione (GSH), superoxide dismutase (SOD) and catalase (CAT) levels. To assess liver function, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities were measured in serum samples collected from the animals' tail veins. In addition, liver tissues were subjected to histopathological and immunohistochemical examination to evaluate structural and molecular changes associated with treatment.

Results: Amiodarone administration led to a significant increase in oxidative stress markers and a reduction in antioxidant levels in rat liver tissue. Additionally, serum levels of ALT and AST were elevated, indicating liver dysfunction. Histopathological and immunohistochemical analyses revealed severe (grade 3) oxidative damage in the liver tissue. All biochemical parameters in the 5 mg/kg ATP and resveratrol + 2 mg/kg ATP treatment groups were comparable to those observed in the HG group. Histopathological and immunohistochemical evaluations showed a reduction in liver damage severity to grade 2 in the groups treated with ATP (2 mg/kg) and resveratrol alone, and to grade 1 in the groups receiving ATP (5 mg/kg) or the combination of resveratrol + ATP (2 mg/kg).

Conclusions: The results of the present study suggest that adjusting the ATP dosage or using a combination of ATP and resveratrol may be effective strategies for minimizing amiodarone-induced liver damage.

Background: Hepatocellular carcinoma (HCC) is the 6th most common cancer worldwide and claims roughly 700,000 lives each year; nearly 50% of global HCC fatalities occur in China.

Objectives: To conduct a comprehensive meta-analysis identifying predictors of sorafenib efficacy in combination with thermal ablation for HCC treatment.

Material and methods: A comprehensive literature search was conducted up to October 2024, reviewing 720 identified studies. From these, 19 studies were selected that included a total of 3,341 participants with HCC at baseline. The meta-analysis examined the effects of sorafenib in combination with physical thermal ablation, using odds ratios (ORs) and 95% confidence intervals (95% CIs). Analyses were performed using two-sided methods and either fixed-effect or random-effects models, depending on the level of heterogeneity.

Results: The meta-analysis revealed that combining physical thermal ablation with sorafenib significantly improved outcomes in HCC patients: Overall survival (OS) was more than doubled (OR = 2.03; 95% CI: 1.55-2.67; p < 0.001), recurrence rates were significantly reduced (OR = 0.62; 95% CI: 0.39-0.98; p = 0.04), and overall treatment efficacy was markedly higher (OR = 2.53; 95% CI: 1.61-3.96; p < 0.001) compared with thermal ablation alone.

Conclusion: In individuals with HCC, physical thermal ablation and sorafenib had significantly higher OS, lower recurrence rates, and high overall efficacy compared to physical thermal ablation. To validate this discovery, more research is needed, and caution must be implemented when interacting with its values.

Disasters, wars and health emergencies profoundly affect mental health, with nearly 1/3 of affected populations developing conditions such as posttraumatic stress disorder (PTSD), depression or anxiety, particularly among vulnerable groups like children, the elderly and the chronically ill. Access to mental health and psychosocial support (MHPSS) is often limited by conflict-related disruptions, stigma or resource shortages, while healthcare workers themselves face immense psychological strain and inadequate protection. Long-term strategies integrating disaster preparedness, mental health services and professional support are essential to safeguard both affected populations and frontline workers during emergencies.

Today, it is well established that the tumor microenvironment (TME), the tumor niche, along with melanoma cells, plays a crucial role in cancer dissemination and influences the effectiveness of anticancer therapies. Therefore, it may serve as a potential therapeutic target in melanoma treatment. In our research, we focused on the effects exerted by cells within the melanoma microenvironment on cancer progression and the development of therapy resistance. Specifically, we examined stromal cells accompanying melanoma cells in the tumor - cancer-associated fibroblasts (CAFs), cancer-associated keratinocytes (CAKs), and cancer-associated adipocytes (CAAs). Particular attention was given to keratinocytes, as their role in the melanoma microenvironment remains the least understood.

Background: Healthcare systems can present unique challenges for individuals in the lesbian, gay, bisexual, and transgender (LGBT) community, often making it difficult for them to access suitable and respectful care.

Objectives: The aim of this study was to perform a transcultural adaptations and to evaluate psychometric properties of the Spanish version of the Lesbian, Gay, Bisexual, and Transgender Development of Clinical Skills Scale (LGBT-DOCSS-ES). This adaptation is intended for application within Spanish-speaking healthcare settings.

Material and methods: The LGBT-DOCSS was translated and adapted from the original English version into Spanish using a standardized process, including forward translation, back-translation, and expert panel review. Psychometric properties were tested on a sample of 270 participants from Spain. Internal consistency was evaluated using confirmatory factor analysis (CFA), Cronbach's alpha, the discriminative power index, and McDonald's omega (ω).

Results: The study included 270 participants, with 58.9% being female and 38.9% male. Of the respondents, 52.2% identified as heterosexual, 32.6% as homosexual and 13% as bisexual. The internal consistency of the Spanish version and its domains was good with an overall Cronbach's alpha of 0.746. The alpha ranges for each subscale domains were between 0.769 and 0.822. The McDonald's ω coefficient was 0.808.

Conclusions: The Spanish version of the LGBT-DOCSS-ES has good properties of factorial validity. This tool is a valuable resource for assessing cultural competence and clinical skills among healthcare providers in Spanish-speaking settings.

Background: Porphyromonas gingivalis is a major human oral opportunistic pathogen and a key etiological agent of periodontal disease, contributing to inflammation and bone loss in the oral cavity. Periodontitis is not limited to oral health complications; it has also been associated with a range of systemic conditions, including coronary heart disease (CAD), respiratory disease, rheumatoid arthritis, chronic kidney disease (CKD), and certain types of cancer.

Objectives: Immunization-based prevention of periodontitis appears to be a promising strategy; however, no vaccine is currently available for commercial use. In the present study, a novel vaccine candidate against P. gingivalis was proposed, consisting of a P. gingivalis protein, gingipain, glycosylated with the carbohydrate moiety of P. gingivalis lipopolysaccharide (LPS).

Material and methods: Glycosylation of gingipain was achieved in Escherichia coli by introducing the Campylobacter jejuni N-glycosylation system, the P. gingivalis LPS biosynthetic pathway and the gingipain gene.

Results: The neoglycoprotein was purified using column chromatography to a purity exceeding 99%, yielding a soluble antigen. The modified protein was recognized by commercial antibodies targeting the protein backbone, the carbohydrate moiety, and a custom monoclonal antibody specific to the purified LPS of P. gingivalis American Type Culture Collection (ATCC) 33277. The glycoprotein was used to immunize mice, and the resulting sera were analyzed for their ability to opsonize bacterial cells. The absence of detectable opsonization suggests that the elicited antibodies are more likely directed against the protein component of the vaccine rather than the glycan surface antigen.

Conclusions: The final product was most likely assembled correctly, as it was recognized by LPS-specific antibodies. Further evaluation in an animal model of induced periodontitis is necessary to determine whether the elicited antibodies can effectively inhibit gingipain released by the pathogen. If this vaccine candidate demonstrates protective efficacy, the approach could accelerate and enhance the safety of vaccine design against a wide range of other pathogens.