American journal of translational research最新文献

Objective: To investigate the effects of nursing interventions based on stress and accommodation theory on the mental state and self-management competence of patients with type 2 diabetes mellitus (T2DM).

Methods: Fifty-five T2DM patients admitted to our hospital in 2022 who received standard nursing interventions were selected as the control group, and 61 T2DM patients admitted in 2023 who received stress and adaptation theory-based nursing intervention in addition to standard nursing interventions were enrolled as the observation group. Changes of blood glucose levels, mood state score, self-management competence and life quality were compared between the two groups before and after intervention.

Results: Post-intervention, HBA1c, fasting blood glucose and 2-hour postprandial blood glucose in both groups were remarkably reduced compared to pre-intervention levels (all P<0.05), with the observation group showing clearly lower levels than those in control group (all P<0.05). Post-intervention, both groups exhibited significant improvements in self-esteem and energy scores (all P<0.05), while the scores of panic, tension, fatigue, anger and depression all decreased (all P<0.05). The observation group showed greater improvements in mood state scores compared to the control group (all P<0.05). Self-management ability scores significantly improved across all dimensions in both groups (P<0.05), with the observation group outperforming the control group (P<0.05). The FoP-Q-SF score and DSQL score of life quality decreased significantly in both groups after the intervention (all P<0.05), with the observation group showing apparently lower post-intervention scores than the control group (all P<0.05).

Conclusion: Nursing intervention based on stress and accommodation theory effectively improve blood sugar control, psychological well-being, self-management competence, and quality of life in T2DM patients, making it valuable for clinical promotion.

Objective: This study aimed to explore the role of circ-ITCH in the progression of bladder cancer (BCa).

Methods: Kaplan-Meier analysis was performed to evaluate the prognostic significance of miR-184 in bladder cancer. Clustering analysis compared miR-184 expression levels across various BCa cell lines. Cell Counting Kit-8 (CCK-8) and transwell assays were used to assess cell proliferation and migration. Dual-luciferase reporter assays were employed to examine the regulatory relationship among circ-ITCH, miR-184, and FOXO3. Western blot analysis was conducted to investigate the post-transcriptional regulation of the circ-ITCH/miR-184/FOXO3 axis.

Results: The study demonstrated a correlation between elevated miR-184 expression and poor prognosis in bladder cancer. Compared to SV-HUC, a normal bladder tissue cell line, most BCa cell lines exhibited increased miR-184 expression. Additionally, miR-184 was found to promote BCa cell progression. Importantly, circ-ITCH was identified as a natural sponge for miR-184 in BCa. Overexpression of circ-ITCH in BCa significantly reduced miR-184 expression, thereby inhibiting cell proliferation and migration. Moreover, FOXO3, a target of miR-184, is regulated by circ-ITCH. The suppression of FOXO3 by miR-184 was counteracted by circ-ITCH, which diminished the tumor-promoting effects of miR-184.

Conclusions: This study underscores the pivotal role of the circ-ITCH/miR-184/FOXO3 axis in regulating BCa cell proliferation and migration. It introduces a potential therapeutic target for bladder cancer, suggesting that strategies like circ-ITCH overexpression and miR-184 inhibition could offer promising treatment options.

Objective: To develop predictive models for assessing deep vein thrombosis (DVT) risk among lumbar disc herniation (LDH) patients and evaluate their performances.

Methods: A retrospective study was conducted on 798 LDH patients treated at the First Hospital of Hebei Medical University from January 2017 to December 2023. The patients were divided into a training set (n = 558) and a test set (n = 240) using computer-generated random numbers in a ratio of 7:3. Patients without DVT in the training set were categorized as the non-DVT group (n = 463), while those diagnosed with DVT were the DVT group (n = 95). Univariate analysis was performed to compare clinical data between the two groups. Data with statistical significance were used for the development of a Logistic regression model, Gradient boosting model, and Random Forest model. Model performance was evaluated through receiver operating characteristic (ROC) curve analysis and calibration curve assessment.

Results: In the training set, univariate analysis revealed significant differences in age, platelets (PLT), cholesterol (TC), triglycerides (TG), glycated hemoglobin (HbAlc), D-dimer (D-D), fibrinogen (FIB), activated partial thromboplastin time (APTT), prothrombin time (PT), and thrombin time (TT) between the non-DVT group and the DVT group (all P<0.05). Predictive models were constructed based on these indicators. The areas under the ROC curves (AUCs) in the training set were as follows (in descending order): Random Forest model (0.978) > Gradient boosting model (0.943) > Logistic regression model (0.919). In the test set, the AUCs were: Random Forest model (0.952) > Gradient boosting model (0.941) > Logistic regression model (0.908). The DeLong test indicated that the AUC of the Random Forest model in the training set was significantly higher than that of the Logistic regression model (P<0.05); however, no significant difference was observed between the other two models. Calibration curves demonstrated that the predictive probabilities from all three models closely aligned with actual DVT incidence in both sets.

Conclusion: The Logistic regression model, Gradient boosting model, and Random Forest model constructed in this study exhibit good predictive value for the occurrence of DVT in LDH patients, aiding in the optimization of clinical management of clinical management. Among them, the Random Forest model performed the best of the three.

Objectives: To explore the landscape of BRCA1/2 mutations in gastric cancer patients.

Methods: Next-generation sequencing (NGS), Sanger sequencing, reverse transcription quantitative polymerase chain reaction (RT-qPCR), Immunohistochemistry, The Cancer Genome Atlas (TCGA), gnomAD, and DAVID.

Results: With 95% of bases boasting a phred score surpassing 30 and a minimum coverage depth of 500X, our NGS approach ensures high-quality data acquisition. Analyzing BRCA1 and BRCA2 sequences revealed 11 and 4 mutations, respectively, with one pathogenic mutation identified in each gene. This emphasizes the prominence of BRCA1 mutations in gastric cancer. Sanger sequencing validation confirmed the presence of pathogenic mutations in select cases, consolidating our findings. Frequency analysis utilizing the gnomAD database elucidated the rarity of these mutations in the Asian population, underscoring their uniqueness. Exploring TCGA data further corroborated this rarity, emphasizing the distinctive nature of these mutations in gastric cancer. RT-qPCR analysis unveiled a significant reduction in BRCA1/2 expression in samples harboring pathogenic mutations, hinting at their potential role in down-regulating gene expression. Immunohistochemistry confirmed diminished protein expression in samples with pathogenic mutations, solidifying our observations. Kaplan-Meier survival analysis demonstrated significantly poorer survival outcomes for patients with pathogenic BRCA1/2 mutations compared to those without, emphasizing their potential role in prognosis. Additionally, KEGG pathway analysis highlighted the involvement of BRCA1/2 in critical cancer-associated pathways, emphasizing their role in tumorigenesis.

Conclusion: Our comprehensive findings underscore the clinical significance of BRCA1/2 mutations in gastric cancer, advocating for further research to elucidate their mechanistic implications and therapeutic opportunities.

Objective: To identify risk factors associated with progressive hemorrhagic injury (PHI) in patients with isolated traumatic brain injury (TBI) and to develop prognostic models for predicting patient outcomes.

Methods: A total of 137 patients with isolated TBI who underwent additional CT scans were included in the retrospective study. Single-factor analysis and multivariate logistic regression analysis were performed to identify significant risk factors associated with PHI development. Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the diagnostic value of specific markers for predicting PHI.

Results: Single-factor analysis revealed significant differences between the PHI group (62 patients) and the non-PHI group (75 patients) in various factors, including gender, etiology, pupillary size and reflex, midline shift, associated brain contusion, D-dimer (D-D) levels, neutrophil-to-lymphocyte ratio (NLR), platelet count, blood glucose levels, and Glasgow Coma Scale (GCS) score. Multivariate logistic regression analysis identified NLR, blood glucose level, and GCS score as significant risk factors for PHI in isolated TBI patients, and also identified GCS score, NLR, platelet-to-lymphocyte ratio (PLR), and age as significant factors for predicting prognosis. ROC curve analysis showed that NLR had significant auxiliary diagnostic value for predicting PHI.

Conclusion: NLR, blood glucose level, and GCS score are significant risk factors for PHI development in isolated TBI patients. The constructed prognostic model incorporating age, GCS score, NLR, and PLR offers valuable predictive capabilities for PHI patient outcome in isolated TBI cases.

Objective: This study investigates the mechanism underlying sorafenib resistance in hepatocellular carcinoma cells (HCC), focusing on DNA damage repair (DDR) pathways to develop targeted therapeutic strategies.

Methods: Bioinformatics analysis was used to screen genes associated with sorafenib resistance, which was further demonstrated by western blotting. Cell proliferation was determined using the EdU assay. The presence of binding sites between valproic acid (VPA) and NOTCH1 was analyzed by molecular docking. Comet and flow cytometry assays evaluated DNA damage and cell cycle arrest induced by VPA in sorafenib-resistant cells, with further mechanistic insights gained via western blotting and co-immunoprecipitation (Co-IP).

Results: We found that NOTCH1/ATM axis plays a vital role in the prognosis of patients with liver cancer and in the behavior of sorafenib-resistant cells. HCC resistant to sorafenib exhibited enhanced cell proliferation ability. Moreover, overexpression of NOTCH1 in sorafenib-sensitive HCC cells significantly increased liver cancer cell proliferation. Conversely, silencing NOTCH1 expression in sorafenib-resistant HCC cell lines reduced their proliferative activity. Additionally, VPA enhanced the therapeutic efficacy against sorafenib-resistance cells by modulating NOTCH1/ATM/p-BRCA1/p-CHK2/γ-H2AX signaling axis and homologous recombination (HR) activity.

Conclusion: Targeting NOTCH1 and ATM is a promising strategy to overcome sorafenib resistance in HCC, particularly through the combined use of VPA and sorafenib.

Objective: To evaluate the therapeutic effects of Visual Training System 4 (VTS4) as an adjunctive therapy for patients with refractive amblyopia.

Method: A total of 82 patients with refractive amblyopia (142 eyes) treated at the Zhongshan Ophthalmic Center of Sun Yat-sen University, were enrolled and divided into two groups based on the treatment protocol. The control group included 40 patients (68 eyes) who received conventional comprehensive treatment, while the observation group was comprised of 42 patients (74 eyes) treated with VTS4 in addition to conventional therapy. The therapeutic effects, best-corrected visual acuity (BCVA), spherical equivalent (SE), ocular accommodative function, and ocular convergence were compared between the two groups.

Results: The total effective rate of visual improvement in the observation group was 86.49%, significantly higher than 66.18% in the control group. BCVA at 3 and 6 months was superior in the observation group compared to the control group (P < 0.05). At 6 months, the normal rate of binocular fusion images in the observation group was 94.59%, higher than 76.47% in the control group. The observation group showed greater improvement in accommodative flexibility and amplitude, and lower accommodative lag compared to the control group. Improvements in negative relative accommodation, positive relative accommodation, and near point of convergence were also more pronounced in the observation group (all P < 0.05). No significant differences were observed in SE, axial length, or corneal curvature within or between the groups before and after treatment (all P > 0.05).

Conclusion: VTS4, as an adjunctive therapy for refractive amblyopia, significantly improves visual acuity, enhances accommodative and convergence functions, and demonstrates strong clinical applicability.

Objective: To investigate the effects of Astragalus polysaccharide (APS) on skeletal muscle structure and function in D-galactose (D-gal)-induced C57BL/6J mice.

Methods: Eighteen male C57BL/6J mice of specific pathogen-free (SPF) grade, aged 8 weeks, were selected and divided into three groups: a control group (0.9% saline gavage for 16 weeks), a D-gal group (subcutaneous injection of 200 mg/kg D-galactose in the upper neck region, once daily for 8 weeks), and a D-gal + APS group (subcutaneous injection of 200 mg/kg D-galactose, once daily for 8 weeks, with concurrent administration of 100 mg/kg APS by gavage for 8 weeks). Body composition of the mice was assessed using the ImpediVET Laboratory Composition Measurement Analyzer. The pathological structure of the skeletal muscles was examined using hematoxylin and eosin (HE) staining, and the microstructure and mitochondrial alterations in skeletal muscle were observed under transmission electron microscopy. Protein expression levels of LC3II and PINK1 in skeletal muscle tissues were analyzed using Western blotting analysis.

Results: Compared to the control group, the D-gal-treated mice demonstrated substantial declines in grip strength, the cross-sectional area (CSA) of gastrocnemius muscle fibers, gastrocnemius weight, and the gastrocnemius weight-to-body weight ratio. APS administration markedly improved these parameters in the D-gal-treated mice. H&E staining showed muscle atrophy and senescence in the D-gal-treated mice, accompanied by deformed muscle cell morphology, which was mitigated by APS gavage. The D-gal-treated mice displayed swelling, cristae fracture, lysis, or complete loss, alongside reduced autophagy and increased lengths of bright bands, myofibrillar myonules, and H bands. However, administration of APS alleviated mitochondrial damage, promoted mitophagy, and reduced the lengths of these muscle tissue bands. Additionally, D-gal treatment significantly reduced LC3II and PINK1 protein expression in muscle tissues, while APS treatment notably elevated their expression levels.

Conclusion: APS gavage ameliorates the structural and functional impairments in muscle tissues of the D-gal-treated mice by promoting mitochondrial autophagy.

Objective: To investigate the factors influencing recurrence following laparoscopic conservative surgery in patients with ovarian endometriosis (OEM) and to develop a predictive model.

Methods: In this retrospective study, the clinical data from 212 OEM patients who underwent laparoscopic conservative surgery at Suzhou Ninth People's Hospital from May 2013 to December 2021 were meticulously reviewed. According to disease recurrence over a 2-year follow-up period, the patients were divided into a recurrence group and a non-recurrence group. Univariate and multivariate logistic regression analyses were performed to identify factors associated with postoperative recurrence in OEM patients. A nomogram prediction model for postoperative recurrence in OEM patients was constructed using R 3.4.3 software. The discriminative power of the model was assessed using the area under the receiver operating characteristic (ROC) curve (AUC), with goodness of fit evaluated using the H-L goodness-of-fit test and Bootstrap method (self-sampling method). Clinical net benefit was analyzed through decision curve analysis.

Results: Over a two-year follow-up, 36 cases of recurrence were observed, yielding a recurrence rate of 16.98%. Bilateral cysts (OR = 2.257, P = 0.005), high r-ASRM stage (OR = 2.651, P = 0.001), and elevated postoperative TNF-α levels (OR = 3.607, P = 0.004) were identified as risk factors for recurrence after laparoscopic conservative surgery in patients with OEM, while older age (OR = 0.566, P = 0.018) and postoperative adjuvant medication (OR = 0.509, P = 0.016) were protective factors. The nomogram prediction model, based on the above indicators, had an AUC of 0.895 for postoperative recurrence risk in OEM patients, with no overfitting phenomenon indicated by the goodness-of-fit test (χ² = 1.786, P = 0.987). The Bootstrap validation (1000 samples) showed an average absolute error of 0.018 between predicted and actual probabilities. Decision curve analysis showed that the model effectively predicted a clinically relevant net benefit for postoperative recurrence risk.

Conclusion: A nomogram prediction model incorporating age, cyst distribution, r-ASRM staging, postoperative TNF-α levels, and postoperative adjuvant drugs effectively assesses the recurrence risk in OEM patients.

Objective: To retrospectively evaluate the utility of diaphragmatic ultrasound parameters in assessing ventilator weaning outcomes and survival in ventilator-dependent intensive care unit (ICU) patients.

Methods: A total of 105 ventilator-dependent ICU patients admitted to our hospital between October 2019 and February 2024 were included in this study. Depending on weaning outcomes, patients were divided into a successful group (n = 86) and a failure group (n = 19). Diaphragmatic ultrasound parameters, including diaphragm excursion (DE), diaphragmatic thickness at the end of expiration (DTee), diaphragmatic thickness at the end of inspiration (DTei), and diaphragmatic thickening fraction (DTF), were collected. Receiver operating characteristic (ROC) curves were plotted to assess the predictive value of these parameters for weaning success. Survival curves were analyzed to explore their relationships with survival. Logistic regression analysis was used to identify risk factors influencing survival in ventilator-dependent ICU patients.

Results: Diaphragmatic ultrasound parameters were statistically higher in the successful group compared to the failure group. TFor ventilator-dependent ICU patients, the areas under the curve (AUCs) of DE, DTee, DTei, and DTF in predicting weaning outcomes were 0.757, 0.765, 0.770, and 0.677, respectively. However, when these four indicators were combined for prediction, the AUC could be elevated to 0.938. Logistic regression analysis identified that gender, age, body mass index, disease type, comorbidities, as well as DE, DTee, DTei, and DTF, were not risk factors influencing the survival of these ventilator-dependent ICU patients.

Conclusions: Diaphragmatic ultrasound parameters are valuable tools for assessing the weaning outcomes and survival of ventilator-dependent ICU patients. These parameters provide auxiliary guidance for clinical decision-making and subsequent patient management.