American journal of translational research最新文献

Posterior cervical laminoplasty is a well-established surgical treatment for multilevel cervical spondylotic myelopathy (CSM). However, its application in patients with concomitant cervical kyphotic deformity remains a subject of significant debate and controversy. This review aims to critically examine and synthesize the current evidence surrounding key controversies in the use of laminoplasty for CSM with kyphosis. Specifically, it focuses on: (1) the ongoing debates regarding surgical indications and approach selection criteria, including the roles of cervical alignment (both global and segmental), spinal canal occupancy ratio, and the K-line; (2) the comparative safety profile of posterior versus anterior decompression; (3) the impact of the procedure on postoperative cervical sagittal balance and the risk factors for alignment loss; and (4) the relationship between preoperative cervical alignment and the development of postoperative axial symptoms. The evidence synthesized suggests that mild kyphosis may not preclude successful outcomes with laminoplasty, provided that meticulous patient selection is performed based on a comprehensive assessment of radiographic and clinical factors. Future studies should incorporate dynamic imaging, long-term follow-up, and refined biomechanical models to clarify decompression mechanisms and optimize surgical decision making for this complex patient population.

Objectives: To evaluate the efficacy of recombinant human brain natriuretic peptide (rhBNP) in patients with acute decompensated heart failure (ADHF) complicated with atrial fibrillation (AF) and poor response to conventional treatment.

Methods: The study included 172 ADHF patients with AF who had poor response to conventional therapy and received rhBNP. Primary observations including changes in blood pressure, C-reactive protein (CRP), heart rate, blood urea nitrogen, oxygen saturation, creatinine, and N-terminal pro-brain natriuretic peptide (NT-proBNP) were monitored from admission to discharge. Secondary metrics included left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), and left ventricular end-systolic diameter (LVESD) taken at the 3-month follow-up. AF recurrence was recorded, and logistic regression analyses were conducted.

Results: After treatment with rhBNP, patients' heart rate and blood pressure decreased significantly, oxygen saturation improved, levels of NT-proBNP and CRP decreased, and indicators of renal function improved. At 3 months, LVEF increased and LVESD decreased. Overall, patients in the recurrence group were older, had lower BMI, and showed higher baseline NT-proBNP, CRP, and renal function-related parameters compared with the non-recurrence group. Multivariate analysis demonstrated that low BMI, as well as elevated baseline creatinine, CRP, blood urea nitrogen, and, NT-proBNP were independent risk factors for AF recurrence.

Conclusions: rhBNP significantly improves hemodynamics, reduces inflammation, and ameliorates renal function in ADHF patients with AF who respond poorly to conventional therapy. Low BMI and elevated baseline NT-proBNP, CRP, creatinine, and blood urea nitrogen are independent predictors of AF recurrence.

Objectives: Aneurysmal subarachnoid hemorrhage (aSAH) is a severe neurological emergency with high morbidity and mortality. This study evaluated the prognostic value of the C-reactive protein (CRP)/albumin ratio and serum lactate levels in patients with aSAH.

Methods: A retrospective cohort of 186 patients was analyzed. CRP, albumin, and lactate were measured daily over the first 14 days. The primary outcome was functional status at discharge. Secondary outcomes included incidence of vasospasm and 14-day mortality.

Results: A CRP/albumin ratio > 10 and lactate > 2.5 mmol/L were independently associated with poor outcomes, higher vasospasm rates, and increased mortality.

Conclusion: Both the CRP/albumin ratio and serum lactate are independent, clinically useful biomarkers for predicting poor outcome following aSAH.

Stauntonia chinensis is a medicinal vine used in East Asian traditional medicine and is rich in saponins and triterpenoids with putative multi-target activities. Pre-clinical studies have reported that these compounds exert anti-inflammatory, antioxidant, neuroprotective, and anticancer effects. Evidence supporting these effects are mostly originated from heterogeneous in vitro, in vivo, and computational studies, which have reported modulation of signaling pathways, such as nuclear factor-κB (NF-κB), nuclear factor erythroid 2-related factor 2 (Nrf2), and phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) pathways. Despite these encouraging findings, clinical translation remains limited. Major barriers include poor oral bioavailability, rapid pharmacokinetics, hemolytic effects, and variability in extract standardization. This review evaluates whether phytochemical small molecules derived from Stauntonia chinensis DC exhibit mechanistically coherent and experimentally substantiated multi-target molecular actions. To this end, phytochemical characterization, mechanistic evidence, pharmacokinetics, toxicity, formulation, and translational considerations are systematically integrated to provide a translational roadmap for S. chinensis-derived compound, bridging traditional use with potential clinical applications in complex diseases. Furthermore, sophisticated delivery systems such as liposomes, nanoparticles, and phytosomes, and the rational structural optimization to enhance safety and pharmacokinetics are discussed.

Objectives: To compare the efficacy and safety of unilateral biportal endoscopic technique (UBE) and percutaneous endoscopic debridement, irrigation, and drainage for infectious spondylitis, and provide evidence for clinical decision-making.

Methods: A retrospective study included 108 patients (February 2023-May 2024) divided into a biportal group (n=54, UBE) and single portal group (n=54, percutaneous endoscopic surgery). Surgery-related indicators, inflammatory markers (ESR (erythrocyte sedimentation rate), CRP (C-reactive protein), TNF-α (tumor necrosis factor-α)), VAS (visual analog scale), ODI (Oswestry disability index), Kirkaldy-Willis score, Cobb angle, and bacterial culture positive rate were compared. Multiple linear regression analyzed factors influencing postoperative 120-day ESR.

Results: The biportal group had longer surgical duration, drainage time, and more fluoroscopy (all P<0.05). No significant differences were found in VAS, ODI, Cobb angle, Kirkaldy-Willis excellent-good rate, or bacterial culture positive rate (all P>0.05). ESR, CRP, TNF-α in biportal group were lower at 90 and 120 days postoperatively (P<0.05). UBE and preoperative ESR were independent factors for 120-day ESR (P<0.05).

Conclusions: UBE and percutaneous endoscopic surgery have comparable efficacy in relieving pain, improving function, correcting deformity, and pathogen detection. UBE provides better long-term inflammatory control, and surgical choice should consider disease complexity, surgeon proficiency, and need for inflammatory control.

Aim: This study investigated the effect of elevated blood lipid levels on myocardial injury in rats with myocardial infarction.

Materials and methods: Sprague-Dawley (SD) rats were randomly assigned to six groups (n=9 per group): normal, sham, acute myocardial infarction (AMI), AMI+30% high-fat (HF), AMI+70% HF, AMI+100% HF and AMI+100% HF+PD (atorvastatin treatment). After 3 weeks of dietary intervention or treatment, serum and heart tissue samples were collected. Serum concentrations of triglycerides (TG), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), lactate dehydrogenase (LDH), creatine kinase-MB (CK-MB) and cardiac troponin I (cTnI) were measured. Myocardial pathologic changes were examined using H&E staining. Cardiomyocyte apoptosis was evaluated using the TUNEL assay, andcaspase-3 and caspase-12 protein expression levels in myocardial tissue were determined using western blot analysis.

Results: Compared to the normal group, TG, TC, LDL, LDH, CK-MB and cTnI levels were significantly increased, whereas HDL levels were significantly decreased in the AMI+30% HF, AMI+70% HF and AMI+100% HF groups. These changes were accompanied by a significant increase in cardiomyocyte apoptosis and marked pathological deterioration of myocardial tissue. By contrast, atorvastatin supplementation markedly improved lipid profiles and cardiac function and reduced cardiomyocyte apoptosis.

Conclusions: Alterations in blood lipid levels are closely associated with cardiac dysfunction and myocardial injury following AMI in vivo.

Objectives: The expression of GSDMD and GSDME in ovarian cancerous tissues, adjacent tissues, and cancer cell lines remain poorly characterized. The contribution of pyroptosis to the synergistic therapeutic effects of PI3K-AKT-mTOR inhibitors and cell cycle inhibitors in ovarian carcinoma is unknown.

Method: GSDME and GSDMD expression were quantified in ovarian cancer tissues, adjacent tissues, and cancer cell lines. The cytotoxic effects of temsirolimus (an PI3K-AKT-mTOR inhibitor) and 5-fluorouracil (5-FU, a cell cycle inhibitor) were assessed.

Results: Both GSDMD and GSDME were detected in ovarian cancer tissues and adjacent tissues. However, the N-terminals of GSDME and GSDMD were only expressed in cancerous tissues, with the GSDME-N terminal being particularly prominent. Similarly, in ovarian cancer cell lines, only GSDME-N terminal was increased when treated by temsirolimus and 5-FU, together with significantly suppressed cell proliferation. Synergistic treatment with temsirolimus and 5-FU further reduced cancer cell viability and enhanced pyroptosis by upregulating GSDME-N terminal expression. RNA interference confirmed that GSDME-mediated pyroptosis is essential for the cytotoxic effects of monotherapy and combination chemotherapy. 5-FU fails to induce complete conversion of pyroptosis to ferroptosis when combined with temsirolimus, even at extremely high concentrations. The drug combination also promoted apoptosis and ferroptosis, which were significantly attenuated by N-acetyl-L-cysteine (NAC).

Conclusion: GSDME is the principal executor of spontaneous pyroptosis in ovarian cancer tissues. In chemotherapy employing cell cycle-targeting agents or PI3K-AKT-mTOR pathway inhibitors (alone or in combination) is beneficial, and pyroptosis is an indispensable cell death mechanism. Reactive oxygen species act as a nodal regulator orchestrating pyroptosis, apoptosis, and ferroptosis.

Objectives: To investigate the impact of hemiplegia due to cerebral infarction sequelae on postoperative dislocation after hemiarthroplasty (HHA) in elderly patients with intertrochanteric fractures, identify associated risk factors, and compare dislocation risks between moderate-to-severe and mild hemiplegia.

Methods: We retrospectively analyzed 305 patients aged ≥70 years with intertrochanteric fractures who underwent HHA from January 2020 to May 2023. Inclusion criteria required confirmed cerebral infarction with hemiplegia, Evans-Jensen Type III/IV fracture, and ≥1-year follow-up. Postoperative dislocation was diagnosed radiographically, and preoperative motor dysfunction was assessed by the Fugl-Meyer Scale (mild ≥22, moderate-to-severe <22). Statistical analyses included chi-square and t-tests, Lasso regression, and logistic regression. A risk prediction model was developed and its discriminative capacity assessed by ROC analysis.

Results: Dislocation occurred in 81 patients (26.6%). Significant factors included age ≥75 years, disease duration ≥6 months, fall-related injury, preoperative motor dysfunction, Evans-Jensen Type IV, diabetes mellitus, adverse lifestyle habits, inadequate nursing care, and posterolateral approach (all P<0.05). Multivariate analysis identified age (OR=3.164), preoperative motor dysfunction (OR=2.695), diabetes (OR=2.501), adverse lifestyle (OR=2.181), inadequate nursing care (OR=4.276), and posterolateral approach (OR=3.216) as independent predictors. In moderate-to-severe hemiplegia, age and diabetes were risk factors, whereas in mild hemiplegia, fall-related injury and diabetes predominated. The prediction model showed good performance (AUC=0.811; sensitivity 77.8%, specificity 71.9%).

Conclusions: Hemiplegia from cerebral infarction sequelae significantly increases dislocation risk after HHA in elderly intertrochanteric fracture patients. Independent risk factors vary by hemiplegia severity, and the proposed risk model may aid preoperative risk stratification and clinical decision-making.

Objectives: To investigate whether combined measurement of serum galectin-9 and urinary monocyte chemoattractant protein-1 (MCP-1) can serve as non-invasive biomarkers for assessing disease activity in systemic lupus erythematosus (SLE) and for the early identification of lupus nephritis (LN).

Methods: This retrospective study included 148 SLE patients hospitalized between June 2022 and May 2025. Patients were divided into three groups: inactive SLE group (n=48), active SLE without LN group (n=40), and active SLE with LN group (n=60). Serum galectin-9, urinary MCP-1, and routine indices (e.g., complement levels, autoantibodies) were measured at admission.

Results: Serum markers increased progressively with disease progression: galectin-9 levels (8.59 ± 0.63 vs. 9.68 ± 1.87 vs. 11.72 ± 2.14 ng/mL) and urinary MCP-1 levels (1.58 ± 0.42 vs. 2.85 ± 0.92 vs. 10.45 ± 3.18 pg/mg creatinine, all P<0.05). Correlation analysis showed that both biomarkers were associated with SLE disease activity (both P<0.05). Regarding the diagnosis of LN, the area under the curve (AUC) was 0.782 for galectin-9 and 0.796 for MCP-1. Combined detection further improved diagnostic performance, yielding an AUC of 0.866. Moreover, urinary MCP-1 levels were significantly higher in patients with proliferative LN than in those with non-proliferative LN (12.36 ± 3.28 vs. 8.25 ± 2.84 pg/mg creatinine; P<0.001).

Conclusions: Combined assessment of serum galectin-9 and urine MCP-1 provides a non-invasive approach for evaluating overall disease activity in SLE and may facilitate early identification of LN. Compared to traditional indicators, this strategy had superior diagnostic accuracy.

Objective: To investigate the pathogenic spectrum of oral and maxillofacial space infection and evaluate the clinical efficacy of vacuum sealing drainage (VSD) in its treatment.

Methods: A retrospective analysis was performed on 118 patients with oral and maxillofacial space infection admitted to the Department of Stomatology, the Second Affiliated Hospital of Zhejiang University School of Medicine, from January 2021 to December 2023. All patients underwent pathogenic bacteria detection, and were divided into a conventional incision drainage group (n=72) and a VSD group (n=46) by treatment method. The clinical efficacy, recovery-related indicators, pain scores and serum inflammatory factor levels were compared between the two groups.

Results: The most frequent infection sites were the masseteric, buccal and infraorbital spaces in turn. Staphylococcus aureus, Staphylococcus epidermidis and Klebsiella pneumoniae were the dominant pathogens. Compared with the conventional group, the VSD group showed a higher clinical effective rate, significantly shorter wound healing time, antibiotic course and hospital stay (all P < 0.05). Meanwhile, the VSD group had lower pain rating index (PRI), visual analogue scale (VAS), present pain intensity (PPI) scores, and lower serum levels of tumor necrosis factor-α (TNF-α), high-sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6) (all P < 0.05).

Conclusion: Oral and maxillofacial space infection is mainly caused by Gram-positive cocci. VSD can enhance clinical efficacy, alleviate pain, reduce inflammatory response, and shorten the duration of antibiotic use and hospitalization, which is worthy of clinical promotion.