American journal of translational research最新文献

Objective: To systematically analyze the impact of pulmonary rehabilitation (PR) on postoperative recovery of lung cancer patients undergoing thoracoscopic partial pulmonary resection.

Methods: This study has been registered with PROSPERO (CRD42024574965). A comprehensive search was conducted in PubMed, The Cochrane Library, Embase, Web of Science and CINAHL for literature on the effects of PR on postoperative rehabilitation in lung cancer patients undergoing thoracoscopic partial pulmonary resection, up to May 2024. Studies meeting the inclusion and exclusion criteria were selected for the meta-analysis. Valid data were extracted, and the integrated analysis was performed using RevMan5.3 and Stata 12.0 software.

Results: A total of 10 relevant studies, involving 677 subjects, were included. Of these, 341 patients were in the experimental group, and 336 were in the control group. The meta-analysis showed that PR significantly improved the forced expiratory volume in the first second after surgery (FEV1) [SMD=1.73, 95% CI: (0.52-2.94)], peak expiratory flow (PEF) [SMD=0.45, 95% CI: (0.12-0.78)], forced vital capacity (FVC) [SMD=4.31, 95% CI: (1.98-6.63)], and 6 min walking distance (6MWD) [SMD=1.64, 95% CI: (0.64-2.65)]. PR also reduced the incidence of postoperative complications [OR=0.28, 95% CI: (0.18-0.43)] and shortened the duration of postoperative hospitalization [SMD=-0.56, 95% CI: (-0.88 - -0.24)] in lung cancer patients undergoing thoracoscopic partial pulmonary resection. There was no significant difference in anxiety [SMD=-0.34, 95% CI: (-1.27-0.60)] or depression [SMD=-0.15, 95% CI: (-0.48-0.18)] between the two groups.

Conclusion: PR improves lung function and exercise tolerance, reduces postoperative complications, and shortens postoperative hospital stays in lung cancer patients undergoing thoracoscopic partial pulmonary resection. However, its effect on reducing negative mood remains unclear. Due to the limitations in the number and quality of included studies, further high-quality studies are needed to validate these findings.

Background: Postoperative cerebrospinal fluid (CSF) leak is a life-threatening complication following endoscopic skull base surgery. This study describes a multilayered membrane reconstruction strategy for treating high-flow intraoperative CSF leaks during expanded endoscopic endonasal tumor resection (EEA) and presents the associated outcomes, supplemented by surgical video documentation.

Methods: A retrospective review was performed on patients who underwent multilayered membrane reconstruction for high-flow CSF leaks during EEA.

Results: From January 2019 to June 2023, 15 patients undergoing EEA experienced high-flow intraoperative CSF leaks and received multilayered membrane reconstruction. Tumor pathologies included pituitary adenoma, craniopharyngioma, and meningioma. After a median postoperative follow-up of 13 months, no postoperative CSF leakage, intracranial infection, meningitis, and pneumocephalus was detected.

Conclusion: Our preliminary experience indicates that the multilayered membrane reconstruction technique may be a reliable method for achieving a watertight closure of high-flow intraoperative CSF leaks during EEA and warrants further study.

Objective: To investigate the risk factors for peritonitis in peritoneal dialysis patients and to develop and validate a predictive model.

Methods: A total of 219 patients undergoing continuous ambulatory peritoneal dialysis (CAPD) who had their first peritoneal dialysis catheter placement and regular follow-up at Wuhan No. 1 Hospital between April 2020 and August 2023 were included in this study. Patients were categorized into two groups: a peritoneal dialysis-associated peritonitis (PDAP) group and a non-PDAP group, based on the occurrence of PDAP. Univariate and multivariate logistic regression analyses were conducted to identify risk factors for PDAP in peritoneal dialysis patients. A risk prediction model was constructed, and its predictive performance was assessed using the receiver operating characteristic (ROC) curve.

Results: Among the study population, 59 patients developed PDAP, with an incidence rate of 26.94%. Univariate and multivariate Logistic regression analyses identified serum albumin, age, hemoglobin, diabetes mellitus, and dialysis duration as independent risk factors for PDAP (all P<0.05). The ROC curve analysis of the predictive model yielded an area under the curve (AUC) of 0.914. A validation cohort consisting of 75 patients who underwent peritoneal dialysis between September 2023 and May 2024 included 22 PDAP. In this validation set, the predictive model achieved an AUC of 0.883 for PDAP.

Conclusion: Serum albumin, age, hemoglobin, diabetes, and dialysis duration are independent risk factors for PDAP in peritoneal dialysis patients. The developed predictive model demonstrates strong performance in identifying patients at high risk for PDAP.

Objective: To evaluate the impact of Medpor implantation on extraocular muscle function, eye movement disorders, and diplopia in patients with orbital wall fracture.

Methods: A retrospective study was conducted on 98 patients (98 eyes) who underwent Medpor implantation surgery at Bethune International Peace Hospital from January 2019 to December 2022. The degree of eyeball enophthalmos and total fracture area in patients before and after surgery, as well as orbital volume were measured. The relationship between enophthalmos severity and total fracture area was analyzed. Changes in extraocular muscle function, eye movement, and diplopia were assessed before and after surgery.

Results: Before operation, enophthalmos severity was correlated with the total fracture area (r = 0.323, P = 0.001). After surgery, there was no significant correlation (r = -0.053, P = 0.630). Compared with preoperative measurements, both orbital volume and the volume difference improved significantly after surgery (both P < 0.05). Among the patients who received surgery within 3 weeks, the cure rates for rectus muscle restriction and extraocular muscle paralysis were 94.12% and 100.00%, respectively, higher than those in patients who underwent surgery after 3 weeks (67.27% and 65.62%) (P < 0.05). In comparison of preoperative conditions, notable improvements were observed in both ocular motility disorders and diplopia after operation (both P < 0.05). The total improvement rates in ocular motility disorders at 1, 3 and 6 months of follow-up were 84.69%, 90.82%, 96.94%, respectively, while these rates in diplopia were 89.79%, 91.84% and 95.92%, respectively. Abnormal maxillofacial sensations also improved significantly at 1-, 3-, and 6-month post-surgery (all P < 0.05).

Conclusions: Medpor implantation effectively restores extraocular muscle function in patients with orbital wall fractures, significantly alleviating diplopia, eye movement disorders, and maxillofacial abnormalities.

Objective: To evaluate the efficacy of transcatheter arterial chemoembolization (TACE) alone or in combination with radiotherapy or anlotinib for treating locally advanced hepatocellular carcinoma.

Methods: A retrospective analysis was conducted on 72 patients with locally advanced hepatocellular carcinoma, divided into three groups: TACE alone (n = 20), TACE + anlotinib (TACE+AH, n = 34), and TACE + intensity-modulated radiotherapy (TACE+IMRT, n = 18). TACE was administered every 30 days. For TACE+AH, patients received 12 mg of anlotinib daily for 14 days per cycle. TACE+IMRT involved 400-500 cGy radiotherapy sessions three times weekly, with a total dose of 5000-6000 cGy.

Results: No significant differences in Eastern Cooperative Oncology Group (ECOG) performance scores were observed among the groupspost-treatment. The TACE+IMRT group exhibited the highest objective response rate (ORR) (83.33%) and disease control rate (DCR) (88.89%). Progression-free survival (PFS) at 3, 6, and 12 months was also highest in the TACE+IMRT group, indicating superior outcome compared to the TACE+AH and TACE-alone groups. Independent predictors of PFS included the TACE+IMRT combination and Child-Pugh B grade.

Conclusion: TACE combined with radiotherapy is a safe and effective treatment for locally advanced hepatocellular carcinoma, significantly improving PFS and serving as a protective factor. While TACE combined with anlotinib showed moderate efficacy and manageable adverse events, its therapeutic effect was less pronounced than that of TACE+IMRT.

Objective: Rheumatoid arthritis-associated pneumonia (RAP) is a common complication of rheumatoid arthritis (RA) and is related to poor prognosis. Inflammation plays an important role in the development of RAP. This study aims to analyze and explore the predictive value of the neutrophil/lymphocyte ratio (NLR) combined with the albumin to globulin ratio (AGR) for assessing RAP.

Methods: Data for this study were collected retrospectively from the database of Xuancheng People's Hospital between February 2021 and November 2023. Patients with RAP were assigned to the observation group (n=78), while patients with rheumatoid arthritis (RA) alone were assigned to the control group (n=75). The differences in general clinical data, NLR, and AGR were compared between the two groups. Risk factors for RAP were analyzed using univariate and multivariate Logistic regression.

Results: The observation group had significantly lower AGR levels and higher NLR levels compared to the control group (all P<0.05). Univariate and multivariate logistic regression analyses identified age (95% CI 1.265-3.468; P=0.007), glucocorticoid use (95% CI 1.187-3.187; P=0.009), usage of disease-modifying anti-rheumatic drugs (DMARDs) (95% CI 1.257-2.997; P=0.006), AGR (95% CI 1.147-3.578; P=0.012), NLR (95% CI 1.198-2.978; P=0.008) and course of disease (95% CI 11.178-2.971; P=0.005) as independent prognostic factors for RAP. In addition, the ROC curve analysis showed that joint detection of NLR and AGR had a sensitivity of 98.8% and specificity of 81.8% for predicting RAP.

Conclusion: NLR and AGR play significant roles in the occurrence and progression of RAP and can serve as predictive factors for early detection of RAP.

Objective: To evaluate the response and safety of combining acupuncture based on the Dunhuang "Moxibustion Classic" with carbamazepine in the treatment of neuropathic tinnitus.

Methods: A retrospective analysis was conducted on 105 patients with neuropathic tinnitus treated at The First People's Hospital of Lanzhou City from January 2019 to February 2023. Of these, 49 patients received acupuncture based on the Dunhuang "Moxibustion Classic" (research group), while 56 patients received conventional acupuncture (control group). Both groups were treated with carbamazepine in combination. The Tinnitus Handicap Inventory (THI), Tinnitus Evaluation Questionnaire (TEQ), Visual Analogue Scale for Aural Fullness (VAS), Hamilton Anxiety Rating Scale (HAMA), and Hamilton Depression Rating Scale (HAMD) scores were compared between the two groups. Treatment response and Pittsburgh Sleep Quality Index (PSQI) scores were also analyzed. Logistic regression analysis was performed to identify risk factors affecting patients' sleep quality.

Results: The overall response rate in the control group was significantly lower than that in the research group (P = 0.037). After treatment, THI, PSQI, TEQ, VAS, HAMA, and HAMD scores were higher in the control group than in the research group (P<0.05). The incidence of adverse reactions was significantly higher in the control group than in the research group (P = 0.025). Multivariate logistic regression analysis identified treatment options (P = 0.002, OR = 8.612, 95% CI = 2.466-39.565), disease duration (P = 0.687, OR = 0.779, 95% CI = 0.219-2.544), pre-treatment THI (P = 0.002, OR = 7.061, 95% CI = 2.17-26.368), pre-treatment TEQ (P<0.001, OR = 14.654, 95% CI = 4.196-65.376), and pre-treatment HAMA (P = 0.019, OR = 3.805, 95% CI = 1.271-12.209) as independent risk factors for impaired sleep quality.

Conclusion: The combination of Dunhuang "Moxibustion Classic" acupuncture with carbamazepine is an effective and safe treatment for neuropathic tinnitus, leading to greater improvements in symptoms, sleep quality, anxiety, and depression compared to conventional acupuncture.

Objective: To evaluate the impact of different surgical fixation sequences on ankle joint stability and functional recovery in patients with trimalleolar fractures.

Methods: A retrospective analysis was conducted on the medical records of 144 patients with trimalleolar fractures treated at Xi'an International Medical Center Hospital. Among these, 78 patients underwent the fixation sequence of lateral malleolus-posterior malleolus-medial malleolus (Group A), while 66 patients underwent the sequence of posterior malleolus-lateral malleolus-medial malleolus (Group B). Perioperative parameters, including operation time, intraoperative blood loss, healing time, hospital stay, and treatment cost, were compared between the two groups. Patient recovery was assessed using the Radiographic Union Score for Hip (RUSH) and Visual Analogue Scale (VAS) at postoperative 3 months and Biard-Jackson scores at postoperative 3 and 12 months. Logistic regression analysis was used to identify risk factors influencing postoperative joint function recovery. The incidence of postoperative complications was also compared between the two groups.

Results: Group A demonstrated significantly shorter operation time (P < 0.001) and reduced intraoperative blood loss (P < 0.001) compared to Group B. No significant differences were observed in healing time (P = 0.905), hospital stay (P = 0.374), or treatment cost (P = 0.454) between the two groups. Similarly, RUSH (P = 0.780) and VAS (P = 0.590) scores at post-operative 3 months showed no significant differences between the two groups. However, Group A exhibited significantly higher Biard-Jackson scores at postoperative 3 months compared to Group B (P < 0.001), with no significant difference noted at postoperative 12 months (P = 0.157). The overall incidence of complications did not differ significantly between the groups (P = 0.164). Independent risk factors for prognosis included the treatment plan (P = 0.025), body mass index (P = 0.042), distal tibiofibular injury (P = 0.002), and intraoperative blood loss (P = 0.021).

Conclusion: Patients with trimalleolar fractures who underwent fixation in the sequence of lateral malleolus-posterior malleolus-medial malleolus showed improved ankle joint functional recovery at postoperative 3 months compared to those treated with the posterior malleolus-lateral malleolus-medial malleolus sequence. No significant differences were observed at postoperative 12 months. Operation time and intraoperative blood loss were critical factors influencing short-term recovery outcomes.

Objectives: To identify the factors influencing spontaneous preterm birth (SPTB) and develop a prediction model for clinical practice.

Methods: This retrospective study included a total of 130 pregnant women with spontaneous preterm birth or full-term delivery at Fujian Maternity and Child Health Hospital between January 2020 and December 2023. The SPTB group consisted of 50 women with spontaneous preterm birth, while the full-term group included 70 women with full-term deliveries. Logistic regression analysis was performed to explore the factors associated with clinical prognosis, and a nomogram prediction model for SPTB risk was constructed and validated.

Results: Multivariate logistic regression analysis identified multiple pregnancies (95% CI: 1.415-8.926, P=0.006), abnormal fetal position (95% CI: 1.124-2.331, P=0.008), gestational diabetes (95% CI: 4.918-19.164, P=0.002), mode of conception (95% CI: 1.765-4.285,P=0.002), lower genital tract infection (95% CI: 1.076-2.867, P=0.032), and second trimester cervical length (95% CI: 1.071-2.991, P=0.031) as independent risk factors of SPTB. Using these six variables, a nomogram was developed to predict the incidence of SPTB, with an AUC value of 0.833 (95% CI: 0.665-0.847), demonstrating acceptable agreement between predicted and observed outcomes. Decision curve analysis (DCA) showed a good positive net benefit of the model.

Conclusions: Multiple pregnancies, abnormal fetal position, gestational diabetes, mode of conception, lower genital tract infection, and second-trimester cervical length are independent risk factors for the onset of SPTB. In addition, the nomogram prediction model demonstrated good predictive performance, high accuracy, and clinical applicability.

Objective: To investigate the effects of graded exercise rehabilitation training tailored to pulmonary function classification on dyspnea, pulmonary function, and exercise capacity during postoperative rehabilitation in elderly patients following lung cancer surgery.

Methods: A retrospective analysis was conducted on clinical data from 168 elderly patients undergoing postoperative rehabilitation after lung cancer surgery at Panjin Liaohe Oilfield Gem Flower Hospital from January 2021 to December 2022. Patients were divided into two groups based on the rehabilitation received: the control group (n=71), receiving standard rehabilitation, and the study group (n=97), receiving additional graded exercise rehabilitation based on pulmonary function classification. Outcomes were compared before and after a 12-week intervention, including psychological status (Hamilton Anxiety Scale (HAMA) and Hamilton Depression Rating Scale (HAMD)), symptom scores, dyspnea (Modified Medical Research Council (mMRC) and St. George's Respiratory Questionnaire (SGRQ) scores), pulmonary function (Forced Expiratory Volume in 1 Second (FEV1), Forced Vital Capacity (FVC), Peak Expiratory Flow (PEF), Maximum Voluntary Ventilation (MVV), and respiratory muscle strength), inflammatory markers (Interleukin-8 (IL-8)), tumor markers (Carcinoembryonic Antigen (CEA) and Cytokeratin-19 Fragment antigen 21-1 (CYFRA21-1)), exercise capacity (6-minute walk test (6MWT) distance, Maximum Oxygen Consumption (VO₂max), Maximum Workload (MWL), and Anaerobic Threshold (AT)), sleep quality (Pittsburgh Sleep Quality Index (PSQI)), and quality of life (World Health Organization Quality of Life-BREF (WHOQOL-BREF)).

Results: After 12 weeks, both groups exhibited significant reductions in HAMA, HAMD, cough, sputum production, chest pain, shortness of breath, mMRC, SGRQ, and PSQI scores, with the study group showing more pronounced decreases (all P < 0.05). FEV1, FVC, PEF, 6MWT distance, and WHOQOL-BREF scores increased significantly in both groups, with greater improvements in the study group (all P < 0.05). IL-8, CEA, and CYFRA21-1 levels decreased significantly in both groups, with IL-8 levels lower in the study group (all P < 0.05); however, no significant differences were observed in CEA or CYFRA21-1 between groups post-intervention (both P > 0.05).

Conclusion: Graded exercise rehabilitation based on pulmonary function classification effectively enhances pulmonary function, relieves symptoms, improves sleep quality, and supports recovery in elderly patients post-lung cancer surgery.