American journal of translational research最新文献

Anal fistula is a rapidly developing anorectal disease that can lead to anal dysfunction if left untreated. Minimally invasive surgery is an important treatment option for anal fistula, as it can reduce the risk of anal sphincter injury and protect anal function. However, postoperative complications such as infection, pain, bleeding, edema, and fat liquefaction can occur, resulting in slow wound healing thus negatively impacting the patient's quality of life. Recent studies have shown that Chinese herbal therapy has distinct pharmacological effects and is more effective in treating postoperative complications in anal fistula patients compared to conventional drug therapy. It not only promotes wound healing but also reduces the occurrence of complications. Chinese herbs can also modulate relevant signaling pathways such as PI3K/Akt, HIF-1, and TGF-β/Smad to enhance the wound healing process. Various methods of Chinese herbal medicine (CHM) have been used to treat post-anal fistula operation wounds, including traditional Chinese medicine (TCM) sitz baths, external application of TCM, internal administration of TCM, anal absorption, and acupuncture, all of which have shown promising therapeutic effects in clinical practice. This article aims to review the theory and clinical application of CHM in anal fistula surgery in recent years and provide valuable references for its treatment.

Objective: To investigate the effectiveness of antibiotic bone cement combined with the vacuum sealing drainage (VSD) technique for repairing sacrococcygeal pressure ulcer wounds.

Methods: A retrospective analysis was conducted on data from 136 patients treated at Yantai Affiliated Hospital of Binzhou Medical College between May 2020 and June 2022. The cases were devided into a control group and a study group according to their treatment regimen. Indicators of postoperative recovery including blood routine recovery time, hospital stay, antibiotic application time, and healing time were compared between the two groups. Before the procedure and 6, 12, 24, and 48 hours following the operation, the pain levels of patients in both groups were examined using a visual analogue scale (VAS). On the 3rd, 7th, 14th, 21st, and 28th days of treatment, the pressure ulcer scale for healing (PUSH) was used to measure the pressure ulcer area between the two groups. On the 7th, 14th, 21st, and 28th days following treatment, the capillary density values were compared between the two groups, along with the levels of interleukin-1β (IL-1β), interleukin-12 (IL-12), and c-reactive protein (CRP). The proportions of immunoglobulin M (IgM) and immunoglobulin G (IgG) levels, CD3+, CD4+, and CD8+ T cell subsets, as well as CD4+/CD8+ ratio, were compared between the two groups.

Results: The blood routine recovery time, hospital stays, antibiotic usage duration, and healing time were all significantly shorter in the study group compared to those in the control group (all P<0.05). At 6 h, 12 h, 24 h, and 48 h following surgery, the VAS score in study group was significantly lower than that of the control group (P<0.05). The study group also showed a greater reduction in pressure ulcer area, with lower PUSH scores observed on days 14, 21, and 28 (P<0.05). Post-treatment levels of IL-1β, IL-12, and CRP decreased in both groups, with significantly lower levels in the study group (P<0.05). Following therapy, both groups demonstrated significantly increased levels of CD3+, CD4+, CD4+/CD8+, IgM and IgG and reduced level of CD8+. These improvements were more pronounced in the study group (all P<0.05).

Conclusion: The combination of antibiotic bone cement and VSD is effective in enhancing recovery, reducing pain and inflammation, and improving immune response in the treatment of sacrococcygeal pressure ulcers.

Objective: To explore the clinical effects of high-flow nasal cannulae (HFNC) in elderly patients with acute respiratory failure (ARF) and analyze prognostic factors following oxygen therapy.

Methods: We enrolled 200 ARF patients between January 2022 and June 2023, dividing them into an observation group (n=125) treated with HFNC, and a control group (n=75) receiving conventional oxygen therapy. We compared vital signs before and after treatment and categorized patients into good and poor prognosis groups to analyze demographic data and prognostic factors.

Results: Post-treatment, both groups showed improved vital signs, with the observation group experiencing significantly greater improvements (P<0.05). However, the observation group had a higher incidence of complications compared to controls (P=0.001). Patients with a history of endotracheal intubation or high APACHE II scores were more prevalent in the poor prognosis group (both P<0.05). Logistic regression identified the APACHE II score as a risk factor for poor prognosis, while HFNC emerged as a protective factor.

Conclusions: HFNC is a safe and effective therapy that improves vital signs and alleviates hypoxia in elderly ARF patients. The APACHE II score and type of oxygen therapy are significant prognostic factors, with HFNC offering a protective effect.

Purpose: The aim of this study was to assess the accuracy and diagnostic use of shear wave elastography (SWE) in differentiating central precocious puberty (CPP) with breast development and to analyze the correlations between sex hormone levels and SWE parameters.

Methods: A total of 227 participants were included in this retrospective case-control study, including 113 girls with genuine precocious puberty breast development (the CPP group) and 114 with non-genuine precocious puberty breast development (the non-CPP group). The participants underwent clinical assessment, hormonal assays, and SWE using advanced ultrasound equipment. Statistical analyses, including t-tests, correlation analysis, logistic regression, and receiver operating characteristic (ROC) analysis, were performed to evaluate the diagnostic value of SWE and sex hormone levels in differentiating CPP with breast development.

Results: There were no significant differences in clinical characteristics between the two groups. The sex hormone levels of estradiol, testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and prolactin in the CPP group were significantly higher than those in the non-CPP group. Shear wave velocity (SWV) Maximum (Max), SWV Minimum (Min), SWV Mean, SWV standard deviation (SD), and SWV coefficient of variation in the CPP group were significantly higher than in the non-CPP group. Correlation analysis demonstrated significant positive correlations between LH, FSH, estradiol, and testosterone levels with various SWE parameters, indicating their clinical relevance. Logistic regression analysis identified substantial predictive potential of sex hormone levels and SWE parameters for genuine precocious puberty breast development. Additionally, the ROC analysis highlighted a high predictive value of the combined model of SWE parameters, with an area under the curve (AUC) of 0.903.

Conclusion: The study underscores the correlations between sex hormone levels and SWE parameters. The superior predictive performance of the combined model of SWE parameters emphasizes the value of integrated SWE assessments for improving the accuracy of diagnosing genuine precocious puberty breast development.

Objective: To construct a diagnostic model for follicular thyroid carcinoma (FTC) and papillary thyroid carcinoma (PTC), both subtypes of differentiated thyroid carcinoma (DTC), using color Doppler ultrasound signs in conjunction with serum laboratory markers.

Methods: We conducted a retrospective analysis of patients with thyroid nodules who underwent ultrasonography at Yulin Hospital from February 2021 to March 2023. The cohort included 269 subjects: 105 with benign nodules and 164 with DTC (59 with FTC and 105 with PTC). We compared baseline demographics and laboratory indices between the groups. Diagnostic values of ultrasound features and laboratory markers were assessed using receiver operating characteristic (ROC) curves, and logistic regression was employed to pinpoint independent diagnostic factors for FTC. A predictive nomogram was subsequently developed based on these factors.

Results: There were significant differences between the benign and malignant groups regarding ultrasound signs (including border, morphology, echogenicity, calcification, blood flow, lymph node zoning) and laboratory indices (free triiodothyronine (FT3), free thyroxine (FT4), thyroglobulin (Tg), thyroid-stimulating hormone (TSH), vascular endothelial growth factor (VEGF), tumor-specific growth factor (TSGF)), with all P-values <0.05. The areas under the curve (AUCs) for FT3, FT4, Tg, TSH, VEGF, and TSGF were all above 0.75, with Tg achieving the highest at 0.91. Logistic regression identified borders, morphology, echogenicity, VEGF, and TSGF as independent diagnostic factors for distinguishing between FTC and PTC, with significant P-values. The constructed nomogram demonstrated an AUC of 0.853, indicating high diagnostic accuracy. Both calibration and decision curve analysis (DCA) validated the model's stability and clinical utility.

Conclusion: We successfully developed a nomogram combining ultrasound features and serum markers that enhances the diagnostic precision for FTC. This model offers a valuable tool for clinical diagnostics in differentiated thyroid cancer.

Objective: Patients with Asherman's Syndrome (AS) and an endometrial thickness (EMT) less than 7 mm are infertile women with suboptimal endometrium due to uterine scarring or endometrial atrophy. This study aimed to examine the effect of intrauterine injections of adipose-derived mesenchymal stem cells (ADMSC) from the Stromal Vascular Fraction (SVF) of adipose tissue on EMT and in vitro fertilization (IVF) outcomes: which are improvements in EMT and pregnancy rates.

Methods: This double-arm retrospective study included 41 AS patients with hysteroscopic adhesiolysis. Twenty-one patients with AS refractory endometrium (Group 2) were given ADMSC to improve EMT, and 20 non-treated, age-matched patients served as controls (Group 1). For Group 2, SVF was isolated from 15 ml of adipose tissue and transmyometrial injected into the patient's uterine cavity. For all patients, EMT was examined using ultrasound before embryo transfer.

Results: In Group 2, after ADMSC treatment, EMT significantly improved (3.2 ± 1.8 mm, P<0.001). Afterward, three patients spontaneously became pregnant, and eighteen underwent frozen embryo transfer. A significant increase in implantation (66.7% vs. 4.8%, P = 0.002) and live birth rates (0.0% vs. 47.6%, P = 0.001) were recorded. No significant difference was observed in EMT, cycle implantation, or clinical pregnancy between the two groups, but the live birth rate in Group 2 after ADMSC treatment was higher than in Group 1.

Conclusion: The results demonstrate that autologous intrauterine ADMSC injection can improve EMT, implantation, and pregnancy rates in AS patients with refractory endometrium. This research underscores the life-changing potential of autologous ADMSC treatment for patients with refractory endometrium, providing a promising avenue for future treatments.

Objective: To explore the clinical value of assessing early postoperative blood lipid metabolism levels in predicting anastomotic leakage (AL) after esophageal cancer (EC) surgery.

Methods: The clinical data of EC patients who underwent surgery at the Northern Jiangsu People's Hospital from May 2021 to May 2023 were retrospectively studied. Totally, 28 patients who developed AL were included in the AL group, while 110 patients who did not develop AL were included in the non-AL group. Outcomes compared between the two groups included clinical baseline data, total cholesterol (TC), triglycerides, high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels. Logistic regression analysis was performed to identify independent risk factors for postoperative AL. The predictive value of early postoperative blood lipid metabolism levels for AL was evaluated using Receiver Operating Characteristic (ROC) curves.

Results: The AL group exhibited significantly elevated levels of TC and LDL-C but significantly reduced HDL-C levels compared to the non-AL group (all P<0.05). However, there was no significant difference in triglyceride levels between the two groups (P>0.05). Logistic regression analysis revealed that low BMI (P=0.012; OR: 4.409; 95% CI: 1.391-13.976), comorbid hypertension (P=0.011; OR: 5.891; 95% CI: 1.492-23.259), comorbid diabetes (P=0.022; OR: 4.522; 95% CI: 1.238-16.521), low HDL-C (P=0.007; OR: 19.965; 95% CI: 2.293-173.809), and high LDL-C (P=0.012; OR: 4.321; 95% CI: 1.388-13.449) were independent risk factors for developing AL after EC surgery. The combined prediction model using TC, HDL-C, and LDL-C yielded an area under the curve (AUC) of 0.876, with a sensitivity of 79.09%, specificity of 85.71%, and overall accuracy of 80.44%, significantly outperforming individual lipid measurements.

Conclusion: The combined assessment of TC, HDL-C, and LDL-C can effectively predict the occurrence of AL after EC surgery. For EC patients with relatively low BMI, hypertension, diabetes, relatively low HDL-C, and relatively high LDL-C, prioritizing weight management, hypertension and diabetes control, and lipid management can significantly reduce the risk of AL post-surgery.

Objectives: To systematically investigate the expression, prognostic value, genetic alterations, immune infiltration, and molecular function of Nck-associated protein 1 (NCKAP1) in a pan-cancer analysis, with a specific focus on its association with kidney renal cell carcinoma (KIRC).

Methods: We analyzed the role of NCKAP1 across various tumor types using data from The Cancer Genome Atlas (TCGA). The Gene Expression Profiling Interactive Analysis version 2 (GEPIA2) database was used to assess the correlation between NCKAP1 expression levels and overall survival (OS) and disease-free survival (DFS) across different cancers, as well as its association with cancer stage. Genetic alterations of NCKAP1 were explored using CBioPortal, and their prognostic implications were assessed. NCKAP1 was further analyzed through Gene Ontology and protein interaction network analyses. Immunohistochemistry (IHC) staining from the Human Protein Atlas (HPA) database evaluated NCKAP1 levels in KIRC tissues. Functional assays, including Cell Counting Kit-8 (CCK-8), colony formation, transwell, and wound healing assays, were conducted to determine the effects of NCKAP1 overexpression on cell growth rate and their ability to invade, proliferate, migrate in a KIRC (786-O) cell line. The relationship between NCKAP1 expression and immune infiltration in KIRC was systematically examined using the Tumor Immune Estimation Resource.

Results: NCKAP1 expression was significantly altered in most tumor types compared to corresponding non-tumor tissues. Survival analysis indicated that low NCKAP1 expression was associated with poor OS, DFS, and advanced cancer stage (P < 0.05) specifically in KIRC. Genetic alterations in NCKAP1 were linked to clinical outcome in cancer patients, and a positive correlation was observed between NCKAP1 expression and cancer-associated fibroblast infiltration (P < 0.05). Gene Ontology analysis revealed that NCKAP1 regulates the actin cytoskeleton and interacts with proteins such as CYFIP1, ABI2, WASF2, and BRK1. IHC staining showed significantly lower NCKAP1 levels in KIRC tissues compared to normal tissues. Overexpression of NCKAP1 in KIRC cell lines reduced cell proliferation, invasion, and migration (P < 0.05). NCKAP1 was also positively correlated with macrophage, neutrophil, and CD4+ T cell infiltration (P < 0.001).

Conclusion: NCKAP1 may serve as a prognostic and immunological marker and may be a therapeutic target for KIRC.

Objective: To analyze the effect of Bushen Huayu Decoction combined with entecavir on alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil) and albumin (Alb) in patients with hepatitis cirrhosis.

Methods: A retrospective study was conducted on 102 patients with compensated hepatitis cirrhosis treated at the No. 2 Hospital of Baoding from February 2020 to April 2023. These patients were divided into two groups based on different treatment modalities: a control group treated with entecavir (n=51) and an observation group treated with Bushen Huayu decoction plus entecavir (n=51). The Traditional Chinese Medicine (TCM) syndrome scores, level of liver function indicators, and liver fibrosis symptoms were compared between the two groups before treatment and after 2 weeks and 4 weeks of treatment.

Results: Before treatment, the two groups differed insignificantly in liver fibrosis indicators (HA, IV-C, and PCIII), liver function indices (ALT, AST, TBil, and Alb) and TCM syndrome scores (all P>0.05). After 2 weeks and 4 weeks of treatment, HA, IV-C, and PCIII in both groups decreased. Those in the observation group were significantly lower than those in the control group (P<0.05). The levels ALT, AST, and TBil decreased significantly in both groups. The level of Alb increased significantly, and the alterations in the observation group was more prominent compared with those in the control group (all P<0.05). The scores of TCM syndromes across various aspects all decreased significantly. The scores in the observation group were significantly lower than those of control group (P<0.05).

Conclusion: The combined treatment of Bushen Huayu Decoction and entecavir is helpful to improve the TCM symptoms, reduce the levels of ALT, AST, and TBil, increase the level of Alb, improve the state of liver fibrosis, and promote the recovery of liver function in patients with compensatory hepatitis cirrhosis.

Objective: To evaluate the predictive efficacy of the platelets-to-spleen diameter ratio (PSDR) for developing esophagogastric varices (EV) in patients with cirrhosis due to hepatitis B virus (HBV).

Methods: We conducted a retrospective cohort study using data from patients treated for HBV induced cirrhosis at Xi'an No. 3 Hospital, the Affiliated Hospital of Northwest University, from June 2020 to August 2023. Patients were categorized into two groups based on endoscopic evidence of EV: an EV group and a non-EV group. Clinical, sonographic, and hematological findings were compared within and between these groups. Stratified analyses based on the severity of varices were performed, and multivariate logistic regression was used to identify predictors of EV. Receiver Operating Characteristic (ROC) curve analysis assessed the diagnostic accuracy of PSDR in predicting EV.

Results: The study included 139 patients diagnosed with HBV induced cirrhosis, divided into an EV group (86 patients, with 48 low-risk and 38 high-risk) and a non-EV group (53 patients). Significant differences were found between the groups in several parameters: Child-Pugh classification, Child-Pugh score, portal vein diameter, hepatic vein deceleration index, spleen thickness, and PSDR (all P<0.001). These variables also varied significantly across the different risk categories within the EV group (all P<0.001). Multivariate logistic regression indicated PSDR as an independent predictor of EV development (Odds Ratio [OR]=3.569, 95% Confidence Interval [CI]: 0.970-1.001, P<0.001). ROC curve analysis showed that PSDR had an Area Under the Curve (AUC) of 0.865 (95% CI: 0.764-0.965) for predicting EV, with an optimal threshold of 1013.2, achieving 88.46% sensitivity and 69.23% specificity. For high-risk EV, PSDR showed an AUC of 0.763 (95% CI: 0.670-0.856), with a threshold of 883.5, sensitivity of 79.17%, and specificity of 54.17%.

Conclusion: The PSDR is a significant risk marker and demonstrates strong predictive utility for both the presence and severity of EV in patients with HBV-induced cirrhosis. PSDR provides a valuable, non-invasive diagnostic tool for anticipating the development of EV in this patient population.