American journal of translational research最新文献

Objective: To investigate the application value of nursing signs in the risk management of elderly fracture patients.

Methods: A total of 88 elderly fracture patients admitted to West China Hospital between April 2021 and August 2022, along with 12 nursing staff members, were selected as study participants. The clinical data of these patients were retrospectively analyzed, and the patients were divided into two groups based on the nursing management strategy employed. The control group received routine nursing risk management, whereas the observation group received nursing interventions incorporating nursing signs. The two groups were compared in terms of risk management effectiveness, including the occurrence of adverse events, patient compliance with treatment, quality of life, and anxiety levels.

Results: Following nursing intervention, the observation group showed significantly lower scores on the Self-Rating Anxiety Scale (SAS) and Hamilton Anxiety Scale (HAMA) compared to the control group (P<0.05). The incidence of risk events was lower while the compliance rate was higher in the observation group than those in the control group (all P<0.05). Additionally, the observation group had higher post-intervention scores in all dimensions of the EuroQol Five Dimensions Questionnaire (EQ-5D) than the control group (P<0.05). Nursing staff in the observation group also achieved higher scores in theoretical knowledge and practical risk management skills compared to those in the control group (P<0.05).

Conclusion: The application of nursing signs in the risk management of elderly fracture patients positively impacts patients' emotional well-being and quality of life, significantly reducing the occurrence of related risk events.

Objectives: To identify the risk factors for postoperative relapse of chronic rhinosinusitis with nasal polyps (CRSwNP) using multivariate Logistic regression analysis and to explore potential improvements in clinical treatment measures.

Methods: We selected 270 CRSwNP patients who underwent surgery at The First People's Hospital of Jiangxia District between January 2022 and July 2024. The patients were divided into two groups based on the presence or absence of postoperative relapse: 40 cases with relapse were designated as the relapse group, and the other 230 cases without relapse were designated as the non-relapse group. Serum samples were collected from both groups before surgery to measure eosinophilic cationic protein (ECP)/myeloperoxidase (MPO), immunoglobulin E (IgE), and C-C motif chemokine ligand 4 (CCL4). Receiver operating characteristic (ROC) curves were used to analyze the predictive value of these indices for postoperative relapse in CRSwNP patients. The correlation of these indices with postoperative relapse was analyzed using Spearman's correlation coefficients. Univariate and multivariate analyses were employed to identify factors influencing postoperative relapse of CRSwNP.

Results: The relapse group showed markedly higher ECP/MPO, IgE, and CCL4 compared to the non-relapse group. The area under the curve (AUC) for predicting postoperative relapse of CRSwNP by each single indicator approximated 0.800, while the AUC of combined detection was above 0.900. ECP/MPO, IgE, and CCL4 all exhibited a significant positive correlation with postoperative relapse of CRSwNP. Univariate analysis revealed that the postoperative relapse of CRSwNP was significantly linked to the Davos score of nasal polyps, smoking history, postoperative infection, ECP/MPO, IgE, and CCL4. Multivariate analysis confirmed that ECP/MPO, IgE, and CCL4 were independent risk factors for postoperative recurrence of CRSwNP.

Conclusions: ECP/MPO, IgE, and CCL4 are reliable predictors of postoperative relapse in CRSwNP patients, and their combined detection can further enhance the predictive accuracy. These biomarkers are closely and positively correlated with postoperative relapse and serve as risk factors for postoperative recurrence. Given the elevated risk of postoperative recurrence in CRSwNP patients with high levels of ECP/MPO, IgE, and CCL4, it is recommended to optimize clinical treatment strategies for these patients to reduce the likelihood of recurrence.

Objective: To investigate the psychological stress levels in patients with diabetic foot ulcer (DFU) and evaluate the effects of using a luffa sponge in vacuum sealing drainage (VSD) treatment.

Methods: This retrospective study analyzed the clinical data from 110 DFU patients treated with VSD at The First People's Hospital of Zunyi (The Third Affiliated Hospital of Zunyi Medical University) between September 2021 and October 2023. Patients were categorized into two groups based on psychological stress levels: an observation group (with psychological stress, n=42) and a control group (without psychological stress, n=68). Baseline data were analyzed to identify factors influencing psychological stress. The observation group was further divided into the conventional care group and the loofah fiber care group, each with 21 patients, to evaluate the effect of using a loofah sponge during VSD treatment.

Results: Logistic regression analysis identified Wagner classification and diabetes-related distress levels as significant factors influencing psychological stress (P<0.05). Post-intervention, the loofah fiber care group showed significantly lower scores on HQ-9, GAD-7, and SRSS (all P<0.05). Additionally, the loofah fiber care group showed lower frequencies of ASD dressing changes, shorter wound healing times, shorter hospital stays, and lower VAS pain scores (all P<0.05). Quality of life scores were significantly higher in the loofah fiber care group across all dimensions (P<0.05), and DASS-21 scores were significantly lower post-intervention (P<0.05). The loofah fiber care group also demonstrated significantly better outcomes in Wagner classification and diabetes-related distress levels, with higher patient satisfaction (all P<0.05).

Conclusion: This study highlights significant factors influencing psychological stress in patients with DFU and demonstrates that loofah fiber nursing interventions during VSD treatment improve psychological stress, wound healing, and quality of life. This method provides a promising approach to enhance patient outcomes and satisfaction.

Objective: To identify factors influencing neurological prognosis following traumatic brain injury (TBI) and to analyze the role of brain tissue oxygen pressure (PbtO₂) monitoring in prognostication.

Methods: In this case-control study, medical records of 412 individuals diagnosed with TBI were thoroughly examined and analyzed. The patients were divided into two groups based on their prognosis at three months post-injury: Good Prognosis (n = 321) and Poor Prognosis (n = 91). Demographic and clinical characteristics, brain tissue oxygen partial pressure, radiological and laboratory findings, treatment interventions, and complications were compared between the two groups. Logistic regression analysis was conducted to identify the risk factors for neurological prognosis, and the predictive value of these factors was evaluated using receiver operating characteristic (ROC) curve analysis.

Results: The study identified associations between Injury Severity Score (ISS), Glasgow Coma Scale (GCS), PbtO₂ levels, radiological findings (diffuse axonal injury and subarachnoid hemorrhage), and laboratory parameters (platelet count and arterial oxygen partial pressure (PaO₂)) with neurological prognosis following TBI. Initial PbtO₂ levels demonstrated independent predictive value for poor neurological outcomes (Area Under the Curve (AUC) = 0.804).

Conclusion: The study highlights the prognostic significance of injury severity, brain tissue oxygenation, radiological findings, and laboratory parameters in determining neurological outcomes following TBI. Furthermore, the findings emphasize the potential of PbtO₂ monitoring as a valuable tool in prognostic assessment.

Objective: To assess the predictive value of peripheral blood inflammatory markers for delayed cerebral ischemia (DCI) in patients with intracerebral hemorrhage (ICH) and explore methods for early intervention.

Methods: This single-center retrospective study reviewed medical records of ICH patients admitted to Cangzhou People's Hospital over a 12-month period from January 2022 to December 2023. Of the 150 identified patients with ICH, including 80 patients without DCI (control group) and 70 with DCI (observation group). Demographics and blood biochemical markers during hospitalization were recorded. Binary logistic regression was used to identify independent factors influencing DCI occurrence.

Results: Significant differences were observed between the two groups in neutrophil percentage, lymphocyte percentage, lymphocytes absolute and neutrophil-to-lymphocyte ratio (NLR) (all P<0.05). Logistic regression analysis identified mRS score, lymphocyte percentage, educational level, uric acid, neutrophils percentage, and NLR as independent risk factors for DCI.

Conclusion: Neutrophil percentage and NLR are independent factors influencing delayed cerebral ischemia after intracerebral hemorrhage. These markers are readily accessible and may provide valuable insights for early ICH management.

Objective: To explore the effects and safety of the flexible vacuum-assisted ureteral access sheath combined with a flexible ureteroscope for the treatment of large renal stones over 3 cm.

Methods: In this retrospective study, 122 patients with kidney stones (stone diameter ≥ 3 cm) admitted to our hospital from January 2018 to December 2022 were selected as the study subjects. According to different surgical methods, these patients were divided into an observation group and a control group, with 61 cases in each group. Patients in the control group were treated with the conventional negative pressure-assisted ureteral access sheath combined with flexible ureteroscope, while those in the observation group were treated with the flexible vacuum-assisted ureteral access sheath combined with flexible ureteroscope. The perioperative indexes, stone-free rate, usage rate of basket extraction, inflammation level, renal functional indexes, and incidence of postoperative complications were evaluated and compared between the two groups.

Results: The extubation time, rate of multiple operations, and surgery cost in the observation group were significantly less than those of the control group (all P < 0.05), but the operation time was longer in the observation group than that of the control group (P < 0.05). The stone-free rate at 3 days after surgery in the observation group was higher than that of the control group, while the usage rate of basket extraction of the observation group was significantly less than that of the control group (all P < 0.05). The postoperative levels of C-reactive protein (CRP) and Interleukin (IL)-6 were significantly lower, while the level of IL-10 was significantly higher in the observation group than in the control group (all P < 0.001). The levels of renal functional indexes such as CysC, Scr, and KIM-1 in the observation group were lower than those of the control group (all P < 0.05). The total incidence of postoperative complications in the observation group was 8.20%, which was lower than 24.59% in the control group (P = 0.014). Moreover, postoperative sleep quality was better, and the comfort score was higher in the observation group than that of the control group (all P < 0.001).

Conclusion: The flexible vacuum-assisted ureteral access sheath combined with flexible ureteroscope is effective in the treatment of large renal stones over 3 cm, and may improve the perioperative indexes, postoperative sleep quality and comfort, increase the stone-free rate, alleviate the inflammation levels and kidney functional injury, and reduce the incidence of complications.

Objective: To evaluate the application value of CT diagnostic technology based on the Shukun Imaging Post-Processing System for early screening and diagnosis of lung cancer.

Methods: A total of 35 patients diagnosed with lung cancer postoperatively and 53 patients with benign nodules were included in this retrospective study, all of whom were treated in the Department of Thoracic and Cardiovascular Surgery of the Second Affiliated Hospital of Fujian Medical University from January 2020 to December 2023. All patients underwent chest spiral CT examinations. Original thin-slice axial CT images were processed using Shukun software for three-dimensional reconstruction of the lesions, surrounding lung tissue, and trachea. The diagnoses and malignant risk indicators of pulmonary nodules were established based on the final imaging results.

Results: Statistical analysis showed that the sensitivity of Shukun processing technology in diagnosing early-stage lung cancer was 82.86%, with a specificity of 88.46%, when compared to postoperative pathological analysis. Univariate logistic regression analysis indicated that features such as burr sign, lobulation sign, pleural traction sign, vascular convergence sign, vacuole sign, and nodule size derived from Shukun processing had significant predictive value for malignant nodules (P<0.05).

Conclusion: Shukun processing technology can effectively reconstruct ordinary CT tomographic images into three-dimensional representations, enhancing the visualization of spatial relationships between the tumor and adjacent anatomical structures, including trachea, pleura, bronchi, and blood vessels. It has high clinical diagnostic value for the early diagnosis of malignant pulmonary nodules.

Objective: To investigate the clinical effect of Almonertinib in in patients with epidermal growth factor receptor (EGFR) mutation-positive residual ground-glass opacities following resection of stage I lung cancer.

Methods: A retrospective analysis of 75 patients with EGFR mutation-positive residual ground-glass opacities post-stage I lung cancer surgery was conducted at Tianjin Medical University Cancer Institute and Hospital between January 2021 and December 2023. Patients were categorized into the control group (CG, n = 33, treated with pemetrexed and cisplatin) and the observation group (OG, n = 42, treated with Almonertinib). Cellular immune markers, tumor markers, CT nodule characteristics (size, density), malignancy risk scores before (T0) and after treatment (T1), treatment efficacy at T1, and adverse drug reactions were evaluated.

Results: At T1, both groups showed an increase in CD3+ and CD4+ levels, and a decrease in CD8+ levels compared to T0. The OG group had significantly higher CD3+ and CD4+ levels and lower CD8+ levels compared to the CG group (all P < 0.05). Serum levels of IL-6, IL-8, and TNF-α decreased significantly in both groups at T1, with greater reductions observed in the OG group (all P < 0.05). Additionally, the OG group demonstrated a more substantial reduction in serum carcinoembryonic antigen, carbohydrate antigen 125, carbohydrate antigen 50, cytokeratin 19 fragment antigen 21-1, neuron-specific enolase, and carbohydrate antigen 19-9 levels compared to the CG group (all P < 0.05). Nodule size and density also decreased in both groups, with more significant reductions in the OG group at T1 (all P < 0.05). The Mayo and Brock model predictions indicated a significantly lower risk of malignancy at T1 in the OG group compared to T0 (all P < 0.05). The objective response rate (ORR) and disease control rate (DCR) were significantly higher in the OG group (P < 0.05), and adverse reaction rates were lower in the OG group compared to the CG group at T1 (all P < 0.05).

Conclusion: Almonertinib demonstrates good clinical efficacy and safety for the treatment of EGFR mutation-positive residual ground-glass opacities following stage I lung cancer resection.

Objective: To evaluate the impact and prognosis of a multidisciplinary discharge preparation service model for patients with chronic heart failure.

Methods: A total of 100 patients with chronic heart failure who visited the Wuhan Asia Heart Hospital from January 2022 to September 2023 were included. The patients were divided into an experimental group, receiving a multidisciplinary discharge preparation service, and a control group, receiving conventional treatment. Primary outcomes included New York Heart Association (NYHA) Functional Classification, Left Ventricular Ejection Fraction (LVEF), Serum Uric Acid (SUA) levels, Creatinine Clearance Rate (Ccr), Serum Potassium levels, cardiac death count, and the frequency of heart failure-related hospitalizations. Comparisons between the two groups were conducted to evaluate the effectiveness of the multidisciplinary service model.

Results: After 3 months of treatment, both groups showed significant reductions in NYHA scores, with notable differences before and after treatment (t=-2.631, P=0.025). LVEF levels decreased in both groups following 3 months of discharge preparation service (t=-4.741, P=0.003). The experimental group exhibited greater improvements in SUA and Ccr indices. The highest serum potassium level reached approximately 4.68 mmol/L when LVEF > 50%. In the experimental group, there was 1 case of cardiac death and 6 cases of heart failure-related readmission, while the control group had 2 cases of cardiac death and 8 cases of heart failure-related readmission. There were no significant differences between the two groups in terms of hypoglycemia, urinary tract infections, and gastrointestinal adverse reactions (all P > 0.05).

Conclusion: The multidisciplinary discharge preparation service model significantly improves the clinical condition of patients with chronic heart failure, reducing the risk of heart failure-related deaths and rehospitalizations.

Objective: To investigate the clinical efficacy of dexmedetomidine preemptive analgesia in patients undergoing mastectomy.

Methods: A retrospective study was conducted, including 236 patients who underwent breast tumor resection. Of these, 131 patients in the control group received routine postoperative intravenous patient-controlled analgesia, while 105 patients in the preemptive analgesia group received dexmedetomidine preemptive analgesia during surgery. Visual analog scale (VAS) scores, Ramsay sedation scores, clinical efficacy, pain mediator levels, renal function indices, immune function indices, and adverse effects were statistically analyzed.

Results: The preemptive analgesia group had lower VAS scores and Ramsay scores postoperatively (both P < 0.05). The success rate of analgesia was significantly higher in the preemptive analgesia group compared to the control group (84.8% vs. 74.0%, P < 0.05). After surgery, the levels of pain mediators, including prostaglandin E2 (PGE2), substance P (SP), and neuropeptide Y (NPY), initially increased and then decreased, with lower levels observed in the preemptive analgesia group (all P < 0.05). Renal function indices, including creatinine (Cr), blood urea nitrogen (BUN), and neutrophil gelatinase-associated lipocalin (NGAL), showed a similar trend, with lower levels in the preemptive analgesia group (all P < 0.05). Immune function markers, such as CD3+, CD4+, CD8+, and CD4/CD8+ ratios, demonstrated smaller changes in the preemptive analgesia group compared to the control group (all P < 0.05). The total adverse reaction rate was lower in the preemptive analgesia group (P < 0.05).

Conclusion: Dexmedetomidine preemptive analgesia demonstrates significant clinical benefits in patients undergoing breast tumor resection, including better analgesic efficacy, reduced pain mediator and renal function index levels, improved immune function preservation, and fewer adverse reactions.