American journal of translational research最新文献

Objective: To assess the efficacy of sacubitril-valsartan in the treatment of acute myocardial infarction (AMI) using meta-analysis methods.

Methods: Relevant papers on sacubitril/valsartan for treating AMI were searched on PubMed, Embase, Medical Literature Analysis, and Retrieval System On-Line (MEDLINE), Science Direct, The Cochrane Library, Chinese National Knowledge Infrastructure (CNKI), Wanfang Database, Chinese Scientific Journal Database, and Chinese Biomedical Literature Database (CBM). The time range was from their inception to February 1, 2023.

Results: A total of 10 articles involving 13,135 patients were included for this meta-analysis according to the inclusion and exclusion criteria. Among these patients, 6,581 were treated with sacubitril/valsartan, as the experimental group, and the other 6,554 patients were classified into the control group. After treatment, the risk of hospitalization for heart failure (HF) in the experimental group was lower than that of the control group (OR=0.77, 95% CI: 0.67-0.88, P=0.0002); the average left ventricular end diastolic diameter (LVEDD) (MD=-5.56, 95% CI: -7.92-3.20, P<0.0001) was significantly higher and 6-minute-walk distance (6MWD) (MD=95.86, 95% CI: 30.57-161.16, P=0.004) was significantly longer in the treatment group than in the control group. Besides, the left ventricular ejection fraction (LVEF) (MD=2.99, 95% CI: 0.47-5.51, P=0.02) was significantly lower than that of the control group.

Conclusion: Sacubitril/Valsartan improves cardiac function in patients with AMI, reduces the risk of postoperative myocardial reinfarction, and reduces the risk of hospitalization for HF.

Objective: To conduct a systematic review (SR) to find evidence for a connection between Crohn's disease (CD) and the gut-brain axis (GBA).

Methods: This study conducted a systematic review (SR) employing a search strategy and strict inclusion criteria. It was conducted by searching for studies published between 2017 and 2024 in the following databases: PUBMED, PUBMED PMC, BVS-BIREME, SCOPUS, WEB OF SCIENCE, EMBASE, and COCHRANE.

Results: Fifty original research articles were included. Among these, 20 studies addressed neuroimaging methods to evaluate CD patients' functional or structural brain changes. Neurodegenerative diseases were the second most addressed topic in the studies, with 18 articles related to different diseases such as Parkinson's disease, Alzheimer's disease, dementia, Amyotrophic Lateral Sclerosis, Multiple Sclerosis, and Multiple System Atrophy. Eight articles addressed sleep disorders related to CD; two explored Electroencephalography changes; one investigated Brain-Derived Neurotrophic Factor serum levels and one correlated vagotomy with CD.

Conclusion: Interest in the link between CD and GBA is increasing, but studies remain varied and inconclusive, spanning from epidemiology to brain imaging and neglecting to investigate a mechanistic relationship. This SR underscores the need for further research to better understand the potential role of GBA in the prognosis and etiology of CD, highlighting its complexity.

Objective: To investigate the protective effect of Peimine (PM) against lipopolysaccharide (LPS)-induced acute lung injury (ALI) in mice and the underlying mechanisms.

Methods: KM mice were randomly divided into five groups: Control, LPS, Peimine low-dose (PM-L, 0.1 mg/kg), medium-dose (PM-M, 1 mg/kg), and high-dose (PM-H, 10 mg/kg) groups. Mice in the PM treatment groups received intraperitoneal injection of Peimine at different doses, while the mice in control and LPS groups received physiological saline. Afterwards, mice in the LPS and PM groups were subjected to intranasal instillation of LPS to establish the model of acute lung injury. The wet-to-dry (W/D) weight ratio of lung tissues was calculated, and H&E staining was performed to observe pathological changes in the lung tissues. Serum levels of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), interleukin-1β (IL-1β), and MDA were measured using ELISA kits. Western blot was employed to assess the expression of NF-κB, IκBα, phospho-IκBα, Nrf2, HO-1, and SOD2 in lung tissues. RT-PCR quantified the mRNA levels of Nrf2 and its downstream genes HO-1 and NQO1. Additionally, RAW264.7 cells were treated with various drug concentrations for 24 hours followed by LPS exposure (100 ng/mL) for another 24 hours. Prior to treatment of RAW264.7 cells with PM and LPS, the ML385+PM group was pre-treated with ML385 (3 μM) for 4 hours. ELISA kits were used to measure TNF-α, IL-6, IL-1β, and MDA in cell supernatants, while ROS levels were determined using a ROS assay kit.

Results: Compared with the model group, pretreatment with PM significantly reduced the lung tissue W/D weight ratio, ameliorated lung tissue pathological changes, and inhibited the secretion of TNF-α, IL-6, and IL-1β in bronchoalveolar lavage fluid. PM inhibited the LPS-induced elevation in lung tissue MDA levels, SOD2 consumption, and ROS levels. Furthermore, PM suppressed LPS-induced NF-κB activation and nuclear translocation, while significantly enhancing the protein expression of Nrf2 and HO-1 and increasing the mRNA levels of Nrf2 and its downstream genes, such as HO-1 and NQO1. In RAW264.7 cells, LPS induction led to elevated IL-1β, IL-6, TNF-α, MDA, and ROS levels, which were significantly suppressed by PM treatment. However, the antioxidative and anti-inflammatory effects of PM were effectively blocked by inhibiting the Nrf2 pathway.

Conclusion: PM effectively ameliorates LPS-induced lung injury, primarily through inhibition of the NF-κB pathway, and activation of the Nrf2 pathway, alongside a reduction in the release of inflammatory factors.

Objectives: To evaluate the prognostic value of body composition-related imaging parameters in assessing Crohn's disease (CD) severity and biological responses in Chinese patients.

Methods: We retrospectively analyzed electronic medical records and Computed tomography (CT) images from 117 CD patients, including 90 with sarcopenia and 27 without. We calculated subcutaneous fat area (SFA), visceral fat area, skeletal muscle area (SMA), mesenteric fat index (MFI), skeletal muscle index (SMI), and muscle attenuation (MA). CD Activity Index (CDAI) score and Simple Endoscopic Score for CD (SES-CD) were used to evaluate inflammation and biologic efficacy. Correlation and comparative analyses were performed to determine associations between imaging parameters and clinical data. Receiver operating characteristic curve analysis evaluated the predictive performance of combined body composition indicators.

Results: Sarcopenia was associated with higher CDAI scores and lower body mass index, albumin, and hemoglobin levels but was not associated with SES-CD or rates of clinical/endoscopic remission or response to biologic therapy. SMI was inversely correlated with CDAI score and SES-CD and positively correlated with albumin and hemoglobin. Endoscopy responders had higher SMA, MFI, SMI, and MA than non-responders. SES-CD improvement was positively correlated with MFI and MA and negatively correlated with SFA. The combined analysis of SMI, MFI, and MA yielded an area under the curve of 0.743 for predicting endoscopic response to biologic therapies in CD patients.

Conclusions: SMI may indicate CD severity, while MFI and MA could predict biologic response. Integrating multiple body composition parameters enhances treatment outcome evaluation, suggesting their potential utility in CD assessment.

Objectives: This study aimed to evaluate the therapeutic effect of the QingreHuoxue formula on mice with Idiopathic Membranous Nephropathy (IMN) and its impact on Th17 cells and Tregs.

Methods: A mouse model of IMN was established, and the mice were treated with traditional Chinese medicine, western medicine, or a combination of both. The efficacy and immunomodulatory effects of the QingreHuoxue formula were evaluated by examining renal pathology, urinary protein levels, peripheral blood Th17 and Treg cell counts, and comparing the expression levels of IL-17 and transforming growth factor-β1 in renal tissues.

Results: Compared to the untreated IMN model group, the IMN mice treated with TCM, western medicine, or the combination showed significant improvements in proteinuria, renal pathology, peripheral T lymphocyte counts, and IL-17 expression in renal tissues. Notably, the group treated with a combination of Chinese and western medicine exhibited better outcomes than the group treated with western medicine alone.

Conclusions: The QingreHuoxue formula was effective in reducing proteinuria, modulating T cell immune function, and protecting renal tissue in mice with IMN.

Objective: To evaluate the therapeutic effects of bisphosphonates (specifically zoledronic acid) combined with calcitriol on osteoporosis (OP) induced by endocrine therapy for breast cancer.

Methods: A retrospective analysis was performed on the clinical data from 150 patients with OP induced by endocrine therapy for breast cancer, who were admitted to Yuebei People's Hospital from May 2020 to March 2022. Patients were divided into two groups based on their treatment regimens: 78 patients received oral calcitriol alone (control group), and 72 patients received zoledronic acid combined with calcitriol (study group). Clinical efficacy, pain severity, bone metabolism, bone mineral density (BMD), quality of life, and medication safety were compared between the two groups.

Results: After 12 months of treatment, the total effective rate was significantly higher in the study group compared to the control group (95.83% vs. 79.49%, P < 0.05). Visual analogue scale (VAS) scores decreased progressively at 3, 6, and 12 months in both groups, with the study group showing significantly lower scores (all P < 0.05). Serum alkaline phosphatase (ALP) levels and BMD of the hip, femoral neck, and lumbar spine significantly increased after 12 months in both groups. Scores on the Quality of Life Questionnaire of the European Foundation for Osteoporosis 41 (QUALEFFO-41) decreased significantly in both groups, with greater improvements seen in the study group (P < 0.05). Compared to the control group, the study group showed increased serum calcium and decreased serum phosphorus after 12 months (both P < 0.05). Fracture Risk Assessment Tool (FRAX) scores decreased at 12 and 24 months in both groups, with lower scores in the study group (both P < 0.05). No adverse events were observed in either group during the treatment period.

Conclusion: The combination of bisphosphonates (zoledronic acid) and calcitriol is effective in treating OP induced by endocrine therapy for breast cancer. This combination therapy can regulate bone metabolism, enhance BMD, improve quality of life, and reduce fracture risk, demonstrating a favorable safety profile.

Objective: This study aimed to evaluate the impact of gene polymorphisms on clopidogrel metabolism and to use this analysis to inform treatment strategy for a population in southern Anhui of China.

Methods: The research was conducted from 2019 to 2022, aincluding 430 patients from the Wuhu Hospital, affiliated with East China Normal University who were candidates for clopidogrel therapy. Genes influencing clopidogrel's absorption and metabolism were analyzed to guide treatment. Patient data were collected, and genotype and metabolic type distributions were compared. Patients needing medication adjustments were followed up and divided into two groups based on whether they received adjustments or not, and the re-admission rates for antiplatelet therapy within 12 months were compared.

Results: The 430 samples showed the expected genotypes and gene distribution, with no significant correlation to age or sex. The CYP2C19 metabolic phenotype frequency was moderate at 57.44%, fast at 25.12%, slow at 15.58%, and ultra-fast at 1.86%. The ABCB1-3435C>T genotype distribution was wild type in 38.14%, heterozygous in 42.33%, and mutant homozygous in 19.53%, with the TT group being significantly younger. The PON1-576G>A genotype showed no significant baseline differences. Of the 279 patients needing medication advice, 39.07% received it. The adjusted group had a significantly lower re-admission rate within one year.

Conclusion: The distribution of gene polymorphisms related to clopidogrel metabolism varied within the study population, indicating a potential for personalized medication approaches. The study provides insight into the clinical application of genetic testing for clopidogrel therapy.

Purpose: This study aimed to explore the effectiveness of preoperative computed tomography (CT) radiomic models combined with clinical and CT imaging features for predicting spread through air spaces (STAS) in patients with T1 lung adenocarcinoma.

Methods: The preoperative CT and clinical data of 219 patients with T1 invasive lung adenocarcinoma confirmed by surgery were retrospectively analyzed and randomly divided into training and test sets at a ratio of 7:3. Univariable and multivariable logistic analyses were performed on the clinical and CT manifestations to screen independent predictive factors for STAS (+), and a clinical model was constructed. Radiomic features were extracted from the tumor (T), peritumoral (P) and tumor-peritumoral (TP) regions to construct radiomic models (Model T, Model P and Model TP), and the optimal radiomic model was identified. A combined model was then built on the basis of the best radiomic score (Radscore) and clinically independent predictors. For each model, the effectiveness in predicting STAS (+) was assessed with receiver operating characteristic (ROC) curve analysis, including calculation of the area under the curve (AUC), and a nomogram was created. Calibration curve analysis was used to assess model calibration, and decision curve analysis (DCA) was used to evaluate the clinical value of the model.

Results: Emphysema, the preoperative carcinoembryonic antigen (CEA) level, and the consolidation tumor ratio (CTR) were identified as independent predictors of STAS (+) (all P < 0.01). Model T was considered the optimal radiomic model. In the training set, the AUC of the combined model was greater than that of the clinical model (0.93 vs. 0.85, P < 0.01). However, no significant difference in the AUC was found between the combined model and Model T (0.93 vs. 0.92, P > 0.05). In the test set, the AUC of the combined model was greater than that of the clinical model (0.92 vs. 0.85, P < 0.05), but there was no significant difference compared to the AUC of Model T (0.92 vs. 0.90, P = 0.13). The AUC of Model T was greater than that of the clinical model in the training set (0.92 vs. 0.85, P < 0.01), but this difference was not significant in the test set (0.90 vs. 0.85, P = 0.35). The clinical model, radiomic Model T, and combined model all had high degrees of calibration. Finally, the clinical net benefit of the combined model was greater than that of the other two models with the threshold ranged from 0.10 to 0.40.

Conclusion: The preoperative CT radiomics model combined with clinical and CT imaging features can effectively predict STAS in T1 invasive lung adenocarcinoma patients.

Objective: To evaluate the effectiveness of graded nursing based on the risk early warning concept in long-term bedridden patients.

Methods: The medical records of 124 long-term bedridden patients admitted to the Department of Orthopaedics at the Yongzhou Hospital of Traditional Chinese Medicine from April 2022 to March 2024 were collected retrospectively. Patients were separated into two groups: the control group which received routine nursing, and the study group which received graded nursing based on the "risk early warning" concept. Key metrics recorded included turnover frequency and time to first out-of-bed activity, Braden score, incidence of pressure injury (PI), activities of daily living (ADL), motor function, quality of life, negative emotions, complications, and patient satisfaction.

Results: Low Barden score was a risk factor for PI in long-term bedridden patients (P<0.05, OR=0.040, 95% CI: 0.006-0.254). The turnover interval time and the time to first out-of-bed activity in the study group were shorter than those of the control group (all P<0.05). Compared to the control group, the Braden score, modified Barthel index score, Fugl-Meyer assessment score and quality of life scores of the study group were substantially higher (all P<0.05). The incidence of PI in the study group (4.62%) was lower than that of the control group (22.03%), and the area of PI in the study group was smaller than that of the control group (all P<0.05). Compared to the control group, the scores of self-rating anxiety scale and self-rating depression scale in the study group were substantially lower (all P<0.05). The study group had lower total incidence of complications (3.08% vs. 20.34%) and higher total satisfaction (95.38% vs. 79.66%) than the control group (all P<0.05).

Conclusion: Graded nursing based on the risk early warning concept is highly effective in managing long-term bedridden patients. It reduces the occurrence of PI and complications, shortens the turnover interval time and the time to first out-of-bed activity, improves activities of daily living and motor function as well as quality of life, relieves negative emotions, and improves patient satisfaction.