American journal of translational research最新文献

Purpose: To develop and validate a radiomics model that uses multiple magnetic resonance imaging (MRI) sequences to accurately distinguish hepatocellular carcinoma (HCC) from focal nodular hyperplasia (FNH), thereby improving diagnostic precision and decision-making.

Methods: We conducted a retrospective analysis including 196 patients (97 in HCC and 99 in FNH) diagnosed at the Zhangzhou Affiliated Hospital of Fujian Medical University (August 2011-December 2021). Radiomics features were extracted from the MRI images. LASSO logistic regression models were constructed for feature selection and to differentiate HCC from FNH. The model was further validated using a temporally independent cohort of 91 patients (49 HCC, 42 FNH) from the same institution (January 2022-December 2023). The area under the curve (AUC), accuracy, sensitivity, and specificity were used to evaluate the model's performance.

Results: We obtained 34 features for T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), and contrast enhanced imaging (CEI). The radiomics model demonstrated high diagnostic performance, with AUCs of 0.992 and 0.958 in the training and internal validation, respectively. In the independent external validation set, the model maintained strong performance with an AUC of 0.903, sensitivity of 88.9%, and specificity of 87.2%. In the training and internal validation, the model also showed high accuracy (0.956 and 0.867, respectively) and sensitivity (0.957 and 0.900, respectively). The integrated T2WI + DWI + CEI (TDC)-clinical data model demonstrated higher diagnostic accuracy than the TDC-only model.

Conclusion: The developed multimodal MRI radiomics model effectively differentiated HCC from FNH and offers a non-invasive diagnostic tool that surpasses traditional imaging techniques. Further research is warranted to confirm these findings and explore the model's applications in broader clinical settings.

Objective: To evaluate the efficacy and survival outcomes of bevacizumab combined with minocycline versus bevacizumab monotherapy in patients with glioblastoma (GBM).

Methods: We conducted a retrospective analysis of 132 GBM patients treated at multiple centers between January 2022 and December 2023. Patients were divided into a control group (bevacizumab monotherapy, n = 67) and an observation group (bevacizumab plus minocycline, n = 65). Short-term treatment response, serum biomarkers, immune function, inflammatory and angiogenic factors, quality of life, safety, and long-term survival were assessed.

Results: The observation group showed significantly higher objective response rate (53.85% vs. 29.85%) and disease control rate (78.46% vs. 61.19%), along with improved immune function, reduced inflammatory and angiogenic markers, and enhanced quality of life (all P < 0.05). Median progression-free survival (PFS) (8.5 vs. 6.7 months) and overall survival (OS) (10.6 vs. 8.9 months) were longer in the observation group. No significant difference in treatment-related adverse events was observed.

Conclusion: This retrospective analysis suggests that the combination of bevacizumab and minocycline is associated with promising efficacy in GBM patients, including improved objective response, survival, and quality of life, with a manageable safety profile. These findings support further evaluation in prospective randomized trials to confirm the therapeutic potential of this combination.

Objective: To systematically evaluate the multidimensional efficacy of entecavir in patients with Chronic Hepatitis B (CHB) complicated with metabolic-associated fatty liver disease (MAFLD), with a focus on virological response, liver function, and metabolic parameters.

Methods: A retrospective analysis was conducted on 285 patients with CHB and concurrent MAFLD who received entecavir treatment at Minzu Hospital of Guangxi Zhuang Autonomous Region between January 2022 and May 2024 (MAFLD with comorbidities group). During the same period, 310 CHB patients without MAFLD served as the viral-only group. Both groups were treated with entecavir. Baseline characteristics, treatment efficacy at week 35, virological response, liver function parameters, fibrosis progression, metabolic indicators, and safety profiles were compared between the two groups.

Results: Compared with the viral-only group, patients in the MAFLD with comorbidities group exhibited significantly higher body mass index (BMI), waist circumference (WC), homeostasis model assessment of insulin resistance (HOMA-IR), fasting insulin (FINS), and triglyceride (TG) levels, as well as lower high-density lipoprotein cholesterol (HDL-C) levels, alanine aminotransferase (ALT)/aspartate aminotransferase (AST) normalization rates, hepatitis B virus (HBV) deoxyribonucleic acid (DNA) negativity rates, and hepatitis B e-antigen (HBeAg) seroconversion rates (P < 0.05). AST and GGT levels were also significantly lower in the viral-only group than in the MAFLD with comorbidities group (P < 0.05). Post-treatment fibrosis staging was more advanced in the MAFLD with comorbidities group (P < 0.05). After treatment, patients with MAFLD maintained higher HOMA-IR and TG levels and lower HDL-C levels than those without MAFLD (P < 0.05). During follow-up, the overall incidence of adverse events was 2.11% in the MAFLD with comorbidities group and 1.94% in the viral-only group, with no statistically significant difference between the groups (P > 0.05).

Conclusion: Entecavir can effectively control viral replication in patients with CHB combined with MAFLD. However, the recovery of liver function, improvement of steatosis and improvement of metabolic indicators were all slightly inferior to those of the non-MAFLD population, suggesting that the coexistence of MAFLD may weaken the comprehensive benefits of antiviral treatment.

Objective: To investigate whether adding ropivacaine local infiltration (RLI) to standard analgesia can improve functional recovery outcomes and safety in elderly patients undergoing total knee arthroplasty (TKA).

Methods: This retrospective study included 227 elderly patients who underwent unilateral TKA under spinal anesthesia between January 2023 and January 2025. According to different analgesic regimens, patients were divided into two groups: the conventional multimodal analgesia (CMA) group (n=105) and the RLI group (n=122). The cumulative use of morphine within 48 hours after surgery, visual analog scale (VAS) pain levels during activity, range of motion (ROM) of the knee joint, 6-minute walking distance, functional independence measurement (FIM) score, and incidence of adverse events were compared between the two groups.

Results: At 24 and 48 hours postoperatively, cumulative morphine use was significantly lower in the RLI group compared with the CMA groups (all P<0.05). Activity-related VAS pain scores were significantly lower in the RLI group at all evaluation time points (all P<0.05). In addition, the RLI group demonstrated greater knee ROM (48-hours: 95.84 vs. 92.16, P<0.001), longer six-minute walk distances (48-hours: 213.29 vs. 204.85, P=0.007), and higher FIM motor scores (57.05 vs. 54.49, P=0.008), compared with the CMA group. Patients in the RLI group had a lower incidence of itching and a relatively shorter hospital stay.

Conclusion: In elderly patients undergoing TKA, local infiltration analgesia (LIA) can alleviate early postoperative pain, reduce the use of opioid drugs, and promote faster functional recovery.

Objective: To examine difference in the low-density lipoprotein cholesterol/lymphocyte (LDL-C/LYM) ratio between the acute exacerbation and stable phases of chronic obstructive pulmonary disease (COPD) and assess its diagnostic and prognostic value.

Methods: A total of 196 hospitalized COPD patients were retrospectively analyzed, including 96 in the acute exacerbation phase and 100 in the stable phase. Demographics, inflammatory markers [C-reactive protein (CRP), interleukin-6 (IL-6), white blood cell count (WBC), monocyte percentage (MO%)], pulmonary function indices [percentage of predicted forced expiratory volume in one second (FEV₁% pred), FEV₁/forced vital capacity (FVC), peak expiratory flow (PEF)], and LDL-C/LYM ratios were collected. Intergroup comparisons, correlation analyses, and receiver operating characteristic (ROC) curve analysis were performed.

Results: LDL-C/LYM ratio was significantly higher during acute exacerbation (P < 0.001), positively correlated with CRP, IL-6, WBC, and MO% (r = 0.404-0.606), and negatively with FEV₁% pred, FEV₁/FVC, and PEF (r = -0.310 to -0.402) (all P < 0.001). No significant correlation between LDL-C/LYM ratio and pulmonary function indices were found in the stable group. ROC analysis showed that the LDL-C/LYM ratio had the highest diagnostic accuracy for acute exacerbation [area under the curve (AUC) = 0.828], outperforming other markers, and it correlated positively with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) staging (r = 0.419, P < 0.001).

Conclusion: The LDL-C/LYM ratio is elevated during COPD exacerbations and reflects inflammation and lung function decline, serving as a simple biomarker for diagnosis and prognosis.

Objective: To construct a microscopic inferior epigastric vein-internal spermatic vein model based on testis-related indexes in infertile men with asthenospermia for predictingtreatment efficacy.

Methods: A total of 264 male infertile patients with oligoasthenospermia and varicocele combined with nutcracker syndrome who received treatment of the inferior epigastric-internal spermatic vein under the microscope were collected and retrospectively analyzed. They were divided into a training set (n = 185) and a verification set (n = 79). Demographic characteristics of the patients and testicular-related indicators were collected. Univariate and multivariate analyses were used to screen for risk factors affecting the surgical effect, and a predictive model was constructed. The nomogram was drawn and its clinical application value was evaluated.

Results: Multivariate logistic regression analysis showed that testicular volume, sperm motility, testicular artery blood flow velocity, testosterone level, the degree of varicocele, and the severity of nutcracker syndrome were independent risk factors for the surgical outcome. The constructed predictive model performed well in the training set and the verification set, with the C-index being 0.849 and 0.847, respectively. Decision curve analysis showed that the model had clinical application value within a certain threshold probability range. The prognostic model displayed strong discrimination performance, as evidenced by external validation.

Conclusion: The predictive model and nomogram constructed based on testis-related indicators are valuable for evaluating the therapeutic effect of inferior epigastric-internal spermatic vein surgery under the microscope, and also helpful for clinicians to predict the surgical effect and formulate an individualized treatment plan.

Objectives: To investigate the impact of the timing of invasive mechanical ventilation (IMV) on 28-day clinical outcomes in patients with severe pneumonia (SP) complicated by gastrointestinal dysfunction.

Methods: This retrospective study enrolled 104 patients with SP and gastrointestinal dysfunction who received IMV. Based on the time from meeting IMV criteria to its initiation, patients were divided into an Early Group (≤6 hours, n = 52) and a Delayed Group (>6 hours, n = 52). Clinical efficacy, scores [Clinical Pulmonary Infection Score, Acute Physiology and Chronic Health Evaluation II (APACHE II), Gastrointestinal Dysfunction Score (GIDS)], inflammatory markers [C-reactive protein (CRP), Tumor necrosis factor-α (TNF-α), Procalcitonin (PCT)], blood gas parameters [Oxygenation index (PaO₂/FiO₂) and Arterial partial pressure of oxygen (PaO₂)], gastrointestinal function, and prognosis were compared.

Results: The total effective rate was significantly higher in the Early Group (86.54%) than that in the Delayed Group (76.92%) (P<0.05). Intergroup comparisons at 48 and 72 hours post-IMV revealed that the Early Group demonstrated superior improvement in APACHE II scores, GIDS, blood gas parameters, inflammatory markers, and gastrointestinal markers [Gastrin (GAS), Diamine oxidase (DAO)] (all P<0.05). Furthermore, the Early Group had a higher 28-day survival probability, shorter ICU stay and ventilation duration, and a significantly lower overall incidence of adverse reactions (19.23% vs. 53.84%) (P<0.05).

Conclusions: For patients with SP and gastrointestinal dysfunction, early IMV initiation within 6 hours is more effective in mitigating systemic inflammation, improving blood gas exchange and gastrointestinal function, optimizing infection control, reducing adverse events, and ultimately improving clinical prognosis.

Objective: To evaluate the diagnostic use of integrating multi-parameter flow cytometry (FCM), histopathology, and gene mutation analysis for lymphoma classification using intact lymph node (LN) samples.

Methods: Intact LN samples from 109 patients with lymphadenopathy were retrospectively analyzed by pathology, multi-color FCM, and next-generation sequencing (NGS) targeting 62 lymphoma-related genes.

Results: FCM immunophenotyping showed high concordance with pathology (56/56 lymphoma cases detected by FCM were pathologically confirmed). PD-1 on T cells was significantly elevated in B-cell lymphoma (BCL), especially diffuse large BCL (DLBCL) (P<0.05). All BCLs exhibited monotypic intracellular cKappa or cLambda expression. Significant differences in cell size (FSC) were observed: Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma (CLL/SLL) (mean FSC: 89.42±6.01) and Follicular Lymphoma cells (FL; 93.88±4.94) were smaller than normal B-cells (102.09±11.58), while DLBCL cells (121.84±9.17) were larger (all P<0.05). Subtypes showed distinct mutation profiles, including IGHV (9/11) in CLL/SLL; BCL2 (5/7) and EZH2 (4/7) in FL; and BCL6 (5/13) in DLBCL. Mutation-guided FCM confirmed BCL2 protein expression in two FL cases and BCL6 in one DLBCL case. T/NK-cell lymphomas showed aberrant antigen expression and restricted TRBC1 clonality (1.17%±1.61% or >96.4%) outside the normal polyclonal range (36.60%±7.21%).

Conclusion: FCM on intact LNs is a robust tool with high pathologic concordance. Integrating genetic mutation data with FCM provides a powerful, multi-parameter strategy. This approach moves beyond standard immunophenotyping to include mutation-associated antigens, thereby refining lymphoma classification and enhancing diagnostic accuracy.

Background: Bu-Yi-Xin-Shen formula (BYXSF) is used for the treatment of post-percutaneous coronary intervention (PCI) angina. This study combined bioinformatics and experimental verification to investigate its mechanism of action.

Methods: We retrieved relevant target data from public databases to determine candidate therapeutic targets of BYXSF in post-PCI angina. Key targets were then determined using protein-protein interaction (PPI) network and functional enrichment assays. Molecular docking was used to identify core active ingredients, while toxicity evaluation helped assess their safety profiles. After that, single-cell RNA sequencing (scRNA-seq) uncovered critical cell types and the expression patterns of target genes. Finally, in vivo animal experiments provided evidence for the activation of pathways related to these key targets, further validating the proposed mechanism.

Results: Functional enrichment analysis indicated that phosphatidylinositol 3-kinase-AKT (PI3K-Akt) and Nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) signaling pathways were significantly enriched. Combined with the high interaction degree of genes in the PPI network, PIK3R1, PIK3CA, PIK3CB, EGFR, AKT1, and SRC were determined as key targets. Then, five active ingredients (benzoylnapelline, quercetin, liquiritigenin, sexangularetin, and deltoin) with the lowest binding energies (< -8 kcal/mol) were identified by molecular docking. These active ingredients were found to influence toxicity through processes including vascular inflammation and lipid metabolism/atherosclerosis. The scRNA-seq revealed monocytes as the core cell type mediating BYXSF's therapeutic effects, with distinct expression levels of key targets between high- and low-score groups. Finally, in vivo experiments confirmed that BYXSF alleviated post-PCI angina by regulating the PI3K-Akt and NF-κB signaling pathways.

Conclusion: PIK3R1, PIK3CA, PIK3CB, EGFR, AKT1, and SRC were key genes in the PI3K-Akt and NF-κB pathways, and monocytes were major targets of BYXSF in post-PCI angina. Animal experiments validated this mechanism, laying a foundation for the further development of BYXSF as a therapeutic agent.

Background: Diabetic foot complications are among the most severe and costly complications of diabetes. This study aims to explore the effectiveness of a nurse-led multidisciplinary collaborative nursing model under the "Six-Profession Co-Management Model" in the nursing intervention for community-based patients with high-risk diabetic feet.

Methods: A prospective analysis was conducted from July to December 2023, involving 148 community-based DHRF patients. Participants were randomly allocated (1:1) to a control group receiving conventional nursing care, or an experimental group receiving nurse-led multidisciplinary interventions within the Six-Profession Co-management Model, alongside conventional care. Outcomes including laboratory measures (fasting and postprandial blood glucose, glycated hemoglobin, lipids), high-risk foot examination results, and scores from the Diabetic Foot Care Knowledge and Daily Care Behavior questionnaires were compared between groups before and after the 6-month intervention.

Results: No statistically significant differences were observed in baseline data between the two groups (P > 0.05). Before the intervention, there were no significant differences in laboratory indicators, high-risk foot examination results, or questionnaire scores between the two groups (P > 0.05). After the intervention, significant differences were observed in all these measures, with the experimental group demonstrating markedly better outcomes than the control group (P < 0.05).

Conclusion: The nurse-led multidisciplinary collaborative nursing model under the "Six-Profession Co-Management" framework is effective in managing community-based DHRF patients. It supports risk factor screening and assessment of foot care knowledge and behaviors, offering valuable guidance for early intervention.