American journal of translational research最新文献

Objective: To investigate the expression of the TLR2/NF-κB signaling pathway and the Aggregate Index of Systemic Inflammation (AISI) in patients with papillary thyroid carcinoma (PTC) and to evaluate their clinical relevance to prognosis.

Methods: In this retrospective study, we analyzed surgically resected tumor tissue samples from 273 patients with PTC (PTC group) and paired adjacent non-tumorous tissues (PT group), as well as 104 nodular goiter tissues (NG group). The AISI values, along with the positive rates and mRNA expression levels of TLR2, MyD88, and NF-κB, were compared among the three groups. Differences in these indicators were compared across PTC patients with different clinicopathologic features. All PTC patients were followed up for three years and categorized into a survival group (n = 70) and a death group (n = 203) based on prognosis, and between-group comparisons were performed. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the prognostic performance of each indicator. Kaplan-Meier survival curves were generated to compare overall survival between high- and low-expression subgroups stratified by TLR2, MyD88, NF-κB mRNA and AISI levels. Cox regression analysis was conducted to identify independent prognostic factors in PTC.

Results: Compared to the NG and PT groups, the PTC group showed higher AISI values, and protein positivity and mRNA expression of TLR2, MyD88, and NF-κB (all P<0.05). In the PTC group, the expression levels of these biomarkers and AISI values differed significantly according to tumor stage, lymph node metastasis, degree of differentiation, and extraglandular extension (P<0.05). Significant differences in differentiation grade, lymph node metastasis, extrathyroidal extension, TLR2, MyD88, NF-κB mRNA, and AISI levels were observed between the survival and death groups (P<0.05). The AUC values for predicting patient prognosis based on TLR2, MyD88, NF-κB mRNA, and AISI individually or in combination were 0.802, 0.795, 0.799, 0.815, and 0.818, respectively. Patients with low expression levels of TLR2, MyD88, NF-κB mRNA, and AISI had significantly longer overall survival compared to those with high expression levels (P<0.05).

Conclusion: Poor differentiation, extrathyroidal extension, and high AISI expression are independent factors for poor PTC prognosis. The TLR2/NF-κB signaling pathway and AISI are closely associated with tumor progression and have prognostic value.

Objective: To investigate the impact of Neoadjuvant Hormonal Therapy (NHT) on surgical prognosis and survival in patients with high-risk localized prostate cancer.

Methods: A retrospective analysis was conducted on 371 high-risk prostate cancer patients who were treated at Baoji Central Hospital and Norinco General Hospital from January 2017 to January 2020. The patients were randomly divided into a training set of 286 cases (134 in the non-NHT group and 151 in the NHT group) and a validation set of 86 cases (42 in the non-NHT group and 44 in the NHT group). All patients underwent radical prostatectomy combined with pelvic lymph node dissection (RP+PLND). The baseline characteristics of the training and validation sets were collected. Surgical efficacy indicators (positive surgical margin rate, operative time, blood loss, etc.), 5-year overall survival (OS), metastasis-free survival (MFS), and biochemical recurrence-free survival (BRFS) were compared between the non-NHT and NHT groups in the training set. Independent risk factors for mortality were identified through univariate and multivariate analyses.

Results: There were no significant differences in the baseline characteristics between the non-NHT and NHT groups in both the validation and training sets. In the training set, the NHT group demonstrated significantly better outcomes than the non-NHT group in terms of positive surgical margin rate (14.57% vs. 39.55%, P < 0.001), intraoperative blood loss (428.64±45.31 ml vs. 494.98±62.36 ml, P < 0.001), and operative time (143.00 min vs. 148.00 min, P < 0.001). The 5-year OS, MFS, and BRFS rates in the NHT group were 82.12% (124/151), 66.23% (100/151), and 40.02% (71/151), respectively, which were significantly higher than 55.97% (75/134), 44.03% (59/134), and 27.61% (37/134) in the non-NHT group (P < 0.001 for all). Multivariate analysis identified non-NHT treatment (OR = 7.528, P < 0.001), open surgery (OR = 4.581, P < 0.001), high clinical stage, high postoperative Gleason score, and high preoperative Prostate-Specific Antigen (PSA) as independent risk factors for mortality. Robotic-assisted surgery significantly reduced the incidence of long-term complications such as urethral stricture and bladder neck contracture compared with open surgery (P < 0.05 for all).

Conclusion: Preoperative NHT can improve surgical efficacy and long-term survival in patients with high-risk prostate cancer without increasing perioperative risks. Robotic-assisted surgery reduces long-term complications. NHT and preoperative PSA can serve as strong predictive indicators for the Nomogram model, providing references for individualized treatment. Further exploration of the optimal course of NHT and precision stratification guided by molecular markers is needed in the future.

Objective: This study aimed to compare the clinical efficacy of mechanically activated tissue retractor (MATR) combined with vacuum sealing drainage (VSD) versus conventional VSD for treating deep soft tissue defects.

Methods: This prospective study included 53 patients with deep soft tissue defects treated between July 2024 and April 2025. The combination group (26 patients) received MATR combined with VSD, while the control group (27 patients) received conventional VSD. Outcome measures included defect healing time, rate of defect healing, mature granulation, graft survival status, pain (Visual Analog Scale, VAS), functional mobility (Activities of Daily Living Scale, ADLS), scarring (Vancouver Scar Scale, VSS), and perioperative complications. Chi-square test, t-test, and ANOVA were used to compare differences.

Results: The combination group demonstrated a significantly shorter defect healing time and lower perioperative complication rate than the control group (all P < 0.05). At 14 days and 21 days after surgery, the combination group demonstrated superior defect healing, mature granulation, and skin survival status compared to the control group (all P < 0.05). Additionally, the combination group had significantly lower VAS scores and higher ADLS scores than the control group (all P < 0.05). At 3 months after defect healing, the combination group again showed significantly lower VAS and VSS scores, and higher ADLS scores than the control group (all P < 0.05).

Conclusion: MATR combined with VSD was more effective in treating deep soft tissue defects compared to conventional VSD.

Objectives: To investigate the expression of serum Interleukin-17 (IL-17) and its receptor IL-17R in patients with bacterial pneumonia and their diagnostic value for severe bacterial pneumonia.

Methods: In this retrospective analysis, 172 patients diagnosed with bacterial pneumonia were included and categorized into the severe (n = 61) and non-severe (n = 111) groups. Serum concentrations of IL-17, IL-17R, procalcitonin (PCT), and high-sensitivity C-reactive protein (hs-CRP) were measured using ELISA upon admission and after antibiotic treatment. ROC curves were drawn to assess the diagnostic performance of influencing factors, correlation analyses were performed to explore relationships among biomarkers, and logistic regression to identify independent risk factors.

Results: Before treatment, patients with severe bacterial pneumonia demonstrated significantly higher levels of IL-17, IL-17R, PCT, and hs-CRP compared to non-severe patients (all P < 0.001). All biomarkers decreased significantly after treatment in severe group (all P < 0.05). IL-17 and IL-17R showed good accuracy in identifying severe disease (AUC = 0.808 and 0.777, respectively) and were positively correlated with PCT and hs-CRP (all P < 0.05). Multivariate analysis identified IL-17, IL-17R, PCT, and hs-CRP as independent risk factors for severe bacterial pneumonia.

Conclusions: IL-17 and IL-17R are elevated in bacterial pneumonia, demonstrating close association with disease severity and conventional markers. Their decline after treatment indicates therapeutic effectiveness. These cytokines show diagnostic potential and could help monitor disease progression and treatment response. Future research should confirm these findings in larger cohorts and investigate their interactions with other inflammatory pathways.

Objective: To evaluate the clinical value of nanopore sequencing technology (NST) for the early diagnosis and resistance guidance of Mycoplasma pneumoniae (MP) infection in children.

Methods: We analyzed four pediatric patients with MP pneumonia. Sputum specimens were subjected to NST, and results were compared with serological MP-IgM testing, nucleic acid detection, and chest CT.

Results: In all four cases, MP-IgM yielded false-negative or weakly positive results within the first 5 days. In contrast, NST provided a definitive diagnosis within 24 hours of admission, detecting MP with sequence reads ranging from 14 to 3024 and simultaneously identifying the macrolide-resistant A2063G mutation in the 23S rRNA gene. This led to a confirmed diagnosis 3-7 days earlier than serological methods. Blood cultures were negative in all cases.

Conclusion: NST overcomes the limitations and delay of traditional methods, enabling rapid and accurate diagnosis of MP infection and concurrent detection of resistance mutations. Its integration into clinical practice may significantly improve the management of pediatric MP pneumonia.

Objective: To retrospectively explore how sevoflurane + sufentanil/remifentanil versus propofol + sufentanil/remifentanil impacts clinical outcomes in laparoscopic herniorrhaphy-treated adults.

Methods: We enrolled 102 adult patients grouped into propofol (n=50) and sevoflurane (n=52) groups. Inter-group comparisons were made regarding operative duration, time to induction, extubation, emergence, and consciousness recovery, agitation incidence, first ambulation time, length of stay, and gastrointestinal recovery. Adverse events, hemodynamic parameters, as well as preoperative and postoperative stress markers, inflammatory cytokines, and pain mediators, were also discussed.

Results: The sevoflurane group had statistically shorter times to extubation, consciousness recovery, first ambulation, and gastrointestinal restoration, along with lower agitation and overall adverse event rates. Shorter anesthesia emergence time and more stable hemodynamic parameters were also found in patients receiving sevoflurane compared to the propofol cohort. Better performance in postoperative stress response, inflammatory markers, and pain mediators (except for a milder decrease in β-endorphin [β-EP]) was also determined in sevoflurane-treated patients. No notable intergroup differences were identified in the durations of surgery, induction, and hospitalization.

Conclusion: Compared to the propofol combination, the sevoflurane-sufentanil/remifentanil regimen applied to adult laparoscopic hernia repair patients contributed to superior clinical outcomes.

Objective: To evaluate the effects of percutaneous kyphoplasty (PKP) on surgical outcomes and postoperative well-being in elderly patients with osteoporotic vertebral compression fractures (OVCFs).

Methods: A total of 118 geriatric patients with OVCF treated at the Fourth Affiliated Hospital of Harbin Medical University between March 2022 and March 2025 were retrospectively analyzed. Among them, 54 underwent percutaneous vertebroplasty (PVP group), and 64 received PKP (PKP group). Data collected included surgical outcomes (bone cement injection volume, operative duration) and vertebral morphological parameters (kyphotic Cobb angle, mid/anterior vertebral height). Bone mineral density (BMD) and bone metabolism markers, including osteocalcin (BGP), bone-specific alkaline phosphatase (BALP), were assessed. Functional outcomes (Visual Analog Scale [VAS], Oswestry Disability Index [ODI], and Japanese Orthopaedic Association [JOA] Scale) were evaluated. Additionally, complications such as cement leakage, infection, and pressure ulcers were monitored. Quality of life was assessed using the Short Form-36 Health Survey (SF-36). Variables associated with pain relief were identified through univariate screening followed by multivariate analysis.

Results: Compared with PVP, PKP involved more bone cement use and longer procedural duration. However, PKP achieved more pronounced reductions in post-treatment Cobb angle, VAS, and ODI scores than PVP, along with more significant increases in mid/anterior vertebral height, BMD, BGP, BALP, JOA, and SF-36 scores. The complication rate was similar between groups.

Conclusion: In geriatric OVCF cases, PKP enhances vertebral morphology, BMD, bone metabolism, functional recovery, and patient well-being, while maintaining a safety profile comparable to PVP, despite requiring greater cement volumes and extended surgery time.

Objectives: To establish a clinical and CT-based diagnostic model to predict high-grade lung adenocarcinoma (LAC) in patients with idiopathic pulmonary fibrosis (IPF).

Methods: A total of 289 LAC-IPF patients were enrolled retrospectively and were divided into training (n=171) and test sets (n=118). In each set, the patients were divided into a low-grade LAC group and high-grade LAC group according to pathologic findings. Clinical and high-resolution CT (HRCT) features were analyzed by binary logistic regression analysis to select independent predictors for high-grade LAC by building three models: the clinical model, the radiologic model, and the combined model integrating the independent clinical and radiologic factors. The discriminative performance of the three models was assessed using the receiver operating characteristic (ROC). The model with the best diagnostic performance was verified in the test set.

Results: There was no significant difference between the training and test sets regarding clinical and radiologic factors (P>0.05). The usual interstitial pneumonia (UIP) pattern of IPF, solid morphology of the tumor, cytokeratin 19 fragments (CYFRA21-1, the cutoff value: 2.85 ng/mL) and smoking history were identified as independent predictors for high-grade LAC. The combined model showed the best discriminative performance (AUC: 0.955 in the training set and 0.853 in the test set), with sensitivity, specificity, and accuracy of 94.0%, 87.1%, and 91.2%, respectively.

Conclusions: A clinical and CT-based model can be used as an effective tool to predict high-grade LAC in IPF patients.

Objective: This study aimed to identify the risk factors associated with delayed drug metabolism during high-dose methotrexate (HD-MTX) therapy and to analyze the relationship between delayed metabolism and post-treatment toxic adverse effects.

Methods: A retrospective analysis was performed on 189 patients with acute lymphoblastic leukemia who received HD-MTX therapy at Xi'an Gaoxin Hospital between February 2018 and May 2023. Serum MTX concentrations were measured at 24, 48, and 72 hours after each HD-MTX administration (cycle), with a 48-hour concentration ≥ 1 μmol/L defining delayed metabolism on a per-cycle basis. Clinical characteristics and laboratory parameters were collected, and univariate and multivariate logistic regression analyses were conducted using SPSS version 27.00 and R version 4.3.3 to determine the risk factors for delayed metabolism. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive performance of each significant factor.

Results: Significant differences were observed between the delayed cycles (n = 105) and the non-delayed cycles (n = 450) across several clinical and laboratory variables, including age, body mass index (BMI), MTX dosage, activated partial thromboplastin time (APTT), and D-dimer (DD). Logistic regression analysis identified age, BMI, body surface area, MTX dosage, APTT, fibrinogen, DD, albumin, creatinine clearance rate, and phosphorus levels as independent risk factors for delayed metabolism. ROC curve analysis demonstrated that DD exhibited high predictive accuracy for delayed metabolism (area under the curve = 0.833). Moreover, delayed metabolism was significantly associated with a higher incidence of treatment-related toxicities, including mucosal injury, myelosuppression, renal impairment, and gastrointestinal reactions.

Conclusion: Delayed MTX metabolism is influenced by multiple clinical and biochemical factors, with DD emerging as a key predictor. Patients experiencing delayed metabolism are at greater risk for severe treatment-related toxicities. Clinicians should closely monitor these high-risk patients and consider timely preventive or corrective interventions to mitigate adverse outcomes.

Objective: This study aimed to investigate the principles of acupoint selection and the prescription characteristics of acupuncture therapy for renal edema.

Methods: Data mining technology was adopted to identify high-frequency acupoints and commonly used prescription combinations. Eight rats were selected as the control group without drug intervention, while the remaining rats were divided into the control group, model group, sham acupuncture group, and acupuncture group. Serum Ig-M and Ig-G expression levels were assessed by western blotting, and renal expression of AQP2 and AQP3 was examined using immunofluorescence.

Results: In prescriptions for renal edema, the five most frequently selected acupoints were Shenshu (BL23), Shuishui (ST28), Guanyuan (CV4), Pishu (BL20), and Zusanli (ST36). The four most frequently involved meridians were the Bladder Meridian of Foot-Taiyang, the Conception Vessel, the Kidney Meridian of Foot-Shaoyin, and the Governor Vessel. Commonly used acupoints included Yinlingquan (SP9), Yongquan (KI1), Guanyuan (CV4), Pishu (BL20), Zusanli (ST36), Shenque (CV8), and Shuifen (CV9). Compared to the blank group, the model group exhibited significantly increased serum IgM and IgG expression, while these levels were reduced in the acupuncture group. In contrast, renal AQP2 and AQP3 expression was significantly decreased in the model group relative to the blank group (P<0.05).

Conclusion: Acupuncture targeting the Bladder Meridian of Foot-Taiyang, the Conception Vessel, the Kidney Meridian of Foot-Shaoyin, and the Governor Vessel can alleviate renal edema by enhancing renal aquaporin expression and attenuating inflammatory response.