American journal of translational research最新文献

Objective: To analyze the factors influencing early neurological deterioration (END) after intravenous thrombolysis in patients with acute cerebral infarction (ACI) based on real-world data, and to establish a nomogram predictive model.

Methods: The clinical data of 148 ACI patients who received intravenous thrombolytic therapy within 4.5 hours of onset at Nantong Rici Hospital Affiliated with Yangzhou University, from January 2020 to December 2023, were retrospectively analyzed. Patient clinical and laboratory data were collected. Patients were divided into END and non-END groups according to whether they developed END after intravenous thrombolysis. Factors influencing the emergence of END were identified by univariate and multivariate logistic regression analyses. Risk factors were included to construct a nomogram risk predictive model, which was validated for efficacy. Model discrimination was assessed using the receiver operating characteristic curve (ROC) and the area under the ROC curve (AUC). Model fitting was evaluated using a calibration curve, and consistency was assessed by Hosmer-Lemeshow (HL) analysis.

Results: END occurred in 27 of 148 patients (18.24%). Multivariate analysis identified age, National Institute of Health stroke scale (NIHSS) score, fibrinogen, and the time from onset to thrombolysis as factors influencing END in ACI patients after thrombolysis. A nomogram predictive model was constructed based on the above indicators. The AUC for the model in predicting END in the training set and the test set was 0.994 (95% CI: 0.982-1.000) and 0.977 (95% CI: 0.940-1.000), respectively. HL test showed high goodness of fit (χ² = 1.953, P = 0.982), and the calibration curve showed good agreement between the predicted and observed values.

Conclusion: Age, NIHSS score, fibrinogen, and time from onset to thrombolysis are significant factors influencing the development of END after thrombolysis in ACI patients. The predictive model based on these four variables demonstrates good discriminatory power and may assist in clinical decision-making.

Objectives: This study aimed to evaluate the effectiveness of neoadjuvant immunochemotherapy (NIC) in patients diagnosed with locally advanced esophageal squamous cell carcinoma (LAESCC), by assessing the performance of models that utilize enhanced computed tomography (CT) images at the pre, post, and delta/pre group stages.

Methods: A total of 225 patients were included in our study and randomly divided into a training set (n = 157) and test set I (n = 68). In addition, we conducted a test set II involving 60 patients from another center. We obtained omics features from CT images before and after NIC. Then, the delta radiomics features were obtained by calculating the differences between the post and pre group features, which was then divided by the pre group features to obtain the delta/pre group. Imaging and clinicopathological data were collected in the two centers according to the same inclusion and exclusion criteria. The tumor regression grading (TRG) system was used according to the Japanese Esophageal Cancer (11th edition). Three sets of models were built and their performance was assessed using receiver operating characteristic (ROC) curve, confusion matrix, and calibration curve. The clinical utility of the model was evaluated through decision curve analysis and nomogram.

Results: The area under the curve value of the delta/pre-radiomics (Rad) score model was 0.876 in the training set and 0.827 and 0.749 in the two test sets, which was significantly higher than that in the pre and post Rad score models. The radiomics nomogram was constructed using Rad scores derived from the post model, delta/pre model, Ki67, P53, and the pathological stage of lymph node after neoadjuvant therapy (ypN), demonstrating robust performance. The internal correction curve (apparent) and the external correction curve (bias-corrected) exhibited negligible deviations from the ideal curve, thereby demonstrating a high level of similarity.

Conclusion: Nomogram, based on delta/pre-enhanced CT features and clinical risk indicators, is a non-invasive tool to predict therapeutic effects in patients with LAESCC after NIC.

Objectives: Polyarteritis nodosa (PAN) is a rare autoimmune disease that can cause severe functional impairment. Early diagnosis and timely intervention are essential to reduce disease severity and improve outcomes.

Methods: Serum proteins from PAN patients and healthy controls were analyzed using data-independent acquisition mass spectrometry (DIA-MS), identifying 55 differentially expressed proteins. Validation was conducted on an independent set of 35 serum samples (10 healthy controls, 15 disease controls, and 10 PAN patients) to evaluate the diagnostic potential of selected biomarkers.

Results: Eighteen proteins showed significantly altered expression in PAN patients compared to controls. A diagnostic panel of seven proteins - AZGP1, F13B, LBP, RBP4, SERPINF1, PGLYRP2, and PPBP - was identified using the least absolute shrinkage and selection operator (LASSO) binary logistic regression model. This panel achieved an area under the receiver operating characteristic (ROC) curve of 0.994, effectively distinguishing PAN patients from controls.

Conclusion: By combining DIA-MS technology with the LASSO regression model, this study developed a 7-protein diagnostic panel, providing a highly accurate and efficient tool for PAN diagnosis.

Objective: To evaluate the clinical efficacy of Soft-Shelled Turtle Shell and Salt Moxibustion in treating kidney yang deficiency-type Laolin in middle-aged and elderly women and assessing treatment impact on quality of life.

Methods: A retrospective analysis was conducted on 72 middle-aged and elderly female patients with kidney yang deficiency-type Laolin treated at Suzhou Hospital of Traditional Chinese Medicine between June 2023 and April 2024 (research group). Patients with the same condition who received only basic treatment and care served as the control group. The research group received Soft-Shelled Turtle Shell and Salt Moxibustion in addition to the control treatment. Outcomes including traditional Chinese medicine (TCM) syndrome scores, clinical efficacy, immunoglobulin M (IgM), immunoglobulin G (IgG), routine urine white blood cell count, urine bacterial counts, quality of life scores, and complication rates were compared between the two groups.

Results: The research group demonstrated significantly greater improvement in TCM syndrome scores, clinical efficacy, and urine bacterial counts compared to the control group (all P<0.05). Post-treatment IgM and IgG levels were also significantly higher in the research group (both P<0.05). Additionally, the research group exhibited a more pronounced reduction in urine white blood cell counts and achieved significantly higher quality of life scores (both P<0.05). The incidence of adverse reactions in the research group was lower than that in the control group (P<0.05). Patient satisfaction with care was notably higher in the research group (P<0.05).

Conclusion: Soft-Shelled Turtle Shell and Salt Moxibustion is highly effective in treating middle-aged and elderly female patients with kidney yang deficiency-type Laolin. It significantly improves TCM syndrome scores, immunoglobulin levels, urine bacterial counts, and routine urine white blood cell counts while enhancing patients' quality of life. The therapy is safe, with minimal and self-limiting adverse reactions, primarily mild skin irritation.

Objective: To evaluate the effectiveness of evidence-based collaborative nursing in reducing complications, alleviating negative emotions, and improving the quality of life in patients undergoing radical prostatectomy.

Methods: In this retrospective study, Sixty-three patients who underwent surgery for prostate cancer between September 2021 and August 2022 were included as the control group, while 75 patients hospitalized between September 2022 and August 2023 were selected as the observation group. All these patients were treated at Tianjin Medical University General Hospital. The control group received routine nursing care, while the observation group received evidence-based collaborative nursing in addition to standard care. Complications, emotional state, self-care ability, fear of disease progression, quality of life, urodynamic index and the satisfaction with care were compared and analyzed between the two groups.

Results: The observation group experienced significantly fewer complications than the control group (P<0.05). After intervention, both groups showed a significant reduction in negative emotional scores and an increase in positive emotional scores compared to pre-intervention (all P<0.05), with the observation group demonstrating more pronounced alterations (all P<0.05). Self-care ability scores in both groups improved significantly post-intervention (P<0.05), with the observation group showing higher scores than the control group (P<0.05). Scores related to fear of disease progression were significantly lower in both groups post-intervention, with the observation group showing a greater reduction (P<0.05). Quality of life scores in the functional dimension improved and symptom scores decreased in both groups post-intervention (P<0.05), with the observation group showing better outcomes than the control group (P<0.05). Urodynamic indices, including maximum urine flow, maximum urethral closure, and maximum bladder capacity, improved significantly in both groups post-intervention (P<0.05), with the observation group outperforming the control group (P<0.05). Additionally, the observation group reported higher satisfaction with nursing care compared to the control group (P<0.05).

Conclusion: Evidence-based collaborative caring significantly improves emotional well-being, enhances self-care ability and quality of life, and reduces postoperative complications in patients undergoing radical prostatectomy. This approach holds great potential for broader clinical application.

Objective: To investigate the effects of continuous blood purification (CBP) combined with antibiotics on pulmonary surfactant protein D (SP-D), Clara cell protein-16 (CC-16), and prognosis in patients with severe acute pancreatitis (SAP) complicated by acute respiratory distress syndrome (ARDS).

Methods: A total of 128 patients with SAP and ARDS treated at Fudan University Shanghai Cancer Center from June 2021 to June 2023 were enrolled. Patients were divided into two groups: a control group (n=64) receiving routine treatment (gastrointestinal decompression, somatostatin administration, nutritional support, correction of water-electrolyte imbalance, and microcirculation improvement) and an observation group (n=64) treated with CBP combined with antibiotics. Clinical data, including the pancreatic edema resolution time, ventilator weaning time, and hospital stay, were compared between groups. Additional comparisons included intra-abdominal pressure (IAP), blood amylase (AMS), urinary amylase (UAMY), inflammatory markers [tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), interleukin-1β (IL-1β)], respiratory mechanics indices [airway peak pressure (Peak), airway plateau pressure (Plat), respiratory rate (F)], and blood oxygen levels [partial pressure of arterial oxygen (PaO₂), PaO₂/fraction of inspired oxygen (FiO₂)] before and after treatment.

Results: The observation group demonstrated significantly better outcomes compared to the control group in terms of pancreatic edema resolution time, ventilator weaning time, hospital stay, and other indicators (all P<0.05). The 28-day mortality rate in the observation group was significantly lower than in the control group (P<0.05). Post-treatment levels of CC-16, SP-D, Peak, Plat, and other indicators improved significantly in both groups compared to baseline (all P<0.05). The observation group exhibited significantly greater improvements in PaO₂ and PaO₂/FiO₂ compared to the control group (all P<0.05).

Conclusion: CBP combined with antibiotics significantly improves clinical symptoms, reduces inflammatory markers, enhances prognosis, and lowers mortality rates in patients with SAP complicated by ARDS.

Objectives: The study aims to establish a reliable chronic kidney disease (CKD) mouse model by examining the effects of an adenine-containing diet on renal function and pathology. It also explores the impact of CKD on motor function and infarct volume following cerebral infarction and investigates the role of calcium in modulating the AMPK/SIRT1/HIF1-α signaling pathways.

Method: The CKD mouse model was induced through an adenine-enriched diet. Renal function impairment was assessed by analyzing blood samples for creatinine and blood urea nitrogen levels at 0 and 6 weeks. Pathologic changes in renal tissue were examined. The study also evaluated motor function, infarct volume, survival rates, body weight changes, and functional assessments. Additionally, cerebral cortex angiogenesis was assessed in the context of ischemic stroke.

Result: The CKD mouse model showed significant renal tissue alterations, including luminal dilation, glomerular hypertrophy, fibrosis, and inflammatory infiltration. There was a notable reduction in angiogenic markers in the CKD group compared to controls. The study also found increased cerebral calcium levels and altered expression of AMPK, SIRT1, HIF1-α, and VEGF in the CKD group.

Conclusions: The research successfully created the CKD mouse model and emphasized the disease's many effects, including its influence on neurological disorders. The results provide an understanding of the molecular processes behind changes brought on by CKD and may have consequences for angiogenesis and signaling pathway-focused therapeutic approaches.

Objectives: To investigate whether neuroendocrine differentiation (NED) markers, activation of the integrated stress response (ISR), and TRAIL pathway alter neuroendocrine tumor (NET) cell death and ONC201 sensitivity.

Methods: We conducted cell viability assays to determine ONC201 sensitivity. Western blot analysis was performed to evaluate NED, ISR, and TRAIL pathway markers. Expression levels of NED markers were compared between cell lines with and without BRN2 overexpression.

Results: Prostate cancer (PCa) and small cell lung cancer (SCLC) cell lines (N = 6) were sensitive to ONC201. Endogenous NET marker levels varied across PCa and SCLC cells. Transient BRN2 overexpression slightly reduced some NET markers while maintaining the sensitivity of PCa cells to ONC201.

Conclusions: PCa cell lines exhibit sensitivity to ONC201, with variability of NED features. These findings are relevant to the design of future studies evaluating imipridone efficacy in PCa and suggest that non-NET patients could be included in such studies.

Objective: To investigate the relationship between obesity-related indices and target organ damage in hypertension, with the goal of improving damage prevention and treatment strategies.

Methods: This retrospective study included 150 hypertension cases from January 2022 to December 2023 treated at Beijing Ditan Hospital, including 72 cases of isolated hypertension, 48 with hypertension complicated by kidney damage, 47 with hypertension and left ventricular hypertrophy, and 44 with hypertension and carotid atherosclerosis. Clinical indicators and obesity-related indices were collected to analyze their correlation with target organ damage in hypertension.

Results: A Body Shape Index (ABSI) (OR: 1.003 [1.001-1.913], P=0.007), BMI (OR: 1.054 [1.005-1.694], P=0.023), and BRI (OR: 0.562 [0.287-0.934], P=0.034) were independently associated with hypertensive kidney damage. Age (OR: 1.037 [1.000-1.635], P=0.034), ABSI (OR: 0.901 [0.882-0.998], P=0.034), and blood pressure grading (OR: 1.473 [1.175-1.845], P=0.002) were independent risk factors for hypertensive left ventricular hypertrophy. ABSI (OR: 1.012 [1.001-1.623], P=0.032) and smoking history (OR: 0.892 [0.781-0.998], P=0.021) were independent risk factors for hypertensive carotid artery plaque formation.

Conclusion: ABSI is an independent risk factor for target organ damage in hypertension.

Objective: To translate and adapt the Oxford Arthroplasty Early Recovery Score into Chinese, creating an assessment tool suitable for the early postoperative recovery of patients undergoing Joint arthroplasty.

Methods: By adopting the convenience sampling method, 200 patients who had undergone hip arthroplasty at The Affiliated Hospital of North Sichuan Medical College between February 2022 and February 2023, with a two-week follow-up, were selected as the research subjects. Clinical and disease-related data were collected, and a preliminarily analysis was conducted to identify factors influencing early postoperative recovery.

Results: A total of 200 questionnaires were distributed, and all were retrieved, with no invalid questionnaires excluded, resulting in an effective response rate of 100%. The total score of the early postoperative recovery quality of patients averaged (-2.49±12.32) points, the average score of pain sensation was (0.86±5.16) points, the average physical function was (-3.72±4.07) points, and the average psychosocial status was (-2.00±5.02) points. Statistical analysis showed that gender (P=0.004), age (P<0.0001), per capita monthly household income (P<0.0001), course of disease (P<0.0001), and BMI (P=0.006) had a significant effect on early postoperative recovery.

Conclusion: The Chinese version of the OARS scale has good reliability and validity, making it a useful tool for assessing limb function recovery and physical symptom perception in the early postoperative stage for patients undergoing joint arthroplasty.