American journal of translational research最新文献

Background: While standard therapeutic regimens for Kawasaki disease (KD) in children have exhibited some efficacy, they remain far from ideal. Thus, the pursuit of alternative or improved treatment modalities remis clinically critical.

Objective: This study primarily aimed to assess the effect of dipyridamole (DIP) plus human intravenous immunoglobulin (IVIG) and aspirin (ASP) as to efficacy, antiplatelet aggregation factors, and inflammatory markers in children with KD.

Methods: A total of 95 pediatric KD patients were selected from February 2021 to July 2024, with 44 cases in the control group treated with IVIG + ASP and 51 cases in the research group given DIP in addition to IVIG + ASP. The efficacy, symptom resolution time (defervescence, limb swelling, mucosal congestion, and cervical lymphadenopathy), coronary artery injury, coagulation function (thrombin time [TT], prothrombin time [PT], and activated partial thromboplastin time [APTT]), antiplatelet aggregation factors (erythrocyte sedimentation rate [ESR], white blood cell count [WBC], and platelet count [PLT]), and inflammatory factors (C-reactive protein [CRP], and tumor necrosis factor-α [TNF-α], interleukin-6 [IL-6]) levels were compared between the two groups.

Results: The research group exhibited a higher overall treatment efficacy rate, shorter symptom resolution times, and a significantly lower incidence of coronary artery injury compared to the control group. No significant differences were observed between the two groups or before and after treatment within the same group in coagulation function indices. Markedly reduced levels of anti-platelet aggregation factors and inflammatory markers were observed in the research group versus those in the control group.

Conclusion: DIP in combination with IVIG and ASP significantly enhances treatment efficacy and improves levels of antiplatelet aggregation factors and inflammatory markers in children with KD.

Objective: To evaluate the diagnostic performance of lipoprotein A (LP(a)) and high-sensitivity C-reactive protein (hs-CRP) combined assay for coronary heart disease (CHD) and their association with the severity of coronary lesions.

Methods: This retrospective study included 106 patients who underwent coronary angiography (CAG) due to thoracic distress at Xi'an International Medical Center Hospital from June 2020 to October 2021. The patients were categorized into two groups: the CHD group (n=67) and the non-CHD group (n=39). Subgroup analysis was performed within the CHD group based on the Gensini score. Serum levels of LP(a) and hs-CRP were compared between the groups and subgroups, and their correlations with the Gensini score were analyzed. The diagnostic performance of LP(a), hs-CRP, and their combined assay for detecting CHD was evaluated using receiver operating characteristic (ROC) curve analysis.

Results: Serum levels of LP(a) and hs-CRP were significantly higher in the CHD group than those in the non-CHD group (P<0.001). Within the CHD subgroups, both LP(a) and hs-CRP levels were significantly elevated in the moderate and high Gensini score groups compared to the low Gensini score group (P<0.001). There was a positive correlation between LP(a) and hs-CRP levels with the Gensini score (r=0.288, P=0.003; r=0.276, P=0.004). The area under the ROC curve (AUC) for the combination of LP(a) and hs-CRP (0.924, 95% CI: 0.865-0.983) was significantly greater than that for LP(a) (0.858, 95% CI: 0.783-0.933) or hs-CRP (0.854, 95% CI: 0.772-0.936) alone (P<0.05).

Conclusion: Elevated serum levels of LP(a) and hs-CRP are associated with CHD and correlate with the severity of coronary lesions. The LP(a) and hs-CRP combined assay improves the diagnostic performance for CHD, suggesting potential clinical value.

Purpose: To investigate the predictive value of physiological capacity and surgical stress scores for perioperative complications in radical resection for colorectal cancer (CRC).

Methods: A retrospective case-control study was performed from October 2021 to October 2023 at a single center, involving patients scheduled for radical resection of CRC. Patients were divided into groups with and without perioperative complications, and a propensity score matching was performed to minimize potential bias from clinical confounding variables. General patient data, including demographic information, comorbidities, tumor characteristics, surgical parameters, postoperative recovery, and Estimation of Physiologic Ability and Surgical Stress (E-PASS) scores, were collected and analyzed.

Results: After propensity score matching, factors such as age, diabetes, pulmonary disease, heart disease, and American Society of Anesthesiologists (ASA) grade remained significant predictors for complications (P < 0.05). Prolonged operation, increased blood loss, specific surgery types, and emergent surgeries were linked to a higher risk of perioperative complications (all P < 0.05). Patients with complications experienced longer postoperative hospital stays, increased adjuvant chemotherapy use, and lower quality of life scores (all P < 0.05). Perioperative risk score (PRS), surgical stress score (SSS), and composite risk score (CRS) were positively correlated with the incidence of perioperative complications (all P < 0.001). The AUC values for PRS, SSS, and CRS were 0.848, 0.854, and 0.882 respectively, indicating moderate to high predictive value for perioperative complications.

Conclusion: Physiological capacity and surgical stress scores, age, comorbidities, surgical parameters, postoperative recovery, and the E-PASS scores emerged as key predictive factors for perioperative complications in radical resection for CRC.

Dilated cardiomyopathy (DCM) is a complex heart condition marked by genetic mutations, myocardial dysfunction, and progressive heart failure. N6-methyladenosine (m⁶A) methylation, a key epigenetic modification, plays a crucial role in DCM by regulating gene expression in various pathologic processes, including cardiomyocyte death, inflammation, fibrosis, and mitochondrial dysfunction. m⁶A modifications influence cardiomyocyte survival by modulating apoptosis, necroptosis, ferroptosis, and autophagy-related genes, balancing cellular death and survival pathways. Additionally, m⁶A-driven regulation of inflammation and fibrosis contributes to immune microenvironment stability and extracellular matrix remodeling, affecting fibroblast activation and myocardial stiffness. Mitochondrial health, vital for cardiomyocyte energy demands, is also regulated by m⁶A methylation. Enzymes like methyltransferase-like (METTL) 3 and METTL14 promote mitophagy-related gene expression, while fat mass and obesity-associated protein modulates calcium homeostasis, mitigating oxidative stress and energy imbalances. Targeting m⁶A-related enzymes with small molecules, gene editing, or RNA interference (RNAi) offers potential for tailored DCM therapy. Emerging technologies, such as nanopore m⁶A-modified mRNA detection, reveal new insight into cardiomyocyte metabolism, suggesting novel therapeutic avenues. This review underscores m⁶A methylation as a pivotal epigenetic mechanism of DCM, providing a basis for advanced diagnosis and therapy.

Objective: This study aims to investigate the correlation between lung function and sarcopenia in elderly patients with chronic obstructive pulmonary disease (COPD) and to analyze the factors influencing sarcopenia. The goal is to provide evidence for comprehensive management of COPD patients.

Methods: A total of 294 elderly COPD patients admitted to Lanzhou City No. 1 People's Hospital from March 2022 to March 2024 were selected as study subjects. The patients were divided into a training group (n=205) and a validation group (n=89) in a 7:3 ratio. Lung function was assessed through pulmonary function tests, and sarcopenia was defined by evaluating muscle mass and muscle quality using bioelectrical impedance analysis. Based on the diagnostic criteria for sarcopenia, patients were categorized into a sarcopenia group (n=113) and a non-sarcopenia group (n=181). Basic information, lifestyle habits, and medical history were collected to analyze the correlation between lung function and sarcopenia, as well as influencing factors. Additionally, logistic regression analysis was conducted to identify independent risk factors, and a nomogram model was developed for risk prediction.

Results: Multivariate logistic regression analysis revealed that age (P<0.001, OR=0.053), weight (P=0.032, OR=3.321), Cys-C (P=0.018, OR=0.283), Hb (P=0.001, OR=7.014), FVC (P=0.04, OR=3.605), FEV1 (P=0.001, OR=9.674), and CAT score (P<0.001, OR=0.085) were independent risk factors for sarcopenia in COPD patients. The nomogram model based on these independent risk factors demonstrated good predictive performance for sarcopenia in elderly COPD patients. ROC curve analysis showed that the area under the curve (AUC) of the nomogram model was 0.886 (95% CI: 0.819-0.932) in the training group and 0.809 (95% CI: 0.726-0.883) in the validation group, indicating a high predictive accuracy. Additionally, ROC curve analysis showed that the AUCs for age, BMI, and FEV1/FVC in diagnosing sarcopenia in elderly COPD patients were 0.710 (95% CI: 0.747-0.863), 0.647 (95% CI: 0.766-0.878), and 0.682 (95% CI: 0.701-0.833), respectively. Gene Set Enrichment Analysis (GSEA) revealed that pathways significantly enriched in the high Cys-C expression group included oxidative phosphorylation, fatty acid biosynthesis, the AMPK signaling pathway, the HIF-1 signaling pathway, and glycolysis/gluconeogenesis pathways, which may play important roles in energy metabolism and muscle function regulation in sarcopenic patients.

Conclusion: Lung function decline in elderly COPD patients is closely associated with the occurrence of sarcopenia. Increasing age is an independent risk factor for sarcopenia in COPD patients, while higher BMI and FEV1/FVC are protective factors. The nomogram model based on these independent risk factors can effectively predict sarcopenia in elderly COPD patients.

Objective: To establish and evaluate a rat model of cervical spondylosis (CS) with yin deficiency syndrome.

Methods: Thirty-six male Sprague-Dawley rats were randomly assigned to the control group, CS group, and CS with Yin deficiency syndrome (YCS) group (n = 12 per group). The control group underwent daily routine care for 37 days. The CS group underwent induction of cervical static-dynamic imbalance, followed by 30 days of standard care. The YCS group underwent cervical static-dynamic imbalance induction, followed by 7 days of sleep deprivation to model Yin deficiency cervical spondylosis. Behavioral performance, heart rate, blood pressure, mechanical pain thresholds, serum cAMP, cGMP, cAMP/cGMP levels, and the expression of collagen-II, Bcl-2, Bax, and Bcl-2/Bax in cervical intervertebral discs were analyzed at various time points.

Results: Following CS induction, modeled rats exhibited significant changes in intervertebral disc structure, including misalignment of the annulus fibrosus, atrophy of the nucleus pulposus, rough cartilaginous endplate boundaries, and disc degeneration. Mechanical pain thresholds decreased. In the YCS group, compared with the CS and control groups, rats showed heightened excitability, dull fur, reddish mouth, lips, nose, paws, and tail, resistance to handling, slower weight gain, initial heart rate elevation followed by decline, and progressive blood pressure reduction. Serum cAMP and cAMP/cGMP ratios were significantly elevated, while cGMP levels were reduced. Collagen-II, Bcl-2, and Bcl-2/Bax levels decreased, and Bax levels increased.

Conclusion: The established rat model of Yin deficiency syndrome aligns with clinical and traditional Chinese medicine characteristics, making it a promising model for studying Yin deficiency syndrome.

Objective: To investigate the effects of subanesthetic doses of esketamine on serum inflammatory cytokine levels and its impact on postoperative cognition and pain in patients undergoing elective orthopedic surgery.

Methods: From November 2023 to March 2024, patients scheduled for elective orthopedic surgery were randomly divided into an observation group or a control group, with 100 patients in each group (ChiCTR2300079156). The observation group received an intravenous injection of 0.25 mg/kg esketamine before the induction of general anesthesia, while the control group was administered an equivalent volume of normal saline. Postoperative measurements included serum levels of interleukin-6 (IL-6), interleukin-1 (IL-1), and interleukin-10 (IL-10), as well as immunoglobulin levels (IgM and IgG), complete blood count (including white blood cell count, hemoglobin, and platelet count), intraoperative blood loss, cognitive function scores (assessed using the Mini-Mental State Examination [MMSE]), postoperative pain scores, and the incidence of adverse reactions (including nausea, vomiting, headache, dizziness, hallucinations, agitation, allergic reactions, and cardiovascular and respiratory responses).

Results: Postoperatively, serum levels of IL-6 and IL-1 in the observation group were significantly lower than those in the control group (P<0.05), while IL-10 levels were significantly higher (P<0.05). The control group showed a significant decrease in immunoglobulin levels (IgM and IgG) after surgery, whereas the observation group exhibited higher postoperative immunoglobulin levels compared to control group. In terms of complete blood count, the observation group had significantly better white blood cell and platelet counts compared to the control group (P<0.05), with no significant difference in hemoglobin levels. Intraoperative blood loss was significantly lower in the observation group (P<0.05). Cognitive function, as measured by the MMSE scores, was significantly better in the observation group compared to the control group at 6 and 24 hours postoperatively (P<0.05). Additionally, the observation group had significantly lower pain scores at 6 and 24 hours postoperatively and a lower incidence of adverse reactions.

Conclusion: Subanesthetic doses of esketamine in elective orthopedic surgery can effectively reduce postoperative inflammatory cytokine levels, improve immunoglobulin levels, reduce intraoperative blood loss, protect postoperative cognitive function, and significantly decrease the incidence of postoperative pain and adverse reactions. These findings suggest that subanesthetic dosing of esketamine has a high level of safety and efficacy in this clinical setting.

Objective: To evaluate the efficacy of nasal high-flow humidified oxygen therapy (HFHO) in improving oxygenation and respiratory function.

Methods: This retrospective analysis included 193 patients with Stanford Type B aortic dissection and hypoxemia admitted to Xingtai People's Hospital from January 2020 to January 2023. Patients were divided into two groups: HFHO (n = 107) and conventional oxygen therapy (CO, n = 125). The primary endpoints included changes in the oxygenation index (PaO₂/FiO₂), respiratory parameters, and Radiological Atelectasis Score (RAS). Secondary outcomes included re-intubation rates, ICU length of stay, and overall hospital stay duration.

Results: Baseline demographic and disease characteristics were similar between groups (all P > 0.05). The HFHO group displayed a significant improvement in PaO₂/FiO₂ post-treatment (225.55 ± 3.28 mmHg) compared to the CO group (224.56 ± 2.31 mmHg; P = 0.010). The HFHO group also had a significantly lower respiratory rate (24.71 ± 0.89 bpm; P = 0.038) and higher SpO₂ (90.92% ± 0.93%; P < 0.001) post-treatment. Additionally, HFHO was associated with a lower re-intubation rate (6.54% vs 17.6%; P = 0.011) and shorter ICU (3.88 ± 0.63 days; P = 0.023) and hospital stays (10.57 ± 0.6 days; P = 0.004). The RAS significantly improved in the HFHO group by days 3-5 post-operation (1.17 ± 0.3; P = 0.008).

Conclusion: HFHO offers superior outcomes in oxygenation and respiratory function compared to conventional oxygen therapy in patients with Stanford Type B aortic dissection and hypoxemia.

Objectives: Clinical studies suggest that Chinese Tuina therapy may benefit diabetic peripheral neuropathy (DPN), but the evidence is inconclusive. This study evaluates its clinical efficacy and safety for DPN treatment.

Methods: Ten databases were searched, covering the period from their inception to February 21, 2024. Relevant data were extracted from studies meeting the inclusion criteria, and a meta-analysis was conducted using RevMan 5.3 software.

Results: A total of 24 randomized controlled trials (RCTs) involving 1,989 participants were included in the study. The meta-analysis results showed that, compared to a control group, the Chinese Tuina therapy group demonstrated a higher overall clinical efficacy rate and improved Toronto Clinical Scoring System (TCSS) scores, indicating that Chinese Tuina may provide benefits beyond conventional treatment. Furthermore, improvements were observed in the motor and sensory nerve conduction velocities (MNCV and SNCV) of certain specific nerves, such as the common peroneal nerve, sural nerve, and ulnar nerve. Although the differences in MNCV and SNCV of the tibial and median nerves were not statistically significant, the overall improvement in clinical outcome supports the conclusion that Chinese Tuina is superior to conventional treatment.

Conclusion: Chinese Tuina therapy is a safe and effective treatment option for DPN. It can alleviate clinical symptoms and improve the MNCV of the common peroneal nerve as well as the SNCV of the sural and ulnar nerves. Its efficacy in the tibial and median nerves remains unconfirmed, highlighting a need for future large-scale, high-quality RCTs.