American journal of translational research最新文献

Objective: To investigate the clinical efficacy of warm reinforcing acupuncture (WRA) combined with whole-body vibration training (WBVT) on knee joint function and inflammatory factors in patients with stroke complicated by knee osteoarthritis (KOA).

Methods: A retrospective study was conducted on 207 patients with stroke complicated by KOA admitted to our hospital between March 2023 and March 2025. A total of 93 patients received WRA combined with WBVT and routine treatment (observation group); the remaining 114 patients received only routine treatment (control group). Baseline characteristics, clinical efficacy, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, Lysholm Knee Scoring Scale (LKSS) scores, Visual Analog Scale (VAS) pain scores, Barthel Index (BI) scores, and serum inflammatory factor levels (C-reactive protein [CRP], tumor necrosis factor-α [TNF-α], and interleukin-6 [IL-6]) were compared between the two groups.

Results: After treatment, the observation group showed significantly greater improvement than the control group in WOMAC score (pain, stiffness, daily living function), LKSS score, VAS score, and BI score (all P<0.001). The observation group also had lower serum CRP, TNF-α, and IL-6 levels (all P<0.001). The total effective rate in the observation group was 92.47%, while it was 80.40% in the control group (x ²=5.89, P=0.015).

Conclusion: The combination of WRA and WBVT can significantly improve knee joint function, relieve pain, improve self-care ability, and inhibit inflammatory responses in stroke patients with KOA. This combined treatment offers a new approach for the rehabilitation of stroke patients with KOA.

Objectives: This research explored the connection between serum exosomal miR-21 expression and the risk of gastric cancer (GC), and evaluated the viability of using this non-invasive marker for early GC diagnosis.

Methods: A retrospective evaluation was performed on 539 individuals who had received serum exosomal miR-21 testing. Based on diagnoses within 12 months, patients were categorized into a GC group (n=235) and a non-GC group (n=304). To measure the levels of exosomal miR-21, we used the technique of reverse transcription quantitative polymerase chain reaction (RT-qPCR).

Results: The GC group had significantly higher body mass index (BMI), rates of manual labor, smoking, drinking, high-salt/pickled diet, chronic gastritis, Helicobacter pylori (Hp) infection, and family history of GC (all P<0.05). The laboratory findings indicated that the GC group exhibited significantly higher levels of white blood cell count, platelet count, alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen, creatinine, carcinoembryonic antigen, carbohydrate antigen (CA) 19-9, CA 72-4, and serum exosomal miR-21 levels, but lower levels of hemoglobin, total cholesterol, and triglyceride (all P<0.05). Logistic regression revealed that high miR-21 constitute an independent risk factor for GC (OR=3.477, P<0.001). Receiver operating characteristic for early GC diagnosis showed an area under the curve of 0.772 for miR-21 alone, and a combined model with CA72-4 increased it to 0.927. The high miR-21 group demonstrated a markedly greater GC incidence (P<0.001).

Conclusions: Serum exosomal miR-21 is linked to GC and demonstrates potential as a non-invasive biomarker for early detection, particularly when combined with CA72-4.

Objective: This retrospective research was designed to compare the treatment outcomes of H-type hypertension (HTH) patients treated with Amlodipine Besylate-Folic Acid Tablets (Amlo-FA) vs. Enalapril Maleate-Folic Acid Tablets (Ena-FA).

Methods: This investigation comprised 155 HTH cases. The control group was treated with the Ena-FA regimen, while the observation group received Amlo-FA therapy. Patients' clinical data were comparatively analyzed.

Results: Compared to controls, the observation group demonstrated superior overall treatment effectiveness (90.48% vs. 71.83%, P=0.003). Following treatment, systolic blood pressure (SBP; (129.86±6.24) mmHg vs. (139.66±8.04) mmHg, P<0.001), diastolic blood pressure (DBP; (80.26±7.46) mmHg vs. (89.00±9.68) mmHg, P<0.001), homocysteine (Hcy; (13.06±3.18) μmol/L vs. (19.39±3.37) μmol/L, P<0.001), carotid intima-media thickness (CIMT; (1.11±0.28) mm vs. (1.29±0.27) mm, P<0.001), fasting blood glucose (FPG; (5.74±1.68) mmol/L vs. (6.40±2.02) mmol/L, P=0.028), glycosylated hemoglobin (HbA1c; (5.85±1.85)% vs. (6.93±1.90)%, P<0.001), urinary albumin-to-creatinine ratio (UACR; (53.64±15.44) mg/L vs. (74.17±16.96) mg/L, P<0.001), total cholesterol (TC; (4.92±1.61) mmol/L vs. (6.42±1.63) mmol/L, P<0.001), TG (triglycerides; (1.66±0.72) mmol/L vs. (2.44±0.68) mmol/L, P<0.001), and low-density lipoprotein cholesterol (LDL-C; (2.35±0.70) mmol/L vs. (2.99±0.84) mmol/L, P<0.001) were markedly reduced in the observation cohort relative to the control group outcomes. Conversely, high-density lipoprotein cholesterol (HDL-C; (1.78±0.69) mmol/L vs. (1.47±0.50) mmol/L, P=0.002), Medication Adherence Self-Efficacy Scale (MASES; (89.31±8.87) score vs. (79.70±7.61) score, P<0.001), and the 8-item Morisky Medication Adherence Scale (MMAS-8; 5.00 (3.00, 6.00) score vs. 6.00 (4.00, 7.00) score, P<0.001) scores showed a significant increase under the same comparisons. The overall side effect profile was significantly more favorable in the observation group (5.95% vs. 16.90%, P=0.030). No significant inter-group differences were observed in the incidence of various individual and total adverse cardiovascular and cerebrovascular events (4.76% vs. 12.68%, P>0.05). Finally, comorbid diabetes (B=1.447, OR=4.250, P=0.010) and treatment methods (B=-1.196, OR=0.303, P=0.013) were factors independently influencing patients' curative effects.

Conclusion: Amlo-FA is effective in treating HTH.

Objectives: To investigate the cause-specific mortality patterns in young people (<50 years) diagnosed with prostate cancer (PCa).

Methods: Using the Surveillance, Epidemiology, and End Results (SEER) database, we identified young PCa patients diagnosed between 2000 and 2018. Causes of death were analyzed, and standardized mortality ratios (SMRs) were calculated. An independent clinical cohort (n=200) was used for external validation.

Results: Among 19,352 patients with localized PCa, 1,177 deaths were observed, of which 21.4% were due to pCAs, 22.9% to site-specific malignancies (SMTs), and 55.7% to other non-tumor causes. Colorectal cancer exhibited a significantly reduced mortality risk among SMTs (SMR: 0.67) compared to the general population. Heart disease (SMR: 0.67) was the leading non-cancer cause of death. In 4,445 individuals with regional PCa, 540 deaths were observed, with PCa-specific causes accounting for 54.6%. Lung cancer mortality was significantly reduced (SMR: 0.51). Among 1,070 patients with metastatic PCa, 769 deaths were recorded, with 87.6% attributed to PCa. This stage-specific mortality pattern was consistently validated in the independent clinical cohort.

Conclusions: Cause-specific mortality among young PCa patients varies substantially by disease stage at diagnosis. Non-PCa causes predominate in patients with localized disease, whereas PCa remains the principal cause of death in metastatic cases.

Objective: To investigate the effects of Shuangshen Ningxin Capsules (SSNX) on myocardial function in patients with diabetic cardiomyopathy (DCM) and its underlying mechanism.

Methods: A streptozotocin (STZ)-induced DCM model was established in C57BL/6J mice. The mice were administered low or high doses of SSNX (90 mg/kg/d or 180 mg/kg/d). Cardiac function was evaluated by echocardiographic parameters, H&E staining, Masson staining, and TUNEL assays. Transcriptomics analysis and Western blotting analysis were performed to explore potential molecular mechanisms. An in vitro high glucose (35 mmol/L)-induced DCM cell model was also established. Cells were treated with SSNX (40 μg/mL or 80 μg/mL) alone or in combination with the ferroptosis activator erastin (10 μM) or the NRF2 inhibitor ML385 (20 μM). Biochemical assays, EdU staining, and Western blotting were performed to investigate the effects of SSNX on cell proliferation, ferroptosis, and the NRF2/HO-1 pathway in DCM cells.

Results: SSNX significantly improved cardiac dysfunction and attenuated cardiomyocyte hypertrophy, myocardial fibrosis, and apoptosis in DCM mice. Transcriptomics analysis revealed that after SSNX intervention, 16 originally upregulated genes were downregulated, while 33 originally downregulated genes were upregulated. These differentially expressed genes (DEGs) were associated with ferroptosis-related pathways. In vitro experiments showed that SSNX inhibited ferroptosis in the myocardium of DCM mice through activating the NRF2/HO-1 signaling pathway. Moreover, SSNX significantly reversed high glucose-induced suppression of the proliferation of cardiomyocytes, inhibition of the NRF2/HO-1 signaling pathway, and induction of ferroptosis.

Conclusion: SSNX alleviates myocardial injury in DCM mice, and the mechanism underlying the effect of SSNX may involve activation of the NRF2/HO-1 signaling pathway to inhibit ferroptosis.

Objective: To elucidate the oncogenic role and molecular pathways associated with long non-coding RNA ZBTB46-AS1 (lncRNA ZBTB46-AS1) in ovarian cancer (OC) progression.

Methods: Bioinformatics analyses of the Gene Expression Omnibus (GEO) and The Cancer Genome Atlas (TCGA) databases were used to assess ZBTB46-AS1 expression and prognostic value. Quantitative real-time polymerase chain reaction (qRT-PCR) verified its expression in 22 pairs of OC and adjacent normal tissues, as well as OC cell lines. In vitro functional assays [Cell Counting Kit-8 (CCK8), colony formation, Transwell] and in vivo models [xenograft, lung metastasis] were performed to evaluate the effects of ZBTB46-AS1 knockdown. RNA pull-down, RNA immunoprecipitation (RIP), dual-luciferase reporter, and co-immunoprecipitation (Co-IP) assays clarified its interaction with TATA-box-binding protein-associated factor 6 (TAF6) and tumor suppressor protein p53.

Results: ZBTB46-AS1 was significantly upregulated in OC tissues and cell lines, correlating with poor overall survival (OS) of patients. Stable knockdown of ZBTB46-AS1 inhibited the proliferation, colony formation, and epithelial-mesenchymal transition (EMT) of OC cells in vitro, as well as tumor growth and distant metastasis in vivo. Mechanistically, ZBTB46-AS1 directly interacted with TAF6, which attenuated the binding between TAF6 and p53, suppressed p53 transcriptional activity, and consequently downregulated the expression of p21. Notably, co-silencing of ZBTB46-AS1 and p53 effectively reversed the inhibitory effects induced by ZBTB46-AS1 knockdown on OC cell malignant phenotypes.

Conclusion: ZBTB46-AS1 promotes OC progression via the TAF6-p53 axis, serving as a potential prognostic marker and therapeutic target.

Objective: To explore the feasibility of establishing an auxiliary diagnostic model for secondary pulmonary bacterial infection in influenza using routine indicators from fever clinics.

Methods: A retrospective analysis of 510 influenza cases (divided into modeling and validation sets in a 7:3 ratio) was conducted, with an additional 72 cases selected for external validation. Logistic regression was adopted as the traditional diagnostic model, while two machine learning models (decision tree and random forest) were constructed using R4.2.3 software. The diagnostic performance of each model was evaluated using multiple indicators, including accuracy, sensitivity, specificity, positive predictive value, negative predictive value, receiver operating characteristic curve, and area under the curve (AUC).

Results: Among the 357 influenza patients in the modeling set, 101 developed secondary pulmonary bacterial infection, while 256 did not. Multivariate logistic regression analysis showed that age, white blood cell count, C-reactive protein, serum amyloid A, creatine kinase isoenzyme, and D-dimer were independent risk factors for secondary pulmonary bacterial infection (all P<0.05). In the modeling set, validation set, and external validation set, the machine learning model generally outperformed the logistic regression model in all diagnostic performance metrics. The random forest model performed exceptionally well on all three datasets, with AUC values of 0.951, 0.902, and 0.852, respectively.

Conclusion: In auxiliary diagnostic models constructed based on routine fever clinic testing indicators, machine learning models, especially the random forest model, demonstrate high diagnostic accuracy and good generalization ability for influenza-related secondary pulmonary bacterial infection.

Objective: To evaluate the anesthetic effects of esketamine and remimazolam across different age groups, optimizing personalized anesthesia strategies.

Methods: This retrospective study analyzed 264 surgical patients (esketamine n = 135, remimazolam n = 129) stratified by age (adults n = 141, children n = 123). Seventeen key perioperative parameters were assessed. Two-way analysis of variance (ANOVA) was performed to examine drug-specific, population-dependent, and interaction effects, while point-biserial correlation analysis was employed to assess relationships between parameters.

Results: Remimazolam demonstrated superior pharmacokinetic profiles, with a shorter time to sedation target, shorter recovery time, and lower dosage requirements compared to esketamine (all P < 0.001). However, it was associated with more pronounced respiratory depression, a higher incidence of intraoperative body movements, and hemodynamic suppression. Conversely, esketamine provided greater hemodynamic stability, minimal respiratory impact, and a significantly lower incidence of postoperative restlessness (P < 0.001). Pediatric patients showed a higher incidence of postoperative nausea and vomiting (PONV) with both agents. Significant drug-population interactions (P < 0.05) were observed for sedation onset, respiratory depression, and recovery time.

Conclusion: Remimazolam offers faster onset and recovery but carries higher cardiorespiratory risks. Esketamine provides superior hemodynamic stability and is associated with less restlessness. The anesthetic effects show significant age-dependent variations, necessitating individualized drug selection based on patient age, physiological status, and surgical type.

Objective: To evaluate the effectiveness of a bundled management intervention for infection prevention, antibiotic use optimization, and clinical and economic outcomes for patients with multidrug-resistant bacterial infections.

Methods: This retrospective study included 130 patients with multidrug-resistant bacterial infections. Data on knowledge awareness, hand hygiene compliance, infection incidence, clinical outcomes, antibiotic use, hospital stay, and costs were collected through questionnaires, observations, and medical records to evaluate the intervention's effectiveness.

Results: The bundled management intervention significantly improved knowledge awareness, hand hygiene compliance, and adherence to infection control practices among patients, caregivers, and healthcare staff. It reduced MDR infection rates (3.07% vs. 15.38%), mortality (3.08% vs. 12.31%), and antibiotic overuse while lowering hospital costs and treatment duration compared to standard care (P < 0.05).

Conclusion: The bundled management approach effectively enhanced infection prevention, optimized antibiotic use, improved clinical outcomes, and reduced healthcare costs, offering a robust strategy for managing MDR bacterial infections.

Objective: To elucidate the analgesic role and underlying mechanism of botulinum toxin type A (BTX-A) in chronic post-thoracotomy pain (CPTP).

Methods: Postoperative wound scar tissues were collected from patients with and without CPTP. Histopathologic changes were evaluated using hematoxylin-eosin (H&E) staining, and the expression levels of high mobility group box 1 (HMGB1), Toll-like receptor 4 (TLR4), interleukin-10 (IL-10), and tumor necrosis factor-α (TNF-α) were assessed. Spinal microglia were cultured in vitro to establish a cell model of CPTP. The activated microglial cells were then treated with BTX-A to evaluate its effects on substance P (SP)-induced microglia activation, HMGB1 expression, TLR4/NF-κB pathway, and inflammatory cytokine (TNF-α and IL-10) secretion. Additionally, microglia were transfected with an HMGB1 lentiviral vector to assess the regulatory role of HMGB1 on TLR4/NF-κB signaling, microglial activation, cytokine release, and the inhibitory effects of BTX-A.

Results: H&E staining showed strong inflammatory cell infiltration and upregulated expression of HMGB1, TLR4, IL-10, and TNF-α in tissues from the CPTP group (P < 0.05). Transfection with HMGB1 lentiviral vector significantly increased the expression levels of TLR4, p-P65, and p-IκB-α in microglial cells, enhanced cell proliferation, and promoted IL-10 and TNF-α secretion. TLR4/NF-κB pathway activation positively regulated microglial activation and TNF-α and IL-10 expression. Moreover, HMGB1 overexpression attenuated the inhibitory effects of BTX-A on microglial activation.

Conclusions: BTX-A may alleviate post-thoracotomy pain by downregulating the HMGB1/TLR4/NF-κB pathway, thereby reducing the secretion of inflammatory factors and inhibiting microglial activation.