American journal of translational research最新文献

Background: Immune checkpoint inhibitors (ICIs) have significantly enhanced the clinical outcomes for cancer patients. Nevertheless, they may be associated with the occurrence of ICI-associated thyroid dysfunction (ICI-TD). This study aimed to assess the risk of thyroid dysfunction in patients receiving ICI therapy.

Methods: We systematically searched the PubMed, Embase, and Cochrane Library databases for phase II/III randomized controlled trials (RCTs) evaluating the use of ICIs in malignant tumors. The statistical analyses were conducted using Stata (version 17), and the risk of bias was assessed using Review Manager (version 5.4).

Results: In total, 40 RCTs encompassing 12,376 patients were included. A higher relative risk (RR) of all-grade hyperthyroidism (RR = 9.91, 95% CI: 5.80-16.94; P < 0.01) was observed compared to hypothyroidism (RR = 7.70, 95% CI: 4.88-12.17; P < 0.01). Subgroup analyses indicated that combination ICI therapy was associated with a significantly higher incidence of ICI-TD than monotherapy. Among combination regimens, the PD-L1 combined with CTLA-4 group showed the highest risk of hypothyroidism (RR = 20.87, 95% CI: 5.07-85.81; P < 0.001), whereas the PD-1 combined with CTLA-4 group exhibited the highest risk of hyperthyroidism (RR = 17.34, 95% CI: 3.88-77.45; P < 0.001).

Conclusion: ICI-associated hyperthyroidism was found to occur more frequently than hypothyroidism. Moreover, combination therapies significantly increased the incidence of ICI-TD.

Objective: To investigate the relationship between oxidative stress (OS) and clinical outcome in patients with rotator cuff injury (RCI).

Methods: Eighty-two surgically treated RCI patients (May 2022-February 2025) were enrolled in this retrospective study. All participants underwent arthroscopic rotator cuff repair and were further grouped into a good prognosis group (n=39) or a poor prognosis group (n=43) based on the University of California, Los Angeles (UCLA) Shoulder Rating Scale (UCLA ≥29 vs. UCLA <29). Relevant clinical details like age, sex, tear area, disease duration, injury pattern, and UCLA scores, were collected. Serum samples were tested pre- and postoperatively for the quantification of OS biomarkers: reactive oxygen species (ROS), malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione peroxidase (GPx). Pearson correlation analysis was used to evaluate the association between OS biomarkers and UCLA scores. Receiver operating characteristic (ROC) curve analysis was used to assess their predictive value for clinical outcomes. Prognostic determinants were identified using univariate and multivariate logistic regression analyses.

Results: ROS and MDA concentrations were markedly elevated in poor-prognosis patients compared to favorable-prognosis individuals, whereas SOD and GPx activities were reduced. Surgical intervention significantly elevated the levels of SOD and GPx, and reduced the levels of ROS and MDA. Correlation analyses linked higher UCLA scores to elevated ROS/MDA levels and reduced SOD/GPx activity. ROC curve analysis showed that the predictive accuracy (area under the curve [AUC]) for individual OS biomarkers ranged from 0.750-0.810, which was markedly improved (AUC=0.939) when used in combination. Univariate and multivariate logistic regression analysis further identified ROS, MDA, SOD, and GPx as independent factors influencing clinical prognoses in RCI patients.

Conclusion: OS levels can serve as a key determinant of clinical outcome in RCI patients.

Aim: To evaluate the efficacy and safety of combining Linggui Bafa Tui Na with Fuxiong San in the treatment of pediatric Mycoplasma pneumonia (MP).

Methods: This retrospective study included 110 children diagnosed with MP at the East Campus of Zhengzhou Children's Hospital between January 2022 and January 2025. Participants were divided into two groups according to treatment regimen: the control group (n = 54) received Linggui Bafa Tui Na alone, while the observation group (n = 56) received combined Linggui Bafa Tui Na and Fuxiong San pasting therapy. Primary outcomes included clinical cure rate, pulmonary function parameters (forced expiratory volume in one second [FEV₁], forced vital capacity [FVC], and peak expiratory flow [PEF]), and inflammatory biomarkers (white blood cell [WBC] count, neutrophil count, C-reactive protein, and procalcitonin [PCT]). Secondary outcomes comprised immunoglobulin levels (immunoglobulin A [IgA], IgM, IgG), symptom duration, and adverse effects. Multivariate regression was used to analyze the effects of treatment type and weight on clinical outcomes.

Results: Compared with the control group, the observation group showed greater reductions in inflammatory markers - WBC count (8.5 ± 1.2 → 6.3 ± 0.9, P < 0.001), neutrophil count (4.2 ± 0.8 → 2.9 ± 0.6, P < 0.001), and PCT (0.98 ± 0.12 → 0.47 ± 0.08, P < 0.001) - and more pronounced improvements in pulmonary - FEV₁ (75.3 ± 12.4 → 88.7 ± 10.3, P < 0.001), FVC (72.1 ± 13.8 → 85.6 ± 11.2, P < 0.001), and PEF (210.4 ± 45.7 → 270.5 ± 41.2, P < 0.001). The clinical cure rate was significantly higher in the observation group (85.7% vs. 59.3%, P < 0.001), with fewer adverse effects (23.2% vs. 61.1%, P < 0.001).

Conclusion: The combination of Linggui Bafa Tui Na and Fuxiong San pasting therapy provides superior efficacy and safety over Linggui Bafa Tui Na alone for pediatric MP, improving clinical outcomes and reducing adverse effects.

Objective: This study sought to comprehensively assess the impact of aerobic exercise on cognitive performance and depressive symptoms in individuals diagnosed with depression, in order to provide a more comprehensive evidence base for the clinic.

Methods: PubMed, Embase, Web of Science, Cochrane Library, CNKI, Wanfang Data, and SinoMed were searched for randomized controlled trials (RCTs) published up to June 2025. Eligible studies included clinically diagnosed patients with depression receiving aerobic exercise as the intervention. Meta-analyses were conducted using RevMan 5.4. Standardized mean differences (SMD) were pooled as effect sizes. Heterogeneity was assessed using the I² statistic. The Cochrane Risk of Bias 1.0 tool was used to assess methodological quality.

Results: A total of 17 RCTs were included. According to the results of the meta-analysis, aerobic exercise was associated with marked enhancements in working memory (Digit Span Backward, SMD = 0.16, P = 0.05) and executive function (Trail Making Test-B, SMD = -0.29, P = 0.03) in patients with depression. Notably, as comprehensive cognitive assessment tools, the Montreal Cognitive Assessment and the Mini-Mental State Examination demonstrated significant effects of aerobic exercise (SMD = 1.68, P = 0.0003). Regarding depressive symptoms, significant improvement was found with the Hamilton Depression Rating Scale (SMD = -0.87, P = 0.04). Additionally, four studies reported unique single-scale outcomes suggesting potential trends toward improvement in both cognitive and emotional domains.

Conclusion: Engagement in aerobic exercise appears to support improvements in executive function and working memory among patients with depression, though its impact on other cognitive domains and mood-related outcomes remains inconclusive. These findings should be interpreted with caution.

Objective: To investigate the expression levels, biological functions, and clinical significance of budding uninhibited by benzimidazoles 1 (BUB1) in esophageal squamous cell carcinoma (ESCC).

Methods: A total of 50 pairs of ESCC and adjacent normal tissues were collected for analysis. The human normal esophageal epithelial cell line (Het-1A) and the human esophageal cancer cell line (EC109) were cultured. Cells were transfected with pcDNA 3.1+BUB1 and shRNA-BUB1. The effects of BUB1 on cancer cells were assessed using CCK-8, Transwell migration and invasion assays, real-time quantitative PCR, and Western blot. Immunohistochemical staining was performed to analyze BUB1 expression in cancer tissues. Logistic regression analysis was used to evaluate the association between BUB1 expression and clinicopathological parameters. The predictive value of BUB1 expression for tumor differentiation, lymph node metastasis, and clinical stage was assessed using receiver operating characteristic (ROC) curve analysis.

Results: BUB1 was highly expressed in cancer tissues and cells. Overexpression of BUB1 promoted the proliferation, migration, and invasion of EC109 cells in vitro, while silencing BUB1 inhibited these processes (all P<0.05). The positive expression rate of BUB1 was higher in cancer tissues compared to normal tissues (70% vs. 30%, P<0.05). Logistic regression analysis revealed that BUB1 expression was significantly associated with tumor differentiation, lymph node metastasis, and clinical stage (all P<0.05). ROC curve analysis showed that the area under the curve (AUC) for BUB1 expression predicting tumor differentiation, lymph node metastasis, and clinical stage was 0.762, 0.789, and 0.831, respectively.

Conclusion: BUB1 promotes the proliferation, migration, and invasion of esophageal cancer cells. Increased BUB1 expression is closely associated with tumor differentiation, lymph node metastasis, and clinical stage.

Objectives: Hypertension is a well-established risk factor for cerebral small vessel disease (CSVD) and cognitive impairment. However, the combined effects of demographic, clinical, and vascular factors on cognitive decline in elderly hypertensive patients with CSVD are not fully clarified. In the current study, we aimed to analyze clinical risk factors and cognitive profiles associated with hypertension-related CSVD in older adults.

Methods: We compared hypertensive patients with mild cognitive impairment (MCI), hypertensive patients without MCI, and normotensive controls in 351 cases. Baseline demographics, comorbidities, and medication history were assessed. Logistic regression models were constructed to identify the independent predictors of cognitive impairment. Model performance was evaluated using receiver operating characteristic (ROC) curves, calibration plots, and subgroup analyses stratified by age, sex, and dipping status.

Results: Patients with hypertension and MCI were older, more often female, and exhibited a higher prevalence of diabetes, dyslipidemia, and coronary artery disease compared with controls. Logistic regression identified advanced age, female sex, and non-dipping blood pressure profiles as independent predictors of MCI. The predictive model demonstrated good discrimination and calibration. Subgroup analyses revealed that advanced age, female sex, and nondipping blood pressure patterns were associated with higher cognitive impairment rates.

Conclusions: Our findings suggest that traditional vascular risk factors contribute to cognitive decline in elderly hypertensive patients with CSVD. The proposed model provides a clinically useful tool for risk stratification and early intervention.

Background: Deep second-degree burn wounds lead to infection, significant inflammation, and delayed healing, with sole dressing therapies exhibiting limited efficacy. This study was to investigate the therapeutic effect of Xiangpi Shengji ointment combined with nano-silver medical antibacterial dressing to provide a clinical reference.

Methods: A retrospective analysis was implemented on 115 patients with deep second-degree burns at the First Hospital of Hebei Medical University from February 2023 to August 2025. Patients were rolled into a treatment group (n=59, combination therapy) and a control group (n=56, nano-silver dressing alone). Inflammatory factors, growth factors, infection markers, healing indicators, pain and scar scores, and clinical efficacy were compared between the two groups employing SPSS 20.0 for statistical analysis.

Results: On days 7 and 14, IL-16 was lower in the treatment group than that in the control group, while growth factor EGF was higher from day 14 onward (both P<0.05). The treatment group had a lower bacterial positivity rate, lower incidence of fever, shorter eschar separation time, wound healing time, and hospital stay (all P<0.05). Visual Analogue Scale and VSS scores were greatly lower at all post-treatment time points in the treatment group (both P<0.05). The total effective rate was 91.53% in the treatment group, markedly surpassed 71.43% in the control group (all P<0.05).

Conclusion: The combined regimen can alleviate inflammation, inhibit infection, promote repair, shorten healing time and hospital stay, improve pain and scar outcomes, and enhance therapeutic efficacy, demonstrating value for clinical application.

Objective: To determine the effects of acetylcysteine (NAC) plus bronchoalveolar lavage (BAL) under fiberoptic bronchoscopy (FB) on blood oxygenation and inflammation in elderly severe pneumonia patients.

Methods: The data of 180 elderly patients with severe pneumonia treated in the Affiliated Hospital 2 of Nantong University between January 2022 and January 2024 were analyzed retrospectively. Eighty-six patients were treated with BAL under FB (BAL group) and 94 patients were treated with NAC based on BAL under FB (BAL + NAC group). Outcomes included pre-/post-treatment blood gas, pulmonary function, inflammatory factors, correlation between inflammatory markers and blood gas parameters, clinical efficacy, symptom resolution time, and adverse reactions.

Results: After treatment, both groups exhibited an increase in arterial partial pressure of oxygen (PaO₂), arterial oxygen saturation (SaO₂), forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC) and decreased C-reactive protein (CRP) and interleukin-6 (IL-6), with more significant changes in the BAL + NAC group (all P < 0.05). Inflammatory markers (CRP/IL-6) were negatively correlated with oxygenation parameters (PaO₂/SpO₂, all P < 0.01). Additionally, the BAL + NAC group had earlier resolution time of chest pain, expectoration, cough, and lung rales, a higher overall response rate, and no significant difference in adverse reaction incidence versus the BAL group.

Conclusion: NAC combined with BAL under FB is effective for elderly patients with severe pneumonia. It can strongly improve the blood gas indexes and lung function, relieve inflammatory reactions, and quickly relieve clinical symptoms, without increasing adverse reactions. Thus it is worthy of clinical promotion.

Objective: To explore the effects of multimodal endoluminal interventional technology combined therapy on clinical efficacy, pulmonary vascular resistance (PVR), pulmonary microvessel density (MVD), and long-term prognosis in patients with chronic pulmonary artery stenotic pulmonary hypertension (CPAS-PH).

Methods: This retrospective analysis included 117 CPAS-PH patients (January 2019 - December 2022) who received the combined therapy. They were divided into a control group (n=50) and an observation group (n=67). Baseline data, preoperative and 6-month postoperative PVR, MVD, left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), 6-minute walking distance (6MWD), N-terminal pro-B-type natriuretic peptide (NT-proBNP), and complications were collected. Kaplan-Meier method was used to analyze 2-year survival, Cox regression to identify independent prognostic factors and nomogram and ROC curve to verify diagnostic efficacy.

Results: The observation group had a lower 6-month postoperative PVR, LVEDD, NT-proBNP, adverse reaction rate, and 2-year mortality (all P<0.001), but higher MVD, LVEF, 6MWD, and follow-up duration (all P<0.001) than the control group. Multivariate Cox analysis showed PVR≥5.305 WU (HR=4.324, 95% CI: 1.666-11.221, P=0.003), LVEDD≥56.95 mm (HR=3.632, 95% CI: 1.110-11.887, P=0.033) were prognostic factors. Having MVD≥14.5 (HR=0.279, 95% CI: 0.113-0.685, P=0.005) and LVEF≥39.34% (HR=0.093, 95% CI: 0.024-0.354, P=0.001) were protective factors. The nomogram and ROC curve confirmed good diagnostic efficacy.

Conclusion: Multimodal endoluminal interventional combined therapy effectively reduces PVR, promotes pulmonary microvascular remodeling, and improves cardiac function and exercise tolerance, with favorable long-term prognosis. Postoperative 6-month PVR, MVD, LVEF, and LVEDD are important evaluation indicators.

Objective: To investigate the correlation between thyroid-stimulating hormone (TSH) levels and insulin function indices, including the homeostatic model assessment of insulin resistance (HOMA-IR) and β-cell function (HOMA-ISLET), in patients with type 2 diabetes mellitus (T2DM) complicated by subclinical hypothyroidism (SCH), and to evaluate their diagnostic value for identifying elevated TSH states.

Methods: A total of 384 T2DM patients treated between April 2022 and November 2024 were retrospectively analyzed. Among them, 184 patients with SCH comprised the combined group, and 200 patients with T2DM alone comprised the diabetes group. Demographic data, fasting plasma glucose (FPG), fasting insulin (FINS), and TSH were collected to calculate HOMA-IR and HOMA-ISLET. Inter-group comparisons, correlation analyses, and receiver operating characteristic (ROC) curve analyses were performed.

Results: Compared to the diabetes group, the combined group showed significantly higher TSH, HOMA-IR, and HOMA-ISLET (all P < 0.001). TSH correlated positively with HOMA-IR and negatively with HOMA-ISLET (combined group: r = 0.587 and -0.464; diabetes group: r = 0.334 and -0.545; all P < 0.001). ROC analysis demonstrated favorable diagnostic performance for HOMA-IR (AUC = 0.720 for SCH; 0.892 for elevated TSH) and HOMA-ISLET (AUC = 0.711 for SCH; 0.878 for elevated TSH). HOMA-IR showed stronger discriminative ability than HOMA-ISLET in distinguishing diabetes-only from high TSH states (AUC = 0.928 vs. 0.709).

Conclusions: Elevated TSH levels are closely associated with increased insulin resistance and impaired β-cell function in T2DM. Both HOMA-IR and HOMA-ISLET are valuable diagnostic tools, with HOMA-IR demonstrating superior clinical applicability for detecting T2DM with SCH and elevated TSH states.