American journal of translational research最新文献

Objective: To explore the diagnostic value of nanopore sequencing technology for detecting nontuberculous mycobacterial pulmonary disease (NTM-PD) in bronchial alveolar lavage fluid (BALF).

Methods: A retrospective analysis was conducted on 83 patients with suspected NTM-PD admitted to Anhui Chest Hospital from January 2021 to November 2023. All patients underwent bronchoscopic examination, and BALF samples were collected for smear acid-fast staining, mycobacterial culture, and nanopore sequencing. The diagnostic efficiencies of these three methods were compared.

Results: Among these patients, 27 were diagnosed with NTM-PD, 43 with pulmonary tuberculosis (PTB), and 13 with other lung diseases (OLD). The sensitivity, specificity, positive and negative predictive value of nanopore sequencing for diagnosing NTM-PD were 88.9%, 87.5%, 77.4%, and 94.2%, respectively. Nanopore sequencing demonstrated significantly higher sensitivity than smear and culture methods. The area under the receiver operating characteristic (ROC) curve (AUC) for nanopore sequencing was 0.882, significantly higher than that of smear (0.547) and culture (0.658), with P values less than 0.05.

Conclusion: Nanopore sequencing technology has high diagnostic efficiency for NTM-PD and can directly identify bacterial species, but specificity issues should be considered in clinical application.

Objective: To observe the therapeutic effect of Sacubitril Valsartan sodium tablets (SVST) on heart failure (HF) complicated by pulmonary infection (PI), and to provide a reference for future medication.

Methods: A total of 89 patients with HF complicated by PI who were treated at Dongying People's Hospital from January 2019 to May 2020 were selected as study subjects in this retrospective study. The control group consisted of 41 patients who received conventional treatment, while the study group included 48 patients who received SVST in addition to conventional treatment. The time to disappearance/improvement of chest tightness, shortness of breath, cough, and moist rales in both groups were recorded. The levels of brain natriuretic peptide (BNP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and procalcitonin (PCT) were measured before and after treatment. Changes in cardiac function were observed, and the Clinical Pulmonary Infection Score (CPIS) and Sequential Organ Failure Assessment (SOFA) were used to assess PI. The clinical efficacy and adverse reactions were evaluated after treatment. Follow-up lasted 2 years, during which the readmission rate due to HF and mortality rate were calculated.

Results: Patients in the study group experienced a shorter time to disappearance/improvement of chest tightness, shortness of breath, cough, and moist rales compared to the control group (all P<0.05). The study group also showed reduced levels of BNP, IL-6, TNF-α, and PCT, as well as lower CPIS and SOFA scores after treatment (all P<0.05), with significantly improved cardiac function (P<0.05). Additionally, the total effective rate was higher in the study group than in the control group (P<0.05), and there was no significant difference in adverse reactions between the two groups (P>0.05). Follow-up revealed no difference in mortality between the two groups (P>0.05), but the study group had a lower readmission rate (P<0.05).

Conclusion: SVST is effective in treating HF complicated by PI, ensures a good prognosis for patients, and is recommended for clinical use.

Objective: To evaluate the efficacy and safety of semaglutide combined with metformin in treating type 2 diabetes mellitus (T2DM) patients who are overweight or obese.

Methods: We conducted a comprehensive search across multiple databases including Wanfang, CNKI, Chinese Biomedical Literature, VIP, Embase, PubMed, Cochrane Library, and Web of Science. Studies were screened to include randomized controlled trials (RCTs) comparing semaglutide combined with metformin versus metformin alone in T2DM patients with obesity or who are overweight. Primary outcomes included glycemic efficacy and body mass index (BMI). Secondary endpoints included pancreatic function, blood lipids, and incidence of adverse effects. Pooled and sensitivity analyses were performed, and risk of bias was assessed.

Results: Ten studies met the inclusion criteria, all involving oral semaglutide. Compared with placebo, semaglutide with metformin significantly reduced fasting blood glucose (SMD: -0.94; 95% CI: -1.53 to -0.35) and 2-hour postprandial glucose (SMD: -0.97; 95% CI: -1.44 to -1.50; P<0.0001). It also lowered HbA1c levels (SMD: -1.13; 95% CI: -1.85 to -0.42; P<0.001) and BMI (SMD: -1.08; 95% CI: -1.47 to -0.69). Improvements were also noted in HOMA-IR and blood lipid levels. However, there were no significant differences in the incidence of adverse reactions, such as hypoglycemia, gastrointestinal reactions, and dizziness and headache between the two groups (all P>0.05).

Conclusion: Treatment with semaglutide combined with metformin significantly improved glycemic control, insulin resistance, weight, BMI, and lipid profiles in patients with T2DM who are overweight or obese.

Objective: To compare the postoperative pain experienced by elderly patients with unstable trochanteric fractures treated with proximal femoral nail anti-rotation (PFNA) and InterTan Nail, focusing on identifying differences among this demographic.

Methods: A total of 40 elderly patients (age >80 years old) underwent treatment with either the PFNA Nail or InterTan Nail. Observational metrics included the Visual Analogue Scale (VAS) for pain, changes in implant position via X-ray, blood loss, fixation failures, and Harris Hip Scores (HHS) to assess complications and hip function at various time points.

Results: The study included 26 patients in the PFNA Nail group (Group A) and 26 patients in the InterTan Nail group (Group B). No significant differences were found in the main observational indicators between the two groups (all P>0.05). Both groups showed significant improvement in HHS post-surgery (all P<0.05). However, early post-operative pain scores were lower in the Group B (3.65±1.2) compared to Group A (5.5±0.9) (P<0.001).

Conclusions: Despite different implant materials being used, outcomes in both groups were consistent and reliable among elderly patients. No significant differences were observed in terms of postoperative functional recovery, mortality, or complications between the groups. Notably, in the early postoperative period (3 days postoperatively), the Group B demonstrated significantly superior pain scores.

Objective: To evaluate the effect of paclitaxel and cisplatin (TP regimen) combined with intraperitoneal hyperthermic perfusion chemotherapy on immune function and quality of life in patients with advanced ovarian cancer.

Methods: This retrospective study involved 107 patients with advanced ovarian cancer who were treated in Baoji Central Hospital between March 2016 and March 2020. The control group was treated with the TP regimen alone (n=48), while the observation group received additional intraperitoneal heat infusion chemotherapy containing 60 mg of cisplatin on the 8th day following the final chemotherapy (n=59). Immunoglobulin (IgG, IgA, IgM) levels, quality of life, tumor marker levels, incidence of adverse effects, and 3-year survival were compared between the two groups. Besides, factors affecting patients' prognosis were detected by unifactorial and multifactorial analyses.

Results: Before treatment, there was no significant difference between the two groups in terms of IgG, IgA, and IgM levels (all P>0.05). After treatment, the observation group showed significantly higher levels of IgG, IgA, and IgM than those in the control group (all P<0.05). There were no significant differences in pre-treatment Kamofsky (KPS) score, carcinoembryonic antigen (CEA), and carbohydrate antigen 125 (CA125) between the two groups (all P>0.05). However, after treatment, the KPS score was significantly increased in the observation group as compared to pre-treatment or control group (both P<0.05), while CEA and CA125 significantly decreased in the observation group as compared to pre-treatment or control group (all P<0.05). Nevertheless, the incidence of gastrointestinal reactions in the observation group was higher than that in the control group (P<0.05). The survival rate of the observation group was significantly higher than that of the control group (P<0.05). The AUC of post-treatment IgG for predicting 3-year survival of patients was 0.743. The 3-year survival rate of patients with IgG≥10.950 g/L was significantly higher than that of patients with IgG<10.950 g/L (P<0.05). Multifactorial Cox regression analysis revealed that higher FIGO stage, presence of ascites, higher post-treatment IgG level, and higher post-treatment CEA and CA125 levels were independent risk factors for patients' 3-year mortality.

Conclusion: TP regimen combined with intraperitoneal hyperthermic perfusion chemotherapy significantly improves immune function and quality of life in patients with advanced ovarian cancer, although it increases the incidence of gastrointestinal reactions. Higher FIGO stage, presence of ascites, higher IgG after treatment, higher CEA, and higher CA125 were independent risk factors for patients' 3-year mortality.

This comprehensive meta-analysis investigated the effects of Rapid Maxillary Expansion (RME) on external root resorption, which is a prevalent orthodontic treatment intended to correct transverse maxillary deficiency and constricted dental arches. By conducting a systematic literature search across prominent electronic databases, including the Cochrane Library, EMBASE, LILACS, MEDLINE, PubMed, and Web of Science, the study compiled evidence until April 2023. A spectrum of search terms was utilized to capture diverse aspects of root resorption, RME, palatal expansion methods, and tooth erosion. Registered with INPLASY (202430057), the meta-analysis meticulously screened 11 studies that fulfilled stringent inclusion criteria. The quality of these studies was assessed using the Cochrane Bias Risk Assessment Tool for Randomized Controlled Trials (RCTs) and the Methodological Index for Non-Randomized Studies (MINORS) for other research designs. The collective analyses disclosed a substantial impact of RME on external root resorption, indicating that the treatment may induce pronounced root erosion. Subgroup analyses further elucidated distinct patterns in root resorption among various types of RME, underscoring the variability in treatment outcomes and the need for personalized care. Consequently, the meta-analysis unequivocally confirmed that external root resorption may be a concerning consequence of RME treatment, necessitating thorough monitoring and management strategies to mitigate potential adverse effects on dental health.

Objectives: To identify the determinants of quality of life (QoL) among early-stage upper gastrointestinal cancer (UGIC) patients in Nanchong City to inform the development of targeted treatment plans.

Methods: In this retrospective study, 642 patients diagnosed with UGIC were included. A phenomenological approach was employed, involving in-depth face-to-face interviews to explore patients' real-life experiences with QoL, with an emphasis on spiritual and psychological aspects. Data analysis followed Colaizzi's seven-step method. Statistical analyses included one-way Analysis of Variance (ANOVA), t-tests, binary logistic regression, and Pearson correlation tests.

Results: QoL was significantly reduced in patients with early-stage GI cancer (P<0.001), with prevalent symptoms of anxiety and depression necessitating focused psychological interventions and enhanced medical care. Influential factors on QoL included income, health insurance coverage, illness duration, and levels of anxiety and depression (P<0.001). A strong negative correlation was observed between QoL scores and both the Hamilton Anxiety Scale (r=-0.7808, P<0.001) and the Hamilton Depression Rating Scale (r=-0.7493, P<0.001).

Conclusion: This study underscores the substantial impact of anxiety and depression on the QoL of patients with early-stage UGIC. The findings provide a theoretical basis for implementing comprehensive long-term care strategies.

Objective: Kidney-tonifying formulas are frequently used in clinical practices to enhance follicular development and maturation. This research explored the impacts of the Bushen Tiaojing formula (BSTJF) on the development of mouse preantral follicles in vitro and its relationship with granulosa cells and gonadotropins.

Methods: Preantral follicles were extracted from mice and cultured with or without serum from rats that were previously treated with or without BSTJF. During cultivation, the follicles were monitored for morphological changes and developmental maturation. Exhausted medium was collected every other day for the measurement of progesterone and estradiol (E₂) levels by ELISA. Granulosa cells in in-vitro medium were collected on days 8, 10, and 12 and analyzed for determining the expressions of apoptosis-associated genes (Bax, Bcl-2, and Caspase-3). Propagation and apoptosis rates of collected granulosa cells were measured by CCK-8 assay and flow cytometry.

Results: Compared with control follicles, follicles cultured with serum from BSTJF-treated rats had a higher survival rate, larger follicle diameter, higher Bcl-2 expression, and lower Bax and Caspase-3 expressions (all P ≤ 0.05). In addition, their granulosa cells presented substantially elevated proliferation (P ≤ 0.05) and a lower rate of apoptosis (P ≤ 0.05) compared with granulosa cells from control follicles. The level of E₂ in the culture media of all groups increased slowly in the first 6 days. Subsequently, after formation of the antrum, the levels of E₂ and progesterone were enhanced in the medium of follicles cultured with serum from BSTJF-treated rats compared with those in the media of control follicles (all P ≤ 0.05).

Conclusion: Serum from BSTJF-treated rats facilitated the in vitro development and maturation of mouse follicles by increasing the expression of anti-apoptotic gene Bcl-2, reducing the expressions of pro-apoptotic genes Bax and Caspase-3 as well as the apoptosis of granulosa cells, promoting the proliferation of granulosa cells and increasing the secretion of E₂ and progesterone in the cells.

Objective: To understand the discharge planning needs of family caregivers for the elderly with nasal feeding.

Methods: From May to August in 2021, in-depth interviews were conducted with eleven family caregivers for elderly patients with nasal feeding at a tertiary hospital in Shenzhen. The interviews were analyzed using phenomenological research methods and the Knowledge, Awareness, and Practice (KAP) theory to identify and refine key themes.

Results: The discharge planning needs of family caregivers for elderly with nasal feeding can be summarized into three themes: ① Learning needs related to nasal feeding knowledge and discharge planning (Knowledge), ② Factors affecting the family caregivers of elderly with nasal feeding (Awareness), and ③ Practical needs in caregiving (Practice).

Conclusion: Discharge planning for family caregivers of elderly individuals receiving nasal feeding should focus on the accurate assessment of tube placement and patient condition, operational skills, emergency response, and complication management. Medical professionals should evaluate these needs to develop personalized discharge readiness service plans, ensuring the quality of care for elderly patients with nasal feeding at home.