American journal of translational research最新文献

Objective: To investigate the clinical efficacy of dexmedetomidine preemptive analgesia in patients undergoing mastectomy.

Methods: A retrospective study was conducted, including 236 patients who underwent breast tumor resection. Of these, 131 patients in the control group received routine postoperative intravenous patient-controlled analgesia, while 105 patients in the preemptive analgesia group received dexmedetomidine preemptive analgesia during surgery. Visual analog scale (VAS) scores, Ramsay sedation scores, clinical efficacy, pain mediator levels, renal function indices, immune function indices, and adverse effects were statistically analyzed.

Results: The preemptive analgesia group had lower VAS scores and Ramsay scores postoperatively (both P < 0.05). The success rate of analgesia was significantly higher in the preemptive analgesia group compared to the control group (84.8% vs. 74.0%, P < 0.05). After surgery, the levels of pain mediators, including prostaglandin E2 (PGE2), substance P (SP), and neuropeptide Y (NPY), initially increased and then decreased, with lower levels observed in the preemptive analgesia group (all P < 0.05). Renal function indices, including creatinine (Cr), blood urea nitrogen (BUN), and neutrophil gelatinase-associated lipocalin (NGAL), showed a similar trend, with lower levels in the preemptive analgesia group (all P < 0.05). Immune function markers, such as CD3+, CD4+, CD8+, and CD4/CD8+ ratios, demonstrated smaller changes in the preemptive analgesia group compared to the control group (all P < 0.05). The total adverse reaction rate was lower in the preemptive analgesia group (P < 0.05).

Conclusion: Dexmedetomidine preemptive analgesia demonstrates significant clinical benefits in patients undergoing breast tumor resection, including better analgesic efficacy, reduced pain mediator and renal function index levels, improved immune function preservation, and fewer adverse reactions.

Objective: To develop a nomogram to predict the risk of portal vein tumor thrombosis (PVTT) in hepatocellular carcinoma (HCC) patients.

Methods: Patients diagnosed with HCC at Hunan Provincial People's Hospital between January 2010 and January 2022 were enrolled. Data on demographic characteristics, comorbidities, and laboratory tests were collected. Multivariate logistic regression was used to identify independent risk factors for PVTT, which were then incorporated into a predictive nomogram. The nomogram's discriminative ability was evaluated using the area under the receiver operating characteristic (AUC) curve. Clinical utility was assessed through decision curve analysis (DCA).

Results: Being male (OR 1.991, 95% CI 1.314-3.017, P = 0.001), Barcelona Clinic Liver Cancer (BCLC) staging (stage C: OR 8.043, 95% CI 4.334-14.926, P<0.001; stage D: OR 7.977, 95% CI 3.532-18.017, P<0.001), tumor size >5 cm (OR 1.792, 95% CI 1.116-2.876, P = 0.016), and D-dimer (OR 1.126, 95% CI 1.083-1.171, P<0.001) were identified as independent risk factors for PVTT. The nomogram formula is: Logit = -2.8961 + 0.6586 (male) + BCLC staging (-0.1922 for B, 1.9251 for C, or 1.7938 for D) + 0.5418 (tumor size >5 cm) + 0.1051 DDi. The nomogram achieved an AUC of 0.798 (95% CI 0.774-0.822) in the training set and 0.822 (95% CI 0.782-0.862) in the validation set. Sensitivities were 86.6% and 90.7%, while specificies were 68.2% and 71.8% in the training and validation sets, respectively, demonstrating strong discrimination and predictive accuracy. DCA indicated a favorable risk threshold probability.

Conclusion: A nomogram incorporating male sex, BCLC staging, tumor size, and D-dimer demonstrated good predictive performance for PVTT. This tool may aid in the early comprehensive assessment of PVTT risk in HCC patients.

Proteinase-activated receptor-2 (PAR2) is closely linked to tumor malignancy, but its biological role in cancer remains underexplored. In this study, we assessed PAR2 expression in lung adenocarcinoma (LUAD) and normal lung tissues, analyzed associations between clinicopathological features and survival rates, and confirmed that PAR2 promotes apoptosis resistance and reduces cisplatin-induced cytotoxicity in lung cancer cells. Using TCGA datasets, western blotting, qPCR, and immunohistochemistry (IHC), we observed a significant increase in PAR2 levels in LUAD samples compared to normal tissues (P<0.05), with high PAR2 expression correlating with poor differentiation and lymphatic invasion (P<0.05). Upregulated PAR2 was associated with reduced survival. Additionally, PAR2 inhibition increased the BAX/BCL-2 axis and contributed to cisplatin-induced endoplasmic reticulum stress and apoptosis in H1299 cells. However, PAR2 inhibition reduced cisplatin-induced ATF4 expression. Overall, PAR2 upregulation is strongly associated with poor postoperative survival, differentiation, and lymphatic metastasis in LUAD and modulates cisplatin cytotoxicity.

Objectives: To retrospectively investigate the effect of a mobile app-based self-care diary, a nursing management method, on post-heart transplantation diabetes.

Methods: A retrospective analysis was conducted on the general data of 87 patients who underwent heart transplantation in the Cardiac and Thoracic Vascular Surgery Department of Nanjing First Hospital between January 2018 and December 2023. Based on the nursing method, the patients were divided into a control group that received routine nursing measures (n=47 cases) and an observation group that implemented a mobile APP-based self-care diary combined with nursing (n=40 cases). Blood glucose indicators and generic quality of life inventory-74 (GQOLI-74) scores were compared between the two groups three months post-surgery.

Results: Three months after hospital discharge, the observation group showed significantly higher values in the largest amplitude of glycemic excursions (LAGE) and the variation coefficient of fasting plasma glucose (CV-FPG) as well as the general quality of life inventory (GQOLI-74) score compared to the control group (all P<0.01).

Conclusions: Using a mobile APP-based self-care diary in combination with nursing methods can effectively stabilize blood glucose levels and improve the life quality in post-heart transplantation diabetic patients, demonstrating significant clinical value.

Objective: To explore the application and the clinical value of metagenomic sequencing in system evaluation of potential kidney donors, along with donor-derived infection in kidney transplantation.

Methods: A prospective study was conducted on 40 voluntary renal donors in Ningbo Urology and Kidney Disease hospital from January 2021 to August 2023. The results of donor pathogen fed back by metagenomic sequencing were analyzed to understand the clinical significance of metagenomic sequencing in donor evaluation.

Results: (1) Detection rate of pathogens. The probability of pathogens detected by traditional laboratories and metagenomic sequencing was 72.50% and 90.00%, respectively. Compared with traditional laboratory tests, metagenomic sequencing detected significantly more pathogens (P < 0.05). The percentage of co-infection of multiple pathogens detected by traditional laboratory tests (31.03%) in donors was significantly lower than that detected by metagenomic sequencing (88.89%) (P < 0.001). Traditional laboratory tests detected bacteria in 20 donors and fungi in 9 donors, but its performance on detecting viruses and mycoplasmas was limited. Metagenomic sequencing detected bacteria in 30 donors, fungi in 12 donors, viruses in 9 donors, and mycoplasmas in 9 donors. The positive rates of bacteria, viruses and mycoplasmas detected by metagenomic sequencing were significantly higher than those detected by traditional laboratory tests (P < 0.05). (2) Predictive value. The sensitivity, specificity, positive predictive value, and negative predictive value of metagenomic sequencing were 97.30%, 100.00%, 100% and 75.00%, respectively, while those of traditional laboratory tests were 78.39%, 100.00%, 100.00% and 27.27%, respectively. (3) The diagnostic efficiency of metagenomic sequencing was superior to that of traditional laboratory tests. (4) Time needed for result feedback. From specimen collection to the result feedback given to the clinician, the time required for traditional laboratory tests was longer than that for metagenomic sequencing, with significant differences (P < 0.001). In addition, the required time for traditional laboratory tests in detecting bacterial positivity was longer than that for metagenomic sequencing, with a statistically significant difference (P < 0.001).

Conclusion: This study probes into the application of metagenomic sequencing in the evaluation of donor pathogens, especially in negative samples detected by traditional laboratory tests. Our findings suggest that metagenomic sequencing can improve the sensitivity and specificity of diagnosis, increase the detection rate of pathogens, and minimize the turnover time.

Objective: To investigate the clinical efficacy of comprehensive treatment focusing on transarterial chemoembolization (TACE) for postoperative liver metastasis in patients with gastric cancer and analyze the factors influencing prognosis.

Methods: A retrospective study was conducted on 116 patients who developed liver metastasis after gastric cancer surgery and were admitted to Gansu Provincial Cancer Hospital between January 2018 and February 2020. The observation group, consisting of 62 patients, received TACE with fluorouracil (FU) + irinotecan (CPT-11) + oxaliplatin (OXA) and moderate lipiodol embolization. The control group, consisting of 54 patients, received systemic S-1 and Oxaliplatin regimen (SOX) alone. The clinical efficacy and incidence of adverse reactions were compared between the two groups. Liver function indicators, tumor markers, and immunoglobulin changes were analyzed in both groups. The 2-year survival rate of patients was analyzed using the Kaplan-Meier (K-M) curve. Lasso-Cox regression was used to identify independent prognostic factors affecting the 2-year survival rate. A Nomogram model was constructed to predict outcomes.

Results: The overall clinical efficacy (P = 0.001) and objective response rate (ORR) (P = 0.001) were significantly lower in the control group compared to the observation group. No significant differences were found in ALT and AST changes between the two groups (P > 0.05). Post-treatment, CEA and CA19-9 levels were significantly lower, and IgG and IgM levels were significantly higher in the observation group (P < 0.001). There was no significant difference in the incidence of adverse reactions (P > 0.05). Lasso-Cox regression identified treatment plan, pathological differentiation, degree of liver metastasis, and pre-treatment CEA as independent prognostic factors for 2-year survival. Based on these, a Nomogram model was constructed. In the training group, the model had AUC values over 0.8 for 1- and 2-year survival rates, and in the validation group, the AUC was 0.765 and 0.687, respectively, indicating good predictive performance.

Conclusion: Compared to the conventional SOX regimen, comprehensive treatment focusing on TACE embolization for postoperative liver metastasis in gastric cancer is more effective and can improve survival rates.

Objective: To evaluate the efficacy of double filtration plasmapheresis combined with immunosuppressive agents in the treatment of severe lupus nephritis.

Method: A retrospective analysis was conducted on the medical records of 102 cases of severe lupus nephritis treated between January 2021 and December 2022 in the General Practice Department at the Affiliated Hospital of North Sichuan Medical College. Patients who received immunosuppressive agents were included in the control group and those who received additional double filtration plasmapheresis were included in the observation group. Changes in liver and kidney function indicators, immune function indicators, disease activity, peripheral blood immunoglobulins, total albumin levels, gamma globulin levels, erythrocyte sedimentation rates (ESR), and inflammatory marker levels, and overall clinical efficacy were compared between the two groups.

Results: After therapy, kidney function indicators in the observation group were lower than in the control group, while serum albumin (Alb), total albumin level, complement component 3 (C3) and C4 levels were higher (all P<0.05). Anti-double-stranded DNA antibody (ds-DNA) and white blood cell (WBC) counts in the observation group were also lower than those in the control group. Additionally, the systemic lupus erythematosus disease activity index (SLEDAI) scores, the levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP), and ESR were lower in the observation group than those in the control group (all P<0.05). The total clinical effective rate was higher in the observation group than in the control group (P<0.05).

Conclusion: The combination of immunosuppressive agents with double filtration plasmapheresis in patients with severe lupus nephritis can significantly improve liver and kidney function, enhance immune function, and reduce inflammation, demonstrating good therapeutic effects and safety.

Background: Liver Hepatocellular Carcinoma (LIHC) is a prevalent and aggressive liver cancer with limited therapeutic options. Identifying key genes involved in LIHC can enhance our understanding of its molecular mechanisms and aid in the development of targeted therapies. This study aims to identify differentially expressed genes (DEGs) and key hub genes in LIHC using bioinformatics approaches and experimental validation.

Method: We analyzed two LIHC-related datasets, GSE84598 and GSE19665, from the Gene Expression Omnibus (GEO) database to identify DEGs. Differential expression analysis was performed using the limma package in R to identify DEGs between cancerous and non-cancerous liver tissues. A Protein-Protein Interaction (PPI) network was constructed using STRING to determine key hub genes. Further validation of these hub genes was conducted through UALCAN, OncoDB, and the Human Protein Atlas (HPA) databases for mRNA and protein expression levels. Promoter methylation and mutational analyses were performed using cBioPortal. Kaplan-Meier survival analysis assessed the impact of hub gene expression on patient survival. Correlations with immune cell abundance and drug sensitivity were explored using GSCA. Finally, AURKA was knocked down in HepG2 cells, and cell proliferation, colony formation, and wound healing assays were performed.

Results: Analysis identified 180 DEGs, with four key hub genes, including AURKA, BUB1B, CCNA2, and PTTG1 showing significant overexpression and hypomethylation in LIHC tissues. AURKA knockdown in HepG2 cells led to decreased cell proliferation, reduced colony formation, and impaired wound healing, confirming its role in LIHC progression. These hub genes were also hypomethylated and their elevated expression correlated with poor overall survival.

Conclusion: AURKA, BUB1B, CCNA2, and PTTG1 are crucial for LIHC pathogenesis and may serve as potential biomarkers or therapeutic targets. Our findings provide new insights into LIHC mechanisms and suggest promising avenues for future research and therapeutic development.

Objectives: To analyze the efficacy and influencing factors of percutaneous transhepatic cholangiography and biliary drainage (PTCD) in patients with malignant obstructive jaundice (MOJ).

Methods: The study included 151 MOJ patients admitted from January 2021 to January 2024. Seventy patients in the control group received endoscopic retrograde cholangiopancreatography (ERCP), while 81 patients in the research group underwent PTCD. Clinical outcomes, including surgical success rate, efficacy (overall remission, high- and low-level intestinal obstruction remission), safety (bile leakage, septicemia, hemobilia, pancreatitis, and gastrointestinal bleeding), and clinical-related indicators (hospital stay, surgical cost, treatment cost), as well as serum biochemical markers (alanine aminotransferase [ALT], direct bilirubin [DBIL], and total bilirubin [TBIL]), were compared between the groups. Binary logistic regression was used to identify factors influencing PTCD efficacy.

Results: The surgical success rate was significantly higher in the research group than that in the control group (P < 0.05). Although the overall remission rates were similar between the groups (P > 0.05), the research group had a lower low-level intestinal obstruction remission rate and a higher high-level intestinal obstruction remission rate (P < 0.05). Safety profiles and changes in pre- and post-operative serum biochemical markers did not differ significantly between the groups (all P > 0.05). The research group experienced longer hospital stays and lower surgical costs compared to the control group (both P < 0.05), while treatment costs were similar (P > 0.05). Binary logistic regression identified obstruction site, and preoperative liver dysfunction as factors influencing PTCD efficacy.

Conclusions: PTCD demonstrated a higher surgical success rate than ERCP in MOJ patients, with comparable overall efficacy, safety, and treatment costs. PTCD was associated with longer hospital stays and lower surgical costs. Both procedures similarly improved ALT, DBIL, and TBIL levels. PTCD showed the greatest therapeutic benefit in cases of high-level intestinal obstruction.