American Journal Of Translational Research[JOURNAL]
Sun
200 papers
Application value and safety advantages of remimazolam tosilate in sedation for emergency rescue endotracheal intubation.
Yang D, Chen J, Lin X … +5 more , Wang J, Huang Z, Huang Z, Fang X, Zhang F
Am J Transl Res · 2026 · PMID 42170479 · Full text
OBJECTIVES: Emergency tracheal intubation is a high-risk, life-support procedure that requires rapid and safe sedation. This study aimed to evaluate the clinical effectiveness and safety of remimazolam tosilate compared...
OBJECTIVES: Emergency tracheal intubation is a high-risk, life-support procedure that requires rapid and safe sedation. This study aimed to evaluate the clinical effectiveness and safety of remimazolam tosilate compared to propofol for sedation during emergency resuscitation intubation. METHODS: This retrospective cohort study included adult patients who underwent sedation-assisted emergency intubation between June 2022 and June 2025. Patients were grouped according to the primary sedative administered: propofol or remimazolam. Sedation depth was assessed using the Ramsay score, and intubation success rates were recorded. Hemodynamic indices and respiratory rates were documented pre- and post-intubation. The incidence of adverse events and cognitive function at postoperative 72 hours were also evaluated. RESULTS: A total of 216 patients were included (104 in the propofol group and 112 in the remimazolam group). Propofol demonstrated a faster onset of sedation (42.12 ± 6.63 vs. 95.12 ± 10.17 seconds, P < 0.001), whereas remimazolam achieved a significantly higher first-attempt intubation success rate (87.50% vs. 66.35%, P < 0.001). After intubation, patients in the remimazolam group maintained higher systolic blood pressure (122.20 ± 9.77 vs. 116.42 ± 17.38 mmHg, P=0.003) and mean arterial pressure, as well as a lower rate-pressure product (10395.81 ± 928.89 vs. 10754.15 ± 1168.58 mmHg/min, P=0.014). The remimazolam group also exhibited lower incidences of hypotension (9.82% vs. 20.19%, P=0.032) and respiratory depression (5.36% vs. 17.31%, P=0.005), and experienced less injection pain (5.36% vs. 27.88%, P < 0.001). CONCLUSIONS: In emergency intubation, compared to propofol, remimazolam tosilate demonstrated a slower onset of sedation but offers better hemodynamic stability, higher first-attempt success rates, more favorable respiratory profiles, and improved early cognitive recovery, making it a valuable alternative sedative.
Retrospective analysis of the association between anti-Müllerian hormone levels and metabolism and reproductive outcome across different PCOS phenotypes.
Lu L, Wang Y, Yan J … +1 more , Zhao M
Am J Transl Res · 2026 · PMID 42170478 · Full text
OBJECTIVE: The aim of this study is to explore the relationship between the levels of anti-Müllerian hormone (AMH) and metabolic and reproductive outcomes across different polycystic ovary syndrome (PCOS) phenotypes. MET...
OBJECTIVE: The aim of this study is to explore the relationship between the levels of anti-Müllerian hormone (AMH) and metabolic and reproductive outcomes across different polycystic ovary syndrome (PCOS) phenotypes. METHODS: In this retrospective study, 286 PCOS patients undergoing intrauterine insemination (IUI) were defined into a high AMH group (>7.0 ng/mL, n = 159) and a low AMH group (≤7.0 ng/mL, n = 127) based on the upper normal limit. Serum AMH, basal hormones (testosterone [TESTO], basal follicle-stimulating hormone [bFSH], basal luteinizing hormone [bLH]), and metabolic indicators (triglycerides [TG], total cholesterol, fasting blood glucose, fasting insulin [FINS], homeostasis model assessment of insulin resistance [HOMA-IR]) were measured on menstrual cycle days 2-4. Reproductive outcomes were recorded. RESULTS: The high AMH group had higher prevalence of polycystic ovarian morphology (81.13% vs. 70.08%, P = 0.029) and classic phenotype (35.22% vs. 19.69%, P = 0.004). TESTO (50.82 vs. 45.28 ng/dL, P = 0.002), bLH (8.17 vs. 7.46 IU/L, P = 0.013), TG (0.96 vs. 0.87 mmol/L, P = 0.008), FINS (9.79 vs. 8.86 mIU/L, P = 0.006), and HOMA-IR (2.28 vs. 2.09, P = 0.009) were notably elevated in the high AMH group, as was the rate of early miscarriage (10.06% vs. 2.36%, P = 0.009). A multivariate analysis revealed that high AMH independently increases the risk of early miscarriage (OR = 2.844, P = 0.023). CONCLUSIONS: Elevated AMH is associated with more severe PCOS phenotypes, adverse metabolic profiles, and increased early miscarriage risk, suggesting its utility as a biomarker for stratification and prognosis in PCOS patients.
A preoperative inflammation-oxidative stress imbalance strongly predicts post-traumatic arthritis after acetabular fracture fixation.
Shi C, Wang Z, Dong J … +1 more , Wang K
Am J Transl Res · 2026 · PMID 42170477 · Full text
OBJECTIVE: This study aimed to evaluate the correlation between the development of post-traumatic arthritis (PTA) and a preoperative inflammation and oxidative stress imbalance. Further, the study aimed to evaluate the p...
OBJECTIVE: This study aimed to evaluate the correlation between the development of post-traumatic arthritis (PTA) and a preoperative inflammation and oxidative stress imbalance. Further, the study aimed to evaluate the predictive power of a model based on inflammation and oxidative stress imbalance Index (IOSI). METHODS: This retrospective cohort study was conducted from January 2020 to December 2023 and included 258 patients who underwent open reduction and internal fixation of acetabular fractures (training cohort) and 127 patients from another center (external validation cohort). Blood specimens were collected and analyzed for preoperative and discharge levels of IL-6, TNF-α, MDA, SOD, and IOSI. Multivariate logistic regression was applied to identify independent predictors of PTA. Two predictive models were constructed that were a conventional preoperative indicator prediction model (Risk1) and an IOSI-based model (Risk2). Receiver operating characteristic curves, area under the curve AUC, and net reclassification improvement NRI were used to assess model performance. RESULTS: Post-traumatic arthritis (PTA) occurred in 66/258 patients (25.6%) in the training cohort. Compared with the non-PTA group, patients who developed PTA had significantly higher preoperative IL-6, TNF-α, and malondialdehyde (MDA) levels and lower superoxide dismutase (SOD) levels (all P<0.001), resulting in a markedly increased preoperative inflammation-oxidative stress imbalance index (IOSI) (P<0.001). Multivariate logistic regression identified delayed time from injury to surgery (OR=8.463, 95% CI 4.107-18.436; P<0.001), concomitant femoral head fracture (OR=2.832, 95% CI 1.226-6.672; P=0.015), and preoperative IOSI (OR=23.388, 95% CI 10.107-60.825; P<0.001) as independent predictors of PTA. Preoperative IOSI showed the best discriminative performance among individual indicators (AUC 0.813-0.919; cut-off 1.302; sensitivity 84.85%; specificity 78.12%). The IOSI-based model (Risk2) achieved an AUC of 0.911 in the training cohort and 0.821 in the external validation cohort, outperforming the conventional model (Risk1; AUC 0.879 and 0.700, respectively). In the training cohort, the AUC difference between Risk2 and Risk1 was not significant (DeLong P=0.232), whereas Risk2 showed significantly improved discrimination in external validation (P<0.05) and better reclassification (NRI=0.3565). CONCLUSION: A preoperative inflammation-oxidative stress imbalance could predict PTA after acetabular fracture fixation.
GDF15 predisposes aortic dissection through regulation of vascular smooth muscle cell proliferation and phenotypic change via the ERK/Akt pathway.
Tan Q, Yang Z, Zhang J
Am J Transl Res · 2026 · PMID 42170476 · Full text
OBJECTIVE: Aortic dissection (AD) represents a life-threatening vascular disorder characterized by abnormal vascular smooth muscle cell (VSMC) behavior and extracellular matrix remodeling. Growth differentiation factor 1...
OBJECTIVE: Aortic dissection (AD) represents a life-threatening vascular disorder characterized by abnormal vascular smooth muscle cell (VSMC) behavior and extracellular matrix remodeling. Growth differentiation factor 15 (GDF15) is a stress-related cytokine associated with the pathogenesis of cardiovascular diseases, but its exact role in AD remains to be elucidated. METHODS: Human aortic smooth muscle cells (HASMCs) were incubated with angiotensin II (Ang II) to simulate an in vitro pathological tension environment. Gain- and loss-of-function experiments were carried out to investigate the functional role of GDF15 in regulating cell growth, migration, phenotypic transformation, and inflammatory reaction. The involvement of the ERK/protein kinase B (Akt) pathway was studied using a ERK inhibitor. Clinical significance was analyzed by detecting the plasma levels of GDF15 and matrix metalloproteinases (MMPs) in AD patients and healthy controls. RESULTS: Ang II upregulated GDF15 expression in HASMCs in a dose- and time-dependent manner. GDF15 overexpression promoted HASMC proliferation, migration, and phenotypic switching from a contractile to a synthetic state, accompanied by increased expression of MMP-2 and MMP-9 and pro-inflammatory cytokines (TNF-α, IL-6, and MCP-1). GDF15 knockdown produced opposite effects. Mechanistically, GDF15 activated both ERK and Akt pathways; however, pharmacological inhibition experiments suggested that the pro-remodeling effects of GDF15 were primarily mediated through ERK signaling. Clinically, plasma concentrations of GDF15, MMP-2, and MMP-9 were significantly higher in AD patients compared with healthy controls. CONCLUSIONS: GDF15 promotes aberrant remodeling of HASMCs by enhancing proliferation, migration, phenotypic transformation, and inflammatory responses via ERK-dependent signaling. Elevated plasma GDF15 levels in AD patients suggest that GDF15 can serve as a potential diagnostic biomarker and therapeutic target for AD.
Application of magnetic resonance diffusion tensor imaging for the treatment of hemifacial spasm.
Guo Y, Dong X, Liu M … +1 more , Meng F
Am J Transl Res · 2026 · PMID 42170475 · Full text
OBJECTIVES: To evaluate diffusion tensor imaging (DTI) for assessing facial nerve root exit zone (REZ) microstructure in hemifacial spasm (HFS) and predicting microvascular decompression (MVD) outcomes. METHODS: Data fro...
OBJECTIVES: To evaluate diffusion tensor imaging (DTI) for assessing facial nerve root exit zone (REZ) microstructure in hemifacial spasm (HFS) and predicting microvascular decompression (MVD) outcomes. METHODS: Data from 60 patients with primary unilateral HFS and 30 healthy volunteers were retrospectively examined. High-resolution 3.0T DTI was performed on all participants. DTI data (b=1000 s/mm, 32 directions) were processed using FMRIB Software Library. The fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were derived from the facial nerve REZ. Group comparisons and receiver operating characteristic curve analysis assessed diagnostic performance. Preoperative DTI parameters were also evaluated for predicting MVD outcomes. RESULTS: In HFS, FA on the symptomatic side (0.35±0.06) was significantly lower than that on the contralateral side (0.48±0.05) and controls (0.49±0.04, <0.001). MD and RD were significantly elevated (both <0.001), while AD remained stable. The area under the curve (AUC) for FA in diagnosing HFS was 0.968 (sensitivity 86.00%, specificity 98.00%). Multivariate logistic regression analysis showed that the preoperative FA value was an independent predictor of postoperative outcomes (odds ratio=0.752, =0.005), and the optimal cutoff value for FA was ≤ 0.378 (AUC=0.780). CONCLUSIONS: DTI noninvasively quantifies facial nerve REZ microstructural damage in HFS, characterized by reduced FA and elevated RD. As diagnostic and prognostic biomarkers, FA differentiates pathological compression from asymptomatic contact, supporting clinical decisions.
Synergistic combination of taxifolin and baicalein protects against alloxan-induced diabetic cardiomyopathy by mitigating oxidative stress through the Nrf2/HO-1 signaling pathway.
Liang Q, Wu T, Zhao L
Am J Transl Res · 2026 · PMID 42170474 · Full text
OBJECTIVE: To investigate the cardioprotective effects of taxifolin (TXN) and baicalein (BCN) in an alloxan-induced diabetic rat model. METHODS: Diabetic rats were treated with TXN, BCN, or their combination for 30 days....
OBJECTIVE: To investigate the cardioprotective effects of taxifolin (TXN) and baicalein (BCN) in an alloxan-induced diabetic rat model. METHODS: Diabetic rats were treated with TXN, BCN, or their combination for 30 days. Blood glucose, lipid profile, cardiac enzymes, oxidative stress markers, and gene expression were assessed. Histopathologic and immunohistochemical analyses were performed to evaluate cardiac structure and protein expression. cytotoxicity assays were conducted on H9c2 cardiomyocytes. RESULTS: TXN and BCN significantly reduced blood glucose levels, improved lipid profiles, and decreased oxidative stress in diabetic rats. They also enhanced nuclear factor erythroid 2-related factor 2 (Nrf2) signaling and upregulated antioxidant gene expression. Histologic analysis revealed reduced myocardial damage and fibrosis in treated rats. studies demonstrated no cytotoxicity for TXN and BCN. CONCLUSION: TXN and BCN exhibit cardioprotective effects in diabetic rats by improving glucose metabolism, modulating lipid profiles, and enhancing antioxidant defense through the Nrf2 signaling pathway. These findings suggest that TXN and BCN hold promise as potential therapeutic agents for the prevention and treatment of diabetic cardiomyopathy.
Analysis of pathogen spectrum changes and epidemiological characteristics of superficial mycosis in the Shantou region of China from 2022 to 2024.
Hou B, Hu B, Huang J
Am J Transl Res · 2026 · PMID 42170473 · Full text
OBJECTIVE: The etiological spectrum of superficial mycoses varies regionally. This retrospective study investigated the clinical type composition and pathogen distribution shifts in Shantou from 2022-2024 to inform local...
OBJECTIVE: The etiological spectrum of superficial mycoses varies regionally. This retrospective study investigated the clinical type composition and pathogen distribution shifts in Shantou from 2022-2024 to inform localized diagnosis and treatment. METHODS: A total of 2,635 patients with positive fungal cultures from the Shantou Institute of Dermatology and Venereology were enrolled. Categorical data were compared using Chi-square or Fisher's exact tests; non-normally distributed continuous data were expressed as median (IQR). Advanced visualizations (Sankey diagrams, heatmaps) were generated using Python. P < 0.05 was considered significant. RESULTS: The cohort comprised 1,488 males (56.47%) and 1,147 females (43.53%), with a median age of 31.0 years (IQR: 18.0-48.0). The five most common diagnoses were pityrosporum folliculitis (463, 17.57%), tinea pedis (286, 10.85%), tinea cruris (284, 10.78%), onychomycosis (273, 10.36%), and tinea corporis (243, 9.22%). Predominant pathogens were Malassezia (1,112, 42.20%), yeast-like fungi (784, 29.75%), Trichophyton rubrum (273, 10.36%), and T. mentagrophytes (252, 9.56%). Significant gender differences were observed for tinea cruris, tinea corporis, onychomycosis, and seborrheic dermatitis (all P < 0.05), but not for pityrosporum folliculitis (P = 0.754). Gender-based variations were also significant for Malassezia (P = 0.002) and T. rubrum (P < 0.001). Pathogen distribution differed significantly across age groups (all P < 0.001). CONCLUSIONS: The etiological spectrum in Shantou has shifted, with Malassezia now the leading pathogen. Distinct gender- and age-specific patterns warrant increased clinical vigilance and targeted prevention strategies.
Letrozole yields superior pregnancy outcomes and safety profile compared with clomiphene citrate in intrauterine insemination cycles: a propensity score matching analysis.
Li H, Li J
Am J Transl Res · 2026 · PMID 42170472 · Full text
OBJECTIVE: By using the propensity score matching (PSM) method, this study compared the pregnancy outcomes of two ovulation induction regimens, clomiphene citrate (CC) and letrozole (LE), in intrauterine insemination (IU...
OBJECTIVE: By using the propensity score matching (PSM) method, this study compared the pregnancy outcomes of two ovulation induction regimens, clomiphene citrate (CC) and letrozole (LE), in intrauterine insemination (IUI) cycles. It aimed to evaluate the impact of these regimens on the clinical pregnancy rate, live birth rate, safety, and cost-effectiveness. METHODS: Patients who underwent IUI with CC or LE monotherapy for ovulation induction from May 2024 to August 2025 were included. Baseline data and ovulation induction-associated parameters were retrieved from the electronic medical record system, and confounders were balanced by PSM. The clinical pregnancy rate and live birth rate served as the primary outcome measures of this study, while the biochemical pregnancy rate, implantation rate, OHSS incidence, multifetal gestation rate, and treatment cost constituted the secondary measures. RESULTS: 216 patients (108 each in the CC and LE groups) were included. Higher clinical pregnancy and live birth rates were confirmed in the LE group compared to the CC group (P<0.05). In the LE group, the first-trimester pregnancy rate and the second-trimester pregnancy continuation rate were superior (P<0.05). Concerning the implantation rate, the singleton pregnancy rate was higher and the multifetal gestation rate was lower in the LE group (P<0.05). The LE group also performed better in terms of Estradiol (E) levels on the day of human chorionic gonadotropin (HCG) administration, with an elevated percentage of type A endometrium (P<0.05). CONCLUSIONS: LE shows higher pregnancy efficiency, better endometrial receptivity, and lower risk of multifetal gestation in IUI cycles.
Effects of sacubitril/valsartan combined with ivabradine in treating cardiorenal syndrome.
Li G, Liu H, Zhou S … +1 more , Xiong W
Am J Transl Res · 2026 · PMID 42170471 · Full text
OBJECTIVE: To investigate the effects of sacubitril/valsartan combined with ivabradine in treating cardiorenal syndrome (CRS). METHODS: Information from 120 selected participants was retrospectively analyzed and divided...
OBJECTIVE: To investigate the effects of sacubitril/valsartan combined with ivabradine in treating cardiorenal syndrome (CRS). METHODS: Information from 120 selected participants was retrospectively analyzed and divided into an experimental group (n=60) and a control group (n=60). The control group received sacubitril/valsartan alone, while the experimental group received sacubitril/valsartan plus ivabradine. Clinical efficacy, blood lipids, cardiac and renal function, and oxidative stress were observed in both groups. RESULTS: The experimental group showed better clinical efficacy, lipid metabolism, cardiac function, renal function, and oxidative stress than the control group, and a lower incidence of major adverse cardiovascular events (MACE) (all P<0.05). CONCLUSION: Sacubitril/valsartan combined with ivabradine is effective in treating CRS patients, with superior efficacy across various indicators and its usage has a lower incidence of MACE.
Value of dual-energy CT parameters DER and DEI in predicting calcium-containing urinary stones and differentiating pure calcium oxalate monohydrate.
Hou B, Zheng Q
Am J Transl Res · 2026 · PMID 42170470 · Full text
OBJECTIVE: To investigate the diagnostic value of quantitative parameters (including dual-energy ratio (DER) and dual-energy index (DEI)) from dual-source dual-energy computed tomography (DECT) in predicting calcium-cont...
OBJECTIVE: To investigate the diagnostic value of quantitative parameters (including dual-energy ratio (DER) and dual-energy index (DEI)) from dual-source dual-energy computed tomography (DECT) in predicting calcium-containing urinary stone subtypes and differentiating pure calcium oxalate monohydrate (COM) stones. METHODS: We conducted a retrospective analysis of 311 patients with urinary stones diagnosed between May 2022 and September 2024, including 119 patients with uric acid (UA) stones and 192 patients with non UA calcium-containing stones according to Fourier-transform infrared spectroscopy. All patients underwent DECT, and CT attenuation values were measured on virtual monoenergetic images at 40 keV and 80 keV. Multiple parameters were calculated from these measurements: dual-energy density (DED), DER, DEI, and effective atomic number (Eff-Z). Infrared spectroscopy was used as the gold standard for stone composition analysis. ROC curve analysis was used to test the diagnostic efficacy of CT-based parameters. A confusion matrix was then constructed to comprehensively evaluate diagnostic performance, including sensitivity, specificity, and accuracy. RESULTS: When evaluating the ability of various imaging parameters to differentiate between uric acid stones and calcium-containing stones, Eff-Z demonstrated the strongest discriminative ability, with an AUC of 0.938 and an accuracy of 88.42%. DER and DEI followed closely, with slightly lower diagnostic efficacy but still significant. In the comparison between COM and non-COM stones, after adjusting for orientation, DER (AUC 0.854, accuracy 80.21%) and DEI (AUC 0.760, accuracy 70.31%) still provided effective differential diagnostic criteria. There were statistical differences in DER and DEI measurements (both P<0.001). CONCLUSION: DER, DEI, and Eff-Z from dual-source CT can effectively differentiate between uric acid stones and calcium-containing stones, with Eff-Z being the best indicator. DER and DEI can further help identify pure COM stones, providing value for preoperative non-invasive assessment.
Therapeutic efficacy of combined esmolol and carvedilol treatment for myocardial ischemia in patients with coronary heart disease.
Gao P, He S, Chen W … +4 more , Shan D, Liu R, Li C, Zhai G
Am J Transl Res · 2026 · PMID 42170469 · Full text
OBJECTIVE: To evaluate the effects of esmolol plus carvedilol in treating myocardial ischemia in coronary heart disease (CHD), with a focus on blood pressure (BP), heart rate (HR), and safety. METHODS: A total of 120 pat...
OBJECTIVE: To evaluate the effects of esmolol plus carvedilol in treating myocardial ischemia in coronary heart disease (CHD), with a focus on blood pressure (BP), heart rate (HR), and safety. METHODS: A total of 120 patients with CHD-related myocardial ischemia admitted to our hospital between January 2022 and January 2023 were enrolled. Among them, 60 patients were treated with carvedilol monotherapy (control group), and the other 60 cases received esmolol in combination with carvedilol (research group). Therapeutic efficacy, BP, HR, premature beat counts, dynamic electrocardiogram parameters (duration and frequency of ST-segment depression), cardiac function indicators (left ventricular end-diastolic dimension [LVEDD], left ventricular posterior wall thickness [LVPWT], left ventricular septal thickness [LVST], left ventricular ejection fraction [LVEF]), and biochemical indicators (N-terminal pro-B-type natriuretic peptide [NT-proBNP], superoxide dismutase [SOD]) were assessed. Safety profiles, including nausea and vomiting, hypotension, and drowsiness, were recorded. Furthermore, factors influencing therapeutic efficacy were analyzed. RESULTS: Compared with the control group, patients in the research group exhibited significantly lower BP (systolic: (105.27±7.72) mmHg vs. (113.78±11.46) mmHg; diastolic: (64.98±4.81) mmHg vs. (71.35±7.76) mmHg and HR (67.90±5.63) bpm vs. (85.67±7.35) bpm). In addition, post-treatment premature beat counts (premature ventricular contraction count: (71.15±26.02) times/24 h vs. (253.67±78.62) times/24 h; premature atrial contraction count: (105.35±41.38) times/24 h vs. (279.53±59.30) times/24 h; junctional premature contraction count: (73.85±30.65) times/24 h vs. (153.58±40.07) times/24 h) were notably reduced in the research group. The duration ((22.90±3.43) min vs. (54.50±4.34) min) and frequency ((7.25±1.97) times vs. (12.47±3.33) times), of ST-segment depression were significantly decreased in the research group. Moreover, LVEDD ((42.05±4.21) mm vs. (46.48±3.98) mm), LVPWT ((9.23±2.25) mm vs. (11.18±2.59) mm), LVST ((8.72±2.48) mm vs. (10.30±2.71) mm), and NT-proBNP ((310.63±32.83) pg/mL vs. (403.87±40.51) pg/mL) were significantly reduced in the research group, whereas LVEF ((59.63±6.77)% vs. (53.73±5.04)%) and SOD ((112.72±10.12) U/mL vs. (90.60±9.85) U/mL) were significantly increased. The overall incidence of adverse events was lower in the research group. Multivariate analysis identified HR (OR=4.592, 95% CI: 1.289-16.366, P=0.019), LVEF (OR=0.290, 95% CI: 0.086-0.976, P=0.046), and NT-proBNP (OR=3.729, 95% CI: 1.124-12.371, P=0.031) as independent factors influencing therapeutic efficacy. CONCLUSIONS: Esmolol combined with carvedilol demonstrates superior efficacy and safety compared with carvedilol monotherapy in patients with myocardial ischemia secondary to CHD.
Therapeutic efficacy of minimally invasive techniques in shoulder/knee/tibial shaft fractures.
Xiao B, Lu M, Chen X … +3 more , Qiu D, He Y, Li X
Am J Transl Res · 2026 · PMID 42170468 · Full text
OBJECTIVE: To evaluate the effect of minimally invasive techniques (MITs) on the treatment outcomes and postoperative complications (POCs) of patients with orthopedic trauma. METHODS: A total of 103 patients with orthope...
OBJECTIVE: To evaluate the effect of minimally invasive techniques (MITs) on the treatment outcomes and postoperative complications (POCs) of patients with orthopedic trauma. METHODS: A total of 103 patients with orthopedic trauma were retrospectively selected and allocated to a control (receiving traditional surgery) and an observation group (receiving MITs). Inter-group comparisons were performed regarding therapeutic efficacy, operation-related indices, postoperative recovery, Short Musculoskeletal Function Assessment (SMFA) scores, modified Barthel Index (MBI), and Visual Analogue Scale (VAS) scores, as well as POCs. Multivariate analysis was conducted to identify independent factors associated with therapeutic efficacy. RESULTS: The observation group demonstrated statistically superior overall therapeutic efficacy and operation-related indices compared with the control group, with lower incidence of POCs. Additionally, patients in the observation group exhibited a greater increase in MBI scores and more significant reductions in SMFA scores at 1 month postoperatively. The VAS scores in the observation group also decreased greatly on postoperative, compared with the control group. Disease duration, VAS, and treatment mode were identified as independent predictors of therapeutic efficacy in patients with orthopedic trauma. CONCLUSION: Compared with conventional surgery, MITs provide superior clinical efficacy and reduce the incidence of POCs in the management of orthopedic trauma.
Clinical efficacy and safety of endoscopic metal titanium clip and local injection hemostasis for acute non-variceal upper gastrointestinal tract bleeding: a meta-analysis.
Chen W, Li W, Zhou Y
Am J Transl Res · 2026 · PMID 42170467 · Full text
This meta-analysis systematically evaluated the clinical efficacy and safety of endoscopic metal titanium clips versus local injection hemostasis for acute non-variceal upper gastrointestinal bleeding (ANVUGIB). A compre...
This meta-analysis systematically evaluated the clinical efficacy and safety of endoscopic metal titanium clips versus local injection hemostasis for acute non-variceal upper gastrointestinal bleeding (ANVUGIB). A comprehensive search of PubMed, Cochrane Library, Embase, Web of Science, CNKI, and Wanfang data was conducted from inception to June 2025, identifying nine randomized controlled trials involving 871 patients. No significant differences were observed between the titanium clip and injection groups regarding initial hemostasis rate (RR = 1.02, 95% CI: 1.00-1.05, P = 0.08), hospitalization time (MD = -0.59 days, 95% CI: -1.75-0.57, P = 0.32), mortality (RR = 1.23, 95% CI: 0.62-2.43, P = 0.56), or blood transfusion volume (MD = -0.35 mL, 95% CI: -0.85-0.14, P = 0.16). However, the titanium clip group demonstrated significantly lower rebleeding rates (RR = 0.58, 95% CI: 0.36-0.92, P = 0.02) and reduced surgical requirements (RR = 0.32, 95% CI: 0.12-0.85, P = 0.02). Subgroup analysis showed that titanium clips were particularly advantageous in reducing rebleeding among peptic ulcer patients (RR = 0.25, P = 0.0008). Sensitivity analysis confirmed the robustness of these findings, and no significant publication bias was detected. In conclusion, while endoscopic metal titanium clips and local injection offer comparable initial hemostatic efficacy and safety for ANVUGIB, titanium clips are superior for reducing rebleeding and the need for surgical intervention, especially in patients with peptic ulcers or a high risk of rebleeding, and should therefore be prioritized as a hemostatic strategy.
Postpartum cardiac complications after hypertensive disorders of pregnancy: predictive roles of retinal arteriolar-to-venular ratio and NT-proBNP.
Ju G, Zhuang Y, Liao Z … +1 more , Tang D
Am J Transl Res · 2026 · PMID 42170466 · Full text
OBJECTIVE: To investigate whether retinal arteriolar-to-venular ratio (AVR) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) assessed at 42 days postpartum can predict cardiac complications within 6 months in wo...
OBJECTIVE: To investigate whether retinal arteriolar-to-venular ratio (AVR) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) assessed at 42 days postpartum can predict cardiac complications within 6 months in women with hypertensive disorders of pregnancy (HDP), and to evaluate whether NT-proBNP mediates the association between AVR and cardiac complications. METHODS: This retrospective cohort study enrolled 386 women with HDP and 105 normotensive controls between March 2021 and March 2024. At 42 days postpartum, participants underwent cardiac assessment (NT-proBNP, echocardiography) and retinal microvascular measurement (central retinal arteriolar equivalent, central retinal venular equivalent, AVR). Cardiac complications were defined as heart failure or persistent/recurrent hypertension within 6 months postpartum. Logistic regression, receiver operating characteristic (ROC) curve analysis, and mediation analysis were performed. RESULTS: Compared with controls, women with HDP showed higher NT-proBNP, larger left ventricular end-diastolic diameter, and lower AVR (all P<0.05). These parameters worsened progressively with HDP severity. During follow-up, 97 women (25.1%) developed cardiac complications. Elevated NT-proBNP and reduced AVR were independent predictors of complications. The combined model achieved greater AUC than AVR alone. Mediation analysis indicated NT-proBNP partially mediated the AVR-complication relationship. CONCLUSIONS: Women with HDP exhibit early postpartum cardiac dysfunction and retinal microvascular impairment. Lower AVR, partly mediated through NT-proBNP, may help identify those at higher risk of cardiac complications.
Ligation of the intersphincteric fistula tract vs. fistulotomy for complex anal fistula: a retrospective study.
Ye S, Chen W, Zhang Y … +6 more , Zhang J, Rong F, Cheng Q, Feng Q, Huang J, Qian H
Am J Transl Res · 2026 · PMID 42170465 · Full text
OBJECTIVES: To evaluate the clinical efficacy and functional outcome of ligation of the intersphincteric fistula tract (LIFT) versus fistulotomy in patients with complex anal fistulas. METHODS: A retrospective review was...
OBJECTIVES: To evaluate the clinical efficacy and functional outcome of ligation of the intersphincteric fistula tract (LIFT) versus fistulotomy in patients with complex anal fistulas. METHODS: A retrospective review was conducted of patients with complex anal fistulas treated at The Affiliated People's Hospital of Ningbo University from May 2020 to May 2022. To reduce confounding and selection bias, 1:1 matching was performed based on key baseline variables such as fistula type and patient comorbidities. A total of 100 matched patients were assigned to either the LIFT group (n=50) or the fistulotomy group (n=50). RESULTS: The LIFT procedure required more operative time but resulted in significantly less intraoperative blood loss, faster wound healing, and shorter hospital stay (all P<0.05). Postoperative pain scores on days 1, 3, and 7 and Wexner incontinence scores at 1, 2, and 7 months were all significantly lower in the LIFT group (all P<0.05). After a median follow-up of 18.5 months, no significant difference in recurrence-free survival was observed between the two groups (log-rank P=0.695). The LIFT group had a significantly lower overall complication rate (4.00% vs. 16.00%, P<0.05) and a higher overall treatment efficacy rate (96.00% vs. 82.00%, P<0.05). Cox regression identified diabetes mellitus - but not surgical procedure - as an independent predictor of recurrence. CONCLUSIONS: LIFT offers advantages in sphincter preservation, reduced bleeding, faster recovery, and fewer complications, while providing comparable long-term recurrence outcomes to fistulotomy.
Clinical progress and prospects of biodegradable intestinal stents.
Li K, Wang S, Wang Q … +3 more , Zhang F, Yuan X, Zhang C
Am J Transl Res · 2026 · PMID 42170464 · Full text
Anastomotic leakage and stricture after colorectal surgery are severe complications in gastrointestinal surgery, with their incidence rates reaching as high as 5%-30% and 10%-20%, respectively. Traditional self-expanding...
Anastomotic leakage and stricture after colorectal surgery are severe complications in gastrointestinal surgery, with their incidence rates reaching as high as 5%-30% and 10%-20%, respectively. Traditional self-expanding metal stents (SEMS) have limited clinical applications due to such drawbacks as non-degradability and the requirement for secondary surgical removal. In recent years, biodegradable intestinal stents have become a research hotspot due to their temporary support and degradable properties. Among them, silk fibroin-based stents have stood out for their excellent biocompatibility and mechanical adaptability. This article systematically reviews the clinical indications, material classification, latest advances, clinical challenges, and prospects of degradable intestinal stents, and focuses on discussing the value of silk fibroin-based stents in preventing intestinal anastomotic leakage and stricture.
Study on the clinical effect of warm acupuncture in the treatment of simple obesity complicated with dyslipidemia (spleen deficiency and dampness obstruction type) and insulin resistance.
Li J, Ding Z, Xu P … +4 more , Chen Y, Zhang Y, Li Y, Wang X
Am J Transl Res · 2026 · PMID 42170463 · Full text
OBJECTIVE: To evaluate the effect of warm acupuncture on simple obesity complicated with dyslipidemia (spleen deficiency and dampness obstruction type). METHODS: A retrospective analysis was conducted on 100 patients wit...
OBJECTIVE: To evaluate the effect of warm acupuncture on simple obesity complicated with dyslipidemia (spleen deficiency and dampness obstruction type). METHODS: A retrospective analysis was conducted on 100 patients with obesity and dyslipidemia treated in Henan Provincial People's Hospital from January 2022 to December 2024. Patients were divided into a control group (conventional acupuncture) and an observation group (warm acupuncture) according to their acupuncture regimen. Changes in obesity indices (body weight, body mass index [BMI], body fat percentage [F%], waist circumference [WC], hip circumference [HC]), lipid metabolism parameters (total cholesterol [TC], triglycerides [TG], low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C]), insulin resistance index (HOMA-IR), visceral fat index, and traditional Chinese medicine (TCM) syndrome scores were compared between the two groups. Quality of life (QoL) was assessed, and the incidence of adverse reactions was recorded. RESULTS: Before treatment, there were no significant differences in baseline characteristics between the two groups (all P > 0.05). After treatment, both groups showed significant improvement in all measured indices compared to baseline levels (all P < 0.05). Notably, the warm acupuncture group demonstrated significantly better improvements in F%, lipid metabolism parameters, HOMA-IR, visceral fat index, TCM syndrome scores, and all domains of QoL compared with the control group (all P < 0.05). Although the warm acupuncture group showed a more pronounced numerical trend of reduction in waist circumference, hip circumference, body weight, and BMI, the differences in change values between the groups did not reach statistical significance (P = 0.058, 0.077, 0.296, and 0.072, respectively). There was no significant difference in the incidence of adverse reactions between the two groups (P = 0.576). CONCLUSION: Warm acupuncture is effective in treating simple obesity with dyslipidemia. It significantly improves key metabolic parameters (including body fat percentage, lipid profile, and insulin resistance), reduces TCM symptom scores, and enhances patients' quality of life, without increasing adverse reactions. While its effects on absolute weight, BMI, and circumferences warrant further investigation, warm acupuncture represents a valuable and safe therapeutic option worthy of clinical consideration.
Clinical efficacy of intra-articular sodium hyaluronate injection and optimizing the puncture site in knee osteoarthritis.
Wu Y, Li F, Ke X … +2 more , Qian J, Fu Z
Am J Transl Res · 2026 · PMID 42170462 · Full text
OBJECTIVE: To evaluate the clinical efficacy of intra-articular sodium hyaluronate in knee osteoarthritis (KOA) and to assess the effect of different puncture sites on treatment outcome. METHODS: This retrospective study...
OBJECTIVE: To evaluate the clinical efficacy of intra-articular sodium hyaluronate in knee osteoarthritis (KOA) and to assess the effect of different puncture sites on treatment outcome. METHODS: This retrospective study included 198 patients with KOA treated between September 2023 and September 2025. Patients were divided into a sodium hyaluronate group (n=102) and a triamcinolone acetonide group (n=96). The sodium hyaluronate group was further categorized by puncture site: superolateral (n=26), inferolateral (n=25), superomedial (n=27), and inferomedial (n=24). Clinical outcomes were assessed at baseline and 6 months using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Hospital for Special Surgery knee score (HSS), Arthritis Impact Measurement Scales 2-Short Form (AIMS2-SF), and inflammatory markers including interleukin-1 beta (IL-1β), C-reactive protein (CRP), and tumor necrosis factor alpha (TNF-α). Adverse events were recorded. RESULTS: Baseline characteristics were comparable between groups (P>0.05). After 6 months, both treatments significantly improved clinical scores (P<0.05). The sodium hyaluronate group demonstrated superior pain relief, functional improvement, and lower incidence of adverse events compared with triamcinolone acetonide (P<0.05). In puncture-site analysis, WOMAC scores improved across all subgroups. The inferomedial approach provided greater pain relief, whereas the superolateral and superomedial approaches showed better improvement in joint stiffness, physical function, inflammatory markers, and quality of life (P<0.05). Adverse event rates did not differ among puncture-site groups. CONCLUSION: Intra-articular sodium hyaluronate is effective and safe for KOA. Clinical outcomes vary according to puncture site, with superolateral and superomedial approaches demonstrating consistent overall benefits.
Effect of remazolam combined with hydromorphone postoperative analgesia on cognitive function in elderly patients undergoing hip replacement.
Zheng X, Fu X, Shao Y … +1 more , Lin X
Am J Transl Res · 2026 · PMID 42170461 · Full text
OBJECTIVE: To investigate the effect of remazolam combined with hydromorphone on postoperative cognitive function in elderly patients undergoing hip replacement. METHODS: 184 elderly patients who underwent hip replacemen...
OBJECTIVE: To investigate the effect of remazolam combined with hydromorphone on postoperative cognitive function in elderly patients undergoing hip replacement. METHODS: 184 elderly patients who underwent hip replacement in Sir Run Run Shaw hospital from January 2023 to January 2025 were retrospectively analyzed. According to the intraoperative anesthesia scheme, they were divided into an observation group (remazolam combined with postoperative hydromorphone analgesia) and a control group (propofol combined with postoperative hydromorphone analgesia). The intraoperative hemodynamics, anesthesia recovery, incidence of cognitive dysfunction (POD) within 7 days after operation, scores of mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA), visual analogue scale (VAS) score within 48 hours after operation, hydromorphone dosage, joint function score, adverse reactions, and analgesia satisfaction were compared between the two groups. RESULTS: There was no significant difference in intraoperative hemodynamic indexes or post-anesthesia monitoring treatment room stay time between the two groups (P > 0.05), but the eye opening time and extubation time in the observation group were shorter (P < 0.05) and the incidence of POD in the observation group were lower than in the control group within 7 days after operation. The scores of MoCA and MMSE in the observation group were higher than those in the control group on the 1st and 3rd day after operation (P < 0.05), but there was no difference between the two groups on the 7th day after operation. There was no significant difference in VAS scores between the two groups at each time point after operation, but the cumulative dosage of hydromorphone in the observation group was higher at 6 hours and 24 hours after operation (P < 0.05), and there was no difference between the two groups at 48 hours. The analgesic satisfaction of the observation group was higher (P < 0.05). There was no significant difference in the incidence of adverse reactions or joint function scores between the two groups. CONCLUSION: Remazolam combined with hydromorphone for postoperative analgesia in elderly patients undergoing hip replacement can help reduce the incidence of early POD, promote anesthesia recovery, improve analgesia satisfaction, and does not increase adverse reactions.
Correlation between peritumoral fat space blur on preoperative abdominal enhanced CT and postoperative complications in colorectal cancer: a single-center retrospective study.
Jiang D, Zhang X
Am J Transl Res · 2026 · PMID 42170460 · Full text
OBJECTIVE: To investigate the association between blurred peritumoral fat planes on preoperative contrast-enhanced abdominal CT and postoperative complications in colorectal cancer, and to evaluate its predictive value....
OBJECTIVE: To investigate the association between blurred peritumoral fat planes on preoperative contrast-enhanced abdominal CT and postoperative complications in colorectal cancer, and to evaluate its predictive value. METHODS: This study was a single-center retrospective analysis that consecutively enrolled 135 patients with colorectal adenocarcinoma who underwent curative surgery at Anhui West Health Vocational College Affiliated Hospital between February 2019 and December 2024. Two radiologists, blinded to clinical outcomes, independently assessed the degree of peritumoral fat plane blurring on preoperative CT scans using a 0-3 grading scale. Clinicopathological, surgical, and postoperative complication data were collected. Univariate and multivariate logistic regression analyses were performed to evaluate the association between fat plane blurring and postoperative complications. The predictive performance was assessed using receiver operating characteristic (ROC) curve analysis, and subgroup analyses were conducted. RESULTS: A total of 135 patients were included, with a mean age of 66.3±9.8 years, and 63.0% were male. The distribution of peritumoral fat plane blurring grades was as follows: grade 0 in 22 patients (16.3%), grade 1 in 14 (10.4%), grade 2 in 40 (29.6%), and grade 3 in 59 (43.7%). The overall postoperative complication rate was 61.5% (83/135), and the rate of severe complications (Clavien-Dindo grade ≥III) was 44.4% (60/135). The degree of fat plane blurring was significantly associated with both overall complications (P<0.001) and severe complications (P<0.001), demonstrating a clear dose-response relationship. Multivariate analysis identified the fat plane blurring grade as an independent predictor of postoperative complications (OR=2.59; 95% CI: 1.70-3.95; P<0.001). ROC curve analysis yielded an area under the curve (AUC) of 0.750 for predicting complications. Using a cutoff of grade ≥2, the sensitivity was 81.6% and the specificity was 75.8%. Subgroup analyses confirmed that this association remained consistent across different tumor locations and surgical approaches. CONCLUSIONS: Blurred peritumoral fat planes on preoperative CT are an independent predictor of postoperative complications in colorectal cancer, demonstrating moderate predictive performance. This imaging feature can serve as a practical tool for preoperative risk assessment, aiding in the identification of high-risk patients and guiding individualized perioperative management.
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