American Journal Of Translational Research[JOURNAL]
Sun
200 papers
Complementary diagnostic value of tympanometry and tubomanometry in Eustachian tube dysfunction: a retrospective study with serial strategy optimization.
Liao Z, Liu T, Luo D
Am J Transl Res · 2026 · PMID 42170459 · Full text
BACKGROUND: Clinical diagnosis of Eustachian tube dysfunction (ETD) lacks an objective gold standard. Tympanometry (assessed by Type Y tympanogram incidence) and tubomanometry (TMM) are widely used, but their comparative...
BACKGROUND: Clinical diagnosis of Eustachian tube dysfunction (ETD) lacks an objective gold standard. Tympanometry (assessed by Type Y tympanogram incidence) and tubomanometry (TMM) are widely used, but their comparative diagnostic performance and combined value remain controversial. OBJECTIVE: To retrospectively evaluate and compare the diagnostic accuracy and agreement of tympanometry and TMM for ETD, using clinical comprehensive diagnosis as the reference, and to explore the clinical utility of serial and parallel diagnostic strategies. METHODS: This single-center retrospective study consecutively enrolled 165 patients with ear symptoms who underwent both tests (January 2022-January 2025). Clinical comprehensive diagnosis (blinded to test results) served as the gold standard. Sensitivity, specificity, predictive values, accuracy, area under the ROC curve (AUC), and Cohen's Kappa were calculated. Serial (both tests positive) and parallel (either test positive) strategies were evaluated. RESULTS: ETD was diagnosed in 75/165 patients (45.5%). The AUC for TMM was 0.875 (95% CI: 0.825-0.925), higher than that for tympanometry (0.836, 95% CI: 0.786-0.886), but the difference was not statistically significant (P = 0.375). Tympanometry showed very high sensitivity (0.987) and NPV (0.985) but low specificity (0.711); TMM had higher specificity (0.778) and PPV (0.765). Agreement between the two methods was moderate (Kappa = 0.475, overall agreement 73.9%). Among combined strategies, the serial approach yielded the highest specificity (0.922) and accuracy (0.891), while the parallel approach demonstrated high sensitivity suitable for screening but with low specificity (0.567). CONCLUSION: Tympanometry and TMM exhibit complementary diagnostic characteristics: tympanometry is an excellent screening tool for ruling out ETD, whereas TMM is more reliable for confirmation. The moderate agreement suggests they capture different pathophysiological dimensions of ETD. The serial strategy optimizes diagnostic specificity and accuracy, supporting its use when confirmation is required.
Correlation of serum MAp44 protein concentration with degree of myocardial injury and 30-day prognosis in patients with acute myocardial infarction.
Song CY, Li HY, Wang YY … +4 more , Chang PF, Zhao QF, Li SF, Wang R
Am J Transl Res · 2026 · PMID 42170458 · Full text
OBJECTIVE: To analyze the relationship between serum mannan-binding lectin-associated protein 44 (MAp44) level and myocardial injury severity in acute myocardial infarction (AMI) patients, and explore its value for 30-da...
OBJECTIVE: To analyze the relationship between serum mannan-binding lectin-associated protein 44 (MAp44) level and myocardial injury severity in acute myocardial infarction (AMI) patients, and explore its value for 30-day prognostic assessment. METHODS: A retrospective study included 128 AMI patients admitted to The First Hospital of Zhangjiakou from January 2023 to June 2024, divided into mild (n=57) and severe myocardial injury groups (n=71). General data and MAp44 levels were compared. For 30-day prognosis, patients were stratified into a major adverse cardiovascular event (MACE, n=37) and a non-MACE group (n=91). Univariate and multivariate analyses identified poor prognostic factors, and predictive values of indicators were compared. An independent cohort (82 AMI patients, February-October 2025) validated the model. RESULTS: The severe group had significantly lower MAp44 and higher cardiac troponin T (cTnT) than the mild group (P<0.001). MAp44 was negatively correlated with cTnT (r=-0.666, P<0.001). The 30-day MACE incidence was 28.91%. Extensive infarction, ≥2 coronary lesions, elevated cTnT, and low MAp44 were MACE risk factors (P<0.05). The combined model (infarction size + coronary lesions + cTnT, and + MAp44) had the highest prognostic value (AUC=0.890, sensitivity =78.40%, specificity =83.50%), with 84.1% accuracy in the validation cohort. CONCLUSION: Serum MAp44 levels decrease with increasing myocardial injury severity in AMI patients; low MAp44 is an independent risk factor for 30-day MACE.
The divergent effects of population aging: comparative analysis of the burden of Alzheimer's disease and other dementias in China and G20 countries, 1990-2050.
Qiu G, Huang Y, Wang Q … +4 more , Si K, Xu S, Yu Y, Hu P
Am J Transl Res · 2026 · PMID 42170457 · Full text
OBJECTIVES: Alzheimer's disease and other dementias (ADOD) pose a serious and escalating public health challenge globally, particularly in China. This study aimed to compare the ADOD burden between China and Group of 20...
OBJECTIVES: Alzheimer's disease and other dementias (ADOD) pose a serious and escalating public health challenge globally, particularly in China. This study aimed to compare the ADOD burden between China and Group of 20 (G20) countries to inform targeted policy development. METHODS: We assessed the burden of ADOD among adults aged 40 years and older in China and G20 countries during 1990-2021, using data from Global Burden of Disease 2021. Significant temporal trends were observed by joinpoint regression. Decomposition analyses estimated the effects of aging, population increase, and epidemiologic changes. Projections through the mid-century (2050) were derived using the autoregressive integrated moving average (ARIMA) models. RESULTS: In 2021, China exhibited the highest age-standardized prevalence (900.82 per 100,000), incidence (151.47 per 100,000), and Disability-Adjusted Life Years (DALYs) (562.39 per 100,000) of ADOD among all G20 countries. During 1990-2021, China also experienced the most pronounced increases in these metrics (322.18%, 314.42%, and 272.71%). Aging was the primary driver of the ADOD burden growth in China. In contrast, aging played a dual role in G20 countries, with an adverse effect on the prevalence and incidence while remaining a contributory factor to deaths and DALYs. CONCLUSION: Despite recent improvements, China faces a growing ADOD burden, largely propelled by population aging. This contrasts with the more complex role of aging in G20 countries, where aging shows a substantially mitigating effect on prevalence and incidence yet a persistent driving effect on deaths and DALYs. This underscores an urgent need for China to develop tailored strategies informed by experience from the G20.
Development and validation of a clinically available risk model for medium-to-high opioid consumption after total knee arthroplasty.
Ding Y, Wu K, Zhang Z
Am J Transl Res · 2026 · PMID 42170456 · Full text
OBJECTIVES: To develop and internally validate a clinically interpretable preoperative model for predicting medium-to-high opioid consumption within 72 h after unilateral total knee arthroplasty (TKA). METHODS: We retros...
OBJECTIVES: To develop and internally validate a clinically interpretable preoperative model for predicting medium-to-high opioid consumption within 72 h after unilateral total knee arthroplasty (TKA). METHODS: We retrospectively analyzed 806 patients who underwent primary unilateral TKA between October 2017 and September 2021. Patients were randomly divided into a training cohort (70%) and a validation cohort (30%). The primary outcome was total opioid consumption within the first 72 postoperative hours, categorized as low versus medium-to-high consumption. Baseline and perioperative variables were first compared using appropriate univariable statistical tests, and variables showing potential associations, together with clinically relevant factors, were entered into a multivariable logistic regression model with bidirectional stepwise selection. The final model was presented as a nomogram. Discrimination, calibration, and clinical utility were assessed using the area under the receiver operating characteristic curve (AUC), calibration plots with intercepts and slopes, Hosmer-Lemeshow testing, and decision curve analysis. RESULTS: Female sex, diabetes mellitus, higher body mass index, and higher preoperative day-1 serum interleukin-6 (IL-6) levels were independent predictors of medium-to-high postoperative opioid consumption. The model showed acceptable discrimination in the training cohort (AUC 0.727) and modest discrimination in the validation cohort (AUC 0.665). Calibration was acceptable in both cohorts (training: intercept 0.012, slope 0.953; validation: intercept 0.009, slope 0.941). Decision curve analysis supported potential clinical utility across relevant threshold probabilities. CONCLUSIONS: A simple preoperative model based on routinely available demographic, clinical, and inflammatory variables may help identify patients at increased risk of higher opioid requirements after unilateral TKA and may support individualized multimodal analgesic planning.
Diagnostic value of linked color imaging for detecting gastritis subtypes and precancerous lesions.
Li T
Am J Transl Res · 2026 · PMID 42170455 · Full text
AIMS: To evaluate the correlation between Linked Color Imaging (LCI) and the detection of gastritis subtypes and precancerous lesions under white light endoscopy. METHODS: This retrospective observational included 198 ad...
AIMS: To evaluate the correlation between Linked Color Imaging (LCI) and the detection of gastritis subtypes and precancerous lesions under white light endoscopy. METHODS: This retrospective observational included 198 adult patients who underwent upper gastrointestinal endoscopy at our institution between January 2022 and January 2025. Patients were divided into two groups based on endoscopic imaging modality used: the white light endoscopy (WLE) group (n = 96), in which gastric mucosal examination was performed using conventional white light endoscopy only, and the LCI group (n = 102), in which linked color imaging was used in conjunction white light observation during the examination. The primary outcome was the detection of gastritis subtypes and gastric precancerous lesions, with histopathological diagnosis serving as the reference standard. Multilevel mixed-effects logistic regression analysis was performed to evaluate the independent relationship between imaging modality and lesion detection. RESULTS: Intestinal metaplasia (IM) was more frequently detected with LCI than with WLE (29.4% vs. 14.6%, P = 0.012), particularly extensive IM (17.6% vs. 5.2%, P = 0.006), corpus IM (12.7% vs. 4.2%, P = 0.031), and incomplete IM (16.7% vs. 6.3%, P = 0.022). Endoscopy-histology concordance was significantly higher in the LCI group (85.4% vs. 72.1%, P = 0.021). Gastric precancerous lesions were detected more frequently with LCI (36.3% vs. 21.9%, P = 0.026), specifically flat-type dysplasia ([13.7% vs. 3.1%, P = 0.008) and lesions ≤ 10 mm (18.6% vs. 8.3%, P = 0.035). Quantitative visibility metrics were consistently superior in LCI group (all P < 0.001). In multilevel mixed-effects logistic regression, LCI use remained a significant predictor of lesion detection (OR = 0.360, 95% CI 0.173-0.746; P = 0.006), with flat morphology, advanced age, and corpus location also independently associated with lesion detection. CONCLUSION: LCI significantly improves the detection of atrophic gastritis, intestinal metaplasia, and gastric precancerous lesions compared with WLE, particularly for subtle, flat, and small lesions.
Comparison of glucolipid metabolic profile, thyroid hormone levels, and reproductive endocrine function in polycystic ovary syndrome patients with/without metabolic syndrome.
Li X, Wang M
Am J Transl Res · 2026 · PMID 42170454 · Full text
OBJECTIVE: To compare the differences in glucose and lipid metabolism profiles, thyroid hormone levels, and reproductive endocrine function between polycystic ovary syndrome (PCOS) patients with and without metabolic syn...
OBJECTIVE: To compare the differences in glucose and lipid metabolism profiles, thyroid hormone levels, and reproductive endocrine function between polycystic ovary syndrome (PCOS) patients with and without metabolic syndrome (MS). METHODS: This retrospective study included 160 PCOS patients treated in Shanghai Pudong New Area People's Hospital from January 2020 to December 2021. Patients were divided into two groups based on whether they had MS: a PCOS group without MS (n=105) and a PCOS group with MS (n=55). Clinical and laboratory parameters were compared between the two groups. RESULTS: The prevalence of MS in PCOS patients was 34.38%. Compared with the PCOS group, the PCOS+MS group exhibited significantly elevated levels of fasting plasma glucose, 2-hour postprandial glucose, fasting insulin, homeostasis model assessment of insulin resistance, total cholesterol, triglycerides, low-density lipoprotein cholesterol, and thyroid-stimulating hormone (all P<0.05), while high-density lipoprotein cholesterol levels were significantly decreased (P<0.05). No significant differences were found in free triiodothyronine, free thyroxine, or key reproductive hormones (testosterone, estradiol, follicle-stimulating hormone, luteinizing hormone) between the groups (all P>0.05). CONCLUSION: MS is common in PCOS patients and is associated with increased glucose and lipid metabolism disorders and elevated TSH, but not with changes in the reproductive endocrine profile. Early screening for MS in PCOS patients is recommended to facilitate timely management of metabolic and thyroid abnormalities.
Prognostic nomogram for acute cerebral infarction based on risk factors: treatment with urinary kallidinogenase and edaravone-dexborneol.
Ma F, Xu D, Xu Y … +2 more , Wei L, Li H
Am J Transl Res · 2026 · PMID 42170453 · Full text
OBJECTIVE: To investigate the prognostic factors in patients with acute cerebral infarction (ACI) treated with urinary kallidinogenase combined with edaravone-dexborneol and to construct a predictive model. METHODS: A to...
OBJECTIVE: To investigate the prognostic factors in patients with acute cerebral infarction (ACI) treated with urinary kallidinogenase combined with edaravone-dexborneol and to construct a predictive model. METHODS: A total of 120 ACI patients admitted to Dongyang People's Hospital, affiliated to Wenzhou University, from January 2022 to December 2023 were retrospectively collected, of whom 101 were included after screening. An additional 105 ACI patients admitted to other hospitals during the same period were collected as an external validation cohort. Prognosis was assessed using the modified Rankin Scale (mRS), and patients were classified into the good prognosis group (mRS ≤ 2 points) and the poor prognosis group (mRS > 2 points). Clinical data of the two groups were collected for univariate and binary logistic regression analyses to construct a nomogram prediction model, and ROC curve analysis was used to validate the predictive performance. RESULTS: Univariate analysis indicated that comorbidities, TOAST classification, infarct location, thrombolytic/anticoagulant therapy drugs, age, disease duration, National Institutes of Health Stroke Scale (NIHSS) score at admission, Glasgow Coma Scale (GCS) score at admission, and fasting blood glucose were factors associated with poor prognosis. Binary logistic regression analysis showed that brainstem infarction, clopidogrel as thrombolytic/anticoagulant therapy, and NIHSS score at admission were independent risk factors. Model Y was constructed, and the Hosmer-Lemeshow test yielded χ = 9.660 and P = 0.290. A nomogram prediction model was developed, and ROC curve analysis showed that the AUC of the training set was 0.867 (95% = 0.789-0.867), the AUC of the test set was 0.769 (95% CI = 0.502-1.000), and the AUC of the validation cohort was 0.879 (95% = 0.810-0.949). CONCLUSION: The prognosis of ACI patients treated with urinary kallidinogenase combined with edaravone-dexborneol is influenced by multiple factors. Clinicians may construct a prognostic prediction model based on previous medical records to identify risk factors and adjust treatment strategies to improve prognosis.
Association of magnesium depletion score, triglyceride-glucose index, and C-reactive protein-albumin-lymphocyte index with diabetic sarcopenia: a cross-sectional study based on NHANES 2014-2018 data.
Yang Q, Lian X, Guo J
Am J Transl Res · 2026 · PMID 42170452 · Full text
OBJECTIVE: To evaluate the predictive performance of three novel biomarkers - magnesium depletion score (MDS), triglyceride-glucose index (TyG), and C-reactive protein-albumin-lymphocyte index (CAL) - for diabetic sarcop...
OBJECTIVE: To evaluate the predictive performance of three novel biomarkers - magnesium depletion score (MDS), triglyceride-glucose index (TyG), and C-reactive protein-albumin-lymphocyte index (CAL) - for diabetic sarcopenia. METHODS: Data were obtained from 1,318 adult patients with type 2 diabetes mellitus (T2DM) from the National Health and Nutrition Examination Survey (NHANES) database (2014-2018). Sarcopenia was diagnosed according to the criteria of the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), based on skeletal muscle mass index measured by dual-energy X-ray absorptiometry combined with grip strength and gait speed. Multivariate logistic regression analysis was performed, and receiver operating characteristic (ROC) curves with area under the curve (AUC) were used to compare and analyze the predictive efficacy of MDS, TyG, and CAL for diabetic sarcopenia. RESULTS: The prevalence of diabetic sarcopenia was 22.1%. Levels of MDS, TyG, and CAL differed significantly between the sarcopenia and non-sarcopenia groups (all P < 0.05). Multivariate analysis identified age, body mass index, disease duration, MDS, TyG, and CAL as independent factors associated with sarcopenia in patients with T2DM. ROC curve analysis showed that the combined model incorporating MDS, TyG, and CAL achieved an AUC of 0.925 for identifying sarcopenia. CONCLUSION: Sarcopenia in T2DM patients is associated with baseline clinical characteristics. MDS, TyG, and CAL are independent factors associated with diabetic sarcopenia and demonstrate strong potential for its early identification.
Comparison of postoperative recovery and complications: laparoscopic sacrocolpopexy versus transvaginal sacrospinous ligament suspension.
Liu H, Gong Y, Li D … +1 more , Bo Y
Am J Transl Res · 2026 · PMID 42170451 · Full text
OBJECTIVE: The goal of this study was to determine whether functional recovery and complication rates differed between laparoscopic sacrocolpopexy (LSC) and transvaginal sacrospinous ligament suspension (TSS) in patients...
OBJECTIVE: The goal of this study was to determine whether functional recovery and complication rates differed between laparoscopic sacrocolpopexy (LSC) and transvaginal sacrospinous ligament suspension (TSS) in patients with moderate-to-severe uterine prolapse and vaginal wall prolapse. METHODS: We conducted a retrospective cohort study of 321 patients who underwent surgery between April 2021 and February 2023. Participants were divided into an LSC group (n=163) and a TSS group (n=158). Since pelvic organ prolapse may occur following childbirth, complication and recurrence rates were compared between groups. Factors associated with recurrence were analyzed using logistic regression. RESULTS: Compared to LSC, TSS had shorter operation time, less blood loss, and faster return of flatus. Both groups improved in pelvic organ prolapse quantification scores, pelvic floor distress inventory-20, and pelvic organ prolapse/urinary incontinence sexual questionnaire-12, with greater improvement in the LSC group. TSS was associated with higher rates of urinary incontinence and recurrence (5.52% vs. 13.29%). Multivariate analysis showed TSS, prior pelvic surgery, and combined compartment prolapse were risk factors for recurrence, while age <60 and body mass index <24 kg/m were protective. CONCLUSION: In patients with moderate-to-severe uterine and vaginal wall prolapse who are medically fit, LSC provides superior pelvic floor anatomical restoration, quality of life improvement, and recurrence control compared to TSS. For patients who cannot tolerate laparoscopic surgery, TSS remains a safe alternative, with both procedures demonstrating comparable overall safety.
Clinical efficacy and safety of telitacicept combined with methotrexate in the treatment of rheumatoid arthritis.
Tao Y, Zhang J, Li H … +2 more , Zhou J, Wu M
Am J Transl Res · 2026 · PMID 42170450 · Full text
OBJECTIVE: To investigate the clinical efficacy of telitacicept combined with methotrexate in treating rheumatoid arthritis (RA) and its effects on related indicators including inflammatory response, oxidative stress, an...
OBJECTIVE: To investigate the clinical efficacy of telitacicept combined with methotrexate in treating rheumatoid arthritis (RA) and its effects on related indicators including inflammatory response, oxidative stress, and bone metabolism. METHODS: Clinical data of 109 RA patients were retrospectively analyzed and divided into an observation group (n=59) and a control group (n=50). Disease activity scores, inflammatory response indicators, oxidative stress indicators, bone metabolism biomarkers, and imaging scores were compared before and after treatment. RESULTS: After treatment, the observation group showed significantly lower disease activity scores and response indicators than the control group (all P<0.05), decreased malondialdehyde levels, increased superoxide dismutase and glutathione peroxidase levels (all P<0.05), and improved bone metabolism indicators such as procollagen type I N-terminal propeptide and matrix metalloproteinase-3. Some imaging scores indicated a short-term improvement trend. CONCLUSION: Telitacicept combined with methotrexate can effectively improve disease activity, inflammation, and oxidative stress in RA patients in the short term and exert positive effects on bone metabolism- indicators, but its long-term structural protective effect and underlying mechanism need further investigation.
Antimicrobial effects of compound Huangbai liquid on , and MRSA: clinical, bacterial, and animal experimental studies.
Li Z, Feng H, Peng H … +9 more , Song F, Zhou C, Zhang J, Wei F, Hu X, Li W, Li L, Wei Y, Yu Q
Am J Transl Res · 2026 · PMID 42170449 · Full text
OBJECTIVE: The aim of this study was to systematically evaluate the antimicrobial potential of Compound Huangbai Liquid (HB) against ) and methicillin-resistant (MRSA) infections. METHODS: A multidimensional research st...
OBJECTIVE: The aim of this study was to systematically evaluate the antimicrobial potential of Compound Huangbai Liquid (HB) against ) and methicillin-resistant (MRSA) infections. METHODS: A multidimensional research strategy combining clinical trials, bacteriological experiments and animal model studies was used. The clinical efficacy and adverse effects of HB were observed in patients with abdominal abscesses and non-lactating breast abscesses. The antimicrobial activity of HB was assessed in vitro by minimal inhibitory concentration (MIC), and its antibacterial, anti-inflammatory as well as pro-healing mechanisms were explored in a mouse infection model. RESULTS: Clinical studies of abdominal abscesses showed that patients in the HB treatment group had a significantly lower rate of pus bacterial positivity, lower serum white blood cell (WBC), neutrophil (NEU) and C-reactive protein (CRP) levels, higher levels of vascular endothelial growth factor (VEGF), epidermal growth factor (EGF) and basic fibroblast growth factor (βFGF), reduced pus volume and shorter hospitalization time. Clinical studies of non-lactating breast abscesses showed that HB significantly reduced tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) levels, promoted wound healing and relieved pain. No significant adverse effects were observed in either clinical study, and there was no statistically significant difference in the recurrence rate during long-term follow-up, indicating that HB has a favorable safety profile and stable efficacy. The results of bacteriological experiments showed that the MICs of HB on and were 140 µg/mL and 500 µg/mL, respectively, showing concentration-dependent bacteriostatic effects. Animal experiments further revealed that HB significantly reduced the wound bacterial load, inhibited inflammatory cell infiltration, increased the number of fibroblasts, and down-regulated the levels of inflammatory factors such as IL-1, IL-6, and TNF-α, while up-regulating the expression of tissue repair factors such as EGF, VEGF-A, and TGF-β. CONCLUSION: HB possesses antimicrobial effects against and and possesses the prospect of further development as an antimicrobial adjuvant therapeutic agent.
Infantile hypophosphatasia caused by compound heterozygous variants in the gene: a case report.
Wu Q, Xiang M, Xiong W … +3 more , Wang B, Wu S, Chen M
Am J Transl Res · 2026 · PMID 42170448 · Full text
This article reports a case of infantile hypophosphatasia (HPP) due to compound heterozygous () gene mutations, and analyzes its clinical phenotype and genetic characteristics. A retrospective analysis was conducted on...
This article reports a case of infantile hypophosphatasia (HPP) due to compound heterozygous () gene mutations, and analyzes its clinical phenotype and genetic characteristics. A retrospective analysis was conducted on the clinical data, genetic testing results, and family history of a male infant with HPP. The infant presented with intrauterine and postpartum growth retardation, respiratory failure, feeding difficulties, vitamin B6-responsive epileptic seizures, bone hypomineralization, hypercalcemia, and very low alkaline phosphatase (ALP). Genetic testing revealed compound heterozygous mutations: c.533A>G (p.Tyr178Cys) and c.644T>A (p.Ile215Asn), inherited from his father and mother, respectively, both parents being phenotypically normal. The mother had previously terminated a pregnancy due to fetal bone deformity. This case of infantile HPP resulted from compound heterozygous mutations, with typical clinical features including bone hypomineralization, hypercalcemia, and profoundly low ALP. Without enzyme replacement therapy, the disease is progressing.
Identification of chemotherapy-related risk factors for lymphedema in breast cancer patients using Lasso regression and model development.
Guo Y, An A, Li P … +2 more , Li J, Zhang B
Am J Transl Res · 2026 · PMID 42170447 · Full text
OBJECTIVE: We aimed to identify chemotherapy-related predictors of upper-limb breast cancer-related lymphedema (BCRL) and to build and validate a clinically usable prediction model. METHODS: Our multicenter study analyze...
OBJECTIVE: We aimed to identify chemotherapy-related predictors of upper-limb breast cancer-related lymphedema (BCRL) and to build and validate a clinically usable prediction model. METHODS: Our multicenter study analyzed 670 breast cancer patients treated with chemotherapy from December 2018 through February 2024. We divided patients into training (381 patients, Gansu Provincial Cancer Hospital) and validation (289 patients, Zhangye Second People's Hospital) cohorts. The prediction model combined four machine learning algorithms - decision tree, random forest, support vector machine, and XGBoost-using Lasso regression as the final integrator. We employed K-fold cross-validation to prevent data leakage. Performance metrics included AUC, Brier score, calibration curves, and decision curve analysis. SHAP values helped us understand which factors mattered most. Variables showing P<0.10 in initial screening entered the multivariable model after checking for multicollinearity. RESULTS: Eight factors showed preliminary associations with lymphedema by simple comparisons. However, comprehensive analysis accounting for overlapping effects identified six independent predictors: disease stage, complete versus limited axillary surgery, sentinel node procedure, total nodes removed, radiation treatment, and whether chemotherapy came before or after surgery. Statistical significance was strongest for stage (P<0.001) and weakest for chemotherapy timing (P=0.033). When we tested the model, discrimination remained good though slightly lower than development (AUC dropped from 0.773 to 0.713). Prediction errors stayed modest (Brier scores 0.136-0.146). Calibration was excellent since predicted probabilities matched observed rates. Clinical decision analysis suggested the model adds value when risk thresholds fall between 0-63%, peaking near 18-19% threshold. Feature importance analysis confirmed disease burden (stage, node count), and treatment aggressiveness (surgery type, radiation, chemotherapy sequence) jointly determined risk. CONCLUSION: We identified six factors that independently raise lymphedema risk after breast cancer treatment. The machine learning model we developed discriminates risk well enough for clinical application. It may help doctors intensify monitoring for high-risk patients while avoiding unnecessary intervention for low-risk patients.
Efficacy and immune-inflammatory modulation of combined glucocorticoid and anti-tuberculosis therapy in patients with bronchial asthma and pulmonary tuberculosis.
Fang L, Liao X, Lin J
Am J Transl Res · 2026 · PMID 42170446 · Full text
OBJECTIVE: To evaluate the efficacy and immunomodulatory effects of glucocorticoid combination therapy with anti-tuberculosis treatment in patients with asthma complicated by pulmonary tuberculosis. METHODS: Clinical dat...
OBJECTIVE: To evaluate the efficacy and immunomodulatory effects of glucocorticoid combination therapy with anti-tuberculosis treatment in patients with asthma complicated by pulmonary tuberculosis. METHODS: Clinical data of 128 patients with bronchial asthma complicated with pulmonary tuberculosis were retrospectively analyzed. According to the treatment plan, the patients were divided into a control group and an observation group. The improvements in clinical symptoms, lung function indexes, immune and inflammation markers, chest X-ray results, sputum negative conversion rate, and incidence of adverse reactions were compared between the two groups. RESULTS: Patients in the observation group demonstrated superior improvement in clinical symptoms compared to the control group. After six months of treatment, both groups demonstrated significant improvements in pulmonary function scores relative to baseline, with the observation group showing greater improvement than the control group. Inflammatory and immune markers were significantly reduced in both groups compared to pre-treatment levels, with the reduction being greater in the observation group than in the control group. After 6 months of treatment, lesion absorption and cavitary closure were more favorable in the observation group. At the 6-month follow-up, the bacteriological recurrence rate in the observation group was significantly lower than that of the control group. CONCLUSION: The combined use of glucocorticoids and anti-tuberculosis drugs provides dual advantages: it effectively controls asthma while enhancing the efficacy of anti-tuberculosis treatment.
Genetically prioritized plasma proteins in intracerebral hemorrhage identified by Mendelian randomization with functional evidence of neuronal vulnerability.
Gu H, Bu YS, Niu JJ … +9 more , Zhao HM, Li JH, Jiang XT, Wu ST, Xu GL, Yu S, Feng HX, Kong FZ, Wu GH
Am J Transl Res · 2026 · PMID 42170445 · Full text
OBJECTIVES: Our study aims to assess the causal association between plasma proteins, immune cell phenotypes and intracerebral hemorrhage (ICH) and explore their downstream biological correlation. METHODS: We adopted the...
OBJECTIVES: Our study aims to assess the causal association between plasma proteins, immune cell phenotypes and intracerebral hemorrhage (ICH) and explore their downstream biological correlation. METHODS: We adopted the two-sample Mendelian randomization (MR) approach. The analysis evaluated the effects of more than 4,000 plasma proteins and 731 immune cell phenotypes on the risk of ICH. Bidirectional MR, mediation effect and sensitivity analysis confirm the causal relationship. We transfect SH-SY5Y neuroblastoma cells and overexpress AHSP or ITGB5 to observe possible function effects. RESULTS: MR analysis linked 299 plasma proteins with ICH (P < 0.05), of which 60 proteins showed strong statistical support (P < 0.01) and there was no reverse causality. Eighteen types of immune cells also affect ICH risk. Mediation analysis identified 6 causal axes to link specific proteins (IGF1R, NT5E/CD73, ITGB5, CUZD1, and AHSP) with ICH, in which different B cell and T cell subgroups play a key intermediary role. Overexpression of AHSP or ITGB5 inhibits the proliferation and migration of SH-SY5Y cells while promoting their apoptosis. CONCLUSIONS: We combined genetics and laboratory data to find that several plasma proteins affect ICH risk. The immune pathway seems to link these proteins with ICH. Although we acknowledge the limitations of MR analysis and in vitro experimental frameworks, the apoptosis promoting effects of AHSP and ITGB5 provide preliminary functional evidence of their role in neuronal damage. Targeting these pathways may provide new strategies for intervention in ICH.
Non-clostridial gas gangrene involving the thyroid gland complicated by multiple infections in a diabetic patient: a case report.
Hua R, Gan Z, Zhong J … +5 more , Xian J, Liang Y, Deng S, Zhu C, Jiang X
Am J Transl Res · 2026 · PMID 42170444 · Full text
The thyroid gland is usually resistant to infection due to its nature, including rich blood supply and lymphatic drainage. Gas gangrene involving the thyroid is extremely rare and may be related to preexisting thyroid di...
The thyroid gland is usually resistant to infection due to its nature, including rich blood supply and lymphatic drainage. Gas gangrene involving the thyroid is extremely rare and may be related to preexisting thyroid disease or diabetes. Few related cases have been reported, among which non-clostridial gas gangrene (NCGG) is particularly uncommon. Here, we briefly describe the diagnosis and treatment of a rare NCGG case involving the right lobe of the thyroid gland. A 60-year-old female patient presented with neck pain accompanied by discomfort during eating, which acutely worsened with sudden neck swelling one day before admission. Laboratory examination revealed fever, significantly elevated blood glucose, restricted neck movement, increased local skin temperature, and palpable crepitus in the cervical region. Based on clinical assessment, the patient was diagnosed with acute suppurative thyroiditis complicated by gas gangrene and poorly controlled diabetes. Intraoperative findings and post-operative histopathologic examination supported the diagnosis of NCGG. A right thyroid lobectomy was performed, along with resection of the isthmus and the left inferior thyroid pole, followed by vacuum sealing drainage with polyurethane. The patient recovered well, with no evidence of recurrence or complications at the 4-month follow-up. Successful management of this condition requires early debridement, resection of necrotic tissue, appropriate drainage, and close monitoring for potential airway complications, such as tracheomalacia.
Construction and validation of a prognostic nomogram for predicting in-hospital mortality of patients with acute chlorfenapyr poisoning.
Xie Y, Lan Y, Xu Z … +3 more , Chen Y, Shi G, Zheng F
Am J Transl Res · 2026 · PMID 42170443 · Full text
OBJECTIVES: To identify key risk factors for in-hospital mortality in patients with acute chlorfenapyr poisoning and to develop a clinically applicable nomogram to predict in-hospital mortality in this population. METHOD...
OBJECTIVES: To identify key risk factors for in-hospital mortality in patients with acute chlorfenapyr poisoning and to develop a clinically applicable nomogram to predict in-hospital mortality in this population. METHODS: This retrospective study analyzed 130 patients, who were assigned to training (n=91) and validation (n=39) cohorts. The training cohort included 53 survivors and 38 non-survivors, with 30-day mortality as the endpoint. Univariate analysis was used to identify factors associated with mortality. Candidate variables were screened using LASSO regression, followed by multivariate logistic regression to identify independent risk factors. A nomogram was constructed based on these predictive factors, and its discriminative power, calibration, and clinical applicability were evaluated. The performance of the nomogram was validated in an external validation cohort. RESULTS: The mortality rate was 41.8% in the training cohort and 38.5% in the validation cohort. Among the nine candidate variables screened by LASSO regression, multivariate analysis identified four independent predictors: ATP-cytochrome C utilization (OR 78.57, 95% CI 1.81-3412), procalcitonin (OR 65.76, 95% CI 1.04-4175), administered dose (OR 1.08, 95% CI 1.02-1.14), and alanine aminotransferase (ALT) (OR 1.09, 95% CI 1.02-1.17). The predictive model demonstrated excellent discriminative power, with a C-index of 0.988 in the training group and 0.849 in the validation group. The calibration was good (P=0.771 and P=0.942), and decision curve analysis confirmed its significant clinical applicability. CONCLUSION: We developed and validated a practical nomogram that accurately predicts the risk of in-hospital mortality in patients with acute chlorfenapyr poisoning, which may aid in early risk stratification and clinical decision-making.
Clinical significance of microRNA-30d-5p and TGF-β/Smad2 pathway expression levels in polycystic ovary syndrome patients.
Qian Y, Zheng N, Liu J … +3 more , Lu T, Chen Z, Jiang L
Am J Transl Res · 2026 · PMID 42170442 · Full text
OBJECTIVE: To investigate the clinical significance of miR-30d-5p and transforming growth factor-β (TGF-β)/Smad2 pathway expression levels in polycystic ovary syndrome (PCOS) patients. METHODS: A total of 82 PCOS patient...
OBJECTIVE: To investigate the clinical significance of miR-30d-5p and transforming growth factor-β (TGF-β)/Smad2 pathway expression levels in polycystic ovary syndrome (PCOS) patients. METHODS: A total of 82 PCOS patients undergoing their first fertilization-embryo transfer (IVF-ET) (PCOS group) and 82 non-PCOS patients undergoing their first IVF-ET due to fallopian tube factors (control group) were included in this retrospective study. The levels of miR-30d-5p, TGF-β1, Smad2, sex hormones, and insulin in follicular fluid exosomes on the day of oocyte retrieval were compared between the two groups. Correlation analysis was used to analyze the correlation between these indicators in the PCOS group. ROC curve analysis was performed to predict the clinical value of miR-30d-5p, TGF-β1, and Smad2 levels in the PCOS group for low 2PN numbers. RESULTS: There were statistically significant differences between the groups in miR-30d-5p, estrogen, progesterone, TGF-β1, Smad2, testosterone, and insulin levels (all P<0.05). In the PCOS group, miR-30d-5p was negatively correlated with testosterone and insulin levels, and positively correlated with estrogen and progesterone levels; TGF-β1 and Smad2 were positively correlated with testosterone and insulin levels, and negatively correlated with estrogen and progesterone levels (all P<0.05). miR-30d-5p, TGF-β1, and Smad2, alone or in combination, had an AUC >0.7 in predicting low 2PN numbers in PCOS patients. CONCLUSION: The miR-30d-5p and TGF-β/Smad2 pathways are closely related to ovarian sex hormone and insulin levels in patients with PCOS and may participate in the development and progression of PCOS.
FAM19A5 is an independent prognostic biomarker in thyroid cancer.
Luan S, Yuan H, Liu D
Am J Transl Res · 2026 · PMID 42170441 · Full text
OBJECTIVES: Family with sequence similarity 19 member A5 (FAM19A5), also known as TAFA chemokine-like family member 5 (TAFA5), has been implicated in tumorigenesis. This study aimed to investigate the role of FAM19A5 in...
OBJECTIVES: Family with sequence similarity 19 member A5 (FAM19A5), also known as TAFA chemokine-like family member 5 (TAFA5), has been implicated in tumorigenesis. This study aimed to investigate the role of FAM19A5 in thyroid cancer (TC) using bioinformatics analysis and functional assays. METHODS: RNA sequencing (RNA-seq) data and clinicopathologic characteristics of 513 patients with papillary thyroid cancer (PTC) were retrieved from the Cancer Genome Atlas (TCGA) database and re-analyzed. The diagnostic performance of FAM19A5 was evaluated using receiver operating characteristic (ROC) curve analysis. The Kaplan-Meier method was used to analyze overall survival (OS) and disease-specific survival (DSS). Cox regression analysis was performed to identify independent risk factors for PTC. Gene set enrichment analysis (GSEA) was applied to explore signaling pathways associated with FAM19A5. The mRNA expression of FAM19A5 was detected by quantitative real-time PCR (RT-qPCR). Cell proliferation, migration, and invasion were assessed using colony formation, wound healing, and Transwell assays, respectively. Protein expression of FAM19A5 and nuclear factor kappa B (NF-κB) pathway-related proteins was detected by Western blot. RESULTS: FAM19A5 expression was significantly upregulated in TC tissues and cells. Elevated FAM19A5 expression was correlated with advanced T stage, lymph-node metastasis, and poorer OS and DSS. GSEA showed enrichment of NF-κB signaling pathways in tumors with high FAM19A5 high-expression. FAM19A5 knockdown significantly inhibited TC cell proliferation, migration, and invasion. Furthermore, treatment with tumor necrosis factor alpha (TNF-α), an activator of NF-κB, reversed the inhibitory effects induced by FAM19A5 knockdown. CONCLUSIONS: FAM19A5 is an independent predictor of poor prognosis in TC and may serve as a potential therapeutic target. Mechanistically, FAM19A5 knockdown suppresses TC cell proliferation, migration, and invasion, potentially through modulation of the NF-κB pathway.
Construction and validation of a predictive model for drug resistance in clear cell renal cell carcinoma based on the heterogeneous characteristics of pathological omics.
Xu G, Meng Y, Cui Y … +4 more , Li J, Yang P, Wang W, Liu S
Am J Transl Res · 2026 · PMID 42170440 · Full text
Therapeutic resistance in advanced clear cell renal cell carcinoma (ccRCC) is partly driven by intra-tumoral heterogeneity. This study aimed to develop and validate a predictive model for drug resistance by integrating p...
Therapeutic resistance in advanced clear cell renal cell carcinoma (ccRCC) is partly driven by intra-tumoral heterogeneity. This study aimed to develop and validate a predictive model for drug resistance by integrating pathomic heterogeneity features from histopathologic images with clinical variables. This retrospective study included 358 patients from The Cancer Genome Atlas (TCGA)-KIRC (training cohort) and 143 patients from an independent hospital cohort (2018-2022) for external validation. Resistance was defined as radiological progression within 12 months of starting first-line VEGFR-TKI therapy. Whole-slide images were processed to extract pathomics features: nuclear morphometry (area, perimeter, eccentricity) and texture features (contrast, correlation, energy, homogeneity), with standard deviations quantifying heterogeneity. Nuclear Heterogeneity Proportion (NHP) was calculated as the percentage of patches with significant nuclear heterogeneity. A predictive model combining significant pathomics and clinical features was constructed using multivariate logistic regression and presented as a nomogram. The resistant group (n=162) showed significantly higher NHP (39.72% vs. 26.84%, <0.001) and greater heterogeneity in all nuclear and textural features versus non-resistant group (n=196). Multivariate analysis identified high NHP (OR=10.885, <0.001), large tumor size (OR=2.897, =0.002), advanced TNM stage (OR=2.814, =0.015), metastasis (OR=2.642, =0.029), and older age (OR=2.624, =0.021) as independent predictors. The integrated model achieved an AUC of 0.888 internally and 0.925 upon external validation, with 0.897 sensitivity and 0.875 specificity. The integrated pathomic-clinical model robustly predicts drug resistance in ccRCC, highlighting the value of computational pathology for risk stratification and personalized treatment planning.
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