搜索结果：American journal of translational research

As a serious iatrogenic complication, the incidence and clinical importance of contrast-induced nephropathy (CIN) have become increasingly prominent. CIN not only increases the length of hospital stay, medical cost and short-term mortality, but also is an independent predictor of long-term renal function deterioration and adverse cardiovascular events. At present, there is no effective method to completely avoid the occurrence of CIN after the use of contrast media in clinical practice, and the treatment of CIN that has occurred is also limited. Therefore, the prevention of CIN has become the focus of clinical research, and the identification of the risk factors of CIN is the basis and key link in the development of prevention programs. The purpose of this study is to review the existing evidence and further study the pathogenesis, risk factors and early predictors of CIN, so as to provide a reference for medical staff to formulate preventive measures, thereby reducing the risk of CIN and improving medical quality and ensuring patient safety.

The aim of this study was to systematically evaluate the antimicrobial potential of Compound Huangbai Liquid (HB) against Staphylococcus aureus (S. aureus), Escherichia coli (E. coli) and methicillin-resistant Staphylococcus aureus (MRSA) infections. 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. 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 S. aureus and E. coli 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. HB possesses antimicrobial effects against S. aureus and E. coli and possesses the prospect of further development as an antimicrobial adjuvant therapeutic agent.

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. 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. 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. Esmolol combined with carvedilol demonstrates superior efficacy and safety compared with carvedilol monotherapy in patients with myocardial ischemia secondary to CHD.

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. 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. 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 &#xb1; 6.63 vs. 95.12 &#xb1; 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 &#xb1; 9.77 vs. 116.42 &#xb1; 17.38 mmHg, P=0.003) and mean arterial pressure, as well as a lower rate-pressure product (10395.81 &#xb1; 928.89 vs. 10754.15 &#xb1; 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). 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.

Intraoperative neurophysiological monitoring (IONM) plays a critical role in spinal surgery by reducing the risk of nerve injury; however, its quality can be significantly influenced by anesthetic agents. This study aimed to compare the effects of remimazolam and propofol on IONM performance and postoperative recovery. This retrospective analysis included patients who underwent prone-position spinal surgery with IONM between January 2021 and June 2025. Patients were divided into either a remimazolam group or a propofol group according to the primary sedative administered. The outcomes assessed included IONM parameters [somatosensory evoked potentials (SEP)/motor evoked potentials (MEP) amplitude/latency] after intubation (T1) and at 30 min (T3) and 50 min (T4) following recovery from neuromuscular blockade. Additional outcomes included hemodynamics, remifentanil consumption, recovery time, and cognitive function scores. A total of 204 patients included in the analysis (Remimazolam group: 101 cases, Propofol group: 103 cases). Compared to the propofol group, the remimazolam group demonstrated significantly improved IONM signals, higher SEP amplitude at T4 (2.16 vs. 1.97 &#x3bc;V, P<0.001), and higher MEP amplitude at T4 (1680.73 vs. 1500.64 &#x3bc;V, P<0.001). The incidence of hypotension (6.93% vs. 19.42%, P=0.009) and bradycardia (5.94% vs. 14.56%, P=0.043) were significantly lower, while remifentanil consumption was significantly higher (2005.64 vs. 1425.44 ug, P<0.001) in the remimazolam group. In addition, patients in the remimazolam group exhibited shorter recovery times (awakening time: 18.91 vs. 24.25 min, P<0.001) and better cognitive function (MoCA score on postoperative Day 3: 24.41 vs. 23.54, P<0.001). Remimazolam provides superior IONM conditions, a lower incidence of intraoperative hypotension and bradycardia, and faster postoperative recovery compared to propofol in patients undergoing spinal surgery.

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. 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. 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-&#x3b1;, 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. 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.

To investigate the effects of epidural ropivacaine combined with dexamethasone on postpartum uterine cramping pain, inflammatory markers, and breastfeeding behavior in multiparous women. This retrospective cohort study included 336 women who underwent vaginal delivery and received postpartum epidural analgesia between May 2022 and November 2024, including 211 multiparous women. The observation group (n = 172) received 0.15% ropivacaine combined with 10 mg dexamethasone, while the control group (n = 164) received only 0.15% ropivacaine. The severity of uterine cramping pain was assessed using the Visual Analogue Scale (VAS) at 2, 6, 12, 24, and 48 hours postpartum. Serum levels of tumor necrosis factor-&#x3b1; (TNF-&#x3b1;), interleukin-6 (IL-6), and interleukin-10 (IL-10) were measured using ELISA, and C-reactive protein (CRP) was measured using a quantitative laboratory assay, at 6, 24, and 72 hours postpartum. Breastfeeding indicators and adverse events were recorded. The VAS scores at all time points in the observation group were significantly lower than those of the control group (all P < 0.001), with a lower rescue analgesia rate (10.47% vs. 21.34%, P = 0.006). At 24 hours postpartum, the observation group showed significantly lower levels of TNF-&#x3b1;, IL-6, and CRP, and significantly higher levels of IL-10 (all P < 0.001); shorter first breastfeeding time (38.00 minutes vs. 52.00 minutes, P < 0.001); higher frequency of breastfeeding within 48 hours postpartum; and a higher rate of exclusive breastfeeding on day 7 postpartum (84.30% vs. 68.29%, P < 0.001). There were no significant differences in adverse events or neonatal outcome between the two groups (both P > 0.05). Epidural analgesia with ropivacaine combined with dexamethasone effectively alleviates postpartum uterine cramping pain in multiparous women, regulates the inflammatory responses, improves breastfeeding outcomes, and has a good safety profile.

Our study aims to assess the causal association between plasma proteins, immune cell phenotypes and intracerebral hemorrhage (ICH) and explore their downstream biological correlation. 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. 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. 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.

To evaluate the effect of warm acupuncture on simple obesity complicated with dyslipidemia (spleen deficiency and dampness obstruction type). 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. 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). 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.

To evaluate the efficacy and immunomodulatory effects of glucocorticoid combination therapy with anti-tuberculosis treatment in patients with asthma complicated by pulmonary tuberculosis. 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. 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. The combined use of glucocorticoids and anti-tuberculosis drugs provides dual advantages: it effectively controls asthma while enhancing the efficacy of anti-tuberculosis treatment.

To explore the value of q-Dixon magnetic resonance imaging (MRI) in assessing the severity of lumbar osteoporosis in patients with type 2 diabetes mellitus (T2DM). A retrospective analysis was conducted on 100 T2DM patients admitted to our hospital between 2023 and 2024, who were divided into a control group (n = 43), an osteopenia group (n = 26), and an osteoporosis group (n = 31). General data (including use of hypoglycemic agents and menopausal status) was collected. Bone mineral density (BMD) of L1-L4 was measured using dual-energy X-ray absorptiometry (DXA), and bone marrow fat fraction (FF) was measured using q-Dixon technology. Statistical analysis included ANOVA, correlation tests, receiver operating characteristic (ROC) curve analysis, and DeLong's test. Regarding lumbar BMD and FF, the osteoporosis group had lower L1-L4 and total lumbar BMD than the other groups, and the osteopenia group had lower BMD than the control group (all P<0.05); conversely, the osteoporosis group had higher L1-L4 and total lumbar FF than the other groups, and the osteopenia group had higher FF than the control group (all P<0.05). In each group, males had higher L1-L4 segmental and total BMD, as well as total FF than females (all P<0.05), except for L3 BMD in the control group and L1-L4 segmental FF in the control and osteopenia groups (all P>0.05). Significant segmental differences were detected in both BMD and FF across lumbar spine segments. BMD followed a descending order of L3 > L4 > L2 > L1, whereas FF was ordered as L4 > L3 > L2 > L1 (all P<0.05). Kendall correlation analysis showed that L1-L4 and total BMD were negatively correlated with osteoporosis (r = -0.587 to -0.790, all P<0.001); L1-L4 and total FF were positively correlated with osteoporosis (r = 0.387 to 0.506, all P<0.001). Pearson correlation analysis showed that L1-L4 and total FF were negatively correlated with L1-L4 and total BMD (all P<0.01), and the correlation was stronger in females than males. ROC curves showed AUC for assessing osteoporosis severity by total FF was 0.856 (sensitivity 77.42%, specificity 81.16%, Youden index 0.586). DeLong's test showed the AUC of total FF was significantly higher than that of L1 FF (0.734, P = 0.034), while there were no statistically significant differences in the AUCs of total FF compared with those of L2-L4 FF (0.821, 0.829, and 0.823, respectively) (all P>0.05). The q-Dixon technique can effectively assess the severity of lumbar osteoporosis in patients with T2DM. Total FF is a reasonable and reliable non-invasive indicator because it integrates L1-L4 segmental information, has the highest AUC, and exhibits segmental and gender differences, providing a novel clinical strategy.

To investigate the effect of remazolam combined with hydromorphone on postoperative cognitive function in elderly patients undergoing hip replacement. 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. 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. 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.

To investigate the relationship between adherence to sleep restriction therapy and emotional intelligence (EI) among Chinese individuals with sleep disorders in high-stress professions. A retrospective case-control study was conducted using data from the electronic medical records system. A total of 257 patients with sleep disorders who underwent 12 weeks of sleep restriction therapy at The Affiliated Hospital of Southwest Medical University between January 2022 and January 2023 were included. Participants were classified into low EI (n = 76) and high EI (n = 181) groups. Adherence to therapy was the exposure variable. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using binary logistic regression, with subgroup and sensitivity analyses. Higher adherence to sleep restriction therapy was significantly associated with higher EI scores. Compared to fully adherent participants, partially adherent individuals had a 2.39-fold increased risk of lower EI (OR = 2.39, 95% CI: 1.13-5.05), while non-adherent participants had a 5.35-fold elevated risk (OR = 5.35, 95% CI: 1.86-15.38). Subgroup analyses revealed stronger effects in males and individuals aged < 28 years. Males exhibited ORs of 2.02 (95% CI: 0.87-4.66) for partial adherence and 6.75 (95% CI: 2.00-22.77) for non-adherence. Similarly, the < 45-year subgroup showed ORs of 1.36 (95% CI: 0.61-3.03) and 2.99 (95% CI: 1.04-8.56), respectively. Weaker associations were observed in females and those aged &#x2265; 45 years. Better adherence to sleep restriction therapy is positively associated with EI in high-stress professionals with sleep disorders, particularly among males and younger individuals. Optimizing adherence to therapy is a key strategy for improving emotional regulation in these populations.

To evaluate the clinical efficacy and functional outcome of ligation of the intersphincteric fistula tract (LIFT) versus fistulotomy in patients with complex anal fistulas. 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). 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. LIFT offers advantages in sphincter preservation, reduced bleeding, faster recovery, and fewer complications, while providing comparable long-term recurrence outcomes to fistulotomy.

Chondrodysplasia punctata (CDP) is characterized by irregular calcification of the epiphyseal cartilage in the neonatal or infant period, which is determined by both genetic and non-genetic factors. To explore the prenatal ultrasonographic manifestations, genetic etiology, and pregnancy outcomes of fetal CDP. Five fetuses from three families diagnosed with CDP by prenatal ultrasound were retrospectively analyzed, and the clinical features, genetic testing results, and pregnancy outcomes of the CDP cases were analyzed. Prenatal ultrasound showed strong punctate echogenicity of the long diaphyseal epiphysis (mainly in the femur, tibia, and humerus) in all five fetuses. Four fetuses (4/5, 80%) had short long bones. Three fetuses (3/5, 60%) had spinal anomalies and one (1/5, 20%) had Binder syndrome. Cataracts were present in two fetuses (2/5, 40%). Genetic testing was performed on all five fetuses. Chromosome karyotype and chromosomal microarray analysis showed no abnormalities. However, some region-specific pathogenic variants were identified in whole exome sequencing. Labor was induced in four fetuses. Only one fetus was delivered at 39 weeks of gestation, transferred to the Department of Pediatrics for respiratory support due to dyspnea after birth, and had a good prognosis with follow-up. Fetuses diagnosed with CDP mostly exhibit genetic abnormalities and adverse neonatal outcomes. Fetuses with punctate strong echogenicity of the long diaphyseal epiphysis and short long bones identified on ultrasound must be comprehensively screened for other systemic malformations, particularly spinal dysplasia and facial malformations. Genetic testing is recommended.

The aim of this study is to explore the relationship between the levels of anti-M&#xfc;llerian hormone (AMH) and metabolic and reproductive outcomes across different polycystic ovary syndrome (PCOS) phenotypes. 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 (&#x2264;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. 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). 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.

To evaluate the effect of minimally invasive techniques (MITs) on the treatment outcomes and postoperative complications (POCs) of patients with orthopedic trauma. 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. 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. Compared with conventional surgery, MITs provide superior clinical efficacy and reduce the incidence of POCs in the management of orthopedic trauma.

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. 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. 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. 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.

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. 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. 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 (E2) levels on the day of human chorionic gonadotropin (HCG) administration, with an elevated percentage of type A endometrium (P<0.05). LE shows higher pregnancy efficiency, better endometrial receptivity, and lower risk of multifetal gestation in IUI cycles.