Focus Of Medical Research Research Articles

Microbiome in urologic neoplasms: focusing on tumor immunity

Urological tumors are an important disease affecting global human health, and their pathogenesis and treatment have been the focus of medical research. With the in - depth study of microbiomics, the role of the microbiome in urological tumors has gradually attracted attention. However, the current research on tumor - associated microorganisms mostly focuses on one type or one site, and currently, there is a lack of attention to the microbiome in the immunity and immunotherapy of urological tumors. Therefore, in this paper, we systematically review the distribution characteristics of the microbiome (including microorganisms in the gut, urine, and tumor tissues) in urologic tumors, the relationship with disease prognosis, and the potential mechanisms of microbial roles in immunotherapy. In particular, we focus on the molecular mechanisms by which the microbiome at different sites influences tumor immunity through multiple “messengers” and pathways. We aim to further deepen the understanding of microbiome mechanisms in urologic tumors, and also point out the direction for the future development of immunotherapy for urologic tumors.

Development of a magnetic α-Fe2O3/Fe3O4 heterogeneous nanorod-based electrochemical biosensing platform for HPV16 E7 oncoprotein detection

The prevention, diagnosis and treatment of cancer have always been the focus of medical research. In this study, a label-free, rapid, simple, sensitive, and specific method for the detection of HPV16 E7 oncoprotein was developed. The electrochemical biosensor platform was constructed by magnetic self-assembly of α-Fe2O3/Fe3O4@Au nanocomposites onto the surface of magnetic glass carbon electrode (MGCE), and the nanocomposite was connected to aptamer through AuS bond to construct a probe to capture HPV16 E7. Cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS) were applied to verify the performance of the constructed biosensor. The condition optimization and performance analysis were carried out by differential pulse voltammetry (DPV). Under optimal conditions, the biosensor exhibited a strong linearity between current value and the logarithm of HPV16 E7 oncoprotein concentration in the range of 10 pg/mL – 0.1 μg/mL, with a limit of detection (LOD) of 159 fg/mL and a limit of quantification (LOQ) of 530 fg/mL, and it also revealed excellent reproducibility, long-term stability, and anti-interference ability. In a word, the biosensor would contribute to the early diagnosis of oncoprotein HPV16 E7 and had promising application prospects.

Feasibility Study of Yuejuwan as an Adjuvant Therapy for Primary Liver Cancer

Primary liver cancer is one of the common malignant tumours of the digestive system in clinical practice, and in the modern healthcare system, the therapeutic efficacy of primary liver cancer and the quality of patients' survival have always been the focus of medical research. In the face of this challenge, traditional Chinese medicine (TCM) offers unique perspectives and potential solutions, among which Yuejuwan, as a traditional Chinese medicine prescription with a long history, has attracted widespread attention for its application value in the treatment of primary liver cancer. This paper discusses and analyses the treatment of primary liver cancer in terms of the etiology and pathogenesis of liver cancer, the types of evidence, as well as the rationale and prescription of Yuejuwan, and the study of its pharmacological effects, aiming at exploring the feasibility of Yuejuwan as an adjuvant therapy in the treatment of primary liver cancer and its mechanism of action. It provides a new understanding of the identification and treatment of primary liver cancer, in order to improve the clinical efficacy of primary liver cancer, and to achieve the purpose of alleviating the pain of patients and improving the quality of their survival.

Prognostic determinants in cancer survival: a multidimensional evaluation of clinical and genetic factors across 10 cancer types in the participants of Genomics England’s 100,000 Genomes Project

BackgroundCancer is a complex disease, caused and impacted by a combination of genetic, demographic, clinical, environmental and lifestyle factors. Analysis of cancer characteristics, risk factors, treatment options and the heterogeneity across cancer types has been the focus of medical research for years. The aim of this study is to describe and summarise genetic, clinicopathological, behavioural and demographic characteristics and their differences across ten common cancer types and evaluate their impact on overall survival outcomes.MethodsThis study included data from 9977 patients with bladder, breast, colorectal, endometrial, glioma, leukaemia, lung, ovarian, prostate, and renal cancers. Genetic data collected through the 100,000 Genomes Project was linked with clinical and demographic data provided by the National Cancer Registration and Analysis Service (NCRAS), Hospital Episode Statistics (HES) and Office for National Statistics (ONS). Descriptive and Kaplan Meier survival analyses were performed to visualise similarities and differences across cancer types. Cox proportional hazards regression models were applied to identify statistically significant prognostic factor associations with overall survival.Results161 clinical and 124 genetic factors were evaluated for prognostic association with overall survival. Of these, 116 unique factors were found to have significant prognostic effect for overall survival across ten cancer types when adjusted for age, sex and stage. The findings confirmed prognostic associations with overall survival identified in previous studies in factors such as multimorbidity, tumour mutational burden, and mutations in genes BRAF, CDH1, NF1, NRAS, PIK3CA, PTEN, TP53. The results also identified new prognostic associations with overall survival in factors such as mental health conditions, female health-related conditions, previous hospital encounters and mutations in genes FANCE, FBXW7, GATA3, MSH6, PTPN11, RB1, RNF43.ConclusionThis study provides a comprehensive view of clinicopathological and genetic prognostic factors across different cancer types and draws attention to less commonly known factors which might help produce more precise prognosis and survival estimates. The results from this study contribute to the understanding of cancer disease and could be used by researchers to develop complex prognostic models, which in turn could help predict cancer prognosis more accurately and improve patient outcomes.

Stem Cell Division and Its Critical Role in Mammary Gland Development and Tumorigenesis: Current Progress and Remaining Challenges.

The origin of breast cancer (BC) has traditionally been a focus of medical research. It is widely acknowledged that BC originates from immortal mammary stem cells and that these stem cells participate in two division modes: symmetric cell division (SCD) and asymmetrical cell division (ACD). Although both of these modes are key to the process of breast development and their imbalance is closely associated with the onset of BC, the molecular mechanisms underlying these phenomena deserve in-depth exploration. In this review, we first outline the molecular mechanisms governing ACD/SCD and analyze the role of ACD/SCD in various stages of breast development. We describe that the changes in telomerase activity, the role of polar proteins, and the stimulation of ovarian hormones subsequently lead to two distinct consequences: breast development or carcinogenesis. Finally, gene mutations, abnormalities in polar proteins, modulation of signal-transduction pathways, and alterations in the microenvironment disrupt the balance of BC stem cell division modes and cause BC. Important regulatory factors such as mammalian Inscuteable mInsc, Numb, Eya1, PKCα, PKCθ, p53, and IL-6 also play significant roles in regulating pathways of ACD/SCD and may constitute key targets for future research on stem cell division, breast development, and tumor therapy.

Improving prediction of blood cancer using leukemia microarray gene data and Chi2 features with weighted convolutional neural network

Blood cancer has emerged as a growing concern over the past decade, necessitating early diagnosis for timely and effective treatment. The present diagnostic method, which involves a battery of tests and medical experts, is costly and time-consuming. For this reason, it is crucial to establish an automated diagnostic system for accurate predictions. A particular field of focus in medical research is the use of machine learning and leukemia microarray gene data for blood cancer diagnosis. Even with a great deal of research, more improvements are needed to reach the appropriate levels of accuracy and efficacy. This work presents a supervised machine-learning algorithm for blood cancer prediction. This work makes use of the 22,283-gene leukemia microarray gene data. Chi-squared (Chi2) feature selection methods and the synthetic minority oversampling technique (SMOTE)-Tomek resampling is used to overcome issues with imbalanced and high-dimensional datasets. To balance the dataset for each target class, SMOTE-Tomek creates synthetic data, and Chi2 chooses the most important features to train the learning models from 22,283 genes. A novel weighted convolutional neural network (CNN) model is proposed for classification, utilizing the support of three separate CNN models. To determine the importance of the proposed approach, extensive experiments are carried out on the datasets, including a performance comparison with the most advanced techniques. Weighted CNN demonstrates superior performance over other models when coupled with SMOTE-Tomek and Chi2 techniques, achieving a remarkable 99.9% accuracy. Results from k-fold cross-validation further affirm the supremacy of the proposed model.

The hepatoprotective effect of 4-phenyltetrahydroquinolines on carbon tetrachloride induced hepatotoxicity in rats through autophagy inhibition

BackgroundThe liver serves as a metabolic hub within the human body, playing a crucial role in various essential functions, such as detoxification, nutrient metabolism, and hormone regulation. Therefore, protecting the liver against endogenous and exogenous insults has become a primary focus in medical research. Consequently, the potential hepatoprotective properties of multiple 4-phenyltetrahydroquinolines inspired us to thoroughly study the influence of four specially designed and synthesized derivatives on carbon tetrachloride (CCl4)-induced liver injury in rats.Methods and resultsSeventy-seven Wistar albino male rats weighing 140 ± 18 g were divided into eleven groups to investigate both the toxicity profile and the hepatoprotective potential of 4-phenyltetrahydroquinolines. An in-vivo hepatotoxicity model was conducted using CCl4 (1 ml/kg body weight, a 1:1 v/v mixture with corn oil, i.p.) every 72 h for 14 days. The concurrent treatment of rats with our newly synthesized compounds (each at a dose of 25 mg/kg body weight, suspended in 0.5% CMC, p.o.) every 24 h effectively lowered transaminases, preserved liver tissue integrity, and mitigated oxidative stress and inflammation. Moreover, the histopathological examination of liver tissues revealed a significant reduction in liver fibrosis, which was further supported by the immunohistochemical analysis of α-SMA. Additionally, the expression of the apoptotic genes BAX and BCL2 was monitored using real-time PCR, which showed a significant decrease in liver apoptosis. Further investigations unveiled the ability of the compounds to significantly decrease the expression of autophagy-related proteins, Beclin-1 and LC3B, consequently inhibiting autophagy. Finally, our computer-assisted simulation dockingonfirmed the obtained experimental activities.ConclusionOur findings suggest that derivatives of 4-phenyltetrahydroquinoline demonstrate hepatoprotective properties in CCl4-induced liver damage and fibrosis in rats. The potential mechanism of action may be due to the inhibition of autophagy in liver cells.

Digital twins in medicine.

Medical digital twins, which are potentially vital for personalized medicine, have become a recent focus in medical research. Here we present an overview of the state of the art in medical digital twin development, especially in oncology and cardiology, where it is most advanced. We discuss major challenges, such as data integration and privacy, and provide an outlook on future advancements. Emphasizing the importance of this technology in healthcare, we highlight the potential for substantial improvements in patient-specific treatments and diagnostics.

Diagnostic advantages of transrectal ultrasound with gastrointestinal agent instillation for rectal adenoma and early-stage rectal cancer: comparison of conventional transrectal ultrasound techniques.

Despite being a major focus of medical research for decades, rectal cancer remains a major threat to human health. This study aimed to compare and analyze the diagnostic value of transrectal ultrasonography (TRUS) for rectal adenoma and early-stage rectal cancer before and after gastrointestinal agent instillation. In this prospective study, patients diagnosed with rectal adenomas and early-stage rectal cancer by ultrasound were randomly selected for inclusion. All patients underwent ultrasound examination at the Outpatient Department of the First Affiliated Hospital of China Medical University and underwent surgical treatment at the First Affiliated Hospital of China Medical University. Patients with a lesion located 13 cm or more from the edge of the anus, or history of surgery, and a history of radiation and chemotherapy were excluded. A gastrointestinal agent was directly instilled into the rectal cavity during conventional TRUS to compare and analyze the display of rectal lesions before and after such instillation and to evaluate the infiltration depth of rectal lesions. These findings were compared to the pathological findings to determine the diagnostic efficacy. Both the conventional TRUS and TRUS with gastrointestinal agent instillation were able to show the rectal wall structure and rectal lesions; the detection rate of rectal lesions of the former was 75.0%, and that of the latter was 97.1% (P<0.001). Of the 27 rectal adenomas, conventional TRUS detected 10, and TRUS with gastrointestinal agent instillation detected 25 lesions. The accuracy [90.54%; 95% confidence interval (CI): 81.48-96.11%; P=1.05E-08], specificity (87.88%; 95% CI: 71.80-96.60%; P=1.09E-05), and sensitivity (92.68%; 95% CI: 80.08-98.47%; P=1.05E-08) of TRUS in diagnosing early-stage rectal cancer were consistent with the pathological findings (P<0.001). The accuracy (95.95%, 95% CI: 88.61-99.16%; P=3.82E-11), specificity (93.94%, 95% CI: 79.77-99.26%; P=1.31E-07), and sensitivity (97.56%, 95% CI: 87.15-99.94%; P=3.82E-11) of TRUS after gastrointestinal agent infusion in diagnosing early-stage rectal cancer were consistent with the pathological findings (P<0.001). The specificity (87.88%; 95% CI: 71.80-96.60%; P=1.09E-05) of TRUS in diagnosing rectal adenomas was consistent with the pathological finding (P<0.001), but the accuracy (65%; 95% CI: 51.60-76.87%; P=0.25) and sensitivity (37.04%, 95% CI: 19.40-57.63%; P=0.25) were not (P>0.05). Meanwhile, the accuracy (93.33%; 95% CI: 83.80-98.15%; P=5.65E-06), specificity (93.94; 95% CI: 79.77-99.26%; P=1.31E-07), and sensitivity (92.59%; 95% CI: 75.71-99.09%; P=5.65E-06) of TRUS after gastrointestinal agent infusion in diagnosing rectal adenomas were consistent with the pathological findings (P<0.001). TRUS with gastrointestinal agent instillation had significantly improved accuracy in diagnosing early-stage rectal cancer and detecting intrarectal adenomatoid lesions.

Assessment of Patients' Quality-of-Life Post-Thyroidectomy.

The assessment of quality of life (QOL) after thyroidectomy has been a focus of medical research, aiming to understand its impact on patients' overall well-being and functional status. Studies have examined the physical, psychological, and social dimensions of QOL, providing valuable insights into the outcomes of thyroidectomy and improving patient care.The aim of the study is to evaluate the long-term impact of different aspects of patients' quality of life post-thyroidectomy. This cross-sectional study was conducted in Taif City and included 100 participants post-thyroidectomy. Data were collected from medical records and telephone interviews using the modified Arabic version of the EROTC QLQ-H&N43 questionnaire. The collected data were analyzed using R software version 4.2.2. The majority of the 100 participants were female (76%), and most were over 50 years old (38%). The types of surgery performed included hemithyroidectomy (36%), subtotal thyroidectomy (6%), and total thyroidectomy (58%). Participants reported difficulties related to their senses, body satisfaction, sexual satisfaction, eating, speaking, and social interactions. Pain in the mouth and jaw, as well as swallowing difficulties, showed variations among the surgery groups. Other symptoms, such as tooth problems, dry mouth, and swelling in the neck, did not differ significantly among the groups. Numbness in the hands or feet was associated with a subtotal or total thyroidectomy. Difficulties with enjoying meals, eating in front of others, and communication issues showed variations among the surgery groups. This study provided insights into the QOL of thyroidectomy survivors in Taif City. Participants reported challenges related to sensory, body, and sexual issues, as well as difficulties with eating, speaking, and social interactions. The findings highlight the need for interventions and support to address these challenges and optimize the QOL of thyroidectomy patients. Furthermore, research is warranted to explore specific factors contributing to these difficulties and to develop targeted interventions for better patient outcomes.

Role of CKD273 in Diabetic Nephropathy: A Systematic Review

Introduction: Diabetic Nephropathy (DN) is a major cause of increased morbidity and mortality in patients with Diabetes Mellitus (DM). The development of novel biomarkers for kidney disease, especially DN, is becoming a focus of medical research. Serum creatinine and urine albumin measurements had been the gold standards for the diagnosis of DN until the advent of newer markers like Cystatin C, Kidney Injury Molecule-1, etc. Currently, there is no non invasive investigation for the prediction of DN. Nevertheless, the field of proteomics is advancing at a rapid pace, such that urinary proteomic biomarkers have found a spot in the diagnosis of DN. The role of the urinary proteomic Chronic Kidney Disease 273 (CKD273) classifier, in particular, has been demonstrated in early prediction. Aim: To highlight the performance of the CKD273 classifier in the early prediction of DN. Materials and Methods: Pubmed and Scopus databases were extensively searched using the keywords diabetes, DM, renal disease or kidney disease, proteomics or peptide, urinary markers or biomarkers. Full-text original articles conducted on humans and written in English, published between 2014 and 2022, specifically prospective and retrospective observational studies, crosssectional studies, Randomised Controlled Trials (RCT), and casecontrol studies investigating the efficacy of the urinary biomarker CKD273 in the prediction of DN were included in the review. The literature search, strictly based on Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, led to the identification of eight relevant studies, which were included in the present review. The quality and Risk of Bias (RoB) of the selected articles were assessed using the Newcastle Ottowa scale (NOS) and Risk Of Bias 2 (ROB2) tool. Results: The selected studies proved the efficacy of the urinary proteomic classifier CKD273 as a cost-effective biomarker in predicting the decline in renal function in both normoalbuminuric diabetics and DN patients. Conclusion: Based on the articles included in the present systematic review, it has been found that CKD273 plays a vital role in the early prediction of renal dysfunction in normoalbuminuric diabetics as well as in the detection of progressing renal disease in DN patients. It has also been found to be cost-effective compared to established markers such as estimated Glomerular Filtration Rate (eGFR), Urine Albumin Excretion Rate (UAER), etc.

ВЛИЯНИЕ МЕЛАТОНИНА НА УРОВЕНЬ АРТЕРИАЛЬНОГО ДАВЛЕНИЯ У ЛИЦ ПОЖИЛОГО ВОЗРАСТА

The study provides literature data on the impact of melatonin on blood pressure (BP) in elderly individuals with arterial hypertension (AH). AH is a significant risk factor for cardiovascular diseases (CVDs) and is a key focus of medical research. Melatonin, which plays a crucial role in the body's regulatory mechanisms, particularly when its production is disrupted, can significantly influence the development of AH. Melatonin is not a specific treatment for a particular disease but a multifunctional element that helps maintain homeostasis. Combining melatonin with antihypertensive therapy in elderly individuals with AH has been found to lead to more effective treatment outcomes. Exploring the effects of melatonin on BP levels in elderly individuals with AH is of great scientific interest, especially in understanding the relationship between individual melatonin secretion characteristics and predisposition to cardiovascular complications. This topic requires further research for a deeper understanding. Over 400 sources were analyzed on various aspects of the impact of melatonin on BP levels using materials from the PubMed and Google Scholar electronic databases. Out of these, 44 sources were selected and included in the study, considering relevant keywords. Keywords: Melatonin, blood pressure, arterial hypertension, cardiovascular disease, old age.

Cell recognition based on features extracted by AFM and parameter optimization classifiers.

Intelligent technology can assist in the diagnosis and treatment of disease, which would pave the way towards precision medicine in the coming decade. As a key focus of medical research, the diagnosis and prognosis of cancer play an important role in the future survival of patients. In this work, a diagnostic method based on nano-resolution imaging was proposed to meet the demand for precise detection methods in medicine and scientific research. The cell images scanned by AFM were recognized by cell feature engineering and machine learning classifiers. A feature ranking method based on the importance of features to responses was used to screen features closely related to categorization and optimization of feature combinations, which helps to understand the feature differences between cell types at the micro level. The results showed that the Bayesian optimized back propagation neural network has accuracy rates of 90.37% and 92.68% on two cell datasets (HL-7702 & SMMC-7721 and GES-1 & SGC-7901), respectively. This provides an automatic analysis method for identifying cancer cells or abnormal cells, which can help to reduce the burden of medical or scientific research, decrease misjudgment and promote precise medical care for the whole society.

The Z Prize

Should medical research be driven by money? Should rich donors drive medical research focus? In this philosophical short story fiction, Liz heads to a medical research office with her son Micah. When Micah was born she was paid $1,000 by the research company for them to draw and review his DNA. The payment required a one follow-up appoint. Upon arrival Liz finds out the medical company is attempting to win the Z Prize, a prize funded by wealthy donors to find a treatment for the physical and mental deterioration of age. The researches explain Micah has a gene variation that makes him very likely to get Alzheimer’s later in life. This, however, makes him the perfect candidate for testing the company’s new gene editing treatment. Sure, it’s outside of the bounds of US regulations so it will be have to be done in the Caribbean, but if it works, Micah could prove their drug works, put an end to Alzheimer’s, and keep himself from getting it as well. The medical company would win the Z Prize, and Liz would receive a million dollars as payment for allowing them to test the new treatment on her son. She has 48 hours to decide.

ALKBH5 facilitates CYP1B1 mRNA degradation via m6A demethylation to alleviate MSC senescence and osteoarthritis progression

Improving health and delaying aging is the focus of medical research. Previous studies have shown that mesenchymal stem cell (MSC) senescence is closely related to organic aging and the development of aging-related diseases such as osteoarthritis (OA). m6A is a common RNA modification that plays an important role in regulating cell biological functions, and ALKBH5 is one of the key m6A demethylases. However, the role of m6A and ALKBH5 in MSC senescence is still unclear. Here, we found that the m6A level was enhanced and ALKBH5 expression was decreased in aging MSCs induced by multiple replications, H2O2 stimulation or UV irradiation. Downregulation of ALKBH5 expression facilitated MSC senescence by enhancing the stability of CYP1B1 mRNA and inducing mitochondrial dysfunction. In addition, IGF2BP1 was identified as the m6A reader restraining the degradation of m6A-modified CYP1B1 mRNA. Furthermore, Alkbh5 knockout in MSCs aggravated spontaneous OA in mice, and overexpression of Alkbh5 improved the efficacy of MSCs in OA. Overall, this study revealed a novel mechanism of m6A in MSC senescence and identified promising targets to protect against aging and OA.

Robust retinal blood vessel segmentation using a patch-based statistical adaptive multi-scale line detector

The diagnosis of diseases using the retinal vasculature has long been a focus of medical research. Segmenting the vessels from retinal images is still a difficult task because of the variability in retinal vascular thickness and the inhomogeneity of image intensity. In this research work, a two-stage retinal vessel segmentation method is proposed. At the first stage, the large vessels are segmented by using multi-scale line detection by suppressing the small vessels through non-local mean filtering. At the second stage, the image is enhanced through noise suppression attributed largely to the block-matching 3-D filtering inside the nonsubsampled contourlet transform. Then a patch-based multi-scale line detector with adaptive statistical thresholding is used. Finally, both large and small vessels are combined to reconstruct the final vessel segmented image. The proposed method is evaluated on two publicly available databases and achieves an average sensitivity of 82.61%, and 81.67% on the DRIVE and STARE datasets respectively. The proposed method outperforms other state-of-the-art methods and has proven to be effective in boosting the sensitivity of retinal vessel segmentation.

Important oncogenic and immunogenic roles of SPP1 and CSF1 in hepatocellular carcinoma

The treatment and prognosis of liver cancer remain the focus of medical research. Studies have shown that SPP1 and CSF1 play important roles in cell proliferation, invasion, and metastasis. Therefore, this study analyzed the oncogenic and immunologic roles of SPP1 and CSF1 in hepatocellular carcinoma (HCC). We found that the expression levels of SPP1 and CSF1 in HCC were markedly increased and positively correlated. High SPP1 expression was significantly associated with poor OS, DSS, PFS, and RFS. It was not affected by gender, alcohol use, HBV, or race, whereas CSF1 was affected by these factors. Higher expression levels of SPP1 and CSF1 indicated higher levels of immune cell infiltration and a higher immune score with the R software package ESTIMATE. Further analysis revealed that many genes work co-expressed between SPP1 and CSF1 with the LinkedOmics database, which were mainly involved in signal transduction, the integral components of the membrane, protein binding, and osteoclast differentiation. In addition, we screened ten hub genes using cytoHubba, among which the expression of four genes was significantly associated with the prognosis of HCC patients. Finally, we demonstrated the oncogenic and immunologic roles of SPP1 and CSF1 using the vitro experiments. Reducing the expression of either SPP1 or CSF1 could significantly reduce the proliferation of HCC cells and the expression of CSF1, SPP1, and the other four hub genes. This study suggested that SPP1 and CSF1 interact with each other and have the potential to be therapeutic and prognostic targets for HCC.

Application of Artificial Intelligence in the Diagnosis, Treatment, and Prognostic Evaluation of Mediastinal Malignant Tumors.

Artificial intelligence (AI), also known as machine intelligence, is widely utilized in the medical field, promoting medical advances. Malignant tumors are the critical focus of medical research and improvement of clinical diagnosis and treatment. Mediastinal malignancy is an important tumor that attracts increasing attention today due to the difficulties in treatment. Combined with artificial intelligence, challenges from drug discovery to survival improvement are constantly being overcome. This article reviews the progress of the use of AI in the diagnosis, treatment, and prognostic prospects of mediastinal malignant tumors based on current literature findings.

Application of food exchange portion method in home-based nutritional intervention for elderly patients with chronic heart failure

BackgroundThe home treatment of elderly patients with chronic heart failure (CHF) is often accompanied by malnutrition, which increases the risk of re-hospitalisation and affects the prognosis. Therefore, how to effectively improve the nutritional self-management of patients is a current focus of medical research. This study aims to test the effect of home-based nutritional intervention method on improving the nutritional status of elderly patients with CHF.MethodsA total of 90 hospitalised elderly patients with CHF were randomly divided into the experimental group (n = 45) and the control group (n = 45). The patients in both groups were given standardised drug therapy and their nutritional status was evaluated using a body composition analyser prior to discharge (protein, body fat percentage, visceral fat area, skeletal muscle, upper arm muscle circumference, left lower limb and right lower limb muscle mass), with the cardiopulmonary function evaluated using a six-minute walk test and the metabolic equivalents method. The control group was given general nutrition education and routine dietary guidance from cardiac rehabilitation nurses, while the experimental group was given an individualised nutrition prescription by dietitians based on the evaluation results, according to which one-to-one food exchange dietary intervention training was given until the patients mastered the process.ResultsThe nutritional indexes at the end of the study were significantly higher in the experimental group than in the control group and were higher than those before the intervention (P < 0.05). The muscle circumference of the upper arm, the muscle mass of the left lower limb and the right lower limb had no statistical significance following the intervention compared to the control group and before the intervention (P > 0.05). The cardiopulmonary function indexes were significantly better in the experimental group at the end of the study than before the intervention and were better than those in the control group, with statistically significant differences (P < 0.05), while no significant changes were observed in the control group before and after the intervention (P > 0.05).ConclusionThe home-based nutritional intervention method of food exchange portions can effectively improve the nutritional status of elderly patients with CHF, with the distribution of visceral fat more reasonable and the cardiopulmonary function and exercise endurance improved.

In vitro human gut microbiota fermentation models: opportunities, challenges, and pitfalls.

The human gut microbiota (HGM) plays a pivotal role in health and disease. Consequently, nutritional and medical research focusing on HGM modulation strategies as a means of improving host health is steadily increasing. In vitro HGM fermentation models offer a valid complement to human and animal studies when it comes to the mechanistic exploration of novel modulation approaches and their direct effects on HGM composition and activity, while excluding interfering host effects. However, in vitro cultivation of HGM can be challenging due to its high oxygen sensitivity and the difficulties of accurately modeling the physio-chemical complexity of the gut environment. Despite the increased use of in vitro HGM models, there is no consensus about appropriate model selection and operation, sometimes leading to major deficiencies in study design and result interpretation. In this review paper, we aim to analyze crucial aspects of the application, setup and operation, data validation and result interpretation of in vitro HGM models. When carefully designed and implemented, in vitro HGM modeling is a powerful strategy for isolating and investigating biotic and abiotic factors in the HGM, as well as evaluating their effects in a controlled environment akin to the gut. Furthermore, complementary approaches combining different in vitro and in vivo models can strengthen the design and interpretation of human studies.