American journal of translational research最新文献

{"title":"Neonatal bladder exstrophy: a case report and literature review of long-term outcomes.","authors":"Yan Song, Ru Yang, Xiaowen Li","doi":"10.62347/UYRA1911","DOIUrl":"10.62347/UYRA1911","url":null,"abstract":"<p><p>Bladder exstrophy (BE) is a rare, complex, congenital malformation predominantly observed in men. We report a case of a female infant with BE who underwent complete primary repair of BE (CPRE). After 5 weeks of appropriate medical care and nursing, the infant was discharged successfully without urinary retention, hematuria, fever, or abdominal distention. After discharge, the child was followed up via telephone. At 1.5 months post-op, the child showed no signs of urinary incontinence, hydronephrosis, or reflux. However, ultrasonography revealed an unfilled bladder. By the third month, the child voided volitionally through the urethra every 3 h. At 6 months of age, renal ultrasonography revealed an unfilled bladder. Children may undergo augmentation cystoplasty at 2 or 3 years of age. During telephone follow-ups, the parents expressed concerns regarding their child's sexual function and fertility in adulthood. Patient follow-up will be continued to determine long-term health outcomes.</p>","PeriodicalId":7731,"journal":{"name":"American journal of translational research","volume":"17 8","pages":"6481-6487"},"PeriodicalIF":1.6,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145063274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of bacterial infections, antimicrobial sensitivity, and resistance patterns in respiratory samples.","authors":"Hafiza Tuba Ashiq, Zubair Shaheen, Seed Asiri, Wajid Syed, Maliha Khalid Khan, Imran Ahmad Khan, Imtiaz Gull, Muhammad Omer Iqbal, Bandar S Alharbi","doi":"10.62347/EJDU3346","DOIUrl":"10.62347/EJDU3346","url":null,"abstract":"<p><strong>Objective: </strong>Respiratory tract infections (RTIs) are a significant global health concern, particularly with the rise of antimicrobial resistance (AMR). This study aimed to investigate the prevalence of bacterial pathogens, resistance patterns, and gender-specific differences among patients with RTIs admitted to a tertiary-level hospital in South Punjab, Pakistan.</p><p><strong>Methods: </strong>The retrospective study, which lasted from September 2023 to February 2024, included 194 patients with bacterial RTIs. Demographic data, clinical characteristics, and bacterial isolates were analyzed. The antibiotic susceptibility of 194 bacterial isolates was assessed using the disc diffusion method. Bacteria were classified as extensively drug-resistant (XDR), multidrug-resistant (MDR), or pan-drug-resistant (PDR) based on standard criteria. The impact of bacterial resistance on mortality and ICU admissions was examined using multivariate Cox regression analysis.</p><p><strong>Results: </strong>The study cohort had a mean age of 66.5 ± 10.8 years, with 76.4% being male. ICU admissions were higher among males (25%) than females (9%). <i>Pseudomonas aeruginosa</i> (12.89% in males; 15.46% in females) and <i>Klebsiella pneumoniae</i> (3.61% in males; 9.79% in females) were the most prevalent Gram-negative bacteria, whereas <i>Streptococcus</i> spp. and <i>Moraxella catarrhalis</i> were the most common Gram-positive bacteria. A higher mortality rate was observed among MDR-infected patients (12.22%) compared to those with non-resistant strains (4.89%). Resistance to beta-lactams, fluoroquinolones, and macrolides was particularly pronounced in ICU patients. Gender-specific differences in bacterial prevalence and resistance patterns were noted, with females exhibiting higher rates of <i>P. aeruginosa</i> and MRSA infections.</p><p><strong>Conclusion: </strong>The study underscores the growing burden of antimicrobial resistance in RTIs, with significant gender-based disparities. The high prevalence of MDR bacteria highlights the urgent need for targeted antibiotic stewardship programs and infection control measures to mitigate the impact of drug-resistant respiratory infections.</p>","PeriodicalId":7731,"journal":{"name":"American journal of translational research","volume":"17 8","pages":"6542-6555"},"PeriodicalIF":1.6,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145063293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between phase lag index measured by electroencephalography and cognitive dysfunction in patients with cerebral small vessel disease.","authors":"Dan Liu, Xiuqing Tong, Zhi Cao, Shujun Shi, Lin Ma","doi":"10.62347/GYGM9029","DOIUrl":"10.62347/GYGM9029","url":null,"abstract":"<p><strong>Objectives: </strong>Cerebral small vessel disease (CSVD) is a primary cause of cognitive impairment (CI) in the elderly. This study aims to explore the relationship between the phase lag index (PLI), derived from electroencephalography (EEG), and cognitive dysfunction in patients with CSVD.</p><p><strong>Methods: </strong>This retrospective study included patients diagnosed with CSVD from May 2020 to December 2023. EEG data were recorded using 64 electrodes and analyzed for PLI across four frequency bands. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). Blood pressure variability was monitored using a 24-hour portable device.</p><p><strong>Results: </strong>The study included 264 patients, categorized into two groups: CI group (n = 102) and no CI group (n = 162). The CI group exhibited significantly lower global alpha-band PLI (0.28 vs. 0.31, P = 0.006) and reduced alpha-PLI across multiple electrode pairs (0.27 vs. 0.30, P = 0.004). Cognitive scores were also lower in the CI group (MMSE: 26.25 vs. 27.76, P = 0.004; MoCA: 25.38 vs. 26.63, P = 0.007). Additionally, the CI group had higher 24-hour mean systolic blood pressure (SBP, 140.68 vs. 136.36 mmHg, P = 0.038) and lower daytime SBP coefficient of variation (9.46% vs. 10.63%, P = 0.002). Receiver operating characteristic analysis revealed that F8-P8 PLI had an area under the curve of 0.608, indicating moderate discriminatory ability for identifying cognitive dysfunction.</p><p><strong>Conclusion: </strong>Decreased phase synchronization in the EEG alpha-band correlated with cognitive dysfunction in CSVD patients, indicating that impaired neural connectivity may serve as a potential electrophysiological biomarker.</p>","PeriodicalId":7731,"journal":{"name":"American journal of translational research","volume":"17 8","pages":"6663-6675"},"PeriodicalIF":1.6,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145063363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A combined clinical-ultrasound radiomics model for differentiating benign and malignant BI-RADS category 4 breast masses.","authors":"Qing Zhang, Juan Gao, Enock Adjei Agyekum, Linna Zhu, Chao Jiang, Suping Du, Liang Yin","doi":"10.62347/SBKU2090","DOIUrl":"10.62347/SBKU2090","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the diagnostic performance of a model combining gray-scale ultrasound (US) radiomic features and clinical data in distinguishing benign from malignant breast masses classified as Breast Imaging Reporting and Data System (BI-RADS) category 4.</p><p><strong>Methods: </strong>In this retrospective study, 149 women with pathologically confirmed breast masses were included and randomly divided into a training cohort (n=104) and a validation cohort (n=45). A total of 1,046 radiomic features were extracted from US images. Feature selection was performed using Pearson correlation analysis followed by least absolute shrinkage and selection operator (LASSO) regression. Three K-nearest neighbor (KNN) classifiers were developed: a clinical model, an ultrasound radiomics (USR) model, and a combined clinical-USR model. Model performance was assessed using accuracy, sensitivity, specificity, and the area under the receiver operating characteristic curve (AUC).</p><p><strong>Results: </strong>Seven radiomic features and two clinical variables were selected for model construction. In the training cohort, the combined clinical-USR model achieved an AUC of 0.927, with an accuracy of 89.0%, sensitivity of 88.9%, and specificity of 89.8%. In the validation cohort, the AUC of 0.826, with an accuracy of 80.0%, sensitivity of 83.3%, and specificity of 66.7%. The standalone USR model yielded AUCs of 0.902 and 0.883 in the training and validation cohorts, respectively, while the clinical model showed lower AUCs of 0.876 and 0.794. Decision curve analysis (DCA) indicated that the combined model provided a greater net clinical benefit than the clinical model alone.</p><p><strong>Conclusion: </strong>The integration of ultrasound radiomic features with clinical data improves diagnostic performance in differentiating benign from malignant BI-RADS 4 breast masses. The combined model holds potential for aiding clinical decision-making but requires further validation in larger, independent datasets.</p>","PeriodicalId":7731,"journal":{"name":"American journal of translational research","volume":"17 8","pages":"6370-6380"},"PeriodicalIF":1.6,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145063173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TRAIL-mediated armA upregulation enhances the drug resistance of <i>Klebsiella pneumoniae</i> by activating the PI3K/AKT/mTOR signaling pathway.","authors":"Bu Wang, Wei Zhang, Jianhua Liu, Hongxia Zhang, Maochen Li, Xiaocui Peng, Zhihua Zhang, Ning Song","doi":"10.62347/QVUY9908","DOIUrl":"10.62347/QVUY9908","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the roles and mechanisms of tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) in the drug resistance of <i>Klebsiella pneumoniae</i>, focusing on its regulation of the aminoglycoside resistance methylase (armA) and the phosphatidylinositol-3-kinase (PI3K)/protein kinase B (AKT)/mammalian target of rapamycin (mTOR) signaling pathway.</p><p><strong>Methods: </strong>A549 cells were infected with drug-resistant <i>Klebsiella pneumoniae</i> and treated with meropenem. TRAIL overexpression and knockdown were performed using plasmids and small interfering RNA, respectively. Cell viability, apoptosis, and the levels of inflammatory cytokines including tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-1β (IL-1β) were assessed. The mRNA expression of armA was examined using reverse transcription quantitative polymerase chain reaction (RT-qPCR). The expression of key proteins in the PI3K/AKT/mTOR pathway was evaluated using western blots.</p><p><strong>Results: </strong>Drug-resistant <i>Klebsiella pneumoniae</i> infection reduced A549 cell viability, promoted apoptosis, and increased TNF-α, IL-6, and IL-1β levels. Meropenem treatment failed to reverse these effects, confirming the drug resistance. TRAIL overexpression exacerbated <i>Klebsiella pneumoniae</i> infection-induced viability inhibition, apoptosis, and inflammation, suggesting that TRAIL enhances the drug resistance of <i>Klebsiella pneumoniae</i>. In contrast, TRAIL knockdown showed the opposite results. TRAIL overexpression upregulated armA expression and activated the PI3K/AKT/mTOR pathway, but armA inhibition reversed TRAIL-mediated drug resistance and PI3K/AKT/mTOR activation.</p><p><strong>Conclusion: </strong>TRAIL-mediated armA upregulation enhanced the drug resistance of <i>Klebsiella pneumoniae</i> by activating the PI3K/AKT/mTOR signaling pathway. These findings provide new insight into the drug resistance mechanisms of <i>Klebsiella pneumoniae</i>.</p>","PeriodicalId":7731,"journal":{"name":"American journal of translational research","volume":"17 8","pages":"6103-6112"},"PeriodicalIF":1.6,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145063403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tricuspid annular dilation and occluder deviation predict worsening of tricuspid regurgitation after transcatheter closure of atrial septal defect with patent foramen ovale.","authors":"Xuejia Guo, Na Wang, Ya Liu, Miaomiao Pei, Gaiqin Liu, Yanyan Zhang, Ning Zhang","doi":"10.62347/MGNQ6995","DOIUrl":"10.62347/MGNQ6995","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the predictive value of echocardiographic findings for postoperative tricuspid regurgitation (TR) worsening after transcatheter atrial septal defect (ASD) with patent foramen ovale (PFO) closure using domestic occluders, and to develop a dynamic risk prediction model to guide clinical decision-making.</p><p><strong>Methods: </strong>This retrospective cohort study included 109 patients undergoing ASD/PFO closure with occluders (manufactured domestically in China) at a single center (between January 2018 and May 2024). Participants were stratified into an observation group (TR worsening ≥ 1 grade, n = 26) and a control group (stable TR, n = 83). Echocardiographic data - including tricuspid annular diameter, coaptation height, and occluder positional deviation - were assessed preoperatively, immediately postoperatively, and at 1-year follow-up. Univariate and multivariate logistic regression analyses were performed to identify independent predictors. Model performance was evaluated using receiver operating characteristic (ROC) curves.</p><p><strong>Results: </strong>Compared to controls, the observation group (n = 26) exhibited significantly greater tricuspid annular dilation (mean Δdiameter: 3.2 ± 0.8 mm vs 0.9 ± 0.4 mm; P < 0.001) and occluder positional deviation (4.1 ± 1.2 mm vs 1.8 ± 0.6 mm; P < 0.001). Multivariate analysis identified Δtricuspid annular diameter (OR = 1.32 per 1-mm increase, 95% CI: 1.12-1.56; P < 0.001) and occluder deviation (OR = 2.41 per 1-mm increase, 95% CI: 1.68-3.45; P < 0.001) as independent predictors of TR worsening. The combined predictive model demonstrated superior discrimination (AUC = 0.802, 95% CI: 0.742-0.862; sensitivity = 76.9%, specificity = 81.3%) outperforming their individual application (P < 0.001). Subgroup analysis showed consistent predictive performance across occluder types (P_interaction = 0.87).</p><p><strong>Conclusion: </strong>Dynamic tricuspid annular dilation and occluder malposition erre independent risk factors for postoperative TR progression. The echocardiography-based predictive model enhances risk stratification and may inform intraprocedural adjustments and postoperative surveillance.</p>","PeriodicalId":7731,"journal":{"name":"American journal of translational research","volume":"17 8","pages":"6320-6332"},"PeriodicalIF":1.6,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145063406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between nutritional risk and clinical outcomes in patients with acute exacerbation of chronic obstructive pulmonary disease.","authors":"Yang Yang, Manqing You, Lincheng Luo, Hailong Wei","doi":"10.62347/MCZH5861","DOIUrl":"10.62347/MCZH5861","url":null,"abstract":"<p><strong>Objective: </strong>To explore the relationship between nutritional risk and clinical outcomes in patients hospitalized for acute exacerbations of chronic obstructive pulmonary disease COPD (AECOPD).</p><p><strong>Methods: </strong>The medical records of 220 AECOPD patients hospitalized between June 2022 and June 2024 were retrospectively analyzed. The patients were categorized into two groups based on their Nutritional Risk Index (NRI): high-risk ([NRI] < 92) group and low-risk (NRI ≥ 92) group. Clinical outcomes assessed included albumin levels, arterial blood gas parameters, frequency of exacerbations, in-hospital mortality, length of hospital stays, readmission rates, and health-related quality of life (HRQoL). Pulmonary function recovery, including forced expiratory volume in one second (FEV₁) and forced vital capacity (FVC), was also evaluated post-treatment.</p><p><strong>Results: </strong>Compared to the low-risk group, patients in the high-risk group exhibited significantly lower albumin levels (P = 0.007), increased frequency of exacerbations (P = 0.005), higher in-hospital mortality (P = 0.004), prolonged hospital stays (P = 0.001), and elevated readmission rates (P = 0.002). High-risk patients also reported significantly lower physical function (PF) and mental health scores. After treatment, improvements in FEV₁ and FVC were significantly greater in the low-risk group (P < 0.05).</p><p><strong>Conclusion: </strong>Nutritional risk is closely associated with the severity, prognosis, and recurrence of AECOPD. These findings underscore the importance of nutritional assessment and intervention in the management of hospitalized AECOPD patients.</p>","PeriodicalId":7731,"journal":{"name":"American journal of translational research","volume":"17 7","pages":"5746-5756"},"PeriodicalIF":1.6,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12351592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144870928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case report: surgery combined with a SOX adjuvant chemotherapy regimen for patients with gastric adenocarcinoma and hepatocellular carcinoma.","authors":"Zhe-Yuan Wang, Lu Zhang, Zeng-You Li, You-Cheng Zhang, Jing-Jing He","doi":"10.62347/FFUV4293","DOIUrl":"10.62347/FFUV4293","url":null,"abstract":"<p><p>Advances in early tumor detection have led to an increase in the reported incidence of multiple primary cancers. However, the concurrent occurrence of gastric adenocarcinoma and hepatocellular carcinoma remains rare. We present the case of a 68-year-old male patient with chronic hepatitis B who was diagnosed with stage Ib liver cancer (T1bN0M0). Gastroscopy revealed a mucosal lesion in the posterior wall of the gastric body, and biopsy confirmed moderately to poorly differentiated adenocarcinoma. The patient underwent laparoscopic gastrectomy combined with partial liver resection, followed by three cycles of S-1 plus oxaliplatin (SOX) chemotherapy. Given the lack of standardized treatment protocols for managing multiple primary cancers, developing a treatment plan for these two synchronous cancers is challenging. This case underscores the importance of early screening for multiple primary cancers and the need for a multidisciplinary approach to formulate an optimal treatment strategy. Furthermore, we conducted a literature review of reports on the simultaneous occurrence of gastric and hepatic cancers over recent decades. Unlike previous studies, we also examined postoperative adjuvant chemotherapy regimens suitable for both gastric adenocarcinoma and hepatocellular carcinoma patients.</p>","PeriodicalId":7731,"journal":{"name":"American journal of translational research","volume":"17 7","pages":"5710-5717"},"PeriodicalIF":1.6,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12351609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144870933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DCUN1D2 is insignificant for spermatogenesis and male fertility in mice.","authors":"Yuxuan Feng, Mingyuan Bao, Wenyi Sheng, Shiqi Liu, Yuchen Cui, Nianchao Zhou, Tiantian Wu, Xiaoyan Huang, Shunyu Hou, Meng Liu","doi":"10.62347/CLIG5523","DOIUrl":"10.62347/CLIG5523","url":null,"abstract":"<p><strong>Objectives: </strong>Defective in cullin neddylation 1 domain containing 2 (DCUN1D2) belongs to the DCNLs family and can induce cell growth arrest and is also related to neddylation. While its potential role in spermatogenesis is hypothesized, the functional significance of DCUN1D2 in male germ cells remains undefined.</p><p><strong>Methods: </strong>To investigate this, germ cell and Sertoli cell-specific <i>Dcun1d2</i>-knockouts were generated. Sperm parameters were analyzed via computer-assisted sperm analysis (CASA), while histological and immunofluorescence staining were employed to evaluate spermatogenic progression and apoptosis.</p><p><strong>Results: </strong>Compared with the control group, <i>Dcun1d2</i> conditional knockout (cKO) mice exhibited no significant differences in histology, semen quality, sperm apoptosis or fertility tests.</p><p><strong>Conclusions: </strong>This study indicated that DCUN1D2 has no significant effect on mouse spermatogenesis or male fertility. These findings will help avoid redundant studies and provide new information for the study of human fertility genes.</p>","PeriodicalId":7731,"journal":{"name":"American journal of translational research","volume":"17 7","pages":"5614-5624"},"PeriodicalIF":1.6,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12351559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144870953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of risk factors and development of a high-performance predictive model for non-healing in elderly patients with intertrochanteric fractures post-internal fixation.","authors":"Jianyue Wu, Peng Xu, Dong Zhang, Yingjie Ni, Jijun Zhao","doi":"10.62347/KFRM4177","DOIUrl":"10.62347/KFRM4177","url":null,"abstract":"<p><strong>Objective: </strong>To identify risk factors associated with non-healing in elderly patients with intertrochanteric femoral fractures treated with internal fixation and to develop a predictive model for non-union risk.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 889 elderly patients treated with internal fixation for intertrochanteric fractures at Wuxi Xishan People's Hospital from March 2021 to December 2024. Patients were classified into healing (n=806) and poor healing groups (n=83) based on radiographic evidence three months post-surgery. Univariate and multivariate logistic regression analyses were used to identify significant risk factors. A predictive model was developed and validated using receiver operating characteristic (ROC) analysis and the area under the curve (AUC).</p><p><strong>Results: </strong>Significant risk factors for poor healing included smoking history (Odds ratio [OR] 1.750, P=0.022), osteoporosis (OR 2.055, P=0.003), posterior or medial wall bone defects (OR 1.964, P=0.005), low postoperative albumin (OR 1.674, P=0.032), and early weight-bearing (OR 1.765, P=0.018). The use of proximal femoral nail antirotation (PFNA) significantly reduced the risk of poor-healing (OR 0.515, P=0.006). The combined predictive model achieved an AUC of 0.949, indicating high predictive value.</p><p><strong>Conclusions: </strong>Our findings highlight key risk factors for non-healing in elderly patients post-internal fixation for intertrochanteric fractures. The developed predictive model, incorporating clinical, biochemical, and surgical factors, offers high accuracy and may help identify high-risk patients for targeted intervention.</p>","PeriodicalId":7731,"journal":{"name":"American journal of translational research","volume":"17 7","pages":"5766-5778"},"PeriodicalIF":1.6,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12351563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144870961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}