Do nutritional assessment tools (PNI, CONUT, GNRI) predict adverse events after spinal surgeries? A systematic review and meta-analysis.

BACKGROUND: Nutritional assessment tools are used to predict outcomes in cancer. However, their utility in patients undergoing spinal surgery is unclear. This review examined if prognostic nutritional index (PNI), controlling nutritional status (CONUT), and geriatric nutritional risk index (GNRI) can predict adverse events after spinal surgeries. METHODS: PubMed, CENTRAL, Scopus, and Embase were screened by two reviewers for relevant studies up to 26th January 2024. The primary outcome of interest was total adverse events after spinal surgery. Secondary outcomes were surgical site infections (SSI) and mortality. RESULTS: 14 studies were included. Meta-analysis showed that while reduced PNI was not associated with an increased risk of SSI there was a significant association between PNI and higher risk of adverse events. Meta-analysis showed that high CONUT was not associated with an increased risk of complications after spinal surgeries. Pooled analysis showed that low GNRI was associated with an increased risk of both SSI and adverse events. Data on mortality was scarce. CONCLUSIONS: The PNI and GNRI can predict adverse outcomes after spinal surgeries. Limited data shows that high CONUT is also associated with a non-significant increased risk of adverse outcomes. High GNRI was predictive of an increased risk of SSI. Data on mortality is too scarce for strong conclusions.

The relationship between psychosocial job stressors and insomnia: The mediating role of psychological capital.

AIM: This study aimed to examine the association of job-related stressors and insomnia; to determine the association of psychological capital and insomnia; and to explore whether psychological capital mediates the association between job-related stressors and insomnia among Chinese nurses. DESIGN: A cross-sectional questionnaire survey. METHODS: The STROBE statement was utilized to guide the study. A total of 810 nurses from one tertiary grade hospital in Shan Dong Province, China, were recruited for the present study and a total of 658 valid questionnaires were obtained (effective recovery rate: 81.2%). The study survey consisted of demographic variables, psychological capital, job stress and insomnia. Descriptive analysis, independent-samples T-test, one-way analysis of variance, stratified regression analysis, Pearson correlation analyses, ordinary least-squares regression and the bootstrap method were used to analyse data. RESULTS: Findings of the study determined that demographic, work-related, behavioural and work setting (i.e. working hours, chronic disease, negative life events, smoking behaviour and night shift) factors were differentially associated with experiences of insomnia. The empirical study showed that psychological capital had statistically significant mediating effects between job stressors and insomnia. PUBLIC CONTRIBUTION: This study explored the factors associated with nurses' psychological job stressors and insomnia. Some of the associated factors could be used for the prevention and mitigation of psychosocial dysfunction among nurses. This study found nurses in surgery, emergency department, ICU, working >40 h a week, with chronic illness, experiencing negative life events, shift work and high effort, high overcommitment and low reward had higher scores of insomnia respectively. The results of this study also showed that reward was correlated with the increase of psychological capital, and the increase of psychological capital was correlated with the decrease of insomnia in nurses. On the contrary, effort and overcommitment decreased psychological capital, and then increased insomnia among nurses. These findings have important implications for future research and policy interventions to improve sleep quality of nurses and enhance nurses' health and patients' safety. This study significantly suggests that improving nurses' psychological capital is a potential way to help nurses improve sleep quality when psychosocial job stressors are difficult external environment to change.

Low expression of miR-142-3p promotes intervertebral disk degeneration.

BACKGROUND: Intervertebral disk degeneration (IDD) is a degenerative disease characterized by cytoplasm loss and extracellular matrix degradation. Numerous evidence reported that miRNAs participated in IDD development. Nevertheless, the function of miR-142-3p in IDD development remains unknown. This study mainly explored the potential role and function of miR-142-3p in IDD development. METHODS: One percent fetal bovine serum was used to induce the degeneration of ATDC5 cells, and miR-142-3p level was examined by qRT-PCR. Then, miR-142-3p mimic/inhibitor and its corresponding negative control were transfected into ATDC5 normal and degenerative cells. Viability, migration, invasion, apoptosis, cycle, Bax, Bcl-2, P62, and Beclin1 expression levels were assessed using CCK8, wound healing assay, annexin V-FITC/PI staining, western blot, and qRT-PCR, respectively. RESULTS: The results revealed that the expression levels of MMP13, ADAMTS5, MMP3, and Col-X were increased as well as the expression levels of SOX-9 and Col-II were reduced in ATDC5 degenerative cells, indicating the degeneration model was constructed. We observed that miR-142-3p was decreased in ATDC5 degenerative cells and its suppression could promote ATDC5 cell degeneration. However, miR-142-3p overexpression could reverse the cell viability inhibition, as well as apoptosis and autophagy enhancement in ATDC5 degenerative cells. CONCLUSIONS: Our results proved that miR-142-3p may play an important role in disk degeneration. Further animal study is needed to illustrate the role of the miR-142-3p in IDD development.

A Human Anti-Toll Like Receptor 4 Fab Fragment Inhibits Lipopolysaccharide-Induced Pro-Inflammatory Cytokines Production in Macrophages.

The results of clinical and experimental studies suggest that endotoxin/toll-like receptor 4 (TLR4)-mediated proinflammatory and profibrotic signaling activation is critical in the development of hepatic fibrosis. However, studies examining the role of specific TLR4 inhibitor are still lacking. The present study was aimed to prepare a human anti-TLR4 Fab fragment, named hTLR4-Fab01, and to explore its immune activity. We screened the positive clone of anti-human TLR4 phagemid from a human phage-display antibody library using recombinant TLR4 protein, which was used as template cDNA for the amplification of variable regions of the heavy (VH) chain and light chain (VL), then coupled with highly conserved regions of the heavy chain domain 1 (CH1) and the light chain (CL), respectively. Thus, the prokaryotic expression vector pETDuet-1 of hTLR4-Fab01 was constructed and transformed into Escherichia coli (E. coli) BL21. The characteristic of hTLR4-Fab01 was examined by SDS-PAGE, Western blotting, ELISA, affinity and kinetics assay. Further, our data demonstrate that hTLR4-Fab01 could specifically bind to TLR4, and its treatment obviously attenuated the proinflammatory effect, characterized by less LPS-induced TNF-α, IL-1, IL-6 and IL-8 production in human macrophages. In conclusion, we have successfully prepared the hTLR4-Fab01 with efficient activity for blocking LPS-induced proinflammatory cytokines production, suggesting that the hTLR4-Fab01 may be a potential candidate for the treatment of hepatic fibrosis.

Taste dysfunction in irradiated patients with head and neck cancer.

Taste disorders caused by radiation therapy for head and neck cancer are common. This prospective study of 40 patients with head and neck cancer assessed changes in taste sensations during radiation therapy. The relationship between the time course and the degree of taste disorder was studied. The taste recognition threshold and supra-threshold taste intensity performance for the four basic tastes were measured using the whole-mouth taste method before, during, and after radiation therapy. Bitter taste was affected most. An increase in threshold for sweet taste depended upon whether the tip of tongue was included within the radiation field. The slope of the taste intensity performance did not change during or after radiotherapy. The pattern of salivary dysfunction was different from that of taste dysfunction. The main cause of taste disorders during radiation support the hypothesis that taste dysfunction is due to damage to the taste buds in the radiation field.