Immune indicators as predictors of cancer-related fatigue: a risk prediction model in pan-cancer patients

BackgroundCancer‐related fatigue (CRF) is a prevalent and multifactorial symptom that significantly impairs the quality of life in cancer patients. This study aimed to identify immune and clinical factors associated with CRF in a pan-cancer cohort and to develop a predictive model for CRF to inform personalized clinical management.MethodsA retrospective analysis was conducted on clinical data from 146 cancer patients admitted to the Oncology Department of the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine. The variables collected included demographic information, disease‐related data, immunological parameters, and Brief Fatigue Inventory (BFI) scores. Univariate and multivariate logistic regression analyses were used to identify independent risk factors for CRF. A predictive model was developed, and its performance was evaluated using receiver operating characteristic (ROC) curve analysis and decision curve analysis.ResultsAnalysis results showed that multivariate logistic regression identified increasing age, increased absolute counts (AC) of CD4+CD38−T cells, and decreased AC of CD4+CD28−T cells as independent risk factors for CRF (P < 0.05). The predictive model demonstrated moderate performance, with an area under the ROC curve (AUC) of 0.725 in the training set and 0.581 in the validation set.ConclusionThese findings suggest that chronic inflammation, potentially associated with immunosenescence and immune remodeling, may contribute to the onset of CRF. Further research is needed to validate the model in large-scale, diverse patient populations and to develop targeted interventions to alleviate fatigue and improve the quality of life in cancer patients

Causal relationship between the gut microbiota, immune cells, and coronary heart disease: a mediated Mendelian randomization analysis

BackgroundRecent studies have shown that the gut microbiota (GM), immune cells, and coronary heart disease (CHD) are closely related, but the causal nature of these relationships is largely unknown. This study aimed to investigate this causal relationship and reveal the effect of GM and immune cells on the risk of developing CHD using mediated Mendelian randomization (MR) analysis.MethodsFirst, we searched for data related to GM, immune cells, and CHD through published genome-wide association studies (GWAS). We filtered the single nucleotide polymorphisms (SNPs) associated with GM and immune cells and then performed the first MR analysis to identify disease-associated intestinal bacteria and disease-associated immune cells. Subsequently, three MR analyses were conducted: from disease-associated GM to disease-associated immune cells, from disease-associated immune cells to CHD, and from disease-associated GM to CHD. Each MR analysis was conducted using inverse variance weighting (IVW), MR-Egger regression, weighted median, weighted models, and simple models.ResultsA total of six GM and 25 immune cells were found to be associated with CHD. In the MR analysis using the inverse variance weighting (IVW) method, g__Desulfovibrio.s__Desulfovibrio_piger was associated with EM DN (CD4–CD8–) %T cells (P < 0.05 and OR > 1), EM DN (CD4–CD8–) %T cells was associated with CHD (P < 0.05 and OR < 1), and g__Desulfovibrio.s__Desulfovibrio_piger was associated with CHD (P < 0.05 and OR < 1).ConclusionAn increase in the abundance of g__Desulfovibrio.s__Desulfovibrio_piger leads to an increase in the amount of EM DN (CD4–CD8–) %T cells, and an increase in the amount of EM DN (CD4–CD8–) %T cells reduces the risk of developing CHD. Our study provides some references for reducing the incidence of CHD by regulating GM and immune cells

Therapy strategies of fifth metatarsal base fracture with lateral collateral ligament injury

Abstract Background Fifth metatarsal base fracture (fifth MBF) and lateral collateral ankle ligament (LCAL) injury are mainly caused by plantar flexion and inversion of the foot. However, there is no relevant report on the incidence, injury type and treatment principle of the fifth MBF combined with an LCAL injury. Materials and methods We retrospectively analyzed 61 patients with fifth MBF. After admission, patients were given the symptomatic treatment and underwent standard anteroposterior (AP), 30-degree oblique foot radiographs, ankle MR and/or ultrasonic examination. The type of surgery varied base on the individual patients (type of fracture with/without lateral collateral ankle ligament injury). Results In 61 patients, there were 39 patients with LCAL injury. Among the 39 patients with LCAL injury, 24 patients with Grade I–II injury, 6 patients with Grade III injury, and 9 patients with avulsion fractures. There was no significant difference between the patients without LCAL injury and the patients with LCAL injury in terms of age (p = 0.67) and gender (p = 0.575). The incidence of fifth MBF with LCAL injury accounted for 63.93% of fifth metatarsal base fracture; the most common causes of injury included sprains and falls. The average fracture healing time was 8.3 (range, 6–12) weeks. For fifth MBF with displaced more than 2 mm, hook plate or lag screw was used for fixation; for complete rupture of LCAL, suture anchor was used to repairing the ligament; for partial LCAL injury, plaster was used for fixation after surgery; for avulsion fractures, cannulated screw or suture anchor was used for repair. None of the patients had complications such as delayed union, nonunion, and incision infection. Conclusion Early diagnosis and appropriate treatment can obtain good therapeutic results in fifth MBF patients combined with LCAL injury. Moreover, defining a treatment plan for ligament injury is essential for reducing postoperative complications. This study provides a basis for epidemiology, diagnosis, and treatment of fifth MBF with LCAL injury. </jats:sec