As an important intracellular genetic and regulatory center, the nucleus is not only a terminal effector of intracellular biochemical signals, but also has a significant impact on cell function and phenotype through direct or indirect regulation of nuclear mechanistic cues after the cell senses and responds to mechanical stimuli. The nucleus relies on chromatin-nuclear membrane-cytoskeleton infrastructure to couple signal transduction, and responds to these mechanical stimuli in the intracellular and extracellular physical microenvironments. Changes in the morphological structure of the nucleus are the most intuitive manifestation of this mechanical response cascades and are the basis for the direct response of the nucleus to mechanical stimuli. Based on such relationships of the nucleus with cell behavior and phenotype, abnormal nuclear morphological changes are widely used in clinical practice as disease diagnostic tools. This review article highlights the latest advances in how nuclear morphology responds and adapts to mechanical stimuli. Additionally, this article will shed light on the factors that mechanically regulate nuclear morphology as well as the tumor physio-pathological processes involved in nuclear morphology and the underlying mechanobiological mechanisms. It provides new insights into the mechanisms that nuclear mechanics regulates disease development and its use as a potential target for diagnosis and treatment.
ObjectiveTo conduct an umbrella review and meta-analysis of the effectiveness of melatonin in preventing delirium in hospitalized patients. MethodsSystematic reviews evaluating the effectiveness of melatonin for delirium prevention in hospitalized patients were retrieved from CNKI, VIP, WanFang Data, CBM, PubMed, Embase, CINAHL, Cochrane Library, and Web of Science. The search time frame spanned from database inception to March 20, 2025. Methodological quality was assessed using AMSTAR 2, and evidence quality was evaluated via the GRADE system. Data analysis was performed using RevMan 5.4. ResultsA total of 30 systematic reviews were included, and 98 evidence items were extracted. Methodological quality assessment identified 13 high-quality, 2 moderate-quality, 8 low-quality, and 7 very low-quality studies. Evidence quality evaluation revealed 19 high-quality, 34 moderate-quality, 31 low-quality, and 14 very low-quality evidence items. A meta-analysis of re-extracted raw data demonstrated that melatonin significantly reduces the incidence of delirium in hospitalized patients (OR=0.51, 95%CI 0.41 to 0.63, P<0.001). ConclusionMelatonin demonstrates beneficial effects in preventing delirium in hospitalized patients. However, due to limitations in the number and quality of included literature, some findings warrant further validation and clarification through high-quality research.