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JOURNAL/mgres/04.03/01612956-202606000-00004/figure1/v/2025-08-18T154854Z/r/image-tiff Hydrogen sulfide (H2S) holds significant potential for clinical applications in the alleviation of fibrosis. This study aimed to verify the role of H2S in combating peritoneal fibrosis and elucidate its molecular mechanisms. A peritoneal fibrosis model was established through the intraperitoneal injection of 0.1% chlorhexidine gluconate. Subsequently, the mice were administered an intraperitoneal injection of the H2S donor GYY4137. The experimental data indicate that H2S mitigates the progression of peritoneal fibrosis, potentially by inhibiting the expression of high mobility group box-1 and consequently blocking the activation of the (TGF-β)/Smad3 signaling pathway. This study provides a scientific basis for the future clinical application of H2S in the treatment of peritoneal fibrosis.

Acute kidney injury and chronic kidney disease impose substantial burdens on healthcare systems worldwide. Molecular hydrogen (H2) has emerged as a potential therapy due to its selective antioxidant, anti-inflammatory, and antiapoptotic properties. The present study reviews evidence on H₂-based renal interventions, examining therapeutic mechanisms, bibliometric trends, and existing research gaps based on data analytics. This scoping review integrates quantitative bibliometric analysis with qualitative thematic synthesis. This integration, uncommon in conventional scoping reviews, reveals important gaps. Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, 69 publications were identified through Scopus and Web of Science. These publications mostly originated from Asia, particularly China and Japan, with clear peaks of activity in 2019 and 2024, but international collaboration remains limited. H₂ consistently demonstrated protective effects against apoptosis, fibrosis, inflammation, and oxidative stress across acute kidney injury, nephrotoxicity, transplantation, and early chronic kidney disease models. Our findings suggest that hydrogen therapy holds promise for renoprotection in both acute kidney injury and chronic kidney disease. Nonetheless, more robust clinical trials and standardized research methodologies are imperative to facilitate its broader adoption into clinical nephrology practice.

Traumatic central nervous system injuries encompass brain and spinal cord injuries. Recent studies have identified hydrogen sulfide (H₂S) as a potent endogenous gasotransmitter with multifaceted roles in neuroprotection and central nervous system repair. In this systematic review, we explore the mechanisms and therapeutic potential of H₂S in traumatic central nervous system injuries, emphasizing its anti-inflammatory, antioxidant, and anti-apoptotic properties. H₂S suppresses inflammation by modulating the nuclear factor-kappa B pathway, shifting microglial polarization to a reparative phenotype. Further, it mitigates oxidative stress by activating the nuclear factor erythroid 2-related factor 2 and mechanistic target of the rapamycin pathway, and inhibiting glutamate-mediated damage. Additionally, H₂S regulates cell death by inhibiting apoptosis, ferroptosis, pyroptosis, and autophagy while promoting axonal growth and microvascular integrity. Emerging H₂S delivery strategies, including slow-releasing donors such as GYY4137 and advanced hydrogel-based systems, address challenges in achieving sustained and targeted therapeutic effects. Although preclinical evidence has demonstrated the promise of H₂S-based therapies, further research is required to optimize delivery methods, investigate concentration-dependent effects, and validate clinical efficacy. This review provides a comprehensive foundation for advancing H₂S as a therapeutic agent in traumatic central nervous system injuries.

JOURNAL/mgres/04.03/01612956-202606000-00001/figure1/v/2025-08-18T154854Z/r/image-tiff Pulmonary hypertension can lead to hemodynamic instability and worsen the outcome after the repair of cyanotic congenital heart disease with decreased pulmonary blood flow. However, the safety and effectiveness of targeted therapy, such as inhaled nitric oxide, remain controversial. This retrospective cohort study included patients who underwent corrective repair for tetralogy of Fallot, double outlet right ventricle, or pulmonary atresia with ventricular septal defect with hypoplastic pulmonary vasculature at Fuwai Hospital between 2014 and 2021. Patients were divided into a regular treatment group and a combined treatment group depending on whether inhaled nitric oxide was prescribed. The improvement in low cardiac output syndrome within 24 hours after surgery and the main clinical outcomes during hospitalization were compared between the two groups after 1:1 propensity score matching. Compared with those in the regular treatment group, both the incidence of low cardiac output syndrome and the rate of renal replacement therapy were lower in the combined treatment group. Inhaled nitric oxide therapy is effective in the treatment of patients with pulmonary hypertension after corrective repair of cyanotic congenital heart disease.

Background: This review and meta-analysis examined the effectiveness of non-pharmacological therapies delivered through school-based interventions for smoking cessation among adolescents in South and Southeast Asian countries.

Methods: A systematic search was conducted across PubMed, Scopus, Science Direct, BioMed Central, the Cochrane Library, and ProQuest Dissertations & Theses Global from inception to October 2024. Eligible studies comprised randomized controlled trials and quasi-experimental studies that compared non-pharmacological smoking cessation interventions delivered in schools or other educational institutions. Data on smoking abstinence outcomes were extracted from published studies, and odds ratios (ORs) with 95% confidence intervals (CIs) were pooled using a random-effects model via the Mantel-Haenszel estimator.

Results: Seven studies involving 1,260 participants were included. The meta-analysis demonstrated that non-pharmacological school-based therapies significantly increased smoking abstinence compared to controls (OR, 2.83; 95% CI, 1.83-4.40; p<0.001. Subgroup analyzes revealed benefits across both randomized controlled trials and quasi-experimental studies with varying abstinence rates. Studies utilizing biochemical verification showed significant positive effects despite substantial heterogeneity, and short-term (<3 months) abstinence was significantly higher in intervention groups compared to controls. Overall, no differences were found between subgroups regarding intervention effectiveness.

Conclusion: This meta-analysis indicates that non-pharmacological school-based interventions positively impact smoking abstinence rates, although effectiveness may vary based on study design, follow-up duration, and use of biochemical verification. The findings underscore the need for further research with larger sample sizes, extended follow-up periods, and improved methodological rigor in these regions.

Although hyperbaric oxygen therapy (HBOT) is promising for the alleviation of limb trauma or crush muscle injuries, critical examination of the state of related science is lacking. We conducted a scoping review and evaluation of HBOT on muscle injury in preclinical models. A search of PubMed and Web of Science databases yielded 157 reports published from the start of the databases until November 7, 2024, which narrowed to 19 after removing duplicates, non-muscle studies, and dissertations/reviews. The studies involved mice or rats treated with tourniquets or exposed to a myotoxic agent (bupivacaine and cardiotoxin) or crush to induce muscle injury. HBOT counteracted metabolic effects and had differential effects on oxidative stress in the tourniquet model. Overall, HBOT promoted or quickened muscle regeneration initiated by myotoxic agents and crush. These findings also indicate that HBOT benefits may persist, and early initiation of HBOT is important. However, more sessions do not always yield better outcomes. The evaluation of the state of the science revealed that the inclusion of females in these studies is limited, and milder pressure levels have been undertested, which may be important for fewer adverse effects and access. Future research in these and other areas may lead to increased use and acceptability of HBOT for the treatment of limb trauma or crush muscle injuries.

JOURNAL/mgres/04.03/01612956-202606000-00005/figure1/v/2025-08-18T154854Z/r/image-tiff Low-flow anesthesia aims to minimize anesthetic gas consumption while maintaining adequate anesthesia. To examine the effects of minimal-flow anesthesia on perioperative lung dynamics and postoperative pulmonary function tests, a prospective, randomized controlled study was conducted between October 2023 and March 2024 at Atatürk University. A total of 66 patients (15 males, 45 females) with confirmed American Society of Anesthesiologists (ASA) grade I-II, aged 18-65 years, and scheduled for elective laparoscopic cholecystectomy were included in the study. Patients were randomized into two groups: MeFA (medium flow anesthesia, 2 L/min fresh gas flow) and MiFA (minimal flow anesthesia, 0.5 L/min fresh gas flow). In both groups, dynamic compliance values, peak inspiratory pressure (PIP) values, total inhalation anesthetic drug consumption, total remifentanil drug consumption, duration of anesthesia, duration of surgery, and spirometry test results were recorded. Respiratory measurements were recorded at the 5th minute after intubation (T1), 5th (T2), 10th (T3), 30th (T4), and 60th (T5) minutes after surgical incision and immediately after the surgical suturing (T6) pulse. There was no significant difference in compliance or PIP values between the groups from T1 to T5 (P > 0.05). However, at T6, the MeFA group exhibited a significant decrease in compliance and an increase in PIP compared with the MiFA group (P < 0.05). Additionally, significant differences in compliance and PIP values were found across all time intervals compared with those at T1, except for the T5-6 compliance values in the MiFA group (P < 0.001). No significant difference in respiratory function test values was noted between the groups (P > 0.05). The MiFA group exhibited a relatively milder reduction in compliance values and a lesser elevation in PIP values. Compared with medium-flow anesthesia, minimal-flow anesthesia may help mitigate perioperative lung function deterioration. These findings suggest potential benefits in preserving lung mechanics, warranting further research. This trial was registered at clinicaltrials.gov (identifier No. NCT06055335, registered March 25, 2023).

Hyperbaric oxygen therapy, as a unique non-drug treatment method, is gradually gaining wide recognition by clinicians. In the field of neurosurgery, there is conclusive evidence that hyperbaric oxygen has significant positive effects on the treatment of craniocerebral trauma, cerebrovascular diseases, intracranial infections and intracranial tumors. This review focuses on the mechanism and application of hyperbaric oxygen therapy in neurosurgery.

Introduction: Type 2 diabetes mellitus (T2DM) is associated with dyslipidemia and significantly increased cardiovascular risk, making lipid-modifying therapy a crucial preventive intervention in these patients. Despite clear guidelines recommending statin therapy for both primary and secondary prevention, real-world prescription routines and practices show gaps in clinical care. We aimed to evaluate the rates and patterns of lipid-modifying therapy under prescription among T2DM patients across U.S. healthcare facilities.

Methods: We conducted a retrospective observational analysis using the TriNetX US Collaborative Network database, including data from 69 healthcare organizations throughout the United States. Patients with T2DM patients aged 40-75 years were included in our cohort. Under-prescription rates were calculated and analyzed across demographic subgroups using standardized protocols within the TriNetX platform.

Results: Among 5,007,910 T2DM patients, we observed significant statin under-prescription rates. Our analysis showed a prescription rate of 55.1% for statins in eligible patients with T2DM.

Conclusions: Our findings revealed a significant under-prescription of lipid-modifying therapy in T2DM patients. The universal nature of under-prescription suggests barriers to guideline implementation. These results underscore the urgent need for systematic interventions, including automated identification systems, standardized protocols, and optimized provider education to improve cardiovascular risk management in patients with T2DM.