Frontiers in Medicine最新文献

Objective: There is evidence showing both necroptosis and activation of renin-angiotensin system (RAS) are involved in the pathogenesis of hyperbaric hyperoxic lung injury (HLI). This study aimed to investigate whether RAS activation can induce lung cell necroptosis and the cell specificity of necroptosis in the lung in case of hyperbaric HLI.

Methods: Male SD rats were randomly assigned into control group (n = 12), HLI group (n = 18), captopril group (n = 18), and valsartan group (n = 18). Rats were pre-treated with intraperitoneal captopril (50 mg/kg) or intragastrical valsartan (30 mg/kg) for 3 days before hyperbaric exposure. Then, animals were exposed to 99.9% oxygen at 250 kPa for 6 h to induce HLI. After hyperbaric exposure, lung function was non-invasively detected, and then animals were sacrificed for the detection of wet to dry ratio of the lung, blood gas and lung inflammatory factors, and lung tissues were collected for double immunofluorescence staining. Statistical analysis was performed with one way analysis of variance.

Results: Either valsartan or captopril pre-treatment could inhibit lung edema, improve blood gas (0 h) and lung function (48 h), and reduce pro-inflammatory factors in the lung. In addition, valsartan or captopril pre-treatment could inhibit AGT1 expression and lung cell necroptosis, and type I alveolar epithelial cells (AECs) were the major cell type experiencing necroptosis after hyperbaric hyperoxic exposure.

Conclusion: Our study indicates inhibition of RAS can suppress the hyperbaric HLI, which may be, at least partially, related to the inhibition of type I AECs necroptosis. Our findings provide new mechanism for the protective effects of RAS inhibition on hyperbaric HLI.

Background: The microcirculation is affected during sepsis, yet there is currently no clinically available technology for sepsis detection in the microcirculation. This study aimed to detect microcirculatory changes using a dynamic light scattering (DLS) skin sensor during an endotoxic shock with a systemic inflammatory response in a porcine lipopolysaccharide (LPS) model.

Methods: Thirty female Yorkshire x Norwegian Landrace pigs were divided into three groups: control, LPS, and LPS with resuscitation. After baseline measurements, LPS (1.75 μg∙kg^-1∙h^-1) was administered in progressively increasing dosages in the LPS and resuscitation groups. Two mDLS™ sensors, placed centrally and peripherally, measured total blood flow (TBF), relative blood velocity (RBV), and relative hemodynamic indices (relHIs) 1 h before (T0) and 1, 2, and 3 h after LPS administration (T1, T2, and T3). New DLS parameters describing heart rate variability (high-and low-frequency components HF and LF) and self-similarity (the Hurst exponent) were calculated.

Results: No differences in TBF, RBV, and HF values were seen between the study groups after LPS administration. LF was peripherally higher at T2 in subjects receiving LPS than in controls. RelHIs showed a change in blood distribution between T0 and T1 in the resuscitation group. Both intervention groups showed a Hurst exponent decrease centrally at T2 and peripherally already at T1.

Conclusion: Changes in microcirculatory parameters, relHIs, and the Hurst exponent, were recorded for 3 h following LPS administration. The Hurst exponent was significantly lower in the LPS and LPS with resuscitation groups than in controls. Further clinical studies are required to determine the sensitivity and specificity of the non-invasive mDLS™ sensor for sepsis detection.

Purpose: Mini-monovision is a vision correction technique that allows for a broader spectrum of spectacle independence while minimizing anisometropia. This systemic review aims to evaluate the clinical outcomes of pseudophakic mini-monovision with three types of intraocular lenses (IOLs): monofocal, enhanced monofocal, and extended depth of focus (EDOF).

Methods: A comprehensive literature search was conducted using PubMed and MEDLINE to identify studies reporting mini-monovision outcomes within the three categories of IOLs up to July 2024. Inclusion criteria were studies with more than 20 patients, target refraction to achieve mini-monovision difference in the fellow eye, and minimum follow-up of 3 months. The primary outcome measure was uncorrected binocular intermediate visual acuity (UCIVA). The secondary outcomes were binocular uncorrected distance visual acuity (UCDVA), binocular uncorrected near visual acuity (UCNVA), patient-reported outcomes measures (PROMs), spectacle independence, contrast sensitivity, photic phenomenon, enhancement surgeries and IOL exchange.

Results: A total of 113 studies were screened, of which 19, with a total of 1,530 patients, were eligible for inclusion in this review. Mean logMAR binocular UCIVA was 0.16 ± 0.01, 0.11 ± 0.06, 0.08 ± 0.07 (p = 0.41), and mean logMAR UCDVA was 0.08 ± 0.05, 0.04 ± 07, 0.04 ± 0.04 (p = 0.36), in the monofocal, enhanced monofocal, and EDOF groups, respectively. The mean spectacle independence rate was 51% ± 22.1, 55% ± 35.4 and 63.4% ± 24.6 (p = 0.05), respectively, in the monofocal, enhanced monofocal and EDOF groups. A comparable low incidence of halos and glare was observed when enhanced monofocal lenses were evaluated against traditional monofocal lenses. EDOF lenses have, however, demonstrated mixed results. The complications, IOL exchange, and excimer laser enhancement rates were low across all groups.

Conclusion: While enhanced monofocal and EDOF IOLs may provide slightly better binocular intermediate visual outcomes and higher spectacle independence compared to monofocal lenses with regards to mini-monovision and intermediate vision performance, the differences are not statistically significant. All three IOL types exhibit high patient satisfaction rates when choosing a mini-monovision approach with decreased dependence on spectacles.

Background: Hypothermia has been strongly associated with human diseases; it affects life safety. Therapeutic hypothermia generates good results for certain diseases, without serious complications. In clinical practice, research on the treatment of hypothermia and severe hypothermia-induced diseases have achieved fruitful results. However, no bibliometric analysis has been conducted. In this study, we explored the research status and hotspots of hypothermia and human diseases by conducting a bibliometric analysis.

Methods: Articles on hypothermia and human diseases were collected from the Web of Science Core Collection. From 1 January 2005 to 31 August 2024, A total of 1,553 articles were retrieved. After excluding irrelevant articles, 706 articles were analyzed.

Results: The United States and China published the maximum number of research articles on hypothermia and human diseases. Among institutes, Johns Hopkins University and Harvard University published the maximum number of research articles. Scholars, including Ishikawa Takaki, Maeda Hitoshi, and Michiue Tomomi, constituted a highly productive group of authors. The journal, Therapeutic Hypothermia and Temperature Management published the highest number of articles, and Nature Reviews Drug Discovery had the highest impact factor. Cluster analysis of all keywords primarily focused on the following research directions: (i) hypothermia-related injury, (ii) hypothermia treatment, and (iii) the mechanism underlying hypothermia.

Conclusion: This bibliometric study comprehensively summarizes the impact of hypothermia on human diseases and the research overview of the use of moderate hypothermia for treatment. This paper clarifies the research status, frontiers and hotspots, and also puts forward new insights for hypothermia research: strengthen research cooperation to improve the depth of research, increase support for areas with insufficient medical conditions; in the future, single-cell multiomics technology will be used to explore cell types sensitive to different low temperatures and corresponding molecular mechanisms; non-coding RNA regulation will be used to achieve precision treatment of hypothermia diseases; Organoids will be an important object of hypothermia research. These research insights can provide reference for researchers.

A clinical case involving a patient with retrocaval ureter and right ureteropelvic junction obstruction (UPJO) is presented, accompanied by a comprehensive review and discussion of relevant literature. The patient, a 43-year-old female, was admitted to the hospital after discovering right hydronephrosis 2 weeks prior. Computed tomographic urography (CTU) revealed significant right hydronephrosis, a retrocaval ureter, and compression of the right renal variant artery causing UPJO. Retrograde pyelography further demonstrated a stenotic upper segment of the right ureter, exhibiting an "S"-shaped appearance. To address these issues, the patient underwent laparoscopic surgery for retrocaval ureteral realignment and right pyeloureteroplasty. Notably, there were no complications during or after the surgical procedure, and the patient's recovery was uneventful. The coexistence of retrocaval ureter and right UPJO is infrequently encountered in clinical practice. However, the simultaneous correction of these anomalies through laparoscopic surgery has proven to be both safe and feasible.

Background: Gastric ulcers are a form of peptic ulcers that present as ruptures of the mucosal lining of the stomach or the proximal intestinal lining extending beyond the muscularis mucosae, and Helicobacter pylori infection is one of the main causative factors of gastric ulcers. However, the growing incidence of Helicobacter pylori drug resistance and the emergence of specialised ulcers has necessitated continued research on gastric ulcers. This study surveyed global gastric ulcer research over the past two decades with the aim of identifying the major findings and emerging trends in the field.

Methods: Bibliometric analysis was performed using the search terms 'Gastric ulcer', 'Gastric ulcer disease', 'Gastrohelcoma', and 'Stomach ulcers'. Data were extracted from the Web of Science Core Database (WoSCC) and visualised using CiteSpace software.

Results: The Journal of Gastroenterology had the most cited papers. The largest number of papers was from the United States. The most frequently cited keywords were 'Helicobacter pylori', 'peptic ulcer', and 'gastric ulcer'.

Conclusion: The field of gastric ulcer research is rapidly expanding, and the existing research is focused on preventing the occurrence of gastric ulcers, exploring the pathogenesis of gastric ulcers, and identifying new methods of treating gastric ulcers.

Purpose: To evaluate the efficacy, safety, and outcomes of a blade- and cautery-free surgical protocol for pterygium removal.

Methods: Pterygium removal surgery was done in 69 eyes (67 patients; 24 males and 43 females) who were followed up for at least 6 months. The surgery was characterized by blunt separation of the pterygium from the head to the limbal arc using the tip of Vannas scissors and modified procedures, such as transpositional flapping and suture closure. Neither a blade nor a cautery was used.

Results: The reported subjects were 60.7 years old on average, and most of them had primary pterygium (66 out of 69). The proposed surgical protocol was simple to perform, requiring an average operation time of 18.7 min which was shorter than that of the suture and fibrin glue groups mentioned in relevant reports. Post-anesthesia pain was relieved quickly 1 day after surgery without the use of pain killers. During the follow-up period of 11.3 ± 3.1 months, recurrence of pterygium requiring additional surgery was seen in only three eyes (4.3%).

Conclusion: The potential of the examined protocol as an easy, efficient, and reliable approach was demonstrated.

Introduction: The integration of artificial intelligence (AI) into medicine has ushered an era of unprecedented innovation, with substantial impacts on healthcare delivery and patient outcomes. Understanding the current development, primary research focuses, and key contributors in AI applications in medicine through bibliometric analysis is essential.

Methods: For this research, we utilized the Web of Science Core Collection as our main database and performed a review of literature covering the period from January 2019 to December 2023. VOSviewer and R-bibliometrix were performed to conduct bibliometric analysis and network visualization, including the number of publications, countries, journals, citations, authors, and keywords.

Results: A total of 1,811 publications on research for AI in medicine were released across 565 journals by 12,376 authors affiliated with 3,583 institutions from 97 countries. The United States became the foremost producer of scholarly works, significantly impacting the field. Harvard Medical School exhibited the highest publication count among all institutions. The Journal of Medical Internet Research achieved the highest H-index (19), publication count (76), and total citations (1,495). Four keyword clusters were identified, covering AI applications in digital health, COVID-19 and ChatGPT, precision medicine, and public health epidemiology. "Outcomes" and "Risk" demonstrated a notable upward trend, indicating the utilization of AI in engaging with clinicians and patients to discuss patients' health condition risks, foreshadowing future research focal points.

Conclusion: Analyzing our bibliometric data allowed us to identify progress, focus areas, and emerging fields in AI for medicine, pointing to potential future research directions. Since 2019, there has been a steady rise in publications related to AI in medicine, indicating its rapid growth. In addition, we reviewed journals and significant publications to pinpoint prominent countries, institutions, and academics. Researchers will gain important insights into the current landscape, collaborative frameworks, and key research topics in the field from this study. The findings suggest directions for future research.