Medical Gas Research最新文献

Breast cancer is the most commonly diagnosed cancer and the second leading cause of cancer death among women worldwide. Poor prognosis in breast cancer patients is often linked to the presence of intratumoral hypoxic areas caused by abnormal vascularization and insufficient oxygen availability, which results in energetic crisis in cancer cells; metabolic and epigenetic reprogramming; the transcription of genes involved in angiogenesis; cancer cell proliferation; increased motility, aggressiveness and metastasis; the accumulation of mutations; genomic instability; the maintenance of stem cell characteristics; stromal cell recruitment; extracellular matrix remodeling; chronic inflammation; immune evasion; and adaptive responses in the tumoral microbiota. Furthermore, hypoxia is often correlated with resistance to traditional antitumor treatments used alone or in combination, which results in the need to implement novel therapies to overcome or alleviate the negative effects of oxygen deprivation in breast cancer theranostics. In breast cancer modeling research, micro- and nanofabrication-based technologies, including breast cancer-on-chip and breast cancer metastasis-on-chip platforms, are able to recapitulate the metastatic cascade of breast cancer in different controlled oxygen gradients. Mass spectrometry-based proteomics, including mass spectrometry imaging, offers opportunities for detecting, quantifying and understanding the roles of proteins and peptides, protein-protein interaction networks, and posttranslational modifications of proteins involved in hypoxia-associated biopathological processes. In this mini-review, we have summarized several modern approaches that are able to overcome the undesirable effects of hypoxia for breast cancer treatment. Thus, natural compounds with inhibitory effects on hypoxia-related signaling pathways in breast cancer cells and the tumor microenvironment, hyperbaric oxygen therapy, viral vector-based therapy that uses genetically engineered oncolytic viruses, and oncological bacteriotherapy based on biohybrid platforms, including anaerobic bacteria that are able to colonize inaccessible hypoxic regions in breast tumors to deliver chemotherapeutic drugs just into the tumor site, and smart nanoplatforms for abundant O2 generation within hypoxic breast cancer areas, including erythrocyte-like nanoparticles, metal-organic framework-nanoparticles, or engineered microalgae-metal-organic framework oxygenators, have been designed to relieve tumor hypoxia, induce antitumor responses, and improve the effects of traditional anti-breast cancer therapies.

Noninvasive ventilation (NIV) and high-flow nasal cannula are increasingly used to treat acute respiratory failure. Because many of these patients could also benefit from inhaled medications, combining aerosol therapy with NIV or high-flow nasal cannula is a promising approach. Effective drug delivery to the lungs is crucial for successful aerosol therapy during NIV. Prior research has identified several factors that affect aerosol delivery efficiency in NIV patients. Medical gases have a long history of use in managing various respiratory conditions. Among them, oxygen is frequently used for patients with hypoxia (e.g., hypoxemic respiratory failure and in newborns). In addition to deoxygenation, helium oxygen mixture and nitric oxide can also be administered through devices such as masks combined with NIV. This narrative review aims to provide a comprehensive overview on the application of gas mixtures (such as helium oxygen mixtures and nitric oxide) in NIV, focusing on their efficacy, safety, and optimization strategies in different clinical settings.

FactsOxygen is essential for most living organisms on the Earth, but excessive oxygen can cause oxygen toxicity.For individuals with mitochondrial dysfunction, even normal oxygen concentration in the air may be relatively excessive.Consensus regarding oxygen supply for critically ill patients in the intensive care unit has yet to be reached.Open questionsHow to strike a balance between insufficient and excessive oxygen supply during oxygen inhalation?Is it necessary to integrate monitoring of oxygen supply to form a closed-loop oxygen supply system with autonomous regulation for patients/individuals who need oxygen therapy?How to better achieve individualized oxygen supply? Oxygen inhaled through respiration is consumed in the mitochondria, mainly for oxidative phosphorylation to produce energy. Too little or too much oxygen can be extremely harmful to humans. Insufficient oxygen supply to tissues and organs can result in either dysfunctions or necrosis. However, when the oxygen supply is over supplied, the body is unable to consume the excessive oxygen, which puts the cells in a state of hyperoxia, leading to the production of a large number of reactive oxygen species, which can further cause oxidative damage to the cell membranes and organelles, leading to oxygen toxicity. Although the body has several oxygen-sensing mechanisms to prevent organs and cells from being exposed to hypoxia- or hyperoxia-induced oxidative stress, the relevant capacity and duration of action are relatively limited. Thus, continuous and real-time individualized monitoring and guidance is particularly important in oxygen therapy, especially in the elderly, in order to correct hypoxemia and tissue hypoxia while avoiding or reducing oxygen toxicity caused by hyperoxia. This review aims to briefly summarize the physiology of oxygen and to update the latest progress regarding the mechanism of oxygen toxicity, providing theoretical insights on oxygen therapy practice.

Healthcare systems are known to negatively impact the environment, with the operating room significantly contributing to these issues. Specifically, anesthetic gases have been a recent target of many sustainability initiatives, as they are known to be greenhouse gases and have traditionally been a cornerstone of providing general anesthesia. This review focuses on the current literature regarding the impact of anesthetic gases on the environment, including common definitions such as global warming potential and carbon dioxide equivalents. The most commonly used anesthetic gases are reviewed, including their impact on the atmosphere, as well as strategies to reduce their negative impact while maintaining their availability for use in the practice of anesthesiology. Specifically, the clinical applications of the commonly used anesthetic gases, namely sevoflurane, desflurane, isoflurane and nitrous oxide are discussed. This review further identifies and explores alternative methods that help mitigate the negative environmental impact of anesthetic gases, including gas capturing systems, low flow anesthesia and total intravenous anesthesia, as well as barriers to implementing these strategies. We conclude that while many strategies exist to minimize the environmental impact of anesthetic gases, implementation is often hindered by factors such as institutional buy-in and cost/return on investment ratio. FactsHealthcare systems negatively impact the environment, and the operating room is a major contributor.Inhalational anesthetics contribute to hospital greenhouse gas emissions.Understanding the pharmacology and clinical applications of commonly used anesthetic gases allows for meaningful discussion of environmental impact mitigation strategies, balanced with quality patient care.Open questionsWhat are the commonly accepted definitions of low flow anesthesia and how can they be implemented clinically?How can we best quantify the environmental impact of anesthetic gases and hypnotic agents in total intravenous anesthesiaWhat are available strategies to mitigate the detrimental effects of anesthetic gases to the environment?

JOURNAL/mgres/04.03/01612956-990000000-00070/figure1/v/2026-01-23T103412Z/r/image-tiff MPrevious studies have indicated that helium-oxygen mixture (heliox) ventilation could improve blood pressure and microcirculation in elderly hypertensive patients. To explore the advantages of heliox ventilation over conventional nitrogen-oxygen ventilation, a randomized controlled study was conducted from October 2020 to January 2023 in the Intensive Care Unit of Fujian Medical University Union Hospital and included 40 elderly hypertensive patients requiring invasive mechanical ventilation. These patients were randomly assigned to two groups: the heliox ventilation group (n = 20), which received a closed heliox ventilation protocol for 3 hours, and the nitrogen-oxygen ventilation group (n = 20), which received conventional nitrogen-oxygen ventilation. Compared with the nitrogen-oxygen group, the heliox group demonstrated significantly lower central venous pressure and higher central venous oxygen saturation, indicating increased cardiac output and elevated plasma nitric oxide. Moreover, in the heliox group, the change in plasma caveolin-1 was essentially identical to that in nitric oxide. However, there was no significant difference in endothelin-1 levels between the two groups. These findings indicate that heliox ventilation enhances cardiac function in elderly hypertensive patients by improving pulmonary circulation through increased pulmonary vasodilation. The trial was also registered in the Chinese Clinical Trial Registry (registration No. ChiCTR2100043945) on March 6, 2021.

JOURNAL/mgres/04.03/01612956-990000000-00073/figure1/v/2026-01-23T123057Z/r/image-tiff Defects in myelination impair nerve impulse conduction and functional connectivity, which could lead to cognitive, behavioral and motor deficits in various neurological disorders. Adequate oxygen delivery is vital for brain development, while hypoxia in newborns tends to result in developmental deficiencies in myelination of the brain. The disruption of oligodendrocytes and their progenitor cells caused by hypoxia has been well researched. Nonetheless, the impairing dynamic myelination process is still unclear. Utilizing zebrafish as a model, we established hypoxia via cobalt chloride exposure or low oxygen (8%) incubation. Hypoxia significantly reduced oligodendrocyte progenitor cell numbers in the dorsal spinal cord, impaired migration velocity and suppressed proliferation. Myelination deficits were evident through decreased myelin sheath segment intensity in Tg(MBP:eGFP-CAAX) larvae. Time-lapse imaging revealed compromised dynamic myelination by individual oligodendrocytes under hypoxia, with fewer sheaths and reduced extension rates. Mechanistically, hypoxia elevated reactive oxygen species levels and disrupted mitochondrial membrane potential in cultured rat oligodendrocyte progenitor cells. Nanoscale magnesium hydride, a hydrogen-releasing agent, attenuated these effects. In vivo, magnesium hydride treatment rescued oligodendrocyte progenitor cell numbers and enhanced myelinogenesis capacity in hypoxic zebrafish. These findings demonstrate that magnesium hydride mitigates hypoxia-induced oxidative stress and mitochondrial dysfunction, thereby alleviating myelination deficits.

JOURNAL/mgres/04.03/01612956-990000000-00074/figure1/v/2026-01-23T103409Z/r/image-tiff As a non-invasive and drug-free treatment method, hyperbaric oxygen therapy has been applied in cerebrovascular accidents to improve cerebral hypoxia, reduce ischemia-reperfusion injury following stroke and promote neural repair. However, its clinical efficacy remains controversial. This work aims to analyze the progress of research on the role of hyperbaric oxygen in stroke through bibliometric methods and takes relevant literature from the Web of Science core database from 2007 to December 31, 2024. The results showed that from 2007 to the present, the annual number of English publications in this field has shown a fluctuating but gradual upward trend, with the peak in publication volume occurring in 2015. China is in a leading position in this field, but there is still a lack of international cooperation and high-impact journal articles from Chinese institutions and researchers. The top five keywords were "hyperbaric oxygen" (84 occurrences), "stroke" (46 occurrences), "hyperbaric oxygen therapy" (45 occurrences), "focal cerebral ischemia" (27 occurrences), and "cerebral ischemia" (26 occurrences). A total of 13 major research areas were identified, including #0 stem cells, #1 hyperbaric oxygen, #2 perfusion, #3 EPR oximetry, #4 tPA, #5 rehabilitation, #6 acute stroke, #7 TBI, #8 stroke medicine, #9 hyperbaric oxygen preconditioning, #10 preconditioning, #11 ischemia-reperfusion injury, and #12 hyperbaric. At present, there are relatively few clinical trials registered on hyperbaric oxygen therapy for the treatment of stroke. Due to the fact that the effectiveness of hyperbaric oxygen therapy depends on the type and timing of stroke, there is currently no unified standard for the optimal timing and duration of hyperbaric oxygen therapy. Overall, hyperbaric oxygen therapy is safe and reliable, with most adverse reactions being mild and reversible. In summary, hyperbaric oxygen therapy has significant neuroprotective and functional recovery potential in stroke patients.