Medical Gas Research最新文献

JOURNAL/mgres/04.03/01612956-202603000-00004/figure1/v/2025-06-28T140100Z/r/image-tiff Inhalation anesthetics may trigger the hypothalamic-pituitary-adrenal axis. FK-506 binding protein (FKBP5) is a critical regulator of the hypothalamic-pituitary-adrenal axis and has been implicated in postoperative cognitive dysfunction. However, how inhalation anesthetics affect the expression and function of FKBP5 in the brain is unclear. We employed single-nucleus RNA sequencing to delineate the hippocampal transcriptomic profiles of the brains of aged marmosets and mice after sevoflurane anesthesia. The results of single-nucleus RNA sequencing revealed that long-term exposure (6 hours) to sevoflurane significantly increased FKBP5 expression in the hippocampus of aged marmosets and mice, especially in microglia. Western blot assay also verified the above results. The Barnes maze test showed that, compared with heterozygous control mice, microglia-specific FKBP5 conditional knockout mice exhibited improved neurocognitive function after sevoflurane/surgery. Transcriptome sequencing analysis was performed on the brains of microglia-specific FKBP5 conditional knockout mice and heterozygous mice after sevoflurane/surgery and further revealed that FKBP5 was related mainly to inflammatory signaling pathways. Therefore, these findings indicate that long-term exposure to sevoflurane increases FKBP5 expression in the hippocampus of aged marmosets and mice, which thereby affects inflammatory signaling pathways and leads to postoperative cognitive dysfunction.

JOURNAL/mgres/04.03/01612956-202603000-00001/figure1/v/2025-06-28T140100Z/r/image-tiff Avascular necrosis of the femoral head is a condition resulting from disrupted blood supply, leading to ischemia and bone tissue necrosis. Core decompression (CD) restores the blood supply through pressure relief, whereas hyperbaric oxygen (HBO) enhances tissue oxygenation and promotes bone repair. Their combined use may complement each other in improving blood supply, promoting bone healing, and inhibiting disease progression, thus achieving a better therapeutic effect. To assess and compare the efficacy of HBO and/or CD for treating mild to moderate femoral head avascular necrosis, a retrospective study was conducted on patients diagnosed with Ficat stage II non-traumatic osteonecrosis between January 2017 and January 2022 at the Affiliated Central Hospital of Shenyang Medical University, China. A total of 72 patients were divided into HBO, CD, and combination groups, with 24 patients in each group. After 1 year of follow-up, 90% of patients in the HBO group, 85% in the CD group, and 95% in the combination group showed satisfactory improvements in hip joint function. The SF-36 quality of life questionnaire scale scores also significantly improved in all three groups, with the combination group showing the most significant improvement. These findings suggest that HBO offers promising potential for treating non-traumatic femoral head necrosis, with efficacy similar to that of CD. The combination group showed the most significant improvement in both hip joint function and quality of life.

Pulsed radiofrequency combined with ozone therapy has been a newly proposed treatment method for zoster-associated pain in recent years. To explore the effectiveness of a regimen of pulsed radiofrequency combined with ozone for the treatment of zoster-associated pain. We searched commonly used English databases (the Cochrane Library, PubMed, CINAHL, Embase, and Web of Science) and Chinese databases (the CNKI, WanFang, CBM, and VIP databases) for randomized controlled trials. Two researchers independently screened the literature on the basis of the set conditions and extracted data from the included literature. The meta-analysis was conducted via Review Manager 5.4 software. A meta-analysis was conducted on 18 studies, with a total of 1496 participants (742 in the experimental group and 754 in the control group). The results revealed that the pulsed radiofrequency combined with ozone presented lower unidimensional pain scores (standardized mean difference [SMD] = -1.55, 95% confidence interval [CI] = [-2.04, -1.06]; heterogeneity: P < 0.00001, I2 = 94%; test effect: Z = 6.18, P < 0.00001), a lower pain rating index (mean difference [MD] = -2.65, 95% CI = [-3.86, -1.44]; heterogeneity: P = 0.001, I2 = 85%; test effect: Z = 4.29, P < 0.0001) and presented pain intensity scores (MD = -0.58, 95% CI = [-0.62, -0.54]; heterogeneity: P = 0.61, I2 = 0%; test effect: Z = 27.91, P < 0.00001), a lower Pittsburgh sleep quality index (MD = -1.62, 95% CI = [-2.94, -0.31]; heterogeneity: P < 0.00001, I2 = 93%; test effect: Z = 2.42, P = 0.02), and lower interleukin-6 expression levels (SMD = -1.94, 95% CI = [-2.91, -0.97]; heterogeneity: P < 0.00001, I2 = 93%; test effect: Z = 3.92, P < 0.0001), lower gabapentin consumption (MD = -146.92, 95% CI = [-189.93, -103.91]; heterogeneity: P = 0.23, I2 = 30%; test effect: Z = 6.70, P < 0.00001). Pulsed radiofrequency combined with ozone is an effective treatment for zoster-associated pain that can effectively alleviate patients' pain and improve sleep quality, providing a new treatment option for zoster-associated pain in the future.

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.

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.