Prediction of hepatic artery occlusion after liver transplantation by ultrasound characteristics and clinical risk factors

BACKGROUND Hepatic artery occlusion(HAO)after liver transplantation(LT)is a devastating complication,resulting in early graft loss and reduced overall survival.Ultra-sound is an established assessment method for HAO in patients following LT,especially those with complex hepatic artery reconstruction.METHODS We retrospectively analyzed the ultrasound characteristics and the clinic risk factors associated with HAO in 400 adult LT patients who were enrolled and treated at the Third People's Hospital of Shenzhen between November 2016 and July 2022.Fourteen patients diagnosed with acute HAO(A-HAO)by surgery and fifteen diagnosed with chronic HAO(C-HAO)were included.A control group of 33 patients without HAO complications during the same period were randomly selected using a random number table.All patients underwent an ultrasono-graphy examination.Parameters including resistance index(RI),peak systolic velocity(PSV),and portal vein velocity(PVV)were compared across the groups.Additionally,basic clinical data were collected for all patients,including gender,age,primary diagnosis,D-dimer concentration,total operation time,cold ischemia time,hot ischemia time,intraoperative blood loss and transfusion,intraoperative urine volume,infusion,model for end-stage liver disease(MELD)score,and whether complex hepatic artery reconstructions were performed.Furthermore,risk factors influencing HAO formation after LT were analyzed.RESULTS Compared to the non-HAO group,PVV and RI were higher in the A-HAO group,while PSV was lower.Conversely,both PSV and RI were lower in the C-HAO group compared to the non-HAO group.The proportion of patients undergoing complex hepatic artery reconstructions and the gamma-glutamyltransferase(GGT)level before occlusion were significantly higher in the A-HAO group compared to the non-HAO group.However,there were no distinct differences between the two groups in D-dimer,MELD score,pre-occlusion alanine transaminase and aspartate transaminase levels,or intraoperative conditions.CONCLUSION Ultrasound features of the hepatic artery before occlusion are significantly associated with postoperative HAO development.Additionally,complex hepatic artery reconstructions,defined as revascularization of the graft requiring additional anastomosis between donor hepatic arteries,constitute a risk factor for A-HAO.Besides,abnormal pre-occlusion GGT elevation is an important biochemical indicator.Therefore,ultrasound examination serves as an important tool for screening HAO,especially in patients with the identified risk factors.

Stricture Free Survival after Urethroplasty: A 6-Year Malaysian Referral Centre Experience

Background: Urethroplasty is the gold standard for treatment for urethral strictures. We describe our results of urethroplasty and analyse the risk factors associated with stricture recurrence and stricture-free survival. Methods: A retrospective review of urethroplasty surgery carried out from 2016-2022. Patient records were analysed to obtain demographics, clinical, pathological and outcome data. Success of surgery is defined as postoperative Qmax > 15 ml/s or absence of any instrumentation of urethra such as urethral dilatation, after removal of urethral indwelling catheter. Results: A total of 66 patients who fulfilled the inclusion criteria were selected. Mean age was 43.8. Mean follow up was 27.2 ± 21.8 months. Stricture recurred in 18 patients (27.3%). Estimated stricture free survival time was 59.6 months (95% CI: 50.87 - 68.37). Previous surgical history for stricture was found to be predictive of stricture recurrence. After adjusting for age, BMI, aetiology of stricture and stricture length, previous surgical history had a risk of stricture recurrence approximately three times higher compared to those without. Conclusion: Previous surgical intervention for urethral stricture was found to be the most significant factor for stricture recurrence. We strongly advocate that the first curative surgery done for urethral strictures should be done in high volume centres and by experienced reconstructive urologists.

Research landscape on COVID-19 and liver dysfunction: A bibliometric analysis

BACKGROUND The global spread of severe acute respiratory syndrome coronavirus 2,responsible for coronavirus disease 2019(COVID-19),poses a significant risk to public health.Beyond the respiratory issues initially associated with the condition,severe cases of COVID-19 can also lead to complications in other organs,including the liver.Patients with severe COVID-19 may exhibit various clinical signs of liver dysfunction,ranging from minor elevations in liver enzymes without symptoms to more serious cases of impaired liver function.Liver damage is more commonly observed in patients with severe or critical forms of the disease.AIM To present the research landscape on COVID-19 and liver dysfunction while also offering valuable insights into the prominent areas of interest within this particular domain.METHODS On 18 February 2023,Scopus was utilised to conduct a comprehensive exploration of the relationship between COVID-19 and the liver dysfunction.The investigation encompassed the period from 1 January 2020 to 31 December 2022.Primary sources were meticulously examined and organised in a Microsoft Excel 2013 spreadsheet,categorised by journal,institution,funding agency,country and citation type.VOSviewer version 1.6.18 was employed to explore the prominent topics and knowledge network related to the subject.RESULTS There were 2336 publications on COVID-19 and liver dysfunction analysed in this study,of which 558 were published in 2020,891 in 2021 and 887 in 2022.Researchers from 111 different countries participated in the retrieved documents.The United States contributed the most studies,with 497 documents,representing 21.28%of the total,followed by China with 393 documents(16.82%)and Italy with 255 documents(10.92%).In the context of research related to COVID-19 and the liver,co-occurrence analysis identified three distinct clusters of topics:(1)‘COVID-19 vaccines in liver transplant recipients’;(2)‘liver function tests as a predictor of the severity and clinical outcomes in hospitalised patients’;and(3)‘care of patients with liver disease during the COVID-19 pandemic’.CONCLUSION This bibliometric study provides a comprehensive overview of liver-related publications in COVID-19 research over the past 3 years.This study highlights the significant contributions of high-income nations,particularly the United States,China,and Italy,to the production of liver-related scholarly literature in this field.Most of the articles focused on liver dysfunction in patients with COVID-19 and the implications of the virus for gastroenterologists and hepatologists.

Global research trends on diet and nutrition in Crohn’s disease

BACKGROUND Crohn’s disease represents a challenge for patients concerned with the modified diet regimen as well as practitioners who seek the best nutritional therapy.Crohn’s disease can alter the body’s ability to digest food and to absorb nutrients,resulting in severe vitamin deficiencies,malnutrition and sometimes lifethreatening complications.However,a comprehensive bibliometric analysis is lacking to map the current links between nutrition and Crohn’s disease in terms of the number of citations,geographic distribution and growth trends of publications.AIM To introduce the current state of research as well as hotspots in the field of nutrition and Crohn’s disease from a bibliometric standpoint.METHODS We searched the Scopus database and selected the relevant literature on nutrition and Crohn’s disease that met the inclusion criteria.We analyzed the publication trends and research hotspots by using video object segmentation viewer software.RESULTS We included 1237 publications.The number of documents published each year has increased steadily.The United States and the University of Otago,Christchurch,have had the highest productivity,with 208(16.81%)and 29(2.34%)documents,respectively.The“role of exclusive enteral nutrition for complicated Crohn’s disease”and“manipulation of the gut microbiota as a key target for Crohn’s disease”were the major research areas in 2016-2021,and they could be extensively investigated in the future.Meanwhile,research on“malnutrition in patients with Crohn’s disease”appeared to be an area that attracted more research attention before 2016.CONCLUSION This is the first bibliometric analysis to map the knowledge structure and trends regarding nutrition in Crohn’s disease research over the past two decades.The results provide a comprehensive summary and identification of the frontiers of nutrition and Crohn’s disease-related research,which may be used as a resource by researchers in the field.

Unveiling the hidden world of gut health:Exploring cutting-edge research through visualizing randomized controlled trials on the gut microbiota

BACKGROUND The gut microbiota plays a crucial role in gastrointestinal and overall health.Randomized clinical trials(RCTs)play a crucial role in advancing our knowledge and evaluating the efficacy of therapeutic interventions targeting the gut microbiota.AIM To conduct a comprehensive bibliometric analysis of the literature on RCTs involving the gut microbiota.METHODS Using bibliometric tools,a descriptive cross-sectional investigation was conducted on scholarly publications concentrated on RCTs related to gut microbiota,spanning the years 2003 to 2022.The study used VOSviewer version 1.6.9 to examine collaboration networks between different countries and evaluate the frequently employed terms in the titles and abstracts of the retrieved publications.The primary objective of this analysis was to identify key research areas and focal points associated with RCTs involving the gut microbiota.RESULTS A total of 1061 relevant articles were identified from the 24758 research articles published between 2003 and 2022.The number of publications showed a notable increase over time,with a positive correlation(R2=0.978,P<0.001).China(n=276,26.01%),the United States(n=254,23.94%),and the United Kingdom(n=97,9.14%)were the leading contributing countries.Københavns Universitet(n=38,3.58%)and Dankook University(n=35,3.30%)were the top active institutions.The co-occurrence analysis shows current gut microbiota research trends and important topics,such as obesity interventions targeting the gut microbiota,the efficacy and safety of fecal microbiota transplantation,and the effects of dietary interventions on humans.CONCLUSION The study highlights the rapid growth and importance of research on RCTs that involve the gut microbiota.This study provides valuable insight into research trends,identifies key players,and outlines potential future directions in this field.Additionally,the co-occurrence analysis identified important topics that play a critical role in the advancement of science and provided insights into future research directions in this field.

Reconstruction of Postinfarcted Cardiac Functions Through Injection of Tanshinone ⅡA@Reactive Oxygen Species-Sensitive Microspheres Encapsulated in a Thermoreversible Hydrogel

Myocardial damage resulting from acute myocardial infarction often leads to progressive heart failure and sudden death,highlighting the urgent clinical need for effective therapies.Recently,tanshinoneⅡA has been identified as a promising therapeutic agent for myocardial infarction.However,efficient delivery remains a major issue that limits clinical translation.To address this problem,an injectable thermosensitive poly(lactic acid-co-glycolic acid)-block-poly(ethylene glycol)-block-poly(lactic acid-co-glycolic acid)gel(PLGA-PEG-PLGA)system encapsulating tanshinoneⅡA-loaded reactive oxygen species-sensitive microspheres(Gel-MS/tanshinoneⅡA)has been designed and synthesized in this study.The thermosensitive hydrogel exhibits good mechanical properties after reaching body temperature.Microspheres initially immobilized by the gel exhibit excellent reactive oxygen species-triggered release properties in a high-reactive oxygen species environment after myocardial infarction onset.As a result,encapsulated tanshinoneⅡA is effectively released into the infarcted myocardium,where it exerts local anti-pyroptotic and anti-inflammatory effects.Importantly,the combined advantages of this technique contribute to the mitigation of left ventricular remodeling and the restoration of cardiac function following tanshinoneⅡA.Therefore,this novel,precision-guided intra-tissue therapeutic system allows for customized local release of tanshinoneⅡA,presenting a promising alternative treatment strategy aimed at inducing beneficial ventricular remodeling in the post-infarct heart.

Prognostic value of ultrasound in early arterial complications post liver transplant

Liver transplantation is the primary therapeutic intervention for end-stage liver disease.However,vascular complications,particularly those involving the hepatic artery,pose significant risks to patients.The clinical manifestations associated with early arterial complications following liver transplantation are often non-specific.Without timely intervention,these complications can result in graft fai-lure or patient mortality.Therefore,early diagnosis and the formulation of an op-timal treatment plan are imperative.Ultrasound examination remains the pre-dominant imaging modality for detecting complications post liver transplan-tation.This article comprehensively reviews common causes and clinical present-ations of early hepatic artery complications in the post-transplantation period and delineates abnormal sonographic findings for accurate diagnosis of these con-ditions.Overall,ultrasound offers the advantages of convenience,safety,effect-iveness,and non-invasiveness.It enables real-time,dynamic,and precise evalua-tion,making it the preferred diagnostic method for post-liver transplantation assessments.INTRODUCTION Liver transplantation stands as the primary therapeutic approach for end-stage liver disease.Continuous advancements in surgical techniques and the application of novel immunosuppressive agents contribute to ongoing improvements in the success rate and overall survival in patients undergoing liver transplantation procedures.Despite these advan-cements,vascular complications,particularly those involving the hepatic artery,pose significant risks to patients.During the early stages following liver transplantation(within the first 30 d),proper hepatic artery function is crucial for hepatic arterial blood flow.During later stages,collateral circulation,including arteries such as the phrenic artery,right gastric artery,and gastroduodenal artery,becomes important for maintaining hepatic blood supply.It is now understood that the establishment of effective collateral circulation is pivotal for determining the prognosis of hepatic artery complic-ations.The clinical manifestations of these complications are closely linked to factors such as timing,severity,and the specific type of onset.Insufficient hepatic arterial blood flow can lead to abnormal liver function,hepatic infarction,and the formation of hepatic abscesses.Additionally,since the hepatic artery is the sole blood supply to the biliary tract,hepatic artery-related ischemia may result in biliary stricture,obstruction,and the formation of bile ducts.Ultrasound examination remains the primary imaging modality for diagnosing complications post liver transplantation.This article comprehensively reviews common causes and clinical presentations of early hepatic artery complications in the post-transplantation period and outlines abnormal sonographic findings for accurately diagnosing these conditions.NORMAL HEPATIC ARTERY During the intraoperative phase,an ultrasound examination is typically conducted to evaluate the hepatic artery anas-tomosis.The normal internal diameter of the hepatic artery typically ranges from 2 to 5 mm.Two strong echo points are typically identified near the anastomosis.To assess blood flow dynamics,peak systolic velocity,end-diastolic velocity,and resistance index are measured at the donor and recipient sides of the anastomosis following angle correction.Anastomotic stenosis presence and severity can be evaluated by comparing the velocity at the anastomotic site with that at the recipient side.Postoperatively,direct visualization of the anastomosis site through gray ultrasound scans is often challenging.The surgical approach has a significant impact on the proper hepatic artery’s position,resulting in a lower overall success rate of continuous visualization.Color Doppler ultrasound is primarily employed to trace the artery’s path,and spectral measurements are taken at the brightest position of the Color Doppler blood flow signal,primarily used to identify the presence of high-speed turbulence.Hepatic artery spectrum examination plays a crucial role,as a favorable arterial spectral waveform and appropriate hepatic artery flow velocity typically indicate a successful anastomosis,even in cases where the hepatic artery anastomosis cannot be directly visualized by ultrasound.The hepatic artery runs alongside the portal vein,often selected as a reference due to its larger inner diameter.A normal hepatic artery spectrum displays a regular pulsation pattern with a rapid rise in systole and a slow decline in diastole.Parameters for assessing hepatic artery resistance include a resistance index between 0.5 to 0.8 and an artery systolic acceleration of less than 80 ms.Instantaneous increases in the resistance index(RI>0.8)often occur within 2 d after surgery,followed by a subsequent return to normal hepatic arterial parameters.It has been established that the maximum blood flow velocity during systole in the hepatic artery should not exceed 200 cm/s[1].

Mechanisms behind elevated serum levels of plasminogen activator inhibitor-1 in frontotemporal lobar degeneration

Frontotemporal lobar degeneration(FTLD)is a form of progressive dementia characterized by degeneration of the frontal and temporal lobes of the brain.This pathology involves a series of cognitive,behavioral,and neurological symptoms that influence personality,decision-making ability,and language.

Treatment of uveitis and scleritis patients in Malaysia

●AIM:To determine the common causes and visual outcome after treatment among uveitis and scleritis patients.●METHODS:This is a retrospective cohort observational study.All consecutive clinical records of patients with newly diagnosed uveitis and scleritis over a 4-year period,from Jan.1,2017 to Dec.31,2020,were analysed.Data was collected at the presentation and included a follow-up period of one year.●RESULTS:A total of 288 patients were recruited during the study period.Anterior uveitis was the most common anatomical diagnosis(50.0%)followed by panuveitis(25.0%),scleritis(13.5%),posterior uveitis(6.9%),and intermediate uveitis(4.5%).Viral Herpes was the most common cause of infectious cases,while Vogt-Koyanagi-Harada(VKH)disease and human leucocyte antigen(HLA)B27 spondyloarthropathy were the leading causes of identifiable non-infectious cases.Majority of patients presented with unilateral,non-granulomatous uveitis with an absence of hypopyon.Anatomical locations like posterior uveitis and panuveitis,and visual acuity worse than 3/60 at presentation were the factors associated with poor visual outcomes(P<0.05).About 60%of patients had an identifiable cause for the uveitis and scleritis,with nearly equal distribution of infectious(n=85,29.5%)and noninfectious causes(n=84,29.2%).About 14.5%of patients were clinically blind at 1y of follow-up.The most common complication in our uveitis patients was glaucoma(47.5%),followed by cystoid macula oedema(18.9%)and cataract(13.9%).●CONCLUSION:Uveitis and scleritis are important causes of ocular morbidity.They are potentially blinding diseases which can have a good outcome if diagnosed and treated early.

Liver histological changes in untreated chronic hepatitis B patients in indeterminate phase

BACKGROUND Studies with large size samples on the liver histological changes of indeterminate phase chronic hepatitis B(CHB)patients were not previously conducted.AIM To assess the liver histological changes in the indeterminate phase CHB patients using liver biopsy.METHODS The clinical and laboratory data of 1532 untreated CHB patients were collected,and all patients had least once liver biopsy from January 2015 to December 2021.The significant differences among different phases of CHB infection were compared with t-test,and the risk factors of significant liver histological changes were analyzed by the multivariate logistic regression analysis.RESULTS Among 1532 untreated CHB patients,814(53.13%)patients were in the indeterminate phase.Significant liver histological changes(defined as biopsy score≥G2 and/or≥S2)were found in 488/814(59.95%)CHB patients in the indete-rminate phase.Significant liver histological changes were significant differences among different age,platelets(PLTs),and alanine aminotransferase(ALT)subgroup in indeterminate patient.Multivariate logistic regression analysis indicated that age≥40 years old[adjust odd risk(aOR),1.44;95%confidence interval(CI):1.06-1.97;P=0.02],PLTs≤150×10^(9)/L(aOR,2.99;95%CI:1.85-4.83;P<0.0001),and ALT≥upper limits of normal(aOR,1.48;95%CI:1.08,2.05,P=0.0163)were independent risk factors for significant liver histological changes in CHB patients in the indeterminate phase.CONCLUSION Our results suggested that significant liver histological changes were not rare among the untreated CHB patients in indeterminate phase,and additional strategies are urgently required for the management of these patients.

Subconjunctival trypsin injection for anterior chamber fibrin exudates in eyes with globe rupture following vitrectomy

AIM:To compare the safety and clinical outcomes of subconjunctival trypsin and dexamethasone(DEX)injections in the treatment of anterior chamber fibrin exudates in eyes with globe rupture following primary wound repair and vitrectomy.METHODS:A retrospective analysis included 42 males and 10 females(mean age 46.0±6.0y,range 34 to 58y)who underwent primary wound sutures and vitrectomy for globe rupture.Patients with pupil-covered fibrinous exudate or/and membrane in the anterior chamber were treated.On the first postoperative day,subconjunctival injections of either 5000 units(0.4 mL)of trypsin solution(n=25)or 0.5 mL(1 mg)DEX(n=27)were administered to accelerate exudate absorption.Efficacy was assessed by observing break time and partial absorption of the fibrin exudate membrane.Safety and comfort were evaluated by monitoring intraocular pressure(IOP),allergy,pain,and foreign body sensation.RESULTS:Both groups achieved 1/3 absorption of the anterior chamber fibrin exudate membrane,but the trypsin group exhibited shorter break time and partial absorption time compared to the DEX group(P<0.05).Trypsin treatment was also less irritating to patients.No adverse reactions were reported,and IOP remained stable.Visual acuity improved in both groups without statistical difference.CONCLUSION:Compared to DEX,trypsin demonstrates a shorter absorption time for the fibrin exudate membrane with a more comfortable process in treating pupil-covered fibrinous exudate or/and membrane after vitrectomy for globe rupture.

Docking of Human Band 3 Anion Transporter Proteins with Their Plasmodium falciparum Interactors Based on Short Linear Motifs

Plasmodium (P.) falciparum is a pathogen that causes severe forms of malaria. Protein interactions have been shown to occur between P. falciparum and human erythrocytes in human blood. The Band 3 Anion Transporter (B3AT) protein is considered the main invasive pathway for the parasite in erythrocytes that causes clinical symptoms for malaria in humans. The interactions between P. falciparum parasites and erythrocytes along this receptor have previously been explored. Short linear motifs (SLIMs) are short linear mediator sequences that involve several biological processes, acting as mediators of protein interactions identifiable by computational tools such as SLiMFinder. For a given protein, the identification of SLIMs allows predicting its interactors. Using the SLIMs approach, protein-protein interaction network analyses between P. falciparum and its human host, were used to identify a tryptophan-rich protein, A5K5E5_PLAVS as an essential interactor of B3AT. To better understand the interaction mechanism, a guided protein-protein docking approach based on SLIM motifs was performed for human B3AT and A5K5E5_PLAVS. The highlights of this important interaction between P. falciparum and its human host have the potential to pave the way to identify new therapeutic candidates.

Global research on Clostridium difficile-associated diarrhoea:A visualized study

BACKGROUND Clostridioides(Clostridium)difficile(C.difficile)is still the most common cause of healthcare-associated diarrhoea and is increasing in prevalence as a communityacquired infection.In addition,the emergence of antibiotic resistance in C.difficile can increase the likelihood of the disease developing and/or spreading.AIM To provide an up-to-date picture of the trends in publications related to C.difficile infection,together with specific insights into hot-button issues in this field.METHODS Publications on C.difficile infections in the field of microbiology between 2001 and 2020 were identified from the Scopus database and Reference Citation Analysis.Bibliometric indicators were determined,including the number and type of publications,countries,affiliations,funding agencies,journals and citation patterns.VOSviewer was used to determine research areas and hot-button issues by identifying recurring terms with a high relative occurrence in the title and abstract.RESULTS A total of 8127 documents on‘C.difficile-associated diarrhoea’published between 2001 and 2020 were retrieved from the Scopus database.In the last decade,there has been a significant almost fourfold increase in the number of published papers on this topic.The United States was among the countries(44.11%)with the most publications,and the most involved institution was the University of Leeds in the United Kingdom(2.50%).Three clusters of research were identified and included‘illness spectrum and severity,as well as the signs,symptoms and clinical pathogenesis of C.difficile’;‘laboratory diagnosis and characterization of C.difficile’and‘risk factors for C.difficile infection’.CONCLUSION This study contains the most up-to-date and comprehensive data ever compiled in this field.More international research and cross-institutional collaborations are needed to address more global C.difficile concerns and to benefit from greater sharing of expertise,which will result in higher quality or more effective studies in the future.Promising research avenues in the near future may draw the attention of relevant scientists and funding organizations and open up novel C.difficile infection–based diagnosis and treatment approaches.

Global research trends in the microbiome related to irritable bowel syndrome: A bibliometric and visualized study

BACKGROUND Irritable bowel syndrome(IBS) is a common functional gastrointestinal disorder. Dysregulation of the gut–brain axis plays a central role in the pathophysiology of IBS. It is increasingly clear that the microbiome plays a key role in the development and normal functioning of the gut–brain axis.AIM To facilitate the identification of specific areas of focus that may be of relevance to future research. This study represents a bibliometric analysis of the literature pertaining to the microbiome in IBS to understand the development of this field.METHODS The data used in our bibliometric analysis were retrieved from the Scopus database. The terms related to IBS and microbiome were searched in titles or abstracts within the period of 2000–2019. VOSviewer software was used for data visualization.RESULTS A total of 13055 documents related to IBS were retrieved at the global level. There were 1872 scientific publications focused on the microbiome in IBS. There was a strong positive correlation between publication productivity related to IBS in all fields and productivity related to the microbiome in IBS(r = 0.951, P < 0.001). The United States was the most prolific country with 449(24%) publications, followed by the United Kingdom(n = 176, 9.4%), China(n = 154, 8.2%), and Italy(n = 151, 8.1%). The h-index for all retrieved publications related to the microbiome in IBS was 138. The hot topics were stratified into four clusters:(1) The gut–brain axis related to IBS;(2) Clinical trials related to IBS and the microbiome;(3) Drugmediated manipulation of the gut microbiome;and(4) The role of the altered composition of intestinal microbiota in IBS prevention.CONCLUSION This is the first study to evaluate and quantify global research productivity pertaining to the microbiome in IBS. The number of publications regarding the gut microbiota in IBS has continuously grown since 2013. This finding suggests that the future outlook for interventions targeting the gut microbiota in IBS remains promising.

Global trends in research related to sleeve gastrectomy:A bibliometric and visualized study

BACKGROUND One of the most popular bariatric procedures is sleeve gastrectomy,and it has become significantly more common in recent years.AIM To evaluate the research activity in sleeve gastrectomy over the last two decades,and to visualize the hot spots and emerging trends in this type of bariatric surgeryusing bibliometric methods.METHODS The Scopus database was used to search for publications related to sleeve gastrectomy.The retrieved publications were reviewed in terms of year of publication,type of study,country of origin,institutions,journals,and citation patterns by using descriptive analysis.Collaboration network and term cooccurrence analysis were visualized by using VOSviewer software.RESULTS The search strategy yielded a total of 6508 publications on sleeve gastrectomy from 2001 to 2020.As regards the document type,the majority were articles(n=5230;80.36%),followed by reviews(n=544;8.36%).The top three countries are the United States,with 1983 publications(30.47%),followed by France(600;9.22%)and Italy(417;6.71%).The most cited publication was published in 2012 by Schauer et al in the New England Journal of Medicine(n=1435 citations).This publication found that weight loss was greater in the sleeve gastrectomy group than in the medical therapy group.Furthermore,this study demonstrated that 12 mo of medical therapy plus bariatric surgery greatly improved glycemic regulation in obese patients with uncontrolled type 2 diabetes compared with medical therapy alone.The focus of the current literature on sleeve gastrectomy was directed toward several themes such as morbidity and potential complications,the complexity of the procedure and different surgical approaches,and diabetes and body mass index in correlation to sleeve gastrectomy.CONCLUSION The number of sleeve gastrectomy publications has gradually grown over the last 20 years.This bibliometric analysis could help researchers better understand the knowledge base and research frontiers surrounding sleeve gastrectomy.In addition,future studies may focus on emerging research hotspots.

Equivalent efficacy study of QL1101 and bevacizumab on untreated advanced non-squamous non-small cell lung cancer patients: a phase 3 randomized, double-blind clinical trial

Objective:This phase 3 study aimed to test equivalence in efficacy and safety for QL1101,a bevacizumab analogue in Chinese patients with untreated locally advanced non-squamous non-small cell lung cancer(NSCLC).Methods:Eligible patients were randomly assigned 1:1 to receive carboplatin and paclitaxel in combination with either QL1101 or bevacizumab,15 mg/kg every 3-week for 6 cycles.This was followed by maintenance treatment with single agent QL1101 every 3-week.The primary end-point was objective response rate(ORR),with secondary end-points being progression-free survival(PFS),overall survival(OS),disease control rate(DCR),and adverse events(AEs).Results:Of 675 patients,535 eligible patients were randomized to the QL1101 group(n=269)and bevacizumab group(n=266).ORRs were 52.8%and 56.8%,respectively,for the QL1101 and bevacizumab groups,with an ORR hazard ratio 0.93(95%confidence interval:0.8-0131.1).The PFS,OS,DCR,and AEs were comparable between the 2 groups,which remained the same after stratification according to epidermal growth factor receptor mutation or smoking history.Conclusions:QL1101 showed similar efficacy and safety profiles as compared to bevacizumab among Chinese patients with untreated locally advanced non-squamous NSCLC.

Mapping the global research landscape on insulin resistance: Visualization and bibliometric analysis

BACKGROUND Insulin resistance is a risk factor for metabolic syndromes and is associated with a wide variety of metabolic illnesses,including obesity,type 2 diabetes,and cardiovascular disease.AIM To investigate and map global insulin resistance studies.METHODS A bibliometric methodology was applied to the literature retrieved from the Scopus database and Reference Citation Analysis(https://www.referencecitationanalysis.com)by using a validated search strategy.The study period was limited from 2002 to 2021.Bibliometric indicators and mapping were presented.RESULTS A total of 26808 articles on the topic of insulin resistance were included in the Scopus database.The articles included research articles(n=21918;81.76%),review articles(n=2641;9.85%),and letters(n=653;2.44%).During the study period,136 countries contributed to the research on insulin resistance.The highest number of articles was from the United States(n=7360;27.45%),followed by China(n=3713;13.85%),Japan(n=1730,6.45%),Italy(n=1545;5.54%),and the United Kingdom(n=1484;5.54%).The retrieved articles identified two main research themes:“inflammatory mechanisms in the regulation of insulin resistance”and“mechanisms linking obesity to insulin resistance”.CONCLUSION Our data show that insulin resistance has steadily gained interest from researchers,as evidenced by the number of citations and yearly publications.Publications have grown significantly in the last decade,while low-income countries with greater burdens continue to produce fewer publications in this field.This approach might assist researchers in choosing new research areas and recognizing research hotspots and frontiers.In the future,perhaps high-quality clinical evidence will be acquired.

Mapping the global research landscape on nutrition and the gut microbiota:Visualization and bibliometric analysis

BACKGROUND Nutrition is a significant modifiable element that influences the composition of the gastrointestinal microbiota,implying the possibility of therapeutic diet methods that manipulate the composition and diversity of the microbial.AIM To overview research papers on nutrition and gut microbiota and determines the hotspots in this field at the global level.METHODS Scopus and Reference Citation Analysis were used to construct a bibliometric technique.It was decided to create bibliometric indicators and mapping as in most previous studies.2012 through 2021 served as the study's timeframe.RESULTS A total of 5378 documents from the Scopus database were selected for analysis.Of all retrieved studies,78.52%were research papers(n=4223),followed by reviews(n=820;15.25%).China ranked first with a total number of articles of 1634(30.38%),followed by the United States in second place with a total number of articles of 1307(24.3%).In the last decade,emerging hotspots for gut microbiota and nutrition research included"gut microbiota metabolism and interaction with dietary components","connection between the gut microbiota and weight gain",and"the influence of high-fat diet and gut microbiota on metabolic disorders".CONCLUSION This is the first thorough bibliometric analysis of nutrition and gut microbiota publications conducted on a global level.Investigation of the association between nutrition/diet and the gut microbiota is still in its infancy and will be expanded in the future.However,according to recent trends,the"effect of gut microbiota and high-fat diet on metabolic disorders"will be an increasing concern in the future.

Global research production in neonatal abstinence syndrome: A bibliometric analysis

BACKGROUND Recently,neonatal abstinence syndrome(NAS)emerged as a significant global concern with a dramatic increase in healthcare expenditures.The incidence of the NAS has increased notably in the past decade and emergence as a global public health problem.AIM To evaluate the development and trend of global NAS research from 1958 to 2019 by bibliometric analysis.METHODS Analyzed aspects included publication output per year,language,document types,journals,countries/territories,h-index,authors,and top research priorities.The VOSviewer was used to determine the top research priorities,and trends,and to present bibliometric networks concerning various dimensions,such as coauthorship,authors,and countries.RESULTS A total of 1738 articles were retrieved in the Scopus database from 1958 to 2019.It was found that the great majority of the total NAS documents(n=1295)were original articles followed by reviews(n=268)and letters(n=48).The most productive countries in the NAS field were the United States(n=833),Canada(n=112),the United Kingdom(n=111),and Germany(n=77).Treatment and hospital outcomes in NAS,evidence-based nurse-driven interventions for the care of newborns with NAS,and a systematic reviews and network meta-analysis for therapeutic approaches of NAS were found in recent years(after 2010),compared with terms such as pathophysiology,mechanisms of NAS,and signs and symptoms in the early years.CONCLUSION Treatment and pediatric outcomes and the effectiveness of pharmacological treatment may be frontiers in the NAS field,and continued efforts from researchers are needed in those topics.

Hepatitis C: Milestones from discovery to clinical cure

On October 5th, 2020, Drs. Harvey J. Alter, Michael Houghton and Charles M. Rice were rewarded with Nobel Prize in Physiology or Medicine for "the discovery of hepatitis C virus(HCV)". During the past 50 years, remarkable achievements have been made in treatment of HCV infection: it has changed from being a life-threatening chronic disease to being curable. In this commentary, we briefly summarized the milestone events in the "scientific journey" from the first report of non-A, non-B hepatitis and discovery of the pathogen(HCV) to final identification of efficacious direct-acting antivirals. Further, we address the challenges and unmet issues in this field.