Evolutionary trend analysis and knowledge structure mapping of endothelial dysfunction in sepsis:a bibliometrics study

BACKGROUND:A pathophysiological feature of septic organ failure is endothelial dysfunction in sepsis(EDS).The physiological and pathological mechanism of sepsis is considered to be vascular leakage caused by endothelial dysfunction.These pathological changes lead to systemic organ injury.However,an analysis using bibliometric methods has not yet been conducted in the field of EDS.This study was conducted to provide an overview of knowledge structure and research trends in the fi eld of EDS.METHODS:Based on previous research,a literature search was performed in the Web of Science Core Collection(WoSCC)for publications associated with EDS published between the year 2003 and 2023.Various types of data from the publications,such as citation frequency,authorship,keywords and highly cited articles,were extracted.The"Create Citation Report"feature in the WoSCC was employed to calculate the Hirsch index(h-index)and average citations per item(ACI)of authors,institutions,and countries.To conduct bibliometric and visualization analyses,three bibliometric tools were used,including R-bibliometrix,CiteSpace(co-citation analysis of references),and VOSviewer(co-authorship analysis of institutions,co-authorship analysis of authors,co-occurrence analysis of keywords).RESULTS:After excluding invalid records,the study finaly included 4,536 publications with 135,386 citations.Most of these publications originated in the USA,China,Germany,Canada,and Japan.Harvard University emerged as the most prolifi c institution,while professor Jong-Sup Bae and his research team at Kyungpook National University emerged as authors with the greatest infl uence.The"protein C","tissue factor","thrombin","glycocalyx",“acute kidney injury”,“syndecan-1”and“biomarker”were identifi ed as prominent areas of research.Future research may focus on molecular mechanisms(such as as vascular endothelial[VE]-cadherin regulation)and therapeutic interventions to enhance endothelial repair and function.CONCLUSION:Our findings show a growing interest in EDS research.Key areas for future research include signaling pathways,molecular mechanisms,endothelial repair,and interactions between endothelial cells and other cell types in sepsis.

The Chinese guideline for management of snakebites

In 2009,the World Health Organization included snakebite on the list of neglected tropical diseases,acknowledging it as a common occupational hazard for farmers,plantation workers,and others,causing tens of thousands of deaths and chronic physical disabilities every year.This guideline aims to provide practical information to help clinical professionals evaluate and treat snakebite victims.These recommendations are based on clinical experience and clinical research evidence.This guideline focuses on the following topics:snake venom,clinical manifestations,auxiliary examination,diagnosis,treatments,and prevention.

Clinical Features of Perforating Eye Injuries Complicated with Intraocular Foreign Bodies Located at the Posterior Global Wall

Purpose:To investigate the clinical characteristics and therapeutic effects of vitrectomy in patients with perforating eye injuries with foreign bodies at the exit wound in the posterior global wall.Methods:.Fifty-two cases,diagnosed with perforating eye injury with foreign bodies at the exit of the posterior global wall and admitted to our hospital between June 2010 and June2013,were enrolled in this study.All patients underwent vitrectomy and removal of intraocular foreign bodies and were followed up for 6 to 24 months.The causes of injuries were analyzed and postoperative visual acuity and overall treatment efficacy were evaluated.Results:Intraocular foreign bodies were successfully removed in all cases.The incidence of postoperative complication was low.Among 52 subjects,46 showed alleviated symptoms after treatment with an overall efficacy of 88.46%.Conclusion:.Perforating eye injuries combined with residual foreign bodies in the posterior global wall are commonly observed in young people who perform physical labor.Vitrectomy has a high efficacy for the treatment of perforating eye injuries complicated with foreign bodies located at the posterior global wall,with a low incidence of postoperative complications.

NRN1 and CAT Gene Polymorphisms, Complex Noise, and Lifestyles interactively Affect the Risk of Noise-induced Hearing Loss

Objective The effects of interactions between genetic and environmental factors on the noise-induced hearing loss(NIHL)are still unclear.This study aimed to assess interactions among gene polymorphisms,noise metrics,and lifestyles on the risk of NIHL.Methods A case-control study was conducted using 307 patients with NIHL and 307 matched healthy individuals from five manufacturing industries.General demographic data,lifestyle details,and noise exposure levels were recorded.The Kompetitive allele-specific polymerase chain reaction(KASP)was used to analyze the genotypes of 18 SNPs.Results GMDR model demonstrated a relevant interaction between NRN1 rs3805789 and CAT rs7943316(P=0.0107).Subjects with T allele of rs3805789 or T allele of rs7943316 had higher risks of NIHL than those with the SNP pair of rs3805789-CC and rs7943316-AA(P<0.05).There was an interaction among rs3805789,rs7943316,and kurtosis(P=0.0010).Subjects exposed to complex noise and carrying both rs3805789-CT and rs7943316-TT or rs3805789-CT/TT and rs7943316-AA had higher risks of NIHL than those exposed to steady noise and carrying both rs3805789-CC and rs7943316-AA(P<0.05).The best six-locus model involving NRN1 rs3805789,CAT rs7943316,smoking,video volume,physical exercise,and working pressure for the risk of NIHL was found to be the interaction(P=0.0010).An interaction was also found among smoking,video volume,physical exercise,working pressure,and kurtosis(P=0.0107).Conclusion Concurrence of NRN1 and CAT constitutes a genetic risk factor for NIHL.Complex noise exposure significantly increases the risk of NIHL in subjects with a high genetic risk score.Interactions between genes and lifestyles as well as noise metrics and lifestyles affect the risk of NIHL.

Celastrol targeting Nedd4 reduces Nrf2-mediated oxidative stress in astrocytes after ischemic stroke

Stroke is the second leading cause of death worldwide,and oxidative stress plays a crucial role.Celastrol exhibits strong antioxidant properties in several diseases;however,whether it can affect oxidation in cerebral ischemic-reperfusion injury(CIRI)remains unclear.This study aimed to determine whether celastrol could reduce oxidative damage during CIRI and to elucidate the underlying mechanisms.Here,we found that celastrol attenuated oxidative injury in CIRI by upregulating nuclear factor E2-related factor 2(Nrf2).Using alkynyl-tagged celastrol and liquid chromatography-tandem mass spectrometry,we showed that celastrol directly bound to neuronally expressed developmentally downregulated 4(Nedd4)and then released Nrf2 from Nedd4 in astrocytes.Nedd4 promoted the degradation of Nrf2 through K48-linked ubiquitination and thus contributed to astrocytic reactive oxygen species production in CIRI,which was significantly blocked by celastrol.Furthermore,by inhibiting oxidative stress and astrocyte activation,celastrol effectively rescued neurons from axon damage and apoptosis.Our study uncovered Nedd4 as a direct target of celastrol,and that celastrol exerts an antioxidative effect on astrocytes by inhibiting the interaction between Nedd4 and Nrf2 and reducing Nrf2 degradation in CIRI.

Impact of atrial fibrillation on the no-flow phenomenon during primary percutaneous coronary intervention

Background Atrial fibrillation(AF)is reported to be associated with worse flow in patients with the treatment of coronary thrombolysis. However,few studies investigated the impact of atrial fibrillation on the noreflow phenomenon in ST-segment elevation myocardial infarction(STEIMI)patients undergoing primary percutaneous intervention(PCI). Methods 1163 STEMI patients undergoing primary PCI from Jan 2013 to Dec2019 were enrolled. Atrial fibrillation was diagnosed based on the electrocardiogram’s findings. Patients with a TIMI flow rate less than 3 were considered to have no-reflow. Factors related to the no-reflow phenomenon was analyzed by the logistic regression analysis. Results 158 patients were in the AF group and 1005 patients were in the non-AF group. The AF group had a significantly higher occurrence of cardiogenic shock(11.4% vs. 5.6%,P<0.001),and in-hospital mortality(9.5% vs. 3.1%,P<0.001)than the non-AF group. The multivariate analysis showed that AF was an independent risk factor for the no-reflow phenomenon after primary PCI(OR:2.11,95% CI:1.27-3.88,P=0.014). Conclusions STEMI patients with AF would have higher in-hospital adverse events and no-reflow phenomenon than though without AF.

Autologous osteoperiosteal transplantation for cystic osteochondral lesions of the talus:Bone reconstruction is essential

Purpose:Autologous osteoperiosteal transplantation(AOPT)is one of the most feasible and effective techniques for cystic osteochondral lesions of the talus(OLT).However,few reports have been reported about the process of graft-host bone healing and bone articular surface reconstruction,which help us to further understand the actual situation of bone healing and modify surgical methods.Methods:The case series study retrospectively evaluated 33 osteochondral lesions in 30 patients undertaking AOPT for OLT with subchondral cysts from December 2016 to October 2021.According to CT observation,we used 4 variables to describe the bony articular repair,including the integration of the articular surface,the height of the bone filling,the status of bone union,and the appearance of bone resorption or cystic change.We also analyzed the demographic data and clinical function.Descriptive statistics were used for demographic and clinical variables.Normally distributed data were presented as mean±SD,and non-normally distributed data were presented as median(Q1,Q3).Associations between these variables and the primary clinical outcomes were examined usingt-test or one-way ANOVA test for continuous variables.Results:The patients’mean age was(41.7±14.0)years old and the mean follow-up time was(29.6±17.8)months.The chondral lesion size was(14.3±4.1)mm.The cyst depth was(10.9±3.7)mm.Significant improvements were observed in functional outcomes(according to the numeric rating scale for pain when walking and the American orthopedic foot and ankle society score)between the preoperative and latest follow-up evaluations,from 4.2±2.1 to 2.2±2.0(p<0.001),and from 66.8±12.9 to 83.2±10.4,respectively(p<0.001).The overall satisfaction reached 8.3 of 10 points.All patients returned to sports and their median daily steps reached 8000 steps with 27(81.8%)patients walking over 6000 steps daily.According to CT observation,"discontinuous bony articular surface and gap>1 mm"was found in 27 grafts(81.8%),and"below the level of the adjacent articular surface,≤1 mm"in a third of the grafts.Abnormal height of bone filling affected numeric rating scale score(p=0.049)and American Orthopedic Foot and Ankle Society score(p=0.027).Of note,bone resorption or cystic changes appeared in up to 13 autografts(39.4%).Conclusions:AOPT is an effective and acceptable technique for cystic OLT.Bone reconstruction is essential for large cystic OLT.How to get better bony articular reconstruction and avoid cyst recurrence should still be paid more attention.

Nanoparticles (NPs)-mediated Siglec15 silencing and macrophage repolarization for enhanced cancer immunotherapy

cell infiltration and proliferation in tumor tissues are the main factors that significantly affect the therapeutic outcomes of cancer immunotherapy.Emerging evidence has shown that interferon-gamma(IFN)could enhance CXCL9 secretion from macrophages to recruit T cells,but Siglec15 expressed on TAMs can attenuate T cell proliferation.Therefore,targeted regulation of macrophage function could be a promising strategy to enhance cancer immunotherapy via concurrently promoting the infiltration and proliferation of T cells in tumor tissues.We herein developed reductionresponsive nanoparticles(NPs)made with poly(disulfide amide)(PDSA)and lipid-poly(ethylene glycol)(lipid-PEG)for systemic delivery of Siglec15 siRNA(siSiglec15)and IFN for enhanced cancer immunotherapy.After intravenous administration,these cargo-loaded could highly accumulate in the tumor tissues and be efficiently internalized by tumor-associated macrophages(TAMs).With the highly concentrated glutathione(GSH)in the cytoplasm to destroy the nanostructure,the loaded IFN and si-Siglec15 could be rapidly released,which could respectively repolarize macrophage phenotype to enhance CXCL9 secretion for T cell infiltration and silence Siglec15 expression to promote T cell proliferation,leading to significant inhibition of hepatocellular carcinoma(HCC)growth when combining with the immune checkpoint inhibitor.The strategy developed herein could be used as an effective tool to enhance cancer immunotherapy.

AstragalosideⅣameliorates insulin induced insulin resistance in HepG2 cells through reactive oxygen species mediated c-Jun N-terminal kinase pathway

OBJECTIVE:To investigate the effects and elucidate the mechanism of Astragaloside IV(AS-IV)for insulin resistance(IR)and type 2 diabet es mellitus(T2DM).METHODS:CCK8 kit was used to detect cell viability,glucose detection kit was used to detect the concentration of glucose in cell supernatant,reactive oxygen species(ROS)detection kit and Western blot were used to explore the mechanism of Astragaloside IV(AS-IV)in improving IR.A diabetic rat model was also established by feeding high sugar and fat diet and streptozotocin(STZ)injection.After treatment with AS-IV,rosiglitazone(ROZ),or normal saline,the fasting blood glucose(FBG),C peptide(C-P),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and the glucose tolerance were assessed.RESULTS:AS-IV could effectively reduce the content of ROS and increase the glucose uptake in high insulintreated IR-type HepG 2 cells.The results of molecular mechanisms indicated that AS-IV could improve insulin resistance by reducing JNK phosphorylation and regulating c-Jun N-terminal kinase(JNK)downstream protein expression.Additionally,AS-IV could significantly reduce the levels of FBG,TNF-α,IL-6 and the glucose tolerance in diabetic rats(P<0.05 or<0.01).The high and medium dose groups of AS-IV could significantly increase the C-P levels in diabetic rats(P<0.05 or<0.01).CONCLUSIONS:Our results indicated that AS-IV improve liver IR through the JNK pathway and ROS,which meant a new molecular target for the treatment of diabetes.The AS-IV also helped to prevent and improved the insulin resistance of rats.

Volume-to-creatinine clearance ratio:a predictor for contrast-induced nephropathy in chronic kidney disease after primary percutaneous coronary intervention

The volume of contrast media to the creatinine clearance （V/CrCl） ratio correlate with the contrast-induced nephropathy （CIN）. The chronic kidney disease （CKD） more likely to develop CIN after primary percutaneous coronary intervention （PCI）. Objectiv has been shown to patients would be e To determine a relatively safe V/CrCl cutoff value to avoid CIN in CKD patients undergoing primary PCI. Methods We enrolled a total of 114 patients with CKD and calculated V/CrCl. Receiver-operator characteristic methods were used to identify the optimal sensitivity and specificity for the observed range of V/CrCl for CIN. We used multivariable logistic regression to assess the predictive value of V/CrCl for the risk of CIN in CKD patients. Results Overall, there were 24 cases （21%） of CIN. The baseline mean and median V/CrCl values were significantly greater among patients with CIN （mean 5.08 ±2.01, median 4.81, and interquartile range 3.53-6.33） than among those without CIN （mean 3.35 ±1.48, median 3.12, and interquartile range 2.27-4.14, P 〈 0.001）. The receiveroperator characteristic curve analysis indicated that a V/CrCl ratio of 3.62 was a fair discriminator for CIN （Cstatistic of 0.75） in CKD patients. After adjusting for other known predictors of CIN,a V/CrCl ratio 〉3.62 remained significantly associated with CIN in CKD patients（odds ratio 8.46,95% confidence interval 2.37-30.19, P 〈 0.001）. medium dose Conclusions based on the AV/CrCl ratio〉3.62 is a simple,useful indicator for determining the safe contrast pre-PCI CrCl values in CKDs.