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.

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.

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].

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.

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.

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.

Current global research landscape on COVID-19 and cancer: Bibliometric and visualization analysis

BACKGROUND Cancer is a severe public health issue that seriously jeopardizes global health.In individuals with coronavirus disease 2019(COVID-19),cancer is considered an independent risk factor for severe illness and increased mortality.AIM To identify research hotspots and prospects,we used bibliometrics to examine the global production of COVID-19 literature published in the field of oncology.METHODS Data on publication output were identified based on the Scopus database between January 1,2020,and June 21,2022.This study used VOSviewer to analyze collaboration networks among countries and assess the terms most often used in the titles and abstracts of retrieved publications to determine research hotspots linked to cancer and COVID-19.The Impact Index Per Article for the top 10 high-cited papers collected from Reference Citation Analysis(RCA)are presented.RESULTS A total of 7015 publications were retrieved from the database.The United States published the greatest number of articles(2025;28.87%),followed by Italy(964;13.74%),the United Kingdom(839;11.96%),and China(538;7.67%).The University of Texas MD Anderson Cancer Center(n=205,2.92%)ranked first,followed by the Memorial Sloan-Kettering Cancer Center(n=176,2.51%).The European Journal of Cancer(n=106,1.51%)ranked first,followed by the Frontiers in Oncology(n=104,1.48%),Cancers(n=102,1.45%),and Pediatric Blood and Cancer(n=95;1.35%).The hot topics were stratified into“cancer care management during the COVID-19 pandemic”;and“COVID-19 vaccines in cancer patients”.CONCLUSION This is the first bibliometric analysis to determine the present state and upcoming hot themes related to cancer and COVID-19 and vice versa using VOSviewer during the early stages of the pandemic.The emergence of hot themes related to cancer and COVID-19 may aid researchers in identifying new research areas in this field.

Global research production pertaining to gastrointestinal involvement in COVID-19:A bibliometric and visualised study

BACKGROUND Coronavirus disease 2019(COVID-19)is a global pandemic that can cause diarrhoea,nausea/vomiting,and abdominal pain,among other gastrointestinal(GI)symptoms.AIM To perform a bibliometric analysis of the global research production pertaining to GI involvement in COVID-19.METHODS The Scopus database was used to search the global literature on GI involvement in COVID-19 during 2020.A bibliometric review of these publications was also performed using VOSviewer.RESULTS Scopus had published 95615 documents on COVID-19 in all areas of research at the time of data collection.In total,1267 publications on the topic of GI and COVID-19 were identified.Research articles(n=606;47.83%),letters(293;23.13%),and reviews(186;14.68%)were the most popular types of documents.The most productive countries and institutions in this field were the United States and Huazhong University of Science and Technology.The most cited paper was Xiao et al,which was published in Gastroenterology as a brief communication,with 798 citations.This paper provides evidence for GI infection of COVID-19 and its possible faecal–oral transmission route.In the term cluster analysis,there were two frontiers in this field:GI manifestations among COVID-19 patients and the implications of COVID-19 for the gastroenterologist.CONCLUSION GI manifestations among COVID-19 patients and implications of COVID-19 for gastroenterologists were of interest,especially in the early stages of the pandemic.

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.

Mapping the landscape and structure of global research on binge eating disorder:Visualization and bibliometric analysis

BACKGROUND Binge-eating disorder(BED)is a clinical syndrome and is considered the most common type of eating disorder.However,our understanding of the global performance and progress of BED research is limited.AIM To describe and perform a bibliometric analysis of the state of BED research.METHODS The term‘Binge eating’was searched in the title throughout the previous year’s up to December 31,2020.We searched the Scopus and Reference Citation Analysis for publications on Binge eating.The VOSviewer software version 1.6.17 was used to produce the network visualization map of the most frequent author,collaborative relationships between countries/regions,and to determine the hotspots related to binge eating research.In addition,conventional bibliometric indicators were generated.RESULTS The search strategy found 2713 total articles and an average of 62 articles per year.Among them,‘Article’represented 82.49%of the publications(n=2238 articles)and was the most frequent type,followed by reviews(n=243;8.96%).The number of publications increased steadily during the last decade of the study period.One hundred and thirty-two countries contributed to binge eating research,with 1495(55.11%)articles published in the United States,followed by Italy with 256(9.44%),the United Kingdom with 183(6.75%),and Germany with 182(6.71%).Currently,the main hot topics related to BED are‘type of treatment and management and treatment provided to BED”;“processes and pathways to binge eating”;and‘diagnosis,signs and symptoms,comorbidities and prevalence and associated factors with BED’.CONCLUSION The number of publications has increased noticeably during the previous decade.There are indeed relatively few publications on BED from low-and middle-income nations,so much is to be learned from the experience of all countries.Studies on this topic are critical in all countries to discover risk factors and effective intervention measures.Although our findings are preliminary,they imply that the future prospects for interventions aimed at BED management are bright,focusing on complex models of care and long-term maintenance of therapeutic gains.

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.

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.

Single-cell transcriptome analysis reveals the regulatory effects of artesunate on splenic immune cells in polymicrobial sepsis

Sepsis is characterized by a severe and life-threatening host immune response to polymicrobial infection accompanied by organ dysfunction.Studies on the therapeutic effect and mechanism of immunomodulatory drugs on the sepsis-induced hyperinflammatory or immunosuppression states of various immune cells remain limited.This study aimed to investigate the protective effects and underlying mechanism of artesunate(ART)on the splenic microenvironment of cecal ligation and puncture-induced sepsis model mice using single-cell RNA sequencing(scRNA-seq)and experimental validations.The scRNA-seq analysis revealed that ART inhibited the activation of pro-inflammatory macrophages recruited during sepsis.ART could restore neutrophils’chemotaxis and immune function in the septic spleen.It inhibited the activation of T regulatory cells but promoted the cytotoxic function of natural killer cells during sepsis.ART also promoted the differentiation and activity of splenic B cells in mice with sepsis.These results indicated that ART could alleviate the inflammatory and/or immunosuppressive states of various immune cells involved in sepsis to balance the immune homeostasis within the host.Overall,this study provided a comprehensive investigation of the regulatory effect of ART on the splenic microenvironment in sepsis,thus contributing to the application of ART as adjunctive therapy for the clinical treatment of sepsis.

Single-cell transcriptomic dissection of the cellular and molecular events underlying the triclosan-induced liver fibrosis in mice

Background: Triclosan [5-chloro-2-(2,4-dichlorophenoxy) phenol, TCS], a common antimicrobial additive in many personal care and health care products, is frequently detected in human blood and urine. Therefore, it has been considered an emerging and potentially toxic pollutant in recent years. Long-term exposure to TCS has been suggested to exert endocrine disruption effects, and promote liver fibrogenesis and tumorigenesis. This study was aimed at clarifying the underlying cellular and molecular mechanisms of hepatotoxicity effect of TCS at the initiation stage.Methods: C57BL/6 mice were exposed to different dosages of TCS for 2 weeks and the organ toxicity was evaluated by various measurements including complete blood count, histological analysis and TCS quantification. Single cell RNA sequencing(scRNA-seq) was then carried out on TCS-or mock-treated mice livers to delineate the TCS-induced hepatotoxicity. The acquired single-cell transcriptomic data were analyzed from different aspects including differential gene expression, transcription factor(TF) regulatory network, pseudotime trajectory, and cellular communication, to systematically dissect the cellular and molecular events after TCS exposure. To verify the TCS-induced liver fibrosis,the expression levels of key fibrogenic proteins were examined by Western blotting, immunofluorescence, Masson’s trichrome and Sirius red stainings. In addition, normal hepatocyte cell MIHA and hepatic stellate cell LX-2 were used as in vitro cell models to experimentally validate the effects of TCS by immunological, proteomic and metabolomic technologies.Results: We established a relatively short term TCS exposure murine model and found the TCS mainly accumulated in the liver. The scRNA-seq performed on the livers of the TCS-treated and control groups profiled the gene expressions of > 76,000 cells belonging to 13 major cell types. Among these types, hepatocytes and hepatic stellate cells(HSCs)were significantly increased in TCS-treated group. We found that TCS promoted fibrosis-associated proliferation of hepatocytes, in which Gata2 and Mef2c are the key driving TFs. Our data also suggested that TCS induced the proliferation and activation of HSCs, which was experimentally verified in both liver tissue and cell model. In addition,other changes including the dysfunction and capillarization of endothelial cells, an increase of fibrotic characteristics in B plasma cells, and M2 phenotype-skewing of macrophage cells, were also deduced from the scRNA-seq analysis, and these changes are likely to contribute to the progression of liver fibrosis. Lastly, the key differential ligand-receptor pairs involved in cellular communications were identified and we confirmed the role of GAS6_AXL interactionmediated cellular communication in promoting liver fibrosis.Conclusions: TCS modulates the cellular activities and fates of several specific cell types(including hepatocytes, HSCs,endothelial cells, B cells, Kupffer cells and liver capsular macrophages) in the liver, and regulates the ligand-receptor interactions between these cells, thereby promoting the proliferation and activation of HSCs, leading to liver fibrosis.Overall, we provide the first comprehensive single-cell atlas of mice livers in response to TCS and delineate the key cellular and molecular processes involved in TCS-induced hepatotoxicity and fibrosis.

Nuclear PLD1 combined with NPM1 induces gemcitabine resistance through tumorigenic IL7R in pancreatic adenocarcinoma

Objective:Pancreatic ductal adenocarcinoma(PDAC)is a highly malignant gastrointestinal cancer with a 5-year survival rate of only 9%.Of PDAC patients,15%-20%are eligible for radical surgery.Gemcitabine is an important chemotherapeutic agent for patients with PDAC;however,the efficacy of gemcitabine is limited due to resistance.Therefore,reducing gemcitabine resistance is essential for improving survival of patients with PDAC.Identifying the key target that determines gemcitabine resistance in PDAC and reversing gemcitabine resistance using target inhibitors in combination with gemcitabine are crucial steps in the quest to improve survival prognosis in patients with PDAC.Methods:We constructed a human genome-wide CRISPRa/dCas 9 overexpression library in PDAC cell lines to screen key targets of drug resistance based on sgRNA abundance and enrichment.Then,co-IP,ChIP,ChIP-seq,transcriptome sequencing,and qPCR were used to determine the specific mechanism by which phospholipase D1(PLD1)confers resistance to gemcitabine.Results:PLD1 combines with nucleophosmin 1(NPM1)and triggers NPM1 nuclear translocation,where NPM1 acts as a transcription factor to upregulate interleukin 7 receptor(IL7R)expression.Upon interleukin 7(IL-7)binding,IL7R activates the JAK1/STAT5 signaling pathway to increase the expression of the anti-apoptotic protein,BCL-2,and induce gemcitabine resistance.The PLD1 inhibitor,Vu0155069,targets PLD1 to induce apoptosis in gemcitabine-resistant PDAC cells.Conclusions:PLD1 is an enzyme that has a critical role in PDAC-associated gemcitabine resistance through a non-enzymatic interaction with NPM1,further promoting the downstream JAK1/STAT5/Bcl-2 pathway.Inhibiting any of the participants of this pathway can increase gemcitabine sensitivity.

A single-cell landscape of triptolide-associated testicular toxicity in mice

Triptolide is a key active component of the widely used traditional Chinese herb medicine Tripterygium wilfordii Hook.F.Although triptolide exerts multiple biological activities and shows promising efficacy in treating inflammatory-related diseases,its well-known safety issues,especially reproductive toxicity has aroused concerns.However,a comprehensive dissection of triptolide-associated testicular toxicity at single cell resolution is still lacking.Here,we observed testicular toxicity after 14 days of triptolide exposure,and then constructed a single-cell transcriptome map of 59,127 cells in mouse testes upon triptolide-treatment.We identified triptolide-associated shared and cell-type specific differentially expressed genes,enriched pathways,and ligand-receptor pairs in different cell types of mouse testes.In addition to the loss of germ cells,our results revealed increased macrophages and the inflammatory response in triptolide-treated mouse testes,suggesting a critical role of inflammation in triptolide-induced testicular injury.We also found increased reactive oxygen species(ROS)signaling and downregulated pathways associated with spermatid development in somatic cells,especially Leydig and Sertoli cells,in triptolide-treated mice,indicating that dysregulation of these signaling pathways may contribute to triptolide-induced testicular toxicity.Overall,our high-resolution single-cell landscape offers comprehensive information regarding triptolide-associated gene expression profiles in major cell types of mouse testes at single cell resolution,providing an invaluable resource for understanding the underlying mechanism of triptolide-associated testicular injury and additional discoveries of therapeutic targets of triptolide-induced male reproductive toxicity.