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.

Aspirin suppresses growth of human gastric carcinoma cell by inhibiting survivin expression

Regular use of aspirin （ASA） could reduce the risk of gastric cancer although the precise mechanism remains unclear. Down-regulation of survivin may be one of the cyclooxygenase-independent mechanisms whereby ASA induces apoptosis of gastric cancer cell. In this study, we investigated the effect of ASA on the growth, apoptosis and survivin expression of gastric cancer cell line SGC7901. The survival of cells treated with 3.0 and 10.0 mmol/L ASA for 24 h was decreased by 44.6% and 88.5%, respectively. ASA at 3.0 mmol/L inhibited the viability of SGC7901 cells in a time-dependent manner. Apoptosis analysis showed similar results with MTT assay. ASA at 3.0 and 10.0 mmol/L decreased the mRNA transcript levels of survivin and reduced survivin protein levels in SGC7901 cells also in a time-dependent manner. Our findings indicated that ASA inhibited the proliferation of SGC7901 by suppressing survivin at both the transcriptional and translational level.

Stronger inhibition of gastric acid secretion by lafutidine, a novel H_2 receptor antagonist, than by the proton pump inhibitor lansoprazole

AIM: To compare the antisecretory activity and plasma drug concentrations of a single oral dose of 10 mg lafutidine, a novel H2 receptor antagonist, with those of the proton pump inhibitor lansoprazole (LPZ) 30 mg. METHODS: Ten volunteers without H pylori infection participated in this crossover study comparing lafutidine 10 mg with LPZ 30 mg. Intragastric pH was monitored for 6 h in all participants, and blood samples were collected from four randomly selected individuals after single-dose administration of each drug. RESULTS: The median intragastric pH was significantly higher in individuals who received lafutidine 10 mg than in those who received LPZ 30 mg 2, 3, 4, 5, and 6 h after administration. Maximal plasma drug concentration was reached more promptly with lafutidine 10 mg than with LPZ 30 mg. CONCLUSION: In H pylori-negative individuals, gastric acid secretion is more markedly inhibited by lafutidinethan by LPZ.

Early effects of Lansoprazole orally disintegrating tablets on intragastric pH in CYP2C19 extensive metabolizers

AIM: To compare rabeprazole (RPZ; 10 mg) with Lansoprazole orally disintegrating tablets (LPZ; 30 mg OD) in terms of antisecretory activity and blood drug concentration after a single dose. METHODS: Eight H pylori-negative cytochrome P450 (CYP) 2C19 extensive metabolizers were assigned to receive a single oral dose of RPZ 10 mg or LPZ 30 mg OD. Twelve hour intragastric pH monitoring was perform- ed on the day of treatment. Blood samples were also collected after the administration of each drug. RESULTS: LPZ 30 mg OD induced a significantly earlier rise in blood drug concentration than RPZ 10 mg; consequently, LPZ 30 mg OD induced a significantly earlier rise in median pH in the third and fourth hours of the study. CONCLUSION: In H pylori-negative CYP2C19 extensive metabolizers, LPZ 30 mg OD induced a significantly faster inhibition of gastric acid secretion than RPZ 10 mg.

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.

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.

Pharmacotherapy treatment patterns at hospital discharge and clinical outcomes among patients with heart failure with reduced ejection fraction

Background:This study aimed to assess the prescribing patterns of evidencebased pharmacotherapy and their association with clinical outcomes in patients with heart failure with reduced ejection fraction(HFrEF)in Thailand.Methods:A retrospective cohort study of patients with HFrEF was conducted.Treatment with aβ-blocker and renin-angiotensin system inhibitors(RASIs)with or without mineralocorticoid receptor antagonists(MRAs)at discharge was regarded as guideline-directed medical therapy(GDMT).All others were considered non-GDMT.The primary endpoint was the composite of all-cause mortality or heart failure(HF)rehospitalization.Inverse-probabilitytreatment-weighted adjusted Cox proportional hazard models were used to examine the treatment effects.Results:In total,653 patients with HFrEF(mean age 64.1±14.3 years;55.9%male)were included.GDMT withβ-blockers and RASIs with or without MRAs was prescribed at a rate of 35.4%.During a median of 1-year follow-up,167 patients(27.5%)had a composite event,81 patients(13.3%)had all-cause mortality,and 109 patients(18.0%)had HF rehospitalization.Patients treated with GDMT at discharge showed significantly lower rates of the primary endpoint(adjusted hazard ratio[HR]0.63;95%CI 0.44-0.89;p=0.009)compared with patients who did not receive GDMT.The use of GDMT was also associated with a significantly lower risk of all-cause mortality(adjusted HR 0.59;95%CI 0.36-0.98;p=0.045)and HF rehospitalization(adjusted HR 0.65;95%CI 0.43-0.96;p=0.031).Conclusions:For HFrEF treatment,GDMT initiation at hospital discharge was associated with a significantly reduced risk of all-cause mortality and HF rehospitalization.Nevertheless,prescribing GDMT remains underused,and it could be encouraged to improve HF outcomes in real-world settings.

Efficacy and safety of different dual antiplatelet strategies in patients undergoing percutaneous coronary intervention:A systematic review and network meta-analysis

Background:Dual antiplatelet therapy(DAPT)is key for preventing ischaemic events post-percutaneous coronary intervention(PCI).Various DAPT modifications like the shortened duration or P2Y12 inhibitor(P2Y12i)de-escalation are implemented to reduce bleeding risk.However,these strategies lack direct comparative studies.This study aimed to assess the efficacy and safety of such DAPT strategies,including de-escalated and short DAPT,in patients undergoing PCI.Methods:We searched PubMed,Embase,Cochrane Central Register of Controlled Trials,and ClinicalTrials.gov databases for relevant randomized controlled trials(RCTs).We performed a network meta-analysis(NMA)to estimate risk ratios(RRs)and 95%confidence intervals(CIs).The primary efficacy endpoint was major adverse cardiac events(MACEs),and the primary safety endpoint was major bleeding.Secondary endpoints included individual components of MACEs and net adverse clinical events(NACEs).Results:A total of 17 RCTs comprising 53,156 patients(median age,62.0 years,24.8%female)were included.NMA suggested that de-escalation DAPT was associated with a significantly lower risk of MACEs(risk ratio[RR]=0.79,95%confidence interval[CI]=0.64-0.98),bleeding(RR=0.63,95%CI=0.49-0.82),and NACEs(RR=0.69,95%CI=0.60-0.79)compared with standard DAPT.Short DAPT followed by P2Y12i monotherapy exhibited a significantly decreased risk of major bleeding(RR=0.63,95%CI=0.46-0.86)compared with standard DAPT.Conclusions:De-escalation DAPT was the most effective strategy for preventing the risk of MACEs without increasing bleeding events,while short DAPT followed by P2Y12i monotherapy was the most effective strategy for reducing the risk of bleeding among patients undergoing PCI.

Autologous bone marrow stem cell transplantation in critical limb ischemia： a meta-analysis of randomized controlled trials

Background Amputation-free survival （AFS） has been recommended as the gold standard for evaluating No-Option Critical Limb Ischemia （NO-CLI） therapy. Early-phase clinical trials suggest that autologous bone-marrow derived cells （BMCs） transplantation may have a positive effect on patients with NO-CLI, especially decreasing the incidence of amputation. However, the BMCs therapeutic efficacy remains controversial and whether BMCs therapy is suitable for all CLI patients is unclear. Methods We conducted a meta-analysis using data from randomized controlled trials （RCTs） by comparing autologous BMCs therapy with controls in patients with critical limb ischemia, and the primary endpoint is the incidence of amputation. Pubmed, EBSCO and the Cochrane Central Register of Controlled Trials （to approximately July 25, 2012） were searched. Results Seven RCTs with 373 patients were enrolled in the meta-analysis. Because serious disease was the main reason leading to amputation in one trial, six studies with 333 patients were finally included in the meta-analysis. Pooling the data of the final six studies, we found that BMCs therapy significantly decreased the incidence of amputation in patients with CLI （odds ratio （OR）, 0.37; 95% confidence interval （CI）, 0.22 to 0.62; P=-0.0002）, and the efficacy had not significantly declined within 6 months after BMCs were transplanted; OR, 0.33; 95% CI, 0.16 to 0.70; P=0.004 within 6 months and OR, 0.30; 95% CI, 0.11 to 0.79; P=0.01 within 3 months. The rate of AFS after BMCs therapy was significantly increased in patients with Rutherford class 5 CLI （OR 3.28; 95% CI, 1.12 to 9.65; P=0.03）, while there was no significant improvement in patients with Rutherford class 4 （OR 0.35; 95% CI, 0.05 to 2.33; P=0.28） compared with controls. The BMCs therapy also improved ulcer healing （OR, 5.83; 95% CI, 2.37 to 14.29; P=-0.0001）. Conclusions Our analysis suggests that autologous BMCs therapy has a beneficial effect in decreasing the incidence of amputation and the efficacy does not decrease significantly within 6 months after BMCs transplantation. Patients with Rutherford class 5 are suitable for BMCs therapy, while the efficiency in patients with Rutherford 4 needs further evaluation.