bluuebunny/crossref_metadata_2025 huggingface dataset:
Transfusion-associated graft-versus-host disease (TA-GVHD) and graft-versus-host disease (GVHD): Pathophysiology and management (contrasted and compared)
Authors: Valsami Serena , Dryllis Georgios , Papanastasi Kassiani , Kokoris Styliani , Kriebardis Anastasios , Nikitiadis Konstantinos , Konstantopoulos Konstantinos , Politou Marianna
Published: January 2025

Transfusion of blood products is a common lifesaving medical procedure in clinical practice. However, it poses the risk of potential adverse reactions for the recipient. Transfusion-associated graft-versus-host-disease (TA-GVHD) is a rare adverse event, fatal in >90% of cases. TA-GVHD pathophysiology is not completely understood involving two factors: (i) underlying immunosuppression and (ii) human leukocyte antigen compatibility between blood donor and recipient. Clinical presentation is not specific, and the difficulty in correlating the clinical syndrome to the transfusion renders diagnosis challenging. As no effective treatment exists to date, irradiation of blood products remains the cornerstone of TA-GVHD prevention. Distinct differences emerge in comparing TA-GVHD to GVHD, a common event of the bone marrow graft to the recipient after allogeneic hematopoietic stem cell transplantation; thus, GVHD may be a helpful disease model used to better understand TA-GVHD. This is a review of TA-GVHD in comparison with GVHD.
Knowledge and practices of lactational amenorrhea among urban slum-dwelling women in Chandigarh
Authors: Kalia Meenu , Rohilla Ravi , Walia Dinesh Kumar , Goel Naveen Krishan , Vashisht Deepak , Vashisht Pooja , Singh Prabhdeep
Published: January 2025

BACKGROUND:

Unmet family planning needs persist globally, especially in developing countries. The lactational amenorrhea method (LAM) offers a natural, cost-effective option for post-partum women, promoting optimal breastfeeding and maternal health while providing effective contraception.

OBJECTIVES:

To assess knowledge, perceptions and beliefs, and practices regarding LAM among reproductive-age women in the urban slums of Chandigarh.

MATERIALS AND METHODS:

A cross-sectional, community-based study was conducted among 427 women living in the urban slums of Chandigarh with their youngest child aged between 1 and 2 years using a pre-designed and pre-tested interview schedule.

RESULTS:

About 38.6% of the participants had heard about LAM, while only 7% of the participants in the study were aware of its contraceptive effect. More than two-third of the participants (69.8%) considered contraceptive use during lactational amenorrhea safe. The majority (95.1%) did not use any contraception during lactational amenorrhea.

CONCLUSION:

The study revealed insufficient awareness and utilization of LAM among participants, emphasizing the need for improved education and counseling during post-natal care. Training health workers can enhance maternal contraceptive support, promoting both child health and effective contraception.
Assessing the Relationship between Graft–Host Junction Profile and Corneal Astigmatism and Higher-Order Aberrations in Postpenetrating Keratoplasty Eyes
Authors: Mohebi Masoomeh , Masoumi Ahmad , Abdi Parisa , Fakhredin Hanieh , Raeisi Saeed , Ghanbari Hamidreza
Published: January 2025

Purpose:

To assess the relationship between graft–host junction (GHJ) profile and corneal astigmatism and higher-order aberrations (HOAs) in postpenetrating keratoplasty (post-PKP) eyes.

Methods:

A retrospective observational cross-sectional study was carried out at the Corneal Department of the Farabi Eye Hospital from April 2019 to March 2020. The objective of the study was to review the clinical records of 32 eyes belonging to 25 patients who had undergone PKP. The classification of the eyes was based on the most frequent alignment pattern observed in the eight GHJ sections using anterior segment optical coherence tomography (AS-OCT). The three classifications included the well-apposed junction, mal-apposed junction, and equally apposed junction.

Results:

A total of 256 GHJ sections were analyzed in 32 AS-OCT images, comprising 24 keratoconus and 8 nonkeratoconus eyes. Among them, 10 eyes (31.25%) exhibited well-apposed junctions, 15 eyes (46.8%) had mal-apposed junctions, and 7 eyes (21.8%) displayed equally apposed junctions. The most prevalent type of mal-apposition observed was protrusion, accounting for 67 sections (25.3%). The mal-apposed group displayed a significantly higher mean spherical equivalent (SE) (P = 0.01) and postoperative astigmatism (P < 0.001), whereas there was no significant difference in total HOAs between the mal-apposed group and the other groups (P = 0.58).

Conclusions:

Significant associations were observed between the alignment pattern of GHJ after PKP and both SE and keratometric astigmatism. Conversely, no significant association was found between the alignment pattern of GHJ and HOAs.
Retinal Nerve Fiber Layer Damages from Macular Grasping during Vitrectomy Comparing Traditional and Three-Dimensional Microscope: A Randomized Clinical Trial
Authors: Caretti Luigi , Guerriero Alberto , Verzola Giacomo , Pillon Giulia , Monterosso Cristina , Daniele Anna Rita
Published: January 2025

Purpose:

To analyze the advantages of the new advanced three-dimensional (3D) heads-up microscopy system in vitreoretinal surgery compared to a standard optical microscope, by evaluating postoperative tissue trauma, defined by the extent of swelling of the arcuate nerve fiber layer (SANFL).

Methods:

Sixty-four consecutive eyes affected by macular pucker or macular hole underwent macular peeling using a traditional optical microscope (Leica F40) or a 3D heads-up microscopy system (NGENUITY 3D Visualization System). Infrared, blue autofluorescence imaging, and spectral-domain optical coherence tomography (OCT) were performed preoperatively and 2 weeks, 1 month, and 3 months after surgery. The presence of SANFLs was checked postoperatively on infrared and blue autofluorescence fundus imaging, and the extent of each SANFL was measured on OCT near-infrared fundus images.

Results:

The presence and the extension of SANFLs were comparable in the two groups (P > 0.05), with a regression over time that was similar in the two groups. The change of the peripapillary retinal nerve fiber layer thickness in the various sectors also appeared to have a similar trend with no statistically significant differences in the two groups (P > 0.05).

Conclusion:

NGENUITY system is comparable in terms of visual and anatomical results, offering perspectives for the integration of new advanced visualization technologies.
Pigmented Paravenous Chorioretinal Atrophy and Mucopolysaccharidosis: A Case Report
Authors: Algouti Zineb , Bezza Houda , Kriet Mohamed , El asri Fouad
Published: January 2025

Purpose:

To report the atypical case of a patient with mucopolysaccharidosis type II (MPS II) in whom bilateral pigmented paravenous chorioretinal atrophy (PPRCA) was found.

Methods:

An observational case report.

Results:

We present the case of a 31-year-old male patient who presented with decreased visual acuity and in whom fundus examination and multimodal imaging revealed a typical appearance of bilateral symmetrical PPRCA. Our patient also had thick facies with hypertelorism and stubby hands, which prompted an enzyme assay revealing MPS II.

Conclusions:

PPRCA is an uncommon condition with an uncertain origin that continues to be a subject of debate. Our case represents an unusual association that points to a potential genetic origin; however, further studies are needed to understand this condition.
A Systematic Review and Meta-Analysis on the Efficacy and Safety of Topical Pilocarpine 1.25% in Presbyopia Treatment
Authors: Singh Mamta , Sinha Bibhuti Prassan , Dutta Siddhartha , Deokar Kunal Khanderao , Mishra Deepak , Goswami Khyati
Published: January 2025

Purpose:

To do a qualitative and quantitative assessment of the existing literature on the effectiveness and safety of pilocarpine 1.25% eye drops in presbyopia management.

Methods:

Relevant articles were extracted from the online database using keywords – “pilocarpine and presbyopia”, “AGN-190584 and presbyopia”, and “Vuity and presbyopia”. The primary outcome measure considered was an improvement in distance-corrected near visual acuity (DCNVA) and secondary outcome measures were improvement in distance-corrected intermediate visual acuity (DCIVA) and adverse events (AEs). Risk of bias (ROB) assessment was done using the ROB2 tool and R software was used for quantitative analysis.

Results:

The 3 included randomized control trials (RCTs) had a total of 980 participants between 40–55 years of age. They were randomized into 2 groups – 489 in the pilocarpine group and 491 in the vehicle group. In the pilocarpine group, 1.25% of pilocarpine was used either once (in the Gemini 1 and 2 trials) or twice daily (Virgo trial). A significantly higher proportion of patients reported improvement of DCIVA and gain of ≥ 3 lines in binocular DCNVA in the pilocarpine group than the vehicle group (P < 0.01). Headache was the most commonly reported AE (13.49% of participants). Three case reports published on pilocarpine use for presbyopia management have reported vitreomacular traction in 1 and retinal detachment in 5 eyes.

Conclusions:

The available evidence documents significant improvement in near and intermediate vision in presbyopia participants with pilocarpine 1.25% drop. However, more RCTs, involving a wider age group, larger refractive error, longer follow-up, and clinical testing in a real-world scenario are required to conclusively prove its role in presbyopia management.
The Effect of Upper Eyelid Blepharoplasty on Corneal Biomechanical Parameters Measured by Corvis ST
Authors: Rafizadeh Seyed Mohsen , Ghochani Ghazal , Khorrami-Nejad Masoud , Jumah Rawshan , Hashemian Hesam
Published: January 2025

Purpose:

To determine the effect of upper eyelid blepharoplasty (UEB) surgery on corneal biomechanical parameters 4 months after the procedure.

Methods:

In this prospective longitudinal study, numerous corneal biomechanical parameters were evaluated before and 4 months after UEB surgery. All parameters were measured by the Corneal Visualization Scheimpflug Technology (Corvis ST, CVS, Oculus Optikgeräte GmbH, Germany) device.

Results:

The study included 35 eyelids of the right eyes of 35 patients with dermatochalasis who underwent UEB, with a mean age of 56.9 ± 8.9 (range, 40–75) years. With a Bonferroni corrected significance level of P < 0.001 to account for multiple comparisons, significant increases were observed in the first applanation (A1) and second applanation (A2) times and the highest concavity (HC) time following the UEB surgery. Intraocular pressure (IOP) and biomechanical-compensated IOP (bIOP) also showed a significant increase. Other corneal biomechanical parameters did not show significant differences following the UEB procedure (P > 0.001).

Conclusions:

UEB surgery resulted in significant changes in A1 and A2 applanation times, HC time, IOP, and bIOP. These findings suggest that altered eyelid pressure after UEB surgery can impact specific corneal biomechanical properties. It is advisable for practitioners to evaluate postoperative IOP measurement carefully in patients undergoing UEB surgery due to its potential impact on corneal biomechanical properties.
Sevoflurane and its metabolic byproduct compound A induce nephrotoxicity: a systematic review and meta-analysis of animal studies
Authors: Hong Intek , Bigam Kevin D. , McConnell Brie M. , Özelsel Timur J. P. , Sondekoppam Rakesh V.
Published: January 2025

Animal models investigating sevoflurane or compound A and renal function serve as the initial basis for concerns regarding renal injury following sevoflurane anesthesia and subsequent recommendations of minimum fresh gas flow, but this evidence basis has not been critically appraised. Primary literature searches were performed in MEDLINE OVID, PubMed, EMBASE, the Cochrane Library), the Cochrane Central Register of Controlled Trials, the International HTA Database, CINAHL, and Web of Science to identify randomized controlled trials and quasi-experimental studies in animals utilizing sevoflurane or compound A. The primary outcomes included renal function as determined by blood urea nitrogen, serum creatinine, creatinine clearance, and urine volume. The secondary outcomes included the serum fluoride concentration and histopathological findings. A total of 2537 records were screened, and 21 randomized controlled trials and 9 quasi-experimental animal studies were identified. No associations between sevoflurane exposure and subsequent changes in renal function (blood urea nitrogen, serum creatinine or changes in urine volume) were noted. A similar effect on renal function was observed following compound A exposure, but urine volume was elevated following compound A exposure. In addition, the histopathological damage following compound A exposure was observed only at concentrations that are unachievable in clinical practice. Our review of evidence from animal models revealed that sevoflurane usage was not associated with changes in renal function tests or urine volume. Histopathologic changes after sevoflurane exposure were either nonexistent or minor. Studies on compound A did not reveal an alteration in renal function, although histopathological evidence of injury was present when compound A was administered at very high, unphysiologic concentrations. In light of the existing evidence, the initial concerns of sevoflurane-related nephrotoxicity based on animal studies that leads to minimum fresh gas flow recommendations are called into question.
Recent advances in medical gas sensing with artificial intelligence–enabled technology
Authors: Mahapatra Chitaranjan
Published: January 2025

Recent advancements in artificial intelligence–enabled medical gas sensing have led to enhanced accuracy, safety, and efficiency in healthcare. Medical gases, including oxygen, nitrous oxide, and carbon dioxide, are essential for various treatments but pose health risks if improperly managed. This review highlights the integration of artificial intelligence in medical gas sensing, enhancing traditional sensors through advanced data processing, pattern recognition, and real-time monitoring capabilities. Artificial intelligence improves the ability to detect harmful gas levels, enabling immediate intervention to prevent adverse health effects. Moreover, developments in nanotechnology have resulted in advanced materials, such as metal oxides and carbon-based nanomaterials, which increase sensitivity and selectivity. These innovations, combined with artificial intelligence, support continuous patient monitoring and predictive diagnostics, paving the way for future breakthroughs in medical care.
Management Strategies of Vestibular Neuritis:- A Review
Authors: Swain Santosh Kumar , Preetam Chappity
Published: January 2025

ABSTRACT

A common peripheral vestibular disorder called vestibular neuritis (VN) results in abrupt development of vertigo symptoms without any accompanying auditory symptoms, such as tinnitus, aural fullness, or hearing impairment. The precise cause of VN is yet unknown. The clinical history and test results serve as the foundation for the VN diagnostic criteria. Despite an unclear cause of VN, a thorough understanding of its clinical course and management has been established. Clinically, VN is characterized by a spinning sensation that lasts longer than 24 hours, the absence of cochlear symptoms, and other neurological symptoms. The diagnosis of VN is done by different tests which include a head impulse test, bithermal caloric test, and vestibular-evoked myogenic potential tests. The treatment of VN is based on different stages of this disease such as acute, subacute, and chronic. Antiemetics, vestibular suppressants, and intravenous hydration are some of the symptomatic treatments available. For those with chronic VN, vestibular rehabilitation is a highly useful tool in lowering feelings of lightheadedness and floating. The usefulness of antivertigo medications for VN is not well shown. The purpose of this review article was to explore the current management strategies of VN.
Comparative study of chocolate balloon versus conventional balloon on vessel preparation for femoropopliteal artery diseases: Propensity score-matched analysis of the CIVILIAN registry
Authors: Fan Weijian , Ye Meng , Wu Ziheng , Feng Zibo , Guo Lianrui , Shi Zhenyu , Fang Xin , He Chunshui , Lu Shuangshuang , Shi Weihao
Published: January 2025

OBJECTIVE:

The objective of this study was to compare the safety and effectiveness of Chocolate and conventional balloons for vessel preparation followed by drug-coated balloon (DCB) in femoropopliteal (FP) artery disease.

METHODS:

This was a retrospective, multi-centered real-world study. Patients’ data of demographics, lesions, and peri-procedural characteristics were consecutively collected between August 2021 and December 2022. All patients were matched through propensity score matched (PSM) analysis. Primary endpoints included the rate of flow-limiting dissections after ultimate dilatation. Secondary endpoints were the rate of bailout stenting and freedom from clinically driven target lesion revascularization (CD-TLR) at 6-month follow-up.

RESULTS:

Patients were finally divided into the Chocolate percutaneous transluminal angioplasty (PTA) (n = 148) and the conventional balloon (n = 148) groups after PSM. Regarding the primary endpoint, rates of flow-limiting dissections were slightly lower in the Chocolate PTA group (19.6% vs. 20.3%, P = 0.88). Sub-analysis also showed similar trends in the two groups without sequential dilatation. The rate of flow-limiting dissections was significantly lower in the Chocolate PTA group without combining predilatation (11.7% and 13.3%, P = 0.04). Predictors of bailout stenting in the Chocolate PTA group were chronic limb ischemia, severe calcification, and TASCII C/D. The overall freedom from CD-TLR rate during follow-up was 100% and 98.0% ±1.2% in the Chocolate and conventional groups, respectively (P = 0.08).

CONCLUSION:

Chocolate balloon combined with DCB resulted in a comparable reduced rate of severe dissections and bailout stenting in FP disease patients compared with conventional balloon, especially when combing with non-sequential dilatation. Meanwhile, the Chocolate balloon could achieve significant better outcomes for vessel preparation without performing predilatation.
A retrospective cohort study: Balloon blockage-guided intercostal angiography synchronously displaying intercostal arteries
Authors: Wang Chao , Fang Guanyu , Jin Jie , Wu Jianjin , Liu Yandong , Ji Xiangguo , Bai Jun , Qu Lefeng
Published: January 2025

PURPOSE:

The purpose of this study was to evaluate the effectiveness and safety of balloon blockage-guided intercostal angiography (BBIA) for simultaneous observation of intercostal arteries.

MATERIALS AND METHODS:

Eight patients who underwent BBIA were retrospectively enrolled at a single institution from January 2018 to June 2019. All the procedures were performed during endovascular aneurysm repair. The patients’ demographics, angiographic parameters, and complications were recorded and analyzed.

RESULTS:

The mean age of the patients was 69.4 ± 5.0 years and male: female ratio was 7:1. Mean body mass index was 24.1 ± 2.9 kg/m². The number of patients with smoking, hypertension, diabetes, and hyperlipidemia was 4 (50%), 7 (87.5%), 0 (0%) and 2 (25%), respectively. The total procedural duration, balloon-blocking time, and fluoroscopy time were averaged into 24.1 ± 3.0 min, 35.8 ± 5.0 s, and 5.6 ± 0.6 min, respectively. The mean contrast volume was 85.3 ± 11.6 ml and the mean radiation exposure was 417.3 ± 36.6 mGy. The technical success rate was 100%. A mean of 14 ± 2.5 intercostal arteries was finally visualized. No major complication related to intercostal artery angiography was noted; however, two minor complications were observed, one patient developed hematoma at the groin site after the procedure. Another patient presented with low back pain.

CONCLUSIONS:

BBIA is a safe and effective method for visualizing multiple intercostal arteries simultaneously. The technique may present an alternative for rapidly locating the pathologies at intercostal artery.
Investigation and management of iliac artery endofibrosis
Authors: Tong Yisha , Qi Sara
Published: January 2025

Iliac artery endofibrosis (IAE) is a nonatherosclerotic vascular condition characterized by subintimal fibrosis of the external iliac artery (EIA). It typically affects young otherwise healthy endurance athletes, especially competitive cyclists. It causes claudication during intense sporting activities. IAE is also known as cyclist’s iliac syndrome, external iliac artery endofibrosis, iliac artery compression, iliac artery syndrome, and iliac outlet syndrome. IAE is relatively rare and perhaps underrecognized. This article reviews current knowledge of the clinical features, diagnostic investigations, and management options for IAE to help multidisciplinary healthcare professionals familiarize themselves with this condition.
Continuum of glucose and bone metabolism impairment across autonomous cortisol secretion: A cross-sectional study
Authors: Han Min-Min , Cao Xiao-Ming , Liu Zi-Ang , Zhang Yi , Liu Yun-Feng
Published: January 2025

BACKGROUND

Autonomous cortisol secretion (ACS) is linked to a higher prevalence of metabolic abnormalities and an increased risk of major adverse cardiovascular events.

AIM

To evaluate glucose and bone metabolism in patients with ACS using a continuous glucose monitoring system (CGMS) and dual-energy X-ray absorptiometry (DXA).

METHODS

Patients diagnosed with ACS, including Cushing syndrome, mild ACS (MACS), and nonfunctional adrenal incidentaloma (NFAI), were recruited for this study. Glucose variability and glycemic status were assessed using CGMS. Regional bone mineral content (BMC), bone mineral density (BMD), and bone area (BA) were evaluated using DXA. CGMS- and DXA-derived parameters were compared across the subgroups of ACS. Correlation analysis was performed to examine relationships between varying degrees of cortisol secretion, measured by cortisol after 1 mg overnight dexamethasone suppression test (DST) or 24-hour urine free cortisol (24h UFC), and CGMS- or DXA-derived parameters.

RESULTS

A total of 64 patients with ACS were included in this study: 19 with Cushing syndrome, 11 with MACS, and 34 with NFAI. Glucose variability, time above range (TAR), and time in range (TIR) along with specific areal BMC, BMD, and BA, differed significantly between groups of Cushing syndrome and NFAI. A significant positive correlation was observed between glucose variability or TAR and cortisol after 1 mg overnight DST or 24h UFC. By contrast, TIR, along with regional BMC, BMD, and BA, were negatively correlated with varying degrees of cortisol secretion.

CONCLUSION

Glucose and bone metabolism impairments are on a continuum alteration from NFAI to MACS and Cushing syndrome. Prompt attention should be given to these patients with ACS, especially those with mild hormone secretion. Parameters of glucose variability and glycemic status along with bone condition in regions rich in cancellous bone will provide valuable information.
Optimizing dialysis modalities for diabetic end-stage kidney disease: A focus on personalized care and resource-limited settings
Authors: Prabhahar Arun , Batta Akshey , Hatwal Juniali , Kumar Vivek , Ramachandran Raja , Batta Akash
Published: January 2025

Diabetes is the leading cause of chronic kidney disease (CKD) and end-stage kidney disease (ESKD) worldwide. While both haemodialysis (HD) and peritoneal dialysis (PD) are commonly used treatment options for ESKD, the choice of dialysis modality in diabetic ESKD patients remains a critical decision influenced by various patient-related, healthcare system, and socio-economic factors. This article examines the factors influencing the selection of dialysis modalities for diabetic patients, with a focus on the challenges and opportunities in low-resource settings. Key considerations include the impact of comorbidities such as peripheral arterial disease and CKD-related mineral bone disorder (MBD), as well as patient preferences, caregiver burden, and the availability of healthcare infrastructure. The article highlights the need for personalized approaches to dialysis selection, considering both clinical outcomes and quality of life. It also emphasizes the potential benefits of home dialysis, including home HD and PD, in improving patient autonomy and long-term survival. The article advocates for better government policies, increased awareness, and improved support systems to enhance the accessibility and efficacy of dialysis treatments, particularly in underserved populations. Further research comparing the outcomes of different dialysis modalities across diverse settings is essential to guide global treatment strategies for diabetic ESKD patients.
Role of duodenal mucosal resurfacing in controlling diabetes in rats
Authors: Nie Li-Juan , Cheng Zhe , He Yi-Xian , Yan Qian-Hua , Sun Yao-Huan , Yang Xin-Yi , Tian Jie , Zhu Peng-Fei , Yu Jiang-Yi , Zhou Hui-Ping , Zhou Xi-Qiao
Published: January 2025

BACKGROUND

The duodenum plays a significant role in metabolic regulation, and thickened mucous membranes are associated with insulin resistance. Duodenal mucosal resurfacing (DMR), a new-style endoscopic procedure using hydrothermal energy to ablate this thickened layer, shows promise for enhancing glucose and lipid metabolism in type 2 diabetes (T2D) patients. However, the mechanisms driving these improvements remain largely unexplored.

AIM

To investigate the mechanisms by which DMR improves metabolic disorders using a rat model.

METHODS

Rats with T2D underwent a revised DMR procedure via a gastric incision using a specialized catheter to abrade the duodenal mucosa. The duodenum was evaluated using histology, immunofluorescence, and western blotting. Serum assays measured glucose, lipid profiles, lipopolysaccharide, and intestinal hormones, while the gut microbiota and metabolomics profiles were analyzed through 16S rRNA gene sequencing and ultra performance liquid chromatography-mass spectrum/mass spectrum, severally.

RESULTS

DMR significantly improved glucose and lipid metabolic disorders in T2D rats. It increased the serum levels of cholecystokinin, gastric inhibitory peptide, and glucagon-like peptide 1, and reduced the length and depth of duodenal villi and crypts. DMR also enhanced the intestinal barrier integrity and reduced lipopolysaccharide translocation. Additionally, DMR modified the gut microbiome and metabolome, particularly affecting the Blautia genus. Correlation analysis revealed significant links between the gut microbiota, metabolites, and T2D phenotypes.

CONCLUSION

This study illustrates that DMR addresses metabolic dysfunctions in T2D through multifaceted mechanisms, highlighting the potential role of the Blautia genus on T2D pathogenesis and DMR’s therapeutic impact.
O-linked β-N-acetylglucosamine transferase regulates macrophage polarization in diabetic periodontitis: In vivo and in vitro study
Authors: Wu Ye-Ke , Liu Min , Zhou Hong-Ling , He Xiang , Wei Jing , Hua Wei-Han , Li Hui-Jing , Yuan Qiang-Hua , Xie Yun-Fei
Published: January 2025

BACKGROUND

Periodontitis, when exacerbated by diabetes, is characterized by increased M1 macrophage polarization and decreased M2 polarization. O-linked β-N-acetylglucosamine (O-GlcNAcylation), catalyzed by O-GlcNAc transferase (OGT), promotes inflammatory responses in diabetic periodontitis (DP). Additionally, p38 mitogen-activated protein kinase regulates macrophage polarization. However, the interplay between OGT, macrophage polarization, and p38 signaling in the progression of DP remains unexplored.

AIM

To investigate the effect of OGT on macrophage polarization in DP and its role in mediating O-GlcNAcylation of p38.

METHODS

For in vivo experiments, mice were divided into four groups: Control, DP model, model + short hairpin (sh) RNA-negative control, and model + sh-OGT. Diabetes was induced by streptozotocin, followed by ligation and lipopolysaccharide (LPS) administration to induce periodontitis. The impact of OGT was assessed by injecting sh-OGT lentivirus. Maxillary bone destruction was evaluated using micro-computed tomography analysis and tartrate-resistant acid phosphatase staining, while macrophage polarization was determined through quantitative real-time polymerase chain reaction (qPCR) and immunohistochemistry. For in vitro experiments, RAW264.7 cells were treated with LPS and high glucose (HG) (25 mmol/L D-glucose) to establish a cell model of DP. OGT was inhibited by OGT inhibitor (OSMI4) treatment and knocked down by sh-OGT transfection. M1/M2 polarization was analyzed using qPCR, immunofluorescence, and flow cytometry. Levels of O-GlcNAcylation were measured using immunoprecipitation and western blotting.

RESULTS

Our results demonstrated that M1 macrophage polarization led to maxillary bone loss in DP mice, associated with elevated O-GlcNAcylation and OGT levels. Knockdown of OGT promoted the shift from M1 to M2 macrophage polarization in both mouse periodontal tissues and LPS + HG-induced RAW264.7 cells. Furthermore, LPS + HG enhanced the O-GlcNAcylation of p38 in RAW264.7 cells. OGT interacted with p38 to promote its O-GlcNAcylation at residues A28, T241, and T347, as well as its phosphorylation at residue Y221.

CONCLUSION

Inhibition of OGT-mediated p38 O-GlcNAcylation deactivates the p38 pathway by suppressing its self-phosphorylation, thereby promoting M1 to M2 macrophage polarization and mitigating DP. These findings suggested that modulating macrophage polarization through regulation of O-GlcNAcylation may represent a novel therapeutic strategy for treating DP.
Programmed cell death receptor 1 inhibitor Pembrolizumab in the treatment of advanced gastric cancer
Authors: Yi Xue-Mei , Cai Hong-Qiao , Jiao Yan
Published: January 2025

This editorial discusses Christodoulidis et al 's article, which appeared in the most recent edition. The clinical trials have demonstrated the programmed cell death receptor 1 (PD-1) inhibitor Pembrolizumab involved combination therapy can improve the efficacy of advanced gastric cancer (AGC). Pembrolizumab combined with chemotherapy can enhance its sensitivity, and further eliminate tumor cells that develop resistance to chemotherapy. The combination of Pembrolizumab and Trastuzumab targeting human epidermal growth factor receptor 2 showed improved prognosis. The overall toxic effects of Pembrolizumab are significantly lower than traditional chemotherapy, and the safety is controllable. PD-1 inhibitor Pembrolizumab sheds a light on the treatment of AGC and brings new hope to the clinical practice.
Humanistic and graded psychological nursing care for patients undergoing endoscopic submucosal dissection of gastrointestinal tumors
Authors: Jiang Ying , Bu Bao-Lian , Yang Wei , Zhi Yuan , Ye Hong-Yan
Published: January 2025

BACKGROUND

Endoscopic submucosal dissection (ESD) has become a widely accepted, minimally invasive treatment for gastrointestinal submucosal tumors. It has been reported that humanistic nursing care with graded psychological interventions can effectively enhance patients’ physical activity in patients, reduce postoperative complications, and improve their postoperative quality of life.

AIM

To investigate the effects of combining humanistic care with graded psychological support on nursing satisfaction and quality of life in patients undergoing ESD for gastrointestinal submucosal tumors.

METHODS

A retrospective analysis was conducted on the clinical data of 180 patients who underwent ESD surgery for gastrointestinal submucosal tumors at our hospital between March 2021 and February 2023. Patients were allocated into groups based on the nursing care they received: The control group, which received routine care (n = 90), and the observation group, which was subjected to humanistic nursing care in combination with graded psychological support (n = 90). Patient anxiety and depression were assessed using the self-rating anxiety scale (SAS) and self-rating depression scale (SDS). Quality of life was evaluated using the short-form 36 health survey, and additional indications such as time to first food intake, surgery duration, length of hospital stay, nursing satisfaction, and adverse reactions were also recorded. Data was analyzed using SPSS22.0, with t -tests employed for continuous variables and χ 2 tests for categorical data.

RESULTS

Patients in the observation group experienced significantly shorter times to first postoperative meal, surgery, and hospital stay compared to the control group. After the intervention, the SAS score of the observation group was 43.17 ± 5.68, and the SDS score was 41.57 ± 6.52, both significantly lower than those of the control group, with SAS score of 52.38 ± 5.21 and SDS score of 51.23 ± 8.25. In addition, the observation group scored significantly higher in daily living, physical function, psychological well-being, and social functioning (80.01 ± 6.39, 83.59 ± 6.89, 81.69 ± 5.34, and 85.23 ± 6.05, respectively). Moreover, the observation group also exhibited higher satisfaction and self-efficacy scores and a lower incidence of adverse reactions compared to the control group (P < 0.05).

CONCLUSION

For patients undergoing ESD for gastrointestinal submucosal tumors, humanistic nursing care in combination with graded psychological nursing care significantly shorten the times to first postoperative meal, surgery, and hospital stay, effectively alleviates anxiety and depression, improves quality of life and nursing satisfaction, and mitigate the incidence of adverse reactions.
Retrospective comparative study of different surgical methods for gastric ulcer perforation: Efficacy and postoperative complications
Authors: Pang Yu-Fan , Shu Liang , Xia Cheng-Wei
Published: January 2025

BACKGROUND

Gastric ulcer perforation is a critical condition that can lead to significant morbidity and mortality if not promptly addressed. It is often the result of chronic peptic ulcer disease, which is characterized by a breach in the gastric wall due to ulceration. Surgical intervention is essential for managing this life-threatening complication. However, the optimal surgical technique remains debatable among clinicians. Various methods have been employed, including simple closure, omental patch repair, and partial gastrectomy, each with distinct advantages and disadvantages. Understanding the comparative efficacy and postoperative outcomes of these techniques is crucial for improving patient care and surgical decision-making. This study addresses the need for a comprehensive analysis in this area.

AIM

To compare the efficacy and postoperative complications of different surgical methods for the treatment of gastric ulcer perforation.

METHODS

A retrospective analysis was conducted on 120 patients who underwent surgery for gastric ulcer perforation between September 2020 and June 2023. The patients were divided into three groups based on the surgical method: Simple closure, omental patch repair, and partial gastrectomy. The primary outcomes were the operative success rate and incidence of postoperative complications. Secondary outcomes included the length of hospital stay, recovery time, and long-term quality of life.

RESULTS

The operative success rates for simple closure, omental patch repair, and partial gastrectomy were 92.5%, 95%, and 97.5%, respectively. Postoperative complications occurred in 20%, 15%, and 17.5% of patients in each group, respectively. The partial gastrectomy group showed a significantly longer operative time (P < 0.001) but the lowest rate of ulcer recurrence (2.5%, P < 0.05). The omental patch repair group demonstrated the shortest hospital stay (mean 7.2 days, P < 0.05) and fastest recovery time.

CONCLUSION

While all three surgical methods showed high success rates, omental patch repair demonstrated the best overall outcomes, with a balance of high efficacy, low complication rates, and shorter recovery time. However, the choice of the surgical method should be tailored to individual patient factors and the surgeon’s expertise.
Harnessing the prognostic power of preoperative systemic immune-inflammation index/albumin ratio in hepatocellular carcinoma resection
Authors: Zhang Zhao-Nan , Hao Liang , Han Shuang , Li Shan-Shan , Lin Si-Xiang , Miao Yan-Dong
Published: January 2025

The recent study by Chen et al , published in the World Journal of Gastroenterology , introduces a groundbreaking assessment tool-the preoperative systemic immune-inflammation index/albumin (SII/ALB) ratio-for patients with hepatocellular carcinoma (HCC) undergoing curative resection. This study not only establishes the independent prognostic significance of the SII/ALB ratio but also incorporates it into a predictive nomogram, enhancing its utility for clinical decision-making. The SII/ALB ratio, by integrating inflammatory and nutritional biomarkers, offers a novel lens through which the prognosis of HCC patients can be viewed, suggesting a more tailored approach to patient management. The development of the nomogram, validated for its accuracy in predicting patient outcomes, marks a pivotal advance, potentially guiding surgical decisions and postoperative care. However, the study's focus on a single-center cohort prompts the need for validation in a broader, more diverse patient population to ensure its applicability across various clinical settings. Moreover, longitudinal studies could elucidate the dynamic changes in SII/ALB post-surgery, offering insights into its potential as a continuous monitor for recurrence and long-term survival. This abstract aim to underscore the critical findings of Chen et al 's study while calling for further research to explore the full potential of the SII/ALB ratio in the global management of hepatocellular carcinoma.
Acute abdominal pain complicated by cecal perforation caused by an unnoticed swallowed toothpick: A case report
Authors: Chen Tao
Published: January 2025

BACKGROUND

Acute abdominal pain is one of the most common gastrointestinal symptoms. The etiology of acute abdomen can be challenging for gastroenterologists to establish. Cecal foreign body is a rare cause of cecal perforation.

CASE SUMMARY

We report a 35-year-old male from China who initially exhibited symptoms suggestive of acute appendicitis. However, during a minimally invasive colonoscopy procedure, the authors found that a wooden toothpick caused the perforation. The patient presented to our emergency department with a 2 days history of right lower abdominal pain and low grade fever. The patient was in good health and had eaten fish 2 days earlier. Physical examination revealed mild pain with positive rebound tenderness in the right lower abdomen. However, computed tomography of the abdomen confirmed a strip of high-density shadows protruding beyond the intestinal cavity outline, with a small amount of peritoneal seepage in the ileocecal area. Combined with the medical history, the possibility of foreign body perforation by a fishbone and peripheral peritonitis were considered. However, the high-density shadow was identified as a wooden toothpick, which was removed via a minimally invasive procedure using a foreign body forceps under colonoscopy. The patient's condition improved significantly within 5 days after treatment.

CONCLUSION

We emphasize the importance of a detailed patient history, accurate diagnosis and proper treatment in patients with acute abdomen.
Magnamosis for rectal reconstruction in canines
Authors: Liu Shi-Qi , Zhang Hong-Ke , Lv Yi , Xu Xiang-Hua , Li Yu-Feng , Quan Dong-Wen
Published: January 2025

BACKGROUND

The magnamosis, a minimal invasive, suture-free procedure, has been used for digestive tract or vessel reconstruction, such as gastrointestinal anastomosis, bilioenteric anastomosis, and coronary artery bypass. Although some case reports have demonstrated the potential of magnamosis for the treatment of congenital rectal atresia (RA), they cannot provide strong evidence for its widespread application.

AIM

To assess the feasibility and safety of magnamosis in treating RA in dogs as compared to suturing anastomosis. The findings of this study can be beneficial in guiding the clinical application of magnamosis.

METHODS

Thirty-six dogs were randomly assigned to the magnamosis group (n =18) and the suturing anastomosis group (n =18). The rectum was freed laparoscopically in all dogs. In the magnamosis group, rectal anastomosis was performed using a pair of magnetic rings, while the suturing anastomosis group underwent a straight-sighted end-to-end rectal anastomosis with 4-0 absorbable sutures. The anastomosis time was recorded, and abdominal plain film examination was performed to locate the magnets until they were expelled postoperatively. Specimens of the anastomosis were evaluated at one month, three months, and six months after surgery.

RESULTS

The mean time for rectal anastomosis was significantly shorter in the magnamosis group (12.22 ± 2.78 minutes) than the suturing anastomosis group (18.11 ± 1.68 minutes). There was one incidence of anastomotic bleeding in the suturing anastomosis group, whereas no complication was recorded in the magnamosis group. The magnets were discharged post-surgery in 7.17 ± 1.30 days in all the dogs. The histopathological examination revealed a smoother healing of anastomotic mucosa in the magnamosis group as compared to that in the suturing anastomosis group. Moreover, the fiber alignment was also more natural in the magnamosis group with minimal inflammation.

CONCLUSION

Rectal reconstruction using magnamosis is a feasible, safe, and effective alternative to suturing anastomosis in dogs, with the added benefit of faster and more natural healing of the anastomosis.
Analysis of risk factors for dysphagia in patients after laparoscopic radical gastrectomy
Authors: Chen Sang-Sang , Dong Zhe-Bin , Xiang Han-Ting , Chen Zheng-Wei , Chen Tian-Ci , Huang Jia-Rong , Liang Chao , Yu Wei-Ming
Published: January 2025

BACKGROUND

Gastric cancer is among the most prevalent malignancies worldwide. Despite significant advancements in chemoradiotherapy, targeted therapy, and neoadjuvant therapy, conventional surgical intervention remains the cornerstone of gastric cancer management. Improvements in surgical techniques, coupled with the use of staplers and other advanced instruments, have substantially reduced the incidence of complications and mortality following gastric cancer surgery. However, dysphagia remains a common postoperative complication.

AIM

To retrospectively investigate the potential factors contributing to dysphagia in patients who have undergone laparoscopic radical gastrectomy for gastric cancer and to explore effective strategies for its postoperative management.

METHODS

In this retrospective study, we analyzed data from patients who underwent elective laparoscopic total gastrectomy at Lihuili Hospital, Ningbo University, between January 2018 and May 2022. A total of 115 eligible postoperative patients were included. Postoperatively, patients completed questionnaires and were categorized into two groups based on their responses: The dysphagia group (Eating Assessment Tool-10 score ≥ 3) and the non-dysphagia group (Eating Assessment Tool-10 score < 3). Risk factors associated with dysphagia following total gastrectomy were assessed using χ 2 tests, Fisher’s exact tests, t -tests, Pearson correlation coefficients, and univariate and multivariate regression analyses.

RESULTS

Multivariate analysis further identified anastomotic style, prolonged intubation time, advanced age, and low albumin (ALB) levels as independent risk factors for postoperative dysphagia. Implementing targeted preventive measures for high-risk groups may significantly enhance postoperative quality of life.

CONCLUSION

Univariate analysis revealed that anastomotic style, low serum ALB levels, advanced age, and prolonged intubation time were significantly associated with postoperative dysphagia in gastric cancer patients. Multivariate analysis further identified anastomotic style, prolonged intubation time, advanced age, and low ALB levels as independent risk factors for postoperative dysphagia. Implementing targeted preventive measures for high-risk groups may significantly enhance postoperative quality of life.
Clip-stone and T clip-sinus post laparoscopic biliary surgery: Two case reports and review of the literature
Authors: Huang Ying-Zi , Lin Yuan-Yu , Xie Ju-Ping , Deng Gang , Tang Di
Published: January 2025

BACKGROUND

Laparoscopic cholecystectomy (LC) and laparoscopic common bile duct exploration (LCBDE) are widely used in gallbladder and biliary tract diseases. During these procedures, vessels or tissues are commonly ligated using clips. However, postoperative migration of clips to the common bile duct (CBD) or T-tube sinus tract is an overlooked complication of laparoscopic biliary surgery. Previously, most reported cases of postoperative clip migration involved metal clips, with only a few cases involving Hem-o-lok clips and review of the literature.

CASE SUMMARY

This report describes two cases in which Hem-o-lok clips migrated into the CBD and the T-tube sinus tract following laparoscopic surgery. Case 1 is a 68-year-old female admitted due to abdominal discomfort, and two Hem-o-lok clips were found to have migrated into the CBD 17 months after LC and LCBDE with T-tube drainage, and were removed using a stone extraction balloon. The patient was discharged smoothly after recovery. Case 2 is a 74-year-old male who underwent LC and LCBDE with T-tube drainage and laparoscopic biliary tract basket stone extraction. Nine weeks postoperatively, following T-tube removal, a Hem-o-lok clip was found in the sinus tract, and was extracted from the T-tube sinus tract. The patient recovered smoothly postoperatively. This study also reviews the literature from 2013 to July 2024 on using Hem-o-lok clips in LC and/or LCBDE treatment of gallbladder and biliary diseases and the postoperative migration of these clips into the CBD, T-tube sinus tract, or duodenum.

CONCLUSION

In patients with a history of LC and/or LCBDE, clip migration should be considered as a differential diagnosis.
Environmental Aspects in ESG Strategies for Mid-sized Enterprises: The Case of HL Group
Authors: Lee Junwoo , Lee Seungsoo , Hwang Geonwook , Rhee Jay Hyuk , Ok Yong Sik
Published: January 2025

This study aims to analyze HL groups’ corporate efforts concerning the environmental (E) aspects of ESG (Environmental, Social, Governance) practices and propose future considerations. The analysis examined sustainability reports from 2021 to 2023 for HL groups’ subsidiaries – HL Holdings, HL Mando, HL D&I, and HL Klemove. The study focused on carbon emissions, water usage, waste generation, and energy consumption. Additionally, activities related to biodiversity conservation were examined through keyword analysis, materiality analysis, and adherence to GRI 304 Standards. In terms of carbon emissions, for all companies, Scope 2 emissions were higher than Scope 1 emissions. Therefore, it is necessary to set carbon neutrality goals and implement reduction strategies such as renewable energy development. In terms of water usage, HL D&I Halla transparently disclosed the water usage during the construction process and reduced its water usage by 8% in 2023 compared to 2022. Regarding waste emissions, HL D&I Halla reduced waste by 63% in 2023 compared to the previous year and achieved a 100% recycling rate. For energy usage, it was confirmed that all companies are voluntarily making efforts to reduce their energy consumption. In a comparison with other companies in the mobility industry, HL Mando showed an increase in all factors except for Scope 1 emissions. However, the company is making efforts towards eco-friendly management by establishing an environmental department and setting carbon neutrality goals. In the construction industry, HL D&I Halla showed a decrease in all analyzed factors. In terms of biodiversity conservation, no company selected biodiversity as a significant issue in 2023. Despite HL groups’ efforts in the environmental domain, some companies were found to have insufficient performance in eco-friendly management. Specifically, regarding biodiversity conservation, all four companies need to make more concrete and practical efforts in the future.