Current Medical Science最新文献

{"title":"Collagen-Coated 3D-TechTra Scaffold Integrated with Human Umbilical Cord Mesenchymal Stem Cells Enhances Tracheal Tissue Regeneration and Reduces Stenosis in Rabbit Models.","authors":"Badrul Hisham Yahaya, Nur Fitriyani Afiqah Abu Bakar, Asmak Abdul Samat, Anan A Ishtiah, Loqman Mohamad Yusof, Zuratul Ain Abdul Hamid, Noor Diyana Osman, Nor Azlina Khalil, Rodiah Mohd Radzi, Muhamad Yusri Musa, Mariatti Jaafar","doi":"10.1007/s11596-025-00119-y","DOIUrl":"https://doi.org/10.1007/s11596-025-00119-y","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the potential of a collagen-coated, 3D-printed tracheal scaffold (3D-TechTra) integrated with human umbilical cord mesenchymal stem cells (hUC-MSCs) for tracheal tissue regeneration.</p><p><strong>Methods: </strong>The thermoplastic polyurethane/polylactic acid (TPU/PLA) scaffold was engineered to optimize mechanical properties and biocompatibility, with the goal of mimicking the structural and tensile characteristics of native tracheal tissue. Subsequently, preclinical experiments were conducted using rabbit models: the performance of the collagen-coated TPU/PLA scaffold with hUC-MSCs was compared with that of uncoated scaffolds and collagen-only scaffolds. In vitro tests were also performed to assess the adhesion, proliferation, and differentiation of hUC-MSCs on the scaffold. For in vivo evaluation, multiple analytical methods were employed, including immunohistological analysis (to detect glycosaminoglycan deposition and extracellular matrix remodeling), radiographic and endoscopic evaluations (to assess tracheal contour and airway obstruction), and survival analysis (to monitor animal outcomes and systemic toxicity).</p><p><strong>Results: </strong>In vitro, hUC-MSCs successfully adhered to and proliferated on the TPU/PLA scaffold, and differentiated into adipogenic, osteogenic, and chondrogenic lineages, which supported the potential for tissue-specific regeneration; in vivo, compared with uncoated or collagen-only scaffolds, the collagen-coated TPU/PLA scaffold integrated with hUC-MSCs exhibited enhanced integration with host tissues, superior biocompatibility, and reduced tracheal stenosis, while also preserving airway patency, alleviating inflammation, and facilitating epithelial regeneration, smooth muscle formation, and vascularization. Immunohistological analysis further revealed significant glycosaminoglycan deposition and extracellular matrix remodeling in the hUC-MSC-treated group, and radiographic and endoscopic evaluations confirmed preserved tracheal contour and reduced airway obstruction; additionally, survival analysis showed significantly improved outcomes in animals treated with the collagen-coated TPU/PLA scaffold containing hUC-MSCs, with no systemic toxicity observed.</p><p><strong>Conclusions: </strong>This study demonstrated the synergistic potential of TPU/PLA scaffolds, collagen coatings, and hUC-MSCs, providing valuable evidence for advancing the application of these components in tracheal tissue engineering.</p>","PeriodicalId":10820,"journal":{"name":"Current Medical Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Real-World Pharmacological Assessment of Tenofovir Amibufenamide and Tenofovir Alafenamide in 48-Week Chronic Hepatitis B Treatment: Efficacy, Safety, and Cost-Effectiveness.","authors":"Li-Li Liu, Yi Feng, Chao-Yi Ren, Yi Liu, Ming-Hui Zhu, Guo-Xiang Hao, Tian-Tian Gao","doi":"10.1007/s11596-025-00120-5","DOIUrl":"https://doi.org/10.1007/s11596-025-00120-5","url":null,"abstract":"<p><strong>Objective: </strong>Chronic hepatitis B (CHB), characterized by a significant global disease burden and substantial healthcare costs, remains a critical public health challenge. Although tenofovir amibufenamide (TMF) and tenofovir alafenamide (TAF), including formulations from centralized volume-based procurement (CVBP-TAF) and imported sources (I-TAF), are all recommended treatment regimens, comparative studies on the efficacy, safety, and cost-effectiveness of these three regimens remain relatively limited. This retrospective cohort study aims to systematically compare the application effects of these three regimens in the treatment of CHB.</p><p><strong>Methods: </strong>We conducted a single-center retrospective cohort study at Tianjin University Central Hospital from September 2019 to September 2024. CHB patients who had received TMF, CVBP-TAF, or I-TAF for 48 weeks were enrolled. Efficacy endpoints included HBV-DNA negative conversion, HBeAg seroclearance, and alanine aminotransferase (ALT) normalization. Safety outcomes encompassed nephrotoxicity, hepatotoxicity, and lipid profile changes. Cost-effectiveness analysis was used to calculate the cost-effectiveness ratio (CER) per unit efficacy gain and incremental CER using a healthcare payer perspective.</p><p><strong>Results: </strong>A total of 173 patients were included, with 58 in the TMF group, 58 in the I-TAF group, and 57 in the CVBP-TAF group. TMF demonstrated superior efficacy to I-TAF and CVBP-TAF, as evidenced by significantly higher HBV-DNA negative conversion rate and ALT normalization rate. No significant differences in safety outcomes were observed among the three groups. Cost-effectiveness analysis showed that CVBP-TAF had the lowest CER (4.62 CNY/%), followed by TMF with an intermediate CER (60.45 CNY/%), while I-TAF had the highest CER (66.49 CNY/%).</p><p><strong>Conclusion: </strong>TMF demonstrates stronger antiviral efficacy than both TAF formulations, with comparable safety profiles. Despite the cost advantages of CVBP-TAF resulting from procurement policies, the clinical benefits of TMF support its use. Future strategies should improve the affordability of TMF to expand its accessibility.</p>","PeriodicalId":10820,"journal":{"name":"Current Medical Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"miR-320a Regulates Placenta Endothelial Function After Fetal Cardiopulmonary Bypass via the ATG7-SIRT1/FOXO1 Pathway.","authors":"Yun Teng, Miao Tian, Xiao-Kang Luo, Qiu-Ping Jiang, Hai-Yun Yuan, Jian Zhuang, Ji-Mei Chen, Cheng-Bin Zhou","doi":"10.1007/s11596-025-00115-2","DOIUrl":"https://doi.org/10.1007/s11596-025-00115-2","url":null,"abstract":"<p><strong>Objective: </strong>Placental dysfunction induced by fetal cardiopulmonary bypass (CPB) imposes limitations on the clinical application of this procedure. The potential impact of microRNA-mediated autophagy in placental endothelial cells on overall placental function remains elusive, necessitating a comprehensive exploration of the underlying mechanisms involved.</p><p><strong>Methods: </strong>We established fetal sheep CPB models and employed immunohistochemistry to assess the placental expression of ATG7. Bioinformatic analysis, coupled with dual-luciferase reporter assays, was used to elucidate the intricate relationship between miR-320a and ATG7. Changes in ATG7 expression were further investigated through Western blotting and quantitative polymerase chain reaction (qPCR). Human umbilical vein endothelial cells (HUVECs) were cultured, and in vitro experiments were conducted to evaluate their regulatory effects on endothelial function. Immunoblotting was used to measure the expression levels of ATG7, endothelin-1 (ET-1), SIRT1, and FOXO1, whereas enzyme-linked immunosorbent assay (ELISA) was used to quantify nitric oxide (NO) production.</p><p><strong>Results: </strong>Sixty minutes after CPB, a substantial decrease in ATG7 expression in placental tissue was observed. The downregulation of ATG7 expression led to increased ET-1 production in HUVECs, concomitant with decreased NO production. miR-320a was identified as a specific regulator of ATG7 expression, with subsequent experiments demonstrating a significant reduction in placental ATG7 levels upon injection of the miR-320a agomir compared with the miR-320a antagomir during fetal sheep CPB. In HUVECs, miR-320a downregulated ATG7, resulting in increased ET-1 production and diminished NO production. Treatment with the miR-320a mimic/miR-320a inhibitor revealed that miR-320a inhibited the SIRT1/FOXO1 pathway in HUVECs by downregulating ATG7 expression, culminating in increased ET-1 production and reduced NO levels.</p><p><strong>Conclusion: </strong>The observed downregulation of placental ATG7 expression subsequent to fetal CPB is intricately associated with endothelial dysfunction. Furthermore, our findings underscore the specific regulatory role of miR-320a in modulating ATG7 expression within the placenta. At the cellular level, increasing the level of miR-320a has emerged as a potential strategy for modulating endothelial function through the inhibition of ATG7 and the SIRT1/FOXO1 pathway.</p>","PeriodicalId":10820,"journal":{"name":"Current Medical Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of MiR-29b/BRD4 with Airway Dysbiosis in Chronic Obstructive Pulmonary Disease after Smoking Cessation.","authors":"Si-Yi Zhou, Yu-Xin Zeng, Yu Tao, Jian-Miao Wang","doi":"10.1007/s11596-025-00118-z","DOIUrl":"https://doi.org/10.1007/s11596-025-00118-z","url":null,"abstract":"<p><strong>Objective: </strong>Our earlier research revealed a connection between microRNA-29b (miR-29b) and bromodomain-containing protein 4 (BRD4) and airway inflammation in chronic obstructive pulmonary disease (COPD). We examined their correlation with airway inflammation and dysbiosis in COPD individuals who had ceased smoking.</p><p><strong>Methods: </strong>Bacterial community composition and diversity were evaluated in bronchoalveolar lavage fluid (BALF) from COPD patients who had ceased smoking, and the expression of miR-29b/BRD4, interleukin (IL)-6 and IL-8 in bronchial brushings was measured. BEAS-2B cells were exposed to COPD BALF filtrate to establish an in vitro model. The expression levels of miR-29b, BRD4, IL-6, and IL-8 were subsequently assessed in these treated cells.</p><p><strong>Results: </strong>The bacterial community composition in the lungs of individuals with COPD was different from that in the lungs of non-COPD subjects. In COPD patients, lung microbial diversity was significantly reduced, and this decline was correlated with both pulmonary function and airway inflammation. Additionally, the expression of miR-29b was lowered, whereas BRD4 expression was elevated in the lower airways of individuals with COPD. Both miR-29b and BRD4 were linked with pulmonary function, airway inflammation, and diversity indices. miR-29b regulated the production of inflammatory cytokines induced by BALF filtrate through its targeting of BRD4 in bronchial epithelial cells.</p><p><strong>Conclusion: </strong>Our findings indicate that airway inflammation is associated with airway dysbiosis in COPD patients after smoking cessation and that miR-29b/BRD4 are involved in dysbiosis-associated airway inflammation.</p>","PeriodicalId":10820,"journal":{"name":"Current Medical Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating CT Radiomics and Clinical Information to Predict Prognosis of Advanced NSCLC Patients Receiving Chemoimmunotherapy.","authors":"Hao Zhong, Hao-Han Zhang, Jie Wu, Xin-Yi Zhao, Yu-Chao Dan, Jing Li, Lan Li, Ming Luo, Yu Xu, Bin Xu, Qi-Bin Song","doi":"10.1007/s11596-025-00117-0","DOIUrl":"https://doi.org/10.1007/s11596-025-00117-0","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to develop an effective predictive tool that combines radiomics and clinical information to predict the survival outcomes of patients with advanced non-small cell lung cancer (NSCLC) undergoing chemoimmunotherapy.</p><p><strong>Methods: </strong>Data were collected from 201 patients with advanced NSCLC who received first-line chemoimmunotherapy across three institutions: those from Centers I & II (n = 164) were randomly split in a 7:3 ratio into training (n = 115) and validation (n = 49) cohorts, and those form Center III (n = 37) were designated as the external test cohort. The analysis was conducted using CT images and clinical data obtained before and after induction chemoimmunotherapy. We developed multiple intratumoral and peritumoral radiomics-based models, along with clinical prediction model that integrated patients' baseline clinicopathological characteristics with plasma biomarker profiles, to predict progression-free survival (PFS). Based on expectations derived from prior established models, a stepwise backward elimination approach was utilized to select candidate submodels for the combined model construction. This combined model was internally validated using time-dependent ROC curves in training and validation sets and externally validated in the external test set.</p><p><strong>Results: </strong>The combined model was constructed by integrating four candidate sub-models (DeltaSub, Clinical, P4mm, and Habitat) selected through the stepwise regression analysis. The combined model demonstrated superior performance compared to conventional models that utilized only clinical features, as well as Classical-Pre, Classical-Post, delta intratumor feature-based, and peritumor feature-based models. The combined model demonstrated satisfactory predictive performance across all three datasets, achieving a C-index of 0.849 (95% CI: 0.812-0.885) in the training set, 0.744 (95% CI: 0.664-0.842) in the validation set, and 0.731 (95% CI: 0.639-0.824) in the external test set for PFS.</p><p><strong>Conclusions: </strong>We developed a novel radiomic-clinical model to predict PFS for advanced NSCLC patients treated with first-line chemoimmunotherapy. This model enhanced survival assessment through comprehensive feature integration.</p>","PeriodicalId":10820,"journal":{"name":"Current Medical Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic Effects of Qifangfeixian Granules on Pulmonary Fibrosis in Patients with Interstitial Lung Disease.","authors":"Lu-Qin Yang, Hui-Lan Zhang, Yong-Hao Li","doi":"10.1007/s11596-025-00106-3","DOIUrl":"https://doi.org/10.1007/s11596-025-00106-3","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the curative effect of the Qifangfeixian granule on interstitial lung disease (ILD).</p><p><strong>Methods: </strong>This study combined animal experiments and clinical trials. Pathological changes in bleomycin (BLM)-induced pulmonary fibrosis in mice were assessed using hematoxylin and eosin (H&E), Masson, and Sirius Red staining. In the clinical study, 40 ILD patients were enrolled, with 20 in the control group and 20 in the treatment group. The treatment group received Qifangfeixian granules in addition to standard therapy for 12 weeks. Pulmonary function parameters, including forced vital capacity (FVC, L), FVC_pred%, diffusing capacity for carbon monoxide (DLCO, mmol/min/kPa), and DLCO_pred%, were measured before and after treatment.</p><p><strong>Results: </strong>Compared with those of the control group, the inflammatory infiltration and collagen fibres in the BLM group were significantly increased, and the inflammatory infiltration and collagen fibres in the BLM group were significantly reduced after Qifangfeixian granule treatment. Compared with those in the control group, the lung function parameters in the treatment group were significantly improved. Specifically, the FVC increased by +0.10 ± 0.18 L in the treatment group, whereas the control group showed a decrease of -0.05 ± 0.21 L (P = 0.008). Additionally, FVC_pred% was improved significantly in the treatment group (+2.6% ± 5.3%) compared with the control group (-2.0% ± 6.7%, P = 0.009).</p><p><strong>Conclusion: </strong>Qifangfeixian granules can improve not only the pulmonary fibrosis of BLM-induced model mice but also the pulmonary function of patients with ILD in practice, and their clinical efficacy is accurate.</p>","PeriodicalId":10820,"journal":{"name":"Current Medical Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Screw Distribution on Stability and Interfragmentary Strain of Lower Tibial Fractures: A Finite Element Analysis.","authors":"Huan Su, Huan Xiao, Jian-Jun Zhou, Fang Lei, Liang Liang, De-Wei Wang","doi":"10.1007/s11596-025-00116-1","DOIUrl":"https://doi.org/10.1007/s11596-025-00116-1","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to explore the influence of working length (determined by the screw position) on the stiffness and interfragmentary strain (IFS) of femoral locking compression plate (LCP) external fixators for lower tibial fractures under full weight-bearing conditions, with the goal of providing a reference basis for clinical applications.</p><p><strong>Methods: </strong>Finite element analysis software was used to construct a model of a lower tibial fracture with external femoral LCP fixation. The models were divided into four groups according to the different working lengths (external femoral locking plate fixation 1 [EF1], EF2, EF3, and EF4). Stress distribution clouds, fracture end displacements, stiffness and IFS were tested for each model group at different loads.</p><p><strong>Results: </strong>Compared with those in the EF1 group, the stiffnesses in the EF2, EF3, and EF4 groups decreased by 28%, 31%, and 37%, respectively, under axial compression loading. Compared with those in the EF1 group, the stiffnesses in the EF2, EF3, and EF4 groups decreased by 19%, 33%, and 35%, respectively, under axial torsion loading. Compared with those in the EF1 group, the stiffnesses in the EF2, EF3, and EF4 groups decreased by 32%, 33%, and 35%, respectively, under a three-point bending load. The IFS of the four finite element models increased with the working length of the plate, with EF1 (76%) < EF2 (107%) < EF3 (110%) < EF4 (122%). Finite element analysis revealed that under full weight-bearing conditions, the structural stiffness of the femoral LCP external fixator decreased with increasing working length, leading to an increase in the IFS, which resulted in an IFS that exceeded the ideal range required for secondary healing.</p><p><strong>Conclusion: </strong>For unstable lower tibial fractures, screws in the femoral LCP external fixator should be placed as close to the fracture end as possible to increase stability and promote fracture healing.</p>","PeriodicalId":10820,"journal":{"name":"Current Medical Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Protective Effects of Quercetin on Ferritinophagy in Alcoholic-Induced Liver Iron Overload.","authors":"You Jin, Hong-Mei Zeng, Chan Peng, Jie Huang, Shi-Ting Huang, Qian Zhang, Hao-Bin Yang, Ping Yao, Lan Ni","doi":"10.1007/s11596-025-00113-4","DOIUrl":"https://doi.org/10.1007/s11596-025-00113-4","url":null,"abstract":"<p><strong>Objective: </strong>Iron overload resulting from chronic alcohol consumption may aggravate liver damage, and the potential mechanisms involving ferritinophagic flux and the role of naturally occurring quercetin in alcohol-induced liver disease remain unclear.</p><p><strong>Methods: </strong>Adult male C57BL/6J mice were iso-calorically pair-fed with ethanol-containing Lieber De Carli liquid diets according to a chronic-plus-binge ethanol feeding protocol with either quercetin (100 mg/kg.bw) or iron-rich/limited treatment for 12 weeks, and liver damage, as well as the underlying mechanisms of lysosome-dependent ferritinophagy, was explored, following the study of ethanol-incubated HepG2 cells with specific pharmacological reagents or gene regulation in vitro.</p><p><strong>Results: </strong>Chronic-plus-binge ethanol feeding led to an increase in the hepatosomatic ratio, hepatic lipid accumulation and triglyceride (TG) content of the mice and induced the release of alanine aminotransferase (ALT), aspartate transaminase (AST), and serum TG levels, which were normalized partially by quercetin treatment or iron limitation but worsened by iron supplementation. Similar findings were observed in vitro. Moreover, quercetin intervention alleviated iron deposition, inhibited the upregulation of p62 and downregulation of nuclear receptor coactivator 4 (NCOA4) and microtubule-associated protein 1 light chain 3 (LC3)-II, and blocked the colocalization of NCOA4 and ferritin heavy chain and the nuclear translocation of forkhead box protein O1 (FOXO1) induced by ethanol. These effects were also observed when the cells were subjected to iron limitation but were abolished by iron supplementation, NCOA4 transfection, or AS1842856, a FOXO1 inhibitor.</p><p><strong>Conclusion: </strong>Quercetin ameliorates secondary iron overload and subsequent liver damage caused by alcohol abuse by maintaining ferritinophagic flux and lysosome function via the FOXO1-TFEB NCOA4 signaling pathway.</p>","PeriodicalId":10820,"journal":{"name":"Current Medical Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global, Regional, and National Burden of Pulmonary Arterial Hypertension from 1990 to 2021 and Projections to 2040: A Systematic Analysis of Incidence, Mortality, and Disability-Adjusted Life Years.","authors":"Lin-Ling Yu, Ding-Sheng Jiang, Xiong Wang, Ze-Min Fang, Wei-Hong Chen, Jin-Zhu Zhao, Xin Yi, Wei Liu","doi":"10.1007/s11596-025-00108-1","DOIUrl":"https://doi.org/10.1007/s11596-025-00108-1","url":null,"abstract":"<p><strong>Objective: </strong>Pulmonary arterial hypertension (PAH) poses a growing global health challenge, yet comprehensive epidemiological data remain limited. This study aims to assess the burden of PAH from 1990 to 2021 and project trends to 2040, addressing critical gaps in incidence, mortality, and disability-adjusted life years (DALYs) across diverse socio-demographic contexts.</p><p><strong>Methods: </strong>Using data from the Global Burden of Disease (GBD) 2021 study, we analyzed PAH burden across 204 countries and territories, stratified by age, sex, region, and socio-demographic index (SDI). Age-standardized rates (per 100,000 populations) for incidence (ASIR), mortality (ASMR), and DALYs (ASDR) were calculated. Future trends were projected via a Bayesian age-period-cohort (BAPC) model.</p><p><strong>Results: </strong>In 2021, there were 43,251 (95% uncertainty interval [UI]: 34,705, 52,441) global incident PAH cases (age standardized incidence rate [ASIR]: 0.52). From 1990 to 2021, PAH incidence rose by 85.62%, with the steepest increase in high-middle SDI regions (average annual percentage change [AAPC]: + 0.19%). Despite a 48.36% rise in deaths, the age-standardized mortality rate (ASMR) declined annually by 0.84%, reflecting improved management. Central Europe had the highest ASMR (1.06 per 100,000), while low SDI regions showed reduced ASIR (-0.31% AAPC), likely due to underdiagnosis. PAH caused 642,104 DALYs globally in 2021, with infants (< 1 year) bearing the highest DALY rate. Projections indicate 75,000 annual cases by 2040, emphasizing an escalating burden.</p><p><strong>Conclusion: </strong>PAH burden is increasing disproportionately in aging populations and high-middle SDI regions, while low SDI areas face underdiagnosis and healthcare disparities. Targeted interventions, equitable resource allocation, and enhanced diagnostic capacity are urgently needed to mitigate future PAH-related morbidity and mortality.</p>","PeriodicalId":10820,"journal":{"name":"Current Medical Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ESE-1 Regulates CREB-Mediated PTEN Expression to Activate the PI3K/Akt Pathway and Promote High-Glucose-Induced Endothelial Cell Injury.","authors":"Tao Liu, Jian-Jun Hu","doi":"10.1007/s11596-025-00105-4","DOIUrl":"https://doi.org/10.1007/s11596-025-00105-4","url":null,"abstract":"<p><strong>Objective: </strong>Endothelial dysfunction is a central contributor to the vascular complications observed in individuals with diabetes. cAMP response element-binding protein (CREB) plays a crucial role in mediating hyperglycemia-induced endothelial dysfunction. Phosphatase and tensin homolog (PTEN) has been implicated in the regulation of endothelial inflammation, yet the precise mechanism by which CREB modulates PTEN to protect endothelial cells under high glucose conditions remains unknown. This study aims to elucidate this potential mechanism.</p><p><strong>Methods: </strong>Human umbilical vein endothelial cells (HUVECs) were exposed to high glucose (30 mM) or normal glucose (5.5 mM) for 6 days. Cell viability and apoptosis were assessed via the Cell Counting Kit-8 and flow cytometry. To evaluate oxidative stress, the levels of reactive oxygen species (ROS), lactate dehydrogenase (LDH), and malondialdehyde (MDA) were measured via commercial assay kits. The interaction between CREB and endothelial specific molecule 1 (ESE-1) was assessed via coimmunoprecipitation. Chromatin immunoprecipitation and luciferase reporter assays were used to investigate the transcriptional regulation of PTEN by ESE-1 and CREB. Western blotting was performed to analyze the expression of intercellular adhesion molecule-1 and E-selectin. The adhesion of HUVECs was evaluated via monocyte‒endothelial cell adhesion assays.</p><p><strong>Results: </strong>Our findings revealed a direct interaction between CREB and ESE-1, which together regulate PTEN expression to activate the phosphoinositide 3-kinase/protein kinase B pathway. Under high-glucose conditions, we observed significant increases in oxidative stress, inflammatory responses, and adhesion in HUVECs. ESE-1 knockdown reversed these effects, restoring endothelial cell function. Moreover, the overexpression of PTEN in high glucose-treated HUVECs rescued the endothelial injury induced by ESE-1 knockdown, suggesting that PTEN plays a pivotal role in mediating the protective effects.</p><p><strong>Conclusion: </strong>ESE-1, through the regulation of CREB-mediated PTEN expression, activates the PI3K/AKT pathway and modulates key processes such as oxidative stress, inflammation, and adhesion in endothelial cells under high-glucose stress.</p>","PeriodicalId":10820,"journal":{"name":"Current Medical Science","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}