Frontiers in Medicine最新文献

{"title":"Commentary: The effects of acupuncture on patients with premature ovarian insufficiency and polycystic ovary syndrome: an umbrella review of systematic reviews and meta-analyses.","authors":"Haomin Sun, Jianqiao Fang, Xiaomei Shao","doi":"10.3389/fmed.2025.1551033","DOIUrl":"https://doi.org/10.3389/fmed.2025.1551033","url":null,"abstract":"","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1551033"},"PeriodicalIF":3.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12504250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between obesity-related indicators and uncontrolled diabetes mellitus in the elderly: a community-based study in China.","authors":"Xinxi Zhang, Mingqi Liu, Hangjiong Xuan, Haiping Fang, Xiaojing Yang, Jianqiang Fan","doi":"10.3389/fmed.2025.1640888","DOIUrl":"https://doi.org/10.3389/fmed.2025.1640888","url":null,"abstract":"<p><strong>Aims: </strong>Poorly controlled diabetes is closely associated with obesity. This study aimed to investigate the associations and predictive values of obesity-related indicators including waist circumference (WC), body mass index (BMI), weight-adjusted waist index (WWI), and waist-to-height ratio (WHTR) with uncontrolled diabetes mellitus (DM) in an elderly Chinese community population.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 15,673 elderly diabetic patients from health examinations in Shangyu District in 2024. Receiver operating characteristic (ROC) curve analysis was used to compare the predictive performance of four obesity indicators for uncontrolled DM. Multivariable logistic regression was performed to assess their associations, while the threshold effects were detected by two piecewise linear models. Subgroup analyses were also performed.</p><p><strong>Results: </strong>ROC analysis revealed WC had the highest Area under curve (AUC) (0.53, 95%CI: 0.52-0.54), significantly outperforming BMI (<i>p</i> < 0.001). Multivariable analysis demonstrated that WC, WWI and WHTR exhibited piecewise linear relationships with uncontrolled DM. Notably, WC showed a nonlinear association only in women (threshold = 70.5 cm), beyond which the risk of uncontrolled DM significantly increased (OR = 1.02, 95%CI: 1.01-1.03). WWI displayed a nonlinear pattern exclusively in men (threshold = 9.60 cm/√kg), with higher values associated with elevated risk (OR = 1.37, 95%CI: 1.24-1.51). WHTR exhibited nonlinear relationships in both genders (thresholds: men = 0.46, women = 0.45), with high risk of uncontrolled DM observed at above thresholds.</p><p><strong>Conclusion: </strong>WC was the strongest predictor of uncontrolled DM in the elderly population. The nonlinear relationships between WC/WWI and the risk of uncontrolled DM exhibit gender-specific threshold effects.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1640888"},"PeriodicalIF":3.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12504510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Angiopoietin-1 induces survival and proliferation of hair follicle dermal papilla cells through integrin α5β1 signaling.","authors":"Jang-Hyuk Yun","doi":"10.3389/fmed.2025.1649763","DOIUrl":"https://doi.org/10.3389/fmed.2025.1649763","url":null,"abstract":"<p><strong>Background: </strong>Androgenetic alopecia is a common form of hair loss primarily mediated by dihydrotestosterone (DHT), which induces apoptosis and inhibits proliferation in dermal papilla cells (DPCs). Current treatments, such as minoxidil and finasteride, often show limited efficacy and can cause adverse effects, underscoring the need for safer and more targeted therapies.</p><p><strong>Methods: </strong>This study investigated the protective and proliferative effects of angiopoietin-1 (Ang1) on human follicle dermal papilla cells (HFDPCs) under DHT-induced stress. Apoptosis and proliferation were assessed using flow cytometry and BrdU assays. Western blotting was used to examine intracellular signaling pathways. The expression and functional relevance of Tie and integrin receptors were evaluated using gene expression analysis and blocking antibodies.</p><p><strong>Results: </strong>Ang1 significantly reduced DHT-induced apoptosis and restored proliferation in HFDPCs. These effects were mediated via activation of the PI3K/AKT and MAPK/ERK1/2 pathways through integrin α5β1. Neither Tie-1 nor Tie-2 receptors were detected in HFDPCs, indicating that Ang1 acts through a Tie-2-independent mechanism. Given the well-established role of Ang1 in promoting vascular stability via the Tie-1-Tie-2 axis in endothelial cells, it is plausible that Ang1 may also support follicular health indirectly by enhancing perifollicular vascularization.</p><p><strong>Conclusion: </strong>Ang1 enhances HFDPC survival and proliferation through integrin α5β1-mediated signaling. In addition to its direct protective effects on DPCs, Ang1 may promote angiogenic support in the hair follicle microenvironment. These findings position Ang1 as a potential dual-action therapeutic candidate for androgenetic alopecia.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1649763"},"PeriodicalIF":3.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12504495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrative analysis of serum microorganisms and serum metabolomics in osteoporosis patients based on 16S rDNA sequencing and UHPLC/MS-based metabolomics.","authors":"Yu Liu, Yun Li, Jiehua Li","doi":"10.3389/fmed.2025.1664359","DOIUrl":"https://doi.org/10.3389/fmed.2025.1664359","url":null,"abstract":"<p><strong>Introduction: </strong>Although significant progress has been made in the treatment and research of osteoporosis patients in recent years, the genetic mechanism of osteoporosis has not yet been fully elucidated.</p><p><strong>Methods: </strong>We conducted a comprehensive analysis using 16S sequencing and UHPLC-MS/MS metabolomics data to characterize the microbial composition and metabolic composition in the serum of osteoporosis patients.</p><p><strong>Results: </strong>At the phylum level, <i>Proteobacteria</i> are mainly present in Osteoporosis; In Normal, it is mainly <i>Bacteroidota</i>. At the genus level, <i>Cupriavidus</i> is the main species in Osteoporosis; In Normal, the main ones are <i>Blautia</i>, <i>Bacteroides</i>, <i>Alcaligenes</i> and <i>Pseudomonas</i>. Serum metabolomics revealed different metabolites (230 significantly differentially expressed metabolites) and lipid metabolism pathways (such as Glycerophospholipid metabolism) among the two groups. The combined serum microbiota and serum metabolomics datasets demonstrate a correlation reflecting the impact of microbiota on metabolic activity (<i>p</i> < 0.05).</p><p><strong>Discussion: </strong>Our research findings indicate that microbiota and metabolomics analysis provide important candidate biomarkers. The correlation between these serum microbiota and host metabolism is of great significance for optimizing early diagnosis and developing personalized treatment strategies. This study elucidates the relationship between serum microbiota and metabolites in osteoporosis.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1664359"},"PeriodicalIF":3.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12504294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-fidelity 3D models of human cadavers and their organs with the use of handheld scanner-Alternative method in medical education and clinical practice.","authors":"Weronika Michalik, Magdalena Szczepanik, Konrad Biel, Michał Mordarski, Kacper Bak, Kamila Fryzlewicz, Karol Jaszewski, Szymon Maciaszek, Monika Pierzchała, Areej Arshad, Daniel Rams, Jerzy Walocha, Halina Dobrzynski, Małgorzata Mazur","doi":"10.3389/fmed.2025.1644808","DOIUrl":"https://doi.org/10.3389/fmed.2025.1644808","url":null,"abstract":"<p><strong>Background: </strong>Traditional cadaveric dissection is considered the gold standard in anatomical education; however, its accessibility is limited by ethical, logistical, and financial constraints. Recent advancements in three-dimensional (3D) scanning technologies provide an alternative approach that enhances anatomical visualization while preserving the fidelity of real human specimens.</p><p><strong>Aim: </strong>This study aimed to create digitized 3D models of dissected human cadaveric specimens using a handheld structured-light scanner, thus providing a sustainable and accessible resource for educational and clinical applications.</p><p><strong>Methods: </strong>Eight human cadaveric specimens were dissected and scanned using the Artec 3D Spider handheld scanner. The obtained scans were processed in Artec Studio 17 Professional and further processed in Blender software. Finalized 3D models were exported in.MP4 format and paired with two-dimensional (2D) images for enhanced anatomical understanding.</p><p><strong>Results: </strong>A total of 12 anatomical 3D models were successfully created, capturing detailed anatomical landmarks with a resolution of 0.1 mm and an accuracy of 0.05 mm. The models encompassed key anatomical regions or organs, including the brain, skull, face, neck, thorax, heart, abdomen, pelvis, and lower limb. The combination of 3D models alongside 2D images allowed for interactive and immersive learning, as well as improving spatial comprehension of complex anatomical structures.</p><p><strong>Conclusion: </strong>The use of high-fidelity 3D scanning technology provides a promising alternative to traditional dissection by offering an accessible, sustainable, and detailed representation of spatial relationships in the human body. This approach enhances medical education and clinical practice, bridging the gap between theoretical knowledge and practical application.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1644808"},"PeriodicalIF":3.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12504884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the relationships between clinical manifestations and sex hormones, thyroid hormones, and menstrual factors in female Parkinson's disease patients.","authors":"Fan Wang, Jing Zhao, Jichen Du, Jilai Li, Peifu Wang, Zhong Yi, Tao Feng, Zhirong Wan","doi":"10.3389/fmed.2025.1573768","DOIUrl":"https://doi.org/10.3389/fmed.2025.1573768","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Parkinson's disease (PD) affects both sexes, but there are notable differences in its clinical manifestations and management in women.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to compare variations in sex and thyroid hormone levels and menstrual factors between postmenopausal women with and without motor complications (PWP-MC and PWP-nMC, respectively) and analyze their correlations with motor complications.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Ninety-five Postmenopausal Women with Parkinson's Disease (PWP) provided data on age at menarche, age at menopause, menstrual cycle duration (interval between cycle starts (days)), total years of menstruation (menopausal age - age at menarche), thyroid disease history, and gynecological surgical history. Six sex hormones and seven thyroid function indicators were measured, followed by an analysis of the relationships among sex hormone levels, thyroid function, menstrual factors, clinical characteristics, and disease severity in PWP. The effects of sex hormones and menstrual factors on motor complications in PWP were also investigated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The results revealed several key findings: (1) PWP-MC exhibited lower serum prolactin levels than PWP-nMC (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). (2) In PWP, serum estradiol levels were negatively correlated with Hamilton Anxiety Rating Scale (HAMA) scores (&lt;i&gt;r&lt;/i&gt; = -0.208, &lt;i&gt;p&lt;/i&gt; = 0.043). (3) There were no statistically significant differences in age at menarche, age at menopause, menstrual cycle duration, menstruation duration (Days of active bleeding per cycle), or total years of menstruation between PWP-MC and PWP-nMC (&lt;i&gt;p&lt;/i&gt; &gt; 0.05). (4) In PWP, age at menarche was negatively correlated with Mini-Mental State Examination (MMSE) scale scores (&lt;i&gt;r&lt;/i&gt; = -0.264, &lt;i&gt;p&lt;/i&gt; = 0.01) and Montreal Cognitive Assessment (MoCA) scale scores (&lt;i&gt;r&lt;/i&gt; = -0.297, &lt;i&gt;p&lt;/i&gt; = 0.004); total years of menstruation were positively correlated with MoCA scale scores (&lt;i&gt;r&lt;/i&gt; = 0.278, &lt;i&gt;p&lt;/i&gt; = 0.006); menstrual cycle duration was negatively correlated with Unified Parkinson's Disease Rating Scale, Part III (UPDRS-III) scores (&lt;i&gt;r&lt;/i&gt; = -0.246, &lt;i&gt;p&lt;/i&gt; = 0.016) and Hoehn-Yahr (H-Y) stages (&lt;i&gt;r&lt;/i&gt; = -0.236, &lt;i&gt;p&lt;/i&gt; = 0.021); and menstruation duration was positively correlated with HAMA (&lt;i&gt;r&lt;/i&gt; = 0.215, &lt;i&gt;p&lt;/i&gt; = 0.036) and Non-Motor Symptoms Scale (NMSS) scores (&lt;i&gt;r&lt;/i&gt; = 0.214, &lt;i&gt;p&lt;/i&gt; = 0.037). (5) In PWP-MC, age at menopause and total years of menstruation were positively correlated with Hamilton Depression Rating Scale (HAMD) scores (&lt;i&gt;r&lt;/i&gt; = 0.335, &lt;i&gt;p&lt;/i&gt; = 0.043; &lt;i&gt;r&lt;/i&gt; = 0.352, &lt;i&gt;p&lt;/i&gt; = 0.033, respectively); menstruation duration was negatively correlated with UPDRS-III scores (&lt;i&gt;r&lt;/i&gt; = -0.362, &lt;i&gt;p&lt;/i&gt; = 0.028) and positively correlated with HAMD (&lt;i&gt;r&lt;/i&gt; = 0.329, &lt;i&gt;p&lt;/i&gt; = 0.047) and HAMA (&lt;i&gt;r&lt;/i&gt; = 0.451, &lt;i&gt;p&lt;/i&gt; = 0.005) scores; and menstruation duration was positively correlated with NMSS (&lt;i&gt;r&lt;/i&gt; = 0.","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1573768"},"PeriodicalIF":3.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12504241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A bibliometric analysis of the current state and future directions of osteoporosis pharmacological treatment.","authors":"Xianxian Zhou, Hua Xiong, Dexi Hu","doi":"10.3389/fmed.2025.1622425","DOIUrl":"https://doi.org/10.3389/fmed.2025.1622425","url":null,"abstract":"<p><strong>Introduction: </strong>Osteoporosis is a major health threat, particularly with the aging population in China. Medication remains a cornerstone of management, and bibliometric analysis can provide insights into current research status and future directions.</p><p><strong>Methods: </strong>Relevant literature from the Science Citation Index Core Collection (2015-2024) was analyzed using bibliometric methods. Visual maps were generated with Citespace 6.3R3 and VOSviewer 1.6.19 to assess research trends and hotspots.</p><p><strong>Results: </strong>A total of 2,738 publications were included, showing a steady growth in research since 2015. The United States led in output, with the University of Toronto as the most productive institution. Brandi, Maria Luisa, and Kanis JA were the most influential authors, while Osteoporosis International and The Journal of Bone and Mineral Research were the most cited journals. Key themes included extracellular vesicles, romosozumab, bisphosphonates, and breast cancer, with recent attention on targeted drug delivery, treatment efficacy, and medication management. Emerging keywords from 2022 to 2023, such as exosomes, inflammation, and osteogenic differentiation, reflected advances in therapeutic mechanisms and clinical applications.</p><p><strong>Conclusion: </strong>Future research will likely emphasize targeted drug delivery, clinical efficacy and safety, and molecular targeted therapies, with the development of new anti-osteoporosis drugs remaining a key focus.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1622425"},"PeriodicalIF":3.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12504286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of a new coaxial bipolar electrode for the treatment of vertebral metastases: a pilot study in an ovine model.","authors":"Francesca Salamanna, Matilde Tschon, Giuseppe Tedesco, Lucia Martini, Melania Maglio, Luca Cavazza, Noemi Dolciotti, Federico Rossano, Micaela Liberti, Simona Salati, Matteo Cadossi, Davide Maria Donati, Laura Campanacci, Gianluca Giavaresi, Alessandro Gasbarrini, Milena Fini","doi":"10.3389/fmed.2025.1627296","DOIUrl":"https://doi.org/10.3389/fmed.2025.1627296","url":null,"abstract":"<p><strong>Introduction: </strong>Spinal metastases account for approximately 90% of masses detected through spinal imaging. Therefore, it is imperative to advance therapies. Electroporation modifies the permeability of cancer cell membranes using electric energy, increasing the local uptake of chemotherapeutics and promoting local tumor control. The aim of this study was to evaluate the safety of delivering electrical pulses that induce tissue ablation using novel coaxial bipolar electrodes in healthy bone and clinically relevant structures in an ovine model.</p><p><strong>Methods: </strong>Electroporation was performed on sheep vertebral bodies (L2-L4) applying an electric field intensity sufficient to deliver at least 3,500 J/Kg, absorbed energy previously shown to be effective in ablating bone tissue. The study also examined the impact on surrounding sensitive structures, such as peripheral nerves and the spinal cord. Effectiveness and safety assessment was performed by clinical evaluation, histological analysis and numerical simulation.</p><p><strong>Results: </strong>The results showed that the ablation induced by electroporation was clearly visible 7 days after treatment. This was confirmed histologically by the absence of osteoblasts, the complete inhibition of bone apposition, the presence of pyknotic osteocytes and the empty lacunae. The absence of tetracycline fluorescence further confirmed the absence of bone tissue growth in the ablated area. Histomorphometric analysis showed a significant difference (<i>p <</i> 0.0005) in the ablated area between the L2 vertebral body (where the electric field was applied with a single bipolar electrode; ablation area: 99.56 ± 18.00 mm²) and L3 and L4 vertebrae (where the electric field was applied by 2 bipolar electrodes; ablation area: 238.97 ± 81.44 mm²). Computational modeling showed that the estimated ablation volume was 0.43 cm³ in L2 and 3.45 cm³ in L4. Furthermore, no deficits following the application of the electrical pulses were observed in spinal nerves and spinal cord.</p><p><strong>Discussion: </strong>In agreement with these findings, temperature estimation based on computational simulation showed negligible increase in the spinal cord at the level of treated vertebra. Utilizing coaxial bipolar electrodes within the vertebral body through a transpedicular approach could offer a safe and minimally invasive procedure to treat spinal tumors and metastases, regardless of lesion size, while safeguarding critical neural structures.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1627296"},"PeriodicalIF":3.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12504192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"General anesthesia with spontaneous breathing and laryngeal mask airway intubation combined with peripheral nerve block in orthopedic surgery: a retrospective study.","authors":"Jiahui Tu, Piao Peng, Zhaodong Xiong","doi":"10.3389/fmed.2025.1584437","DOIUrl":"https://doi.org/10.3389/fmed.2025.1584437","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the effect of general anesthesia with spontaneous breathing laryngeal mask airway (LMA) intubation combined with a peripheral nerve block (PNB) in orthopedic surgery through a retrospective study.</p><p><strong>Methods: </strong>Data from 160 adult patients (American Society of Anesthesiologists grade 1-3) who underwent elective orthopedic surgery under general anesthesia with LMA intubation combined with PNB were retrospectively analyzed. All patients received ultrasound-guided PNB before general anesthesia. Among them, 78 patients were assigned to the spontaneous breathing group and 82 patients to the pressure-controlled ventilation group. The parameters compared included baseline characteristics, perioperative anesthetic drug dosages, anesthesia recovery time, adverse events during recovery, numerical rating scale score at 2 h postoperatively, postoperative pulmonary complications, hospitalization costs, and length of stay.</p><p><strong>Results: </strong>Both groups successfully completed the surgeries. Compared to the pressure-controlled ventilation group, the spontaneous breathing group exhibited significantly lower doses of fentanyl and rocuronium bromide (<i>p</i> < 0.001), shorter length of stay (<i>p</i> = 0.047), reduced incidence of postoperative hypertension in the post-anesthesia care unit (<i>p</i> < 0.001), and lower anesthesia costs (<i>p</i> < 0.001) and total hospitalization costs (<i>p</i> = 0.001). No statistically significant differences were observed between the two groups in baseline characteristics, anesthesia recovery time, incidence of postoperative hypoxemia or hypotension in the post-anesthesia care unit, numerical rating score at 2 h postoperatively, incidence of postoperative pulmonary complications, or surgical costs.</p><p><strong>Conclusion: </strong>General anesthesia with spontaneous breathing LMA intubation combined with PNB is safe and feasible for elective orthopedic surgeries in adults. This approach is beneficial in shortening the length of stay and reducing hospitalization costs.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1584437"},"PeriodicalIF":3.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12504287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of GPT-4 for planning acupuncture treatment: comparison with human clinician performance.","authors":"Da-Eun Yoon, Cheol-Han Kim, Yeonhee Ryu, Ye-Seul Lee, Younbyoung Chae","doi":"10.3389/fmed.2025.1632303","DOIUrl":"https://doi.org/10.3389/fmed.2025.1632303","url":null,"abstract":"<p><strong>Background: </strong>The medical knowledge of GPT-4 has been evaluated on patient data, providing diagnostic and treatment suggestions. However, few studies have directly compared the clinical suggestions of GPT-4 with those of groups of practitioners.</p><p><strong>Methods: </strong>This study assessed the ability of GPT-4 to make medical decisions regarding acupuncture treatment by comparing its selection of acupoints with those made by human clinicians. Ten case reports published in Korean medical journals were selected and put in a standardized format. The standardized patient information was given to 80 Korean Medicine doctors and GPT-4 to diagnose and prescribe three to five acupoints per case. To evaluate the performance of GPT-4, the similarities in acupoint selection between the doctors and GPT-4 were quantified based on the percentage overlap and correlations of the selection probabilities of acupoints in each case.</p><p><strong>Results: </strong>The average percentage overlap for acupoints among cases at the 10% cutoff was 51.3%, i.e., more than half of the GPT-4 acupoint suggestions overlapped the acupoints selected by the doctors. In half of the cases, significant correlations were observed in the acupoint selection probabilities, implying that GPT-4 acupoint suggestions are similar to those of doctors.</p><p><strong>Conclusions: </strong>GPT-4 made reasonable acupoint suggestions, with notable overlap observed with the prescriptions of doctors. This shows its promise for supporting medical decisions, education, and personalized medicine for patients undergoing acupuncture treatment. Future studies and validation are necessary to ensure the reliability and efficacy of applying GPT-4 in real-world settings.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1632303"},"PeriodicalIF":3.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12504477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}