Frontiers in Medicine最新文献

{"title":"REDD1 attenuates cholestatic liver fibrosis and suppresses PI3K/AKT/mTOR pathway.","authors":"Xiaonan Li, Xin Liu, Xinrui Shi, Zixu Li, Qizhi Shuai, Tingjuan Huang, Yun Liu, Junjie Ren","doi":"10.3389/fmed.2025.1628260","DOIUrl":"https://doi.org/10.3389/fmed.2025.1628260","url":null,"abstract":"<p><strong>Introduction: </strong>Liver fibrosis is reversible. Cholestasis is an important factor causing liver fibrosis. However, there are currently no effective anti-fibrotic drugs for cholestatic liver fibrosis in clinical practice.</p><p><strong>Methods: </strong>mRNA sequencing was performed using mouse bile duct ligation (BDL) of liver tissue, and RT-qPCR was used to screen for the target gene REDD1. Immunohistochemistry was used to detect the expression of REDD1, CD68, α-SMA, and PI3K/AKT/mTOR signaling pathways in primary biliary cholangitis (PBC) patient liver tissue. Subsequently, adenovirus mediated REDD1 was transfected into mouse liver tissue via tail vein to evaluate its therapeutic effect.</p><p><strong>Results: </strong>RNA sequencing revealed REDD1 was significantly upregulated in BDL-induced fibrotic liver tissue. REDD1 expression correlated positively with α-SMA and CD68 in PBC patients, suggesting its involvement in fibrogenesis. However, REDD1 overexpression ameliorated BDL-induced liver injury, reduced serum ALT/AST levels, and decreased collagen deposition, as evidenced by histological and molecular analyses (α-SMA and collagen I), indicating that REDD1 exhibited compensatory elevation in liver fibrosis. Additionally, PI3K/AKT/mTOR pathway was involved in the improvement of liver fibrosis by REDD1.</p><p><strong>Conclusions: </strong>These findings highlight REDD1 as a potential therapeutic target for liver fibrosis, acting probably through modulation of the PI3K/AKT/mTOR pathway to mitigate fibrotic processes.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1628260"},"PeriodicalIF":3.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12504318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258082","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":"One-year outcomes of a surgical technique for stabilizing the intraocular lens-capsular bag complex in severely subluxated cataracts using permanent polypropylene capsular hooks.","authors":"Rui Feng, Guoliang Li, Yanni Luo, Binjian Wang, Yihao Zhao, Chao Qu","doi":"10.3389/fmed.2025.1574908","DOIUrl":"https://doi.org/10.3389/fmed.2025.1574908","url":null,"abstract":"<p><strong>Purpose: </strong>To report the one-year follow-up outcomes of a surgical technique designed to rescue severely subluxated cataracts and stabilize the intraocular lens (IOL)-capsular bag complex using permanent polypropylene capsular hooks.</p><p><strong>Methods: </strong>Four patients (four eyes) with severely subluxated cataracts underwent surgery. A spatula was used to elevate and stabilize the dislocated lens in the retropupillary space to facilitate capsulorhexis. Phacoemulsification and aspiration were performed using capsular retractors and a capsular tension ring. Permanent polypropylene capsular hooks were implanted to stabilize the IOL-capsular bag complex. Postoperative outcomes were assessed over a follow-up period of at least 1 year. Descriptive analyses were performed to summarize and report the outcomes of this limited case series.</p><p><strong>Results: </strong>The follow-up period ranged from 13 to 20 months. All patients demonstrated improved and stable subjective refraction and best-corrected visual acuity (BCVA). At the final follow-up, the mean postoperative prediction error was -0.17 ± 0.29 D. Slit-lamp examinations showed that the IOL-capsular bag complex and the permanent polypropylene capsular hooks remained stable. Anterior segment optical coherence tomography (AS-OCT) revealed minimal IOL tilt of 1.52 ± 1.20. No intraoperative or postoperative complications were reported.</p><p><strong>Conclusion: </strong>The technique offers a viable approach for managing severely subluxated cataracts, providing stable support for the IOL-capsular bag complex and yielding favorable clinical outcomes. However, as this novel technique was evaluated in a small sample size, further studies with larger cohorts and longer follow-up periods are needed to confirm its long-term safety and efficacy.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1574908"},"PeriodicalIF":3.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12504315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258041","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":"Global burden of childhood Burkitt lymphoma (1990-2021): epidemiological trends, regional disparities, and projections for 2035 from the Global Burden of Disease Study.","authors":"Guoqian Ma, Changyu Hou, Yuan Li, Fan Jia","doi":"10.3389/fmed.2025.1619750","DOIUrl":"https://doi.org/10.3389/fmed.2025.1619750","url":null,"abstract":"<p><strong>Background: </strong>Burkitt lymphoma (BL) is a highly aggressive pediatric B-cell lymphoma with marked geographic heterogeneity. Up-to-date global estimates are needed to inform prevention and care.</p><p><strong>Methods: </strong>We analyzed Global Burden of Disease (GBD) 2021 data to estimate incidence, mortality, and disability-adjusted life years (DALYs) for childhood BL (0-14 years) from 1990 to 2021 across 204 countries/territories, stratified by sex, age, region, and Sociodemographic Index (SDI). Trends were summarized using joinpoint annual percent change and estimated annual percentage change (EAPC). Bayesian age-period-cohort models projected the burden to 2035.</p><p><strong>Findings: </strong>In 2021, there were 4,083 incident BL cases globally [95% uncertainty interval (UI) 2,688-5,171]. The global incidence rate was 0.20 per 100,000 (95% UI 0.13-0.26) versus 0.16 per 100,000 (95% UI 0.10-0.23) in 1990. Burden varied substantially by development level: the low-SDI region had the highest incidence rate (0.44 per 100,000, 95% UI 0.26-0.59), mortality rate (0.43 per 100,000, 95% UI 0.25-0.58), and DALY rate (36.19 per 100,000, 95% UI 21.00-48.64). High-SDI regions showed lower mortality rates and evidence of declines, consistent with broader access to timely diagnosis, multi-agent chemotherapy, and supportive care. By 2035, the incidence rate is expected to reach 0.15 (95% CI 0.11-0.19) per 100,000, the mortality rate to 0.10 (95% CI 0.07-0.13) per 100,000, and the DALY rate to 8.21 (95% CI 5.98-10.43) per 100,000.</p><p><strong>Interpretation: </strong>Global BL rates appear broadly stable, with pronounced inequities concentrated in low-SDI settings. Apparent improvements are heterogeneous, not universal, and are most evident in high-SDI regions where treatment and supportive care are widely available. Projections to 2035 suggest modest declines in global rates, contingent on sustained malaria control and expanded access to diagnosis and curative therapy in high-burden regions. Targeted investments linking infection control with pediatric oncology capacity are required to reduce the global burden of childhood BL.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1619750"},"PeriodicalIF":3.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12504260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258046","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":"Bridging the gaps between randomized controlled trials and real-world use of thrombopoietin receptor agonists for adult primary immune thrombocytopenia: a systematic review and meta-analysis.","authors":"Liping Luo, Shanshan Jin, Zhujin Song, Gaowei Chong, Haiying Ding, Su Zeng, Mengfei Dai, Miaolian Wu","doi":"10.3389/fmed.2025.1667457","DOIUrl":"https://doi.org/10.3389/fmed.2025.1667457","url":null,"abstract":"<p><strong>Background: </strong>Randomized controlled trials (RCTs) evaluate short-term efficacy/safety of thrombopoietin receptor agonists (TPO-RAs) in immune thrombocytopenia (ITP), leaving long-term outcomes unclear. This study integrates real-world evidence (RWE) with RCT to assess TPO-RA performance across treatment durations.</p><p><strong>Methods: </strong>A systematic literature search identified RCTs and real-world studies (RWS) assessing TPO-RAs in adults with primary ITP. Short-term (≤6 months) and long-term (6-12/>12 months) outcomes included platelet response, rescue therapy, bleeding events, and adverse events (AEs). Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random/fixed-effects models.</p><p><strong>Results: </strong>Meta-analysis included 12 RCTs and 32 RWS. Short-term TPO-RA administration yielded 70% platelet response versus placebo (OR = 18.07, 95% CI:12.4-26.16, <i>p</i> < 0.001), escalating to 85% (6-12 months) and 91% (>12 months) in RWS. TPO-RAs reduced bleeding risks (any: OR = 0.43, significant: OR = 0.40, both <i>p</i> < 0.001). Rescue therapy increased from 12% (short-term) to 32% (>12 months). Serious AE (SAE) incidence matched placebo short-term (OR = 0.69, 95% CI:0.47-1.01) but rose from 8% (RCTs) to 27% (RWS > 12 months).</p><p><strong>Conclusion: </strong>TPO-RAs sustain durable platelet response but exhibit increase in rescue therapy and SAEs over time. Longitudinal RWS integration into ITP management is critical, necessitating protocolized safety monitoring and personalized regiments to optimize chronic TPO-RA utilization.</p><p><strong>Systematic review registration: </strong>http://www.crd.york.ac.uk/PROSPERO, identifier [CRD42025649608].</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1667457"},"PeriodicalIF":3.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12504389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258059","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":"Diagnostic efficacy of magnifying endoscopy with blue laser imaging for laryngopharyngeal reflux.","authors":"Rong Wang, Min Yu, Chaoyuan Chen, Xi Chen, Yongxiu Lin, Jianzhen Li, Gang Liu, Huan Huang, Dazhou Li, Wen Wang","doi":"10.3389/fmed.2025.1642702","DOIUrl":"https://doi.org/10.3389/fmed.2025.1642702","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to analyze the utility of magnifying endoscopy with blue laser imaging (ME-BLI) in diagnosing laryngopharyngeal reflux (LPR).</p><p><strong>Methods: </strong>The study enrolled 106 patients based on LPR-related symptoms. Using the reflux symptom index (RSI) and reflux finding score (RFS) scales as the clinical reference standard, the study cohort comprised 68 patients with LPR (RSI >13 and/or RFS >7) and 38 controls (RSI ≤13 and RFS ≤7). All participants underwent upper gastrointestinal endoscopy with ME-BLI. The patients were classified into Grades 1-4 based on the pharyngolaryngeal appearance under ME-BLI and the visibility and characteristics of intraepithelial papillary capillary loops (IPCLs) in the pharyngolaryngeal mucosa. Grades 3 and 4 were defined as LPR-positive. The diagnostic performance of ME-BLI for LPR was compared to the RSI/RFS criteria.</p><p><strong>Results: </strong>Compared with the RSI/RFS clinical reference standard, ME-BLI demonstrated a sensitivity of 89.71% (95% CI: 81.54-94.44%), a specificity of 73.68% (95% CI: 59.72-84.03%), a positive predictive value of 85.92% (95% CI: 76.34-92.04%), and a negative predictive value of 80.00% (95% CI: 64.06-90.04%) for LPR diagnosis. It also showed good consistency with RSI/RFS diagnosis (Kappa = 0.65, 95% CI: 0.52-0.78, <i>p</i> < 0.001). Good interobserver agreement in ME-BLI grading was noted (ICC = 0.858, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>LPR has characteristic pharyngeal manifestations. ME-BLI could potentially improve LPR diagnostic accuracy; however, further validation is required.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1642702"},"PeriodicalIF":3.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12504507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258038","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":"Tear film thickness and stability following femtosecond-assisted laser <i>in situ</i> keratomileusis: a comparison of high- and low-myopia.","authors":"Yan Li, Haibo Yan, Hua Yang, Shiyang Niu, Hong Qi, Chunyan Zhang","doi":"10.3389/fmed.2025.1650495","DOIUrl":"https://doi.org/10.3389/fmed.2025.1650495","url":null,"abstract":"<p><strong>Background: </strong>To investigate the relationship between tear film thickness, corneal epithelial thickness, tear film breakup location, and dry eye in patients with high- and low-myopia undergoing femtosecond-assisted laser <i>in situ</i> keratomileusis (FS-LASIK).</p><p><strong>Methods: </strong>A total of 52 patients (52 eyes) were enrolled and divided into a low-myopia group (LMG; spherical equivalent ≤-3.00 D; 26 eyes) and a high-myopia group (HMG; spherical equivalent ≥-6.00 D; 26 eyes). The Ocular Surface Disease Index (OSDI), fluorescein tear film breakup time (FBUT), corneal epithelial thickness (CET), tear film thickness (TFT), and other tear film stability markers were evaluated preoperatively. Each parameter was evaluated preoperatively at 1 and 3 months postoperatively.</p><p><strong>Results: </strong>At 1 month postoperatively, the HMG showed significantly higher OSDI scores and CET compared to the LMG (<i>p</i> < 0.05). Conversely, the FBUT and TFT were significantly lower in the HMG at the same time point (<i>p</i> < 0.05). Within a 6- to 7-mm corneal diameter, the TFT was significantly lower in the HMG than in the LMG (<i>p</i> < 0.05). Furthermore, the change in CET from baseline at 1 and 3 months postoperatively was significantly greater in the HMG, especially within the 5-mm corneal diameter (<i>p</i> < 0.05). There were no significant differences in spherical equivalent (SE) or uncorrected distance visual acuity (UDVA) between 1 and 3 months postoperatively within either group (<i>p</i> > 0.05).</p><p><strong>Conclusion: </strong>The observed alterations in tear film thickness, tear film distribution, FBUT, and tear film breakup location, affected by varying corneal stromal ablation depths, contribute to the development of dry eye disease following FS-LASIK. The extent of corneal epithelial remodeling after FS-LASIK correlates with the degree of refractive correction but not with refractive regression, and may play a role in tear film stability recovery.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1650495"},"PeriodicalIF":3.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12504243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257620","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":"VFM-SSL-BMADCC-Framework: vision foundation model and self-supervised learning based automated framework for differential cell counts on whole-slide bone marrow aspirate smears.","authors":"Shirong Zhou, Longrong Ran, Yuanyou Yao, Xing Wu, Yao Liu, Chengliang Wang, Zhongshi He, Zailin Yang","doi":"10.3389/fmed.2025.1624683","DOIUrl":"https://doi.org/10.3389/fmed.2025.1624683","url":null,"abstract":"<p><strong>Background: </strong>Differential cell counts (DCCs) on bone marrow aspirate (BMA) smear is a critical step in the diagnosis and treatment of blood and bone marrow diseases. However, manual counts relies on the experience of pathologists and is very time-consuming. In recent years, deep learning-based intelligent cell detection models have achieved high detection accuracy on datasets of specific diseases and medical centers, but these models depend on a large amount of annotated data and have poor generalization. When the detection task changes or model is applied in different medical centers, we need to re-annotate a large amount of data and retrain the model to ensure detection accuracy.</p><p><strong>Methods: </strong>To address the above issues, we designed an automated framework for whole-slide bone marrow aspirate smear differential cell counts (BMADCC), called VFM-SSL-BMADCC-Framework. This framework only requires whole-slide images (WSIs) as input to generate DCCs. The vision foundation model SAM, known for its strong generalization ability, precisely segments cells within the countable regions of the BMA. The MAE, pre-trained on a large unlabeled cell dataset, excels in generalized feature extraction, enabling accurate classification of cells for counting. Additionally, TextureUnet and TCNet, with their powerful texture feature extraction capabilities, effectively segment the body-tail junction areas from WSIs and classify suitable tiles for DCCs. The framework was trained and validated on 40 WSIs from Chongqing Cancer Hospital. To assess its generalization ability across different medical centers and diseases, correlation tests were conducted using 13 WSIs from Chongqing Cancer Hospital and 5 WSIs from Southwest Hospital.</p><p><strong>Results: </strong>The framework demonstrated high accuracy across all stages: The IoU for region of interest (ROI) segmentation was 46.19%, and the accuracy for tile of interest (TOI) classification was 90.45%, the Recall75 for cell segmentation was 99.01%, and the accuracy for cell classification was 77.92%. Experimental results indicated that the automated framework had excellent cell classification and counts performance, suitable for BMADCC across different medical centers and diseases. The differential cell counts results from all centers were highly consistent with manual analysis.</p><p><strong>Conclusion: </strong>The proposed VFM-SSL-BMADCC-Framework effectively automates differential cell counts on bone marrow aspirate smears, reducing reliance on extensive annotations and improving generalization across medical centers.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1624683"},"PeriodicalIF":3.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12504877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257764","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":"Case Report: A rare case of giant gallbladder associated with adverse reactions to anlotinib.","authors":"Jihao Cheng, Xin Wang, Jingyun Liao, Yuping Shen","doi":"10.3389/fmed.2025.1665373","DOIUrl":"https://doi.org/10.3389/fmed.2025.1665373","url":null,"abstract":"<p><p>Giant gallbladder (GGB) is a rare condition that is generally associated with biliary obstruction. GGB induced by chemotherapeutic agents have not been previously reported. This article presents a case of GGB potentially related to adverse effects of anlotinib. The patient was a 74-year-old female who had been taking anlotinib regularly for 2 years following the diagnosis of a malignant lung tumor. The patient was admitted because of abdominal pain accompanied by vomiting and discomfort for 11 days. No fever was observed during onset, but inflammatory markers were abnormally elevated, accompanied by impaired liver function. On physical examination, a tender mass was palpable in the right inguinal region. Abdominal computed tomography showed an enlarged gallbladder (18.6 × 7.2 × 5.3 cm). Enhanced magnetic resonance imaging and magnetic resonance cholangiopancreatography ruled out biliary stones or space-occupying lesions, leading to a final diagnosis of acute cholecystitis with GGB. The patient received antibiotic treatment and anlotinib was immediately discontinued. After 1 week of anti-infective therapy, the abdominal pain resolved, vomiting ceased, liver function and inflammatory markers returned to normal ranges, and the gallbladder regressed to a normal size. To our knowledge, this is the first reported case of GGB associated with anlotinib use. Through a literature review, we conducted an in-depth discussion on the pathogenesis of GGB and the pharmacological effects of anlotinib, with the aim of sharing experiences and alerting clinicians to such adverse events.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1665373"},"PeriodicalIF":3.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12504277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258004","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":"Clinical factors associated with uterine rupture in type II angular pregnancy: a 10-year single-institution retrospective study.","authors":"Bao-You Huang, Portia Cobbinah, Hao-Ran Hu, Ya-Shi Zhu, Mei-Qin Yang, Jian-Yi Ding, Xin-Xin Xu, Hui-Juan Zhou, Bo Yin, Ling-Fei Han","doi":"10.3389/fmed.2025.1656273","DOIUrl":"https://doi.org/10.3389/fmed.2025.1656273","url":null,"abstract":"<p><strong>Objective: </strong>To introduce the classification and focus on retrospectively investigating clinical factors associated with uterine rupture.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed 222 cases of angular pregnancies from January 2010 and December 2021. The selected cases were classified into two types, type I (<i>n</i> = 19) and type II (<i>n</i> = 199). Additionally, type II cases were further subdivided into the ruptured group (<i>n</i> = 25) and the unruptured group (<i>n</i> = 174). Clinical data were collected, and univariate and multivariate analyses were performed to identify significant indicators.</p><p><strong>Results: </strong>The mean maternal age was 31.5 ± 5.8 years, with a mean BMI (body mass index) of 22.0 ± 3.2 kg/m² in 199 type II patients. Spontaneous uterine rupture occurred in 25 (12.6%) patients, while 174 (87.4%) remained unruptured. Univariate analysis revealed that abdominal pain (<i>P</i> < 0.001), a history of previous ipsilateral salpingectomy (<i>P</i> = 0.002), vaginal bleeding (<i>P</i> = 0.005), and gestational age (GA) ≥ 7 weeks (<i>P</i> = 0.044) were significant factors of rupture in type II angular pregnancy. Multivariate analysis identified abdominal pain (OR = 10.410, 95% CI: 3.286-32.977, <i>P</i> < 0.000) and ipsilateral salpingectomy (OR = 3.270, 95% CI: 1.209-8.847, <i>P</i> = 0.020) as statistically significant independent risk factors. The ruptured group had clinically and statistically significant lower hemoglobin and higher transfusion rates.</p><p><strong>Conclusion: </strong>The classification system of angular pregnancy (AP) is a valuable tool that facilitates appropriate management and good prognostic outcomes. Type I angular pregnancy can be followed up till term. Type II angular pregnancy is a high-risk form, and clinicians must carefully assess and investigate other factors such as the history of ipsilateral salpingectomy and abdominal pain and high alert for uterine rupture.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1656273"},"PeriodicalIF":3.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12506676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258007","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":"Comparison of the regenerative potential of different functionalized gelatin-based hydrogels as fillers of rabbit corneal wounds.","authors":"Cristina Romo-Valera, Jaime Etxebarria, Vanesa Freire, Maddalen Rodriguez-Astigarraga, Jon Arluzea, Noelia Andollo","doi":"10.3389/fmed.2025.1667446","DOIUrl":"https://doi.org/10.3389/fmed.2025.1667446","url":null,"abstract":"<p><strong>Objectives: </strong>Persistent epithelial defects (PEDs) and chronic corneal ulcers are lesions resistant to treatment for over 2 weeks, risking inadequate healing, reduced sensitivity, and corneal lysis or perforation. This study evaluates the regenerative potential of functionalized gelatin-based hydrogels for treating rabbit corneal wounds as a non-surgical alternative.</p><p><strong>Methods: </strong>Thirty female New Zealand white rabbits underwent anterior stromal keratectomy and were assigned to five groups: control (0.2% HA artificial tears) and four hydrogel treatment groups. Hydrogels included non-functionalized gelatin-RFP (H) and functionalized versions with infliximab (H-Ab), autologous serum (H-AS), and human amniotic membrane extracts (H-HAMe). Crosslinking was performed <i>in situ</i> with blue light. Corneas were evaluated at 7 and 21 days for re-epithelialization, fibrosis, and inflammation using histology, qPCR and immunohistochemistry, focusing on markers of proliferation (Ki67), differentiation (CK3), stemness (<i>PAX6, p63, CD44</i>), adhesion (integrin β4), and fibrosis (<i>α</i>-SMA).</p><p><strong>Results: </strong>All treatments supported re-epithelialization by day 7 and restored barrier function (ZO-1), with H-AS achieving the fastest closure. Expression of the adhesion marker integrin β4 improved over time across all groups. Hydrogel formulations promoted limbal activation (<i>PAX6, CD44</i>), with H-AS and H-HAMe showing elevated <i>p63</i> expression at day 7. All hydrogels reduced fibrosis (<i>α</i>-SMA), though extracellular matrix organization varied. H-Ab and H-HAMe reduced inflammation (<i>IL-1β</i>), while H-AS showed minimal irritability.</p><p><strong>Conclusion: </strong>Functionalized gelatin-RFP hydrogels promote re-epithelialization, reduce fibrosis and inflammation, and restore ocular integrity, offering a promising solution for corneal wound repair.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1667446"},"PeriodicalIF":3.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12504313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258077","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}