Frontiers in Medicine最新文献

{"title":"Correction: Effect of individualized end-inspiratory pause guided by driving pressure on respiratory mechanics during prone spinal surgery: a randomized controlled trial.","authors":"Ting Zhang, Feng Lv, Shuangyu He, Yuntian Zhang, Li Ren, Juying Jin","doi":"10.3389/fmed.2025.1631254","DOIUrl":"https://doi.org/10.3389/fmed.2025.1631254","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/fmed.2025.1537788.].</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1631254"},"PeriodicalIF":3.1,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527260","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":"Association between educational level and postoperative delirium in older patients undergoing abdominal surgery: a two-sample cohort study.","authors":"Mingju Xiang, Jie Liu, Jing Wang, Feng Li, Tingting Fan, Jia Tang","doi":"10.3389/fmed.2025.1581503","DOIUrl":"https://doi.org/10.3389/fmed.2025.1581503","url":null,"abstract":"<p><strong>Background: </strong>Postoperative delirium (POD) is a critical complication in older patients following abdominal surgery, significantly contributing to delayed recovery and prolonged hospital stays. Understanding the risk factors associated with POD is essential for developing effective prevention and intervention strategies. This study investigates the potential impact of educational attainment on the incidence of delirium in this patient population.</p><p><strong>Methods: </strong>This study utilized a two-sample cohort design to collect demographic and educational attainment, and clinical data, including, from older patients undergoing abdominal surgery. The assessment of delirium during the recovery phase was conducted using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) and the 3-Minute Diagnostic Interview for Confusion Assessment Method within the first three postoperative days. In the exploratory cohort, the relationship between education and postoperative delirium was determined by univariate analysis, followed by multivariate logistic regression to determine that education was an independent predictor. The identified risk factors were subsequently validated in an independent validation cohort to ensure robustness and generalizability.</p><p><strong>Results: </strong>The exploratory cohort consisted of 342 cases, while the validation cohort included 150 cases. Exploratory cohort regression analysis identified lower educational attainment and procedures or anesthesia lasting longer than 4 h as independent risk factors for POD. Anesthesia time of more than 4 h was also an independent risk factor for delirium during resuscitation.</p><p><strong>Conclusion: </strong>Lower educational attainment is significantly related to an increased chance of POD in older adults undergoing abdominal procedures. These findings suggest that preoperative assessments should incorporate educational level as a potential risk factor, providing a basis for targeted prevention and intervention strategies to mitigate POD.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1581503"},"PeriodicalIF":3.1,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527310","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":"Retinal vessel metric analysis of type 1 diabetes mellitus in OCT angiography.","authors":"Nianfeng Tang, Na Su, Zetian Zhang, Keren Xie, Qiang Chen, Wen Fan, Junjie Shan, Songtao Yuan","doi":"10.3389/fmed.2025.1562809","DOIUrl":"https://doi.org/10.3389/fmed.2025.1562809","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate retinal vascular characteristics in type 1 diabetes mellitus (T1DM) patients at different stages via optical coherence tomography angiography (OCTA).</p><p><strong>Design: </strong>A retrospective observational study.</p><p><strong>Method: </strong>63 T1DM patients (110 eyes) who underwent OCTA (3*3 mm) examination and 40 age-matched healthy individuals (79 eyes) were included. A deep learning model was used to segment the retinal arteries and veins on OCTA images, and the vascular metrics in the macular area, including fractal dimension (FD), vessel diameter index (VDI), vascular length fraction (VLF), vascular tortuosity, and vessel density (VD) in different zones (fovea, superior parafoveal, inferior parafoveal, nasal parafoveal, and temporal parafoveal) were calculated.</p><p><strong>Results: </strong>In accordance to the diagnostic criteria for diabetic retinopathy (DR), T1DM patients were classified into groups. There were 12 individuals (19 eyes) in the NPDR group, all of whom exhibited non-proliferative DR, and 51 (91 eyes) in the NDR (non-DR) group. The NDR group was divided into 2 subgroups according to the duration of T1DM, with 28 people (49 eyes) having a duration of less than 5 years and 23 people (42 eyes) having a duration of 5 years or more. Built-in metrics of OCTA showed that the VD in each zone of NPDR group was significantly lower than that of control group and NDR group (all <i>p</i> < 0.05). In addition, the VD of the inferior parafoveal vein (<i>P</i> = 0.022) and superior parafoveal artery (<i>P</i> = 0.03) were significantly decreased in the NPDR group. Comparing the VD among NDR subgroups and control group, the VD of the superficial inferior parafovea of T1DM patients of early stage (less than 5 years) was significantly lower than that of normal people (<i>p</i> < 0.05), while the VD of the inferior parafoveal artery increased (<i>P</i> = 0.012).</p><p><strong>Conclusion: </strong>We employed a deep learning vessel segmentation model to analyze the changes in arterial and venous metrics in OCTA images of T1DM patients. Early damage of NPDR to large vessels occurs in the inferior parafoveal vein and the superior parafoveal artery. In patients without DR, the arterial VD of the inferior parafovea has a compensatory increase.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1562809"},"PeriodicalIF":3.1,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527318","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":"Lymphocyte-to-high-density lipoprotein ratio and mortality in asthma patients: a novel immunoinflammatory biomarker with nonlinear association.","authors":"Tu-Lei Tian, Guan-Wei Wu, Mei-Ling Xie, Xiang-Kun Qu, Xiao-Tong Wang, Chang-Lu Sun","doi":"10.3389/fmed.2025.1553188","DOIUrl":"https://doi.org/10.3389/fmed.2025.1553188","url":null,"abstract":"<p><strong>Background: </strong>The lymphocyte-to-high-density lipoprotein ratio (LHR), a novel biomarker reflecting systemic inflammation and immune status, has been widely studied in various diseases. However, its association with mortality risk among asthma patients remains unexplored.</p><p><strong>Methods: </strong>This study utilized data from the National Health and Nutrition Examination Survey (NHANES) spanning 1999-2018, including 5,323 adult asthma patients. Mortality outcomes were ascertained through linkage with the National Death Index (NDI) up to December 31, 2019. Cox proportional hazards models and Fine-Gray competing risk models were employed to examine the association between LHR and mortality risks. Dose-response relationships were assessed using restricted cubic spline analyses.</p><p><strong>Results: </strong>Over a mean follow-up period of 106.95 months, 724 all-cause deaths (13.6%) were recorded. After multivariable adjustment, a one-unit increase in log-transformed LHR was associated with reduced risks of mortality: 18% for all-cause (HR = 0.82, 95% CI: 0.74-0.91), 21% for cardiovascular disease (CVD) (HR = 0.79, 95% CI: 0.65-0.96), and 41% for chronic lower respiratory disease (CLRD) (HR = 0.59, 95% CI: 0.45-0.77). Restricted cubic spline analyses showed an L-shaped association of LHR with all-cause and CLRD mortality, with inflection points at 1.78 and 1.52, respectively. For CVD mortality, a linear association was observed. Competing risk models further confirmed the association of LHR with reduced CLRD mortality (SHR = 0.64, 95% CI: 0.46-0.88), while the association with CVD mortality was no longer significant (SHR = 0.85, 95% CI: 0.70-1.03).</p><p><strong>Conclusion: </strong>LHR is nonlinearly associated with all-cause and CLRD mortality and shows a significant inverse association with CLRD mortality risk. These findings were further validated using competing risk models, highlighting the robustness of the results.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1553188"},"PeriodicalIF":3.1,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527269","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":"Analysis of the learning curve for transvaginal natural orifice transluminal endoscopic surgery in ovarian cystectomy.","authors":"Qiang Zhang, Wenting Dong, Biao Huang, Aijie Xie, Zhaolin Gong, Dan Feng, Li He, Yonghong Lin","doi":"10.3389/fmed.2025.1629418","DOIUrl":"https://doi.org/10.3389/fmed.2025.1629418","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the learning curve for transvaginal natural orifice transluminal endoscopic surgery (vNOTES) in ovarian cystectomy and to identify perioperative factors influencing operative time.</p><p><strong>Methods: </strong>This prospective observational study included 39 patients who underwent vNOTES ovarian cystectomy at Chengdu Women's and Children's Central Hospital between June 2022 and June 2024. Patients were grouped into two surgical phases based on the operating team's self-assessed proficiency. Cumulative sum analysis of operative time (CUSUMOT) was used to model the learning curve and define distinct learning stages. Multivariate linear regression was performed to identify independent predictors of operative time.</p><p><strong>Results: </strong>The mean patient age was 35.14 ± 9.73 years, and the mean operative time was 74.01 ± 30.09 min. Three cases (7.7%) required intraoperative conversion to transumbilical laparoscopy, and two patients (5.1%) experienced perioperative complications. CUSUMOT analysis revealed four distinct learning phases: learning (9 cases), plateau (10 cases), challenging (12 cases), and mature (8 cases). Operative time during the mature phase was significantly shorter than in earlier phases. Multivariate regression identified pelvic adhesions (<i>β</i> = 6.92, <i>p</i> = 0.027), bilateral cysts (β = 6.38, <i>p</i> = 0.019), cyst diameter (β = 2.85 per cm, <i>p</i> = 0.026), and learning curve phase (<i>β</i> = -17.10 for Phase II, <i>p</i> = 0.035) as independent predictors of operative time.</p><p><strong>Conclusion: </strong>vNOTES is a safe and feasible approach for ovarian cystectomy with a measurable learning curve. Proficiency can be achieved after approximately 20 cases. Pelvic adhesions, cyst characteristics, and surgical experience significantly impact operative time. CUSUM analysis is a useful tool for evaluating surgical competency and guiding clinical training in vNOTES procedures.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1629418"},"PeriodicalIF":3.1,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527309","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":"Comprehensive proteomic profiling of intestinal tissues in patients with ulcerative colitis.","authors":"Huiling Wang, Qi Xie, Yi Xie, Weiguang Luo","doi":"10.3389/fmed.2025.1537168","DOIUrl":"https://doi.org/10.3389/fmed.2025.1537168","url":null,"abstract":"<p><strong>Introduction: </strong>Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized by persistent inflammation of the colonic mucosa. This condition can significantly affect the quality of life of those affected. While UC is common, its underlying mechanisms are not yet fully understood, highlighting the need for a comprehensive proteomic analysis of intestinal tissues to identify potential biological changes associated with the disease. This study aimed to investigate the proteomic differences in the intestinal tissues of patients with UC and healthy individuals using high-throughput liquid chromatography-tandem mass spectrometry (LC-MS/MS) and bioinformatics methods.</p><p><strong>Methods: </strong>The study employed a comprehensive proteomic analysis using LC-MS/MS to identify protein expression differences in intestinal tissues from five patients with UC versus five healthy controls. Subsequent bioinformatics analyses, including Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses, elucidated altered biological processes.</p><p><strong>Results: </strong>We identified 194 upregulated and 323 downregulated proteins in the tissues of patients with UC, indicating a significant difference in protein expression. GO analysis revealed that the upregulated proteins were mainly involved in immune responses and metabolic processes, while the downregulated proteins were associated with organic and cellular metabolism. Additionally, KEGG pathway analysis showed that upregulated proteins were enriched in pathways related to ribosomes and phagosomes, whereas downregulated proteins were primarily linked to oxidative phosphorylation, thermogenesis, and the citric acid cycle, pointing to substantial changes in cellular energy metabolism. Protein-protein interaction (PPI) network analysis identified several key nodes, particularly those connected to ribosomal and phagocytic functions, which may play significant roles in the pathophysiology of UC.</p><p><strong>Conclusion: </strong>This study offers new insights into the biological mechanisms underlying UC and lays the foundation for future therapeutic strategies targeting these proteomic changes. Further experimental validation and clinical investigations are necessary to uncover additional mechanisms of UC and to facilitate the development of effective treatments.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1537168"},"PeriodicalIF":3.1,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12203869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527259","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":"Visual outcomes with a non-diffractive enhanced depth-of-focus IOL in patients with age-related macular degeneration.","authors":"Juan Carlos Elvira, Patricia Devesa, Belén Elvira-Giner, Pedro Tañá-Sanz, Paz Orts-Vila, Pedro Tañá-Rivero","doi":"10.3389/fmed.2025.1505401","DOIUrl":"https://doi.org/10.3389/fmed.2025.1505401","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate visual function in eyes with age-related macular degeneration (AMD) implanted with a non-diffractive enhanced depth-of-focus (EDOF) intraocular lens (IOL) after cataract surgery.</p><p><strong>Design: </strong>Prospective, observational, non-randomized clinical study.</p><p><strong>Methods: </strong>Twenty-two eyes from 22 patients diagnosed with AMD and cataracts were submitted to standard cataract surgery with a non-diffractive EDOF IOL implantation (AcrySof IQ Vivity). We measured monocular uncorrected and best-corrected-distance visual acuity (UDVA and CDVA), uncorrected- and distance-corrected-intermediate visual acuity (UIVA and DCIVA), uncorrected- and distance-corrected-near visual acuity (UNVA and DCNVA), manifest refractive spherical equivalent (MRSE) and cylinder, monocular defocus curve and patient-reported outcome questionnaires (Catquest-9SF and NEI VFQ-25). Follow-up visits were carried out at 1, 3 and 6 months post-surgery.</p><p><strong>Results: </strong>At 6 months post-surgery all eyes were within ± 0.50 D with a mean MRSE of -0.19 ± 0.20 D, 95.45% had a refractive cylinder of ≤ 0.50 D with a mean cylinder of -0.24 ± 0.27 D. The mean values of postoperative monocular CDVA, DCIVA, and DCNVA were 0.02 ± 0.08, 0.16 ± 0.11, and 0.26 ± 0.15 logMAR, respectively. The defocus curve showed good visual acuity at distance and intermediate with a depth-of-focus of about 1.60 D. A total of 81.82% of patients did not report any difficulty with their vision in their everyday-life and 86.36% reported being quite satisfied to very satisfied with their current vision. The NEI VFQ-25 showed that all values improved significantly (<i>p</i> < 0.05) after the surgery in the different parameters analyzed except for ocular pain (<i>p</i> = 0.390) and color vision (<i>p</i> = 0.333).</p><p><strong>Conclusion: </strong>The use of a non-diffractive EDOF IOL in AMD eyes with cataracts is a safe and effective surgical approach for visually correcting aphakia, providing good visual acuity at far and intermediate distances. Our outcomes support the use of non-diffractive EDOF IOLs in patients with AMD diagnosed with cataracts aiming to obtain spectacle-independence at far and intermediate distances.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1505401"},"PeriodicalIF":3.1,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12203608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527294","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":"An integrated machine learning framework for developing and validating diagnostic models and drug predictions based on ulcerative colitis genes.","authors":"Na An, Zhongwen Lu, Yang Li, Bing Yang, Shaozhen Ji, Xu Dong, Zhaoliang Ding","doi":"10.3389/fmed.2025.1571529","DOIUrl":"https://doi.org/10.3389/fmed.2025.1571529","url":null,"abstract":"<p><p>Ulcerative colitis (UC) is a long-lasting inflammatory bowel disease that causes inflammation in the intestines and triggers autoimmune responses. This study aims to identify immune-related biomarkers for ulcerative colitis (UC) and explore potential therapeutic targets. First, we downloaded the expression profiles of datasets GSE87466, GSE87473, and GSE92415 from the GEO database. Next, we identified differentially expressed genes (DEGs) that are associated with UC. Using the WGCNA algorithm, we screened key module genes in UC and retrieved immune-related genes (IRGs) from the ImmPort database. We identified immune-related differentially expressed genes by intersecting the results from WGCNA, DEGs, and IRGs. To build a diagnostic model for UC, we applied 113 combinations of 12 machine learning algorithms. This included 10-fold cross-validation on the training set and external validation on the test set. The single-cell results presented the cellular profile of UC and indicated that the key genes were significantly associated with macrophages, epithelial cells, and fibroblasts. The single-cell results presented the cell atlas of UC and suggested that key genes were significantly associated with macrophages, epithelial cells and fibroblasts. Quantitative polymerase chain reaction (q-PCR) was used to verify the expression levels of the core biomarkers screened out by machine learning. We conducted enrichment analysis using Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and gene set enrichment analysis (GSEA), which showed biological processes and signaling pathways associated with UC. Immune cell infiltration analysis based on CIBERSORT was also performed. We also screened potential drugs from the DSigDB drug database. To evaluate their effectiveness, we performed molecular docking and dynamics simulations. The results suggested that compounds like thalidomide and troglitazone are promising candidates for new UC drug development. Our findings provide insights into the pathogenesis of UC, its clinical treatment, and potential drug development.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1571529"},"PeriodicalIF":3.1,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527307","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: Successful treatment of severe fever with thrombocytopenia syndrome associated with hemophagocytic lymphohistiocytosis by preemptively using favipiravir and methylprednisolone.","authors":"Liang Qiao, Ting-Juan Zhang, Yuan Feng, Lei Yang, Ping Cai, Su-Wan Liu, Yong-Hui Ji, Jun Qian, Jing-Dong Zhou","doi":"10.3389/fmed.2025.1566719","DOIUrl":"https://doi.org/10.3389/fmed.2025.1566719","url":null,"abstract":"<p><strong>Background: </strong>Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by a novel Bunyavirus with a high mortality rate. Cytokine storm could be regarded as an important feature of SFTS patients. Severe or critical cases of SFTS are often complicated with the presence of hemophagocytic lymphohistiocytosis (HLH), resulted in rapid disease progression and extremely adverse prognosis. Currently, effective treatments for these severe cases remain unavailable. Herein, we reported a case of SFTS associated with HLH successfully treated by favipiravir and methylprednisolone.</p><p><strong>Case presentation: </strong>A 73-year-old male farmer was admitted to our hospital with a fever, fatigue, and bicytopenia for 1 week on June 20, 2024. The patient had a history of farm work. The diagnosis of SFTS was confirmed by detection of Bunyavirus RNA in the blood samples. Bone marrow examination revealed marked infiltration of macrophages with hemophagocytosis in the bone marrow leading to a diagnosis of HLH. Notably, the patient was preemptively treated with favipiravir together with methylprednisolone and supportive therapy before the diagnosis of SFTS associated with HLH. Excitingly, the patient was recovered after 10 days treatment.</p><p><strong>Conclusion: </strong>Early recognition of SFTS complicated with HLH is particularly important, and the preemptive application of favipiravir may improve the prognosis of these patients.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1566719"},"PeriodicalIF":3.1,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527258","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":"Emerging trends and focus of Toll-like receptors in kidney diseases: a 20-year bibliometric analysis.","authors":"Peihan Liu, Xinyao Luo, Dingyuan Wan, Yupei Li, Baihai Su","doi":"10.3389/fmed.2025.1599196","DOIUrl":"https://doi.org/10.3389/fmed.2025.1599196","url":null,"abstract":"<p><strong>Background: </strong>An increasing number of studies have explored the role of Toll-like receptors (TLRs) in the pathogenesis of kidney diseases and their corresponding therapeutic potential. However, there is no comprehensive bibliometric analysis in this field. This study aims to investigate the hotspots and evolution of TLRs and kidney disease research over the past two decades.</p><p><strong>Methods: </strong>Publications from the Web of Science Core Collection database were searched and extracted on December 21, 2024 using the terms \"Toll-like receptor\" and \"kidney disease\" (and their synonyms in MeSH). CiteSpace was used to explore publications from January 1, 2000, to December 21, 2024, to visualize the contributions of countries, institutions, journals, and authors, and to detect the evolution of research focus and emerging trends in this field.</p><p><strong>Results: </strong>A total of 2,505 studies with 101,150 references were included in this study. The United States and China are the leading forces among all countries. The Egyptian Knowledge Bank is the leading institution, and Hans-Joachim Anders is considered the most influential expert in this field. PLOS One is the journal with the most publications, and Journal of Immunology is the most co-cited journal. According to the co-citation analysis, COVID-19 is the latest research hotspot. Additionally, both ischemia-reperfusion injury and diabetic nephropathy have been long-standing research hotspots and still hold significant values. Moreover, the use of TLR inhibitors as a therapeutic strategy for kidney diseases is increasingly emphasized.</p><p><strong>Conclusion: </strong>Our study demonstrates a growing understanding of the crucial role of TLRs in kidney diseases over the past two decades. Future research should attach more importance to the identification of novel endogenous ligands for TLRs, which will be critical for developing TLR inhibitors as a viable therapeutic strategy.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1599196"},"PeriodicalIF":3.1,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527264","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}