Yanbian University Hospital

BackgroundThe therapeutic role of natural medicines in pathological scars has received widespread attention in recent years. However, there is no systematic bibliometric study to analyze the research hotspots and trends in this field.PurposeThis study aimed to provide researchers with a comprehensive summary of natural medicines in pathological scars; visualize the current research status, hotspot directions, and development trends; and offer references for subsequent research and clinical translation in this field.MethodsPublications related to the topic from 2008 to 2025 were retrieved from the WOSCC and PubMed databases. Bibliometric analyses were performed using VOSviewer, CiteSpace, Scimago Graphica, Microsoft Office Excel, and GraphPad Prism.ResultsGlobal publications on natural medicines for pathological scar treatment have steadily increased. A total of 234 papers were retrieved, contributed by 1,395 authors from 396 institutions across 39 countries/regions. China far outnumbered other countries in publication output, with four of the top five authors residing in China. Shanghai Jiao Tong University ranked first among institutions by publication count. The most recent keywords—drug delivery, transdermal delivery, antioxidant, angiogenesis, and the transforming growth factor-β (TGF-β)/Smad—suggest emerging research frontiers.ConclusionResearch on natural medicines in pathological scars is still in a developmental stage. This is the first bibliometric analysis in this domain, highlighting the current hotspots and shedding light on future research directions.

Tinnitus is a common symptom among adults in the United States. Increasing evidence indicates that prolonged exposure to heavy metals and excessive intake of trace elements from environmental pollution can increase the likelihood of hearing loss. Although studies have reported associations between heavy metals and hearing loss, the relationship between heavy metals and tinnitus remains uninvestigated. After accounting for the complex survey design, we assessed cross-sectional data on blood lead, cadmium, mercury, selenium, and manganese levels in 4950 participants from the National Health and Nutrition Examination Survey database (2012–2018). We used weighted multivariate logistic regression, weighted multivariate linear regression, restricted cubic spline regression, and receiver operating characteristic curve analysis to investigate the relationship between these 5 blood heavy metals and tinnitus. Subgroup and sensitivity analyses were performed to evaluate consistency across subgroups and the robustness of the findings. Compared with the lowest quartile (Q1), the odds of tinnitus were significantly higher in the highest quartiles of blood lead (odds ratio = 1.63, 95% CI: 1.23–2.16) and cadmium (odds ratio = 1.32, 95% CI: 1.02–1.70). Restricted cubic spline curves indicated a nonlinear association between the odds of tinnitus and blood lead, cadmium, mercury, and selenium levels. However, no nonlinear relationship was found regarding blood manganese levels (P for nonlinear = .1334; P total = .2446). Subgroup analyses suggested that sex and ethnicity may modify the strength of the association between blood cadmium and blood lead levels with tinnitus prevalence. The association between blood mercury levels and tinnitus was highly homogeneous and stable across all examined demographic and clinical subgroups. The link between blood selenium levels and tinnitus was more pronounced among males, non-Hispanic whites, and individuals aged 40 to 60 years. Blood lead, cadmium, mercury, and selenium levels were significantly associated with the prevalence of tinnitus. High levels of these metals may be potential indicators for tinnitus management.

Abstract The apical barrier technique using bioceramic materials is established for treating immature permanent teeth with pulp necrosis. This study reports an unexpected observation: continued root development when iRoot BP Plus was inadvertently placed 3-4mm short of the radiographic apex. This retrospective case series analyzed four immature permanent teeth where iRoot BP Plus apical barrier was placed 3-4mm short of the apex due to technical factors, between October 2020 and December 2022, with follow-up periods of 22–48 months (mean: 32.5 months). All patients were male, aged 8–12 years. Affected teeth included mandibular second premolars and maxillary central incisor. Clinical diagnoses included acute pulpitis (n = 1) and apical periodontitis (n = 3). Treatment involved chemomechanical debridement, calcium hydroxide intracanal medication, followed by iRoot BP Plus placement which was positioned 3-4mm from the radiographic apex. Despite suboptimal material placement, all cases (100%) achieved periapical healing. Remarkably, three cases (75%) demonstrated continued root development with progressive apical closure beyond the bioceramic material, while one case showed periapical healing without significant root development. These unexpected findings suggest that placing iRoot BP Plus 3-4mm short of the apex may preserve the apical papilla and its stem cells (SCAPs), allowing continued physiological root development. This observation warrants prospective investigation as a potential intentional treatment modification.

Captive Asiatic black bears (Ursus thibetanus) may face increased health risks under conditions of stress or close human contact, including vulnerability to infectious diseases. Bacterial pathogens such as Mycobacterium tuberculosis complex and Klebsiella pneumoniae pose health risks in captive settings. However, co-infections involving these pathogens have not been previously reported in captive Asiatic black bears. Two male Asiatic black bears (Ursus thibetanus), aged 2 and 3 years, developed persistent diarrhea, which improved temporarily after penicillin and cephalosporin treatment but relapsed shortly after. Despite ongoing therapy, both showed progressive weight loss, lethargy, and depression. Five days before death, acute respiratory signs, including fever, tachypnea, and coughing, appeared, followed by rapid decline. Necropsy revealed multisystemic lesions. Histopathological examination, Ziehl–Neelsen and Gram staining revealed acid-fast bacilli and Gram-negative bacilli intralesionally, PCR amplification and sequencing of DNA extracted from lung tissue identified carbapenem-resistant hypervirulent Klebsiella pneumoniae strains carrying multiple virulence and resistance genes, as well as a Mycobacterium spp. agent of the M. tuberculosis complex. This case underscores the risks of fatal co-infections between an agent of the Mycobacterium tuberculosis complex and carbapenem-resistant hypervirulent Klebsiella pneumoniae in captive wildlife. Integrated diagnostics, timely detection, and prudent antibiotic stewardship are essential, but the absence of diagnostic standards could delay recognition. Establishing systematic criteria is urgently needed to improve treatment and long-term health management.

BackgroundThe Prognostic Nutritional Index (PNI) is a critical biomarker reflecting the nutritional and immune status of cancer patients. Its association with the prognosis of various malignant tumors has been extensively investigated. However, a comprehensive systematic evaluation of the prognostic significance of PNI across different cancer types remains limited.MethodsThis umbrella review conducted a systematic search of PubMed, Embase, Web of Science, and the Cochrane Library to include meta-analyses that assessed survival outcomes related to cancer across diverse malignancy categories. The quality of the evidence was evaluated utilizing the GRADE and AMSTAR tools. Effect sizes, expressed as hazard ratios (HR) or odds ratios (OR), were synthesized using either random-effects or fixed-effects models. Additionally, analyses of heterogeneity, indicated by I2, and assessments of publication bias were performed as appropriate.ResultsThe Prognostic Nutritional Index (PNI) demonstrates associations across multiple cancer types, with a low PNI significantly linked to poor prognosis in 12 categories of malignant tumors. The HRs for 103 outcomes ranged from 1.15 to 2.98 (p < 0.05). The overall quality of evidence is predominantly low or very low, as assessed by the GRADE criteria, affecting 89.3% of outcomes. This is largely attributed to heterogeneity (47.8% with I2 > 50%), publication bias (40%), and limitations in AMSTAR scoring. Notably, 11 outcomes provided moderate-quality evidence, all indicating substantial effect sizes. Specifically, PNI shows significant prognostic value in breast cancer (preoperative overall survival [OS] HR = 2.56, postoperative HR = 2.63), cervical cancer (OS HR = 2.98), and among patients receiving immunotherapy (e.g., lung cancer immune checkpoint inhibitor [ICI] group OS HR = 2.68).ConclusionA low Prognostic Nutritional Index is consistently associated with poorer outcomes across various cancer types, particularly in predicting responses to immunotherapy. However, due to the current limited quality of evidence, it cannot yet be recommended as a standalone prognostic or decision-making tool across all tumors. Future rigorously designed, multi-center studies are required to validate its clinical utility.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/,CRD42025111093.