Background Being the S-enantiomer of racemic ketamine, esketamine is found to be effective for sedation, analgesia, and treating depression. However, there is no comprehensive bibliometric analysis about esketamine research. In this study, we aimed to determine the scientific output and emerging topics related to esketamine. Methods Esketamine-related articles and reviews that published between 2000 and 2020 were obtained from the Web of Science Core Collection database, using key word search of “esketamine” “esketamine hydrochloride”, “s-ketamine”, “S(+)-ketamine”, “(S)-ketamine”, or “(–)-ketamine”. Various bibliographic elements were collected, including the annual number of publications, citation frequency, countries/regions, institutions, authors, journals, and keywords. Two sorts of scientometric software, namely VOS viewer and CiteSpace, were used to conduct bibliometric and knowledge-map analyses. Results A total of 683 publications were included in the current study. We found the number of publications in esketamine research field had increased annually since 2016. The United States was the leader in this field, with the highest publications number (162, 23.72%), total citations (3504/9713, 36.08%) and H-index (40). The most productive institution was Chiba University in Japan, and esketamine-related papers were mainly published in the journal Anesthesia & Analgesia . The keyword co-occurrence analysis showed that keywords relevant to depression were the most frequent. Moreover, all identified keywords could be divided into four clusters, with the research focus gradually shifting from cluster of “anesthesia and analgesia detection” to “depression treatment effect.”. Conclusion The past two decades have shown a marked increase in esketamine research. The United States maintained a top position worldwide, making the most significant contributions in the field of esketamine research. The contributions and collaborations of Asian countries have continuously increased and is a strong area of growth as well as development in recent years. Additionally, the emerging hotspots of esketamine research concentrate on clarifying its depression treatment effect.
Aim: This study aimed to elucidate the incidence and risk factors for postictal delirium (PID) among Chinese patients undergoing electroconvulsive therapy (ECT). Methods: In this retrospective study, 203 patients who underwent ECT in the Third Affiliated Hospital of Sun Yat-Sen University from July 2016 to July 2017 had their PID severity measured by a previously developed scale. For data analysis, two groups were created: PID patients and non-PID patients. The groups were analyzed based on three types of independent variables: patient-related, electroconvulsive treatment, and hemodynamic variables. Data analysis was performed through descriptive statistics, Chi-squared tests, Fisher exact tests, and/or independent sampled t-tests. Logistic regression analysis was used to identify independent risk factors for postictal delirium (P < 0.05).Results: Results showed that 81 patients (39.9%) developed moderate to severe PID in their first ECT session. Patients receiving ECT for the first time (P = 0.016), agitation before the ECT (P = 0.028), and high heart rate variances (P = 0.044) were identified as risk factors for PID, and they were significantly correlated with the occurrence of moderate to severe PID (P < 0.01). Conclusion: The patients receiving ECT for the first time, with agitation states before ECT and/or with high heart rate variance during ECT procedures might be at higher risk for moderate to severe PID. The medical staff related to this type of treatment may benefit from detailed knowledge about the aforementioned risk factors for predicting PID and to anticipate the best possible management for these patients.
Background Peripheral nerve damage causes neuroinflammation, which plays a critical role in establishing and maintaining neuropathic pain (NeP). The mechanisms contributing to neuroinflammation remain poorly elucidated, and pharmacological strategies for NeP are limited. Thus, in this study, we planned to explore the possible link between astrocyte senescence and NeP disorders following chronic sciatic nerve injury. Methods An NeP animal model was established by inducing chronic constrictive injury (CCI) to the sciatic nerve in adult rats. A senolytic drug combination of dasatinib and quercetin was gavaged daily from the first postoperative day until the end of the study. Paw mechanical withdrawal threshold (PMWT) and paw thermal withdrawal latency (PTWL) were evaluated to assess behaviors in response to pain in the experimental rats. Senescence-associated β-galactosidase staining, western blot analysis, and immunofluorescence were applied to examine the levels of proinflammatory factors and severity of the senescence-like response in the spinal cord. Lipopolysaccharide (LPS) was administered to induce senescence of spinal astrocytes in primary cultures in vitro, to explore the potential impacts of senescence on the secretion of proinflammatory factors. Furthermore, single-cell RNA sequencing (scRNA-seq) was conducted to identify senescence-related molecular responses in spinal astrocytes under neuropathic pain. Results Following sciatic nerve CCI, rats exhibited reduced PMWT and PTWL, increased levels of spinal proinflammatory factors, and an enhanced degree of senescence in spinal astrocytes. Treatment with dasatinib and quercetin effectively attenuated spinal neuroinflammation and mitigated the hypersensitivities of the rats subjected to sciatic nerve CCI. Mechanistically, the dasatinib-quercetin combination reversed senescence in LPS-stimulated primary cultured astrocytes and decreased the levels of proinflammatory factors. The scRNA-seq data revealed four potential senescence-related genes in the spinal astrocyte population, and the expression of clusterin (CLU) protein was validated via in vitro experiments. Conclusion The findings indicate the potential role of astrocyte senescence in neuroinflammation following peripheral nerve injury, and suggest that targeting CLU activation in astrocytes might provide a novel therapeutic strategy to treat NeP. Graphical abstract
Bone marrow‐derived mesenchymal stem cells (BMSCs) show a good property for pain treatment by modulating inflammatory response. However, the underlying therapeutic effect and related mechanism of BMSCs on inflammatory pain remain unclear. Therefore, we explored the function and potential mechanism of BMSCs performing in a complete Freund's adjuvant (CFA)‐induced inflammatory pain model in this study. Here, BMSCs were injected into the CFA‐treated rats, and we used behavioural tests to evaluate the changes in hypersensitivity. High‐throughput sequencing was used to screen out the hub genes. Molecular biology experiments were performed to detect the level of P2X3 or inflammatory mediators in rats and observed the distribution of P2X3 in neural cells. Furthermore, the function of the P2X3 was explored via inhibitor and activator experiments. Finally, we found that BMSCs alleviated hyperalgesia and spinal levels of pro‐inflammatory factors in CFA‐treated rats. High‐throughput sequencing showed that P2X3 and P2X7 were identified as hub genes, and only the expression level of P2X3 was significantly down‐regulated after BMSCs treatment. Immunohistochemistry showed that P2X3 mainly colocalized with microglia and astrocytes. The levels of P2X3 and pro‐inflammatory factors were all significantly reduced after BMSC injection. Moreover, similar attenuation was found in the CFA‐treated rats after injecting the P2X3 inhibitor, and a P2X3 antagonist reversed the attenuation induced by the BMSCs. These findings suggest that BMSCs exerted a therapeutic effect on inflammatory pain by inhibiting the expression of P2X3 and the excessive production of inflammatory mediators was associated with an increased P2X3 level and BMSC therapy reverse these effects.
Aim: This study aimed to elucidate the incidence and risk factors for postictal delirium (PID) among Chinese patients undergoing electroconvulsive therapy (ECT). Methods: In this retrospective study, 203 patients who underwent ECT in the Third A liated Hospital of Sun Yat-Sen University from July 2016 to July 2017 had their PID severity measured by a previously developed scale. For data analysis, two groups were created: PID patients and non-PID patients. The groups were analyzed based on three types of independent variables: patient-related, electroconvulsive treatment, and hemodynamic variables. Data analysis was performed through descriptive statistics, Chisquared tests, Fisher exact tests, and/or independent sampled t-tests. Logistic regression analysis was used to identify independent risk factors for postictal delirium (P < 0.05). Results: Results showed that 81 patients (39.9%) developed moderate to severe PID in their rst ECT session. Patients receiving ECT for the rst time (P = 0.016), agitation before the ECT (P = 0.028), and high heart rate variances (P = 0.044) were identi ed as risk factors for PID, and they were signi cantly correlated with the occurrence of moderate to severe PID (P < 0.01). Conclusion: The patients receiving ECT for the rst time, with agitation states before ECT and/or with high heart rate variance during ECT procedures might be at higher risk for moderate to severe PID. The medical staff related to this type of treatment may bene t from detailed knowledge about the aforementioned risk factors for predicting PID and to anticipate the best possible management for these patients.
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