Background: Leptospirosis is an acute zoonotic disease caused by pathogenic Leptospira, primarily transmitted to humans through contact with water or soil contaminated by the bacteria. It is globally distributed, with heightened prevalence in tropical regions. While prior studies have examined the pathophysiology, epidemiology, and risk factors of leptospirosis, few have explored trends and emerging topics in the field. This study applies bibliometric analysis to generate a visual knowledge map, identifying research hotspots and forecasting future trends in leptospirosis investigations.Methods: Data were extracted from the Web of Science Core Collection (WOSCC), encompassing all publications up to May 1, 2024. CiteSpace and VOSViewer software were used to analyze annual publication trends, as well as contributions from countries, institutions, journals, authors, references, and keywords, thereby pinpointing current research priorities and potential future directions.Results: A total of 5,244 articles were included, sourced from 4,716 institutions, 955 journals, and 156 countries or regions. The United States led with 1,315 publications and had the most significant influence in the field. “PLOS Neglected Tropical Diseases” published the highest number of articles (166), while “Infection and Immunity” garnered the most citations (6,591). Prominent research areas included restriction endonucleases, monoclonal antibodies, outer membrane proteins, water environments, detection methods, and antimicrobial agents. Research focus has shifted from early genomic and antigenic studies to investigations into outer membrane protein functions and environmental persistence, culminating in recent advances in molecular mechanisms and diagnostic technology development.Conclusion: This bibliometric analysis provides a comprehensive snapshot of leptospirosis research, emphasizing collaborations and impact among authors, countries, institutions, and journals. It offers valuable insights into ongoing trends and serves as a reference for future collaboration and research opportunities in the field.

Background: Research on extracorporeal membrane oxygenation (ECMO)-assisted support for pulmonary embolism (PE) has been increasing, yet no systematic bibliometric analysis has been conducted. This study evaluates global research trends in this field by analyzing countries, institutions, authors, journals, references, and keywords.Methods: Relevant articles and reviews published up to August 15, 2023, were retrieved from the Web of Science Core Collection (WOSCC). VOSviewer and CiteSpace software were used for bibliometric analysis of collected data.Results: Publications on ECMO-assisted support for PE surged from 2015 to 2023, comprising 82.7% (306/370) of total studies. The United States, Germany, and China contributed 62.97% (233/370) of the research. Perfusion-UK had the most publications, while Journal of the American College of Cardiology was the most cited journal. The University of Maryland, Massachusetts General Hospital, and Harvard Medical School were the leading institutions. Chetan Pasrija published the highest number of papers, while Konstantinidis SV was the most co-cited author. Research hot spots include: (1) ECMO management and survival rates, (2) combined treatments with thrombolysis or surgical thrombectomy, (3) anticoagulation and clot formation, and (4) ECMO support in COVID-19.Conclusion: This study aims to increase awareness of research hot spots on ECMO-assisted support for PE by determining the collaboration and impact of authors, countries, institutions, and journals. In addition, it comprehensively reviews research trends on ECMO regarding PE. It also provides a reference for potential collaborators, institutions, and future research prospects.

Background: Sepsis frequently results in complications such as acute respiratory distress syndrome (ARDS) and cardiomyopathy. This study aims to identify common diagnostic markers and elucidate the underlying mechanisms of these sepsis-induced complications. Methods: We obtained datasets related to ARDS and sepsis-induced cardiomyopathy (SIC) from the GEO database and applied weighted gene co-expression network analysis (WGCNA) to identify differentially expressed genes (DEGs), which were integrated with key module genes. Feature genes were selected using support vector machine-recursive feature elimination (SVM-RFE) and random forest (RF) algorithms. An artificial neural network (ANN) model was constructed and its diagnostic performance was evaluated using receiver operating characteristic (ROC) curves. Machine learning algorithms effectively identified key hub genes associated with sepsis-induced ARDS and cardiomyopathy, with their robustness validated through ROC analysis. A cellular model of sepsis-induced lung injury was employed to examine hub gene expression. Additionally, we investigated inflammation and immune responses by characterizing immune landscapes using CIBERSORT and performing correlation analyses among feature genes, immune infiltration, and clinical characteristics. Finally, potential small-molecule compounds were identified from the PubChem database. Results: Five key genes—LCN2, AIF1L, STAT3, SOCS3 and SDHD—were identified. SOCS3 showed strong diagnostic potential with gene set enrichment analysis (GSEA) highlighting its role in biological processes and immune responses. SOCS3 expression correlated strongly with immune cells. Dexamethasone, resveratrol and curcumin were identified as potential SOCS3-targeting drugs. Conclusion: Five genes were identified as diagnostic biomarkers for sepsis-induced ARDS and cardiomyopathy, with SOCS3 serving as a key hub gene and potential therapeutic target.

Article: Investigating hub genes in the relationship between septic cardiomyopathy and cuproptosis and potential Chinese herbal drug candidates with bioinformatic tools - Minerva Cardiology and Angiology 2024 May 27 - Minerva Medica - Journals

Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly being employed to treat patients with refractory septic shock. Despite its growing use, there is a notable absence of prognostic assessment tools specifically designed for septic shock patients who have received VA-ECMO therapy. The aim of this study is to develop and validate a prognostic model for patients with refractory septic shock undergoing VA-ECMO, and to identify those who may derive the greatest benefit from this treatment. This single-center, retrospective cohort study was conducted at a comprehensive intensive care unit in China. Adult patients with refractory septic shock who received VA-ECMO treatment were included. Two hundred consecutive patients were randomly divided into training and validation cohorts in a 7:3 ratio. Least absolute shrinkage and selection operator regression analysis was employed to select relevant variables for the logistic regression model, and its performance was tested in both training and validation cohorts based on discrimination, calibration, and net benefit. Between January 2019 and September 2024, 293 patients were screened, 200 of whom were eligible and were divided into development ( n = 140) and validation ( n = 60) cohorts. The 28-day survival rate was 23.0%, and median duration of ECMO run was 6.0 days (IQR 2.0–8.0). Age, APACHE II score at ICU admission, immunosuppression status, hypertension, IL-6, and APTT measured within 6 h before ECMO initiation were the six predictors included in the nomograms. The nomogram demonstrated strong discriminative power in the training cohort (area under the curve [AUC]: 0.873, 95% CI 0.812–0.929), as well as in the validation cohort (area under the curve [AUC]: 0.818 (95% CI 0.687–0.920). The model's reliability in predicting outcomes was evident from the high consistency between predicted probabilities and observed proportions during calibration. Decision curve analysis indicated that the model's clinical benefit was advantageous. The novel validated nomogram is designed to predict outcomes after VA-ECMO treatment in individuals with refractory septic shock. It can support physicians in performing precise mortality risk evaluations and making more informed decisions regarding the application of VA-ECMO treatment.

Introduction: Sepsis is a life-threatening organ dysfunction syndrome with persistently high global mortality, driven by dysregulated host immune response. Existing single-target therapies fail to simultaneously address hyperinflammation and impaired tissue repair, leading to limited clinical efficacy and repeated translational failures. Methods: Integrated multi-omics datasets (scRNA-seq, miRNA-seq, blood/lung RNA-seq) delineated immune cell dynamics and dysregulated pathways in sepsis. Guided by omics findings, we designed two small-molecule combinations (C1, C2) targeting the identified pathways. Their efficacy and mechanism were validated in in vitro and in vivo sepsis models. Results: Septic patients showed a hallmark immune remodeling signature: expansion of pro-inflammatory myeloid cells (neutrophils, monocytes) and depletion of protective lymphoid cells (B cells, NK cells). A dual-pathway small-molecule combination C2 targeting inflammatory cascades and Hippo/Wnt regenerative pathways, exerted significant synergistic therapeutic effects. It robustly rebalanced systemic and organ-specific inflammation (suppressed Il1b , Il6 , Nos2 , Tnfa ; elevated Il10 , Arg1 , Tgfb , Nos3 ) in vitro and in vivo , ameliorated multi-organ injury, and improved 7-day survival in septic mice from 20% (untreated) to 70%. Single-compound control experiments confirmed that the enhanced efficacy of C2 stems from dual-pathway synergy, not individual components. Discussion: This study revealed immune dysregulation as the core pathogenesis of sepsis. The C2 combination simultaneously mitigates hyperinflammation and promotes tissue repair, providing a novel, mechanism-driven, and clinically translatable combination strategy for sepsis management.