From Stories to Science: Mapping Global Trends in Narrative Medicine Research (2004-2024).

Narrative medicine is defined as a medical approach that utilizes the power of stories, both patients' illness narratives and healthcare providers' reflective accounts, to promote healing, foster empathy, and enhance the therapeutic relationship through close attention to the language, metaphor, and meaning embedded in illness experiences. Despite its growing importance in contemporary healthcare, comprehensive bibliometric analyses of narrative medicine research trends remain limited. This study aims to systematically map global research patterns, identify key contributors, and analyze thematic evolution in narrative medicine literature over the past two decades.

Chinese expert consensus on the combined use of antiviral drugs for novel coronavirus infection.

The persistent mutation of the novel coronavirus (SARS-CoV-2) not only remains a threat to human health but also continues to challenge existing antiviral therapeutic strategies. In current clinical practice, the resistance of novel coronavirus to antivirals, the rebound of viral load after treatment with drugs such as nirmatrelvir/ritonavir (NTV/r), and the urgent need for rapid clearance of the virus in the management of critically and emergently ill patients suggest that the existing single-drug regimens may have limitations and that the intensity of suppression may be insufficient in some cases. In clinical practice, we have observed that a combination of antivirals with different mechanisms of action can result in better efficacy and not significantly increase adverse drug reactions (ADRs).

Expert consensus on combination antiviral therapy for high-risk COVID-19 patients: A timely call to action.

On May 5, 2023, the WHO declared that the COVID-19 pandemic no longer constitutes a public health emergency of international concern (PHEIC), but SARS-CoV-2 continues to spread and evolve on a global scale. The WHO reported that COVID-19 still poses a threat to humanity, and especially in some areas with large numbers of infected people. For some high-risk COVID-19 patients, such as those with underlying conditions, elderly patients, patients who need long-term immunosuppressive therapy after organ transplantation, patients with immunosuppressive diseases, patients who tend not to test negative for SARS-CoV-2 despite standard antiviral therapy, and cancer patients, special attention is still required after infection with SARS-CoV-2.

The Role of Large Language Models (LLMs) in Hepato-Pancreato-Biliary Surgery: Opportunities and Challenges.

The integration of large language models (LLMs) into healthcare represents a transformative development in modern medicine, with hepato-pancreato-biliary (HPB) surgery positioned at the forefront of this technological revolution. This editorial examines the multifaceted role of LLMs, including ChatGPT, Claude, and Gemini, in HPB surgical practice, analyzing both their unprecedented opportunities and significant challenges. LLMs demonstrate remarkable potential across multiple domains of HPB surgery, including clinical documentation automation, enhanced surgical decision-making through complex patient data analysis, improved preoperative planning with radiological interpretation, real-time intraoperative decision support, and optimized postoperative patient monitoring with personalized follow-up recommendations.

Laparoscopic micro-incision technique at cystic duct confluence for pediatric choledocholithiasis management: A case report.

Background: The management of pediatric choledocholithiasis is complicated by anatomical constraints and the subsequent risks of conventional therapies requiring external drainage. This case report introduces a novel laparoscopic microincision technique at the cystic duct confluence, designed to eliminate T-tube dependence, minimize ductal trauma, and expedite recovery, which are critical priorities for active children. We present this innovation to address unmet pediatric-specific surgical needs and demonstrate its feasibility as a tailored, minimally invasive solution for choledocholithiasis in children.

Gallstones in the Era of Metabolic Syndrome: Pathophysiology, Risk Prediction, and Management.

Gallstone disease (GSD) and metabolic syndrome (MetS) are increasingly prevalent conditions with significant global health implications. Recent evidence highlights a strong epidemiological association between these disorders, driven by shared pathophysiological mechanisms. This review provides a comprehensive analysis of the intricate relationship between MetS and GSD, focusing on the role of insulin resistance, dyslipidemia, obesity, and gut microbiota dysbiosis in gallstone formation.

Limitations and enhancement opportunities for variceal rebleeding prediction model in patients with cirrhosis.

A multicenter study recently published introduced a novel prognostic model for predicting esophagogastric variceal rebleeding after endoscopic treatment in patients with cirrhosis. The model incorporated six readily available clinical variables-albumin level, aspartate aminotransferase level, white blood cell count, ascites, portal vein thrombosis, and bleeding signs-and demonstrated promising predictive performance. However, limitations, including the retrospective design and exclusion of patients with hepatocellular carcinoma, may affect the generalizability of the model.

Advancements in Managing Choledocholithiasis and Acute Cholangitis in the Elderly: A Comprehensive Review.

The increasing elderly population has led to a rising prevalence of choledocholithiasis and acute cholangitis, presenting unique diagnostic and therapeutic challenges owing to age-related physiological changes and multiple comorbidities. This comprehensive review synthesizes current evidence and recent advances in managing these conditions in elderly patients, with a particular focus on diagnostic innovations, therapeutic strategies, and perioperative optimization. Recent advances in diagnostic modalities, including enhanced imaging techniques and AI-assisted systems, have improved early detection accuracy, whereas minimally invasive interventions, particularly endoscopic retrograde cholangiopancreatography (ERCP) and laparoscopic common bile duct exploration (LCBDE), have demonstrated superior outcomes when combined with comprehensive perioperative care.

Enhancing Clinical Medical Education Through Hand Gesture Analogy Teaching: A Narrative Review.

This narrative review assesses the effectiveness of hand gesture analogy teaching in clinical medical education, addressing the growing demand for innovative pedagogical strategies. Through a comprehensive analysis of existing literature, it evaluates the theoretical foundations, implementation strategies, and practical applications of this method across various domains of medical education. Hand gesture analogy teaching significantly enhances student learning by improving engagement, spatial reasoning, and procedural knowledge retention more effectively than conventional instructional methods.

Modern Management of Common Bile Duct Stones: Breakthroughs, Challenges, and Future Perspectives.

Common bile duct (CBD) stone management has evolved significantly with technological advances and an improved understanding of pathophysiology. This comprehensive review examines current evidence and emerging trends in CBD stone management, emphasizing modern diagnostic approaches and treatment paradigms. Recent developments in imaging techniques, including AI-assisted analysis, have enhanced diagnostic accuracy.

Association between modified dietary inflammation index score and lumbar vertebrae bone mineral density in patients with hypertension: data from NHANES-a population-based study.

Background: The modified Dietary Inflammation Index Score (M-DIS) is a scoring system used to quantify the inflammatory effects of nutrients and foods. Inflammation may affect Bone Mineral Density (BMD) and increase the risk of osteoporosis and fractures. The purpose of this study was to utilize data from the National Health and Nutrition Examination Survey (NHANES) to evaluate the relationship between M-DIS and lumbar vertebrae BMD in patients with hypertension.

The Hidden Agony of the Pancreas: A Comprehensive Case Study of Paraduodenal Pancreatitis.

Paraduodenal pancreatitis (PP), also known as groove pancreatitis (GP), is a rare and distinct variant of chronic pancreatitis and presents significant diagnostic and therapeutic challenges. This comprehensive case study explores a 54-year-old male patient's journey, highlighting the intricate relationship between clinical presentation, diagnostic modalities, and management strategies. Despite a history of smoking and alcohol consumption, the diagnosis of PP was primarily reliant on advanced imaging techniques, including computed tomography and magnetic resonance imaging, which revealed characteristic findings of GP.

Gallbladder Diverticulum as a Rare Disease and a Therapeutic Challenge: A Case Report.

This case report details a rare instance of gallbladder diverticulum, highlighting the diagnostic and therapeutic challenges associated with this condition. Gallbladder diverticulum is an uncommon anomaly that often mimics the symptoms of more prevalent gallbladder diseases, making an accurate diagnosis challenging. The patient, a 55-year-old female, presented with atypical abdominal pain and was initially suspected to have chronic cholecystitis.

A Surgeon's Challenge: Diagnosing and Managing Hidden Bile Duct Stones Post-cholecystectomy.

This case report details the diagnostic and management challenges encountered with hidden bile duct stones post-cholecystectomy in a 58-year-old female patient. Despite a successful laparoscopic cholecystectomy, the patient developed sudden upper abdominal pain and jaundice, leading to the discovery of an impacted bile duct stone. The case underscores the limitations of conventional preoperative diagnostics and highlights the importance of advanced imaging techniques and a multidisciplinary approach for optimal outcomes.

Paper-based ratiometric fluorescent sensing platform based on mixed quantum dots for the detection of glucose in urine.

A paper-based ratiometric fluorescent sensing platform has been developed for glucose detection based on a dual-emission fluorescent probe consisting of carbon quantum dots (C QDs) and CdTe QDs. When the two kinds of QDs are mixed, the fluorescence of C QDs is reversibly quenched by CdTe QDs. However, in the presence of glucose, the fluorescence of CdTe QDs is quenched by HO catalyzed by glucose oxidase (GOx), which restores the fluorescence of C QDs.

Does every Staphylococcus aureus infection require anti-MRSA drugs? Three case reports of a Staphylococcus aureus infection.

Staphylococcus aureus is a common clinical pathogen. Does every S. aureus infection require anti-MRSA drugs? Reported here are three cases of a community-acquired infection with S.

Selective use of pancreatic duct occlusion during pancreaticoduodenectomy in patients with a small-size duct and atrophic parenchyma in the distal pancreas: A retrospective study.

Background: Despite the advancements in surgical techniques, postoperative pancreatic fistula (POPF) remains a potentially life-threatening complication of pancreaticoduodenectomy (PD). Pancreatic duct occlusion (PDO) without anastomosis has also been proposed to alleviate the clinical consequences of POPF in selected patients after PD.

Objectives: To assess the safety and effectiveness of PDO with mechanical closure after PD in patients with an atrophic pancreatic body-tail and a small pancreatic duct.

Attention should be paid to acute hepatitis of unknown etiology in children.

Since April 5, 2022, an increase in cases of severe acute hepatitis of unknown etiology among children with no underlying conditions was first reported in the United Kingdom (UK). Testing excluded viral hepatitis types A, B, C, D, and E and other known common and uncommon infectious and non-infectious causes of acute hepatitis. As of May 26, 2022, 650 cases of acute hepatitis of unknown etiology in children have been reported in at least 33 countries worldwide, with 99 additional cases pending classification.

Biological functions, mechanisms, and clinical significance of circular RNA in pancreatic cancer: a promising rising star.

Pancreatic cancer (PC) is a highly malignant solid tumor with insidious onset and easy early metastasis. Despite tremendous efforts devoted to research in this field, the mechanisms underlying PC tumorigenesis and progression remain unclear. Additionally, robust biomarkers and satisfactory therapeutic strategies for clinical use in PC patients are still lacking.

Brain abscess due to Aggregatibacter aphrophilus in association with atrial septal defect：Case report and literature review.

Background: Aggregatibacter aphrophilus（A. aphrophilus）is one of the organisms of the HACEK group. Previously reported cases of brain abscesses caused by A.