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Objective: In this study, we examined the effectiveness of hyperbaric oxygen (HBO) therapy in ameliorating cognitive deficits in mice with Alzheimer’s disease (AD), while also assessing its impact on the autophagic pathway within the context of AD. Methods: 20 double-transgenic mice expressing the amyloid precursor protein and presenilin 1 (APP/PS1) were purposefully selected and randomly assigned to groups A and B. Concurrently, 20 C57BL/6 mice were chosen and randomly categorized into groups C and D, each consisting of 10 mice. Mice in groups B and D received HBO treatment. The Morris water maze assay was used to assess changes in mouse behavior. Immunohistochemistry techniques were used to quantify the expression levels of amyloid-beta 42 (Aβ42) and microtubuleassociated protein 1A/1B-light chain 3 (LC3) in hippocampal tissues, while western blot analysis was used to investigate the levels of LC3-II, p62, phosphoinositide 3-kinase (PI3K), and mammalian target of rapamycin (mTOR) proteins within hippocampal tissues. Results: Mice allocated to group B exhibited reduced escape latency and prolonged dwell time in the target quadrant compared to other groups. Histological examination revealed conspicuous plaque-like deposits of Aβ42 in the hippocampal tissues of mice in groups A and B. Group B displayed diminished Aβ42-positive reactants and augmented microtubule-associated protein 1A/1B-LC3-positive reactants compared to group A. LC3-positive reactants were also detected in the hippocampal tissues of mice in groups C and D, surpassing the levels observed in groups A and B. Furthermore, group B demonstrated significantly lower expression of mTOR protein and markedly higher expression of LC3-II protein in mouse hippocampal tissues when compared to group A (P < 0.05). Conversely, there were no significant disparities noted in PI3K and p62 protein expression between groups B and A. Notably, no discernible discrepancies were observed in the expression levels of mTOR, PI3K, LC3-II, and p62 proteins between groups C and D within mouse hippocampal tissues. Conclusion: HBO treatment demonstrates efficacy in enhancing cognitive function in mice with AD and holds promise as a potential therapeutic intervention for AD by facilitating the activation of the mTOR pathwaymediated autophagy. [ABSTRACT FROM AUTHOR]

Objective Pulmonary oxygen poisoning resulting from hyperbaric oxygen, frequently occurs in specialized operations, without any current effective prevention or treatment measures. To elucidate the impact and mechanism of neostigmine (NEO) in combination with anisodamine (ANI) (neoscopolamine) on pulmonary oxygen toxicity. Methods The animal model of pulmonary oxygen poisoning was established. C57BL/6 mice were exposed to 2.5 ATA 99.9% oxygen for 6 h. The control group mice were injected with normal saline ip, while the treatment group mice received injections of ANI (25 mg/kg, ip）and NEO (50 μg/kg, ip）. Lung tissues were collected and stained with HE to observe any pathological injuries after exposure. Evans blue stain was utilized to identify lung permeability, wet/dry lung ratio, and protein concentration in the bronchoalveolar lavage fluid (BALF) to assess the lung injury’s severity. The modifications in inflammatory factors, oxidative stress indicators, and iron content in lung tissue were assessed. Results The results showed that the 2.5 ATA 99.9% oxygen-exposed group experienced a significant worsening of lung injury, as well as increased lung permeability, lung wet/dry ratio, and protein content in alveolar lavage fluid when compared to the control group. Moreover, mRNA levels of pro-inflammatory cytokines IL-1β, IL-6, TNF-α, and IFN-γ in the lung tissue of the model group were significantly elevated, while the levels of anti-inflammatory cytokines IL-4 and TGF-β were significantly reduced. The oxidative index MDA also significantly increased, while the antioxidant index GSH significantly decreased. Additionally, the expression of GPX4, a marker of ferroptosis, increased with an increase in iron content. Neoscopolamine treatment successfully reversed those effects. Conclusion The combined use of ANI and NEO had a protective effect on pulmonary oxygen poisoning. Neoscopolamine may inhibit inflammation and oxidative stress by activating the cholinergic anti-inflammatory pathway, thereby reducing the content of free iron in lung tissue and finally inhibiting cell ferroptosis. [ABSTRACT FROM AUTHOR]

Craniectomy is a lifesaving procedure to alleviate dangerously high intracranial pressure by removing a bone flap from the calvarium. However, the osteointegration of reimplanted bone flap with the existing bone tissue is still a clinical challenge. Hyperbaric oxygen (HBO) therapy has shown efficacy in promoting bone repair and could be a promising treatment for accelerating postoperative recovery. However, the specific cell types that are responsive to HBO treatment are not well understood. In this study, we created a murine model of craniectomy, with reimplantation of the cranial flap after 1 week. The effects of HBO treatment on bone formation and blood vessel formation around reimplanted bone were examined by micro‐computed tomography, histological staining, and immunofluorescence staining. Single‐cell RNA sequencing (scRNAseq) was utilized to identify key cell subtypes and signaling pathways after HBO treatment. We found that HBO treatment increased bone volume around reimplanted cranial flaps. HBO also increased the volume of Osterix‐expressing cells and type H vessels. scRNAseq data showed more mature osteoblasts and endothelial cells, with higher expressions of adhesion and migration‐related genes after HBO treatment. Cell–cell interaction analysis revealed a higher expression level of genes between mature osteoblasts and endothelial cells from the angiopoietin 2‐integrin α5β1 pathway. Taken together, HBO therapy promotes the healing process of craniectomy by regulating the crosstalk between vascular endothelial cells and osteogenic cells. These findings provide evidence in a preclinical model that HBO therapy enhances osteointegration by regulating angiogenesis–osteogenesis coupling, providing a scientific basis for utilizing HBO therapy for accelerating postoperative recovery after craniectomy. [ABSTRACT FROM AUTHOR]

Purpose: Malignant otitis externa (MOE) is a rare form of invasive osteomyelitis of the external ear canal. It is typically caused by Pseudomonas aeruginosa in immunocompromised patients. The diagnosis is clinical, and the initial treatment involves systemic antibiotics or antifungal therapy. Surgery is usually only considered when medical treatment has failed. Although hyperbaric oxygen therapy (HBOT) is recommended for refractory osteomyelitis, there are no specific guidelines for MOE. Methods: This is a retrospective study that evaluates clinical data, treatment, and results obtained in patients diagnosed with MOE treated with HBOT at the Pedro Hispano Hospital between 2007 and 2022. Results: During the study period, fifteen patients diagnosed with MOE were admitted for treatment with HBOT. All patients received antibiotic and/or antifungal therapy, and three required surgical intervention before starting HBOT. The pathology was successfully managed on all patients. Conclusions: HBOT may be an effective adjuvant treatment option in patients with MOE but it lacks robust scientific evidence. However, its therapeutic value should not be underestimated due to the good results and few adverse effects reported in recent retrospective studies and case reports. [ABSTRACT FROM AUTHOR]

Introduction: The rising incidence of filler-induced vascular complications in the context of aesthetic procedures necessitates a thorough assessment of therapeutic options. Hyperbaric oxygen therapy (HBOT) has emerged as a potential intervention for filler-induced vascular occlusion (FIVO), although optimal dosing and timing remain undefined. Methods: This review explores the pathophysiology of FIVO and elucidates HBOT's multifaceted role in salvaging ischemic tissue. The physical and biochemical mechanisms of HBOT, including its vasodilatory, anti-spasmodic, and anti-inflammatory effects, are examined. Results: HBOT serves as an adjunctive therapy in FIVO management, emphasizing timely intervention, adherence to specific pressures (two atmosphere absolute), and session durations (60 minutes) to optimize efficacy and minimize complications. While existing HBOT protocols for compromised grafts provide insights, standardized guidelines for FIVO are lacking. Conclusion: HBOT enhances tissue oxygenation, modulates reactive oxygen species, and influences angiogenesis and hypoxia response. However, it does not replace key treatment protocols for filler vascular complications. Further research and standardized protocols are warranted to define HBOT's definitive role in mitigating filler-induced vascular complications. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]

Acute ischemic stroke (AIS) is a major global health concern due to its high mortality and disability rates. Hemorrhagic transformation, a common complication of AIS, leads to poor prognosis yet lacks effective treatments. Preclinical studies indicate that hyperbaric oxygen (HBO) treatment within 12 h of AIS onset alleviates ischemia/reperfusion injuries, including hemorrhagic transformation. However, clinical trials have yielded conflicting results, suggesting some underlying mechanisms remain unclear. In this study, we confirmed that HBO treatments beginning within 1 h post reperfusion significantly alleviated the haemorrhage and neurological deficits in hyperglycemic transient middle cerebral arterial occlusion (tMCAO) mice, partly due to the inhibition of the NLRP3 inflammasome-mediated pro-inflammatory response in microglia. Notably, reactive oxygen species (ROS) mediate the anti-inflammatory and protective effect of early HBO treatment, as edaravone and N-Acetyl-l-Cysteine (NAC), two commonly used antioxidants, reversed the suppressive effect of HBO treatment on NLRP3 inflammasome-mediated inflammation in microglia. Furthermore, NAC countered the protective effect of early HBO treatment in tMCAO mice with hyperglycemia. These findings support that early HBO treatment is a promising intervention for AIS, however, caution is warranted when combining antioxidants with HBO treatment. Further assessments are needed to clarify the role of antioxidants in HBO therapy for AIS. [ABSTRACT FROM AUTHOR]

Diabetic nephropathy (DN) is a microvascular complication of diabetes mellitus (DM) and is the main cause of 20 to 40 times higher mortality compared to diabetes without nephropathy. Therefore, the author wants to prove the effect of hyperbaric oxygen therapy (HBO) on changes in blood glucose levels, proteinuria and kidney tissue necrosis cells in DN animal models. This study used 27 male white rats Rattus Norvegicus strain Wistar, weighing 170 - 220 grams, aged 8-12 weeks, healthy and active, divided into 3 groups, namely the normal rats group (G0), the DN rats without HBO group (G1) and the DN rats with HBO group (G2). Making a DN model with Streptozotocin (STZ) induction 75 mg / kgBW intraperitoneally in a single dose. HBO was performed in a 2.4 ATA pressurized air chamber by inhaling 98% O2 for 3 x 30 minutes interspersed with inhaling normal air for 2 x 5 minutes for 5 consecutive days. The results showed a significant decrease in blood glucose levels p = 0.000 (p <0.05). In proteinuria levels, there was an insignificant decrease p = 0.077 (p > 0.05) in G2 compared to G1. Repair of kidney tissue damage was also indicated by a decrease in necrotic cells by 45.45% in G2 compared to G1. These results prove that HBO can repair kidney damage in DN model mice, so HBO is expected to be used as an additional therapy in cases of diabetic nephropathy. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effects of mild hypothermia combined with hyperbaric oxygen on myocardial injury markers, oxidative stress response and neurofactors levels in patients with acute carbon monoxide poisoning (ACMP), so as to provide clinical guidance for the treatment of ACMP. Methods: A total of 96 ACMP patients admitted to our hospital from January 2022 to May 2023 were selected and divided into study group (n = 48) and control group (n = 48) by random number table method. The control group was given hyperbaric oxygen therapy, and the study group was given mild hypothermia combined hyperbaric oxygen therapy. Myocardial injury markers, oxidative stress, neurofactors, neurological function, coma degree, ability of daily living, mortality, incidence of acute carbon monoxide poisoning delayed encephalopathy (DEACMP) and adverse reactions were compared between the two groups. Results: After treatment, the levels of brain natriuretic peptide (BNP), creatine kinase isoenzyme (CK-MB) and creatine kinase isoenzyme (cTnI) in two groups were decreased (P < 0.05) and the levels in the study group were lower than those in the control group(P<0.05). After treatment, the levels of glutathione peroxidase enzyme (GSH-Px) and superoxide dismutase(SOD) in the two groups were increased (P < 0.05), while the levels of malondialdehyde (MDA) and nitric oxide (NO) were decreased (P < 0.05) The levels of GSH-Px and SOD in the study group were higher than those in the control group (P < 0.05), and the levels of MDA and NO were lower (P < 0.05) After treatment, serum neuron specific enolase (NSE), myelin basic protein (MBP) and cerebrospinal fluid central nerve specific protein (S100ß) were decreased in both groups (P < 0.05), and those in the study group were lower than those in the control group (P < 0.05) . After treatment, the score of National Institutes of Health Stroke Scale (NIHSS) decreased (P < 0.05) while the score of Glasgow Coma Scale (GCS) and Barthel (BI) of standard daily living ability increased (P < 0.05) The NIHSS score of the study group was lower than that of the control group P < 0.05 ), and the scores of GCS and BI were higher (P < 0.05) Mortality and incidence of DEACMP in the study group were 2.08% (1/48) and 16.67% (8/48), which were lower than 10.42% (5/48) and 27.08% (13/48) in the control group (P<0.05). The incidence of adverse reactions in the study group was 12.50% (6/48), which had no statistical significance compared with 18.75% (9/48) in the control group (P>0. 05). Conclusion: The application of mild hypothermia combined with hyperbaric oxygen in the treatment of ACMP patients can reduce the degree of myocardial and nerve damage and coma, relieve the oxidative stress reaction, promote the recovery of nerve function, improve the ability of daily living, reduce the mortality and the incidence of DEACMP, with high safety. [ABSTRACT FROM AUTHOR]

Introduction: The effects of methylphenidate, a stimulant often prescribed for the treatment of attention-deficit/hyperactivity disorder (ADHD), on the development of central nervous system oxygen toxicity (COT) have not been experimentally evaluated. Methods: The records of all pure-oxygen-rebreather divers evaluated at our institution from 1975-2022 were assessed. Cases of COT were defined as a new onset of tinnitus, tunnel vision, myoclonus, headache, nausea, loss of consciousness, or seizures resolving within 15 minutes from breathing normobaric air, and matched 4:1 with similar controls. Any medications issued to the diver in the preceding three months, including methylphenidate, were recorded. In the animal arm of this study, male mice were exposed to increasing doses of methylphenidate orally, with subsequent exposure to hyperbaric O2 until clinically evident seizures were recorded. Results: Seventy-five cases of COT were identified in divers, occurring at a median of 80 (range 2-240) minutes after dive initiation at a median depth of 5 m (2-13). Hypercarbia was documented in 11 (14.7%) cases. Prescription of methylphenidate in the preceding three months was not associated with increased risk (OR 0.72, 95% CI 0.16-3.32) of COT. In mice, increasing methylphenidate exposure dose was associated with significantly longer mean COT latency time being 877 s (95% CI 711-1,043) with doses of 0 mg·kg-1; 1,312 s (95% CI 850-1,773) when given 0.75 mg·kg-1; and 1,500 s (95% CI 988-2,012) with 5 mg·kg-1 (F = 4.635, P = 0.014). Conclusions: Observational human data did not demonstrate an association between methylphenidate and an increased risk of COT. Methylphenidate exposure in mice prolongs COT latency and may have protective effects against COT. [ABSTRACT FROM AUTHOR]

目的 评估不同供氧方式的高压氧治疗下，发病30 d内卒中术后患者经皮氧分压（transcutaneous oximetry，TcPO2）的变化。 方法 回顾性纳入2023年1月1日—2024年6月20日在高压氧科接受治疗的发病30 d内卒中术后患者，根据气道情况分为正常气道面罩加储气囊供氧（面罩组）和人工气道头罩供氧（头罩组）。高压氧治疗期间实时监测TcPO2，比较两种供氧方式下TcPO2变化。 结果 本研究共入选26例患者，面罩组和头罩组各13例。面罩组升压开始时TcPO2为（55.92±9.58）mmHg （1 mmHg=0.133 kPa），稳压吸氧阶段TcPO2平均值和最大值分别为（679.30±186.80）mmHg和（881.40±208.20）mmHg，减压结束TcPO2为（83.71±21.54）mmHg。头罩组升压开始时TcPO2为（62.92±14.84）mmHg，稳压吸氧阶段TcPO2平均值和最大值分别为（369.50±163.00）mmHg和（487.90±212.10）mmHg，减压结束TcPO2为（84.25±19.95）mmHg。面罩组稳压吸氧阶段TcPO2的平均值和最大值高于头罩组相应指标，差异有统计学意义（P

Abstract Acute ischemic stroke (AIS) is a major global health concern due to its high mortality and disability rates. Hemorrhagic transformation, a common complication of AIS, leads to poor prognosis yet lacks effective treatments. Preclinical studies indicate that hyperbaric oxygen (HBO) treatment within 12 h of AIS onset alleviates ischemia/reperfusion injuries, including hemorrhagic transformation. However, clinical trials have yielded conflicting results, suggesting some underlying mechanisms remain unclear. In this study, we confirmed that HBO treatments beginning within 1 h post reperfusion significantly alleviated the haemorrhage and neurological deficits in hyperglycemic transient middle cerebral arterial occlusion (tMCAO) mice, partly due to the inhibition of the NLRP3 inflammasome-mediated pro-inflammatory response in microglia. Notably, reactive oxygen species (ROS) mediate the anti-inflammatory and protective effect of early HBO treatment, as edaravone and N-Acetyl-l-Cysteine (NAC), two commonly used antioxidants, reversed the suppressive effect of HBO treatment on NLRP3 inflammasome-mediated inflammation in microglia. Furthermore, NAC countered the protective effect of early HBO treatment in tMCAO mice with hyperglycemia. These findings support that early HBO treatment is a promising intervention for AIS, however, caution is warranted when combining antioxidants with HBO treatment. Further assessments are needed to clarify the role of antioxidants in HBO therapy for AIS.

Segmental maxillary osteotomy, a surgical technique used in orthognathic surgery, involves the risk of palatal mucosa tearing, which can lead to severe complications. Herein, we report the case of a woman with Angle class II malocclusion who underwent multiple elective segmental maxillary osteotomy and augmentation genioplasty procedures for the correction of her malocclusion and the enhancement of her facial profile. A week after surgery, the patient developed a palatal ulcer. We adopted a comprehensive treatment approach involving 14-day hyperbaric oxygen therapy and conventional modalities; this approach resulted in favorable outcomes. Our case underscores the importance of immediate intervention and the synergistic potential of the comprehensive approach against oronasal fistula formation. Our findings indicate that hyperbaric oxygen therapy promotes wound healing, particularly in patients with complications arising from maxillofacial surgery.

Introduction: Our objective was to explore the e_cacy of hyperbaric oxygen in the treatment of sudden sensorineural hearing loss by conducting an umbrella review of all existing evidence. Methods: We conducted an umbrella review, searching for related articles in the PubMed, Web of Science, Embase, and Scopus databases. The search period covered from the inception of each database until April 2024. We extracted authors, country of publication, time of publication, number of included studies and participants, interventions, summary of results, P-values, I², relative risk (95% CI), and outcome measures. The methodological quality, evidence quality, and overlap rate of the included articles were assessed using AMSTAR 2, GRADE, and OVErviews (GROOVE). Results: Methodological quality was assessed using AMSTAR 2. Of the nine included articles, two were assessed as "high," three as "moderate," two as "low," and the remaining two as "very low." The quality of evidence was assessed using the GRADE system. It was found that the quality of evidence in most of the studies was unsatisfactory. It was found that there was a slight overlap among the included articles. Six studies reported positive results (OR 1.37; 95% CI, 1.17-1.61; P = 0.04), with high heterogeneity observed (I² = 63%). Egger's test indicated bias (P = 0.000101). Three studies reported negative results (MD 1.49; 95% CI, -0.32 to 3.29; P = 0.43; I² = 0%), with no significant bias detected (P = 0.106) according to Egger's test. Conclusion: HBO therapy is shown to be an e_ective treatment for SSNHL with fewer side effects. However, the methodological quality and evidence of the systematic reviews and meta-analysis included in this study were generally low. Therefore, more high-quality, large-scale, multi-center randomized controlled trials are needed in the future to verify the efficacy of HBO therapy for SSNHL. Systematic review registration: https://www.crd.york.ac.uk/prospero, identifier [CRD42024523651]. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effects of hyperbaric oxygen combined with alteplase intravenous thrombolysis on cerebral blood perfusion status and serum ischaemic modified albumin (IMA), neurofilament light chain protein (NFL) and Occludin levels in patients with acute ischemic stroke (AIS). Methods: 124 patients with AIS in our hospital from June 2022 to June 2023 were selected as the study objects, and were randomly divided into control group and observation group, 62 cases in each group. The control group was given alteplase intravenous thrombolysis therapy, and the observation group was given hyperbaric oxygen therapy on the basis of the control group. The clinical efficacy, National institute of Health Stroke Scale (NHISS) and modified Rankin scale (m RS) score, cerebral perfusion status [cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), time to peak (TMax], serum IMA,NFL, Occludin levels and incidence of adverse reactions were compared between the two groups. Results: Compared with control group,the total effective rate of observation group was higher, NHISS and m RS score were decreased after 2 weeks of treatment (P＜0.05). Compared with control group, CBF and CBV were increased and MTT and TMax were shortened in observation group after 2 weeks of treatment (P＜0.05). Compared with control group, serum IMA, Occludin and NFL levels in observation group decreased after 2 weeks of treatment (P＜0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P＞0.05). Conclusion: Hyperbaric oxygen combined with alteplase intravenous thrombolytic therapy for AIS patients can improve cerebral blood perfusion, reduce serum IMA, Occludin and NFL levels, and alleviate nerve function injury, with significant efficacy and high safety. [ABSTRACT FROM AUTHOR]

Recently, the role of high-concentration oxygen therapy in cerebral hemorrhage has been extensively discussed. This review describes the research progress in high-concentration oxygen therapy after cerebral hemorrhage. High-concentration oxygen therapy can be classified into two treatment methods: hyperbaric and normobaric high-concentration oxygen therapy. Several studies have reported that high-concentration oxygen therapy uses the pathological mechanisms of secondary ischemia and hypoxia after cerebral hemorrhage as an entry point to improve cerebral oxygenation, metabolic rate, cerebral edema, intracranial pressure, and oxidative stress. We also elucidate the mechanisms by which molecules such as Hypoxia-inducible factor 1-alpha (HIF-1α), vascular endothelial growth factor, and erythropoietin (EPO) may play a role in oxygen therapy. Although people are concerned about the toxicity of hyperoxia, combined with relevant literature, the evidence discussed in this article suggests that as long as the duration, concentration, pressure, and treatment interval of patients with cerebral hemorrhage are properly understood and oxygen is administered within the treatment window, it can be effective to avoid hyperoxic oxygen toxicity. Combined with the latest research, we believe that high-concentration oxygen therapy plays an important positive role in injuries and outcomes after cerebral hemorrhage, and we recommend expanding the use of normal-pressure high-concentration oxygen therapy for cerebral hemorrhage. [ABSTRACT FROM AUTHOR]

In this study, we wanted to investigate the effectiveness of combining disease‐modifying anti‐rheumatic drugs (DMARD) with hyperbaric oxygen therapy (HBOT) in reducing inflammation in a rheumatoid arthritis (RA) model using rats. We divided 56 male Sprague–Dawley rats into seven groups and induced RA using complete Freund's adjuvant. Some groups received HBOT, whereas others were given etanercept or leflunomide. We started the treatment on the 10th day after inducing RA and continued it for 18 days. To evaluate the effectiveness of the treatments, we measured paw swelling and used X‐rays to examine the joints before and after the treatment. We also analysed the levels of two inflammatory markers, tumour necrosis factor (TNF)‐α and interleukin (IL)‐1β, using an enzyme‐linked immunosorbent assay. Additionally, we conducted histological analysis and assessed the expressions of anti‐IL‐1β and anti‐TNF‐α antibodies. All the treatment groups showed a significant decrease in arthritis scores, paw swelling and levels of TNF‐α and IL‐1β. The X‐ray images revealed improvements in joint structure, and the histopathological analysis showed reduced inflammation and collagen abnormalities. Combining DMARD with HBOT had similar effects to individual therapies, suggesting a cost‐effective and potentially safer approach for improving outcomes in rats with RA. [ABSTRACT FROM AUTHOR]

Objective To investigate the effects of hyperbaric oxygen combined with ulinastatin on choline acetyltransferase (ChAT), malondialdehyde (MDA), and myocardial function in rats with acute organophosphorus pesticide poisoning. Methods 50 specific-pathogen-free (SPF) male SD rats were randomly divided into five groups of ten each: normal group (N), model group (M), hyperbaric oxygen group (H), and ulinastatin group (U), and hyperbaric oxygen combined ulinastatin (O) group. The model of acute organophosphorus pesticide poisoning was established in the M, H, U, and O groups via cumulative subcutaneous injections on the neck back, and the N group did not set up the model. After the success of the modeling, the H group was treated with hyperbaric oxygen therapy, and the U group was intraperitoneally injected with ulinastatin at a dose of 100 000 U/kg.The O group received a combination of hyperbaric oxygen and ulinastatin treatment, whereas the N and M groups were gavaged with an equivalent volume of saline. The rats' myocardial function was assessed through cardiac echocardiography, brain tissue pathology was examined using hematoxylin and eosin (HE) staining and Nissl staining, cardiomyocyte apoptosis was evaluated by TUNEL assay, and ChAT and acetylcholine (Ach) content in rat brain tissues were determined through histochemical methods. Serum levels of MDA and superoxide dismutase (SOD) were measured using the thiobarbituric acid reactive substances (TBARS) assay. Statistical analysis was performed by SPSS 22.0. Results Compared with Group N, the left ventricular end systolic dimension (LVSD) and left ventricular end diastolic dimension (LVDD) in Group M were both enlarged, with increased interventricular septum (IVS) thickness, aggravated left ventricular strain (LVS), increased number of apoptotic cardiomyocytes, and elevated Ach and MDA levels (P<0.05). Additionally, the left ventricular ejection fraction (LVEF) decreased, while ChAT and SOD levels also decreased (P<0.05). When compared to Group M, both Groups H and U exhibited reduced LVSD and LVDD, thinner IVS, decreased LVS, and fewer apoptotic cardiomyocytes. Furthermore, Ach and MDA levels were lower (P<0.05), while LVEF, ChAT, and SOD levels were higher (P<0.05). No statistically significant difference was observed between Groups U and H (P>0.05), while Group O showed more pronounced changes compared to Group U (P<0.05). Rats in Group N exhibited normal brain tissue pathological morphology, while those in Group M suffered severe damage to brain tissue structure. Compared to Group M, significant improvements in symptoms were observed in Groups H, U, and O. Conclusions Hyperbaric oxygen combined with ulinastatin has a significant effect on acute organophosphorus pesticide poisoning rats, which can significantly increase ChAT content, decrease MDA content, and effectively improve myocardial function. [ABSTRACT FROM AUTHOR]

Orthodontic treatment often involves tooth retraction involving the alveolar bone. Metalloproteinase-8 (MMP-8) protein, osteoblast cells, and osteoclasts are indicators of bone remodeling. Combining α-mangostin and hyperbaric oxygen therapy can improve bone repair after orthodontic retraction. To assess the alveolar cell bone and MMP-8 expression for bone remodeling in endodontic retraction after α-mangostin administration and hyperbaric oxygen therapy. A total of 25 model animals were subjected to short (orthodontic) elastomeric chain retraction for 28 days. Then, osteoblast and osteoclast bone cells were treated with H and E staining and MMP-8 protein with immunohistochemistry. The α-mangostin therapy or combination with hyperbaric oxygen therapy was a significant increase in the number of osteoblasts (p=0.010) and osteoclasts (p=0.021), as well as MMP-8 expression (p=0.038) in the treatment group. There was a strong and significant positive correlation between the number of osteoblasts and osteoclasts (r=0.803, p= 0.012), osteoclasts and MMP-8 (r=0.973, p=0.021), and osteoblasts and MMP-8 (r=0.82, p=0.041). The α-mangosteen, hyperbaric oxygen, and combination therapy showed the ability to improve alveolar bone repair initiated by an increase in osteoblast cells and a decrease in osteoclast cells in line with the response of MMP-8 protein. [ABSTRACT FROM AUTHOR]

Hyperbaric oxygen (HBO2) breathing induces generalized tonic and clonic seizures through poorly understood mechanisms. The purpose of the research was to evaluate the mechanisms of involvement of monoamine oxidase (MAO) in the development of hyperbaric oxygen seizures. In rats placed in a pressure chamber under an oxygen pressure of 5 ATA, convulsive reactions were analyzed after the administration of pyrazidol, an MAO-A inhibitor, and pargyline, an MAO-B inhibitor. Studies have shown a decrease in the activity of MAO isoforms in HBO2 as well as a delay in the development of seizures in animals with inhibition of MAO-A and MAO-B. The level of GABA in the brain decreased with HBO2, and inhibition of MAO-B with pargyline prevented the decrease in the inhibitory transmitter. The results indicate that MAO isoforms play an important role in regulating epileptogenesis in extreme hyperoxia. Hyperbaric oxygen, inhibiting the catalytic activity of MAO by transforming its molecular structure, leads to disruption of the regulation of the exchange of monoamine neurotransmitters and a decrease in the level of GABA in the brain, which together leads to an imbalance of excitation/inhibition processes in the central nervous system, which is the basis for the development of oxygen epilepsy. [ABSTRACT FROM AUTHOR]

Despite constant achievements in treatment, acute kidney injury (AKI) remains a significant public health problem and a cause of mortality in the human population. In developed countries, AKI is a significant and frequent hospital complication, especially among patients admitted to intensive care units, where mortality rates can reach up to 50%. In addition, AKI has been implicated as an independent risk factor for the development of chronic kidney disease. Hyperbaric oxygenation (HBO) has been used as a primary or adjunctive therapy for the past 50 years, both in experimental and clinical studies. HBO is a treatment in which the patient is occasionally exposed to 100% oxygen at a pressure greater than atmospheric pressure at sea level. However, despite decades of extensive research, the potentially beneficial effects of this therapeutic approach are still not fully understood, although many potential mechanisms have been proposed, such as antioxidative, anti-inflammatory, anti-apoptotic, etc. Furthermore, the low cost and insignificant adverse events make HBO a potentially important strategy in the prevention and treatment of different diseases. Considering all of this, this review highlights the potential role of HBO in maintaining cellular homeostasis disrupted due to AKI, caused in different experimental models. [ABSTRACT FROM AUTHOR]

Objective: To analyze the efficacy and associated factors affecting the prognosis in patients with disturbance of consciousness after hyperbaric oxygen (HBO) treatment. Methods: A retrospective study was carried out on patients with disorders of consciousness (DOC) receiving HBO treatment from January to January 2022 in the Second Department of Rehabilitation Medicine of the Second Hospital of Hebei Medical University, China. Results: HBO therapy improved the Glasgow Coma Scale (GCS) and Chinese Nanjing Persistent Vegetative State Scale (CNPVSS), as well as the clinical efficacy in patients with DOC. The comparison of GCS and CNPVSS scores in patients with DOC before and after HBO treatment was all statistically significant, with 325 patients (67.1%) showing effective results and 159 patients (32.9%) having unchanged outcomes. Univariate analysis indicated that there were statistically significant differences in age, HBO intervention time, HBO treatment times, pre‐treatment GCS score, and etiology and underlying diseases between the good and poor prognoses groups. Multivariate regression analysis showed that HBO intervention time ≤7 days, HBO treatment ＞ times, high GCS score before HBO treatment, and brain trauma were independent influencing factors in achieving a good prognosis for patients with DOC. Low pre‐treatment GCS scores were an independent risk factor for a poor prognosis in patients with brain trauma while being male, late HBO intervention time, fewer HBO treatment times, and low pre‐treatment GCS scores were independent risk factors for a poor prognosis in patients with DOC after a stroke. Being ≥50 years of age, late HBO intervention time, and low pre‐treatment GCS scores were independent risk factors for a poor prognosis in patients with DOC after hypoxic‐ischaemic encephalopathy. Conclusion: HBO therapy can improve the GCS, CNPVSS scores and clinical efficacy in patients with DOC, and the timing of HBO intervention ≤7 days, times of HBO treatment, high pre‐treatment GCS score, and brain trauma were the independent influencing factors of good prognosis in patients with DOC. [ABSTRACT FROM AUTHOR]

MMP-8 protein, osteoblast cells, and osteoclasts are markers of bone remodeling. Combining α-mangostin with hyperbaric oxygen therapy can enhance bone regeneration during orthodontic retraction. The aim of the research is to assess the alveolar cell bone and MMP-8 expression for bone remodeling in endodontic retraction after α-mangostin administration and hyperbaric oxygen therapy. Short (orthodontic) elastomeric chain retraction was performed on 25 model animals over a 28-day period. The osteoblast and osteoclast bone cells were then stained with H and E, and immunohistochemistry was used to detect MMP-8 protein. The α-mangosteen, hyperbaric oxygen, and combination therapy group improved alveolar bone repair by increasing osteoblast cells and decreasing osteoclast cells, which corresponded to bone formation of matrix and an increase in MMP- 8 protein. α-mangosteen therapy or in combination with hyperbaric oxygen therapy improved MMP-8 protein expression in alveolar bone after orthodontic retraction, resulting in balanced generation of osteoblast and osteoclast cells. [ABSTRACT FROM AUTHOR]

The hip is the most common location for avascular necrosis of the femoral head (AVN), with an estimated incidence in the United States of 10,000 to 20,000 new cases per year. The current standard of care for early disease is core decompression, with bone marrow injections becoming more commonplace. Hyperbaric oxygen enhances oxygen delivery to tissue, promotes an anti-inflammatory and pro-healing environment, and helps initiate angiogenesis. We believe that these properties of HBO2 make it a unique tool for AVN and applied it in conjunction with the standard of care for our patient. [ABSTRACT FROM AUTHOR]

Carbon monoxide poisoning is one of the leading causes of mortality and morbidity by poisoning in the world. Signs and symptoms are nonspecific and related to impaired oxygen delivery to tissues, with the brain being the most affected organ due to its high oxygen demand. CO-Hb is a poor indicator of severity and long-term outcome, with clinicians relying more on clinical features such as level of consciousness and need for intubation, organ dysfunction and shock and also pH level. A 45-year-old female was found unconscious in her home with the fireplace lit and smoke all over the house. She was last seen well 18 hours before. She was brought to the emergency department and was admitted to the ICU in coma and cardiogenic shock, with a metabolic acidosis with hyperlactacidemia and a CO-Hb level of 15.5%. Laboratorial investigation revealed hepatic cytolysis, acute renal failure, rhabdomyolysis and a troponin I level of 338 ng/L. ECG showed no acute myocardial ischemia. Echocardiogram revealed diffuse hypokinesia with an ejection fraction of 25%. Head CT scan showed bilateral and symmetrical hypodensities of the globus pallidus. The patient underwent hyperbaric oxygen treatment with full neurological and cardiac recovery, allowing extubation 48 hours after admission. This rare severe case of coma due to carbon monoxide intoxication with globus pallidus injury and cardiogenic shock was successfully treated with hyperbaric oxygen, showing that it can be the right treatment choice in these cases, with an excellent impact on neurological and cardiac outcome. [ABSTRACT FROM AUTHOR]

Hypoxia in malignant tumors is a major factor in inducing the failure of clinical cancer treatment. Although several strategies have been developed to relieve hypoxia, most are still in the preclinical research phase. Therefore, hyperbaric oxygen (HBO), an approved adjuvant therapy for alleviating hypoxia clinically, is an excellent choice for enhancing the efficacy of cancer treatment that is impeded by tumor hypoxia. In this minireview, recent advances in HBO‐facilitated cancer treatment, including clinical applications and nanomedicine‐mediated cancer therapy are introduced. At the end of this minireview, the potential challenges faced by HBO therapy before clinical use are discussed. It is hoped that this review will provide a reference for future clinical research on the application of HBO in cancer treatment. [ABSTRACT FROM AUTHOR]

For short periods, even without the presence of red blood cells, hyperbaric oxygen can safely allow plasma to meet the oxygen delivery requirements of a human at rest. By this means, hyperbaric oxygen, in special instances, may be used as a bridge to lessen blood transfusion requirements. Hyperbaric oxygen, applied intermittently, can readily avert oxygen toxicity while meeting the body's oxygen requirements. In acute injury or illness, accumulated oxygen debt is shadowed by adenosine triphosphate debt. Hyperbaric oxygen efficiently provides superior diffusion distances of oxygen in tissue compared to those provided by breathing normobaric oxygen. Intermittent application of hyperbaric oxygen can resupply adenosine triphosphate for energy for gene expression and reparative and anti-inflammatory cellular function. This advantageous effect is termed the hyperbaric oxygen paradox. Similarly, the normobaric oxygen paradox has been used to elicit erythropoietin expression. Referfusion injury after an ischemic insult can be ameliorated by hyperbaric oxygen administration. Oxygen toxicity can be averted by short hyperbaric oxygen exposure times with air breaks during treatments and also by lengthening the time between hyperbaric oxygen sessions as the treatment advances. Hyperbaric chambers can be assembled to provide everything available to a patient in modern-day intensive care units. The complication rate of hyperbaric oxygen therapy is very low. Accordingly, hyperbaric oxygen, when safely available in hospital settings, should be considered as an adjunct for the management of critically injured or ill patients with disabling anemia.

Hydrogen peroxide is a commonly used oxidizing agent with many different uses such as: as a multi-purpose disinfectant, non-chlorine bleach, hair dye, chlorine neutralizer in water, as a cleaning agent. bleaching in paper production, making wound cleaning agents, sterilizing ophthalmic instruments, etc. Owing to its applications in many fields, ingestion of hydrogen peroxide is not a rare case of poisoning. A 30-year-old female patient presented to our poison control center because of epigastric pain after drinking industrial hydrogen peroxide. Physical examination revealed that the patient was conscious, had no signs of infection, was hemodynamically stable, and had abdominal tenderness in many epigastric areas. Computed tomography results showed air in the biliary tract in the liver, air in the stomach wall, and poor drug enhancement in the stomach wall. Faced with the risk of gastric wall necrosis and gas embolism, the patient was prescribed hyperbaric oxygen therapy (HBO). After 3 days of hyperbaric oxygen treatment, the patient’s clinical condition improved significantly. This article aims to discuss the mechanism of injury in hydrogen peroxide poisoning and hyperbaric oxygen therapy HBO in concentrated hydrogen peroxide poisoning.

摘要： 目的 探讨对神经内科研究生应用高压氧科混合式教学模式的效果。 方法 纳入2023年4—12月在高压氧科实习的神经内科研究生为研究对象。授课前发放调查问卷摸底研究生基础情况和需求后，应用混合式教学模式向研究生讲授高压氧理论知识和实际操作（共40学时），授课后根据出科考试和问卷调查评估教学效果。 结果 研究共纳入15名神经内科研究生，前期调查问卷显示，13名（86.67%）神经内科研究生希望将高压氧作为选修课程。采用混合式模式教学后，15名神经内科研究生均通过出科考试，出科考试成绩为（93.53±3.14）分。神经内科研究生对高压氧定义和作用机制的知晓率从授课前的40.00%（6例）提升至100%（15例）（P=0.0003）；对高压氧治疗适应证和禁忌证的知晓率从授课前的33.33%（5例）提升至93.33%（14例）（P=0.0008）；教学后，研究生对高压氧治疗方案的知晓率为80.00%（12例）。神经内科研究生对教学的满意度为100%（15例）。 结论 混合式教学模式可提升高压氧教学水平，使神经内科研究生有效掌握高压氧学科知识，教学效果显著。 Abstract: Objective To explore the effect of blending learning model in training teaching of hyperbaric oxygen (HBO) for postgraduates majoring in neurology. Methods Postgraduates who major in neurology and work as interns in the Department of HBO from April to December 2023 were enrolled in this study. After sending out questionnaires to investigate the basic situation and needs of postgraduates, the blending learning model was applied to teach theoretical knowledge and practical operations of HBO, and the total credit hours were 40. Exams and questionnaires were used to evaluate the teaching effect. Results A total of 15 neurology postgraduates were included in the study. According to the questionnaire, 13 (86.67%) neurology postgraduates hoped to take HBO as an elective course. After adopting the blending learning model, all 15 neurology postgraduates passed the exam, and the score was (93.53±3.14) points. During the course, the awareness rates of HBO definition and mechanism in these postgraduates increased from 40.00% (6 cases) to 100% (15 cases) (P=0.0003), and the awareness rates of HBO indications and contraindications increased from 33.33% (5 cases) to 93.33% (14 cases) (P=0.0003). Besides, 12 postgraduates (80%) were aware of HBO treatment regimens. The satisfaction rating of these postgraduates was 100% (15 cases). Conclusions Blending learning model can effectively enhance the teaching level of HBO, and enable the postgraduates who major in neurology to master the knowledge of HBO more effectively.

Yonggui Zhang,1 Xianzhong Lin,2 Chen Ye,2 Peiling Zhang3 1Department of Anesthesiology, The Second Hospital of Longyan, Fujian, People’s Republic of China; 2Department of Anesthesiology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, People’s Republic of China; 3Department of Anesthesiology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, People’s Republic of ChinaCorrespondence: Xianzhong Lin, Department of Anesthesiology, the First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou, People’s Republic of China, Email lxzyjs@fjmu.edu.cnBackground: With the aging of the population and the increasing incidence of neurological diseases, amnestic mild cognitive impairment (aMCI) has attracted attention. Hyperbaric oxygen (HBO) has gradually shown the potential in the treatment of aMCI as an emerging treatment method in recent times. This study is to observe the effect of HBO on the long-term learning memory of aMCI rats, and investigate the associated mechanisms.Methods: Seventy-two male rats (4-month-old) were randomly divided into control (CON) group, aMCI group, HBO group, 24 rats in each group. Each group was randomly divided into CON1, CON7, CON28; aMCI1, aMCI7, aMCI28; HBO1, HBO7, HBO28, 8 rats in each group. The aMCI model rats were established in aMCI and HBO groups. HBO group was treated with HBO for 7 days. The ethological and cytopathology which include Morris water maze (MWM) test, HE staining, TUNEL staining and the expression of Fas/FasL on neuron membrane were conducted to evaluate the effects of HBO on day 1, day 7 and day 28 after HBO treatment.Results: MWM test showed that the spatial learning and memory ability of the rats decreased in aMCI group, and recovered in HBO group; Compared with aMCI group, the pathological damage of hippocampal nerve cells was alleviated, the number of apoptotic cells was significantly reduced (P < 0.05), and the expression of Fas/FasL on the surface of nerve cell membrane was significantly weakened in HBO group (P < 0.05). There were no significant changes in the spatial learning and memory ability, pathological damage of hippocampal neurons, the number of apoptotic cells, and the changes of Fas/FasL on the surface of hippocampal neurons in HBO1, HBO7, and HBO28 groups (P > 0.05). However, in aMCI1, aMCI7, and aMCI28 groups gradually aggravated (P < 0.05).Conclusion: 1. HBO can improve the long-term learning and memory impairment by attenuating neuronal apoptosis in aMCI rats. 2. Fas/FasL mediated cell receptor death pathway is involved in the apoptosis of hippocampal neurons.Keywords: amnesic mild cognitive impairment, hyperbaric oxygen, apoptosis, learning and memory impairment

Abstract Background There are a lot of studies on the treatment of tumors with hyperbaric oxygen, while most of them are in breast cancer, prostate cancer and so on. However, there are still few studies on hyperbaric oxygen in treating hepatocellular carcinoma (HCC). According to the current data, hyperbaric oxygen is an effective means to intervene in tumors. The Warburg effect is a unique marker of glucose metabolism in tumors related to hypoxia, making it possible for hyperbaric oxygen to interfere with the tumor through the Warburg effect. Method We used the hypoxia/hyperbaric oxygen(HBO)-exposed HCC cells for in vitro studies. Glucose uptake, lactic acid, and adenosine triphosphate (ATP) assessed the Warburg effect. The expression of miR-103a-3p in HCC was detected by using qRT-PCR. The effect of miR-103a-3p/TRIM35 expression level on the cells was measured using the CCK8 method and flow cytometry. The molecular biological mechanism of miR-103a-3p in HCC was examined using the luciferase reporter, MS2-RIP assays. Result HBO inhibited the Warburg effect in hypoxic HCC cells. HBO suppressed the expression of miR-103a-3p in hypoxic HCC cells, and miR-103a-3p inhibited the expression of TRIM35 in hypoxic HCC cells. With HBO exposure, miR-103a-3p/TRIM35 regulated the Warburg effect of hypoxic HCC cells. Conclusion These findings reveal that HBO regulates the Warburg effect of hypoxic HCC cells through miR-103a-3p/TRIM35 and inhibits tumor growth.

Abstract Background Effective drug delivery of nanomedicines to targeted sites remains challenging. Given that hypobaric hypoxia and hyperbaric oxygen exposure can significantly change pharmacokinetics of drugs, it is interesting to determine whether they can regulate tissue distribution of nanomedicine, especially in tumor, for enhanced cancer therapy. Results Hypobaric hypoxia exposure improved the pharmacokinetics of paclitaxel-loaded liposomes and facilitated their distribution in the heart and liver, whereas hyperbaric oxygen exposure did not benefit and even impaired the pharmacokinetics and distribution. Particularly, both hypobaric hypoxia and hyperbaric oxygen exposure could not improve the distribution in subcutaneous tumor. Thus, we constructed orthotopic liver tumor model and discussed whether high distribution of the liposomal nanomedicine in the liver, facilitated by hypobaric hypoxia exposure, could ensure their effective accumulation in liver tumor for enhanced cancer therapy. Conclusions The liposomal nanomedicine with adjuvant hypobaric hypoxia exposure significantly inhibited the growth of orthotopic liver tumor for prolonged survival time, achieved by hypobaric hypoxia-promoted accumulation at tumor sites of the liver. It might be the first example of the application of adjuvant intermittent hypobaric hypoxia exposure in treating liver cancer.

Background: Central nervous system (CNS) injury is the most prominent feature of heatstroke and the hippocampus is prone to damage. However, the mechanisms underlying the heatstroke-induced hippocampal injury remain unclear. Hyperbaric oxygen (HBO) therapy prevents CNS injury in heatstroke mice. However, the underlying mechanisms of HBO in heatstroke-induced hippocampal injury remain unclear. This study aimed to elucidate the protective effects of HBO against hippocampal injury and its potential role in microglial pyroptosis in heatstroke rats.Methods: A rat heatstroke model and a heat stress model with a mouse microglial cell line (BV2) were, respectively, used to illustrate the effect of HBO on heat-induced microglial pyroptosis in vivo and in vitro. We used a combination of molecular and histological methods to assess microglial pyroptosis and neuroinflammation both in vivo and in vitro.Results: The results revealed that HBO improved heatstroke-induced survival outcomes, hippocampal injury, and neurological dysfunction in rats. In addition, HBO mitigates microglial pyroptosis and reduces the expression of pro-inflammatory cytokines in the hippocampus of heatstroke rats. In vitro experiments showed that HBO attenuated BV2 cell injury under heat stress. Furthermore, HBO prevented heat-induced pyroptosis of BV2 cells, and the expression of pro-inflammatory cytokines IL-18 and IL-1β was reduced. Mechanistically, HBO alleviates heatstroke-induced neuroinflammation and hippocampal injury by preventing microglial pyroptosis. Conclusions: In conclusion, HBO attenuates heatstroke-induced neuroinflammation and hippocampal injury by inhibiting microglial pyroptosis.

ABSTRACTHyperbaric oxygen (HBO) therapy is a well-established method for improving tissue oxygenation and is typically used for the treatment of various inflammatory conditions, including infectious diseases. However, its effect on the intestinal mucosa, a microenvironment known to be physiologically hypoxic, remains unclear. Here, we demonstrated that daily treatment with hyperbaric oxygen affects gut microbiome composition, worsening antibiotic-induced dysbiosis. Accordingly, HBO-treated mice were more susceptible to Clostridioides difficile infection (CDI), an enteric pathogen highly associated with antibiotic-induced colitis. These observations were closely linked with a decline in the level of microbiota-derived short-chain fatty acids (SCFAs). Butyrate, a SCFA produced primarily by anaerobic microbial species, mitigated HBO-induced susceptibility to CDI and increased epithelial barrier integrity by improving group 3 innate lymphoid cell (ILC3) responses. Mice displaying tissue-specific deletion of HIF-1 in RORγt-positive cells exhibited no protective effect of butyrate during CDI. In contrast, the reinforcement of HIF-1 signaling in RORγt-positive cells through the conditional deletion of VHL mitigated disease outcome, even after HBO therapy. Taken together, we conclude that HBO induces intestinal dysbiosis and impairs the production of SCFAs affecting the HIF-1α-IL-22 axis in ILC3 and worsening the response of mice to subsequent C. difficile infection.

Bacckground: Approximately 80% to 85% of sudden sensorineural hearing loss (SSNHL) is idiopathic, but immune-mediated mechanisms are thought to be involved. Behçet disease is an autoinflammatory vasculitis that may involve vessels of the inner ear. It can cause sensorineural hearing loss (SNHL) and an increased risk of SSNHL. Study Sample: We report a 21-year-old man who was diagnosed with Behçet disease in childhood and presented to our clinic with a 10-day history of abrupt hearing deterioration in both ears. Pure-tone audiometry showed severe to profound bilateral SNHL. Results: Oral prednisolone was prescribed for 3 weeks. Concurrent intratympanic steroid injections (ITSIs) were administered in each ear every 2 days for 5 days. A total of 15 daily sessions of hyperbaric oxygen therapy (HBOT) were completed. Acupuncture was performed every 2 days for 1 month. After these combined therapies, the patient's hearing threshold by 20 dB and his speech recognition threshold were improved. Conclusions: Some patients with SSNHL recover no hearing improvement after routine treatment, and alternative treatments including ITSI, HBOT, and acupuncture can be considered as optional. We used an aggressive multimodal approach to treat severe bilateral SSNHL in patient with Behçet disease. [ABSTRACT FROM AUTHOR]

This study aims to determine the prevalence of vestibular schwannoma (VS) among patients presenting with sudden hearing loss (SHL) and to characterize the clinical features of individuals diagnosed with both VS and SHL. We conducted an observational retrospective review at a tertiary referral center, spanning a 30-year period, focusing on patients diagnosed with SHL where VS was confirmed as the underlying cause. We included patients meeting these criteria while excluding those lacking imaging or with a pre-existing diagnosis of VS. We evaluated the audiological characteristics at the time of diagnosis and assessed clinical outcomes following treatment. Among the 403 patients presenting with SHL during the study period, 9 (2.2%) were diagnosed with VS, aged between 25 and 72 years. Although audiometric profiles varied, high-frequency hearing loss predominated, mostly categorized as mild to moderate. Six patients (66%) had Koos grade I-II schwannomas. Only 2 patients achieved complete hearing recovery post-treatment, while 4 showed no improvement. VS is a rare etiology of SHL, accounting for slightly over 2% of cases. Its symptomatology, severity, and audiometric patterns do not significantly differ from SHL caused by other factors. Tumor size does not correlate with hearing characteristics. Treatment modalities resemble those for other SHL cases, and hearing improvement does not obviate the necessity for follow-up magnetic resonance imaging (MRI) scans. [ABSTRACT FROM AUTHOR]

BACKGROUND: Currently, cerebral infarction (CI) is mainly treated by emergency craniotomy or conservative treatment. However, some studies have questioned the functional recovery of patients after hyperbaric oxygen therapy (HBOT)-specialized care. OBJECTIVE: This paper mainly explores the influence of HBOT-specialized care on limb motor function (LMF) and mental state of CI patients with hemiplegia. METHODS: The medical records of 113 CI patients with hemiplegia treated in our hospital from March 2020 to March 2022 were collected. Of these, 53 received routine care nursing (conventional group) and 60 cases were given HBOT-specialized care (research group). Patient general data, scores of Fugl-Meyer Assessment (FMA), National Institutes of Health Stroke Scale (NIHSS), Self-rating Anxiety/Depression Scale (SAS/SDS) and Barthel Index (BI), and nursing efficiency were comparatively analyzed. RESULTS: The two groups showed comparability in general data. FMA and BI scores were increased in the research group after rehabilitation treatment, higher than the baseline and those of the conventional group, while NIHSS, SAS, and SDS scores were reduced, lower compared with baseline and those of the conventional group. In addition, significantly higher nursing efficiency was determined in the research group. CONCLUSION: HBOT-specialized care has beneficial effects on LMF, mental state, negative emotions and self-care ability of CI patients with hemiplegia and can enhance nursing efficacy, which deserves clinical popularization. [ABSTRACT FROM AUTHOR]

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Background: The environmental oxygen tension has been reported to impact the blastocyst quality and cell numbers in the inner cell mass (ICM) during human and murine embryogenesis. While the molecular mechanisms leading to increased ICM cell numbers and pluripotency gene expression under hypoxia have been deciphered, it remains unknown which regulatory pathways caused the underweight fetal body and overweight placenta after maternal exposure to hyperbaric oxygen (HBO). Results: The blastocysts from the HBO‐exposed pregnant mice revealed significantly increased signals of reactive oxygen species (ROS) and nuclear Nrf2 staining, decreased Nf2 and Oct4 expression, increased nuclear Tp53bp1 and active caspase‐3 staining, and ectopic nuclear signals of Cdx2, Yap, and the Notch1 intracellular domain (N1ICD) in the ICM. In the ICM of the HBO‐exposed blastocysts, both Nf2 cDNA microinjection and Nrf2 shRNA microinjection significantly decreased the ectopic nuclear expression of Cdx2, Tp53bp1, and Yap whereas increased Oct4 expression, while Nrf2 shRNA microinjection also significantly decreased Notch1 mRNA levels and nuclear expression of N1ICD and active caspase‐3. Conclusion: We show for the first time that maternal exposure to HBO at the preimplantation stage induces apoptosis and impairs ICM cell specification via upregulating Nrf2‐Notch1‐Cdx2 expression and downregulating Nf2‐Oct4 expression. Key Findings: Compared to the blastocysts derived from normoxia‐exposed female mice, the blastocysts from hyperbaric oxygen (HBO)‐exposed mothers exhibited significantly increased levels of reactive oxygen species (ROS) and nuclear Nrf2 staining, along with significantly decreased membranous Nf2 staining throughout the entire embryo in immunofluorescence analyses. Additionally, there was a significant decrease in Oct4 expression, increased nuclear staining of Tp53bp1 and active caspase‐3, and ectopic expression of Cdx2, Yap, and the Notch1 intracellular domain (N1ICD) specifically within the inner cell mass (ICM).Both microinjections of Nf2 overexpressor cDNA and Nrf2 shRNA into the pronuclear zygotes followed by oviduct transfer before daily HBO exposures significantly decreased the nuclear expression of Cdx2, Tp53bp1 and Yap whereas increased Oct4 expression in the ICM of the HBO‐exposed blastocysts.Microinjection of Nrf2 shRNA into the pronuclear zygotes before daily HBO exposures significantly decreased Notch1 mRNA levels and nuclear expression of ectopic N1ICD and active caspase‐3 in the ICM of the HBO‐exposed blastocysts.Microinjection of Nf2 overexpressor cDNA into the pronuclear zygotes before HBO exposure did not affect the levels of cell apoptosis, Notch1 mRNA and ectopic N1ICD expression in the ICM of the HBO‐exposed blastocysts. [ABSTRACT FROM AUTHOR]

Background: There are a lot of studies on the treatment of tumors with hyperbaric oxygen, while most of them are in breast cancer, prostate cancer and so on. However, there are still few studies on hyperbaric oxygen in treating hepatocellular carcinoma (HCC). According to the current data, hyperbaric oxygen is an effective means to intervene in tumors. The Warburg effect is a unique marker of glucose metabolism in tumors related to hypoxia, making it possible for hyperbaric oxygen to interfere with the tumor through the Warburg effect. Method: We used the hypoxia/hyperbaric oxygen(HBO)-exposed HCC cells for in vitro studies. Glucose uptake, lactic acid, and adenosine triphosphate (ATP) assessed the Warburg effect. The expression of miR-103a-3p in HCC was detected by using qRT-PCR. The effect of miR-103a-3p/TRIM35 expression level on the cells was measured using the CCK8 method and flow cytometry. The molecular biological mechanism of miR-103a-3p in HCC was examined using the luciferase reporter, MS2-RIP assays. Result: HBO inhibited the Warburg effect in hypoxic HCC cells. HBO suppressed the expression of miR-103a-3p in hypoxic HCC cells, and miR-103a-3p inhibited the expression of TRIM35 in hypoxic HCC cells. With HBO exposure, miR-103a-3p/TRIM35 regulated the Warburg effect of hypoxic HCC cells. Conclusion: These findings reveal that HBO regulates the Warburg effect of hypoxic HCC cells through miR-103a-3p/TRIM35 and inhibits tumor growth. [ABSTRACT FROM AUTHOR]

Spinocerebellar ataxias (SCAs) are a large and diverse group of autosomal-dominant neurodegenerative diseases. No drugs have been approved for these relentlessly progressive and fatal SCAs. Our previous studies indicate that oxidative stress, neuroinflammation, and neuronal apoptosis are elevated in the SCA17 mice, which are the main therapeutic targets of hyperbaric oxygen treatment (HBOT). HBOT is considered to be an alternative and less invasive therapy for SCAs. In this study, we evaluated the HBOT (2.2 ATA for 14 days) effect and the persistence for the management of SCA17 mice and their wild-type littermates. We found HBOT attenuated the motor coordination and cognitive impairment of SCA17 mice and which persisted for about 1 month after the treatment. The results of several biochemistry and liver/kidney hematoxylin and eosin staining show the HBOT condition has no obvious toxicity in the mice. Immunostaining analyses show that the neuroprotective effect of HBOT could be through the promotion of BDNF production and the amelioration of neuroinflammation. Surprisingly, HBOT executes different effects on the male and female SCA17 mice, including the reduction of neuroinflammation and activation of CaMKII and ERK. This study suggests HBOT is a potential alternative therapeutic treatment for SCA17. Accumulated findings have revealed the similarity in disease pathomechanisms and possible therapeutic strategies in polyQ diseases; therefore, HBOT could be an optional treatment as well as the other polyQ diseases. [ABSTRACT FROM AUTHOR]

Background: Effective drug delivery of nanomedicines to targeted sites remains challenging. Given that hypobaric hypoxia and hyperbaric oxygen exposure can significantly change pharmacokinetics of drugs, it is interesting to determine whether they can regulate tissue distribution of nanomedicine, especially in tumor, for enhanced cancer therapy. Results: Hypobaric hypoxia exposure improved the pharmacokinetics of paclitaxel-loaded liposomes and facilitated their distribution in the heart and liver, whereas hyperbaric oxygen exposure did not benefit and even impaired the pharmacokinetics and distribution. Particularly, both hypobaric hypoxia and hyperbaric oxygen exposure could not improve the distribution in subcutaneous tumor. Thus, we constructed orthotopic liver tumor model and discussed whether high distribution of the liposomal nanomedicine in the liver, facilitated by hypobaric hypoxia exposure, could ensure their effective accumulation in liver tumor for enhanced cancer therapy. Conclusions: The liposomal nanomedicine with adjuvant hypobaric hypoxia exposure significantly inhibited the growth of orthotopic liver tumor for prolonged survival time, achieved by hypobaric hypoxia-promoted accumulation at tumor sites of the liver. It might be the first example of the application of adjuvant intermittent hypobaric hypoxia exposure in treating liver cancer. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the efficacy of hyperbaric oxygen (HBO) for the treatment of non-arteritic central retinal artery occlusion (NACRAO, CRAO). Materials and Methods: The records of patients diagnosed with CRAO between January 2017 and April 2023 at XXX Hospital were retrospectively reviewed. Treatments and detailed ophthalmological examination findings at the baseline and post-treatment follow-up of the patients were recorded. After ocular massage and acute antiglaucomatous treatment; the patients were divided into 3 groups, as group 1 received HBO therapy after anterior chamber paracentesis (ACP), group 2 received only HBO therapy, group 3 received only ACP. Data were analysed with the IBM SPSS Statistics 22 program using non-parametric tests. Results: Thirty-four patients with a median age of 72 (28-92), 12 (35.3%) women and 22 (64.7%) men, were included in the study. There were 10, 14, and 10 patients in groups 1, 2 and 3, respectively. The groups were similar in terms of age, gender, systemic diseases and time of admission (p >0.05). In groups 1, 2 and 3: baseline median visual acuity (VA) was 2.3 (2.3-3.0), 2.3 (1.3-3.0), and 2.3 (1.3-3.0) logMAR (p =0.573); the median VA at last visit was 1.9 (0.3-3.0), 1.9 (0.3-3.0), and 2.5 (1.3-3.0) logMAR (p =0.624), respectively. Only in group 1, the final VA increased significantly from baseline (p =0.035), while no significant change in VA was observed in the other groups (p =0.138 and p =0.786 for groups 2 and 3, respectively). Final VA was moderately positively correlated with baseline VA (r =0.425, p =0.012) and moderately negatively correlated with time of admission (r =-0.381, p =0.026). Conclusion: HBO therapy combined with ACP applied in the early period in the treatment of CRAO positively affects the visual prognosis. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effects of hyperbaric oxygen combined with high-frequency repetitive transcranial magnetic stimulation (rTMS) on wake-promoting effect, neuroelectrophysiology and brain injury markers in patients with disturbance of consciousness (DOC) after severe craniocerebral injury. Methods: 80 patients with DOC after severe craniocerebral injury who were admitted to Lu'an Hospital Affiliated to Anhui University of Traditional Chinese Medicine from June 2021 to June 2023 were selected. Patients were divided into control group (n=40, hyperbaric oxygen therapy ) and observation group (n=40, hyperbaric oxygen combine with high-frequency rTMS therapy) according to the random number table method. Control group received hyperbaric oxygen therapy, and observation group received hyperbaric oxygen combine with high-frequency rTMS therapy. The efficacy, wake-promoting effect, neuroelectrophysiology and brain injury markers were compared between two groups. Results: The total clinical effective rate in observation group was higher than that in control group(P<0.05). The scores of revised coma recovery scale (CRS-R) and Glasgow coma scale (GCS) in two groups increased 4 weeks after treatment, and observation group was higher than that of control group (P<0.05). The brainstem auditory evoked potential (BAFP), four limb sensory evoked potential (SEP) and electroencephalogram (EEG) grading were improved in two groups 4 weeks after treatment, and the improvement effect in observation group was better than that in control group (P<0.05). Myelin basic protein (MBP), neuron-specific enolase (NSE) and S100β protein decreased in two groups 4 weeks after treatment, and observation group was lower than that of control group(P<0.05). Conclusions: Hyperbaric oxygen combined with high-frequency rTMS therapy can effectively wake up patients with DOC after severe craniocerebral injury, improve neuroelectrophysiological activities, and reduce the degree of brain injury. [ABSTRACT FROM AUTHOR]

Objective: To study the effects of hyperbaric oxygen treatment on the expression of oxidative factors and nuclear factor E2 related factor 2 / heme oxygenase-1 signaling pathway in the brain of traumatic brain injury rats. Methods: 72 male SD rats were randomly divided into sham operation group, traumatic brain injury group and hyperbaric oxygen treatment group, with 24 rats in each group. The rats in each group were divided into 3 d and 7 d subgroups, with 12 rats in each group. The modified neurological severity score was performed on the 3 d and 7 d. The expression levels of superoxide dismutase, malondialdehyde and catalase in brain tissue were detected by enzyme activity kits. The expression levels of Nrf2 and HO-1 proteins in brain tissue were detected by Western blot. Results: The neurological function of rats in TBI group and HBO group decreased in varying degrees compared with rats in SHAM group at 3 d and 7 d after the experiment (P<0.05), and the neurological function of rats in HBO group was improved compared with TBI group (P<0.05). The expression levels of SOD and CAT of rats in TBI and HBO groups were lower than those in SHAM group (P<0.05), and the expression level of MDA was higher than that in SHAM group (P<0.05); At the same time, the expression levels of SOD and CAT of rats in HBO group were higher than those in TBI group (P<0.05), and the expression level of MDA was lower than that in TBI group (P<0.05). Western blot showed that three days after the experiment, the expression levels of Nrf2 and HO-1 protein of rats in TBI group and HBO group were higher than those in SHAM group (P<0.05), and the expression levels of Nrf2 and HO-1 protein in HBO group were higher than those in TBI group (P<0.05). However, on the 7th day after the experiment, the expression levels of Nrf2 and HO-1 protein of rats in TBI group were lower than those in SHAM group (P<0.05), and the expression levels of Nrf2 and HO-1 protein in HBO group were higher than those in SHAM group and TBI group (P<0.05). Conclusions: Rats have different degrees of neurological damage on the 3 d and 7 d after TBI. Hyperbaric oxygen treatment can improve neurological function by regulating Nrf2 / HO-1 signal pathway, which can regulate the expression levels of SOD, MDA, CAT and inhibit oxidative stress response. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the potential benefits of hyperbaric oxygen intervention on people with Alzheimer's disease (AD) based on the existing randomized controlled trials (RCTs). Methods: A systematic search was conducted in nine databases until November 17, 2023, for RCTs assessing the effect of hyperbaric oxygen intervention for AD. The primary outcomes included Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale-Cognitive (ADAS-Cog), activities of daily living (ADL), and adverse events. All results were shown in forest plots, and sensitivity analysis was adopted to further verify the robustness of the pooled results. Results: A total of 11 RCTs recruiting 847 participants were included in this meta-analysis. Based on the pooled evidence, hyperbaric oxygen could remarkably ameliorate MMSE [MD = 3.08, 95%CI (2.56, 3.61), p < 0.00001], ADAS-Cog [MD = -4.53, 95%CI (-5.05, -4.00), p < 0.00001], ADL [MD = 10.12, 95%CI (4.46, 15.79), p = 0.0005], MDA levels [SMD = -2.83, 95%CI (-5.27, -0.38), p = 0.02], SOD levels [SMD = 2.12, 95%CI (1.10, 3.15), p < 0.0001], IL-1-β levels [SMD = -1.00, 95%CI (-1.48, -0.53), p < 0.0001], and TGF-β1 levels [MD = 4.87, 95%CI (3.98, 5.76), p < 0.00001] without adverse events [OR = 1.17, 95%CI (0.68, 2.03), p = 0.58] for people with AD. The pooled results were robust after checking by sensitivity analysis. Conclusion: These evidences suggest that hyperbaric oxygen is an effective and safe intervention for the treatment of AD. Further studies with more rigorous design will help to fully evaluate the clinical value of hyperbaric oxygen on cognition function in people with AD. [ABSTRACT FROM AUTHOR]

Introduction: Increasing cancer survivorship, in part due to new radiation treatments, has created a larger population at risk for delayed complications of treatment. Radiation cystitis continues to occur despite targeted radiation techniques. Materials and Methods: To investigate value-based care applying hyperbaric oxygen (HBO2) to treat delayed radiation cystitis, we reviewed public-access Medicare data from 3,309 patients from Oct 1, 2014, through Dec 31, 2019. Using novel statistical modeling, we compared cost and clinical effectiveness in a hyperbaric oxygen group to a control group receiving conventional therapies. Results: Treatment in the hyperbaric group provided a 36% reduction in urinary bleeding, a 78% reduced frequency of blood transfusion for hematuria, a 31% reduction in endoscopic procedures, and fewer hospitalizations when study patients were compared to control. There was a 53% reduction in mortality and reduced unadjusted Medicare costs of $5,059 per patient within the first year after completion of HBO2 treatment per patient. When at least 40 treatments were provided, cost savings per patient increased to $11,548 for the HBO2 study group compared to the control group. This represents a 37% reduction in Medicare spending for the HBO2-treated group. We also validate a dose-response curve effect with a complete course of 40 or more HBO2 treatments having better clinical outcomes than those treated with fewer treatments. Conclusion: These data support previous studies that demonstrate clinical benefits now with costeffectiveness when adjunctive HBO2 treatments are added to routine interventions. The methodology provides a comparative group selected without bias. It also provides validation of statistical modeling techniques that may be valuable in future analysis, complementary to more traditional methods. [ABSTRACT FROM AUTHOR]

Inner ear decompression sickness (IEDCS) is an uncommon diving-related injury affecting the vestibulocochlear system, with symptoms typically including vertigo, tinnitus, and hearing loss, either in isolation or combination. Classically associated with deep, mixed-gas diving, more recent case series have shown that IEDCS is indeed possible after seemingly innocuous recreational dives, and there has been one previous report of IEDCS following routine hyperbaric chamber operations. The presence of right-to-left shunt (RLS), dehydration, and increases in intrathoracic pressure have been identified as risk factors for IEDCS, and previous studies have shown a predominance of vestibular rather than cochlear symptoms, with a preference for lateralization to the right side. Most importantly, rapid identification and initiation of recompression treatment are critical to preventing long-term or permanent inner ear deficits. This case of a U.S. Navy (USN) diver with previously unidentified RLS reemphasizes the potential for IEDCS following uncomplicated diving and recompression chamber operations -- only the second reported instance of the latter. [ABSTRACT FROM AUTHOR]

Background: Diabetes Mellitus is a chronic disease characterized by uncontrolled blood sugar levels, which lead to end-organ damage. While the diagnosis and treatment of its complications have been extensively studied, the effect of Hyperbaric Oxygen Therapy (HBO2) on diabetes-related oral complications remains unexplored. Aim: This prospective clinical study aims to investigate the effect of HBO2 on diabetes-related oral complications. Methods: Twenty patients diagnosed with diabetic foot ulcers and scheduled for HBO2 were included in this study. We recorded stimulated and unstimulated saliva pH, buffering capacity, flow rate, and subjective symptoms such as dry mouth, halitosis, taste loss, difficulty swallowing, and clinical examination findings before HBO2 and after the 21st session. Results: Upon comparing the findings, we observed a significant decrease in dry mouth and halitosis, periodontal disease severity, and healing of candida-related stomatitis and angular cheilitis. Despite not reaching statistical significance for other saliva parameters, the unstimulated salivary flow rate increased to normal limits (0.3-0.4 ml/min) in 6 out of 8 patients with a flow rate of less than 0.25 ml/min. Conclusion: Our study investigated the effect of HBO2 on diabetes-related oral complications for the first time, highlighting symptomatic relief for dry mouth and halitosis. Although our results are insufficient to report a definitive benefit, they underscore the need for further research on the oral health effects of HBO2. [ABSTRACT FROM AUTHOR]

Emergency hyperbaric oxygen treatment capability is limited in the United States, and there is little documentation of calls received by centers available 24 hours a day, seven days a week, 365 days a year. Our study aimed to calculate the number of calls received for urgent hyperbaric oxygen (HBO2). We logged calls from two HBO2 chambers on the East Coast of the United States that serve a densely populated region in 2021. The total number of emergency calls was 187 at the University of Maryland (UMD) and 127 at the University of Pennsylvania (UPenn). There were calls on 180/365 (46%) days during the study period at UMD and 239/365 (63%) days at UPenn. The most common indication was carbon monoxide toxicity. The peak month of calls was March. Emergency HBO2 calls are common, and more centers must accept emergency cases. Data from geographically diverse centers would add generalizability to these results and capture more diving-related emergencies. [ABSTRACT FROM AUTHOR]