Medical Research Articles

Traditional Chinese medicine for sjögren’s syndrome: a national survey of attitudes and perceptions among Chinese patients and rheumatologists

BackgroundThis study explored similarities and differences among Chinese patients and rheumatologists in their attitudes towards and perceptions of traditional Chinese medicine (TCM) for Sjögren’s syndrome (SS), including analyzing factors that influenced their decision making.MethodsAn anonymous questionnaire was used to conduct a multicenter survey among patients with SS at three tertiary care medical centers in Beijing and among rheumatology clinicians at several hospitals across China. Results were analyzed using descriptive statistics.ResultsThere were 942 valid questionnaires from patients from 31 provinces and cities in China, with a male-to-female ratio of approximately 1:14, a mean age of 48.81 years, and a median disease duration of 7 (4, 10) years. There were 320 valid questionnaires from rheumatologists, covering 30 provinces and cities in China, with a male-to-female ratio of approximately 0.87:1, a mean age of 48 years, and a median work duration of 10.5 (6, 15) years. The rheumatologists treated a median of 15 (11, 50) SS cases per month, and the median proportion of SS to all rheumatic diseases was 6.66% (6–10%). Many patients believed TCM could cure the root of the disease, and the most expected TCM therapies were TCM patent prescriptions and medicinal teas. Conversely, rheumatologists placed high value on the efficacy of TCM, and most commonly prescribed Chinese herbal decoctions. Most doctor-patient groups were positive about TCM treatment, citing the low side effects as the major advantage. Regression analysis showed that for patients over 40 years old with a course of disease > 4 years, the probability of using TCM has increased by 1–6 times; the probability of recommending TCM in clinical work of doctors who have worked for more than 15 years, TCM and integrated traditional Chinese and western medicine has increased 1–2 times.ConclusionsTCM has become widely accepted and earned attention from doctor-patient groups, especially among older patients and experienced rheumatologists. However, negative prejudices and absence of accurate information about TCM treatments and SS itself require improvement. The contradiction between TCM dosage form and efficacy is a major problem, and patient demand for convenient and efficient TCM patent preparations suggests future work should focus on developing TCM patent preparations with clear compositions and mechanisms.

Gallium complexation for DO3A coated nanoparticles: a comprehensive study

This review provides a comprehensive review of the synthesis and utilization of DO3A-functionalized NPs (Particularly for MRI and PET/CT analysis). The main focus of the study is the formation of a complex of gallium with NPs coated with DO3A, as well as showing the possibility of improving contrast agents and creating new gallium-based nanomaterials for medical use. The synthesis process studies parameters like pH, temperature, and the effect of substitution of the ligand using various chemical analysis techniques to determine the physicochemical properties of these nano-scale particles. This implies that gallium-loaded NPs have the potential to enhance the fight against infectious diseases, as proved by the NPs' vital role in antimicrobial therapies for PET imaging. Research with animals has shown significant biodistribution to the organs and tissues of interest, which have helped enhance the imaging features of MRI and PET/CT scans. Likewise, the findings on biocompatibility and toxicity point to possible clinical application of these nanoparticles. As for future research directions, the synthesis of other new derivatives of Gd-DO3A complexes containing lipophilic monoamides and the examination of ionization's influence on encapsulation efficiency have been mentioned. This review stresses the promising use of DO3A-coated nanoparticles for nanomedicine as therapeutic agents or imaging probes.

Hyaluronic acid and the relevance of its use in dysfunction of the temporomandian joint

To identify the most revealing studies in the field of non-cosmetic medical use of hyaluronic acid and determine its prospects for further use in the treatment of problems with the temporomandibular joint.The material for the work was the research of specialists from Mexico, Italy, the USA and Russia, analyzing the use of hyaluronic acid in various areas of joint treatment.An analysis was made of five large studies on this topic, during which patients with joint diseases received intra-articular injections of hyaluronic acid using samples. Patients, depending on the purpose of a particular study, were asked to take a course of hyaluronic acid and a placebo / other medicinal substance.As a result of the analysis, it was found that most of the above studies showed a positive effect of hyaluronic acid in the short and long term in the treatment of diseases of the temporomandibular joint. At the same time, in order to further expand the use of this substance, additional research is required in specific areas.

AbdomenAtlas: A large-scale, detailed-annotated, & multi-center dataset for efficient transfer learning and open algorithmic benchmarking

We introduce the largest abdominal CT dataset (termed AbdomenAtlas) of 20,460 three-dimensional CT volumes sourced from 112 hospitals across diverse populations, geographies, and facilities. AbdomenAtlas provides 673 K high-quality masks of anatomical structures in the abdominal region annotated by a team of 10 radiologists with the help of AI algorithms. We start by having expert radiologists manually annotate 22 anatomical structures in 5,246 CT volumes. Following this, a semi-automatic annotation procedure is performed for the remaining CT volumes, where radiologists revise the annotations predicted by AI, and in turn, AI improves its predictions by learning from revised annotations. Such a large-scale, detailed-annotated, and multi-center dataset is needed for two reasons. Firstly, AbdomenAtlas provides important resources for AI development at scale, branded as large pre-trained models, which can alleviate the annotation workload of expert radiologists to transfer to broader clinical applications. Secondly, AbdomenAtlas establishes a large-scale benchmark for evaluating AI algorithms—the more data we use to test the algorithms, the better we can guarantee reliable performance in complex clinical scenarios. An ISBI & MICCAI challenge named BodyMaps: Towards 3D Atlas of Human Body was launched using a subset of our AbdomenAtlas, aiming to stimulate AI innovation and to benchmark segmentation accuracy, inference efficiency, and domain generalizability. We hope our AbdomenAtlas can set the stage for larger-scale clinical trials and offer exceptional opportunities to practitioners in the medical imaging community. Codes, models, and datasets are available at https://www.zongweiz.com/dataset.

Traditional care and alternative therapies for pregnant women: a comparative review

Traditional care and alternative therapies are gradually becoming prevalent in the era of pharmaceutical medicine. Pregnant women are now using more of the traditional therapies because of the increasing acceptance, notably after the COVID-19 outbreak, to handle pregnancy issues such as morning sickness, anxiety, and pain naturally and holistically. The article includes some of the most popular traditional and alternative treatments, which include yoga, ayurveda, herbal treatment, acupressure, reflexology, massage therapy, moxibustion plus music and dance therapy, as well as aromatherapy, hypnotherapy homeopathy, and reiki. Patients will require knowledge of what each one of them has to benefit them when they use them during pregnancy since not all could be safe or even helpful while expecting a baby. A well-known fact in the literature today is an increasing reliance on traditional treatments, which is considered risk-free compared to conventional medicine, enhancing physical and psychological well-being. The paper is a basic guide to pregnancy management that may involve using traditional and alternative medicines, which have been proved by research. If these care and therapies are accompanied by good medical advice on issues concerning the wellness of the unborn child and its mother in general, will help to ease their pregnancy journey.

The Near‐Infrared Light Emitted by LiScO2:Cr3+ Phosphor Used to Induce Gland Secretion for Sjogren's Syndrome

AbstractPhotobiomodulation is promisingly used as a noninvasive new weapon against Sjogren's syndrome, which is a disorder of immune system with two main symptoms of dry eyes and a dry mouth. This work reports a new NIR LED device made from LiScO2:Cr3+ phosphor for the application. The absorbance, internal, and external quantum efficiency of the optimal Li(Sc0.98Cr0.02)O2 phosphor reach 40.9%, 34.5%, and 14.1%, respectively; and the output power and energy conversion efficiency of the LED device packaged using the phosphor driven under 20 mA are 4.23 mW, respectively. The emission spectrum of the LED device can well cover the action spectrum of oxidized CuA in cytochrome c oxidase molecules. Both the pathological changes of mice submandibular gland and the expression of human submandibular gland epithelial cells (HSG) in AQP5, M3R andEGR1 confirm that the NIR light has great potential application for treating Sjogren's syndrome. Moreover, study with mice approved that the therapy using the NIR light is more efficient than the conventional medicine treatment using hydroxychloroquine sulfate.

Beyond the petri dish: Model organisms in non-clinical exploration

Animal models have been integral to scientific research for decades, offering invaluable insights into complex biological processes, advancing medical knowledge, and aiding the development of new treatments. This review explores the significance of animal models in various research fields, emphasizing their biological similarity to humans as a key factor. Animals, ranging from mice and rats to primates, fruit flies, and worms, share fundamental physiological, anatomical, and genetic characteristics with humans, making them crucial proxies for studying diseases and biological pathways. This review underscores the essential role of animal models in preclinical research, particularly in evaluating drug candidates for safety, efficacy, and potential side effects before human trials. The controlled experimental environment provided by animal models allows researchers to manipulate variables, isolate factors, and establish cause-and-effect relationships, enhancing the understanding of complex genetic disorders.

Transparent Insights into Alzheimer’s Progression: A Time-Aware Approach with Explainable AI

Alzheimer’s disease, acknowledged for its intricate and degenerative characteristics, presents considerable challenges, particularly among the elderly population. The relentless nature of Alzheimer’s, marked by the gradual deterioration of cognitive function, underscores the urgency to develop effective strategies for early diagnosis and intervention. Artificial intelligence has played a significant role in terms of disease diagnosis and treatments. However, it has got limited acceptance in the medical community due to its lack of transparency. This study aims to advance the understanding and prediction of Alzheimer’s disease progression through the integration of time-aware modeling and Explainable AI techniques. It makes significant contributions by addressing two key objectives in the context of Alzheimer’s disease. First, by including temporal aspects, it accurately depicts the pace at which relevant predictors change over time, thereby capturing the dynamic nature of Alzheimer’s disease. Second, by giving interpretable insights into the algorithm’s decision-making process, the study hopes to empower researchers and physicians. This approach not only enhances transparency but also builds trust in the model’s outcomes. The ADNI dataset, comprising 2980 observations, was employed for developing a prediction model using various machine learning classifiers. Among these classifiers, the Random Forest model emerged as the top performer, exhibiting superior accuracy, a high Coefficient of Determination (R2), and an impressive F1 score. To enhance interpretability, subsequent analyses utilized LIME and SHAP techniques. By combining time-aware modeling with Explainable AI methods, we seek to unravel the dynamic relationships within the dataset, providing transparent insights into the temporal evolution of Alzheimer’s disease. Thus, this paper contributes to the creation of a clinically relevant and practical model for monitoring Alzheimer’s disease progression that holds the potential for a deeper understanding of the evolving nature of the disease and paving the way for personalized and timely interventions.

Rowing in the same direction to achieve organizational goals: Integrating mentoring, leadership training, and coaching to manage and evaluate individual performance

Academic medicine provides ample opportunities and resources for medical innovation, but presents unique challenges for physician-scientists, support staff, and hospital administration. In an environment that prioritizes individual research-related productivity for professional advancement, how can management guide its workforce toward common organizational objectives? Here, we describe an approach that aligns individual goals to a high-level strategic plan continuously by combining annual goal setting, performance management, mentoring of early career faculty, leadership training, and professional coaching to achieve the three pillars of the academic mission: patient care, research and teaching.

Risk Factor Analysis for Occurrence of Linezolid-Resistant Bacteria in the Digestive and Respiratory Tract of Food-Producing Animals in Belgium: A Pilot Study

Linezolid is a critically important antimicrobial used in human medicine. While linezolid is not licensed for food-producing animals, the veterinary use of other antimicrobials, such as phenicols (e.g., florfenicol), could cross/co-select for linezolid-resistant (LR) bacteria. Such LR strains pose a great concern for public health due to their potential transfer between animals and humans. This study explored possible associations between epidemiological risk factors, including phenicol use, and the occurrence of LR bacteria, such as enterococci and staphylococci, in poultry, pigs, and veal calves in Belgium. Florfenicol use significantly increased the likelihood of harboring LR bacteria in veal calves, sows, and fattening pigs, particularly for the digestive tract (odds ratio (OR): [3.19–5.29]) and the respiratory tract (OR: [6.11–9.09]). LR strains from feces from fattening pigs were significantly associated with production type (OR: [3.31–44.14]) and the presence of other animal species (OR: 0.41). The occurrence of LR strains in the respiratory tract from sows was also significantly associated with using antimicrobials other than florfenicol (OR: 10.07) and purchasing animals (OR: 7.28). Our study highlights the potential risks of using certain veterinary antimicrobials, such as florfenicol, in food-producing animals and emphasizes the need for responsible antimicrobial use to safeguard both animal and public health.

Fasudil and viscosity of gelatin promote hepatic differentiation by regulating organelles in human umbilical cord matrix-mesenchymal stem cells

BackgroundHuman mesenchymal stem cells originating from umbilical cord matrix are a promising therapeutic resource, and their differentiated cells are spotlighted as a tissue regeneration treatment. However, there are limitations to the medical use of differentiated cells from human umbilical cord matrix-mesenchymal stem cells (hUCM-MSCs), such as efficient differentiation methods.MethodsTo effectively differentiate hUCM-MSCs into hepatocyte-like cells (HLCs), we used the ROCK inhibitor, fasudil, which is known to induce endoderm formation, and gelatin, which provides extracellular matrix to the differentiated cells. To estimate a differentiation efficiency of early stage according to combination of gelatin and fasudil, transcription analysis was conducted. Moreover, to demonstrate that organelle states affect differentiation, we performed transcription, tomographic, and mitochondrial function analysis at each stage of hepatic differentiation. Finally, we evaluated hepatocyte function based on the expression of mRNA and protein, secretion of albumin, and activity of CYP3A4 in mature HLCs.ResultsFasudil induced endoderm-related genes (GATA4, SOX17, and FOXA2) in hUCM-MSCs, and it also induced lipid droplets (LDs) inside the differentiated cells. However, the excessive induction of LDs caused by fasudil inhibited mitochondrial function and prevented differentiation into hepatoblasts. To prevent the excessive LDs formation, we used gelatin as a coating material. When hUCM-MSCs were induced into hepatoblasts with fasudil on high-viscosity (1%) gelatin-coated dishes, hepatoblast-related genes (AFP and HNF4A) showed significant upregulation on high-viscosity gelatin-coated dishes compared to those treated with low-viscosity (0.1%) gelatin. Moreover, other germline cell fates, such as ectoderm and mesoderm, were repressed under these conditions. In addition, LDs abundance was also reduced, whereas mitochondrial function was increased. On the other hand, unlike early stage of the differentiation, low viscosity gelatin was more effective in generating mature HLCs. In this condition, the accumulation of LDs was inhibited in the cells, and mitochondria were activated. Consequently, HLCs originated from hUCM-MSCs were genetically and functionally more matured in low-viscosity gelatin.ConclusionsThis study demonstrated an effective method for differentiating hUCM-MSCs into hepatic cells using fasudil and gelatin of varying viscosities. Moreover, we suggest that efficient hepatic differentiation and the function of hepatic cells differentiated from hUCM-MSCs depend not only on genetic changes but also on the regulation of organelle states.

A study on Chinese Medicine to alleviate the Adverse Effects of Western Medicine in the Treatment of Lupus Nephritis

A study on Chinese Medicine to alleviate the Adverse Effects of Western Medicine in the Treatment of Lupus Nephritis

Effects of training load on heart rate variability and blood pressure in track and field athletes and skiers

BACKGROUND: Adaptation of human body to the harsh conditions of the European North remains a topic of ongoing interest, despite numerous studies on the subject. There is a need to study population groups whose daily activities involve physical activity in extreme northern conditions. One such group includes athletes who participate in endurance sports. For athletes engaged in cyclical sports, competitive activities becomes can be particularly demanding, requiring sustained physical exertion and maximum power generation. Training and competing in harsh conditions place significant strain on the body’s cardiovascular regulation mechanisms. Over time, this may result in detrimental structural and biochemical changes in the cardiovascular system. AIM: To identify the patterns of changes in heart rate regulation among track and field athletes and skiers after a training load. MATERIAL AND METHODS: Athletes from the Arkhangelsk region, including skiers and track and field athletes in the mass sports categories, who regularly compete in regional events, took part in the study. The studies took place in the medical offices of sports complexes, where the UPFT-1/30“Psychophysiologist” device was used to record and analyze cardiointervalograms. Blood pressure was recorded before and after training sessions using the Criticare System 8100H monitor. RESULTS: The initial variational span (VR) values of the duration of cardio intervals before exercise were slightly lower than the reference values in both the group of skiers and the group of athletes. At the same time, the mean square deviation (SD) values initially fell within normal range. Following the training load, both groups experienced a statistically significant decrease in SD and VR values, falling below the lower limit of the permissible range. Furthermore, spectral analysis of the cardiac intervals before exercise indicated a high level of neurohumoral regulation. After exercise, there was a statistically significant decrease in the initial values of TP in both groups, aligning with the average level of neurohumoral regulation. CONCLUSION: The results obtained in track and field athletes with a predominant anaerobic training load and skiers with a predominant aerobic load suggest that the training load of a predominantly aerobic nature may lead to less pronounced stress on the regulatory systems. This hypothesis was further supported by the results of the changes in blood pressure.

Effects of States' Methods for Estimating Nonfatal Overdose, United States, 2021.

Previous nonfatal overdose is a key risk factor for drug overdose death; however, current nonfatal overdose surveillance is limited to people who receive medical attention. We identified states that tracked nonfatal overdoses treated in prehospital and hospital care settings, assessed the effects of different surveillance methods on the magnitude of nonfatal overdose estimates, and estimated states' nonfatal-to-fatal overdose ratio. Two analysts independently reviewed state websites to characterize states' methods of capturing nonfatal overdose events from December 2022 through February 2023. We collected information on surveillance methods in 5 states that met the inclusion criteria, including data source, measure specification, drug(s) involved, and whether states performed deduplication or published mutually exclusive measure specifications to capture unique events across care settings. We calculated nonfatal-to-fatal overdose ratios to assess the effects of different data sources on estimates of nonfatal overdoses. Illinois, Maine, North Carolina, and West Virginia used syndromic surveillance data and New Jersey used hospital discharge data to track nonfatal overdose-related emergency department visits. Illinois and West Virginia tracked nonfatal overdose-related encounters with emergency medical services. Other states tracked opioid overdoses reversed following naloxone administration by emergency medical services, law enforcement, and community members. Maine, New Jersey, and West Virginia published nonfatal overdose information by using mutually exclusive measure specifications; the number of nonfatal overdoses per fatal overdose in these states ranged from approximately 5:1 to 14:1. Establishing a standard framework to combine data from existing national surveillance systems in prehospital and hospital care settings can improve nonfatal overdose estimates and enable comparisons between jurisdictions to help decision makers identify areas most in need of essential services.

Motherhood, medicine and magazines in interwar Vienna: the case of Die Mutter (The Mother, 1924–1926)

In an era long before ‘Doctor Google’, the question of how people accessed information about their bodies and their health is significant. This article investigates how medical knowledge about motherhood...

Knowledge and Attitude of Nurses in Surgical and in-Hospital Area of Raden Mataher Hospital to Medical Waste Picks

During the operation of hospitals, various types of waste are generated in the form of liquid, solid, and gaseous substances. Medical waste must be handled correctly and safely to ensure the health and safety of staff and other people in the hospital environment. The management of hospital waste, especially the sorting of medical waste, must have the consistent goal of protecting the population from environmental pollution threats caused by hospitals. Medical waste sorting requires advanced knowledge and attitude of nurses, the purpose of this study is to find out the knowledge of nurses about medical waste sorting and the attitude of nurses about medical waste sorting. The management of medical waste must be handled appropriately and safely to ensure the safety of health professionals and workers and others in the hospital environment. The design of this study was descriptive and quantitative and included 71 nurses as head nurses and team leaders in surgical and inpatient settings. The total sampling technique was 71 nurses. Data collection was done by distributing questionnaires to the respondents. This study showed that 71 respondents with high knowledge sorted medical waste well and 49 (69%) had a good nursing attitude, 47 (66.2%) respondents sorted medical waste well. The analysis showed that a p-value of 0.01 was obtained for the relationship between medical waste sorting knowledge and nurses' attitudes towards medical waste sorting. Most of the nurses had high knowledge and good attitudes about medical waste management. In addition, it was necessary to increase the socialization of dangerous and toxic waste (B3) carried out by the hospital to improve the knowledge and attitudes of nurses in the sorting of medical waste.

Trends of Korean medicine service utilization for lumbar disc herniation and spinal stenosis: A 10-year analysis of the 2010 to 2019 data.

This retrospective, cross-sectional, and descriptive study aimed to analyze the trend of utilizing traditional Korean medicine services in patients with lumbar disc herniation (LDH) and/or lumbar spinal stenosis (LSS). In this study, based on the national patient sample data provided by Health Insurance Review and Assessment Service (HIRA), the trend of Korean medicine service utilization was investigated, including the following information: demographic characteristics of the patients, the total expenditure, number of claim statements per category, medical care expenditure per category, and routes of visiting traditional Korean medicine institutions. The study population comprised patients who visited Korean medicine institutions at least once from January 2010 to December 2019, with LSS and LDH as the primary diagnosis. LDH patients who used traditional Korean medicine services for treatment increased by about 1.36 times. LDH and LSS patients under 45 years of age were more likely to be males, but women accounted for a higher percentage among those over 45 years of age. Overall, women accounted for a slightly higher percentage than their counterparts for both diseases. From details of treatments received that were extracted from the claims data, acupuncture treatment accounted for the highest percentage for both disorders. Moreover, 50.7% of the patients who visited Korean medicine institutions to treat the two diseases also visited conventional Western medicine institutions. These patients, who were diagnosed with their condition at a Korean medicine institution, visited a conventional institution and then returned; the conventional institutions were primarily used for examination (40.5%). Increased utilization of traditional Korean medicine services was confirmed among patients with LDH and/or LSS; in particular, a sharp increase was noted among patients with LSS. The results of this study will be useful as basic research data for clinicians, researchers, and policy makers.

Bibliometric Insight Into Thyroid Cancer Research: A Comprehensive Review and Future Directions.

In the past 3 decades, thyroid cancer research has surged, becoming the leading topic in clinical thyroidology. Despite this, there's a lack of data identifying key articles, authors, and journals. This study aims to provide insights for authors, physicians, and research labs by highlighting the most influential journals, authors, and research topics in thyroid cancer. A comprehensive search was conducted using the Scopus database, employing the medical subject heading (MeSH) terms "Thyroid" and "Cancer" in the titles, abstracts, or keywords of articles. The search was limited to English articles in academic medicine journals published between January 1993 and December 2021. The search yielded 21472 articles across 3076 journals, authored by 13974 senior authors. The number of journals publishing on thyroid cancer expanded from 29 in 1993 to 733 in 2021, marking an average annual growth of 14%. Article output on the topic increased from 54 in the initial year to 1580 by 2021, with an annual growth rate of 16%. A thematic analysis revealed 369 articles mentioning "BRAF" since 2004, 479 articles on "ultrasound" techniques, 325 on "ablation" methods, and 453 articles focusing on "genetics" in thyroid cancer. The Journal of Clinical Endocrinology and Metabolism emerged as the most prolific, publishing 1017 articles over the 29-year period. This study guides resource allocation towards impactful journals for thyroid cancer researchers, helps identify key contributors for collaboration or mentorship, and provides a framework for similar analyses in other fields.

Improving departmental psychological safety through a medical school-wide initiative

BackgroundPsychological safety is a team-based phenomenon whereby group members are empowered to ask questions, take appropriate risks, admit mistakes, propose novel ideas, and candidly voice concerns. Growing research supports the benefits of psychological safety in healthcare and education for patient safety, learning, and innovation. However, there is a paucity of research on how to create psychological safety, especially within academic medicine. To meet this need, the present study describes and evaluates a multi-year, medical school-wide psychological safety initiative.MethodsWe created, implemented, and assessed a multi-pronged psychological safety initiative including educational training sessions, departmental champions, videos, infographics, and targeted training for medical school leaders. Employees’ perceptions of psychological safety at both the departmental and institutional levels were assessed annually. The impact of educational training sessions was quantified by post-session surveys.ResultsDeidentified employee surveys revealed a statistically significant increase in departmental psychological safety between the first and second annual surveys. Perceived psychological safety remained lower at the institution-wide level than at the departmental level. No significant differences in psychological safety were observed based on gender, position, or employment length. Post-educational training session surveys showed that the sessions significantly increased knowledge of the topic as well as motivation to create a culture of psychological safety within the medical school.ConclusionsThis study establishes an evidence-based method for increasing psychological safety within medical school departments and serves as a template for other health professions schools seeking to promote psychological safety. Training leadership, faculty, and staff is an important first step towards creating a culture of psychological safety for everyone, including trainees.

Performance of ChatGPT Across Different Versions in Medical Licensing Examinations Worldwide: Systematic Review and Meta-Analysis.

Over the past 2 years, researchers have used various medical licensing examinations to test whether ChatGPT (OpenAI) possesses accurate medical knowledge. The performance of each version of ChatGPT on the medical licensing examination in multiple environments showed remarkable differences. At this stage, there is still a lack of a comprehensive understanding of the variability in ChatGPT's performance on different medical licensing examinations. In this study, we reviewed all studies on ChatGPT performance in medical licensing examinations up to March 2024. This review aims to contribute to the evolving discourse on artificial intelligence (AI) in medical education by providing a comprehensive analysis of the performance of ChatGPT in various environments. The insights gained from this systematic review will guide educators, policymakers, and technical experts to effectively and judiciously use AI in medical education. We searched the literature published between January 1, 2022, and March 29, 2024, by searching query strings in Web of Science, PubMed, and Scopus. Two authors screened the literature according to the inclusion and exclusion criteria, extracted data, and independently assessed the quality of the literature concerning Quality Assessment of Diagnostic Accuracy Studies-2. We conducted both qualitative and quantitative analyses. A total of 45 studies on the performance of different versions of ChatGPT in medical licensing examinations were included in this study. GPT-4 achieved an overall accuracy rate of 81% (95% CI 78-84; P<.01), significantly surpassing the 58% (95% CI 53-63; P<.01) accuracy rate of GPT-3.5. GPT-4 passed the medical examinations in 26 of 29 cases, outperforming the average scores of medical students in 13 of 17 cases. Translating the examination questions into English improved GPT-3.5's performance but did not affect GPT-4. GPT-3.5 showed no difference in performance between examinations from English-speaking and non-English-speaking countries (P=.72), but GPT-4 performed better on examinations from English-speaking countries significantly (P=.02). Any type of prompt could significantly improve GPT-3.5's (P=.03) and GPT-4's (P<.01) performance. GPT-3.5 performed better on short-text questions than on long-text questions. The difficulty of the questions affected the performance of GPT-3.5 and GPT-4. In image-based multiple-choice questions (MCQs), ChatGPT's accuracy rate ranges from 13.1% to 100%. ChatGPT performed significantly worse on open-ended questions than on MCQs. GPT-4 demonstrates considerable potential for future use in medical education. However, due to its insufficient accuracy, inconsistent performance, and the challenges posed by differing medical policies and knowledge across countries, GPT-4 is not yet suitable for use in medical education. PROSPERO CRD42024506687; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=506687.