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ANTIMICROBIAL WOUND DRESSINGS FOR FULL-THICKNESS INFECTED BURN WOUNDS. 用于全厚感染性烧伤创面的抗菌伤口敷料。
IF 2.7 3区 医学
SHOCK Pub Date : 2024-10-01 Epub Date: 2024-08-08 DOI: 10.1097/SHK.0000000000002426
Abhishek Dhyani, Taylor Repetto, Shannon VanAken, Jean Nemzek, J Scott VanEpps, Geeta Mehta, Anish Tuteja
{"title":"ANTIMICROBIAL WOUND DRESSINGS FOR FULL-THICKNESS INFECTED BURN WOUNDS.","authors":"Abhishek Dhyani, Taylor Repetto, Shannon VanAken, Jean Nemzek, J Scott VanEpps, Geeta Mehta, Anish Tuteja","doi":"10.1097/SHK.0000000000002426","DOIUrl":"10.1097/SHK.0000000000002426","url":null,"abstract":"<p><strong>Abstract: </strong>Infection of wounds delays healing, increases treatment costs, and leads to major complications. Current methods to manage such infections include antibiotic ointments and antimicrobial wound dressings, both of which have significant drawbacks, including frequent reapplication and contribution to antimicrobial resistance. In this work, we developed wound dressings fabricated with a medical-grade polyurethane coating composed of natural plant secondary metabolites, cinnamaldehyde, and alpha-terpineol. Our wound dressings are easy to change and do not adhere to the wound bed. They kill gram-positive and -negative microbes in infected wounds due to the Food and Drug Administration-approved for human consumption components. The wound dressings were fabricated by dip coating. Antimicrobial efficacy was determined by quantifying the bacteria colonies after a 24 h of immersion. Wound healing and bacterial reduction were assessed in an in vivo full-thickness porcine burn model. Our antimicrobial wound dressings showed a > 5-log reduction (99.999%) of different gram-positive and gram-negative bacteria, while maintaining absorbency. In the in vivo porcine burn model, our wound dressings were superior to bacitracin in decreasing bacterial burden during daily changes, without interfering with wound healing. Additionally, the dressings had a significantly lower adhesion to the wound bed. Our antimicrobial wound dressings reduced the burden of clinically relevant bacteria more than commercial antimicrobial wound dressings. In an in vivo infected burn wound model, our coatings performed as well or better than bacitracin. We anticipate that our wound dressings would be useful for the treatment of various types of acute and chronic wounds.</p>","PeriodicalId":21667,"journal":{"name":"SHOCK","volume":" ","pages":"588-595"},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
CECAL SLURRY AS AN ALTERNATIVE MODEL TO CECAL LIGATION AND PUNCTURE FOR THE STUDY OF SEPSIS-INDUCED CARDIOVASCULAR DYSFUNCTION. 盲肠浆液作为盲肠结扎和穿刺的替代模型,用于研究败血症诱发的心血管功能障碍。
IF 2.7 3区 医学
SHOCK Pub Date : 2024-10-01 Epub Date: 2024-06-11 DOI: 10.1097/SHK.0000000000002412
Gabrielle Delfrate, Lucas Braga Albino, Jamil Assreuy, Daniel Fernandes
{"title":"CECAL SLURRY AS AN ALTERNATIVE MODEL TO CECAL LIGATION AND PUNCTURE FOR THE STUDY OF SEPSIS-INDUCED CARDIOVASCULAR DYSFUNCTION.","authors":"Gabrielle Delfrate, Lucas Braga Albino, Jamil Assreuy, Daniel Fernandes","doi":"10.1097/SHK.0000000000002412","DOIUrl":"10.1097/SHK.0000000000002412","url":null,"abstract":"<p><strong>Abstract: </strong>Sepsis is a life-threatening condition widely studied by animal models. Cecal ligation and puncture (CLP) is still regarded as the gold standard model for sepsis. However, CLP has limitations due to its invasiveness and variability. Cecal slurry (CS) model is a nonsurgical and thus less invasive alternative. However, the lack of standardization of the CS model in the literature limits its practical application. Additionally, it is not well studied whether CS model reproduces septic cardiovascular dysfunction in rats, which is a crucial issue in septic patients. Thus, this study aimed to standardize the CS model in Wistar rats and evaluate sepsis-induced cardiovascular dysfunction compared to CLP. Our results showed that CS model induced important features of sepsis cardiovascular dysfunction 24 h after its onset, such as hypotension, tachycardia, and decreased contractile response to vasoconstrictors both in vivo and ex vivo as well changes in renal blood flow. Increases in blood lactate, AST, ALT, creatinine, and urea indicated organ dysfunction. CS model also induced increased production of nitric oxide metabolites and bacterial spread to tissues. CS model causes less animal suffering, it is a nonsurgical model, and, more importantly, it replicates the cardiovascular dysfunction induced by sepsis with better homogeneity than CLP. Therefore, CS model serves as an alternative and possibly as a better model for sepsis research.</p>","PeriodicalId":21667,"journal":{"name":"SHOCK","volume":" ","pages":"547-555"},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141420638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
TRENDS AND OUTCOMES IN SEPSIS HOSPITALIZATIONS WITH AND WITHOUT ACUTE KIDNEY INJURY: A NATIONWIDE INPATIENT ANALYSIS. 伴有和不伴有急性肾损伤的败血症住院患者的趋势和结果:全国住院病人分析。
IF 2.7 3区 医学
SHOCK Pub Date : 2024-10-01 Epub Date: 2024-06-11 DOI: 10.1097/SHK.0000000000002386
Haibo Li, Ran Yu, Qi Zhou, Jiannan Song, Qi Zhou, Wanli Ma, Jian Wang, Zhanfei Hu, Qinfeng Yang, Keyuan Chen
{"title":"TRENDS AND OUTCOMES IN SEPSIS HOSPITALIZATIONS WITH AND WITHOUT ACUTE KIDNEY INJURY: A NATIONWIDE INPATIENT ANALYSIS.","authors":"Haibo Li, Ran Yu, Qi Zhou, Jiannan Song, Qi Zhou, Wanli Ma, Jian Wang, Zhanfei Hu, Qinfeng Yang, Keyuan Chen","doi":"10.1097/SHK.0000000000002386","DOIUrl":"10.1097/SHK.0000000000002386","url":null,"abstract":"<p><strong>Abstract: </strong>Background: Despite rapid advances in treatment, sepsis currently remains a major public health challenge worldwide. Over the past several years, there has been an increase in the clinical incidence of sepsis, as well as an increase in hospitalization rates, which bear the majority of the economic burden associated with sepsis. Sepsis is a public health burden due to the high fatality rates and accompanying morbidity. However, the sepsis-related mortality rates have fallen steadily over the years. One of the most common organs to fail in patients with sepsis is the kidney, and acute kidney injury (AKI) is associated with high mortality rates. This study's primary goal was to assess the impact of AKI on the evolution and outcome of hospitalization of patients with sepsis. Methods: Adults (≥18 years) hospitalized for sepsis in the United States between 2010 and 2019 were retrospectively analyzed using the nationally representative Nationwide Inpatient Sample database. Sepsis and AKI were defined using the codes of the International Classification of Diseases, Ninth Revision, Clinical Modification and the International Classification of Diseases, Tenth Revision, Clinical Modification. Results: Of the 4,258,360 outcomes, 3,946,048 met the inclusion criteria. The prevalence of AKI among sepsis inpatients increased from 39.10% in 2010 to 41% in 2019, but the impact of AKI on mortality declined over time, with in-hospital mortality from AKI among sepsis inpatients decreasing from 26.30% in 2010 to 16.30% in 2019. Hospitalizations linked to AKI were substantially more likely to involve infection sites such as the urinary tract, gastrointestinal tract, and endocarditis. Numerous pathogenic floras, including Escherichia coli , Staphylococcus aureus , Streptococcal , Enterococcus , and Pseudomonas , had greater rates among sepsis-related contacts with AKI. Furthermore, compared to hospitalization without comorbid AKI, the median total hospital charges and length of stay days for sepsis hospitalization with comorbid AKI were greater. Conclusion: With time, patients with sepsis have a higher frequency of AKI and a corresponding decline in mortality.</p>","PeriodicalId":21667,"journal":{"name":"SHOCK","volume":" ","pages":"470-479"},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141420730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
COMPARISON OF OXIRIS AND CONVENTIONAL CONTINUOUS RENAL REPLACEMENT THERAPY IN MANAGING SEVERE ABDOMINAL INFECTIONS: IMPACT ON SEPTIC SHOCK MORTALITY. 比较 oXiris 和常规连续性肾脏替代疗法在治疗严重腹腔感染中的应用:对脓毒性休克死亡率的影响。
IF 2.7 3区 医学
SHOCK Pub Date : 2024-10-01 Epub Date: 2024-08-14 DOI: 10.1097/SHK.0000000000002437
Xiu-Yu Liao, Yu-Ting Chen, Ming-Jun Liu, Qiu-Xia Liao, Jian-Dong Lin, Hai-Rong Lin, Ying-Hong Huang, Ye Zhou
{"title":"COMPARISON OF OXIRIS AND CONVENTIONAL CONTINUOUS RENAL REPLACEMENT THERAPY IN MANAGING SEVERE ABDOMINAL INFECTIONS: IMPACT ON SEPTIC SHOCK MORTALITY.","authors":"Xiu-Yu Liao, Yu-Ting Chen, Ming-Jun Liu, Qiu-Xia Liao, Jian-Dong Lin, Hai-Rong Lin, Ying-Hong Huang, Ye Zhou","doi":"10.1097/SHK.0000000000002437","DOIUrl":"10.1097/SHK.0000000000002437","url":null,"abstract":"<p><strong>Abstract: </strong>Objective: The objective of this study is to assess and compare the efficacy of oXiris with conventional continuous renal replacement therapy (CRRT) in managing severe abdominal infections. Methods: A retrospective analysis encompassing cases from 2017 to 2023 was conducted at the Department of Critical Care Medicine within the First Affiliated Hospital of Fujian Medical University. Parameters including heart rate (HR), mean arterial pressure (MAP), oxygenation index, lactate (Lac), platelet count, neutrophil ratio, procalcitonin, C-reactive protein (CRP), interleukin 6 (IL-6), norepinephrine dosage, Acute Physiology and Chronic Health Evaluation II (APACHE II), and Sequential Organ Failure Assessment (SOFA) were recorded prior to treatment initiation, at 24 h, and 72 h after treatment for both the oXiris and conventional CRRT groups. In addition, the duration of respiratory support, CRRT treatment, length of stay in the intensive care unit (ICU), total hospitalization period, and mortality rates at 14 and 28 days for both groups were recorded. Results: 1) Within the conventional CRRT group, notable enhancement was observed solely in Lac levels at 24 h after treatment compared with pretreatment levels. In addition, at 72 h after treatment, improvements were evident in HR, Lac, CRP, and IL-6 levels. 2) Conversely, the oXiris group exhibited improvements in HR, MAP, Lac, oxygenation index, neutrophil ratio, and IL-6 at 24 h after treatment when compared with baseline values. In addition, reductions were observed in APACHE II and SOFA scores. At 72 h after treatment, all parameters demonstrated enhancement except for platelet count. 3) Analysis of the changes in the indexes (Δ) between the two groups at 24 h after treatment revealed variances in HR, MAP, Lac, norepinephrine dosage, CRP levels, IL-6 levels, APACHE II scores, and SOFA scores. 4) The Δ indexes at 72 h after treatment indicated more significant improvements following oXiris treatment for both groups, except for procalcitonin. 5) The 14-day mortality rate (24.4%) exhibited a significant reduction in the oXiris group when compared with the conventional group (43.6%). However, no significant difference was observed in the 28-day mortality rate between the two groups. 6) Subsequent to multifactorial logistic regression analysis, the results indicated that oXiris treatment correlated with a noteworthy decrease in the 14-day and 28-day mortality rates associated with severe abdominal infections, by 71.3% and 67.6%, respectively. Conclusion: oXiris demonstrates clear advantages over conventional CRRT in the management of severe abdominal infections. Notably, it reduces the fatality rates, thereby establishing itself as a promising and potent therapeutic option.</p>","PeriodicalId":21667,"journal":{"name":"SHOCK","volume":" ","pages":"529-538"},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
EFFICACY OF A SEPSIS CLINICAL DECISION SUPPORT SYSTEM IN IDENTIFYING PATIENTS WITH SEPSIS IN THE EMERGENCY DEPARTMENT. 败血症临床决策支持系统在识别急诊科败血症患者方面的功效。
IF 2.7 3区 医学
SHOCK Pub Date : 2024-10-01 Epub Date: 2024-05-27 DOI: 10.1097/SHK.0000000000002394
Yueh-Tseng Hou, Meng-Yu Wu, Yu-Long Chen, Tzu-Hung Liu, Ruei-Ting Cheng, Pei-Lan Hsu, An-Kuo Chao, Ching-Chieh Huang, Fei-Wen Cheng, Po-Lin Lai, I-Feng Wu, Giou-Teng Yiang
{"title":"EFFICACY OF A SEPSIS CLINICAL DECISION SUPPORT SYSTEM IN IDENTIFYING PATIENTS WITH SEPSIS IN THE EMERGENCY DEPARTMENT.","authors":"Yueh-Tseng Hou, Meng-Yu Wu, Yu-Long Chen, Tzu-Hung Liu, Ruei-Ting Cheng, Pei-Lan Hsu, An-Kuo Chao, Ching-Chieh Huang, Fei-Wen Cheng, Po-Lin Lai, I-Feng Wu, Giou-Teng Yiang","doi":"10.1097/SHK.0000000000002394","DOIUrl":"10.1097/SHK.0000000000002394","url":null,"abstract":"<p><strong>Abstract: </strong>Background: Early prediction of sepsis onset is crucial for reducing mortality and the overall cost burden of sepsis treatment. Currently, few effective and accurate prediction tools are available for sepsis. Hence, in this study, we developed an effective sepsis clinical decision support system (S-CDSS) to assist emergency physicians to predict sepsis. Methods: This study included patients who had visited the emergency department (ED) of Taipei Tzu Chi Hospital, Taiwan, between January 1, 2020, and June 31, 2022. The patients were divided into a derivation cohort (n = 70,758) and a validation cohort (n = 27,545). The derivation cohort was subjected to 6-fold stratified cross-validation, reserving 20% of the data (n = 11,793) for model testing. The primary study outcome was a sepsis prediction ( International Classification of Diseases , Tenth Revision , Clinical Modification ) before discharge from the ED. The S-CDSS incorporated the LightGBM algorithm to ensure timely and accurate prediction of sepsis. The validation cohort was subjected to multivariate logistic regression to identify the associations of S-CDSS-based high- and medium-risk alerts with clinical outcomes in the overall patient cohort. For each clinical outcome in high- and medium-risk patients, we calculated the sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios, and accuracy of S-CDSS-based predictions. Results: The S-CDSS was integrated into our hospital information system. The system featured three risk warning labels (red, yellow, and white, indicating high, medium, and low risks, respectively) to alert emergency physicians. The sensitivity and specificity of the S-CDSS in the derivation cohort were 86.9% and 92.5%, respectively. In the validation cohort, high- and medium-risk alerts were significantly associated with all clinical outcomes, exhibiting high prediction specificity for intubation, general ward admission, intensive care unit admission, ED mortality, and in-hospital mortality (93.29%, 97.32%, 94.03%, 93.04%, and 93.97%, respectively). Conclusion: Our findings suggest that the S-CDSS can effectively identify patients with suspected sepsis in the ED. Furthermore, S-CDSS-based predictions appear to be strongly associated with clinical outcomes in patients with sepsis.</p>","PeriodicalId":21667,"journal":{"name":"SHOCK","volume":" ","pages":"480-487"},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141176086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
MICROBIOME AND INFLAMMASOME ALTERATIONS FOUND DURING RADIATION DOSE FINDING IN A SINCLAIR MINIPIG MODEL OF GASTROINTESTINAL ACUTE RADIATION SYNDROME. 在辛克莱迷你猪胃肠道急性辐射综合征模型中发现辐射剂量发现期间的微生物组和炎症组改变。
IF 2.7 3区 医学
SHOCK Pub Date : 2024-10-01 Epub Date: 2024-09-03 DOI: 10.1097/SHK.0000000000002422
Timothy S Horseman, Babita Parajuli, Andrew M Frank, Alia Weaver, David A Schauer, Sean Moran, Joseph A Anderson, Gregory P Holmes-Hampton, David M Burmeister
{"title":"MICROBIOME AND INFLAMMASOME ALTERATIONS FOUND DURING RADIATION DOSE FINDING IN A SINCLAIR MINIPIG MODEL OF GASTROINTESTINAL ACUTE RADIATION SYNDROME.","authors":"Timothy S Horseman, Babita Parajuli, Andrew M Frank, Alia Weaver, David A Schauer, Sean Moran, Joseph A Anderson, Gregory P Holmes-Hampton, David M Burmeister","doi":"10.1097/SHK.0000000000002422","DOIUrl":"10.1097/SHK.0000000000002422","url":null,"abstract":"<p><strong>Abstract: </strong>Both abdominal radiotherapy and a nuclear event can result in gastrointestinal symptoms, including acute radiation syndrome (GI-ARS). GI-ARS is characterized by compromised intestinal barrier integrity increasing the risk for infectious complications. Physiologically relevant animal models are crucial for elucidating host responses and therapeutic targets. We aimed to determine the radiation dose requirements for creating GI-ARS in the Sinclair minipig. Male, sexually mature swine were randomly divided into sham (n = 6) and three lower hemibody radiation dosage groups of 8, 10, and 12 Gy (n = 5/group) delivered using linear accelerator-derived x-rays (1.9 Gy/min). Animals were monitored for GI-ARS symptoms for 14 days with rectal swab and blood collection at days 0-3, 7, 10, and 14 followed by necropsy for western blotting and histology. Dose-dependent increases in weight loss, diarrhea severity, and mortality (log-rank test, P = 0.041) were seen. Villi length was significantly reduced in all irradiated animals compared to controls ( P < 0.001). Serum citrulline decreased and bacterial translocation increased after irradiation compared to controls. Increased NLRP3 levels in post-mortem jejunum were seen ( P = 0.0043) as well as increased IL-1β levels in the 12 Gy group ( P = 0.041). Radiation dose and survival were associated with significant gut microbial community shifts in beta diversity. Moreover, decedents had increased Porphyromonas, Campylobacter, Bacteroides , Parvimonas , and decreased Fusobacterium and decreased Aerococcus, Lactobacillus, Prevotella, and Streptococcus . Our novel Sinclair minipig model showed dose-dependent clinical symptoms of GI-ARS. These findings provide invaluable insights into the intricate interplay between GI-ARS, intestinal inflammation, and gut microbiota alterations offering potential targets for therapeutic and diagnostic interventions after radiation exposure.</p>","PeriodicalId":21667,"journal":{"name":"SHOCK","volume":" ","pages":"556-564"},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11446529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141627603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
SHOCK SYNOPSIS AUGUST 2024. 震撼简介 2024 年 8 月。
IF 2.7 3区 医学
SHOCK Pub Date : 2024-10-01 Epub Date: 2024-09-03 DOI: 10.1097/SHK.0000000000002477
Basilia Zingarelli
{"title":"SHOCK SYNOPSIS AUGUST 2024.","authors":"Basilia Zingarelli","doi":"10.1097/SHK.0000000000002477","DOIUrl":"https://doi.org/10.1097/SHK.0000000000002477","url":null,"abstract":"","PeriodicalId":21667,"journal":{"name":"SHOCK","volume":"62 4","pages":"459-460"},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142353164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
KLF15 ATTENUATES LIPOPOLYSACCHARIDE-INDUCED APOPTOSIS AND INFLAMMATORY RESPONSE IN RENAL TUBULAR EPITHELIAL CELLS VIA PPARΔ. KLF15通过PPARδ减轻脂多糖诱导的肾小管上皮细胞凋亡和炎症反应。
IF 2.7 3区 医学
SHOCK Pub Date : 2024-10-01 Epub Date: 2024-09-03 DOI: 10.1097/SHK.0000000000002431
Yili Shao, Xiaojun Li, Wang Zhou, Shaojie Qian, Ligang Wang, Xiangming Fang
{"title":"KLF15 ATTENUATES LIPOPOLYSACCHARIDE-INDUCED APOPTOSIS AND INFLAMMATORY RESPONSE IN RENAL TUBULAR EPITHELIAL CELLS VIA PPARΔ.","authors":"Yili Shao, Xiaojun Li, Wang Zhou, Shaojie Qian, Ligang Wang, Xiangming Fang","doi":"10.1097/SHK.0000000000002431","DOIUrl":"10.1097/SHK.0000000000002431","url":null,"abstract":"<p><strong>Abstract: </strong>Background: The kidney is the most commonly affected organ in sepsis patients, and Krüppel-like transcription factor 15 (KLF15) has a kidney-protective effect and is highly enriched in the kidneys. This study aims to explore the role of KLF15 in sepsis-related acute kidney injury. Methods: A septic injury model in HK2 cells was established through the administration of lipopolysaccharide (LPS), followed by the transfection of an overexpression plasmid for KLF15. Cell viability was assessed using Cell Counting Kit-8 assay, and apoptosis was measured via flow cytometry. The levels of inflammatory cytokines were detected using ELISA, and western blot assay was employed to assess the expression of KLF15, PPARδ, as well as inflammatory and apoptosis-related proteins. The interaction between KLF15 and PPARδ was confirmed through the utilization of online databases and immunoprecipitation experiments. The mechanism was further validated using PPARδ agonists and small interfering RNA. Results: LPS-induced HK2 cells showed downregulated expression of KLF15 and PPARδ, along with decreased viability, accompanied by increased levels of apoptosis, TNFα, IL-1β, and IL-6. Additionally, LPS upregulated the expression of Bax, cytoplasmic cytochrome C [Cytc (cyt)], Cox-2, and p-NF-κB-p65 in HK2 cells, while simultaneously downregulating the expression of Bcl2 and mitochondrial cytochrome c [Cytc (mit)]. immunoprecipitation experiment revealed a possible interaction between KLF15 and PPARδ in HK2 cells. Ov-KLF15, Ov-PPARδ, or administration of PPARδ agonists effectively alleviated the aforementioned alterations induced by LPS. However, interference with PPARδ significantly attenuated the protective effect of Ov-KLF15 on HK2 cells. Conclusion: KLF15 attenuates LPS-induced apoptosis and inflammatory responses in HK2 cells via PPARδ.</p>","PeriodicalId":21667,"journal":{"name":"SHOCK","volume":" ","pages":"574-581"},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
CLINICAL APPLICATION OF EARLY POSTOPERATIVE NUTRITIONAL SUPPORT IN PATIENTS WITH HIGH-RISK VALVULAR HEART DISEASE. 高危瓣膜性心脏病患者术后早期营养支持的临床应用。
IF 2.7 3区 医学
SHOCK Pub Date : 2024-10-01 Epub Date: 2024-08-14 DOI: 10.1097/SHK.0000000000002436
Xiangyang Xu, Boyao Zhang, Mengwei Tan, Xingli Fan, Qian Chen, Zhiyun Xu, Yangfeng Tang, Lin Han
{"title":"CLINICAL APPLICATION OF EARLY POSTOPERATIVE NUTRITIONAL SUPPORT IN PATIENTS WITH HIGH-RISK VALVULAR HEART DISEASE.","authors":"Xiangyang Xu, Boyao Zhang, Mengwei Tan, Xingli Fan, Qian Chen, Zhiyun Xu, Yangfeng Tang, Lin Han","doi":"10.1097/SHK.0000000000002436","DOIUrl":"10.1097/SHK.0000000000002436","url":null,"abstract":"<p><strong>Abstract: </strong>Background : The treatment strategy of early nutritional support after cardiac surgery has gradually been adopted. However, there are no scientific guidelines for the timing and specific programs of early nutritional support. Methods: A retrospective, single-center analysis (2021-2023) was carried out including elderly patients who were admitted for valvular heart disease and received open-heart valve replacement surgery. We designated patients who started the optimized nutritional support after surgery as the optimized enteral nutritional support strategy TN (EN) group and those who received traditional nutritional support as the traditional nutritional support strategy (TN) group. The nutritional and immune indexes, postoperative complications, length of hospital stay, and hospitalization cost of the two groups were compared and analyzed. Results: We identified 378 eligible patients, comprising 193 (51%) patients in the EN group and 185 (49%) patients in the TN group. There was no significant difference in hospital mortality between the two groups, but the proportion of nosocomial pneumonia was significantly lower in the EN group than in the TN group ( P < 0.001). In the Poisson regression analysis, EN was not associated with an increase in gastrointestinal complications ( P = 0.549). The EN group also seemed to have shorter hospital stays and lower hospitalization expenses ( P < 0.001). In the comparison of postoperative gastrointestinal complications, fewer patients experienced diarrhea ( P = 0.021) and abdominal distension ( P = 0.033) in the EN group compared with the TN group. Conclusion: The optimal nutritional support strategy could effectively improve the clinical outcome of high-risk patients with valvular heart disease.</p>","PeriodicalId":21667,"journal":{"name":"SHOCK","volume":" ","pages":"522-528"},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11446509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Correcting the Carotid Flow Time with the Formula of Bazett: mind the units. 使用巴泽特公式校正颈动脉血流时间:注意单位。
IF 2.7 3区 医学
SHOCK Pub Date : 2024-09-19 DOI: 10.1097/SHK.0000000000002487
Jon-Emile S Kenny
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