World journal of emergency medicine最新文献

{"title":"Protective mechanism of quercetin in alleviating sepsis-related acute respiratory distress syndrome based on network pharmacology and <i>in vitro</i> experiments.","authors":"Weichao Ding, Wei Zhang, Juan Chen, Mengmeng Wang, Yi Ren, Jing Feng, Xiaoqin Han, Xiaohang Ji, Shinan Nie, Zhaorui Sun","doi":"10.5847/wjem.j.1920-8642.2024.030","DOIUrl":"10.5847/wjem.j.1920-8642.2024.030","url":null,"abstract":"<p><strong>Background: </strong>Sepsis-related acute respiratory distress syndrome (ARDS) has a high mortality rate, and no effective treatment is available currently. Quercetin is a natural plant product with many pharmacological activities, such as antioxidative, anti-apoptotic, and anti-inflammatory effects. This study aimed to elucidate the protective mechanism of quercetin against sepsis-related ARDS.</p><p><strong>Methods: </strong>In this study, network pharmacology and <i>in vitro</i> experiments were used to investigate the underlying mechanisms of quercetin against sepsis-related ARDS. Core targets and signaling pathways of quercetin against sepsis-related ARDS were screened and were verified by <i>in vitro</i> experiments.</p><p><strong>Results: </strong>A total of 4,230 targets of quercetin, 360 disease targets of sepsis-related ARDS, and 211 intersection targets were obtained via database screening. Among the 211 intersection targets, interleukin-6 (IL-6), tumor necrosis factor (TNF), albumin (ALB), AKT serine/threonine kinase 1 (AKT1), and interleukin-1β (IL-1β) were identified as the core targets. A Gene Ontology (GO) enrichment analysis revealed 894 genes involved in the inflammatory response, apoptosis regulation, and response to hypoxia. Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis identified 106 pathways. After eliminating and generalizing, the hypoxia-inducible factor-1 (HIF-1), TNF, nuclear factor-κB (NF-κB), and nucleotide-binding and oligomerization domain (NOD)-like receptor signaling pathways were identified. Molecular docking revealed that quercetin had good binding activity with the core targets. Moreover, quercetin blocked the HIF-1, TNF, NF-κB, and NOD-like receptor signaling pathways in lipopolysaccharide (LPS)-induced murine alveolar macrophage (MH-S) cells. It also suppressed the inflammatory response, oxidative reactions, and cell apoptosis.</p><p><strong>Conclusion: </strong>Quercetin ameliorates sepsis-related ARDS by binding to its core targets and blocking the HIF-1, TNF, NF-κB, and NOD-like receptor signaling pathways to reduce inflammation, cell apoptosis, and oxidative stress.</p>","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"15 2","pages":"111-120"},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10925531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140111523","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}

{"title":"The value of toxicological analysis in acute poisoning patients with uncertain exposure histories: a retrospective and descriptive study from an institute of poisoning.","authors":"Qifang Shi, Gen Ba, Zhenyu Xia, Zhengsheng Mao, Hao Sun, Jinsong Zhang","doi":"10.5847/wjem.j.1920-8642.2024.022","DOIUrl":"10.5847/wjem.j.1920-8642.2024.022","url":null,"abstract":"<p><strong>Background: </strong>In clinical practice, some patients might not be able or unwilling to provide a thorough history of medication and poison exposure. The aim of this study was to use toxicological analysis to examine the clinical characteristics of patients with acute poisoning whose exposure history was uncertain from a toxicological analysis perspective.</p><p><strong>Methods: </strong>This was a retrospective and descriptive study from an institute of poisoning. Patient registration information and test reports spanning the period from April 1, 2020 to March 31, 2022, were obtained. Patients with uncertain exposure histories and who underwent toxicological analysis were included. Clinical manifestations and categories of toxics were analyzed.</p><p><strong>Results: </strong>Among the 195 patients with positive toxicological analysis results, the main causes of uncertain exposure history was disturbance of consciousness (62.6%), unawareness (23.6%) and unwillingness or lack of cooperation (13.8%). The predominant clinical manifestations were disturbed consciousness (62.6%), followed by vomiting and nausea (14.4%) and liver function abnormalities (8.7%). A comparison of clinical manifestations between patients with positive and negative (<i>n</i>=99) toxicological analyses results revealed significantly different proportions of disturbances in consciousness (63% vs. 21%), dizziness (1.5% vs. 5.1%), multi-organ failure (1.5% vs. 7.1%), and local pain (0 vs 4%). The main categories of substances involved were psychiatric medications (23.1%), sedatives (20.5%), insecticides (13.8%), and herbicides (12.8%).</p><p><strong>Conclusion: </strong>The clinical manifestations of acute poisoning in patients with an uncertain exposure history are diverse and nonspecific, and toxicological analysis plays a pivotal role in the diagnosis and differential diagnosis of such patients.</p>","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"15 2","pages":"98-104"},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10925527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140111526","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}

{"title":"Risk factors for early death in severe non-brain-injured trauma patients.","authors":"Hui Feng, Ronghai Shao, Zihao Fan, Limei Ma, Jiake Gao, Lijun Liu, Lichao Fang, Jianjun Zhu","doi":"10.5847/wjem.j.1920-8642.2024.061","DOIUrl":"https://doi.org/10.5847/wjem.j.1920-8642.2024.061","url":null,"abstract":"","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"15 5","pages":"404-406"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11402882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296706","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}

{"title":"Shared diagnostic genes and potential mechanisms between COVID-19 and sepsis revealed by bioinformatics analysis.","authors":"Weifei Wang, Zhong Chen, Wenyuan Zhang, Yuan Lin, Yaqi Sun, Qi Yao, Jian Lu, Jungang Zheng","doi":"10.5847/wjem.j.1920-8642.2024.064","DOIUrl":"https://doi.org/10.5847/wjem.j.1920-8642.2024.064","url":null,"abstract":"","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"15 5","pages":"410-412"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11402875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296707","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}

{"title":"Successful extracorporeal membrane oxygenation-assisted treatment for a kidney transplant recipient infected with severe COVID-19.","authors":"Dongdong Li, Ping Wang, Yuanqiang Lu","doi":"10.5847/wjem.j.1920-8642.2024.079","DOIUrl":"https://doi.org/10.5847/wjem.j.1920-8642.2024.079","url":null,"abstract":"","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"15 5","pages":"416-418"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11402874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296709","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}

{"title":"<i>Strongyloides stercoralis</i>-induced sepsis and acute respiratory distress syndrome in a patient with Guillain-Barré syndrome.","authors":"Juhao Zeng, Yin Wen, Hongguang Ding, Dongxin Li, Hongke Zeng","doi":"10.5847/wjem.j.1920-8642.2024.063","DOIUrl":"https://doi.org/10.5847/wjem.j.1920-8642.2024.063","url":null,"abstract":"","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"15 5","pages":"413-415"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11402879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296685","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}

{"title":"A rare co-occurrence of spontaneous pneumomediastinum, pneumothorax, and pneumoperitoneum: Macklin effect.","authors":"Renaldo Pavrey, Nikita Makwana, Nisha Das","doi":"10.5847/wjem.j.1920-8642.2024.044","DOIUrl":"10.5847/wjem.j.1920-8642.2024.044","url":null,"abstract":"","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"15 3","pages":"246-248"},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11153363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141296861","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}

{"title":"• Education • Simulation-based assessment for the emergency medicine milestones: a national survey of simulation experts and program directors.","authors":"Afrah A Ali, Ashley Crimmins, Hegang Chen, Danya Khoujah","doi":"10.5847/wjem.j.1920-8642.2024.055","DOIUrl":"https://doi.org/10.5847/wjem.j.1920-8642.2024.055","url":null,"abstract":"","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"15 4","pages":"301-305"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11265633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761269","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}

{"title":"Effect of tubastatin A on NLRP3 inflammasome activation in macrophages under hypoxia/reoxygenation conditions.","authors":"Hao Li, Chang Liu, Ying Cui, Panpan Chang, Wei Chong","doi":"10.5847/wjem.j.1920-8642.2024.059","DOIUrl":"https://doi.org/10.5847/wjem.j.1920-8642.2024.059","url":null,"abstract":"<p><strong>Background: </strong>There are currently no effective drugs to mitigate the ischemia/reperfusion injury caused by fluid resuscitation after hemorrhagic shock (HS). The aim of this study was to explore the potential of the histone deacetylase 6 (HDAC6)-specific inhibitor tubastatin A (TubA) to suppress nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) inflammasome activation in macrophages under hypoxia/reoxygenation (H/R) conditions.</p><p><strong>Methods: </strong>The viability of RAW264.7 cells subjected to H/R after treatment with different concentrations of TubA was assessed using a cell-counting kit-8 (CCK8) assay. Briefly, 2.5 μmol/L TubA was used with RAW264.7 cells under H/R condition. RAW264.7 cells were divided into three groups, namely the control, H/R, and TubA groups. The levels of reactive oxygen species (ROS) in the cells were detected using fluorescence microscopy. The protein expression of HDAC6, heat shock protein 90 (Hsp90), inducible nitric oxide synthase (iNOS), NLRP3, gasdermin-D (GSDMD), Caspase-1, GSDMD-N, and Caspase-1 p20 was detected by western blotting. The levels of interleukin-1β (IL-1β) and IL-18 in the supernatants were detected using enzyme-linked immunosorbent assay (ELISA).</p><p><strong>Results: </strong>HDAC6, Hsp90, and iNOS expression levels were significantly higher (<i>P</i><0.01) in the H/R group than in the control group, but lower in the TubA group than in the H/R group (<i>P</i><0.05). When comparing the H/R group to the control group, ROS levels were significantly higher (<i>P</i><0.01), but significantly reduced in the TubA group (<i>P</i><0.05). The H/R group had higher NLRP3, GSDMD, Caspase-1, GSDMD-N, and Caspase-1 p20 expression levels than the control group (<i>P</i><0.05), however, the TubA group had significantly lower expression levels than the H/R group (<i>P</i><0.05). IL-1β and IL-18 levels in the supernatants were significantly higher in the H/R group compared to the control group (<i>P</i><0.01), but significantly lower in the TubA group compared to the H/R group (<i>P</i><0.01).</p><p><strong>Conclusion: </strong>TubA inhibited the expression of HDAC6, Hsp90, and iNOS in macrophages subjected to H/R. This inhibition led to a decrease in the content of ROS in cells, which subsequently inhibited the activation of the NLRP3 inflammasome and the secretion of IL-1β and IL-18.</p>","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"15 4","pages":"289-296"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11265631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761277","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}

{"title":"Evaluation of hand infections in the emergency department using point-of-care ultrasound.","authors":"David Ahmad Haidar, David Mintz, Brandon M Wubben, Omar Rizvi, Srikar Adhikari","doi":"10.5847/wjem.j.1920-8642.2024.049","DOIUrl":"https://doi.org/10.5847/wjem.j.1920-8642.2024.049","url":null,"abstract":"<p><strong>Background: </strong>We aimed to evaluate the utility of point-of-care ultrasound (POCUS) in the assessment of hand infections that present to the emergency department (ED) and its impact on medical decision making and patient management.</p><p><strong>Methods: </strong>We conducted a retrospective review of patients who presented to two urban academic EDs with clinical presentations concerning for skin and soft tissue infections (SSTI) of the hand between December 2015 and December 2021. Two trained POCUS fellowship physicians reviewed an ED POCUS database for POCUS examinations of the hand. We then reviewed patients' electronic health records (EHR) for demographic characteristics, history, physical examination findings, ED course, additional imaging studies, consultations, impact of POCUS on patient care and final disposition.</p><p><strong>Results: </strong>We included a total of 50 cases (28 male, 22 female) in the final analysis. The most common presenting symptoms and exam findings were pain (100%), swelling (90%), and erythema (74%). The most common sonographic findings were edema (76%), soft tissue swelling (78%), and fluid surrounding the tendon (57%). POCUS was used in medical decision making 68% of the time (<i>n</i>=34), with the use of POCUS leading to changes in management 38% of the time (<i>n</i>=19). POCUS use led to early antibiotic use (11/19), early consultation (10/19), and led to the performance of a required procedure (8/19). The POCUS diagnosis was consistent with the discharge diagnosis of flexor tenosynovitis 8/12 times, abscess 12/16 times, and cellulitis 14/20 times.</p><p><strong>Conclusion: </strong>POCUS is beneficial for evaluating of hand infections that present to the ED and can be used as an important part of medical decision making to expedite patient care.</p>","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"15 4","pages":"283-288"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11265625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761278","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}