Zhonghua wei zhong bing ji jiu yi xue最新文献

{"title":"[Design and application of a specialized protective skirt for patients undergoing extracorporeal membrane oxygenation].","authors":"Yanan Liu, Ying Ren, Cancan Chen, Shuting Zang","doi":"10.3760/cma.j.cn121430-20240107-00020","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240107-00020","url":null,"abstract":"<p><p>Extracorporeal membrane oxygenation (ECMO) provides continuous extracorporeal respiratory and circulatory support for patients with severe heart and lung failure, in order to maintain their lives. Currently, ECMO is an advanced organ support technology and its application in the clinical field of critical care is becoming increasingly common. When ECMO is implemented via percutaneous cannulation at the bilateral femoral artery and vein, the traditional patient pants cannot be used, which leads to exposure of privacy, easy catching of cold, and easy contamination of bed sheets and covers during defecation, making the patient uncomfortable and increasing the risk of infection. Changing bed sheets and covers not only increases the workload of nurses, but also easily causes pipeline displacement or slipping. It is inconvenient to observe the patient's bleeding, displacement, or dislodgement of the pipeline at any time when wearing patient pants. To solve the problems, nursing staff in the emergency intensive care unit of Henan Provincial People's Hospital have designed a protective skirt specifically designed for patients undergoing ECMO, which has obtained a National Utility Model Patent of China (patent number: ZL 2020 2 08120022.9). The special protective skirt for patients with ECMO mainly consists of a skirt body, a transparent observation window, a hip support part, and a fecal collection part. The transparent observation window is convenient for the puncture site and pipeline observation. After the hip support part is inflated, the patient can separate the perianal skin and urine and feces to avoid the occurrence of incontinence dermatitis. The fecal collection part can collect urine and feces to keep the bed unit clean. The protective skirt has a simple structure and is easy to wear and take off. While protecting patient privacy and ensuring patient comfort, it can also observe the condition of the pipeline at any time. It is suitable for patients with lower limb catheterization or urinary and fecal incontinence, and has certain clinical application and promotion value.</p>","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Effect of fluid resuscitation with crystalloid combined with plasma on the prognosis of septic patients with hypoalbuminemia].","authors":"Weiwei Xu, Jingjing Li","doi":"10.3760/cma.j.cn121430-20231012-00864","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20231012-00864","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate the difference in efficacy of two fluid resuscitation regimens, crystalloid alone versus crystalloid combined with plasma infusion, on the prognosis of septic patients with hypoalbuminemia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective study was conducted. Septic patients with hypoalbuminemia admitted to the department of critical care medicine of Dongtai People's Hospital from January 2017 to December 2022 were selected as study subjects. Patients were divided into single group (crystalloid alone) and combined group (crystalloid combined with plasma) according to the fluid resuscitation regimen at the time of admission. General information, as well as coagulation indices before resuscitation (on day 1) and day 3 of resuscitation were collected. The primary study endpoint was 28-day mortality. The single and combined groups were stratified according to albumin level at resuscitation (&lt; 25 g/L, 25-30 g/L, and &gt; 30 g/L) to compare the differences in 28-day mortality among patients with different albumin levels. Kaplan-Meier survival curves of patients' 28-day prognosis were plotted.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 164 septic patients with hypoalbuminemia were included, including 60 patients in the single group and 104 patients in the combined group. (1) There were no significantly differences in age, gender, acute physiology and chronic health evaluation II (APACHE II), sequential organ failure assessment (SOFA), as well as pre-resuscitation platelet count (PLT), prothrombin time (PT), activated partial thromboplastin time (APTT), D-dimer, antithrombin- III (AT- III), international normalized ratio (INR), fibrin degradation product (FDP), serum lactic acid (Lac), and albumin level between the two groups, indicating comparability. (2) The levels of PT and AT- III in the combined group improved significantly on day 3 compared to before resuscitation, and the level of AT- III in the combined group improved more significantly on day 3 compared to the single group [(79.80±17.95)% vs. (66.67±18.69)%, P &lt; 0.01]. Lac and albumin levels improved significantly after resuscitation in both the single and combined groups, but there were no significantly differences in the degree of improvement between the two groups. (3) There was no significantly difference in the 28-day mortality between the single group and the combined group [55.0% (33/60) vs. 42.3% (44/104), P &gt; 0.05]. The 28-day mortality of patients with albumin &lt; 25 g/L was significantly higher than that with albumin 25-30 g/L and &gt; 30 g/L [63.1% (41/65) vs. 36.2% (25/69), 36.7% (11/30), both P &lt; 0.05]. (4) Kaplan-Meier survival curve analysis showed that there was no significantly difference in 28-day cumulative survival rate between the single group and the combined group (Log-Rank: χ &lt;sup&gt;2&lt;/sup&gt; = 2.067,P = 0.151). The median survival rate of albumin was 27.1 g/L [95% confidence interval (95%CI) was 24.203-29.997] in the single group and 28.7 g","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Exploring the optimal range of pulse oxygen saturation in patients with sepsis: a retrospective study based on MIMIC- IV data].","authors":"Yuanwen Ye, Feifei Li, Baohua Yang, Liangen Lin, Linglong Chen","doi":"10.3760/cma.j.cn121430-20231019-00885","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20231019-00885","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To explore the optimal pulse oxygen saturation (SpO&lt;sub&gt;2&lt;/sub&gt;) range during hospitalization for patients with sepsis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A case-control study design was employed. Demographic information, vital signs, comorbidities, laboratory parameters, critical illness scores, clinical treatment information, and clinical outcomes of sepsis patients were extracted from the Medical Information Mart for Intensive Care- IV (MIMIC- IV). A generalized additive model (GAM) combined with a Loess smoothing function was employed to analyze and visualize the nonlinear relationship between SpO&lt;sub&gt;2&lt;/sub&gt; levels during hospitalization and in-hospital all-cause mortality. The optimal range of SpO&lt;sub&gt;2&lt;/sub&gt; was determined, and Logistic regression model along with Kaplan-Meier curve were utilized to validate the association between the determined range of SpO&lt;sub&gt;2&lt;/sub&gt; and in-hospital all-cause mortality.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 5 937 patients met the inclusion criteria, among whom 1 191 (20.1%) died during hospitalization. GAM analysis revealed a nonlinear and U-shaped relationship between SpO&lt;sub&gt;2&lt;/sub&gt; levels and in-hospital all-cause mortality among sepsis patients during hospitalization. Multivariable Logistic regression analysis further confirmed that patients with SpO&lt;sub&gt;2&lt;/sub&gt; levels between 0.96 and 0.98 during hospitalization had a decreased mortality compared to those with SpO&lt;sub&gt;2&lt;/sub&gt; &lt; 0.96 [hypoxia group; odds ratio (OR) = 2.659, 95% confidence interval (95%CI) was 2.190-3.229, P &lt; 0.001] and SpO&lt;sub&gt;2&lt;/sub&gt; &gt; 0.98 (hyperoxia group; OR = 1.594, 95%CI was 1.337-1.900, P &lt; 0.001). Kaplan-Meier survival curve showed that patients with SpO&lt;sub&gt;2&lt;/sub&gt; between 0.96 and 0.98 during hospitalization had a higher probability of survival than those patient with SpO&lt;sub&gt;2&lt;/sub&gt; &lt; 0.96 and SpO&lt;sub&gt;2&lt;/sub&gt; &gt; 0.98 (Log-Rank test: χ &lt;sup&gt;2&lt;/sup&gt; = 113.400, P &lt; 0.001). Sensitivity analyses demonstrated that, with the exception of subgroups with smaller sample sizes, across the strata of age, gender, body mass index (BMI), admission type, race, heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, respiratory rate, body temperature, myocardial infarction, congestive heart failure, cerebrovascular disease, chronic liver disease, diabetes mellitus, sequential organ failure assessment (SOFA), simplified acute physiology score II (SAPS II), systemic inflammatory response syndrome score (SIRS), and Glasgow coma score (GCS), the mortality of patients with SpO&lt;sub&gt;2&lt;/sub&gt; between 0.96 and 0.98 was significantly lower than those of patients with SpO&lt;sub&gt;2&lt;/sub&gt; &lt; 0.96 and SpO&lt;sub&gt;2&lt;/sub&gt; &gt; 0.98.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;During hospitalization, the level of SpO&lt;sub&gt;2&lt;/sub&gt; among sepsis patients exhibits a U-shaped relationship with in-hospital all-cause mortality, indicating that heightened and diminished oxygen levels are both associated with increased ","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Research progress on the application of artificial intelligence in the early diagnosis and treatment of burn diseases].","authors":"Hailong Si, Shutian Gao, Yundou Wang","doi":"10.3760/cma.j.cn121430-20231127-01012","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20231127-01012","url":null,"abstract":"<p><p>Artificial intelligence (AI) technology is advancing rapidly, constantly presenting its application value and broad prospects in the medical field. Especially in the early intervention of burn diseases, the new developments, applications, and challenges of AI technology have a significant impact on the clinical outcomes of burn patients. Based on this, this article reviews the concept, classification, learning style, and application of AI in the early diagnosis and treatment of burn diseases, with a focus on discussing the challenges and suggestions of the application of AI technology in the medical field, in order to provide reference and suggestions for the better application of AI in the early diagnosis and treatment of burn diseases.</p>","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Effect of Wenyang Baidu Yin on early microcirculation disturbance in patients with sepsis (syndrome of Yang deficiency and turbid toxin): a randomized controlled trial].","authors":"Jing Liang, Jie Zhang, Shuo Zhang","doi":"10.3760/cma.j.cn121430-20231120-00996","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20231120-00996","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To observe the effect of Wenyang Baidu Yin on early microcirculation indicators in patients with sepsis (syndrome of Yang deficiency and turbid toxin), analyze the specific therapeutic effect, and provide a new perspective for clinical treatment of microcirculation disorders in sepsis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Sixty-four patients with sepsis admitted to the intensive care unit (ICU) of Shanxi Province Hospital of Integrated Traditional Chinese and Western Medicine from January 2022 to July 2023 were enrolled. Patients were divided into control group and observation group by randomly number table method, with 32 cases in each group. The control group received conventional Western medicine treatment. On the basis of conventional Western medicine treatment, the observation group was given Wenyang Baidu Yin 200 mL/d (100 mL each time, with an interval of 12 hours) orally or by nasal feeding for 3 consecutive days. The central venous oxygen saturation (ScvO&lt;sub&gt;2&lt;/sub&gt;), difference of central venous-to-arterial partial pressure of carbon dioxide (Pcv-aCO&lt;sub&gt;2&lt;/sub&gt;), arterial lactic acid (Lac), pulse perfusion index (PI), capillary refill time (CRT), and skin mottling score (SMS) of two groups were detected before treatment and at 6, 12, 24, and 48 hours of treatment; simultaneously record the traditional Chinese medicine (TCM) syndrome score before treatment and at 72 hours of treatment, as well as the sequential organ failure assessment (SOFA) and acute physiology and chronic health evaluation (APACHE) before treatment and at 24 hours and 72 hours of treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;There were no statistically significant differences in gender, age, and various microcirculation indicators before treatment between the two groups, indicating consistent baseline characteristics. Compared with before treatment, the microcirculation indicators ScvO&lt;sub&gt;2&lt;/sub&gt;, Pcv-aCO&lt;sub&gt;2&lt;/sub&gt;, Lac, PI, CRT, and SMS in both groups showed significant improvement after treatment. Moreover, the observation group showed more significant improvements in Lac and PI compared to the control group at 24 hours and 48 hours of treatment [Lac (mmol/L): 2.45±0.92 vs. 3.07±1.07 at 24 hours, 2.06±0.87 vs. 2.59±1.01 at 48 hours; PI: 3.45±0.89 vs. 2.92±0.98 at 24 hours, 3.56±0.99 vs. 3.01±0.87 at 48 hours, all P &lt; 0.05]. CRT and SMS showed more significant improvements compared to the control group at 48 hours of treatment [CRT (s): 2.04±1.08 vs. 2.62±0.99, SMS: 0.5 (0.0, 1.0) vs. 1.0 (1.0, 1.0), both P &lt; 0.05], while there were no statistically significant differences in ScvO&lt;sub&gt;2&lt;/sub&gt; and Pcv-aCO&lt;sub&gt;2&lt;/sub&gt; at each time point between the two groups. After treatment, the APACHE score, SOFA score, and TCM syndrome score improved in both groups compared to before treatment, and the improvement degree of each score in the observation group was significantly higher than that in the control group [72 hours APACHE II score: 15.0 (12.2, 1","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Inhibition of type 3 deiodinase expression can improve mitochondrial function in skeletal muscle of sepsis by up-regulating peroxisome proliferator-activated receptor-γ coactivator-1α].","authors":"Gang Wang, Jianfeng Duan, Ke Cao, Tao Gao, Anqi Jiang, Yun Xu, Zhanghua Zhu, Wenkui Yu","doi":"10.3760/cma.j.cn121430-20231121-01003","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20231121-01003","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate the protective effects and mechanisms of targeted inhibition of type 3 deiodinase (Dio3) on skeletal muscle mitochondria in sepsis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;(1) In vivo experiments: adeno-associated virus (AAV) was employed to specifically target Dio3 expression in the anterior tibial muscle of rats, and a septic rat model was generated using cecal ligation and puncture (CLP). The male Sprague-Dawley (SD) rats were divided into shNC+Sham group, shD3+Sham group, shNC+CLP group, and shD3+CLP group by random number table method, with 8 rats in each group. After CLP modeling, tibial samples were collected and Western blotting analysis was conducted to assess the protein levels of Dio3, peroxisome proliferator-activated receptor-γ coactivator-1α (PGC1α), and silence-regulatory protein 1 (SIRT1). Real-time fluorescence quantitative polymerase chain reaction (RT-qPCR) was utilized to examine mRNA expression of genes including thyroid hormone receptors (THRα, THRβ), monocarboxylate transporter 10 (MCT10), mitochondrial DNA (mtDNA), and PGC1α. Transmission electron microscopy was employed to investigate mitochondrial morphology. (2) In vitro experiments: involved culturing C2C12 myoblasts, interfering with Dio3 expression using lentivirus, and constructing an endotoxin cell model by treating cells with lipopolysaccharide (LPS). C2C12 cells were divided into shNC group, shD3 group, shNC+LPS group, and shD3+LPS group. Immunofluorescence colocalization analysis was performed to determine the intracellular distribution of PGC1α. Co-immunoprecipitation assay coupled with Western blotting was carried out to evaluate the acetylation level of PGC1α.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;(1) In vivo experiments: compared with the shNC+Sham group, the expression of Dio3 protein in skeletal muscle of the shNC+CLP group was significantly increased (Dio3/β-Tubulin: 3.32±0.70 vs. 1.00±0.49, P &lt; 0.05), however, there was no significant difference in the shD3+Sham group. Dio3 expression in the shD3+CLP group was markedly reduced relative to the shNC+CLP group (Dio3/β-Tubulin: 1.42±0.54 vs. 3.32±0.70, P &lt; 0.05). Compared with the shNC+CLP group, the expression of T3-regulated genes in the shD3+CLP group were restored [THRα mRNA (2&lt;sup&gt;-ΔΔCt&lt;/sup&gt;): 0.67±0.05 vs. 0.33±0.01, THRβ mRNA (2&lt;sup&gt;-ΔΔCt&lt;/sup&gt;): 0.94±0.05 vs. 0.67±0.02, MCT10 mRNA (2&lt;sup&gt;-ΔΔCt&lt;/sup&gt;): 0.65±0.03 vs. 0.57±0.02, all P &lt; 0.05]. Morphology analysis by electron microscopy suggested prominent mitochondrial damage in the skeletal muscle of the shNC+CLP group, while the shD3+CLP group exhibited a marked improvement. Compared with the shNC+Sham group, the shNC+CLP group significantly reduced the number of mitochondria (cells/HP: 10.375±1.375 vs. 13.750±2.063, P &lt; 0.05), while the shD3+CLP group significantly increased the number of mitochondria compared to the shNC+CLP group (cells/HP: 11.250±2.063 vs. 10.375±1.375, P &lt; 0.05). The expression of mtDNA in shNC+CL","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Feasibility and safety study of building a friendly management model for elderly critically ill patients based on geriatric intensive care unit: a prospective controlled study].","authors":"Junma Xu, Yi Xie, Dong Yuan, Chan Shao, Fangqin Xu, Shu Han","doi":"10.3760/cma.j.cn121430-20240109-00024","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240109-00024","url":null,"abstract":"<p><strong>Objective: </strong>To explore the feasibility and safety of integrating the geriatric intensive care unit (GICU) into the friendly management model of the elderly critically ill patients.</p><p><strong>Methods: </strong>A prospective controlled study was conducted. Patients with elderly critically ill admitted to the GICU and the general intensive care unit (ICU) of Jintan First People's Hospital of Changzhou from December 2021 to May 2023 were enrolled. Patients in the ICU group received the traditional intensive care and nursing mode. In addition to the ICU group basic medical care measures, the patients in the GICU group were treated with friendly management models such as flexible visitation, diagnosis and treatment environment optimization, caring diagnosis and treatment, and family participation in hospice care according to their condition assessment. The gender, age, main diagnosis, and acute physiology and chronic health evaluation II (APACHE II) at admission were recorded and compared between the two groups. During the treatment period, the incidence of nosocomial infection, unplanned extubation, falling out of bed/fall, unexpected readmission to ICU/GICU, and ICU/GICU mortality, the incidence of post-intensive care syndrome (PICS), the satisfaction rate of patients/families with medical care, and the satisfaction rate of patients/families with diagnosis and treatment environment were recorded and compared between the two groups.</p><p><strong>Results: </strong>According to the admission criteria for ICU and GICU, as well as the willingness of the patients and/or their families, a total of 59 patients were finally included in the ICU group, and 48 patients were enrolled in the GICU group. There were no significantly differences in gender, age, main diagnosis and APACHE II score between the two groups, and there were comparability. There were no significantly differences in the incidence of adverse events such as nosocomial infection [13.6% (8/59) vs. 12.5% (6/48)], unplanned extubation [5.1% (3/59) vs. 6.2% (3/48)], falling out of bed/fall [3.4% (2/59) vs. 0% (0/48)], unexpected readmission to ICU/GICU [8.5% (5/59) vs. 10.4% (5/48)], and ICU/GICU mortality [6.8% (4/59) vs. 6.2 (3/48)] between the ICU group and GICU group (all P > 0.05). Compared with the ICU group, the incidence of PICS in GICU group was significantly lower [8.3% (4/48) vs. 25.4% (15/59), P < 0.05], the satisfaction rate of patients/families with medical care [89.6% (43/48) vs. 74.6% (44/59)] and satisfaction rate of patients/families with diagnosis and treatment environment [87.5% (42/48) vs. 67.8% (40/59)] were significantly increased (both P < 0.05).</p><p><strong>Conclusions: </strong>The use GICU as a friendly management model for elderly critically ill patients is feasible and safe, and it is worthy of further exploration and research.</p>","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Causal association between immune cells and sepsis: a based on Mendelian randomization method study].","authors":"Qiushuang Yu, Lingxu Li, Yina Tao, Longqiang Zhang, Junfeng Hu, Huaxue Wang","doi":"10.3760/cma.j.cn121430-20240527-00462","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240527-00462","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the causal association between immune cell and different types of sepsis by using Mendelian randomization (MR) method, and to find the immune cell phenotypes causally associated with sepsis.</p><p><strong>Methods: </strong>Summary data for various circulating immune cell phenotypes were obtained from the GWAS catalog (GCST90001391-GCST90002121). Sepsis data were sourced from the UK Biobank database. Single nucleotide polymorphisms (SNP) were used as instrumental variables. The correlation threshold of P < 5×10^-6 was used to identify the strongly correlated instrumental variables, and the code was used to remove the linkage disequilibrium and the instrumental variables with F-value < 10. Inverse variance weighting (IVW) was used as the main research method to evaluate the stability and reliability of the results, including Cochran's Q test, MR-Egger regression and Leave one out. Reverse MR analysis was performed based on the immunophenotypic results of the removal of horizontal pleiotropy, and the immune cell phenotype with one-way causal association was obtained. Odds ratio (OR) and 95% confidence interval (95%CI) were used to represent the effect value of the results.</p><p><strong>Results: </strong>CD16 on CD14^-CD16⁺; monocyte had horizontal pleiotropy in sepsis (OR = 0.965 4, 95%CI was 0.933 5-0.998 3, P = 0.039 6). There were five immunophenotypes that had reverse causal associations with the types associated with sepsis. After excluding immune cell phenotypes with horizontal pleiotropy and reverse causation, a total of 42 immune cell phenotypes with sepsis, 36 immune cell phenotypes with sepsis (28-day death in critical care), 32 immune cell phenotypes with sepsis (critical care), 44 immune cell phenotypes with sepsis (28-day death), and 30 immune cell phenotypes had potential causal associations with sepsis (under 75 years old). After false discovery rate (FDR) correction, the correlations between BAFF-R on IgD^- CD38br and sepsis (28-day death) were negative and strong (OR = 0.737 8, 95%CI was 0.635 9-0.856 0, P = 6.05×10^-5, P_FDR = 0.044 2).</p><p><strong>Conclusions: </strong>A variety of immune cell phenotypes may have a protective effect on sepsis, especially BAFF-R on IgD^- CD38br expression is negatively correlated with sepsis (28-day death), which provides a new idea for immune modulation therapy in sepsis.</p>","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Research progress on the correlation between intestinal microecology and sepsis].","authors":"Zhiyi Liu, Guanghui Xiu","doi":"10.3760/cma.j.cn121430-20231117-00988","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20231117-00988","url":null,"abstract":"<p><p>Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection, with increasing mortality as septic shock and organ failure progress. Mechanisms such as vascular endothelial dysfunction, microcirculatory disorders, coagulation abnormalities, immune suppression, mitochondrial damage, cell pyroptosis, ferroptosis, endoplasmic reticulum stress, and autophagy play crucial roles in organ dysfunction and death caused by sepsis. Concurrently, the imbalance of the gut microbiota also plays an undeniable role in the development of sepsis, with recent studies demonstrating a close connection between the gut microbiome and sepsis. Thus, how to improve the prognosis of patients with sepsis by reconstructing gut microbiota has become a focus of interest for critical care physicians. This article reviews the research progress on the correlation between gut microbiota and sepsis, providing clinical physicians with more therapeutic strategies to improve patient prognosis.</p>","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Expert recommendations on the clinical application of mechanical insufflation-exsufflation in mechanically ventilated patients (2024)].","authors":"Medicine Chinese Society Of Critical Care, Medicine Critical Care Medicine Branch Of Beijing Association Of Holistic Integrative, Working Group Of The Expert Recommendations On The Clinical Application Of Mechanical Insufflation-Exsufflation In Mechanically Ventilated Patients","doi":"10.3760/cma.j.cn121430-20240508-00408","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240508-00408","url":null,"abstract":"<p><p>Mechanical ventilated patients are a high-risk group with impaired cough ability and require corresponding medical techniques for cough assistance to clear airway secretions. Mechanical insufflation-exsufflation (MI-E) technology is widely used in patients with cough weakness caused by neuromuscular diseases. However, there is currently a lack of standardized application procedures for mechanically ventilated patients who retain artificial airways, which can affect treatment outcomes. Chinese Society of Critical Care Medicine organized experts including critical care physicians, nurses, respiratory therapists that focused on the clinical application of mechanical insufflation-exsufflation in mechanically ventilated patients. Through systematic collection, extraction, and summary of evidence-based clinical practice evidence and clinical experience, suggestions are proposed. Expert recommendations on the clinical application of mechanical insufflation-exsufflation in mechanically ventilated patients (2024) was formed by using improved Delphi method, hoping to provide references for standardized application of this technology. At the same time, those recommendations will also provide a reference for future clinical research on the application of mechanical insufflation-exsufflation technology in mechanically ventilated patients.</p>","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}