Zhonghua wei zhong bing ji jiu yi xue最新文献

{"title":"[Advances in electroencephalography for detecting cognitive-motor dissociation in disorders of consciousness].","authors":"Fei Liu, Guangzhi Shi","doi":"10.3760/cma.j.cn121430-20250303-00207","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20250303-00207","url":null,"abstract":"<p><p>Disorders of consciousness including coma, unresponsive wakefulness syndrome (UWS)/the vegetative state (VS), and minimally conscious state (MCS), are a prevalent complication following severe brain injury. Cognitive-motor dissociation (CMD), characterized by absent behavioral signs of consciousness but preserved neural activation detected by electroencephalography (EEG) or advanced imaging, such as functional magnetic resonance imaging (fMRI), occurs in approximately 25% of behaviorally unresponsive patients. As a non-invasive, bedside tool, EEG provides critical insights into consciousness levels and residual cognitive capacity, with CMD detection carrying significant prognostic implications. This review synthesizes recent advances in EEG-based diagnosis and prognosis of disorders of consciousness and CMD.</p>","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"38 3","pages":"302-305"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647044","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":"[Overexpression of mitochondrial Lon protease 1 alleviates myocardial injury in septic mice by attenuating mitochondrial oxidative stress].","authors":"Xun Luo, Shan Zhao, Zhengguang Geng, Bao Fu, Xiaoyun Fu","doi":"10.3760/cma.j.cn121430-20250224-00103","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20250224-00103","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate the effects of mitochondrial Lon protease 1 (LONP1) overexpression on mitochondrial oxidative stress in a mouse model of septic myocardial injury.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Twenty-four SPF-grade male C57BL/6J mice were randomly divided into a normal control group (Control group), a sepsis model group (LPS group), an adeno-associated virus control group (AAV+LPS group), and a LONP1 overexpression group (LONP1+LPS group), with 6 mice in each group. A septic myocardial injury model was established by intraperitoneal injection of lipopolysaccharide (LPS) at 10 mg/kg; the Control group was intraperitoneally injected with an equal volume of normal saline. Three weeks before modeling, the Control group and LPS group were sham-transfected via tail vein injection with an equal volume (100 μL) of normal saline; the AAV+LPS group was injected with adeno-associated virus (AAV) without the Lonp1 gene (100 μL) via tail vein; the LONP1+LPS group was injected with AAV targeting the myocardium and carrying the Lonp1 gene fragment (viral titer: 1×10&lt;sup&gt;12&lt;/sup&gt; vg/mL, 100 μL) via tail vein. In the LONP1+LPS group, Lonp1 gene overexpression was evaluated by frozen section and Western blotting 3 weeks after viral transfection, and modeling was performed after successful overexpression was confirmed. Twenty-four hours after modeling, the establishment of the septic myocardial injury model was assessed by mouse activity, secretions, urine and feces, combined with cardiac echocardiography, and hematoxylin-eosin (HE) staining of myocardial tissue; reactive oxygen species (ROS) production was detected by dihydroethidium (DHE) method; adenosine triphosphate (ATP) production and mitochondrial membrane potential changes were detected by relevant kits. Changes in mitochondrial oxidative stress indicators [4-hydroxynonenal (4-HNE), malondialdehyde (MDA), mitochondrial aconitase 2 (mt-ACO2)] and cardiac function indicators [left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS), left ventricular end-systolic volume (LVESV), left ventricular end-diastolic volume (LVEDV)] were also evaluated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Twenty-four hours after modeling, compared with the Control group, mice in the LPS group exhibited lethargy, piloerection, increased oral and ocular secretions, pyuria, and loose stools; LVEF and LVFS were significantly decreased; HE staining showed degeneration and necrosis of some myocardial fibers in the LPS group, with disordered arrangement and inflammatory cell infiltration. Under fluorescence microscopy after frozen section, successful viral transfection was observed in the LONP1+LPS group; Western blotting showed that, compared with the Control group, LPS group, and AAV+LPS group, protein expression of LONP1 was significantly increased in the LONP1+LPS group (LONP1/GAPDH: 1.47±0.01 vs. 1, 1.11±0.01, 1.12±0.01, all P&lt;0.05). Under fluorescence microscopy, green fluore","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"38 3","pages":"239-246"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646038","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":"[AMP-activated protein kinase activation alleviates lipopolysaccharide-induced sepsis-associated acute kidney injury by inhibiting ferroptosis].","authors":"Mian Wang, Yindong Kang, Bin Zhang, Chunlei Zhang, Forong Li, Xingming Jiang, Jiahao Li, Dehui Chang","doi":"10.3760/cma.j.cn121430-20250303-00123","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20250303-00123","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate the regulatory role of AMP-activated protein kinase (AMPK) activation in ferroptosis during lipopolysaccharide (LPS)-induced sepsis-associated acute kidney injury (SA-AKI) and its molecular mechanisms.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Thirty SPF male C57BL/6 mice were randomly assigned to the control group, LPS group, and LPS+AMPK activator (AICAR) group using a random number table method, with 10 mice per group. Mice in the LPS+AICAR group received an intraperitoneal injection of AICAR at a dose of 500 mg/kg for intervention 30 minutes prior to model establishment, while those in the control group and LPS group were intraperitoneally injected with an equal volume of normal saline. The SA-AKI model was induced via intraperitoneal injection of LPS at 10 mg/kg, and the control group was intraperitoneally administered an equal volume of normal saline. Enzyme-linked immunosorbent assay (ELISA) was performed to measure the serum concentrations of inflammatory factors [including interleukins (IL-1β, IL-6), and tumor necrosis factor-α (TNF-α)]. Serum renal function indicators [including serum creatinine (SCr) and blood urea nitrogen (BUN)], as well as the levels of key ferroptosis-related factors [including Fe&lt;sup&gt;2+&lt;/sup&gt;, malondialdehyde (MDA), and glutathione (GSH)] in renal tissues were measured using biochemical assays. Hematoxylin-eosin (HE) staining was conducted to observe histopathological changes in renal tissues under a light microscope, and transmission electron microscopy was used to examine the ultrastructural alterations of mitochondria in renal tissues. Quantitative real-time polymerase chain reaction (RT-qPCR) and Western blotting were employed to determine the mRNA and protein expression levels of AMPK, key ferroptosis-related enzymes [long-chain acyl-CoA synthetase 4 (ACSL4), solute carrier family 7 member 11 (SLC7A11), and glutathione peroxidase 4 (GPX4)], as well as the nuclear factor E2-related factor 2 (Nrf2)/heme oxygenase-1 (HO-1) signaling pathway-related molecules in renal tissues.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Compared with the control group, mice in the LPS group exhibited renal tubular structural disorder, with vacuolar degeneration, necrosis, and shedding of epithelial cells, interstitial edema, and inflammatory cell infiltration. Mitochondria in renal tissues showed typical ferroptosis characteristics. Moreover, the levels of serum IL-1β, IL-6, TNF-α, SCr, and BUN were significantly elevated. In renal tissues, the levels of Fe&lt;sup&gt;2+&lt;/sup&gt; and MDA, along with the mRNA and protein expression of ACSL4, were increased, whereas the GSH level, protein expression of AMPK, and mRNA and protein expression of SLC7A11, GPX4, Nrf2, and HO-1 were markedly decreased (all P&lt;0.05). In contrast to the LPS group, mice in the LPS+AICAR group displayed significant alleviation of renal tubular structural damage and vacuolar degeneration, as well as reduced interstitial edema and inflammatory inf","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"38 3","pages":"227-233"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647053","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":"[Design and application of a multifunctional continuous humidification device in tracheostomy patients].","authors":"Qiaoqiao Peng, Mingli Zhu, Hongyu Chen, Yuan Li","doi":"10.3760/cma.j.cn121430-20240805-00665","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240805-00665","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Tracheostomy is an important therapeutic measure to relieve airway obstruction and ensure effective ventilation in patients. However, the procedure bypasses the natural upper airway, compromising its normal defensive functions, which can lead to drying of secretions, crust formation, potential tube occlusion, and ultimately pulmonary infection. Adequate airway humidification can help dilute sputum, facilitate sputum drainage, and ultimately reduce the incidence of airway-related complications. Although several airway humidification methods have been reported, their outcomes remain unsatisfactory. To address this, the intensive care unit staff of Hangzhou First People's Hospital, designed a multifunctional continuous humidification device consisting of a cover, connecting tube, and nebulizer for airway humidification, which has been granted a national utility model patent of China (patent number: ZL 2021 2 0079525.4). A total of 48 patients requiring oxygen therapy via a tracheostomy at the intensive care unit of Hangzhou First People's Hospital between August 2023 and June 2024 were selected as the study subjects. Using a random number table, they were assigned in a 1 : 1 ratio to an experimental group (n=24) and a control group (n=24). From the initiation of the transition from mechanical ventilation weaning to continuous oxygen inhalation via the tracheostomy, the experimental group received humidification using the multifunctional continuous humidification device, while the control group received humidification using a traditional humidifier. The daily humidification protocol was consistent for both groups and was implemented by nursing staff who had undergone homogenized training. General patient data, the incidence of complications during humidified oxygen therapy via tracheostomy, nursing staff satisfaction, and sputum viscosity grading on day 1, 7, and 14 of airway humidification were compared between the two groups. The results showed no statistically significant differences in gender, age, disease types, or pre-humidification sputum viscosity grades between the two groups. The incidence of complications in the experimental group was lower than that in the control group during the treatment [crust formation: 4% (1/24) vs. 54% (13/24); airway mucosal injury: 8% (2/24) vs. 42% (10/24); pulmonary infection: 4% (1/24) vs. 54% (13/24)]. Nursing staff satisfaction was also found to be significantly higher in the experimental group [100% (24/24) vs. 17% (4/24)]. All these differences were statistically significant (all P&lt;0.05). The sputum viscosity grades on day 1, 7, and 14 were also significantly more favorable in the experimental group than in the control group (all P&lt;0.05). These findings indicate that the application of this device in tracheostomy patients effectively maintained airway humidification, ensured respiratory tract patency, improved airway clearance efficacy, reduced the frequency of sputum suction, and prevented airway co","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"38 3","pages":"293-296"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147645987","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":"[Design and application of an intermittent urination device].","authors":"Feige Tang, Lijuan Chen","doi":"10.3760/cma.j.cn121430-20241029-00520","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20241029-00520","url":null,"abstract":"<p><p>Clamping training has a protective effect on bladder function. However, due to the risk of excessive bladder distension, it has not been widely applied in clinical practice over the past century, with continuous drainage remaining the predominant approach. The China National Health Industry Standard WS/T 509-2016 Specifications for Prevention and Control of Healthcare-associated Infections in Intensive Care Units explicitly stipulates that indwelling urinary catheters should be kept continuously clamped and opened at regular intervals. To date, this requirement has not been extensively implemented, primarily due to the persistent risk of excessive bladder distension. In patients with elevated intra-abdominal pressure, traditional clamping training tends to induce increased intravesical pressure without adequate bladder filling, which may further lead to upper urinary tract injury. To address this clinical dilemma, the critical care medical staff at Fourth People's Hospital of Sichuan Province have designed a passive intermittent urination device for clamping training. This device can ensure sufficient bladder filling while eliminating the risk of overdistension. Currently, the device has been granted a national invention patent (patent number: ZL 2017 1 1242878.6). Its core mechanism involves shaping the external urinary catheter into a \"Ji\"-shaped configuration. It utilizes the hydrostatic pressure generated by the height of urine column in the catheter to prevent urine outflow, thereby ensuring proper bladder distension. When the intravesical pressure exceeds the preset hydrostatic pressure threshold, urine is automatically drained out, which effectively prevents excessive bladder distension. Meanwhile, the device is not affected by high intra-abdominal pressure and can stably maintain the optimal bladder filling state. Innovatively, this device adopts a liquid barrier (urine) to replace the conventional solid barrier. It not only circumvents the risk of excessive bladder distension during clamping training but also avoids insufficient bladder filling caused by the interference of intra-abdominal pressure with intravesical pressure, thus achieving both efficacy and safety of clamping training. With its simple structure, convenient operation and no need for power supply, this device is expected to facilitate the popularization of clamping training, and further promote its replacement of continuous drainage to become the mainstream clinical practice.</p>","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"38 3","pages":"297-301"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147645995","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":"[Construction and evaluation of a 28-day mortality nomogram prediction model for children with sepsis].","authors":"Shuping Xue, Ya Liu, Mingxiao Chang, Zhenying Wang, Guixia Xu","doi":"10.3760/cma.j.cn121430-20250709-00381","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20250709-00381","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To analyze factors influencing 28-day mortality in children with sepsis, to construct a nomogram prediction model, and evaluate its predictive value.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective cohort study was conducted using clinical data from children with sepsis admitted to the pediatric intensive care unit (PICU) of the Second People's Hospital of Liaocheng from January 2017 to December 2023. Data collected included gender, age, pediatric Critical Illness Score (pCIS), pediatric Sequential Organ Failure Assessment (pSOFA), pediatric Sepsis-Induced Coagulopathy (pSIC) score, white blood cell count (WBC), neutrophil percentage (NEU%), lymphocyte percentage (LYM%), platelet count (PLT), mean platelet volume (MPV), C-reactive protein (CRP), procalcitonin (PCT), blood lactic acid, activated partial thromboplastin time (APTT), prothrombin time (PT), international normalized ratio (INR), fibrinogen (Fib), serum alanine aminotransferase (ALT), total bilirubin (TBil), serum creatinine, blood urea nitrogen (BUN), cardiac troponin I (cTnI), creatine kinase isoenzyme (CK-MB), and 28-day prognosis. According to the prognosis of children with sepsis within 28 days, the children were divided into two groups, namely the survival group and the death group, and the differences of each index between the two groups were compared. Lasso regression analysis was used for preliminary screening of risk factors affecting 28-day mortality in children with sepsis; multivariate Logistic regression analysis was employed to further identify independent risk factors; a nomogram prediction model was constructed based on the independent risk factors screened out, and the model was evaluated simultaneously.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 165 children with sepsis were included, of whom 150 survived and 15 died within 28 days. Compared with the survival group, the death group had higher levels of pCIS score, pSOFA score, pSIC score, LYM%, PCT, blood lactic acid, APTT, PT, INR, serum creatinine, BUN, cTnI, and CK-MB, and lower levels of NEU%, PLT, and Fib (all P&lt;0.05). Lasso regression and multivariate Logistic regression analyses showed that pSIC score [odds ratio (OR)=4.31, 95% confidence interval (95%CI) was 2.23-8.31, P&lt;0.001], blood lactic acid (OR=1.51, 95%CI was 1.26-1.80, P&lt;0.001) and CK-MB (OR=1.05, 95%CI was 1.03-1.07, P&lt;0.001) were independent risk factors for 28-day mortality in children with sepsis. A nomogram prediction model for 28-day mortality in children with sepsis was constructed based on the above three indicators. Receiver operator characteristic curve (ROC curve) showed that the concordance index of the model was 0.95, and the area under the curve (AUC) was 0.976 (95%CI was 0.955-0.997), indicating that the model had good discrimination; calibration curve showed that the calibrated curve was close to the reference curve, indicating that the model had good calibration; decision curve analysis (DCA) showed that ","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"38 3","pages":"253-258"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647012","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":"[Risk factors for critical illness-related corticosteroid insufficiency in sepsis and construction of nomogram prediction model].","authors":"Enfang Zhao, Chunhua Hu, Tingyuan Zhang, Xin Dong, Huanzhang Shao","doi":"10.3760/cma.j.cn121430-20250616-00587","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20250616-00587","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To identify the risk factors of critical illness-related corticosteroid insufficiency (CIRCI) in patients with sepsis and to construct a nomogram model for predicting the occurrence of CIRCI in septic patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A case-control study was conducted. A total of 50 patients with sepsis complicated by CIRCI who were admitted to Henan Provincial People's Hospital from January 2018 to December 2023 were enrolled as the CIRCI group. Meanwhile, 150 patients with sepsis but without CIRCI admitted during the same period were randomly selected as the control group. Baseline characteristics, etiologies of sepsis, vital signs, adrenal function indicators, serological parameters, intervention measures, disease severity scores, and prognosis-related outcomes were collected and compared between the two groups. Multivariate Logistic regression and inverse probability of treatment weighting (IPTW) regression analyses were performed to evaluate the correlation between various factors and the occurrence of CIRCI, screen out the influencing factors of CIRCI in septic patients, and construct a nomogram prediction model. The receiver operator characteristic curve (ROC curve) and calibration curve were used to assess the discrimination of the model. The Bootstrap method (with 1 000 repeated samplings) was adopted for internal validation, and the calibration curve was plotted to evaluate the calibration of the model. Decision curve analysis (DCA) was performed to assess the clinical validity of the model.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;After adjusting for confounding factors, univariate Logistic regression analysis showed that older age, history of type 2 diabetes mellitus, higher white blood cell count (WBC), higher procalcitonin (PCT) level, higher serum K&lt;sup&gt;+&lt;/sup&gt; level, higher Acute Physiology and Chronic Health Evaluation II (APACHE II), and higher Sequential Organ Failure Assessment (SOFA) were associated with an increased risk of CIRCI, whereas higher serum sodium (Na&lt;sup&gt;+&lt;/sup&gt;) level was associated with a decreased risk of CIRCI (all P&lt;0.05). In addition, CIRCI was associated with longer ICU length of stay, longer duration of mechanical ventilation, as well as higher rates of 28-day mortality and ICU mortality (all P&lt;0.05). Multivariate Logistic regression and IPTW regression analyses revealed that history of type 2 diabetes mellitus [odds ratio (OR)=1.574, 95% confidence interval (95%CI) was 0.558-4.437, P=0.022], elevated PCT level (OR=4.271, 95%CI was 1.637-11.139, P=0.003), elevated serum K&lt;sup&gt;+&lt;/sup&gt; level (OR=2.115, 95%CI was 0.909-4.921, P=0.044), elevated APACHE II score (OR=1.258, 95%CI was 1.071-1.478, P=0.006), and elevated SOFA score (OR=1.236, 95%CI was 1.049-1.456, P=0.012) were independent risk factors for CIRCI. A nomogram prediction model was constructed based on the above 5 indicators. The ROC curve demonstrated that the model achieved an area under the curve (AUC) of 0.965 (95%","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"38 3","pages":"221-226"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646763","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":"[Analysis of influencing factors for citrate accumulation in critically ill patients with acute kidney injury undergoing continuous renal replacement therapy with regional citrate anticoagulation].","authors":"Zhongbin Chen, Qing Tang, Caixia Xie, Lei Cha, Qin Yang, Bin Zeng, Yanyu Chen, Dong Liao, Xinxin Huang","doi":"10.3760/cma.j.cn121430-20250623-00347","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20250623-00347","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate the influencing factors of citrate accumulation in critically ill patients with acute kidney injury (AKI) undergoing continuous renal replacement therapy with regional citrate anticoagulation (RCA-CRRT).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective case-control study was conducted, enrolling AKI patients who received RCA-CRRT for ≥24 hours in the intensive care unit (ICU) of Sichuan Provincial People's Hospital from January 2023 to December 2024 as research subjects. Clinical data were collected, including gender, age, Sequential Organ Failure Assessment (SOFA) before RCA-CRRT initiation, mean blood lactic acid level, mean total bilirubin level from the start of RCA-CRRT to the occurrence of citrate accumulation, mean infusion dose of sodium citrate, mean partial pressure of arterial oxygen (PaO&lt;sub&gt;2&lt;/sub&gt;), mean hourly volume of replacement or dialysate fluid, treatment dose, blood flow rate, treatment mode, and the occurrence of citrate accumulation during RCA-CRRT. Patients were divided into two groups based on the total calcium/ionized calcium ratio: a citrate accumulation group (≥2.5) and a non-citrate accumulation group (&lt;2.5). Baseline data were compared between the two groups. Univariate and multivariate Cox proportional hazards regression analyses were used to screen the influencing factors of citrate accumulation. Cumulative risk curves of citrate accumulation were plotted to analyze the risk of citrate accumulation in different treatment modes [continuous veno-venous hemodialysis (CVVHD) vs. continuous veno-venous hemodiafiltration (CVVHDF)].&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 192 AKI patients were enrolled, with 393 circuits of RCA-CRRT treatment, among which citrate accumulation occurred in 134 circuits (34.1%). Univariate Cox proportional hazards analysis showed that treatment mode, total bilirubin level, sodium citrate dose, blood lactic acid level, PaO&lt;sub&gt;2&lt;/sub&gt;, replacement fluid dose, treatment dose and SOFA score were potential influencing factors for citrate accumulation in AKI patients undergoing RCA-CRRT (all P&lt;0.1). Multivariate Cox proportional hazards regression analysis revealed that CVVHD treatment mode [hazard ratio (HR)=2.329, 95% confidence interval (95%CI) was 1.396-3.884], elevated total bilirubin level (HR=1.004, 95%CI was 1.002-1.006), higher citrate dose (HR=1.001, 95%CI was 1.000-1.001) and elevated blood lactic acid level (HR=1.091, 95%CI was 1.036-1.148) were risk factors for citrate accumulation (all P&lt;0.05), while elevated PaO&lt;sub&gt;2&lt;/sub&gt; was a protective factor (HR=0.990, 95%CI was 0.900-1.008, P&lt;0.05). The cumulative risk curve of citrate accumulation indicated that the incidence of citrate accumulation in the CVVHD mode was significantly higher than that in the CVVHDF mode (P=0.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Higher total bilirubin, higher sodium citrate dose, higher lactate, and lower PaO&lt;sub&gt;2&lt;/sub&gt; are associated with an increased r","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"38 3","pages":"234-238"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647026","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 advance on the roles of neutrophils and interleukin-18 in sepsis].","authors":"Junling Wang, Shengyong Ren, Shihao Liu, Bingyu Qin","doi":"10.3760/cma.j.cn121430-20250426-00232","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20250426-00232","url":null,"abstract":"<p><p>Sepsis is a critical illness induced by infection and characterized by dysregulated inflammatory responses. Neutrophils (Neu) are not only key effector cells that directly combat pathogenic microbial infections, but also crucial regulators of immune responses, thus playing a double-edged sword role in sepsis. Interleukin-18 (IL-18) is a classical inflammasome-associated potent pro-inflammatory factor, and plays an imperative role in the migration and activation of neutrophils. Therefore, this article summarizes the roles of neutrophils and IL-18 in sepsis, aiming to provide a theoretical basis for further in-depth exploration of the pathogenesis of sepsis, the development of IL-18 related biological agents, and the formulation of targeted therapeutic strategies.</p>","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"38 3","pages":"306-308"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646741","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":"[Best evidence summary for the prevention and management of brain injury in patients with extracorporeal membrane oxygenation].","authors":"Ke Fang, Jun Wang, Qiancheng Xu, Ruixiang Sun, Haijiao Jiang, Xiaoming Ye, Yang Li, Quan Zhou, Guanggui Shen","doi":"10.3760/cma.j.cn121430-20250727-00403","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20250727-00403","url":null,"abstract":"<p><strong>Objective: </strong>To search, evaluate and summarize evidence for the prevention and management of brain injury in patients supported by extracorporeal membrane oxygenation (ECMO), and to provide evidence-based basis for the prevention and management of brain injury during ECMO support.</p><p><strong>Methods: </strong>A systematic search was conducted in the following databases and resources for clinical decision support tools, guidelines, expert consensus, systematic reviews and high-quality original studies related to the prevention and management of brain injury in ECMO-supported patients: UpToDate, BMJ Best Practice, JBI evidence-based Health Care Center Database, the Cochrane Library, the National Institute for Health and Care Excellence (NICE), the Scottish Intercollegiate Guidelines Network (SIGN), the National Guideline Clearinghouse (NGC), Yimaitong, Extracorporeal Life Support Organization (ELSO), the American College of Cardiology (ACC), PubMed, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), China Biomedical Literature Service System (SinoMed), CNKI, Wanfang Database, VIP Database and other Chinese and English databases, professional team websites, and guideline websites. The search time range is from the establishment of the database to May 2025. Two researchers with systematic training backgrounds in evidence-based nursing methods independently evaluated the quality of the literature, and extracted and summarized the evidence from the literature that met the quality standards.</p><p><strong>Results: </strong>A total of 18 publications were ultimately included, comprising 4 guidelines, 3 expert consensuses, 4 systematic reviews, and 7 original studies [including 1 randomized controlled trial (RCT), 4 cohort studies, and 2 case studies]. Through synthesis, 31 pieces of best evidence for the prevention and management of brain injury in ECMO-supported patients were formulated, covering five major themes: risk factors of brain injury, protective factors of brain injury, assessment and monitoring during treatment, prevention of brain injury, and treatment measures for brain injury.</p><p><strong>Conclusions: </strong>This evidence provides the best evidence-based basis for the prevention and management of brain injury during ECMO treatment. It is recommended to selectively apply the best evidence in combination with the actual clinical environment of medical institutions and individual differences of patients, and to prevent and manage brain injury in ECMO-supported patients in a personalized and reasonable manner.</p>","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"38 3","pages":"265-272"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647072","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}