Zhonghua wei zhong bing ji jiu yi xue最新文献

{"title":"[Platelet/white blood cell ratio in the prediction of postoperative acute kidney injury of patients].","authors":"Jie Long, Rui Liu, Huan Chen, Pan Lei, Changliang Zhu","doi":"10.3760/cma.j.cn121430-20240731-00648","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240731-00648","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the risk factors and predictive value on acute kidney injury (AKI) following surgery, and to elucidate the relationship between platelet/white blood cell ratio (PWR) and AKI.</p><p><strong>Methods: </strong>A retrospective case-control study was conducted. The patients who underwent surgery admitted to Honghui Hospital of Xi'an Jiaotong University from January 2019 to January 2023 were enrolled. The patients who developed AKI during the postoperative hospital stay were categorized as the AKI group, while those with normal renal function or not meeting AKI criteria were categorized as the non-AKI group. Demographic information, clinical characteristics, perioperative medication usage, surgical related information, and preoperative and postoperative laboratory indicators were collected. Binary multivariate Logistic regression analysis was used to identify risk factors for postoperative AKI. Receiver operator characteristic curve (ROC curve) was plotted to assess the predictive efficacy of postoperative PWR for postoperative AKI.</p><p><strong>Results: </strong>A total of 420 patients were enrolled finally, with 72 developing AKI during hospitalization and 348 not developing AKI. Compared with the non-AKI group, the patients in the AKI group had a higher proportion of hypertension and coronary heart disease, a more usage of angiotensin converting enzyme inhibitor (ACEI), mannitol and vancomycin but a less usage of hydroxyethyl starch, a longer duration from injury to surgery and postoperative hospital stay, a greater intraoperative blood transfusion volume, a lower preoperative albumin (Alb), blood sodium, blood chlorine but a higher serum creatinine (SCr), blood urea nitrogen (BUN)/Alb ratio and N-terminal pro-brain natriuretic peptide (NT-proBNP), and a higher postoperative white blood cell count (WBC), BUN, SCr, BUN/Alb ratio, blood potassium, and blood phosphorus but a lower platelet count (PLT), PWR, and Alb. Binary multivariate Logistic regression analysis revealed that perioperative usage of hydroxyethyl starch [odds ratio (OR) = 8.595, 95% confidence interval (95%CI) was 4.112-17.964, P < 0.001], prolonged duration from injury to surgery (OR = 1.084, 95%CI was 1.034-1.137, P = 0.001), increased intraoperative blood transfusion volume (OR = 1.001, 95%CI was 1.000-1.002, P = 0.017) were risk factors for AKI following surgery, and increased postoperative PWR was protective factor (OR = 0.930, 95%CI was 0.894-0.967, P < 0.001). ROC curve analysis indicated that the area under the ROC curve (AUC) of postoperative PWR for predicting postoperative AKI was 0.684 (95%CI was 0.615-0.754); at the optimal cut-off value of 19.34, the sensitivity was 63.8%, and the specificity was 69.8%.</p><p><strong>Conclusions: </strong>Postoperative PWR is an independent risk factor for AKI in patients undergoing surgery. Postoperative PWR reduction in surgical patients can assist in predicting the occurrence of postoperat","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"36 10","pages":"1063-1068"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717217","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":"[Bedside ultrasound monitoring of optic nerve sheath diameter is a predictive factor for 28-day coma, delirium and death in etiologically diverse critically ill patients].","authors":"Haijun Zhi, Xiaoya Cui, Fengwei Zhang, Shujuan Wang, Xuezheng Liang, Bo Wang, Jie Cui, Yong Li","doi":"10.3760/cma.j.cn121430-20230511-00362","DOIUrl":"10.3760/cma.j.cn121430-20230511-00362","url":null,"abstract":"<p><strong>Objective: </strong>To explore whether the optic nerve sheath diameter (ONSD) within 24 hours of intensive care unit (ICU) admission is the predictor of 28-day delirium or coma and death in etiologically diverse critically ill patients.</p><p><strong>Methods: </strong>A prospective, observational study was conducted. The critically ill patients admitted to the emergency ICU of Cangzhou Central Hospital from January 2021 to October 2022 were enrolled. Bedside ultrasound monitoring ONSD was performed within 24 hours of ICU admission. The consciousness status was assessed daily during ICU hospitalization. Coma was defined as Glasgow coma scale (GCS) score < 8 or Richmond agitation-sedation scale (RASS) score -4 or -5. Delirium was defined as responsiveness to verbal stimulation and with a positive confusion assessment method-intensive care unit (CAM-ICU). A positive result of CAM-ICU was defined as acute change or fluctuating course of mental status+inattention+altered level of consciousness or disorganized thinking. X-tile software analysis was used to visualize the best cut-off value for creating divisions in predicting 28-day coma or delirium and death, and then Kaplan-Meier curves were plotted. ONSD≥the optimal cut-off value from X-tile analysis was defined as ONSD broadening. ONSD broadening and related indicators were enrolled, and multivariate Cox regression analysis was used to analyze the risk factors of 28-day coma or delirium and 28-day death in etiologically diverse critically ill patients.</p><p><strong>Results: </strong>A total of 321 critically ill patients were enrolled. Of them, 49 had primary brain injury, 54 had hypoxic ischemic brain injury (HIBI) after cardiac arrest, 70 had acute heart failure, 73 had sepsis, and 75 had other causes. Coma affected 184 patients (57.3%), and delirium affected 173 patients (53.9%). At 28 days of follow-up, 100 patients died, 16 patients remained comatose and 20 patients remained delirious. In all patients, as the GCS score decreased upon admission to the ICU, there was a gradually increasing trend in ONSD [GCS score 15 group: 5.20 (4.93, 5.43) mm, GCS score 10-14 group: 5.30 (4.90, 5.65) mm, GCS score 6-9 group: 5.40 (5.10, 5.80) mm, GCS score < 6 group: 5.70 (5.20, 5.96) mm, P < 0.05]. X-tile software analysis showed that in all patients and five etiological subgroups, ONSD broadening was a predictor for 28-day coma or delirium, and the optimal cut-off value was obtained (5.60 mm for all patients, 4.90 mm for primary brain injury, 5.75 mm for HIBI after cardiac arrest, 5.40 mm for acute heart failure, 5.90 mm for sepsis, and 5.75 mm for other causes). The Kaplan-Meier curves were plotted according to the optimal cut-off values, and the results showed that the higher the ONSD, the higher the incidence and duration of coma or delirium within 28 days in above patient population. X-tile software analysis showed that in all patients, and HIBI after cardiac arrest, sepsis and other causes pa","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"36 10","pages":"1088-1094"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717162","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":"[Effects of neutrophilic granule protein on the expression of lipocalin 2 in inflammatory macrophages].","authors":"Jing Wang, Ji Cheng, Quanwei Bao, Junyu Zhu, Huaping Liang","doi":"10.3760/cma.j.cn121430-20240104-00015","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240104-00015","url":null,"abstract":"<p><strong>Objective: </strong>To explore the effects of neutrophilic granule protein (NGP) on the expression of lipocalin 2 (LCN2) in inflammatory macrophages and its mechanism.</p><p><strong>Methods: </strong>NGP-high-expressed RAW264.7 cells (NGP/RAW cells) and negative control RAW264.7 cells (NC/RAW cells) were cultured in vitro. Primary peritoneal macrophages of NGP-high-expressed mice and wild-type C57BL/6 mice were extracted, then cultured in vitro. The cell inflammatory model was established by stimulating with 10 mg/L lipopolysaccharide (LPS, LPS group), and the phosphate buffer solution (PBS) control group was set up. Enzyme-linked immunosorbent assay (ELISA) was used to detect the level of LCN2 in different types of cells. The protein expression of phosphorylated signal transduction and activator of transcription 1 (p-STAT1) was detected with Western blotting. Other NGP/RAW cells and NC/RAW cells were treated with 10 mg/L LPS, 5 mg/L STAT1 pathway inhibitor (fludarabine)+10 mg/L LPS, respectively. The PBS control group was set up. ELISA was used to detect the level of LCN2.</p><p><strong>Results: </strong>In different types of cells, the levels of LCN2 were increased significantly after LPS stimulation in the LPS group as compared with those in the PBS control group, and peaked at 24 hours (μmol/L: 25.61±1.02 vs. 0.46±0.02 in NC/RAW cells, 74.51±2.14 vs. 0.25±0.04 in NGP/RAW cells, 10.13±0.22 vs. 0.01±0.01 in primary macrophages of wild-type C57BL/6 mice, 28.35±0.61 vs. 0.08±0.01 in primary macrophages of NGP-high-expressed mice, all P < 0.05), indicating that the expression of LCN2 in macrophages altered during inflammation reaction. The level of LCN2 in NGP/RAW cells was found significantly increased at different time points after LPS stimulation comparing with that in NC/RAW cells (μmol/L: 8.32±0.22 vs. 3.12±0.11 at 6 hours, 23.12±0.86 vs. 8.12±0.32 at 12 hours, 74.51±2.14 vs. 25.61±1.02 at 24 hours, all P < 0.05), along with the expression of p-STAT1 was significantly up-regulated. The level of LCN2 in the primary macrophages of NGP-high-expressed mice was also significantly increased at 24 hours after LPS stimulation comparing with that in the primary macrophages of wild-type C57BL/6 mice (μmol/L: 28.35±0.61 vs. 10.13±0.22, P < 0.05). However, after pretreated with STAT1 pathway inhibitors, the production of LCN2 in NGP/RAW cells was decreased significantly comparing with that in the LPS group (μmol/L: 6.81±0.19 vs. 22.54±0.58, P < 0.05). But the inhibitors had no significant effect on LCN2 production in NC/RAW cells showing no significant difference as compared with LPS group (μmol/L: 8.04±0.20 vs. 7.86±0.15, P > 0.05), indicating that NGP could up-regulate the expression of LCN2 in macrophages stimulated by LPS by promoting STAT1 activation.</p><p><strong>Conclusions: </strong>NGP could positively regulate LCN2 expression in inflammatory macrophages by activating STAT1 pathway.</p>","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"36 10","pages":"1033-1037"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717208","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 application of physical restraint reduction scheme for adult patients after cardiac surgery based on eCASH concept].","authors":"Shanshan Lyu, Jing Zheng, Xianfeng Liu, Xuying Guo, Chuanni Wu, Huihui Wang","doi":"10.3760/cma.j.cn121430-20240508-00409","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240508-00409","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To construct a physical restraint reduction scheme based on eCASH concept (that is early Comfort using Analgesia, minimal Sedatives and maximal Human care for adult patients after cardiac surgery, and intervene, and to evaluate its effectiveness.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A non-synchronous case-control study was conducted. A total of 486 patients after cardiac surgery admitted to the cardiac surgery intensive care Unit (ICU) of Shandong Provincial Hospital Affiliated to Shandong First Medical University from July to October 2022 were enrolled as subjects. According to the implementation time node of the physical restraint reduction scheme, 250 patients admitted from July to August were served as the control group, and 236 patients admitted from September to October were served as the observation group. The control group adopted the routine physical restraint nursing process, including selecting the appropriate restraint device according to the patient's condition and consciousness and following the doctor's advice, and checking on time to prevent adverse reactions. The observation group implemented the physical restraint reduction scheme based on eCASH concept, including preoperative visit, postoperative assessment of whether patients needed physical restraint according to the restraint decision wheel and the physical restraint flow, and adopted personalized nursing programs. The restraint rate, restraint duration, incidence of restraint-related complication (edema of the limbs, redness and swelling of the skin in the restricted area, skin rupture, etc.), restraint device application standard rate, delirium rate and incidence of unplanned extubation event were compared between the two groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;There was no significant difference in age, gender, cardiopulmonary bypass, endotracheal catheter retention duration and operation type between the two groups with comparability. The restraint rate in the observation group was significantly lower than that in the control group [16.95% (40/236) vs. 84.40% (211/250), P &lt; 0.01], and the restraint duration was significantly shorter than that in the control group [hours: 0 (0, 1.0) vs. 7.0 (5.5, 10.0), P &lt; 0.01], the incidence of restraint-related complication and delirium were significantly lower than those in the control group [restraint-related complication: 0.85% (2/236) vs. 1.60% (4/250), delirium: 0% (0/236) vs. 2.80% (7/250), both P &lt; 0.05], and the restraint device application standard rate was significantly higher than that in the control group [100.00% (40/40) vs. 90.52% (191/211), P &lt; 0.05]. No unplanned extubation event occurred in both groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The physical restraint reduction scheme based on eCASH concept in adult patients after cardiac surgery can effectively reduce the restraint rate and the incidence of restraint-related complication, shorten the restraint duration, reduce the incidence of deli","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"36 10","pages":"1102-1107"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717201","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 timing and implementation of early rehabilitation for critically ill patient].","authors":"Yan Xu, Dechang Chen","doi":"10.3760/cma.j.cn121430-20240531-00480","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240531-00480","url":null,"abstract":"<p><p>Critical care rehabilitation is an essential component of treating critically ill patients. Implementing early rehabilitation is safe and feasible, with benefits and early rehabilitation is both safe and feasible, with benefits far outweighing potential risks. An individualized rehabilitation plan is necessary for initiating early rehabilitation treatment. This includes identifying the rehabilitation needs of critically ill patients, timely seizing opportunities for rehabilitation intervention, and implementing safe rehabilitation measures through position training, exercise training, respiratory training, and monitoring the rehabilitation process. There remains considerable heterogeneity in the clinical practice of early rehabilitation treatment for critically ill patients. This article provides an updated overview of evidence-based medicine for early rehabilitation treatment of critically ill patients, aiming to offer a reference for clinical medical staff in formulating critical care rehabilitation treatment strategies for these patients.</p>","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"36 9","pages":"992-996"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393868","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":"[Serum Claudin-5 levels facilitate the early prediction of severe acute pancreatitis: a prospective observational study].","authors":"Xinlei Chen, Huihui Wang, Ping Geng, Bingyu Ling, Aiwen Ma, Min Xu, Dingyu Tan","doi":"10.3760/cma.j.cn121430-20240318-00247","DOIUrl":"10.3760/cma.j.cn121430-20240318-00247","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate the value of early tight junction protein Claudin-5 levels in predicting the severity of acute pancreatitis (AP).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A prospective observational study was conducted, including patients diagnosed with AP and admitted to the Northern Jiangsu People's Hospital from December 1, 2021 to November 30, 2022. Eligible healthy volunteers were randomly selected to serve as healthy controls during the same period. Patients were classified into mild acute pancreatitis (MAP) group, moderate-severe acute pancreatitis (MSAP) group, and severe acute pancreatitis (SAP) group based on the 2012 Atlanta classification criteria. Patients with SAP were then divided into three subgroups of 1, 3, and 7 days based on the duration of hospitalization. Baseline data, such as gender, age, underlying disease, and probable etiology, was collected from all enrolled individuals. The enzyme-linked immunosorbent assay (ELISA) was employed to detect serum Claudin-5 levels in each cohort of enrollees. Data on additional serologic indicators, including hematocrit (HCT), albumin (Alb), serum Ca&lt;sup&gt;2+&lt;/sup&gt;, C-reactive protein (CRP), and procalcitonin (PCT) levels, were obtained via the in-hospital test query system in each group of patients with AP. The modified Marshall score (mMarshall), modified CT severity index (mCTSI) score, bedside severity index of severity in acute pancreatitis (BISAP) score, and acute physiology and chronic health evaluation II (APACHE II) were recorded for each group of patients with AP. Differences in the above indicators between groups were analyzed and compared. Spearman's correlation method was employed to examine the relationship between Claudin-5 levels and each influential factor. The receiver operator characteristic curve (ROC curve) was plotted to analyze the predictive value of each influencing factor on SAP. Ridge regression was used to screen for independent risk factors for SAP.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 109 patients with AP were enrolled, comprising 66 in the MAP group, 15 in the MSAP group, and 28 in the SAP group. Additionally, 27 healthy volunteers were enrolled as the healthy control group. No statistically significant differences were observed in gender and age among the enrolled groups, and no statistically significant differences were identified among the three groups of patients with AP in terms of underlying disease and etiologic composition. As the disease progressed, serum Claudin-5 levels exhibited a notable increase across all AP patient groups, and they were all significantly higher than those in the healthy control group [ng/L: 888.58 (574.52, 1 141.59), 3 749.02 (2 784.93, 5 789.92), 4 667.81 (3 935.21, 7 315.66) vs. 291.13 (250.19, 314.75), all P &lt; 0.05]. Subgroup analyses showed that as the disease duration prolonged, patients in the SAP group exhibited a notable decline in Claudin-5 levels at 3 days post-admission, compared with those","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"36 9","pages":"930-936"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393870","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 median nerve electrical stimulation for awakening comatose patients with brain injury].","authors":"Le An, Rui Shao, Xingsheng Wang, Ziren Tang","doi":"10.3760/cma.j.cn121430-20240617-00513","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240617-00513","url":null,"abstract":"<p><p>With the development of medicine, the survival rate of patients with traumatic brain injury has gradually increased, and more lives have been successfully saved. However, the number of comatose patients has also risen, leading to prolonged medical care that increases economic burdens on families and society. The awakening of comatose patients is of great significance. As a non-invasive brain stimulation technique, median nerve electrical stimulation (MNS) has been widely used in clinical awakening therapy, and multiple clinical studies have confirmed the effectiveness of this technology. This article summarizes the research progress of this technology from the aspects of coma mechanism, median nerve pathway, awakening mechanism of MNS, clinical application of MNS, parameter setting of electrical stimulation, and neurological function evaluation.</p>","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"36 9","pages":"997-1000"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393867","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":"[Establishment of a risk prediction model for cerebrogenic multiple organ dysfunction syndrome in patients with acute cerebral hemorrhage].","authors":"Huaibiao Wu, Hao Zhang, Chengjun Guo","doi":"10.3760/cma.j.cn121430-20240202-00109","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240202-00109","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To construct and validate a predictive model for the risk of cerebrogenic multiple organ dysfunction syndrome (CMODS) in patients with acute cerebral hemorrhage.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Clinical data of 93 patients with acute cerebral hemorrhage admitted to Wannan Rehabilitation Hospital from January 2019 to June 2023 were retrospectively analyzed. Data included baseline information, disease severity score, laboratory examination indicators, cerebral hemorrhage status, treatment status, etc. Patients were divided into CMODS group and non-CMODS group according to whether CMODS occurred during hospitalization. The clinical data of the two groups were compared. Multivariate Logistic regression was used to analyze the risk factors of CMODS in patients with acute cerebral hemorrhage. A nomogram model was constructed to predict the risk of CMODS in patients with acute cerebral hemorrhage, and the model was validated. Receiver operator characteristic curve (ROC curve) was used to evaluate the predictive efficiency of nomogram model for CMODS in patients with acute cerebral hemorrhage.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 93 patients with acute cerebral hemorrhage were enrolled, including 26 patients in CMODS group and 67 patients in non-CMODS group. Compared with the non-CMODS group, the ratio of diabetes, acute physiological and chronic health evaluation II (APACHE II)≥35 score, cerebral hemorrhage volume ≥30 mL, endotoxemia, and national institutes of health stroke scale (NIHSS) and intracranial pressure of patients in the CMODS group were significantly higher, while the Glasgow coma score (GCS) was significantly lower and the length of hospital stay was significantly longer, with statistically significant differences (all P &lt; 0.05). Multivariate Logistic regression analysis showed that diabetes mellitus [odds ratio (OR) = 3.615, 95% confidence interval (95%CI) was 1.487-8.785, P = 0.000], APACHE II score (OR = 4.697, 95%CI was 1.933-11.416, P = 0.000), endotoxemia (OR = 4.577, 95%CI was 1.883-11.123, P = 0.000), and cerebral hemorrhage volume (OR = 4.039, 95%CI was 1.662-9.816, P = 0.000) were the risk factors for CMODS in patients with acute cerebral hemorrhage. Taking the above risk factors as predictive variables, a nomogram prediction model was established. The verification results of the nomogram model showed that the C index was 0.804 (95%CI was 0.768-0.841), and the calibration curve was close to the ideal curve with good fit (P &gt; 0.05). ROC curve results showed that the sensitivity and specificity of the nomogram model in predicting CMODS in patients with acute cerebral hemorrhage were 76.92%, 86.57%, respectively, and the area under the ROC curve (AUC) was 0.855 (95%CI was 0.776-0.935).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Diabetes mellitus, APACHE II score, endotoxemia and intracerebral hemorrhage are risk factors for CMODS in patients with acute cerebral hemorrhage. The risk prediction model base","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"36 9","pages":"966-971"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393862","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":"[Annexin A1 activates the G protein-coupled formyl peptide receptor type 2-dependent endothelial nitric oxide synthase pathway to alleviate sepsis associated acute lung injury].","authors":"Yundi Chen, Yuanxiu He, Han Qin, Song Qin","doi":"10.3760/cma.j.cn121430-20240226-00160","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240226-00160","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate whether annexin A1 (ANXA1) improves sepsis-induced lung injury by activating G protein-coupled formyl peptide receptor type 2 (FPR2)-dependent endothelial nitric oxide synthase (eNOS) pathway.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Twenty-four male SD rats were randomly divided into normal group (Control group), lipopolysaccharide (LPS) induced lung injury model group (LPS group), LPS+ANXA1 mimetic peptide group (LPS+Ac2-26 group) and LPS+ANXA1 mimetic peptide+FPR2 inhibitor group (LPS+Ac2-26+WRW4 group), with 6 rats in each group. On the third day before modeling, rats of the LPS+Ac2-26 group were injected with 1 mg/kg Ac2-26 by the tail vein and rats of LPS+Ac2-26+WRW4 group were injected with 1 mg/kg Ac2-26 and 2.2 mg/kg WRW4 by the tail vein. The rats of control group and LPS group were injected same volume of physiological saline. After 48 hours of modeling, the rats were anesthetized and the carotid blood was taken to detect the oxygenation index (OI). Lung tissue was taken from the euthanized rats. The wet/dry (W/D) ratio was determined. The pathological changes of lung tissue were observed under light microscope and pathological score was performed. The levels of tumor necrosis factor-α (TNF-α), interleukins (IL-1β, IL-6, IL-10), malondialdehyde (MDA) and myeloperoxidase (MPO) were detected by enzyme-linked immunosorbent assay (ELISA). The protein expressions of eNOS, inducible nitric oxide synthase (iNOS) and nuclear factor-κB (NF-κB) were detected by Western blotting.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Under light microscope, compared with LPS group, the infiltration degree of inflammatory cells in the lung tissue of LPS+Ac2-26 group was reduced, and the thickness of the alveolar septum was improved. The degree of inflammatory cell infiltration in the lung tissue of LPS+Ac2-26+WRW4 group was more severe than that of LPS+Ac2-26 group, and the thickness of the alveolar septum increased. These findings suggested that ANXA1 significantly inhibited inflammatory cell infiltration and improved alveolar septal thickness, WRW4 reversed the lung improvement effects of ANXA1. Compared with control group, OI in LPS group was significantly decreased, and W/D ratio, pathological score and TNF-α, IL-1β, IL-6, MDA and MPO levels in lung tissue were significantly increased. Compared with LPS group, OI and IL-10 levels in lung tissue were significantly increased in LPS+Ac2-26 group, while W/D ratio, pathological score, TNF-α, IL-1β, IL-6, MDA and MPO levels in lung tissue were significantly decreased. These results indicated that ANXA1 can improve the oxygenation capacity, improve lung tissue leakage, reduce edema, and inhibit lung tissue inflammation in rats with lung injury. Compared with LPS+Ac2-26 group, the LPS+Ac2-26+WRW4 group showed significant decreases in OI and lung tissue IL-10 level [OI (mmHg, 1 mmHg ≈ 0.133 kPa): 132.16±24.00 vs. 248.67±18.70, IL-10 (ng/L): 27.30±3.04 vs. 36.10±3.92, both P &lt; 0.05], the l","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"36 9","pages":"924-929"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393842","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":"[Early diagnostic and prognosis prediction of circ_0054633 for acute lung injury/acute respiratory distress syndrome in children with severe pneumonia].","authors":"Shiyin Mu, Yingxue Zou, Yongsheng Guo, Mei Yu, Bing Huang, Weiwei Gao, Tian Zhang","doi":"10.3760/cma.j.cn121430-20240506-00403","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240506-00403","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To explore the value of circ_0054633 in early diagnosis and prognosis prediction of acute lung injury/acute respiratory distress syndrome (ALI/ARDS) in children with severe pneumonia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective case-control study was conducted on children with diagnosed severe pneumonia admitted to Tianjin Children's Hospital from July 1, 2022, to February 29, 2024. The clinical data was collected by electronic medical record system and clinical follow-up, including gender, age, lung injury prediction score (LIPS), pediatric critical illness score (PCIS), serum circ_0054633, interleukin-6 (IL-6), the indicators of the arterial blood-gas analysis, oxygenation index (PaO&lt;sub&gt;2&lt;/sub&gt;/FiO&lt;sub&gt;2&lt;/sub&gt;) within 24 hours of admission and the survival status of 28 days. According to whether ALI/ARDS occurred, they were divided into the ALI/ARDS group and the non-ALI/ARDS group. The differences of clinical data between the two groups were compared, and multivariate Logistic regression was used to analyze the risk factors for ALI/ARDS in children with severe pneumonia. The receiver operator characteristic curve (ROC curve) will be used to explore the early diagnostic value of ALI/ARDS in children with severe pneumonia. The patients of ALI/ARDS were divided into mild group, moderate group and severe group according to the level of PaO&lt;sub&gt;2&lt;/sub&gt;/FiO&lt;sub&gt;2&lt;/sub&gt;. The levels of serum circ_0054633 and IL-6 in various severity ALI/ARDS were compared. The differences of serum circ_0054633, IL-6 levels, PCIS score and LIPS score were compared between the two groups of ALI/ARDS patients according to different prognoses in 28 days, as well as the correlation between various risk factors and circ_0054633.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total 74 children with severe pneumonia were included, with 34 cases in the ALI/ARDS group and 40 cases in the non-ALI/ARDS group. In ALI/ARDS group, there were 9 cases in the mild group, 15 cases in the moderate group and 10 cases in the severe group; while 12 cases died and 22 cases survived after 28 days. The serum circ_0054633, IL-6 level and LIPS score were higher in the ALI/ARDS group than the non-ALI/ARDS group, while the PCIS score was lower, and the two groups had significant difference. Multivariate Logistic regression analysis showed that circ_0054633 was independent predictors of ALI/ARDS in children with severe pneumonia [odds ratio (OR) = 3.853, 95% confidence interval (95%CI) was 1.912-7.805, P = 0.017]. ROC curve analysis showed that the cut-off values for circ_0054633 in the diagnosis of ALI/ARDS were 3.955, sensitivity was 79.4%, specificity was 92.5%, area under the ROC curve (AUC) was 0.892. The serum circ_0054633 and IL-6 levels were higher in the children who died in 28 days than the children who were survived, while the PCIS score was lower, and the two groups had significant difference. Spearman correlation analysis showed that the level of circ_0054633 in ","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"36 9","pages":"957-961"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393846","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}