Zhonghua wei zhong bing ji jiu yi xue最新文献

{"title":"[Analysis of the effect and safety of autologous blood reinfusion during venous-arterial extracorporeal membrane oxygenation weaning under controlled rotational speed].","authors":"Zhijing Xu, Yu'an Geng, Congmei Wang, Lu Qi, Yangang Shi, Zishu Xu, Linkai Huang, Qian Xu, Ruifang Liu","doi":"10.3760/cma.j.cn121430-20250117-00066","DOIUrl":"10.3760/cma.j.cn121430-20250117-00066","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the efficacy and safety of autologous blood transfusion during weaning from venous-arterial extracorporeal membrane oxygenation (VA-ECMO) under controlled rotational speed.</p><p><strong>Methods: </strong>A retrospective study was conducted, selecting patients who underwent extracorporeal membrane oxygenation (ECMO) and successfully weaned at the emergency and critical care medicine center of Henan Provincial Third People's Hospital from January 2023 to May 2024. General data including gender, age, body mass index (BMI), European system for cardiac operative risk evaluation (EuroScore), and disease types were collected. Vital signs at weaning [heart rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), and peripheral oxygen saturation], parameters before and after weaning [B-type natriuretic peptide (BNP), hemoglobin (Hb), partial pressure of arterial oxygen (PaO₂), partial pressure of arterial carbon dioxide (PaCO₂), arterial lactate, central venous pressure (CVP), inferior vena cava collapsibility index, left ventricular ejection fraction (LVEF), and right heart load], post-weaning inflammatory markers at 1-day and 3-day [body temperature, white blood cell count (WBC), neutrophil percentage (NEU%), C-reactive protein (CRP), procalcitonin (PCT), interleukin-10 (IL-10)], as well as complications (infection, thrombosis, renal failure, gastrointestinal bleeding) and post-weaning blood return status were recorded. Patients were divided into an observation group (with post-weaning blood return) and a control group (without post-weaning blood return) based on the presence of blood return after weaning. The changes in the aforementioned parameters were compared between the two groups.</p><p><strong>Results: </strong>A total of 62 patients were included, with 31 cases in each group. No statistically significant differences were observed between the two groups in baseline characteristics including gender, age, BMI, and EuroScore. At weaning, the observation group exhibited relatively stable vital signs, with no significant differences in heart rate, SBP, DBP, or peripheral oxygen saturation compared to the control group. After weaning, the observation group showed significantly lower levels of BNP, PaCO₂, arterial lactate, CVP, and right heart load compared to pre-weaning values [BNP (ng/L): 2 325.96±78.51 vs. 4 878.48±185.47, PaCO₂ (mmHg, 1 mmHg≈0.133 kPa): 35.23±3.25 vs. 40.75±4.41, arterial lactate (mmol/L): 2.43±0.61 vs. 6.19±1.31, CVP (cmH₂O, 1 cmH₂O≈0.098 kPa): 8.32±0.97 vs. 15.34±1.74, right heart load: 13.24±0.97 vs. 15.69±1.31, all P < 0.05], while Hb, PaO₂, inferior vena cava collapsibility index, and LVEF were significantly higher than pre-weaning values [Hb (g/L): 104.42±9.78 vs. 96.74±6.39, PaO₂ (mmHg): 94.12±7.78 vs. 75.51±4.39, inferior vena cava collapsibility (%): 28±7 vs. 17±3, LVEF (%): 62","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"37 6","pages":"595-598"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875542","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":"[Interaction of α-amylase and inflammatory response in patients with ventilator-associated pneumonia and their prognostic value].","authors":"Yexing Liu, Yanzeng Peng, Yuding Hu, Chao Liu","doi":"10.3760/cma.j.cn121430-20240409-00321","DOIUrl":"10.3760/cma.j.cn121430-20240409-00321","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the interaction between α-amylase (α-AMS) and inflammatory response in patients with ventilator-associated pneumonia (VAP) and their predictive value for prognosis.</p><p><strong>Methods: </strong>A prospective cohort study was conducted. Patients with mechanical ventilation who were treated in the intensive care unit (ICU) of the Second Hospital of Hebei Medical University from June 2020 to June 2023 were enrolled, and the patients were divided into VAP group and non-VAP group according to whether VAP occurred. VAP patients were stratified into mild [acute physiology and chronic health evaluation II (APACHE II) < 10 scores], moderate (APACHE II were 10-20 scores), and severe (APACHE II > 20 scores) groups based on the APACHE II. All patients were followed up for 28 days. In addition, healthy subjects who underwent health examination in our hospital at the same time were selected as the healthy control group. Baseline data including gender, age, mechanical ventilation mode, mechanical ventilation time, underlying diseases, drug use, and laboratory test indicators were collected. The serum levels of α-AMS, interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), C-reactive protein (CRP) and other inflammatory factors were analyzed and compared. Pearson correlation analysis was performed to analyze the correlation between serum α-AMS and inflammatory factors. Logistic regression was used to analyze the influencing factors of poor prognosis in patients with VAP. The receiver operator characteristic curve (ROC curve) was plotted to evaluate the predictive value of α-AMS on the poor prognosis of patients with VAP.</p><p><strong>Results: </strong>A total of 100 mechanically ventilated patients were enrolled, including 60 cases in the VAP group and 40 cases in the non-VAP group. Among the patients with VAP, there were 24 cases in the mild group, 20 cases in the moderate group, and 16 cases in the severe group. A total of 44 patients survived at 28 days, while 16 died. Additionally, 100 healthy individuals were included as the healthy control group. Serum levels of α-AMS, IL-6, TNF-α and CRP in the VAP group were significantly higher than those in the non-VAP group and the healthy control group, while the levels of α-AMS, IL-6, TNF-α and CRP in the non-VAP group were significantly higher than those in the healthy control group. There were statistically significant differences in serum α-AMS, IL-6, TNF-α, CRP levels and APACHE II scores among VAP patients with different disease severities, and the levels of the above indicators in the severe group were significantly higher than those in the moderate group and mild group, and the levels of the above indicators in the moderate VAP group were significantly higher than those in the mild group. Pearson correlation analysis showed that serum α-AMS was positively correlated with IL-6, TNF-α, CRP, and APACHE II scores (r values were 0.404, 0.392 and 0.493, 0.493, all P ","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"37 6","pages":"535-541"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875547","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":"[Meta-analysis of hydrocortisone in the treatment of severe community-acquired pneumonia].","authors":"Xue Gu, Penglei Yang, Lina Yu, Jun Yuan, Zhou Yuan, Xiaoli Zhang, Lianxin Chen, Ying Zhang, Jikuan Hu, Yu Huang, Qihong Chen","doi":"10.3760/cma.j.cn121430-20230710-00500","DOIUrl":"10.3760/cma.j.cn121430-20230710-00500","url":null,"abstract":"<p><strong>Objective: </strong>To explore whether hydrocortisone can improve the prognosis of patients with severe community-acquired pneumonia (sCAP) by Meta-analysis.</p><p><strong>Methods: </strong>Randomized controlled trial (RCT) on hydrocortisone in the treatment of sCAP were extracted from the database including PubMed, Cochrane library, Web of Science, and Embase, and the search time was up to April 29, 2023. The patients in the standard treatment group received standard treatment such as antibiotics and supportive care, while those in the hydrocortisone group received hydrocortisone treatment on the basis of standard treatment. Meta-analysis was used to compare the mortality, duration of mechanical ventilation, mechanical ventilation rate and incidence of adverse reactions (hyperglycemia, gastrointestinal bleeding, secondary infection) between the two groups. The risk of literature bias was assessed. The studies that might have publication bias were corrected by the subtraction and complementation method. At the same time, trial sequential analysis (TSA) was conducted.</p><p><strong>Results: </strong>A total of 5 RCTs involving 1 031 patients were finally enrolled, including 494 patients in the standard treatment group and 537 patients in the hydrocortisone group. Among the 5 studies, the research site of 2 studies was in the mixed ward. Considering the inclusion characteristics of the study population, there was doubt whether its research object was sCAP patients, which might have a certain impact on the results and introduce potential bias. Meta-analysis showed that the mortality in the hydrocortisone group was significantly lower than that in the standard treatment group [6.0% vs. 14.0%; odds ratio (OR) = 0.38, 95% confidence interval (95%CI) was 0.25-0.59, P < 0.01; I² = 9%]. The studies that were asymmetric were corrected by the reduction and supplementation method. Even after filling the missing studies, hydrocortisone could still reduce the death risk of the patient (OR = 0.49, 95%CI was 0.32-0.73, P < 0.01; I² = 31%). TSA showed that the average mortality of the standard treatment group was about 14.0%, and that of the hydrocortisone group was about 6.0%, with a relative risk reduction (RRR) = 57%. The calculated sample size was 699 cases, and the actual sample size was 1 031 cases. The actual sample size exceeded the required sample size, and the Z-curve crossed the O'Brien-Fleming boundary and the curve corresponding to P = 0.05, it meant that hydrocortisone could effectively reduce the mortality of sCAP. Compared with the standard treatment group, no statistical difference in the duration of mechanical ventilation was found in the hydrocortisone group [mean difference (MD) = -3.26, 95%CI was -6.72-0.21, P = 0.07; I² = 0%], but the 8-day mechanical ventilation rate was significantly lowered (19.5% vs. 55.4%; OR = 0.24, 95%CI was 0.12-0.45, P < 0.01; I² = 0%), and also no significantly","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"37 6","pages":"542-548"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875550","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":"[LncRNA-UCA1-microRNA-143-Notch1 regulates autophagy in myocardial ischemia reperfusion injury induced by cardiopulmonary bypass].","authors":"Lingzhi Jiang, Mingshan Wang, Ye Shen","doi":"10.3760/cma.j.cn121430-20240329-00298","DOIUrl":"10.3760/cma.j.cn121430-20240329-00298","url":null,"abstract":"<p><strong>Objective: </strong>To observe the degree of myocardial cell injury and the changes in autophagy level in rats with myocardial ischemia/reperfusion (I/R) injury induced by cardiopulmonary bypass (CPB), and to explore the regulatory role of the long non-coding RNA-urothelial carcinoma antigen 1-microRNA-143-Notch1 axis (lncRNA-UCA1-miR-143-Notch1 axis) in myocardial I/R injury induced by CPB.</p><p><strong>Methods: </strong>Healthy male Sprague-Dawley (SD) rats were randomly divided into the following groups using the random number method: Sham operation (Sham) group, myocardial I/R injury model group (model group), empty lentivirus group, lncRNA-UCA1 upregulation group, miR-143 downregulation group, and lncRNA-UCA1 upregulation+miR-143 upregulation group, with 9 rats in each group. The rat model of myocardial I/R injury induced by CPB was established by thoracotomy aortic ligation under cardiopulmonary bypass support; in the Sham group, only threading was performed without ligation, and other procedures were the same. Seventy-two hours before modeling, the lncRNA-UCA1 upregulated group was injected with 100 μL of myocardial tissue-specific adeno-associated virus (AAV) overexpression vector of lncRNA-UCA1 via tail vein, the miR-143 downregulated group was injected with 100 μL of AAV short hairpin RNA (shRNA) vector of miR-143 via tail vein, the lncRNA-UCA1 upregulation+miR-143 upregulation group was injected with 100 μL of myocardial tissue-AAV overexpression vector of lncRNA-UCA1 and 100 μL of AAV overexpression vector of miR-143 via tail vein, and the empty vector lentivirus group was injected with 100 μL of AAV empty vector (virus titers were 1×10⁹ TU/mL); the Sham group and the model group were injected with equal amounts of normal saline. The animals were euthanized 24 hours after intervention and cardiac tissue specimens were collected. After hematoxylin eosin (HE) staining, the damage of myocardial cells and the changes of muscle fiber tissue were observed under a light microscope; after dual staining with uranyl acetate and lead citrate, the ultrastructural damage of heart tissue was observed under a transmission electron microscopy; the expression of lncRNA-UCA1, miR-143, and Notch1 mRNA in myocardial tissue was detected by real-time fluorescence quantitative reverse transcription-polymerase chain reaction (RT-PCR); the expression of microtubule 1 light chain 3-II/I (LC3-II/I) and Notch1 protein in myocardial tissue was detected by Western blotting.</p><p><strong>Results: </strong>Compared with the Sham group, the myocardial cells of rats in the model group were enlarged, the intercellular space increased, autophagosomes increased, the arrangement of myocardial fibers was disordered, mitochondrial proliferated and deformed. The expression levels of lncRNA-UCA1 and Notch1 mRNA, as well as the protein expression levels of LC3-II/I and Notch1 were significantly increased, while the expression level of miR-143 was signif","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"37 6","pages":"576-582"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875548","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 consensus on diagnosis and treatment of intra-abdominal candidiasis in critically ill patients (2025 edition)].","authors":"Support Peking University Critical Care Medicine Committee Of Critical Care Medicine And Organ, Technology China Association For Promotion Of Health Science And","doi":"10.3760/cma.j.cn121430-20250301-00197","DOIUrl":"10.3760/cma.j.cn121430-20250301-00197","url":null,"abstract":"<p><p>Intra-abdominal candidiasis (IAC) is the most common invasive candidiasis, with a high incidence among critically ill patients, which can significantly increase medical costs and affect prognosis. In order to standardize the diagnosis and treatment of IAC in critically ill patients, experts in related fields were organized by the Peking University Critical Care Medicine (PKUCCM), Committee of Critical Care Medicine and Organ Support, China Association for Promotion of Health Science and Technology organized experts in related fields to initiate and form a working group. Expert writers drafted the consensus based on evidence-based medical evidence. A committee composed of critical care physicians, infectious disease physicians, surgeons, dermatologists specializing in antifungal fields, and clinical pharmacists discussed and revised the consensus draft through a standardized process, and finally formulated this consensus. This consensus contains a total of 20 core recommendations, mainly focusing on the epidemiology, high-risk factors, diagnostic techniques and methods (including traditional microbiological culture techniques, clinical risk prediction tools, serological tests, molecular biological tests, and histopathological examinations) of IAC, diagnostic criteria, stratified treatment strategies, antifungal drug selection, control the sources of infection, combined treatment, de-escalation strategies, drug treatment courses, prognosis, and special types of IAC. The aim is to provide expert guidance for the standardized clinical diagnosis and treatment of IAC in critically ill patients, with a view to improving prognosis of patients.</p>","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"37 6","pages":"509-526"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875545","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 biomarkers of sepsis-induced cardiomyopathy].","authors":"Hongbin Li, Bei Hu","doi":"10.3760/cma.j.cn121430-20241112-00924","DOIUrl":"10.3760/cma.j.cn121430-20241112-00924","url":null,"abstract":"<p><p>Sepsis constitutes one of the principal causes of death globally, and the mortality rate of patients complicated with sepsis-induced cardiomyopathy (SIC) surges by over 50%. Early identification of patients with sepsis, particularly SIC, and implementing clinical intervention are vital measures to reduce the mortality. In recent years, biomarkers for the diagnosis and prognosis of SIC have emerged rapidly. Among classical myocardial injury biomarkers, cardiac troponin (cTn), brain natriuretic peptide (BNP), and soluble growth stimulation gene 2 protein (sST2) have predictive value for the prognosis of SIC. Meanwhile, heart-type fatty acid-binding protein (h-FABP) possess relatively high value in diagnosis. Moreover, plasma metabolites, microRNA (miRNA), as well as recently identified markers related to sepsis or cardiovascular diseases also demonstrate outstanding predictive value in both the diagnosis and prognosis of SIC. For instance, exosomal miR-150-5p, blood miR-155, blood miR-378a-3p, blood miR-21-3p, blood miR-233, blood miR-23b, blood miR-135, lipocalin (LCN), heme oxygenase-1 (HO-1), fibroblast growth factor-21 (FGF-21), and growth differentiation factor-15 (GDF-15) show varying degrees of predictive value when it comes to diagnosing SIC. S100A8/A9 protein, triglyceride-glucose (TyG) index, angiotensinogen II (Ang II) and lactoferrin are correlated with the prognosis of SIC. Meanwhile, it has been discovered that the combination of multiple biomarkers outperforms a single biomarker, and certain combinations exhibit superior diagnostic performance. However, most of these studies use single-center clinical data, which has certain limitations and still calls for more high-quality evidence support. Therefore, identifying biomarker combinations that are supported by high-quality evidence, have bedside application potential, and possess high sensitivity and specificity is of crucial importance for the prevention, diagnosis, and treatment of SIC. This review is carried out on the current articles that report biomarkers with predictive value and the diagnosis and prediction of multiple biomarkers in combination, in the hope of continuously optimizing the diagnostic strategy for the specific identification of early SIC.</p>","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"37 6","pages":"599-604"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875551","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":"[6-Shogaol alleviates cerebral injury after cardiac arrest-cardiopulmonary resuscitation in rats by inhibiting death-associated protein kinase 1-mediated autophagy].","authors":"Ouyang Rao, Shixin Li, Ning Zhu, Hangxiang Zhou, Jie Hu, Yun Li, Junling Tao, Yehong Li, Ying Liu","doi":"10.3760/cma.j.cn121430-20240724-00627","DOIUrl":"10.3760/cma.j.cn121430-20240724-00627","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To observe the neuroprotective effect of 6-shogaol (6-SH) in global cerebral ischemia/reperfusion injury (CIRI) following cardiac arrest (CA) and cardiopulmonary resuscitation (CPR) in rats.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Computer-aided molecular docking was used to determine whether 6-SH could spontaneously bind to death-associated protein kinase 1 (DAPK1). SPF-grade male SD rats were randomly divided into a sham group (n = 5), a CPR group (n = 7), and a CPR+6-SH group (n = 7). The CPR group and CPR+6-SH group were further divided into 12-, 24-, and 48-hour subgroups based on observation time points. A rat model of global CIRI after CA-CPR was established by asphyxiation. In the sham group, only tracheal and vascular intubation was performed without asphyxia and CPR induction. The CPR group was intraperitoneally injected with 1 mL of normal saline immediately after successful modeling. The CPR+6-SH group received an intraperitoneal injection of 20 mg/kg 6-SH (1 mL) immediately after successful modeling, followed by administration every 12 hours until the endpoint. Neurological Deficit Score (NDS) was recorded at each time point after modeling. After completion of observation at each time point, rats were anesthetized and sacrificed, and brain tissue specimens were collected. Histopathological changes of neurons were observed under light microscopy after hematoxylin-eosin (HE) staining. Ultrastructural changes of hippocampal neurons and autophagy were observed by transmission electron microscopy (TEM). Real-time quantitative polymerase chain reaction (RT-qPCR) was used to detect mRNA expression levels of DAPK1, vacuolar protein sorting 34 (VPS34), Beclin1, and microtubule-associated protein 1 light chain 3 (LC3) in brain tissues. Western blotting was used to detect protein expression levels of DAPK1, phosphorylated DAPK1 at serine 308 (p-DAPK1 ser308), VPS34, Beclin1, and LC3. Immunofluorescence was used to observe Beclin1 and LC3 expression in brain tissues under a fluorescence microscope.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Molecular docking results indicated that 6-SH could spontaneously bind to DAPK1. Compared with the sham group, the NDS scores of the CPR group rats were significantly increased at all modeling time points; under light microscopy, disordered cell arrangement, widened intercellular spaces, and edema were observed in brain tissues, with pyknotic and necrotic nuclei in some areas; under TEM, mitochondria were markedly swollen with intact membranes, dissolved matrix, reduced or disappeared cristae, vacuolization, and increased autophagosomes. Compared with the CPR group, the NDS scores of the CPR+6-SH group rats were significantly decreased at all modeling time points; under light microscopy, local neuronal edema and widened perinuclear space were observed; under TEM, mitochondria were mostly mildly swollen with intact membranes, fewer autophagosomes, and alleviated injury. RT-qPCR results showed that ","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"37 6","pages":"568-575"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875540","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":"[Clinical study on the effect of glycosaminoglycans on vascular endothelial glycocalyx in sepsis].","authors":"Zewen Tang, Liang Guo, Zhuxian Zhang, Lei Wang, Ju Lin, Dongcheng Liang, Wei Cao, Leqing Lin","doi":"10.3760/cma.j.cn121430-20240725-00634","DOIUrl":"10.3760/cma.j.cn121430-20240725-00634","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To explore the protective effect of glycosaminoglycans (GAG) on vascular endothelium in patients with sepsis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A prospective study was conducted on adult patients with sepsis admitted to the intensive care unit (ICU) of Hangzhou Normal University Affiliated Hospital from December 2022 to December 2023. Patients were randomly divided into conventional treatment group and GAG intervention group. Both groups were treated according to the 2021 Surviving Sepsis Campaign Guidelines. The GAG intervention group was additionally treated with GAG (2 mL of sulodexide intramuscular injection once daily for 7 days) on the basis of conventional treatment. Venous blood was collected from patients at 0, 6, 24, 48, 72 hours and 7 days after enrollment to detect serum vascular endothelial glycocalyx [heparan sulfate (HS) and syndecan-1 (SDC-1)], inflammatory markers [C-reactive protein (CRP), procalcitonin (PCT), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6)], and coagulation markers [prothrombin time (PT), activated partial thromboplastin time (APTT), antithrombin-III (AT-III), fibrinogen (Fib), D-Dimer], and to perform acute physiology and chronic health evaluation II (APACHE II), sequential organ failure assessment (SOFA), and International Society on Thrombosis and Haemostasis (ISTH) scores. The prognosis of patients (length of hospital stay, ICU and 28-day mortality) was observed. The receiver operator characteristic curve (ROC curve) was drawn to evaluate the value of HS in predicting the prognosis of sepsis patients, and the correlation between endothelial glycocalyx degradation products and various clinical indicators was analyzed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 50 adult patients with sepsis meeting the inclusion criteria were enrolled, with 25 in the conventional treatment group and 25 in the GAG intervention group. In terms of degradation products of endothelial glycocalyx, compared to baseline, both groups showed an increasing trend in HS and SDC-1 levels post-treatment. However, the GAG intervention group exhibited significantly lower HS levels at 72 hours and 7 days, as well as lower SDC-1 levels at 6, 24, 48, 72 hours and 7 days compared to the conventional group. Among the surviving patients, the HS levels at 72 hours and SDC-1 levels at 6 hours of treatment in the GAG intervention group were significantly reduced compared to the conventional treatment group. In terms of severity score, compared with before treatment, the GAG intervention group showed a significant decrease in APACHE II, SOFA, and ISTH scores after 7 days of treatment. The SOFA scores of the GAG intervention group after 48 hours and 7 days of treatment were significantly lower than those of the conventional treatment group. In terms of inflammatory indicators, compared with before treatment, the GAG intervention group showed a significant decrease in IL-6 levels after 48 hours of treatment. With the pr","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"37 6","pages":"527-534"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875543","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":"[Fexolone inhibits neuronal ferroptosis through the Nrf2/HO-1/GPX4 pathway to alleviates sepsis-associated brain injury].","authors":"Rao Sun, Jinyao Zhou, Yang Jiao, Kaixuan Niu, Cheng Yuan, Ximing Deng","doi":"10.3760/cma.j.cn121430-20241231-01080","DOIUrl":"10.3760/cma.j.cn121430-20241231-01080","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To observe the protective effect of Fisetin on sepsis-associated brain injury and explore its possible mechanism from the perspective of ferroptosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Sprague-Dawley (SD) rats (6-8-week-old male) were randomly divided into three groups: sham operation group (Sham group), colonic ligation and puncture (CLP) induced sepsis model group (CLP group) and Fisetin preprocessing group (CLP+Fisetin group), with 18 rats in each group (12 for observing survival rate and 6 for indicator testing). The CLP+Fisetin group was given Fisetin solution 50 mg×kg&lt;sup&gt;-1&lt;/sup&gt;×d&lt;sup&gt;-1&lt;/sup&gt; by gavage continuously for 5 days before CLP, with dimethyl sulfoxide (DMSO) as the solute, while Sham group and CLP group were given the same dose of DMSO. The model was established at 2 hours after the last gavage. The general condition of each group of rats were observed, and the 10-day mortality were record. The behavioral testing (new object recognition experiment, elevated cross maze experiment) were performed after 7 days of modeling. After 24 hours of modeling, nerve reflex scoring was performed, and then the rats were euthanized and brain tissue was collected. The pathological changes of brain tissue were observed under a microscope by hematoxylin-eosin (HE) staining, the deposition of iron ion in brain tissue was observed by Prussian blue staining. The content of iron in brain tissue was determined by tissue iron kit, and the content of malondialdehyde (MDA) in brain tissue was determined by colorimetry. The expressions of tumor necrosis factor-α (TNF-α), neuron damage marker S100β, nuclear factor E2-related factor 2 (Nrf2), heme oxygenases-1 (HO-1) and glutathione peroxidase 4 (GPX4) were detected by Western blotting.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;On day 10 post-operation, 12, 3, and 7 animals survived in the Sham group, CLP group, and CLP+Fisetin group, respectively. Compared with the Sham group, rats in the CLP group showed significantly decreased nerve reflex score, new object discrimination index and open arm dwell time. HE staining showed arranged disorderly of neuronal cells, cytoplasm deep staining, nuclear condensation, unclear structures, neuron loss, and significant inflammation in the hippocampus in the hippocampus. Prussian blue staining showed iron ion deposition in the brain tissue. The contents of iron and MDA in brain tissue were elevated, and the expressions of TNF-α and S100β were up-regulated, while the expressions of Nrf2, HO-1, and GPX4 were down-regulated. Compared with the CLP group, the CLP+Fisetin group showed significantly increased neurological reflex score (7.33±1.15 vs. 4.67±1.53), improved new object discrimination index (0.44±0.02 vs. 0.32±0.04), and longer open arm dwell time (minutes: 78.33±9.29 vs. 41.15±9.64). Neuronal cells in the hippocampus were more organized, with less cytoplasmic staining, nuclear condensation, reduced neuronal loss, and fewer inflammatory cells. Iron ","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"37 5","pages":"452-457"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875524","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":"[Current status of pre-hospital and in-hospital emergency medical information connectivity of 13 provincial-level administrative regions in China: a multi-center cross-sectional survey].","authors":"Junhong Wang, Yinzi Jin, Yi Bai, Nijiati Muyesai, Kang Zheng, Qingbian Ma","doi":"10.3760/cma.j.cn121430-20241210-01012","DOIUrl":"10.3760/cma.j.cn121430-20241210-01012","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate the current status of pre-hospital and in-hospital emergency medical information connectivity in China and provide evidence for optimizing the emergency medical system.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A multi-center cross-sectional study was conducted using a multi-level convenience sampling method to select provincial-level administrative regions and their corresponding capital cities, prefectural cities, and county-level emergency medical institutions. The questionnaire included basic information about respondents, the institutions, the current status of pre-hospital and in-hospital emergency information connectivity, and the satisfaction with the connectivity. The questionnaire has undergone reliability testing and split-half reliability testing, supplemented by semi-structured interviews. Data collection was carried out from January to May 2024, with one responsible person from each institution completing the questionnaire. Multiple Logistic regression analysis to investigated the relevant factors of pre-hospital and in-hospital information connectivity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 225 questionnaires were distributed, and 199 valid responses were collected, with a response rate of 88.4%. Participants were from 199 emergency medical institutions across 13 provincial-level administrative regions. Of the institutions, 112 (56.3%) could achieve pre-hospital and in-hospital information connectivity. The proportion of pre-hospital to in-hospital information connection between emergency institutions in different provinces varies (χ&lt;sup&gt;2&lt;/sup&gt; = 39.398, P &lt; 0.001), with Beijing and Zhejiang having the highest proportion of information connection (both at 100%), and Hainan having the lowest (11.8%). The proportion of information integration in county-level emergency institution was lower than that of provincial and municipal level emergency institutions [40.4% (19/47) vs. 61.7% (29/47), 61.0% (64/105), χ&lt;sup&gt;2&lt;/sup&gt; = 6.304, P = 0.043]. Provinces with high per capita disposable income have a higher proportion of information connectivity than provinces with low per capita disposable income [77.3% (34/44) vs. 50.3% (78/155), χ&lt;sup&gt;2&lt;/sup&gt; = 10.122, P = 0.001]. The information connection ratio of independent pre-hospital emergency centers was higher than that of hospital emergency departments/hospital records [74.6% (47/63) vs. 47.8% (65/136), χ&lt;sup&gt;2&lt;/sup&gt; = 12.581, P &lt; 0.001]. The proportion of information integration in advanced provinces with digital development was higher than that in other provinces [77.6% (38/49) vs. 49.3% (74/150), χ&lt;sup&gt;2&lt;/sup&gt; = 11.849, P = 0.001]. Logistic regression analysis showed that the per capita disposable income of residents in the province was an independent risk factor for the information connection between pre-hospital and in-hospital emergency institutions [odds ratio (OR) = 3.21, 95% confidence interval was 1.56-6.62, P &lt; 0.01]. 72.3% institutions used ","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"37 5","pages":"484-489"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875518","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}