Zhonghua wei zhong bing ji jiu yi xue最新文献

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[Effect of neurofeedback training on relative α variant score monitored by bedside continuous electroencephalography and optic nerve sheath diameter evaluated by ultrasound in patients with ischemic hypoxic encephalopathy].
Zhonghua wei zhong bing ji jiu yi xue Pub Date : 2025-01-01 DOI: 10.3760/cma.j.cn121430-20240509-00421
Jie Sun, Jian Wan
{"title":"[Effect of neurofeedback training on relative α variant score monitored by bedside continuous electroencephalography and optic nerve sheath diameter evaluated by ultrasound in patients with ischemic hypoxic encephalopathy].","authors":"Jie Sun, Jian Wan","doi":"10.3760/cma.j.cn121430-20240509-00421","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240509-00421","url":null,"abstract":"<p><strong>Objective: </strong>To approach the evaluation of relative α variant score monitored by bedside continuous electroencephalography and optic nerve sheath diameter (ONSD) evaluated by ultrasound in patients with ischemic hypoxic encephalopathy, and to observe the effect of neurofeedback training on brain function.</p><p><strong>Methods: </strong>A prospective observational study was conducted. The patients admitted to the emergency and intensive care department of Shanghai Pudong New Area People's Hospital from January 2021 to December 2023, who meet the diagnostic criteria of ischemic hypoxic encephalopathy with the Glasgow coma score (GCS) ≤ 8 at admission receiving neurofeedback training were enrolled as the study object (observation group), and the patients without neurofeedback training and GCS score ≤ 8 at admission were enrolled as the controls (control group). Both groups received intravenous neurotrophic therapy combining ganglioside and cerebrolysin for 10 days as one course of treatment. On this basis, the observation group additionally received continuous neurofeedback training including visual feedback, auditory feedback, meditation and relaxation for 14 days. Bedside continuous electroencephalography was used for monitoring relative α variation score, and ultrasound was used to determine ONSD. The average power and slow wave power [expressed as delta-theta ratio (DTR)] of five channels in electroencephalography before and 14 days after neurofeedback training were examined. The differences in peripheral blood neutrophil/lymphocyte ratio (NLR), Hamilton depression scale (HAMD) score, National Institutes of Health stroke scale (NIHSS) score, plasma levels of 5-hydroxytryptamine (5-HT) and brain-derived neurotrophic factor (BDNF).</p><p><strong>Results: </strong>A total of 60 patients were enrolled in the observation group and 50 patients in the control group finally. There was no significant difference in gender, age or course of disease between the two groups. The ONSD and relative α variant score in the observation group were significantly higher than those in the control group [ONDS (mm): 5.59±0.42 vs. 3.23±0.34, relative α variant score: 2.28±0.39 vs. 0.83±0.28, both P < 0.01]. After neurofeedback training for 14 days, the mean power and DTR in five channels of electroencephalography in the observation group were significantly lower than those before treatment [mean power (μV<sup>2</sup>/Hz): 95.35±3.61 vs. 102.58±4.23 in frontal pole 1 (Fp1), 38.56±4.73 vs. 46.13±2.36 in frontal 3 (F3), 34.33±5.87 vs. 51.71±4.65 in central 3 (C3), 58.37±4.45 vs. 62.95±3.22 in F7, 45.23±2.41 vs. 54.14±2.45 in temporal 3 (T3); DTR (μV<sup>2</sup>/Hz): 75.21±11.34 vs. 84.12±11.35 in ground electrode (GND), 72.31±21.67 vs. 88.23±10.25 in reference electrode (REF), 81.34±8.57 vs. 92.41±8.56 in F4, 71.25±5.42 vs. 87.23±5.64 in parietal 3 (P3), 70.12±5.88 vs. 85.67±6.12 in P4; all P < 0.05]. However, there was no significant difference in the me","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"37 1","pages":"65-69"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450042","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}
引用次数: 0
[Effective implementation of hour-1 bundle for sepsis patients in emergency department based on crisis resource management].
Zhonghua wei zhong bing ji jiu yi xue Pub Date : 2025-01-01 DOI: 10.3760/cma.j.cn121430-20240329-00298
Chengli Wu, Jiaqiong Su, Libo Zhao, Qin Xia, Lan Xia, Wanyu Ma, Ruixia Wang
{"title":"[Effective implementation of hour-1 bundle for sepsis patients in emergency department based on crisis resource management].","authors":"Chengli Wu, Jiaqiong Su, Libo Zhao, Qin Xia, Lan Xia, Wanyu Ma, Ruixia Wang","doi":"10.3760/cma.j.cn121430-20240329-00298","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240329-00298","url":null,"abstract":"<p><strong>Objective: </strong>To explore the implementation effect of hour-1 bundle for sepsis patients based on crisis resource management (CRM) system.</p><p><strong>Methods: </strong>A historical control study was conducted. The hour-1 bundle for sepsis based on CRM was used to train 24 nurses in the emergency department from October 2022 to March 2023. Clinical data of sepsis patients admitted to the emergency department of the First People's Hospital of Zunyi from April 2022 to September 2023 were collected. The patients were divided into three groups based on different stages of CRM system construction: control group (before construction, from April to September in 2022), improvement group (during construction, from October 2022 to March 2023) and observation group (after construction, from April to September in 2023). The baseline data, implementation rate of hour-1 bundle [including blood culture, antibiotic usage, blood lactic acid (Lac) detection, fluid resuscitation, hypertensors usage], identification and diagnosis time, and prognosis parameters [including correction rate of hypoxemia, intensive care unit (ICU) occupancy rate, and 28-day survival rate]. Sepsis cognition survey and non-technical skill (NTS) evaluation of nurses in emergency department were conducted before and after training.</p><p><strong>Results: </strong>Finally 43 cases were enrolled in the control group, improvement group and observation group, respectively. There was no statistically significant difference in baseline data including the gender, age, primary site, heart rate, systolic blood pressure, acute physiology and chronic health evaluation II (APACHE II) score, sequential organ failure assessment (SOFA) score, mechanical ventilation ratio among the three groups with comparability. With the gradual improvement of the CRM system, the implementation rate of 1-hour bundle was gradually increased, and the implementation rate in the control group, improvement group and observation group were 65.12% (28/43), 74.42% (32/43) and 88.37% (38/43), respectively, with statistically significant difference (P < 0.05). It was mainly reflected in the completion rate of blood culture, antibiotic usage rate, Lac detection rate and hypertensors usage rate within 1 hour, which were significantly higher in the observation group than those in the control group [completion rate of blood culture: 90.70% (39/43) vs. 62.79% (27/43), antibiotic usage rate: 88.37% (38/43) vs. 60.47% (26/43), Lac detection rate: 93.02% (40/43) vs. 72.09% (31/43), hypertensors usage rate: 88.37% (38/43) vs. 60.47% (26/43), all P < 0.05]. The fluid resuscitation rates within 1 hour in the three groups were all over 90%, with no statistically significant difference among the three groups. The recognition and diagnosis time in the observation group was significantly shorter than that in the control group and the improvement group (hours: 0.41±0.15 vs. 0.61±0.21, 0.51±0.18, both P < 0.05), the correction rat","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"37 1","pages":"23-28"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450055","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}
引用次数: 0
[Current status of multi-omics research on acute respiratory distress syndrome].
Zhonghua wei zhong bing ji jiu yi xue Pub Date : 2025-01-01 DOI: 10.3760/cma.j.cn121430-20240927-00809
Ying Yang, Na Zang, Enmei Liu
{"title":"[Current status of multi-omics research on acute respiratory distress syndrome].","authors":"Ying Yang, Na Zang, Enmei Liu","doi":"10.3760/cma.j.cn121430-20240927-00809","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240927-00809","url":null,"abstract":"<p><p>Acute respiratory distress syndrome (ARDS) is a clinical syndrome characterized by diffuse alveolar and interstitial edema caused by damage to alveolar-capillary and epithelial cells, often induced by infection, sepsis, trauma, and other factors. It is marked by progressive hypoxemia and respiratory distress. Due to the diverse causes of ARDS, the unclear pathogenesis, and the absence of effective predictive markers or biomarkers, there are no effective treatment measures available, resulting in a high mortality rate. ARDS is increasingly recognized for its heterogeneity, biomarkers, and the emergence of new opportunities for the development of diagnostic tools and personalized treatment strategies provided by omics technologies. A single omics analysis cannot fully reveal the heterogeneity and complexity of ARDS, while multi-omics analysis can provide a more systematic and comprehensive understanding of ARDS. Using clinical samples is closer to the actual disease situation compared to animal models. Multi-omics studies based on clinical samples have achieved significant progress in elucidating the pathophysiology of ARDS, identifying ARDS subtypes, and identifying biomarkers related to ARDS. This review focuses on the current applications of genomics, transcriptomics, metabolomics, and proteomics analyses based on clinical samples in the ARDS field, with a focus on the application of these omics methods in ARDS heterogeneity, potential biomarkers, and pathogenesis. It also introduces the differences in the application of different clinical samples in ARDS omics research, in order to gain a deeper and more comprehensive understanding of the pathogenesis of ARDS and explore new strategies for its prevention and treatment.</p>","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"37 1","pages":"81-86"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449813","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}
引用次数: 0
[Characteristics of changes in non-invasive hemodynamic parameters in neonates with septic shock].
Zhonghua wei zhong bing ji jiu yi xue Pub Date : 2025-01-01 DOI: 10.3760/cma.j.cn121430-20240312-00213
Xiaoyi Fang, Jinzhi Xie, Airun Zhang, Guanming Li, Silan Yang, Xiaoling Huang, Jizhong Guo, Niyang Lin
{"title":"[Characteristics of changes in non-invasive hemodynamic parameters in neonates with septic shock].","authors":"Xiaoyi Fang, Jinzhi Xie, Airun Zhang, Guanming Li, Silan Yang, Xiaoling Huang, Jizhong Guo, Niyang Lin","doi":"10.3760/cma.j.cn121430-20240312-00213","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240312-00213","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To observe the characteristics of changes in non-invasive hemodynamic parameters in neonates with septic shock so as to provide clinical reference for diagnosis and treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A observational study was conducted. The neonates with sepsis complicated with septic shock or not admitted to neonatal intensive care unit (NICU) of the First Affiliated Hospital of Shantou University Medical College were enrolled as the study subjects, who were divided into preterm infant (&lt; 37 weeks) and full-term infant (≥ 37 weeks) according to the gestational age. Healthy full-term infants and hemodynamically stable preterm infants transferring to NICU after birth were enrolled as controls. Electronic cardiometry (EC) was used to measure hemodynamic parameters, including heart rate (HR), mean arterial pressure (MAP), stroke volume (SV), stroke volume index (SVI), cardiac output (CO), cardiac index (CI), systemic vascular resistance (SVR) and systemic vascular resistance index (SVRI), before treatment in the septic shock group, at the time of diagnosis of sepsis in the sepsis without shock group, and before the discharge from the obstetric department or on the day of transferring to NICU in the control group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Finally, 113 neonates with complete data and parental consent for non-invasive hemodynamic monitoring were enrolled, including 32 cases in the septic shock group, 25 cases in the sepsis without shock group and 56 cases in the control group. In the septic shock group, there were 17 cases at the compensated stage and 15 cases at the decompensated stage. There were 21 full-term infants (20 cured or improved and 1 died) and 11 premature infants (7 cured or improved and 4 died), with the mortality of 15.62% (5/32). There were 18 full-term infants and 7 premature infants in the sepsis without shock group and all cured or improved without death. The control group included 28 full-term infants and 28 premature infants transferring to NICU after birth. Non-invasive hemodynamic parameter analysis showed that SV, SVI, CO and CI of full-term infants in the septic shock group were significantly lower than those in the sepsis without shock group and control group [SV (mL): 3.52±0.99 vs. 5.79±1.32, 5.22±1.02, SVI (mL/m&lt;sup&gt;2&lt;/sup&gt;): 16.80 (15.05, 19.65) vs. 27.00 (22.00, 32.00), 27.00 (23.00, 29.75), CO (L/min): 0.52±0.17 vs. 0.80±0.14, 0.72±0.12, CI (mL×s&lt;sup&gt;-1&lt;/sup&gt;×m&lt;sup&gt;-2&lt;/sup&gt;): 40.00 (36.67, 49.18) vs. 62.51 (56.34, 70.85), 60.01 (53.34, 69.68), all P &lt; 0.05], while SVR and SVRI were significantly higher than those in the sepsis without shock group and control group [SVR (kPa×s×L&lt;sup&gt;-1&lt;/sup&gt;): 773.46±291.96 vs. 524.17±84.76, 549.38±72.36, SVRI (kPa×s×L&lt;sup&gt;-1&lt;/sup&gt;×m&lt;sup&gt;-2&lt;/sup&gt;): 149.27±51.76 vs. 108.12±12.66, 107.81±11.87, all P &lt; 0.05]. MAP, SV, SVI, CO and CI of preterm infants in the septic shock group were significantly lower than those in the control group [MAP (mmHg, ","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"37 1","pages":"29-35"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449791","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}
引用次数: 0
[Design and application of an adjustable facial support pad for prone position ventilation].
Zhonghua wei zhong bing ji jiu yi xue Pub Date : 2025-01-01 DOI: 10.3760/cma.j.cn121430-20240607-00492
Zhimin Zhang, Xiaojie Chen, Xinyu Yao, Bin Li, Yafang Wang, Lin Zhang
{"title":"[Design and application of an adjustable facial support pad for prone position ventilation].","authors":"Zhimin Zhang, Xiaojie Chen, Xinyu Yao, Bin Li, Yafang Wang, Lin Zhang","doi":"10.3760/cma.j.cn121430-20240607-00492","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240607-00492","url":null,"abstract":"<p><p>In recent years, prone mechanical ventilation has been widely used to improve oxygenation dysfunction in critically ill patients. During prone mechanical ventilation, the patient's face is compressed for a long time, and due to the difficulty in changing, facial pressure injuries and ocular complications are common and severe. These complications increase patient discomfort, reduce their tolerance and compliance with prone ventilation, and even cause tracheal tube displacement or dislodgement, leading to significant clinical challenges. In order to change this situation, the medical staff of the department of critical care medicine of the Second People's Hospital of Hengshui and the department of critical care medicine of Harrison International Peace Hospital had developed an adjustable facial support pad for prone ventilation, and obtained a National Utility Model Patent of China (ZL 2022 2 3295294.4). The device is composed of a facial support platform, a supporting telescopic foot frame and so on. There are front, back, left and right adjustable tracks below the support cushion platform, which can be adjusted to the best state suitable for the patient's face shape, which can alleviate the facial pressure injuries and ocular complications caused by the different sizes of each patient's face, improve the patient's comfort, and reduce the incidence of facial pressure injury and the occurrence of ocular complications of the patient. The height of the platform is adjusted by the telescopic feet, and there is a hook assembly below, which can be fixed by the clamp of the ventilator tubing, so as to prevent the ventilator tubing from pulling the endotracheal intubation due to the gravity of condensation, resulting in the displacement or even prolapse of the tracheal intubation, and reducing the occurrence of adverse events of tracheal intubation. It is worth promoting in the clinic.</p>","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"37 1","pages":"70-72"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449816","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}
引用次数: 0
[Effect of different filters on the efficacy in patients with sepsis-associated acute kidney injury].
Zhonghua wei zhong bing ji jiu yi xue Pub Date : 2025-01-01 DOI: 10.3760/cma.j.cn121430-20240802-00661
Wenjie Zhou, Tian Zhao, Qi Ma, Xigang Ma
{"title":"[Effect of different filters on the efficacy in patients with sepsis-associated acute kidney injury].","authors":"Wenjie Zhou, Tian Zhao, Qi Ma, Xigang Ma","doi":"10.3760/cma.j.cn121430-20240802-00661","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240802-00661","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate the effects of using different filters in continuous renal replacement therapy (CRRT) on the mortality, inflammatory mediator level and hemodynamics in patients with sepsis-associated acute kidney injury (SA-AKI).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A prospective study was conducted. The patients with SA-AKI undergoing first CRRT admitted to the critical care medicine department of General Hospital of Ningxia Medical University from August 2022 to October 2023 were enrolled as the study objects, and they were divided into observation group and control group by random number table method. All patients received routine treatment including anti-infection, optimized volume management and organ function support. On this basis, the observation group was treated with oXiris filter for CRRT, while the control group was treated with ordinary filter for CRRT, and the first treatment time was ≥ 36 hours. General data of the two groups were collected and compared. At the same time, the inflammatory indicators [high-sensitivity C-reactive protein (hs-CRP), procalcitonin (PCT), interleukin-6 (IL-6)], sequential organ failure assessment (SOFA) score, mean arterial pressure (MAP), blood lactic acid (Lac), noradrenaline dosage and other related indicators were collected before CRRT treatment and 24 hours and 48 hours after treatment, and the 7-day and 28-day mortality of patients were recorded.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Finally, 65 patients were enrolled, including 30 in the observation group and 35 in the control group. There were no significant differences in baseline data including age, gender, acute kidney injury (AKI) stage and infection source between the two groups. The 7-day mortality of observation group was significantly lower than that of control group [16.7% (5/30) vs. 42.9% (15/35), P &lt; 0.05]. There was no significant difference in 28-day mortality between the observation group and the control group [36.7% (11/30) vs. 54.3% (19/35), P &gt; 0.05]. There were no significant differences in inflammation indicators, SOFA score, MAP, Lac and norepinephrine dosage before treatment between the two groups. After 24-hour and 48-hour treatment, the hemodynamics of the two groups were stable compared with before treatment, the inflammatory indicators, SOFA score, Lac and norepinephrine dosage were reduced to varying degrees, and MAP was significantly increased. In the observation group, hs-CRP, PCT, IL-6, SOFA score, MAP, and norepinephrine dosage showed statistical significance at 24 hours after treatment as compared with before treatment [hs-CRP (mg/L): 125.0 (105.0, 171.2) vs. 280.5 (213.2, 313.8), PCT (μg/L): 51.0 (20.0, 62.8) vs. 71.0 (10.8, 100.0), IL-6 (ng/L): 1 762.2 (300.8, 4 327.5) vs. 4 447.5 (630.4, 5 000.0), SOFA score: 13.0 (12.0, 14.0) vs. 16.0 (15.0, 17.0), MAP (mmHg, 1 mmHg ≈ 0.133 kPa): 79.00±12.87 vs. 65.20±11.70, norepinephrine dosage (μg×kg&lt;sup&gt;-1&lt;/sup&gt;×min&lt;sup&gt;-1&lt;/sup&gt;): 0.82±0.33 vs. 1.63±0.51, ","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"37 1","pages":"48-52"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449831","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}
引用次数: 0
[Thoughts on the rescue process of a patient with septic shock].
Zhonghua wei zhong bing ji jiu yi xue Pub Date : 2025-01-01 DOI: 10.3760/cma.j.cn121430-20240709-00576
Jing Dong, Yi Zheng
{"title":"[Thoughts on the rescue process of a patient with septic shock].","authors":"Jing Dong, Yi Zheng","doi":"10.3760/cma.j.cn121430-20240709-00576","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240709-00576","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Septic shock is a common acute and critical illness in intensive care medicine. It can lead to multiple organ failure, of which the heart is one of the target organs. Fluid resuscitation plays an important role in the treatment of septic shock, but when a patient develops septic-induced cardiomyopathy, the circulation is often not improved by fluid resuscitation, and may even lead to deterioration of circulation. On October 2, 2023, a 52-year-old female patient with septic shock was admitted to the department of intensive care medicine of Civil Aviation General Hospital, whose circulation deteriorated during fluid resuscitation. The main complaint of the patient was left face numbness for more than 20 days, aggravated with unconsciousness for 5 days. Upon admission, the patient was in a coma and intubated by oral tube. The blood pressure was 128/82 mmHg (1 mmHg ≈ 0.133 kPa; intravenous pump of norepinephrine 0.2 μg×kg&lt;sup&gt;-1&lt;/sup&gt;×min&lt;sup&gt;-1&lt;/sup&gt;). Chest CT indicated lung infection, and infection markers were elevated. The main diagnoses were septic shock, pneumonia, acute cerebral infarction of left pontine arm and etc. At 12 hours after admission, according to arterial and central vein blood gas analyses, the oxygen uptake rate was 31% (&gt; 30%), and the veno-arterial blood partial pressure of carbon dioxide (Pv-aCO&lt;sub&gt;2&lt;/sub&gt;) was 7 mmHg (&gt; 6 mmHg), blood lactic acid (Lac) increased, combined with the width of the inferior vena cava of 1.0-1.6 cm, also indicated a relative insufficiency of effective circulating blood volume, so appropriate fluid resuscitation was given. After fluid resuscitation, the urine volume of the patient increased from 40 mL/h to 100 mL/h, but the blood pressure did not increase significantly, indicating that there was no volume responsiveness, so dobutamine 3 μg×kg&lt;sup&gt;-1&lt;/sup&gt;×min&lt;sup&gt;-1&lt;/sup&gt; was added to enhance myocardial contractility. The heart rate did not increase significantly, and the blood pressure was relatively stable. At 21 hours after admission, the patient's systolic blood pressure (SBP) suddenly dropped from 110-120 mmHg to 60-70 mmHg, while heart rate dropped from 100-110 bpm to 80-90 bpm. Therefore, the dosage of norepinephrine was increased to 2 μg×kg&lt;sup&gt;-1&lt;/sup&gt;×min&lt;sup&gt;-1&lt;/sup&gt;, and the dosage of dobutamine was increased to 10 μg×kg&lt;sup&gt;-1&lt;/sup&gt;×min&lt;sup&gt;-1&lt;/sup&gt;, but the circulation could not be maintained. In addition, no tension pneumothorax was found in the chest radiography, and blood routine did not indicate the possibility of acute blood loss. Troponin I (TnI) decreased from 3 778.8 ng/L to 2 025.9 ng/L, brain natriuretic peptide (BNP) increased from 15 ng/L to 1 638 ng/L. Myocardial enzymology changes were not consistent with acute myocardial infarction, and pulmonary hypertension was not found in cardiac color ultrasound. Therefore, it is considered that the decrease of blood pressure was caused by the decrease of cardiac function, which was combined with septic cardiomyopathy. Afte","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"37 1","pages":"73-76"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450173","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}
引用次数: 0
[Effects of autophagy on myocardial injury in rats with common bile duct ligation].
Zhonghua wei zhong bing ji jiu yi xue Pub Date : 2025-01-01 DOI: 10.3760/cma.j.cn121430-20231207-01066
Xiaoyu Wang, Lin Lyu, Aijie Liu, Lei Lun, Wenli Bi, He Dong
{"title":"[Effects of autophagy on myocardial injury in rats with common bile duct ligation].","authors":"Xiaoyu Wang, Lin Lyu, Aijie Liu, Lei Lun, Wenli Bi, He Dong","doi":"10.3760/cma.j.cn121430-20231207-01066","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20231207-01066","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate the impact of autophagy on cardiac tissue injury following common bile duct ligation (CBDL) in rats.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Twenty-four SPF grade healthy adult male Sprague-Dawley (SD) rats were randomly divided into four groups, with 6 rats in each group. The sham-operated (Sham) group underwent only dissection of the common bile duct without ligation. The CBDL group underwent CBDL to simulate jaundice-induced myocardial injury. The autophagy inhibitor 3-methyladenine (3-MA)+CBDL group was intraperitoneally injected with 15 mg/kg 3-MA 2 hours before modeling, and then injected once every other day. The CBDL+autophagy enhancer rapamycin (Rapa) group was intraperitoneally injected with Rapa 1 mg/kg 0.5 hour after modeling, and then injected once every other day. The rats in each group were sacrificed 2 weeks after surgery, and blood was taken from the inferior vena cava. Serum total bilirubin (TBil), alanine transaminase (ALT), aspartate transaminase (AST), lactate dehydrogenase (LDH), and MB isoenzyme of creatine kinase (CK-MB) were detected by using a fully automated animal biochemical analyzer. Serum oxidative stress marker superoxide dismutase (SOD) activity and malondialdehyde (MDA) content were detected by colorimetric assay. The heart tissues of rats were taken and pathological changes were observed under a light microscope after hematoxylin-eosin (HE) staining. Transmission electron microscope was used to observe autophagosomes after double staining with uranyl acetate and lead citrate. The expressions of autophagy-related proteins were detected using Western blotting.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Compared with the Sham group, the serum SOD activity of rats in the CBDL group was significantly decreased, while the serum MDA, TBil, ALT, AST, LDH, and CK-MB were significantly increased; the expressions of autophagy-related proteins Beclin-1 and microtubule-associated protein 1 light chain 3-II/I (LC3-II/I) were significantly increased, and p62 protein expression was significantly decreased. Autophagosomes were seen under electron microscopy in the CBDL group, and cardiac histopathological morphology showed focal necrosis in the myocardium as well as infiltration of inflammatory cells, dilatation of small interstitial blood vessels, and myocardial fiber degeneration. Compared with the CBDL group, cardiac tissue injury in rats was attenuated by pretreatment with the autophagy inhibitor 3-MA, with a decrease in inflammatory cell infiltration in myocardial tissue, a reduction in interstitial vasodilatation, and a decrease in the area of myocardial fibrosis; a decrease in the number of autophagosomes by electron microscopy; and a further rise in the viability of serum TBil, ALT, and AST [TBil (μmol/L): 184.40±6.74 vs. 120.70±16.93, ALT (U/L): 501.10±62.18 vs. 178.80±22.30, AST (U/L): 806.50±76.92 vs. 275.50±55.81, all P &lt; 0.01], as well as a decrease in the levels of serum SOD, MDA, LDH, an","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"37 1","pages":"59-64"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450059","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}
引用次数: 0
[Research advance on the role of interleukin-18, interleukin-37b and basophils in sepsis].
Zhonghua wei zhong bing ji jiu yi xue Pub Date : 2025-01-01 DOI: 10.3760/cma.j.cn121430-20230320-00196
Junling Wang, Xin Dong, Mengmeng Zhan, Bingyu Qin
{"title":"[Research advance on the role of interleukin-18, interleukin-37b and basophils in sepsis].","authors":"Junling Wang, Xin Dong, Mengmeng Zhan, Bingyu Qin","doi":"10.3760/cma.j.cn121430-20230320-00196","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20230320-00196","url":null,"abstract":"<p><p>Interleukin-18 (IL-18) and IL-37b have recently become a research hotspot because of their biological antagonistic role in inflammatory response. Sepsis is an abnormal inflammatory response-mediated life-threatening organ dysfunction induced by infection. Septic shock is the most severe form of sepsis, and has attracted great attention in clinical research due to its high mortality. Basophils are one of the classical effector cells in the inflammatory response, which are involved in many aspects of the pathological process of sepsis. IL-18 is an important pro-inflammatory cytokine and plays a key role in the inflammatory response, while IL-37b is known for its anti-inflammatory function. Both IL-18 and IL-37b can regulate the function of basophils and the inflammatory response in sepsis reversely through interleukin-18 receptor α (IL-18Rα). Therefore, it is of great clinical significance to investigate the role and mechanism of IL-18, IL-37b and basophils in the pathogenesis of sepsis. Herein, the relevant literatures on the roles and potential mechanisms of IL-18, IL-37b and basophils in the pathogenesis of sepsis are summarized, aiming to provide theoretical basis and novel ideas for the future research on the potential roles of IL-18, IL-37b and basophils in sepsis.</p>","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"37 1","pages":"77-80"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450024","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}
引用次数: 0
[Research progress on the role of mechanical stretch in the injury and repair of alveolar epithelial cells].
Zhonghua wei zhong bing ji jiu yi xue Pub Date : 2025-01-01 DOI: 10.3760/cma.j.cn121430-20240222-00151
Xinyi Tang, Haoyue Xue, Yongpeng Xie
{"title":"[Research progress on the role of mechanical stretch in the injury and repair of alveolar epithelial cells].","authors":"Xinyi Tang, Haoyue Xue, Yongpeng Xie","doi":"10.3760/cma.j.cn121430-20240222-00151","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240222-00151","url":null,"abstract":"<p><p>Mechanical ventilation (MV) is currently widely used in the treatment of respiratory failure and anesthesia surgery, and is a commonly used respiratory support method for critically ill patients; however, improper usage of MV can lead to ventilator-induced lung injury (VILI), which poses a significant threat to patient life. Alveolar epithelial cell (AEC) has the functions of mechanosensation and mechanotransduction. Physiological mechanical stretching is beneficial for maintaining the lineage homeostasis and normal physiological functions of AEC cells, while excessive mechanical stretching can cause damage to AEC cells. Damage to AEC cells is an important aspect in the occurrence and development of VILI. Understanding the effects of mechanical stretching on AEC cells is crucial for developing safe and effective MV strategies, preventing the occurrence of VILI, and improving the clinical prognosis of VILI patients. From the perspective of cell mechanics, this paper aims to briefly elucidate the mechanical properties of AEC cells, mechanosensation and mechanotransduction of mechanical stretching in AEC cells, and the injury and repair of AEC cells under mechanical stretch stimulation, and potential mechanisms with the goal of helping clinical doctors better understand the pathophysiological mechanism of VILI caused by MV, improve their understanding of VILI, provide safer and more effective strategies for the use of clinical MV, and provide theoretical basis for the prevention and treatment of VILI.</p>","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"37 1","pages":"92-96"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450170","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}
引用次数: 0
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