中华急诊医学杂志最新文献

{"title":"The clinical characteristics and risk factors of mixed Candida/bacterial bloodstream infections","authors":"Feifei Zhou, Yanqiu Gao, Chuli Pan, Hongwei Zhou, Yuhong Jin, Longqiang Ye, W. Cui, Shufang Zhang, Gensheng Zhang","doi":"10.3760/CMA.J.ISSN.1671-0282.2019.06.017","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2019.06.017","url":null,"abstract":"Objective \u0000To investigate the clinical characteristics and associated risk factors for patients with mixed Candida/bacterial bloodstream infections (BSIs). \u0000 \u0000 \u0000Methods \u0000A retrospective study was conducted in the Second Affiliated hHospital of Zhejiang University School of Medicine from February 2012 to June 2015. The clinical data of cases was collected, and the clinical characteristics, the microbiology data and outcomes in patients with mixed Candida/bacterial BSIs confirmed by blood culture were compared with those with candidaemia. A Logistic regression analysis was performed to investigate the independent risk factors. \u0000 \u0000 \u0000Results \u0000A total of 136 candidaemia cases were analyzed including 40 cases (29.4%) of mixed Candida/bacterial BSIs and 96 cases of candidaemia. Among the 136 candidas strains, the proportion of non-albicans exceeded the albicans (50.7% vs 49.3%), although the later was still the predominant one. There was no significant difference in the distribution of candidas strains between patients with mixed Candida/bacterial BSIs and patients with candidaemia. In patients with mixed Candida/bacterial BSIs, 25 strains (61.0%) of gram-positive cocci and 16 strains (39.0%) of gram-negative bacilli were isolated. Compared with patients with candidaemia, patients with mixed Candida/bacterial BSIs needed longer period of antifungal therapy [12.0 (4.0-25.0)days vs 7.0 (3.0-13.5) days, P=0.027], but the crude 30-day and 90-day mortality did not differ between the two groups (40.0% vs 32.3%; 45.0% vs 36.5%; both P>0.05). Univariate analysis revealed that the prior hospital stay, ICU admission at the onset of candidaemia, blood transfusion, human albumin infusion, mechanical ventilation, linezolid use and high SOFA score were related with the occurrence of mixed Candida/bacterial BSIs (all P<0.05). Multivariate analysis showed that only high SOFA score was the independent risk factor (P=0.003). \u0000 \u0000 \u0000Conclusions \u0000Gram-positive cocci were the predominant species in mixed Candida/bacterial BSIs. Compared with candidaemia, mixed Candida/bacterial BSIs needs a longer ICU stay, a longer hospital stay, and a prolonged antifungal therapy. High SOFA score is the independent risk factor for mixed Candida/bacterial BSIs. \u0000 \u0000 \u0000Key words: \u0000Candidaemia; Bacterial bloodstream; Mixed infection; Clinical characteristics; Strains distribution; Antifungal susceptibility; Risk factors; Clinical outcome","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"28 1","pages":"748-754"},"PeriodicalIF":0.0,"publicationDate":"2019-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47998712","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":"Protective effect and mechanism of chemokine C-C motif ligand 6 on glucose and oxygen deprivation induced injury of cardiomyocytes","authors":"Yue Liu, Xiaoyan Zhang, Changwei Ren, Wenjun Zhu, Jiang Dai, Y. Lai","doi":"10.3760/CMA.J.ISSN.1671-0282.2019.06.013","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2019.06.013","url":null,"abstract":"Objective \u0000To study the protective effect of chemokine C-C motif ligand 6 (CCL6) on glucose-oxygen deprivation induced injury in cardiomyocytes and its possible molecular mechanism. \u0000 \u0000 \u0000Methods \u0000Gene expression was analyzed in the public database Gene Expression Omnibus (GEO) database and gene expression of analyzed for myocardial tissue was analyzed gene expression in the sham group and the ischemia-reperfusion group (IR group). Rat H9C2 cardiomyocytes were cultured in vitro, and myocardial cell injury model was established by oxygen glucose deprivation (OGD). Cell viability was detected by MTT assay; apoptosis was determined by Annex V/PI double staining; the expression of related genes was detected by real-time PCR and Western blot. \u0000 \u0000 \u0000Results \u0000Compared with the sham group, transcriptome analysis and real-time PCR showed that the expression of CCL6 in the myocardial tissue of the IR group was significantly decreased (P<0.01). Oxygen glucose deprivation induced a decrease in CCL6 expression levels in H9C2 cardiomyocytes in a time-dependent manner. In addition, oxygen glucose deprivation leads to decreased cell viability and increased apoptosis; while addition of CCL6 promotes cell viability and reduces apoptosis. The lncRNA microarray and real-time PCR showed that CCL6 treatment of cardiomyocytes resulted in a significant decrease in the expression of lncRNA IGF2-AS and further increased the phosphorylation of Akt and GSK-3β. \u0000 \u0000 \u0000Conclusion \u0000CCL6 can inhibit cardiomyocyte injury induced by glucose deprivation, and its molecular mechanism may be related to inhibition of IGF2-AS and enhancement of Akt/GSK-3β signaling pathway. \u0000 \u0000 \u0000Key words: \u0000Cardiomyocytes; Chemokine; Apoptosis","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"28 1","pages":"724-728"},"PeriodicalIF":0.0,"publicationDate":"2019-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46158561","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":"The prognostic value of Th1/Th2 cytokines on septic children with or without neutropenia","authors":"Y. Xi, B. Ning, Ying Wang, Bi-ru Li, J. Qian, H. Ren, Jian Zhang, Fang Zhang","doi":"10.3760/CMA.J.ISSN.1671-0282.2019.06.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2019.06.007","url":null,"abstract":"Objective \u0000To explore the characteristics and value for predicting prognosis of cytokines in septic children with or without neutropenia. \u0000 \u0000 \u0000Methods \u0000Totally 138 septic children were divided into the neutropenia and non-neutropenia groups according to absolute neutropenic count. Septic children were divided into the shock and non-shock groups according to circulation function and organ perfusion. The levels of C-reactive protein, procalcitonin, cytokines, PRISM-Ⅲ and clinical outcomes were analyzed between the relative groups. \u0000 \u0000 \u0000Results \u0000(1) Totally 138 septic children were recruited, 64 with neutropenia and 74 without neutropenia. The level of PRISM-Ⅲ of the neutropenia group was significantly higher than that of the non-neutropenia group (P=0.048).Mortality showed no significant difference between the two groups, but hospital stay in the neutropenia group was longer than that in the non-neutropenia group. The levels of C-reactive protein, IL-6, and IL-10 ihe neutropenia group were significantly higher than those of the non-neutropenia group (P=0.001; P=0.001; P=0.032). The level of TNF-α in the neutropenia group was significantly lower than that of the non-neutropenia group (P=0.032). (2)Among the 64 septic children with neutropenia, 23 were combined with shock. The PRISM-Ⅲ level of the shock group was significantly higher than that of the non-shock group (P=0.001). The mortality of the shock group (43.5%, 10/23) was significantly higher than the non-shock group (2.4%, 1/41) (P=0.001). C-reactive protein, procalcitonin, IL-6, IL-10 and TNF-α in the shock group elevated obviously than those in the non-shock group (P=0.001; P=0.001; P=0.001; P=0.005; P=0.019). The area under receiver operating characteristic curve was 0.8 for IL-6 (cut-off value 315.38 pg/mL), 0.8 for IL-10 (cut-off value 45.18 pg/mL), and 0.85 for TNF-α (cut-off value 1.95 pg/mL). (3) Among the 74 septic children without neutropenia, 19 were combined with shock. The PRISM-Ⅲ level of the shock group was significantly higher than that of the non-shock group (P=0.022).There was no significant difference of mortality between the two groups (P=0.3). IL-10 level in the shock group elevated obviously than that in the non-shock group (P=0.015).(4) Among the 42 children with sepsis shock, 23 were combined with neutropenia. The PRISM-Ⅲ level of the neutropenia group was significantly higher than that of the non-neutropenia group (P=0.005). There was no significant difference of mortality between the two groups (P=0.29). The levels of C-reactive protein, procalcitonin, IL-6 and IL-10 in the neutropenia group were significantly higher than those in the non-neutropenia group (P=0.001; P=0.001; P=0.001; P=0.035). There was no difference of TNF-α level between the two groups.(5) Among the 96 children without sepsis shock, 41 were combined with neutropenia. No difference of PRISM-Ⅲ level was observed between the neutropenia and non-neutropenia groups. The mortality of the neutropenia group","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"28 1","pages":"691-696"},"PeriodicalIF":0.0,"publicationDate":"2019-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46644611","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 observation of venous-arterial extracorporeal membrane oxygenation in the treatment of refractory septic shock in children","authors":"Yun Cui, Fei Wang, Y. Ren, Yiping Zhou, Jingyi Shi, Tingting Xu, Jiangbin Liu","doi":"10.3760/CMA.J.ISSN.1671-0282.2019.06.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2019.06.008","url":null,"abstract":"Objective \u0000To investigate the efficacy of venous-arterial extracorporeal membrane oxygenation (VA-ECMO) in the treatment of refractory septic shock in children. \u0000 \u0000 \u0000Methods \u0000From January 2016 to December 2018, the clinical data of children with refractory septic shock (RSS) treated by VA-ECMO in Department of Critical Medicine Affiliated Children's Hospital of Shanghai Jiao Tong University were retrospectively analyzed. The patients with refractory septic shock (RSS) treated by VA-ECMO were compared with those with non-refractory septic shock (NRSS). \u0000 \u0000 \u0000Results \u0000There were 8 cases in the RSS-ECMO group and 6 cases in the NRSS-ECMO group. The sex, age, PRISM score, complication showed no significant difference in the two groups. The median time of ECMO in the RSS-ECMO group was 182 (141, 216) h , and 5 patients were survived and were discharged from the hospital. The blood lactic acid and vasoactive drug index in the RSS-ECMO group was significantly higher than that in the NRSS-ECMO group (P 0.05). After ECMO establishment, the mean invasive arterial pressure increased significantly at 6 h, and lactic acid decreased significantly at 12 h after ECMO support. SCVO2 returned to normal at 24-h ECMO therapy. \u0000 \u0000 \u0000Conclusions \u0000The success rate of VA-ECMO treatment in children with refractory septic shock complicated with MODS is similar to that of children with non-refractory septic shock. The relationship between ECMO and hemodynamic indexes in sepsis should be further explored. \u0000 \u0000 \u0000Key words: \u0000Venoarterial extracorporeal membrane oxygenation (VA-ECMO); Continuous renal replacement therapy (CRRT); Sepsis; Refractory septic shock; Mortality; Child","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"28 1","pages":"697-701"},"PeriodicalIF":0.0,"publicationDate":"2019-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44817368","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":"Methamphetamine induces autophagy in myocardial cells","authors":"Chao Zhao, Jun Wang, Hao Sun, Lei Jiang, Jin-song Zhang","doi":"10.3760/CMA.J.ISSN.1671-0282.2019.06.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2019.06.010","url":null,"abstract":"Objective \u0000To investigate the process of autophagy in myocardial cells induced by methamphetamine (METH). \u0000 \u0000 \u0000Methods \u0000In vivo study: sixty 6-week-old male C57Bl/6 J mice were randomly(random number) divided into three groups evenly, control group, three-day METH treated group and seven-day METH treated group. Mice in control group was given physiological saline through intraperitoneal injection 2 times per day and lasted 7 days. Mice in three days group and seven days group intake methamphetamine at a dose of 15 mg/kg every time through intraperitoneal injection 2 times a day, lasted 3 days and 7 days respectively. The hearts of the mice were then obtained by anatomical method 24 hours after the last intraperitoneal injection of METH, then autophagy related proteins were detected by western blotting. In vitro study: the model was established by H9C2 cells. The cells were divided into two groups, control group (cells were cultured by normal medium) and METH group (cells were cultured by medium includes 900 mmol/mL METH for 24 hours). The expressions change of autophagy related proteins in cells were tested by Western blotting. Additionally, LC3-Ⅱ was tagged by red fluorescent and then the stained cells were visualized under a Zeiss LSM710 confocal microscope. Furthermore, the numbers of autophagosomes in cells were visualized by transmission electron microscopy. \u0000 \u0000 \u0000Results \u0000The expression of p62,Beclin-1and LC3 were significantly increased in METH group when compared with control group (P<0.05). The level of LC3 was significantly increased in METH treated group compared with control group visualized under a Zeiss LSM710 confocal microscope. The numbers of autophagosomes in METH group are more than control group visualized by transmission electron microscopy. \u0000 \u0000 \u0000Conclusions \u0000Autophagy can be induced by METH in myocardial cells. \u0000 \u0000 \u0000Key words: \u0000Methamphetamine (METH); autophagy; mice (C57Bl/6J); H9C2 cell line","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"28 1","pages":"707-711"},"PeriodicalIF":0.0,"publicationDate":"2019-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47543984","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":"Protective effect of luteolin on acute lung injury in sepsis mice","authors":"Lichao Sun, Xu Chen, Yao Yao, Wen Li, Hongjing Chang, Wenhong Chen, Wen-jing Wu, Panpan Zhang, Hong-bo Zhang","doi":"10.3760/CMA.J.ISSN.1671-0282.2019.06.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2019.06.012","url":null,"abstract":"Objective \u0000To investigate the potential therapeutic effect of luteolin on sepsis-induced ALI and the underlying mechanisms. \u0000 \u0000 \u0000Methods \u0000Total of 50 mice were randomly(random number) divided into five groups: a sham control group, a sepsis-induced ALI group, and three sepsis groups pre-treated with 20, 40, and 80 mg/kg body weight luteolin. Mice in the treatment groups were pre-treated with luteolin at the respective oral dose two days before ALI induction. The lungs were isolated for histopathological examinations, and the bronchoalveolar lavage fluid (BALF) was collected for biochemical analyses. \u0000 \u0000 \u0000Results \u0000Luteolin significantly attenuated sepsis-induced ALI. Additionally, luteolin treatment decreased protein and inflammatory cytokine concentration and the number of infiltrated inflammatory cells in BALF compared with that in the non-treated sepsis mice. Pulmonary myeloperoxidase (MPO) activity was lower in the luteolin-pre-treated sepsis groups than in the sepsis group. The mechanism underlying the protective effect of luteolin on sepsis is related to the up-regulation of certain antioxidation genes, including inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2), superoxide dismutases (SODs), and heme oxygenase 1 (HO-1), and the reduction of inflammatory responses through blockage of the activation of the nuclear factor (NF)-κB pathway. \u0000 \u0000 \u0000Conclusions \u0000Luteolin pre-treatment inhibits sepsis-induced ALI through its anti-inflammatory and antioxidative activity, suggesting that luteolin may be a potential therapeutic agent for sepsis-induced ALI. \u0000 \u0000 \u0000Key words: \u0000Luteolin; Sepsis; COX-2; SODs; iNOS","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"28 1","pages":"717-723"},"PeriodicalIF":0.0,"publicationDate":"2019-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41325633","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":"Monitoring of cerebrospinal fluid dynamics in a model of brain herniation induced by acute intracranial hypertension by PC cine MRI","authors":"周建国, Zhou Jianguo, 朱晓玲, Z. Xiaoling, 韦武鹏, Wei Wupeng, 黄丽轩, Huang Lixuan, 冯永彪, Feng Yongbiao, 张灵, Z. Ling, 马相飞, Mao Xiangfei, 李伟雄, Li Weixiong, 张剑锋, Z. Jianfeng, 欧和生, O. He-sheng, 唐华民, Tang Hua-min","doi":"10.3760/CMA.J.ISSN.1671-0282.2019.05.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2019.05.011","url":null,"abstract":"Objective \u0000To explore the monitoring of cerebrospinal fluid (CSF) dynamics in a model of brain herniation induced by acute intracranial hypertension in Guangxi Bama-Mini pigs by phase-contrast cine magnetic resonance imaging (PC cine MRI). \u0000 \u0000 \u0000Methods \u0000Femoral artery blood were extracted from 10 pigs, and injected into the frontal and temporal parietal lobe to make a model of brain herniation induced by acute intracranial hypertension. The mean arterial blood pressure (MAP), intracranial pressure (ICP), and cerebral perfusion pressure (CPP) were monitored. Routine T1WI, T2WI, coronal, sagittal and cerebrospinal fluid flow sequence (fast PC cine slice) which positioned on the cervical 3 (C3) vertebral body as the center and perpendicular to the spinal scans were performed on all experimental animals before and after blood injection with 3.0T Magnetic Resonance Imaging. The ICP, MAP, CPP, the absolute values ​​of CSF peak flow velocity and the absolute value of carotid peak flow velocity before and after blood injection were compared. \u0000 \u0000 \u0000Results \u0000The ICP, MAP , CPP, and the absolute value of CSF peak flow velocity before injection of autologous arterial blood were statistically significant as compared with those after blood injection [(6.80±2.044) mmHg vs (52.20±1.619) mmHg, (76.80±7.068) mmHg vs (142.80±12.399) mmHg, (70.00±6.074) mmHg vs (90.50±12.250) mmHg, and the absolute value of CSF peak flow velocity was (243.20±77.671) mm/s vs (201.40±55.482) mm/s, respectively, P 0.05]. \u0000 \u0000 \u0000Conclusion \u0000After the formation of brain herniation induced by acute intracranial hypertension, the CSF flow in the C3 level spinal canal showed a low dynamic change, and the CSF flow velocity waveform was disordered and malformed. The non-invasive measurement of CSF dynamics by PC cine MRI can provide an important basis for the change of CSF dynamics in the model of brain herniation induced by acute intracranial hypertension, and provide a theoretical basis for further research on damage control neurosurgery in the future. \u0000 \u0000 \u0000Key words: \u0000Phase-contrast cine magnetic resonance imaging; Cerebrospinal fluid dynamics; Intracranial hypertension; Brain herniation; Pig","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"28 1","pages":"584-590"},"PeriodicalIF":0.0,"publicationDate":"2019-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47845669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of IL-1β on expression of SNAP-25 in the hippocampus in septic neonatal rats","authors":"林兰芬, Lin Lanfen, 周秋萍, Zhou Qiuping, 陈炫, Chen Xuan, 林琼瑜, Lin Qiongyu, 江书奇, Jiang shuqi, 黄佩贤, Hu Peixian, 邓医宇, Deng Yiyu","doi":"10.3760/CMA.J.ISSN.1671-0282.2019.05.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2019.05.012","url":null,"abstract":"Objective \u0000To investigate the effect of interleukin-1β (IL-1β) on the expression of synaptic protein SNAP-25 in the hippocampus in septic neonatal rat induced by systemic lipopolysaccharide (LPS) injection. \u0000 \u0000 \u0000Methods \u0000Sprague-Dawley (SD) rats were randomly divided into two groups: control group and sepsis group. The rat model of sepsis was produced by intraperitoneal injection of 1 mg/kg LPS, and rats in the control group were injected with an equal volume of 0.01 mol/L phosphate buffered saline (PBS). The expression levels of IL-1β and IL-1R1 in the hippocampus at 1, 2 and 3 d, and synaptosomal-associated protein 25 (SNAP-25) at 7, 14 and 24 d after LPS intraperitoneal injection were detected by Western blot. After cultured for 24 h, primary hippocampal neurons were divided into four groups including the control group, IL-1β (40 ng/mL) treatment group, IL-1β (40 ng/mL) + IL-1Ra (40 ng/mL) treatment group, and IL-1Ra (40 ng/mL) treatment group. The effect of IL-1β on SNAP-25 expression in primary hippocampal neuron was determined by Western blot and real-time PCR. The purity of hippocampal neurons were identified by NeuN immunofluorescence staining and the activity of neurons were detected by CCK-8 assay. All data were analyzed by SPSS version 22.0. The data were analyzed by student-t test and Dunnett-t test. The interaction effects were analyzed by factorial ANOVA. Differences were considered to be statistically significant if P< 0.05. \u0000 \u0000 \u0000Results \u0000Compared with the control group, the expressions of IL-1β and IL-1R1 were significantly increased in the hippocampus at 1, 2 and 3 d after intraperitoneal injection of LPS (P 0.05). \u0000 \u0000 \u0000Conclusions \u0000IL-1β may possibly inhibit the expression level of SNAP-25 protein in the hippocampus in the septic rats through its receptor IL-1R1, which would contribute to cognitive dysfunction of septic neonatal rats in later life. \u0000 \u0000 \u0000Key words: \u0000IL-1β; Sepsis; SNAP-25","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"28 1","pages":"591-595"},"PeriodicalIF":0.0,"publicationDate":"2019-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45198718","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":"The effect of hypertension on the prognosis of acute aortic dissection","authors":"L. Dou, Weibo Gao, Chun-bo Wu, Bao-ping Cao","doi":"10.3760/CMA.J.ISSN.1671-0282.2019.05.016","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2019.05.016","url":null,"abstract":"Objective \u0000To investigate the clinical characteristics and prognosis of patients with acute aortic dissection (AAD) and hypertension, and explore other related prognostic factors in AAD. \u0000 \u0000 \u0000Methods \u0000The present study enrolled consecutive patients diagnosed with AAD who were admitted to Peking University People's Hospital between January 2000 to December 2015. Patients diagnosed with AAD by CT angiography, aortography or magnetic resonance imaging within 14 days of onset were included. Patients with infectious diseases, haematological diseases, malignancies, autoimmune diseases and patients without clearly clinical diagnosis or incomplete data were excluded. The patients were initially divided into two groups based on their history of hypertension, and their clinical characteristics were compared and analyzed. We further divided AAD patients into survival group and death group according to their in-patient outcomes, and factors related to their prognoses were analyzed. Logistic regression analysis was applied to analyze the independent risk factors related to hospital death in AAD patients with P<0.05 as the significant value. \u0000 \u0000 \u0000Results \u0000The hypertensive group contained 237/346 cases included (68.45%), patients in this group were generally older than their non-hypertensive counterparts, accompanied by increased prevalence of comorbidities (coronary heart diseases or diabetes) and a statistical significant elevated admission blood pressures (systolic and diastolic, P 0.05). Hypertensive patients were less likely to receive surgical treatment compared with those without hypertension(P 0.05). Further logistic regression analysis revealed the presence of hypertension did not independently predict in-hospital mortality of AAD patients. Factors such as age, Stanford classification of the AAD, NLR and platelet counts were found to have independent predictive values for in-hospital mortality (P<0.05). \u0000 \u0000 \u0000Conclusion \u0000AAD patients with hypertension are generally older, have more comorbidities such as coronary heart diseases and diabetes. The presence of hypertension itself is not directly associated with in-hospital mortality in AAD patients, while the Stanford classification, age, NLR and platelet counts are independent risk predictors. \u0000 \u0000 \u0000Key words: \u0000Hypertension; Acute aortic dissection; Prognosis; Neutrophil to Lymphocyte ratio; Platelet counts","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"28 1","pages":"614-618"},"PeriodicalIF":0.0,"publicationDate":"2019-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43069449","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":"Randomized controlled study of immune nutrition in patients with acute stress","authors":"Rui Liang, Gaiyun Chen, S. Wang, Yanhui Ma, Yuanchen Zhu, T. Sun","doi":"10.3760/CMA.J.ISSN.1671-0282.2019.05.014","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2019.05.014","url":null,"abstract":"Objective \u0000To explore the effects of immune-enhanced enteral nutrition support on the clinical outcome and nutritional status of patients with acute stress. \u0000 \u0000 \u0000Methods \u0000From December 2014 to August 2015, 120 patients with acute stress were enrolled in this study in the First Affiliated Hospital of Zhengzhou University. The patients were randomly divided into the control group and the experimental group, 60 cases in each group. Besides of medical treatment, the control group received routine enteral nutrition, while the experimental group received immune-enhanced nutrition for 8 days. The main parameters related to nutritional status, immune function, blood glucose, infection control of patients were collected. \u0000 \u0000 \u0000Results \u0000No significance of parameters listed above were observed between patients in the two groups at baseline. After intervention, the levels of prealbumin and lymphocyte counts in the experimental group were higher than those in the control group [(162.5±29.7) mg/L and (136.6±15.1) mg/L, (1.86±0.9) ×109/L and (1.45±0.710) ×109/L, P=0.021 and P=0.012]. The levels of C-reactive protein in the experimental group were lower than those in the control group [ (47.2±22.1) mg/L and (82.6±13.4) mg/L, P=0.043]. Moreover, the level of blood glucose in the experimental group was lower than that in the control group [(5.4±1.7) mmol/L and (6.6±3.5) mmol/L, P=0.009]. The patients in the experimental group had better intestinal tolerance (8.3% vs 25%, P=0.014) but lower mortality (6.7% vs 20%, P=0.032) than those in the control group. \u0000 \u0000 \u0000Conclusions \u0000Immune-enhanced enteral nutrition can reduce level of blood glucose and alleviate inflammatory responses of patients with acute stress, thus improving intestinal tolerance, and reducing mortality. \u0000 \u0000 \u0000Key words: \u0000Immune-enhanced enteral nutrition; Acute stress; Inflammation","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"28 1","pages":"604-608"},"PeriodicalIF":0.0,"publicationDate":"2019-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41420524","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}