中华急诊医学杂志最新文献

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Curcumin upregulates mitofusin2 to alleviate acute lung injury in septic mice 姜黄素上调mitofusin2减轻脓毒症小鼠急性肺损伤
中华急诊医学杂志 Pub Date : 2020-01-10 DOI: 10.3760/CMA.J.ISSN.1671-0282.2020.01.009
L. Zheng, Long-wang Chen, Xiyi Hu, J. Lian, Guangju Zhao, G. Hong, Zhongqiu Lu
{"title":"Curcumin upregulates mitofusin2 to alleviate acute lung injury in septic mice","authors":"L. Zheng, Long-wang Chen, Xiyi Hu, J. Lian, Guangju Zhao, G. Hong, Zhongqiu Lu","doi":"10.3760/CMA.J.ISSN.1671-0282.2020.01.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2020.01.009","url":null,"abstract":"Objective To investigate the protective effect and mechanism of curcumin on acute lung injury in septic mice. Methods Totally 120 clean BALB/c male mice were randomly (random number) divided into 8 groups: sham group, sepsis group, curcumin control group, curcumin intervention group, negative virus-sepsis group, negative virus-curcumin intervention group, Mfn2 interference-sepsis group, and Mfn2 interference-curcumin intervention group, 15 rats in each group. Mice in the sepsis and the curcumin groups were given the cecal ligation and puncture (CLP) mice in the curcumin intervention and curcumin control groups were given curcumin 200 mg/(kg·d) for 1 week, and mice in the negative virus-sepsis group and negative virus-curcumin intervention groups were established by injection of a negative adeno-associated virus in the tail vein. The Mfn2 interference-sepsis and Mfn2 interference-curcumin intervention groups were established by injecting an adeno-associated virus carrying the Mfn2 interference sequence through the tail vein. Mice were sacrificed after 24 h in each group. The degree of lung injury was examined by lung wet-to-dry weight ratio and pathological examination. The inflammatory factors of alveolar lavage fluid including TNF-α and IL-6 were detected by ELISA, the activation of caspase-3, a key molecule for apoptosis, was detected by Western blot, and apoptosis was detected by TUNEL. The data were analyzed by SPSS 22.0 software, the count data was analyzed by χ2 test, and the comparison of measurement data between groups was analyzed by one-way ANOVA. Results Compared with the sham group, the wet-to-dry weight ratio of lung tissue in the sepsis group was significantly increased (71.11±3.78 vs 31.11±5.61, P=0.002), the histopathological score was significantly higher (P=0.006), the inflammatory factors TNF-α (P=0.001) and IL-6 (P=0.012) were dramatically increased, and the apoptosis of lung tissue and the expression of caspase-3 cleaved were also significantly increased (P=0.001). Compared with the sepsis group, the wet-to-dry weight ratio and the histopathological score of lung tissue in the curcumin-treated group was significantly lower (32.84±6.15 vs 71.11±3.78, P=0.004), and the inflammatory factors TNF-α(P=0.013) and IL-6 (P=0.003) were obviously decreased, and apoptosis and apoptosis-related protein caspase-3 cleaved expression were also dramatically decreased (P=0.012). After Mfn2 was down-regulated, Mfn2 interference-curcumin intervention group interfered with Mfn2. Compared with the sepsis group, the dry-to-wet weight ratio and the histopathological score of the lung tissue of the mice was not significantly decreased. Further studies found that after down-regulating Mfn2, compared with the Mfn2 interfere-sepsis group, Mfn2 interfere-curcumin intervention group had no such performance. The inflammatory factors TNF-α and IL-6 were not significantly decreased, and the apoptosis of lung tissue and the expression of","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"29 1","pages":"58-64"},"PeriodicalIF":0.0,"publicationDate":"2020-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41855069","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 methods of applying enteral nutritional support methods in elderly patients with severe pneumonia 不同方法应用肠内营养支持对老年重症肺炎患者的影响
中华急诊医学杂志 Pub Date : 2020-01-10 DOI: 10.3760/CMA.J.ISSN.1671-0282.2020.01.015
Hong Sun, K. Li, Qian Yang, H. Ren, Xiandong Liu, Xiaowei Bao
{"title":"Effect of different methods of applying enteral nutritional support methods in elderly patients with severe pneumonia","authors":"Hong Sun, K. Li, Qian Yang, H. Ren, Xiandong Liu, Xiaowei Bao","doi":"10.3760/CMA.J.ISSN.1671-0282.2020.01.015","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2020.01.015","url":null,"abstract":"Objective \u0000To compare the effect of different enteral nutritional support methods in elderly patients with severe pneumonia. \u0000 \u0000 \u0000Methods \u0000Elderly patients (average age over 65 years) with severe pneumonia admitted to our hospital from June 2015 to June 2018 were selected as the study subjects, and 86 patients finally completed the study. The patients were randomly divided into the control group and observation group with 43 patients in each group, and nasojejunal tubes were placed for patients in both groups. Patients in the observation group were fed with enteral nutrition emulsion through continuously-heated nutritional pump, while patients in the control group was meal served with enteral nutrition emulsion. Changes in blood biochemical parameters, immune indexes, inflammation indexes, oxygenation indexes, the GIDF and SOFA scores as well as curative effect (mechanical ventilation time and effective rate of treatment) were monitored and compared before and after 10 days of nutritional support treatment. SPSS 20.0 statistical software package was used for data analysis, and self paired t-test was used for comparison before and after intervention in the same group, χ2 test was used in comparison between different groups, and the counting data was expressed as the rate (n, %). \u0000 \u0000 \u0000Results \u0000There was no significant difference in baseline data between patients in the two groups (P>0.05). After ten days of intervention, compared with the control group, the levels of serum albumin and prealbumin in the observation group were higher [(31.22±2.36) g/L and (0.29±0.24) g/L, P=0.015 and P=0.023], the immune indexes were higher [IgG (13.24±0.70) g/L, P=0.020; IgM (1.43±0.19) g/L, P=0.011; CD4+/CD8+ 1.55±0.49, P=0.043], the inflammation indexes were lower [IL-6 (312.54±42.53) pg/mL, P=0.031; PCT (1.56±0.81) ng/mL, P=0.017], the oxygenation indexes were better [PaO2/FiO2 (315.58±20.37) mmHg, P=0.019], and the GIDF and SOFA scores were significantly lower[(10.6±1.2) and (8.5±1.7), P=0.041 and P=0.038]. The clinical outcome showed that the mechanical ventilation time in the observation group was significantly shorter [(6.01±1.48) d vs (8.12±1.17)d, P=0.039], and the total effective rate of treatment was better than the control group (67.44% vs 41.86%, P=0.027). \u0000 \u0000 \u0000Conclusions \u0000Enteral nutrition support through continuously-heated nutritional pump can improve the nutritional status of elderly patients with severe pneumonia, reduce the incidence of gastrointestinal dysfunction, maintain stable organ fuction, thus resulting in better prognosis in elderly patients with severe pneumonia. \u0000 \u0000 \u0000Key words: \u0000Elderly patients; Severe pneumonia; Enteral nutritional support; Continuously-heated nutritional pump; Gastrointestinal dysfunction","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"29 1","pages":"92-98"},"PeriodicalIF":0.0,"publicationDate":"2020-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48087508","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: 1
Clinical analysis of 59 patients with thrombotic thrombocytopenic purpura 血栓性血小板减少性紫癜59例临床分析
中华急诊医学杂志 Pub Date : 2020-01-10 DOI: 10.3760/CMA.J.ISSN.1671-0282.2020.01.017
Weibo Gao, Maojing Shi, Wenfeng Huang
{"title":"Clinical analysis of 59 patients with thrombotic thrombocytopenic purpura","authors":"Weibo Gao, Maojing Shi, Wenfeng Huang","doi":"10.3760/CMA.J.ISSN.1671-0282.2020.01.017","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2020.01.017","url":null,"abstract":"Objective \u0000To investigate the clinical features, diagnosis, treatment and prognosis of 59 patients with thrombotic thrombocytopenic purpura (TTP), therefore to improve the ability of diagnosis and treatment. \u0000 \u0000 \u0000Methods \u0000The clinical data of 59 patients with TTP admitted to Peking University People's Hospital from January 2004 to October 2018 were retrospectively analyzed. All the patients were clinically diagnosed, fulfilled the triad syndrome, or quinary syndrome. Laboratory data included complete blood count, blood biochemistry, immunology, hemolysis; some patients tested the activity of ADAMTS13.The differences between groups were compared according to the prognosis. \u0000 \u0000 \u0000Results \u0000Among the 59 patients with TTP, 21 were male and 38 were female, with an average age of 46.8 years. Fifty-five patients had the triad syndrome and 46 patients had the quinary syndrome. The platelet count and hemoglobin decreased, the percentage of erythrocyte fragmented increased, and the value or the activity of ADAMTS13 was decreased significantly. PLASMIC scores of 57 patients were between 6 and 7. All 59 patients were treated with glucocorticoid, 41 patients received plasma exchange (PEX), and 28 patients survived; 18 patients did not received PEX, and only 6 patients survived. There was a significant difference of the survival between the two groups (P<0.05). Six patients were treated with rituximab and four patients survived. \u0000 \u0000 \u0000Conclusion \u0000The PLASMIC score can predict the activity of ADAMTS13 well. PEX can significantly improve the survival rate of patients with TTP. \u0000 \u0000 \u0000Key words: \u0000Thrombotic thrombocytopenic purpura; ADAMTS13; PLASMIC score; Plasma exchange; Prognosis","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"29 1","pages":"106-111"},"PeriodicalIF":0.0,"publicationDate":"2020-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69953653","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 therapeutic hypothermia on myocardial Ca2+/calmodulin-dependent protein kinase II and autophagy after cardiopulmonary resuscitation in swine 治疗性低温对猪心肺复苏后心肌Ca2+/钙调素依赖性蛋白激酶II和自噬的影响
中华急诊医学杂志 Pub Date : 2020-01-10 DOI: 10.3760/CMA.J.ISSN.1671-0282.2020.01.006
Qijiang Chen, Jiefeng Xu, Chunshuang Wu, Xiaohong Jin, Zilong Li, Moli Wang
{"title":"Effects of therapeutic hypothermia on myocardial Ca2+/calmodulin-dependent protein kinase II and autophagy after cardiopulmonary resuscitation in swine","authors":"Qijiang Chen, Jiefeng Xu, Chunshuang Wu, Xiaohong Jin, Zilong Li, Moli Wang","doi":"10.3760/CMA.J.ISSN.1671-0282.2020.01.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2020.01.006","url":null,"abstract":"Objective \u0000To investigate the effects of therapeutic hypothermia (TH) on myocardial Ca2+/calmodulin-dependent protein kinaseⅡ (CaMKⅡ) and cell autophagy after cardiopulmonary resuscitation (CPR) in swine. \u0000 \u0000 \u0000Methods \u0000Twenty healthy male domestic swine weighing 33-40 kg were randomly (random number) divided into 3 groups: sham group (n=4), CPR group (n=8) and TH group (n=8). Sham animals only underwent general preparation without experiencing cardiac arrest and resuscitation. The animal model was established by 8 min of electrically induced ventricular fibrillation and then 5 min CPR in the CPR and TH groups. Successful resuscitation was regarded as an organized rhythm with a mean arterial pressure of greater than 50 mmHg for 5 min or more. After successful resuscitation, body temperature was decreased to 33 ℃ by a cooling blanket and then maintained until 24 h post-resuscitation, and followed by a rewarming at a rate of 1 ℃/h for 5 h in the TH group. A normal temperature was maintained by the blanket throughout the experiment in the sham and CPR groups. At 6, 12, 24 and 30 h after resuscitation, the values of stroke volume (SV) and global ejection fraction (GEF) were measured by PiCCO, and meanwhile the serum concentrations of cardiac troponin I (cTnI) were measured by ELISA assay and the serum activities of creatine kinase-MB (CK-MB) were evaluated by an automatic biochemical analyzer. At 30 h after resuscitation, the animals were sacrificed and left ventricular myocardium was obtained for the determination of CaMKⅡ, microtubule-associated protein light chain 3Ⅱ (LC3Ⅱ) and p62 expressions by Western blot. The variables were compared with One way analysis of variance and then the Bonferroni test among the three groups. \u0000 \u0000 \u0000Results \u0000Compared with the sham group, myocardial dysfunction and injury after resuscitation were observed in the CPR and TH groups, which were indicated by decreased SV and GEF and also increased cTnI concentration and CK-MB activity in serum (all P<0.05). Compared with the CPR group, the values of SV and GEF were significantly increased at 6 h after resuscitation, and serum cTnI concentration and CK-MB activity were significantly decreased starting 12 h after resuscitation in the TH group [SV (mL): 25.0±6.9 vs 31.9±3.3 at 6 h, 26.7±5.1 vs 34.6±3.7 at 12 h, 28.8±3.3 vs 35.7±3.2 at 24 h, 29.2±5.2 vs 36.7±3.3 at 30 h; GEF (%): 17.1±2.7 vs 19.9±1.8 at 6 h, 18.7±1.9 vs 21.6±1.8 at 12 h, 19.3±2.3 vs 23.0±2.4 at 24 h, 21.0±1.7 vs 23.7±1.7 at 30 h; cTnI (pg/mL): 564±51 vs 466±56 at 12 h, 534±38 vs 427±60 at 24 h, 476±55 vs 375±46 at 30 h; CK-MB (U/L): 803±164 vs 652±76 at 12 h, 693±96 vs 557±54 at 24 h, 633±91 vs 480±77 at 30 h, all P<0.05]. Tissue detection indicated that the expression of CaMKⅡ and LC3Ⅱ were increased while the expression of p62 was decreased in post-resuscitation myocardium in the CPR and TH groups compared with the sham group (all P<0.05). However, the expression of CaMKⅡ and LC3Ⅱ were decreased and the expres","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"29 1","pages":"43-48"},"PeriodicalIF":0.0,"publicationDate":"2020-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44494889","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
Selection of enteral nutrition preparations for post-pyloric feeding critical ill patients 幽门后喂养危重病人肠内营养制剂的选择
中华急诊医学杂志 Pub Date : 2020-01-10 DOI: 10.3760/CMA.J.ISSN.1671-0282.2020.01.014
Weiwei Gao, Jianying Kan
{"title":"Selection of enteral nutrition preparations for post-pyloric feeding critical ill patients","authors":"Weiwei Gao, Jianying Kan","doi":"10.3760/CMA.J.ISSN.1671-0282.2020.01.014","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2020.01.014","url":null,"abstract":"Objective \u0000To compare the effects of two different types of enteral nutrition on post-pyloric feeding critical ill patients. \u0000 \u0000 \u0000Methods \u0000A prospective study was conducted to continuously collect 60 critical ill patients with indications of post-pyloric feeding in ICU and NICU wards of our hospital from January 2016 to December 2018. They were randomly (random number) divided into the peptide-based enteral nutrition (PBEN) group and intact protein enteral nutrition (IPEN) group with 30 patients in each group. Enteral nutrition was started immediately within 24 h after the nasointestinal tube was placed, and the PBEN group was treated with peptide-based enteral nutrition, while the IPEN group was treated with intact protein enteral nutrition. The nutritional metabolism index, intestinal barrier index on the 7th and 14th days after enteral nutrition treatment were observed and compared. The enteral feeding complications, incidence of feeding intolerance, gastrointestinal adaptability and 7-day enteral nutrition compliance rate of the two groups during the enteral nutrition were also observed and compared. Chi-square test was used for counting data and t test was used for measuring data. \u0000 \u0000 \u0000Results \u0000On the 7th and 14th days after enteral nutrition therapy, there was no statistical difference in nutritional metabolism indexes between the two groups (P>0.05). In comparison of intestinal barrier indexes, diamine oxidase (DAO) level in the PBEN group was lower than that in the IPEN group at the same time, and the difference was statistically significant [7th day:(6.1±2.9) U/mL vs (7.8±2.7) U/mL, t=-2.354, P=0.019; 14th day: (4.7±1.6) U/mL vs (6.9±2.0) U/mL, t=-3.285, P=0.004]. During enteral nutrition, the diarrhea rate of patients in the PBEN group was slightly higher than that in the IPEN group (6.6% vs 3.3%), while the abdominal distension rate in the IPEN group was slightly higher (3.3% vs 10.0%), but there was no statistical difference between the two groups (P>0.05). The gastrointestinal adaptation time of patients in the PBEN group was significantly shorter than that in the IPEN group [(7.8±1.3) h vs (9.1±2.0) h, t=-2.334, P=0.027]. The 7-day enteral nutrition compliance rate showed no significant difference between the two groups(P>0.05). \u0000 \u0000 \u0000Conclusions \u0000Diarrhea was the main complication in the PBEN group and abdominal distension was the main complication in the IPEN group for post-pyloric feeding critical ill patients. Peptide-based enteral nutrition could repair the intestinal barrier function of post-pyloric feeding critical ill patients and increase the adaptability of gastrointestinal tract in the initial stage of enteral nutrition. \u0000 \u0000 \u0000Key words: \u0000Post-pyloric feeding; Peptide-based enteral nutrition; Intact protein enteral nutrition; Feeding intolerance","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"29 1","pages":"87-91"},"PeriodicalIF":0.0,"publicationDate":"2020-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47350723","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
Investigation of mechanical ventilation pressure parameters’ effect on the prognosis of acute respiratory distress syndrome 机械通气压力参数对急性呼吸窘迫综合征预后影响的研究
中华急诊医学杂志 Pub Date : 2020-01-10 DOI: 10.3760/CMA.J.ISSN.1671-0282.2020.01.019
Wenbo Zhang, Yu Jiang, Xiao-wei Liu
{"title":"Investigation of mechanical ventilation pressure parameters’ effect on the prognosis of acute respiratory distress syndrome","authors":"Wenbo Zhang, Yu Jiang, Xiao-wei Liu","doi":"10.3760/CMA.J.ISSN.1671-0282.2020.01.019","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2020.01.019","url":null,"abstract":"Objective \u0000To find out whether we can get the optimality in the prognosis of acute respiratory distress syndrome (ARDS) by combing the pressure parameters in mechanical ventilation with traditional PaO2/FiO2. \u0000 \u0000 \u0000Methods \u0000This is a retrospective study. Patients included here were diagnosed as ARDS in the Emergency Unit (EICU) of the First Affiliated Hospital of China Medical University from January 2018 to December 2018. All the patients were intubated and mechanically ventilated. Patients with a short observation time (< 48 h) or unable to cooperate with treatment were excluded. According to the patient's 28-day survival, patients were divided into the survival and non-survival groups. Parameters in the two groups such as basic characteristics, SOFA score, non-respiratory system SOFA score (nR-SOFA), and PaO2/FiO2 were analyzed with LSD-t test or rank sum test. Simultaneously, plateau pressure, driving pressure, mean airway pressure and the ratio of these mechanical ventilation pressure parameters to the PaO2/FiO2 were also analyzed. \u0000 \u0000 \u0000Results \u0000A total of 147 patients were included in the study and 117 of them were analyzed. The overall 28-day mortality was 31.62% (n=37). There were no significant differences in gender, age, body mass index, initial arterial oxygen partial pressure and carbon dioxide partial pressure between the survival group and non-survival groups (P >0.05). But there was a significant difference in SOFA score(6.53 ± 2.96 vs 8.65 ± 3.00) and nR -SOFA(3.44 ± 2.98 vs 5.27 ± 2.86). Among the evaluation indexes, the PPOI obtained the AUC of 0.828, with the sensitivity of 86.5%, and specificity of 71.2%.The AUC of the SOFA score was 0.707, while the AUC of the PPOI combined with the SOFA score was 0.833. \u0000 \u0000 \u0000Conclusion \u0000Mechanical ventilation pressure parameters can be used to predict the prognosis of patients with ARDS. PPOI may evaluate the prognosis of ARDS in a more simple, timely and real-time manner. \u0000 \u0000 \u0000Key words: \u0000Acute respiratory distress syndrome; Plateau pressure; Driving pressure; Mean airway pressure; Plateau pressure oxygenation index; Prognosis","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"29 1","pages":"121-125"},"PeriodicalIF":0.0,"publicationDate":"2020-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44318668","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: 1
Cognitive survey of telephone cardiopulmonary resuscitation among emergency personnel 急救人员电话心肺复苏认知调查
中华急诊医学杂志 Pub Date : 2020-01-10 DOI: 10.3760/CMA.J.ISSN.1671-0282.2020.01.007
Junhong Wang, K. Zheng, Xiaodan Li, Q. Ma, Jinjun Zhang
{"title":"Cognitive survey of telephone cardiopulmonary resuscitation among emergency personnel","authors":"Junhong Wang, K. Zheng, Xiaodan Li, Q. Ma, Jinjun Zhang","doi":"10.3760/CMA.J.ISSN.1671-0282.2020.01.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2020.01.007","url":null,"abstract":"Objectives \u0000To investigate the cognition of dispatcher-initiated telephone cardiopulmonary resuscitation (TCPR) among emergency medical system(EMS) personnel and compare the cognition of TCPR among EMS personnel in different economic status, and to understand the current situation of TCPR cognition of EMS personnel in China. \u0000 \u0000 \u0000Methods \u0000This study is a multicenter cross-sectional survey. The method of multi-level convenient sampling was adopted, and the test reliability and split half reliability of the questionnaire was tested. Questionnaire survey and data collection were conducted from December 2018 to June 2019. The ethical approval number is M2018264. SPSS 20.0 was used for analysis. χ2 test was used to analyze the differences between groups. \u0000 \u0000 \u0000Results \u0000A total of 1 191 electronic questionnaires were collected. Of them, 80.94% respondents knew TCPR, 97.82% respondents thought that TCPR should be implemented in cardiac arrest, 36.62% respondents thought that bystander cardiopulmonary resuscitation quality monitoring was needed in TCPR, and TCPR training courses were set up in the emergency department which recruited 25.83% respondents. Emergency personnel in developed areas had a better understanding of the criteria for judging patients' breathlessness (11.69% vs 7.89%, P=0.048), of TCPR need ncluding guidance of chest compression (92.45% vs 87.49%, P=0.012) and of bystander cardiopulmonary resuscitation (BCPR) quality monitoring including the frequency of artificial respiration (84.42% vs 74.87%, P=0.029) than those in underdeveloped areas, but there was no significant difference in other indicators (P>0.05). \u0000 \u0000 \u0000Conclusions \u0000TCPR knowledge of EMS personnel in China is unsatisfactory. Further training is needed to improve their understanding of the criteria for judging cardiac arrest in out-of-hospital cardiac arrest patients via telephone, TCPR content and bystander cardiopulmonary resuscitation quality monitoring. There is difference in TCPR knowledge between the EMS personnel in developed and undeveloped areas in China. \u0000 \u0000 \u0000Key words: \u0000Emergency medical services; Telephone guidance; Cardiopulmonary resuscitation; Bystander; Out-of-hospital cardiac arrest; Cognition; Economic status; Cross-sectional survey","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"29 1","pages":"49-53"},"PeriodicalIF":0.0,"publicationDate":"2020-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46796020","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: 1
Effects of estrogen-related receptor alpha on inflammatory response in pulmonary microvascular endothelial cells 雌激素相关受体α对肺微血管内皮细胞炎症反应的影响
中华急诊医学杂志 Pub Date : 2020-01-10 DOI: 10.3760/CMA.J.ISSN.1671-0282.2020.01.010
W. Xia, Zhou Pan, Huanming Zhang, Guang Li, Qingshan Zhou
{"title":"Effects of estrogen-related receptor alpha on inflammatory response in pulmonary microvascular endothelial cells","authors":"W. Xia, Zhou Pan, Huanming Zhang, Guang Li, Qingshan Zhou","doi":"10.3760/CMA.J.ISSN.1671-0282.2020.01.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2020.01.010","url":null,"abstract":"Objective \u0000To investigate the effect of estrogen-related receptor alpha(ERRα)on lipopolysaccharide-induced inflammatory response in rat pulmonary microvascular endothelial cells (PMVECs) and its mechanism. \u0000 \u0000 \u0000Methods \u0000PMVECs were cultured in vitro. When the cells were in the logarithmic growth phase, the cell were ransfected with lentivirus, and a stable low-expression ERRα cell line was constructed. The cells were divided into four groups: Ctr group (normal control group), Ctr+LPS group (normal cell+LPS treatment group), shERRα1 (shERRα1 gene knockdown group), and shERRα1+LPS group (shERRα1 gene knockdown +LPS treatment group). After 20 μg/mL LPS stimulated cells in the control group and shERRα1 group for 6, 12 and 24 h, cell counting kit-8 (cck-8) was used to detect the cell proliferation ability of each group, and enzyme-linked immunosorbent assay (ELISA) was used to detect the concentrations of tumor necrosis factor alpha (TNF-α) and Interleukin-1β (IL-1β) in cell culture fluid. After 12 h LPS stimulation, the expression levels of ERRα and NF-κB related proteins (p-p65, p65, P-IKBα, IKBα) were measured by Western blot. Pairwise comparisons were performed with SNK-q test (two-tailed), and multiple-group comparisons were performed with one-way ANOVA. The non-parametric test of rank transformation was used when homogeneity of variance were not met. P value<0.05 was considered significantly different. \u0000 \u0000 \u0000Results \u0000Compared with the control group, ERRα expression in the shERRα group was significantly decreased (0.09±0.01 vs 0.15±0.01). At 6, 12 and 24 h after LPS stimulation, compared with the control group, the cell proliferation ability (%) of the shERRα1+LPS group was significantly reduced (99.68±4.53 vs 48.62±1.60) and the concentration of TNF-α (ng/mL) (15.76±3.38 vs 5 498.91±367.95) and IL-1β (ng/mL) (14.41±3.86 vs 6 014.92±277.33) in the cell culture supernatant were significantly increased. The change was most obvious after 12 h stimulation. Meanwhile the expression of p-p65 (0.30±0.50 vs 1.05±0.07) and p-IKBα (0.27±0.04 vs 0.77±0.06) were increased significantly, while the expression of IKBα (0.96±0.07 vs 0.14±0.04) was decreased significantly in the shERRα1+LPS group (all P<0.05). \u0000 \u0000 \u0000Conclusion \u0000ERRα gene attenuates LPS-induced inflammatory response in rat pulmonary microvascular endothelial cells by inhibiting NF-κB signaling pathway activation. \u0000 \u0000 \u0000Key words: \u0000Sepsis; Estrogen-related receptor alpha; NF-κB pathway; Gene knockdown","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"29 1","pages":"65-70"},"PeriodicalIF":0.0,"publicationDate":"2020-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46434562","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
Investigation on compliance with sepsis bundle and outcomes in patients with septic shock in Changshu area 常熟地区脓毒症休克患者脓毒症治疗依从性及预后调查
中华急诊医学杂志 Pub Date : 2020-01-01 DOI: 10.3760/cma.j.issn.1671-0282.2020.05.017
Sun Yu
{"title":"Investigation on compliance with sepsis bundle and outcomes in patients with septic shock in Changshu area","authors":"Sun Yu","doi":"10.3760/cma.j.issn.1671-0282.2020.05.017","DOIUrl":"https://doi.org/10.3760/cma.j.issn.1671-0282.2020.05.017","url":null,"abstract":"Objective: To perform a statistical analysis of the ABO blood group distribution of COVID-19 convalescents, and further analyze the ABO blood group distribution in COVID-l9 convalescents with different plasma antibody titer against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-Z).","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"29 1","pages":"700-706"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69953706","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
The comparative study between thromboelastography and conventional coagulation tests in ischemic cerebral vascular disease 缺血性脑血管病血栓弹性成像与常规凝血试验的比较研究
中华急诊医学杂志 Pub Date : 2019-12-10 DOI: 10.3760/CMA.J.ISSN.1671-0282.2019.12.006
Bin Yan, Tianxi Hu, Xin Li, Shi-qi Lu, Qi Wang, Guangjian Xu, Shu-Fang Pei, Yiming Zhao, C. Ruan
{"title":"The comparative study between thromboelastography and conventional coagulation tests in ischemic cerebral vascular disease","authors":"Bin Yan, Tianxi Hu, Xin Li, Shi-qi Lu, Qi Wang, Guangjian Xu, Shu-Fang Pei, Yiming Zhao, C. Ruan","doi":"10.3760/CMA.J.ISSN.1671-0282.2019.12.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2019.12.006","url":null,"abstract":"Objective To explore the correlation and consistency between thromboelastography (TEG) and traditional coagulation tests (CCTs) in ischemic cerebral vascular disease (ICVD). Methods Totally 108 ICVD patients admitted to Nanyang Central Hospital from May 1 to October 31 2018 were enrolled. Patients’ TEG parameters (R value, K value, Angle value, MA value, CI value and G value) and CCTs parameters (PT, APTT, TT, and FIB) were collected and analyzed retrospectively. The Spearman correlation coefficient was used to explore the correlation between TEG and CCTs parameters, and Kappa (κ) to explore the consistency in determining the coagulation status of the patients. The ROC curve was used to analyze the predictive value of TEG parameters for abnormal results of CCTs, and the results of TEG and CCTs were comprehensively analyzed to evaluate the ability to predict the coagulation status of patients. Results (1) PLT was positively correlated with MA value and G value; PT and APTT were positively correlated with K value; TT was positively correlated with R value and K value; FIB was positively correlated with Angle value, MA value and G value. TT was negatively correlated with Angle value and CI value; FIB was negatively correlated with K value. (2) PT and MA values, PT and G values, FIB and MA values, FIB and G values were accordant in valuing the hypoxic state of ICVD patients. (3) PLT and Angle values, PLT and MA values, PLT and CI values, PLT and G values were accordant in assessing hypercoagulable status of ICVD patients; FIB and Angle values, FIB and MA values, FIB and CI value, and FIB and G value were consistent in evaluating the hypercoagulable state of ICVD patients. (4) For detecting TT>20 s, the AUC of K value and Angle value were 0.648, 0.651, respectively; For detecting FIB>4 g/L, the AUC of Angle value and MA value were 0.717 and 0.747, respectively; For detecting PLT>300×109/L, the AUC of MA value was 0.808 (all P<0.05). Conclusions There is weak correlation and consistency between TEG and CCTs parameters in ICVD patients. The TEG parameters have good predictive value in evaluating the abnormal results of CCTs, but cannot replace the CCTs. Combination of these two methods can better reflect the coagulation status of patients, so as to afford assistance. Key words: Thromboelastography; Conventional coagulation tests; Ischemic cerebral vascular disease; Ischemic stroke; Comparation","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"28 1","pages":"1490-1495"},"PeriodicalIF":0.0,"publicationDate":"2019-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48191710","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}
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