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Mechanism of lactic acidemia-promoted pulmonary endothelial cells death in sepsis: role for CIRP-ZBP1-PANoptosis pathway. 脓毒症中乳酸血症促进肺内皮细胞死亡的机制:CIRP-ZBP1-PAN凋亡途径的作用
IF 16.7 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-28 DOI: 10.1186/s40779-024-00574-z
Ting Gong, Qing-De Wang, Patricia A Loughran, Yue-Hua Li, Melanie J Scott, Timothy R Billiar, You-Tan Liu, Jie Fan

Background: Sepsis is often accompanied by lactic acidemia and acute lung injury (ALI). Clinical studies have established that high serum lactate levels are associated with increased mortality rates in septic patients. We further observed a significant correlation between the levels of cold-inducible RNA-binding protein (CIRP) in plasma and bronchoalveolar lavage fluid (BALF), as well as lactate levels, and the severity of post-sepsis ALI. The underlying mechanism, however, remains elusive.

Methods: C57BL/6 wild type (WT), Casp8-/-, Ripk3-/-, and Zbp1-/- mice were subjected to the cecal ligation and puncture (CLP) sepsis model. In this model, we measured intra-macrophage CIRP lactylation and the subsequent release of CIRP. We also tracked the internalization of extracellular CIRP (eCIRP) in pulmonary vascular endothelial cells (PVECs) and its interaction with Z-DNA binding protein 1 (ZBP1). Furthermore, we monitored changes in ZBP1 levels in PVECs and the consequent activation of cell death pathways.

Results: In the current study, we demonstrate that lactate, accumulating during sepsis, promotes the lactylation of CIRP in macrophages, leading to the release of CIRP. Once eCIRP is internalized by PVEC through a Toll-like receptor 4 (TLR4)-mediated endocytosis pathway, it competitively binds to ZBP1 and effectively blocks the interaction between ZBP1 and tripartite motif containing 32 (TRIM32), an E3 ubiquitin ligase targeting ZBP1 for proteasomal degradation. This interference mechanism stabilizes ZBP1, thereby enhancing ZBP1-receptor-interacting protein kinase 3 (RIPK3)-dependent PVEC PANoptosis, a form of cell death involving the simultaneous activation of multiple cell death pathways, thereby exacerbating ALI.

Conclusions: These findings unveil a novel pathway by which lactic acidemia promotes macrophage-derived eCIRP release, which, in turn, mediates ZBP1-dependent PVEC PANoptosis in sepsis-induced ALI. This finding offers new insights into the molecular mechanisms driving sepsis-related pulmonary complications and provides potential new therapeutic strategies.

背景:脓毒症通常伴有乳酸血症和急性肺损伤(ALI)。临床研究证实,高血清乳酸水平与脓毒症患者死亡率的增加有关。我们进一步观察到,血浆和支气管肺泡灌洗液(BALF)中冷诱导 RNA 结合蛋白(CIRP)的水平以及乳酸水平与败血症后 ALI 的严重程度之间存在明显的相关性。然而,其潜在机制仍难以捉摸:方法:对 C57BL/6 野生型(WT)、Casp8-/-、Ripk3-/- 和 Zbp1-/- 小鼠进行盲肠结扎和穿刺(CLP)败血症模型试验。在该模型中,我们测量了巨噬细胞内 CIRP 乳化及随后的 CIRP 释放。我们还追踪了肺血管内皮细胞(PVECs)细胞外 CIRP(eCIRP)的内化及其与 Z-DNA 结合蛋白 1(ZBP1)的相互作用。此外,我们还监测了肺血管内皮细胞中 ZBP1 水平的变化以及随之激活的细胞死亡途径:在当前的研究中,我们证明脓毒症期间积累的乳酸可促进巨噬细胞中 CIRP 的乳化,从而导致 CIRP 的释放。一旦 eCIRP 通过 Toll 样受体 4(TLR4)介导的内吞途径被 PVEC 内化,它就会竞争性地与 ZBP1 结合,并有效地阻断 ZBP1 与包含三方基序 32(TRIM32)的 E3 泛素连接酶之间的相互作用,TRIM32 是一种靶向 ZBP1 进行蛋白酶体降解的 E3 泛素连接酶。这种干扰机制稳定了 ZBP1,从而增强了 ZBP1-受体相互作用蛋白激酶 3(RIPK3)依赖的 PVEC PANoptosis(一种涉及同时激活多种细胞死亡途径的细胞死亡形式),从而加剧了 ALI:这些发现揭示了一种新的途径,即乳酸血症促进巨噬细胞衍生的 eCIRP 释放,进而在败血症诱导的 ALI 中介导 ZBP1 依赖性 PVEC PAN 细胞凋亡。这一发现为脓毒症相关肺部并发症的分子机制提供了新的见解,并提供了潜在的新治疗策略。
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引用次数: 0
International Alliance of Urolithiasis (IAU) consensus on miniaturized percutaneous nephrolithotomy. 国际泌尿系结石联盟(IAU)关于微型经皮肾镜取石术的共识。
IF 16.7 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-28 DOI: 10.1186/s40779-024-00562-3
Guo-Hua Zeng, Wen Zhong, Giorgio Mazzon, Wei Zhu, Sven Lahme, Sanjay Khadgi, Janak Desai, Madhu Agrawal, David Schulsinger, Mantu Gupta, Emanuele Montanari, Juan Manuel Lopez Martinez, Shabir Almousawi, Vincent Emanuel F Malonzo, Seshadri Sriprasad, Otas Durutovic, Vimoshan Arumuham, Stefania Ferretti, Wissam Kamal, Ke-Wei Xu, Fan Cheng, Xiao-Feng Gao, Ji-Wen Cheng, Bhaskar Somani, Mordechai Duvdevani, Kah Ann Git, Christian Seitz, Norberto Bernardo, Tarek Ahmed Amin Ibrahim, Albert Aquino, Takahiro Yasui, Cristian Fiori, Thomas Knoll, Athanasios Papatsoris, Nariman Gadzhiev, Ulanbek Zhanbyrbekuly, Oriol Angerri, Hugo Lopez Ramos, Iliya Saltirov, Mohamad Moussa, Guido Giusti, Fabio Vicentini, Edgar Beltran Suarez, Margaret Pearle, Glenn M Preminger, Qing-Hui Wu, Otas Durutovic, Khurshid Ghani, Marcus Maroccolo, Marianne Brehmer, Palle J Osther, Marek Zawadzki, Azimdjon Tursunkulov, Monolov Nurbek Kytaibekovich, Abdusamad Abdukakhorovich Abuvohidov, Cesar Antonio Recalde Lara, Zamari Noori, Stefano Paolo Zanetti, Sunil Shrestha, Jean de la Rosette, John Denstedt, Zhang-Qun Ye, Kemal Sarica, Simon Choong

Over the past three decades, there has been increasing interest in miniaturized percutaneous nephrolithotomy (mPCNL) techniques featuring smaller tracts as they offer potential solutions to mitigate complications associated with standard PCNL (sPCNL). However, despite this growing acceptance and recognition of its benefits, unresolved controversies and acknowledged limitations continue to impede widespread adoption due to a lack of consensus on optimal perioperative management strategies and procedural tips and tricks. In response to these challenges, an international panel comprising experts from the International Alliance of Urolithiasis (IAU) took on the task of compiling an expert consensus document on mPCNL procedures aimed at providing urologists with a comprehensive clinical framework for practice. This endeavor involved conducting a systematic literature review to identify research gaps (RGs), which formed the foundation for developing a structured questionnaire survey. Subsequently, a two-round modified Delphi survey was implemented, culminating in a group meeting to generate final evidence-based comments. All 64 experts completed the second-round survey, resulting in a response rate of 100.0%. Fifty-eight key questions were raised focusing on mPCNLs within 4 main domains, including general information (13 questions), preoperative work-up (13 questions), procedural tips and tricks (19 questions), and postoperative evaluation and follow-up (13 questions). Additionally, 9 questions evaluated the experts' experience with PCNLs. Consensus was reached on 30 questions after the second-round survey, while professional statements for the remaining 28 key questions were provided after discussion in an online panel meeting. mPCNL, characterized by a tract smaller than 18 Fr and an innovative lithotripsy technique, has firmly established itself as a viable and effective approach for managing upper urinary tract stones in both adults and pediatrics. It offers several advantages over sPCNL including reduced bleeding, fewer requirements for nephrostomy tubes, decreased pain, and shorter hospital stays. The series of detailed techniques presented here serve as a comprehensive guide for urologists, aiming to improve their procedural understanding and optimize patient outcomes.

在过去的三十年里,人们越来越关注以小通道为特点的微型经皮肾镜碎石术(mPCNL)技术,因为这些技术为减轻与标准 PCNL(sPCNL)相关的并发症提供了潜在的解决方案。然而,尽管人们越来越接受并认识到它的好处,但由于对最佳围手术期管理策略和手术技巧缺乏共识,尚未解决的争议和公认的局限性仍阻碍着它的广泛应用。为了应对这些挑战,一个由国际泌尿系结石联盟(IAU)专家组成的国际小组承担了编纂一份有关 mPCNL 手术的专家共识文件的任务,旨在为泌尿科医生提供一个全面的临床实践框架。这项工作包括进行系统的文献综述以确定研究差距 (RG),这为制定结构化问卷调查奠定了基础。随后,进行了两轮修改后的德尔菲调查,最后召开小组会议,提出以证据为基础的最终意见。所有 64 位专家都完成了第二轮调查,回复率为 100.0%。调查共提出了 58 个关键问题,这些问题主要涉及 mPCNL 的 4 个主要领域,包括一般信息(13 个问题)、术前检查(13 个问题)、手术技巧和窍门(19 个问题)以及术后评估和随访(13 个问题)。此外,还有 9 个问题评估了专家们在 PCNL 方面的经验。mPCNL 的特点是结石道小于 18 Fr,并采用了创新的碎石技术,现已成为治疗成人和儿童上尿路结石的一种可行而有效的方法。与 sPCNL 相比,该方法具有多项优势,包括减少出血、减少对肾造瘘管的需求、减轻疼痛和缩短住院时间。本文介绍的一系列详细技术可作为泌尿科医生的综合指南,旨在提高他们对手术的理解,优化患者的治疗效果。
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引用次数: 0
Microenvironment-responsive nanomedicines: a promising direction for tissue regeneration. 微环境响应纳米药物:组织再生的一个前景广阔的方向。
IF 16.7 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-21 DOI: 10.1186/s40779-024-00573-0
Yuan Xiong, Bo-Bin Mi, Mohammad-Ali Shahbazi, Tian Xia, Jun Xiao

Severe tissue defects present formidable challenges to human health, persisting as major contributors to mortality rates. The complex pathological microenvironment, particularly the disrupted immune landscape within these defects, poses substantial hurdles to existing tissue regeneration strategies. However, the emergence of nanobiotechnology has opened a new direction in immunomodulatory nanomedicine, providing encouraging prospects for tissue regeneration and restoration. This review aims to gather recent advances in immunomodulatory nanomedicine to foster tissue regeneration. We begin by elucidating the distinctive features of the local immune microenvironment within defective tissues and its crucial role in tissue regeneration. Subsequently, we explore the design and functional properties of immunomodulatory nanosystems. Finally, we address the challenges and prospects of clinical translation in nanomedicine development, aiming to propose a potent approach to enhance tissue regeneration through synergistic immune modulation and nanomedicine integration.

严重的组织缺陷给人类健康带来了严峻的挑战,一直是造成死亡率的主要因素。复杂的病理微环境,尤其是这些缺陷内紊乱的免疫环境,对现有的组织再生策略构成了巨大障碍。然而,纳米生物技术的出现为免疫调节纳米医学开辟了一个新方向,为组织再生和修复提供了令人鼓舞的前景。本综述旨在收集免疫调节纳米医学在促进组织再生方面的最新进展。首先,我们将阐明缺损组织内局部免疫微环境的独特特征及其在组织再生中的关键作用。随后,我们探讨了免疫调节纳米系统的设计和功能特性。最后,我们探讨了纳米药物开发中临床转化的挑战和前景,旨在提出一种通过协同免疫调节和纳米药物整合来促进组织再生的有效方法。
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引用次数: 0
Cardiovascular adaptations and pathological changes induced by spaceflight: from cellular mechanisms to organ-level impacts. 太空飞行引起的心血管适应和病理变化:从细胞机制到器官层面的影响。
IF 16.7 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-27 DOI: 10.1186/s40779-024-00570-3
Han Han, Hao Jia, Yi-Fan Wang, Jiang-Ping Song

The advancement in extraterrestrial exploration has highlighted the crucial need for studying how the human cardiovascular system adapts to space conditions. Human development occurs under the influence of gravity, shielded from space radiation by Earth's magnetic field, and within an environment characterized by 24-hour day-night cycles resulting from Earth's rotation, thus deviating from these conditions necessitates adaptive responses for survival. With upcoming manned lunar and Martian missions approaching rapidly, it is essential to understand the impact of various stressors induced by outer-space environments on cardiovascular health. This comprehensive review integrates insights from both actual space missions and simulated experiments on Earth, to analyze how microgravity, space radiation, and disrupted circadian affect cardiovascular well-being. Prolonged exposure to microgravity induces myocardial atrophy and endothelial dysfunction, which may be exacerbated by space radiation. Mitochondrial dysfunction and oxidative stress emerge as key underlying mechanisms along with disturbances in ion channel perturbations, cytoskeletal damage, and myofibril changes. Disruptions in circadian rhythms caused by factors such as microgravity, light exposure, and irregular work schedules, could further exacerbate cardiovascular issues. However, current research tends to predominantly focus on disruptions in the core clock gene, overlooking the multifactorial nature of circadian rhythm disturbances in space. Future space missions should prioritize targeted prevention strategies and early detection methods for identifying cardiovascular risks, to preserve astronaut health and ensure mission success.

地外探索的进展凸显了研究人类心血管系统如何适应太空条件的迫切需要。人类是在重力影响下发育的,地球磁场屏蔽了太空辐射,地球自转导致 24 小时昼夜循环,因此偏离这些条件必须做出适应性反应才能生存。随着即将到来的载人登月和火星任务的迅速逼近,了解外太空环境诱发的各种压力源对心血管健康的影响至关重要。本综述综合了实际太空任务和地球模拟实验的见解,分析了微重力、太空辐射和昼夜节律紊乱如何影响心血管健康。长期暴露在微重力环境中会诱发心肌萎缩和内皮功能障碍,而太空辐射可能会加剧这种情况。线粒体功能障碍和氧化应激以及离子通道扰动、细胞骨架损伤和肌纤维变化是关键的潜在机制。微重力、光照和不规律的工作时间等因素造成的昼夜节律紊乱可能会进一步加剧心血管问题。然而,目前的研究往往主要集中在核心时钟基因的干扰上,忽略了太空中昼夜节律紊乱的多因素性质。未来的太空任务应优先考虑有针对性的预防策略和识别心血管风险的早期检测方法,以保护宇航员的健康,确保任务的成功。
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引用次数: 0
Sexual dimorphism in the relationship between BMI and recent suicidal attempts in first-episode drug-naïve patients with major depressive disorder. 重度抑郁障碍首次服药患者的体重指数与近期自杀企图之间的性别二态性。
IF 16.7 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-26 DOI: 10.1186/s40779-024-00572-1
Ze-Zhi Li, Yu-Ping Chen, Xiao-Cui Zang, Denise Zheng, Xiao-E Lang, Yong-Jie Zhou, Feng-Chun Wu, Xiang-Yang Zhang
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引用次数: 0
Tackling exosome and nuclear receptor interaction: an emerging paradigm in the treatment of chronic diseases. 解决外泌体与核受体相互作用的问题:治疗慢性疾病的新兴范例。
IF 16.7 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-26 DOI: 10.1186/s40779-024-00564-1
Babu Santha Aswani, Mangala Hegde, Ravichandran Vishwa, Mohammed S Alqahtani, Mohamed Abbas, Hassan Ali Almubarak, Gautam Sethi, Ajaikumar B Kunnumakkara

Nuclear receptors (NRs) function as crucial transcription factors in orchestrating essential functions within the realms of development, host defense, and homeostasis of body. NRs have garnered increased attention due to their potential as therapeutic targets, with drugs directed at NRs demonstrating significant efficacy in impeding chronic disease progression. Consequently, these pharmacological agents hold promise for the treatment and management of various diseases. Accumulating evidence emphasizes the regulatory role of exosome-derived microRNAs (miRNAs) in chronic inflammation, disease progression, and therapy resistance, primarily by modulating transcription factors, particularly NRs. By exploiting inflammatory pathways such as protein kinase B (Akt)/mammalian target of rapamycin (mTOR), nuclear factor kappa-B (NF-κB), signal transducer and activator of transcription 3 (STAT3), and Wnt/β-catenin signaling, exosomes and NRs play a pivotal role in the panorama of development, physiology, and pathology. The internalization of exosomes modulates NRs and initiates diverse autocrine or paracrine signaling cascades, influencing various processes in recipient cells such as survival, proliferation, differentiation, metabolism, and cellular defense mechanisms. This comprehensive review meticulously examines the involvement of exosome-mediated NR regulation in the pathogenesis of chronic ailments, including atherosclerosis, cancer, diabetes, liver diseases, and respiratory conditions. Additionally, it elucidates the molecular intricacies of exosome-mediated communication between host and recipient cells via NRs, leading to immunomodulation. Furthermore, it outlines the implications of exosome-modulated NR pathways in the prophylaxis of chronic inflammation, delineates current limitations, and provides insights into future perspectives. This review also presents existing evidence on the role of exosomes and their components in the emergence of therapeutic resistance.

核受体(NRs)是协调人体发育、宿主防御和体内平衡等重要功能的关键转录因子。NRs 因其作为治疗靶点的潜力而受到越来越多的关注,针对 NRs 的药物在阻碍慢性疾病进展方面具有显著疗效。因此,这些药理制剂有望治疗和控制各种疾病。不断积累的证据强调了外泌体衍生的微小核糖核酸(miRNA)在慢性炎症、疾病进展和耐药性中的调控作用,主要是通过调节转录因子,特别是 NRs。通过利用蛋白激酶 B(Akt)/哺乳动物雷帕霉素靶标(mTOR)、核因子卡巴-B(NF-κB)、转录信号转导和激活因子 3(STAT3)以及 Wnt/β-catenin 信号转导等炎症通路,外泌体和 NRs 在发育、生理和病理全景中发挥着关键作用。外泌体的内化会调节 NRs 并启动多种自分泌或旁分泌信号级联,影响受体细胞的各种过程,如存活、增殖、分化、新陈代谢和细胞防御机制。这篇综合性综述细致研究了外泌体介导的 NR 调节参与动脉粥样硬化、癌症、糖尿病、肝病和呼吸系统疾病等慢性疾病的发病机制。此外,它还阐明了外泌体介导的宿主和受体细胞之间通过 NRs 进行交流并导致免疫调节的复杂分子机制。此外,它还概述了外泌体调控的 NR 通路在预防慢性炎症方面的意义、目前的局限性,并提供了对未来前景的见解。本综述还介绍了关于外泌体及其成分在治疗耐药性出现中的作用的现有证据。
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引用次数: 0
FOXO1-expressing neutrophils: a double-edged sword in traumatic brain injury 表达 FOXO1 的中性粒细胞:创伤性脑损伤中的双刃剑
IF 21.1 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-19 DOI: 10.1186/s40779-024-00571-2
Dong-Dong Yang, Meng Zhao, Jia-Xiu Du, Yu Shi
<p>Traumatic brain injury (TBI) remains a prominent global cause of mortality and disability, accounting for an estimated 69 million new cases annually [1]. Both civilian and military populations face substantial health challenges due to TBI, particularly in military settings, where combat-related injuries introduce unique considerations for prevalence and management [2]. Despite notable advancements in acute care, our comprehension of the complex pathophysiological mechanisms underlying the long-term effects of TBI remains inadequate [3]. Although the initial mechanical impact triggers the cascade of injury, it is often the subsequent neuroinflammatory processes that propel progressive neuronal damage and lead to long-term neurological impairments [4, 5].</p><p>Neutrophils, the most prevalent circulating leukocytes and first-line defenders against pathogens, have long been recognized as key players in the acute inflammatory response following TBI [6]. Although their rapid infiltration into the injured cerebral tissue is crucial for debris clearance and the initiation of repair mechanisms, excessive or prolonged activation of neutrophils may exacerbate tissue damage and lead to poorer clinical outcomes.</p><p>The groundbreaking research conducted by Zhou et al. [7] published in <i>Military Medical Research</i> unveiled novel insights into the dual role of neutrophils in TBI. They identified a distinct subpopulation of neutrophils characterized by elevated expression of the transcription factor forkhead box protein O1 (FOXO1). This FOXO1-high neutrophil subpopulation predominates during the acute neuroinflammatory response and, unexpectedly, persists into the chronic phase, thereby challenging the traditional perception of neutrophils as short-lived effector cells. These cells exhibit unique characteristics that contribute to both acute and chronic TBI pathologies. In the acute phase, they exacerbate immediate cerebral damage. Conversely, in the chronic phase, FOXO1-high neutrophils disrupt iron homeostasis with oligodendrocytes through the FOXO1-transferrin receptor axis, resulting in myelin loss and depression-like behaviors. This innovative perspective on neutrophil-oligodendrocyte interactions illuminates the intricate crosstalk between immune responses and nervous system functions following TBI, thus emphasizing the multifaceted role of neutrophils in chronic neuroinflammation.</p><p>Zhou et al. [7] also elucidated the molecular mechanisms that underpin the distinctive characteristics of FOXO1-high neutrophils in TBI pathogenesis. Mechanistically, their research revealed that FOXO1 directly enhances both the anti-apoptotic capacity and interleukin-6 production in neutrophils by upregulating the novel target gene <i>versican</i> (<i>VCAN</i>) during the acute phase. Additionally, they demonstrated that FOXO1 induces a metabolic shift from glycolysis to aerobic oxidation in neutrophils. This metabolic reprogramming may contribute to the altered
作者及工作单位河南中医药大学第五临床医学院(郑州市人民医院)神经内科,郑州,450000杨冬冬,赵萌&amp;杜家秀南方医科大学珠江医院康复科,广州,510282、中国Yu Shi作者Dong-Dong Yang查看作者发表的论文您也可以在PubMed Google Scholar中搜索该作者Meng Zhao查看作者发表的论文您也可以在PubMed Google Scholar中搜索该作者Jia-Xiu Du查看作者发表的论文您也可以在PubMed Google Scholar中搜索该作者Yu Shi查看作者发表的论文您也可以在PubMed Google Scholar中搜索该作者ContributionsDDY、MZ、JXD和YS起草了原稿。开放获取本文采用知识共享署名 4.0 国际许可协议进行许可,该协议允许以任何媒介或格式使用、共享、改编、分发和复制,只要您适当注明原作者和来源,提供知识共享许可协议的链接,并说明是否进行了修改。本文中的图片或其他第三方材料均包含在文章的知识共享许可协议中,除非在材料的署名栏中另有说明。如果材料未包含在文章的知识共享许可协议中,且您打算使用的材料不符合法律规定或超出许可使用范围,您需要直接从版权所有者处获得许可。如需查看该许可的副本,请访问 http://creativecommons.org/licenses/by/4.0/。创意共享公共领域专用免责声明(http://creativecommons.org/publicdomain/zero/1.0/)适用于本文提供的数据,除非在数据的信用行中另有说明。转载与授权引用本文Yang, DD., Zhao, M., Du, JX. et al. FOXO1-expressing neutrophils: a double-edged sword in traumatic brain injury.军事医学研究 11, 65 (2024). https://doi.org/10.1186/s40779-024-00571-2Download citationReceived:30 July 2024Accepted:05 September 2024Published: 19 September 2024DOI: https://doi.org/10.1186/s40779-024-00571-2Share this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard Provided by the Springer Nature SharedIt content-sharing initiative Keywords创伤性脑损伤(TBI)FOXO1-高表达中性粒细胞神经炎症急性脑损伤
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引用次数: 0
Global burden of benign prostatic hyperplasia, urinary tract infections, urolithiasis, bladder cancer, kidney cancer, and prostate cancer from 1990 to 2021 1990 至 2021 年良性前列腺增生、尿路感染、尿路结石、膀胱癌、肾癌和前列腺癌的全球负担情况
IF 21.1 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-18 DOI: 10.1186/s40779-024-00569-w
Hao Zi, Meng-Yang Liu, Li-Sha Luo, Qiao Huang, Peng-Cheng Luo, Hang-Hang Luan, Jiao Huang, Dan-Qi Wang, Yong-Bo Wang, Yuan-Yuan Zhang, Ren-Peng Yu, Yi-Tong Li, Hang Zheng, Tong-Zu Liu, Yu Fan, Xian-Tao Zeng
The burden of common urologic diseases, including benign prostatic hyperplasia (BPH), urinary tract infections (UTI), urolithiasis, bladder cancer, kidney cancer, and prostate cancer, varies both geographically and within specific regions. It is essential to conduct a comprehensive and precise assessment of the global burden of urologic diseases. We obtained data on incidence, prevalence, mortality, and disability-adjusted life-years (DALYs) for the aforementioned urologic diseases by age, sex, location, and year from the Global Burden of Disease (GBD) 2021. We analyzed the burden associated with urologic diseases based on socio-demographic index (SDI) and attributable risk factors. The trends in burden over time were assessed using estimated annual percentage changes (EAPC) along with a 95% confidence interval (CI). In 2021, BPH and UTI were the leading causes of age-standardized incidence rate (ASIR) and age-standardized prevalence rate (ASPR), with rates of 5531.88 and 2782.59 per 100,000 persons, respectively. Prostate cancer was the leading cause of both age-standardized mortality rate (ASMR) and age-standardized DALYs rate (ASDR), with rates of 12.63 and 217.83 per 100,000 persons, respectively. From 1990 to 2021, there was an upward trend in ASIR, ASPR, ASMR, and ASDR for UTI, while urolithiasis showed a downward trend. The middle and low-middle SDI quintile levels exhibited higher incidence, prevalence, mortality, and DALYs related to UTI, urolithiasis, and BPH, while the high and high-middle SDI quintile levels showed higher rates for the three cancers. The burden of these six urologic diseases displayed diverse age and sex distribution patterns. In 2021, a high body mass index (BMI) contributed to 20.07% of kidney cancer deaths worldwide, while smoking accounted for 26.48% of bladder cancer deaths and 3.00% of prostate cancer deaths. The global burden of 6 urologic diseases presents a significant public health challenge. Urgent international collaboration is essential to advance the improvement of urologic disease management, encompassing the development of effective diagnostic screening tools and the implementation of high-quality prevention and treatment strategies.
常见的泌尿系统疾病,包括良性前列腺增生症(BPH)、尿路感染(UTI)、尿路结石、膀胱癌、肾癌和前列腺癌,其负担因地理位置和特定地区而异。对泌尿系统疾病的全球负担进行全面而精确的评估至关重要。我们从《2021 年全球疾病负担》(GBD)中获得了按年龄、性别、地区和年份分列的上述泌尿系统疾病的发病率、流行率、死亡率和残疾调整生命年(DALYs)数据。我们根据社会人口指数(SDI)和可归因风险因素分析了与泌尿系统疾病相关的负担。我们使用估算的年度百分比变化(EAPC)和 95% 的置信区间(CI)评估了随着时间推移的负担趋势。2021 年,前列腺增生症和UTI 是导致年龄标准化发病率(ASIR)和年龄标准化患病率(ASPR)的主要原因,发病率分别为每 10 万人 5531.88 例和 2782.59 例。前列腺癌是导致年龄标准化死亡率(ASMR)和年龄标准化残疾调整寿命年数(ASDR)的首要原因,死亡率分别为每 10 万人 12.63 例和 217.83 例。从 1990 年到 2021 年,UTI 的 ASIR、ASPR、ASMR 和 ASDR 呈上升趋势,而尿路结石呈下降趋势。中等水平和中低水平的 SDI 五分位数显示出与 UTI、尿路结石和良性前列腺增生相关的较高发病率、流行率、死亡率和残疾调整寿命年数,而高水平和中高水平的 SDI 五分位数则显示出较高的三种癌症发病率。这六种泌尿系统疾病的负担呈现出不同的年龄和性别分布模式。2021 年,高体重指数(BMI)导致全球 20.07% 的肾癌死亡,而吸烟导致 26.48% 的膀胱癌死亡和 3.00% 的前列腺癌死亡。6 种泌尿系统疾病给全球带来的负担是一项重大的公共卫生挑战。迫切需要开展国际合作,推动改善泌尿系统疾病的管理,包括开发有效的诊断筛查工具和实施高质量的预防和治疗策略。
{"title":"Global burden of benign prostatic hyperplasia, urinary tract infections, urolithiasis, bladder cancer, kidney cancer, and prostate cancer from 1990 to 2021","authors":"Hao Zi, Meng-Yang Liu, Li-Sha Luo, Qiao Huang, Peng-Cheng Luo, Hang-Hang Luan, Jiao Huang, Dan-Qi Wang, Yong-Bo Wang, Yuan-Yuan Zhang, Ren-Peng Yu, Yi-Tong Li, Hang Zheng, Tong-Zu Liu, Yu Fan, Xian-Tao Zeng","doi":"10.1186/s40779-024-00569-w","DOIUrl":"https://doi.org/10.1186/s40779-024-00569-w","url":null,"abstract":"The burden of common urologic diseases, including benign prostatic hyperplasia (BPH), urinary tract infections (UTI), urolithiasis, bladder cancer, kidney cancer, and prostate cancer, varies both geographically and within specific regions. It is essential to conduct a comprehensive and precise assessment of the global burden of urologic diseases. We obtained data on incidence, prevalence, mortality, and disability-adjusted life-years (DALYs) for the aforementioned urologic diseases by age, sex, location, and year from the Global Burden of Disease (GBD) 2021. We analyzed the burden associated with urologic diseases based on socio-demographic index (SDI) and attributable risk factors. The trends in burden over time were assessed using estimated annual percentage changes (EAPC) along with a 95% confidence interval (CI). In 2021, BPH and UTI were the leading causes of age-standardized incidence rate (ASIR) and age-standardized prevalence rate (ASPR), with rates of 5531.88 and 2782.59 per 100,000 persons, respectively. Prostate cancer was the leading cause of both age-standardized mortality rate (ASMR) and age-standardized DALYs rate (ASDR), with rates of 12.63 and 217.83 per 100,000 persons, respectively. From 1990 to 2021, there was an upward trend in ASIR, ASPR, ASMR, and ASDR for UTI, while urolithiasis showed a downward trend. The middle and low-middle SDI quintile levels exhibited higher incidence, prevalence, mortality, and DALYs related to UTI, urolithiasis, and BPH, while the high and high-middle SDI quintile levels showed higher rates for the three cancers. The burden of these six urologic diseases displayed diverse age and sex distribution patterns. In 2021, a high body mass index (BMI) contributed to 20.07% of kidney cancer deaths worldwide, while smoking accounted for 26.48% of bladder cancer deaths and 3.00% of prostate cancer deaths. The global burden of 6 urologic diseases presents a significant public health challenge. Urgent international collaboration is essential to advance the improvement of urologic disease management, encompassing the development of effective diagnostic screening tools and the implementation of high-quality prevention and treatment strategies.","PeriodicalId":18581,"journal":{"name":"Military Medical Research","volume":null,"pages":null},"PeriodicalIF":21.1,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142265919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Frailty as a sequela of burn injury: a post hoc analysis of the “RE-ENERGIZE” multicenter randomized-controlled trial and the National Health Interview Survey 作为烧伤后遗症的虚弱:对 "RE-ENERGIZE "多中心随机对照试验和全国健康访谈调查的事后分析
IF 21.1 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-12 DOI: 10.1186/s40779-024-00568-x
Adriana C. Panayi, Daren K. Heyland, Christian Stoppe, Marc G. Jeschke, Samuel Knoedler, Christian Tapking, Oliver Didzun, Valentin Haug, Amir K. Bigdeli, Ulrich Kneser, Dennis P. Orgill, Gabriel Hundeshagen
With advancements in burn treatment and intensive care leading to decreased mortality rates, a growing cohort of burn survivors is emerging. These individuals may be susceptible to frailty, characterized by reduced physiological reserve and increased vulnerability to stressors commonly associated with aging, which significantly complicates their recovery process. To date, no study has investigated burns as a potential risk factor for frailty. This study aimed to determine the short-term prevalence of frailty among burn survivors’ months after injury and compare it with that of the general population. A post hoc analysis was conducted on the Randomized Trial of Enteral Glutamine to Minimize the Effects of Burn Injury (RE-ENERGIZE) trial, an international randomized-controlled trial involving 1200 burn injury patients with partial- or full-thickness burns. Participants who did not complete the 36-Item Short Form Health Survey (SF-36) questionnaire were excluded. Data for the general population were obtained from the 2022 National Health Interview Survey (NHIS). Frailty was assessed using the FRAIL (Fatigue, Resistance, Ambulation, Illness, Loss of weight) scale. Due to lack of data on loss of weight, for the purposes of this study, malnutrition was used as the fifth variable. Illness and malnutrition were based on admission data, while fatigue, resistance, and ambulation were determined from post-discharge responses to the SF-36. The burn cohort and general population groups were matched using propensity score matching and compared in terms of frailty status. Within the burn group, patients were divided into different subgroups based on their frailty status, and the differences in their (instrumental) activities of daily living (iADL and ADL) were compared. A multivariable analysis was performed within the burn cohort to identify factors predisposing to frailty as well as compromised iADL and ADL. Out of the 1200 burn patients involved in the study, 600 completed the required questionnaires [follow-up time: (5.5 ± 2.3) months] and were matched to 1200 adults from the general population in the U.S. In comparison to the general population, burn patients exhibited a significantly higher likelihood of being pre-frail (42.3% vs. 19.8%, P < 0.0001), or frail (13.0% vs. 1.0%, P < 0.0001). When focusing on specific components, burn patients were more prone to experiencing fatigue (25.8% vs. 13.5%, P < 0.0001), limited resistance (34.0% vs. 2.7%, P < 0.0001), and restricted ambulation (41.8% vs. 3.8%, P < 0.0001). Conversely, the incidence rate of illness was observed to be higher in the general population (1.2% vs. 2.8%, P = 0.03), while no significant difference was detected regarding malnutrition (2.3% vs. 2.6%, P = 0.75). Furthermore, in comparison with robust burn patients, it was significantly more likely for pre-frail and frail patients to disclose compromise in ADL and iADL. The frail cohort reported the most pronounced limitation. Our findings sugg
随着烧伤治疗和重症监护技术的进步,死亡率不断降低,越来越多的烧伤幸存者正在出现。这些人可能容易出现虚弱,其特点是生理储备减少,更容易受到与衰老相关的压力的影响,这使他们的康复过程变得更加复杂。迄今为止,还没有研究将烧伤作为导致虚弱的潜在风险因素进行调查。本研究旨在确定烧伤幸存者在伤后数月内体弱的短期发生率,并将其与普通人群进行比较。这项国际随机对照试验涉及 1200 名部分或全身烧伤的烧伤患者。未完成 36 项简表健康调查 (SF-36) 问卷的参与者被排除在外。普通人群的数据来自 2022 年全国健康访谈调查(NHIS)。虚弱程度采用 FRAIL(疲劳、阻力、行走、疾病、体重减轻)量表进行评估。由于缺乏有关体重减轻的数据,本研究将营养不良作为第五个变量。疾病和营养不良以入院数据为基础,而疲劳、抵抗力和活动能力则根据出院后对 SF-36 的反应来确定。烧伤队列组和普通人群组采用倾向得分匹配法进行匹配,并就虚弱状态进行比较。在烧伤组中,根据患者的虚弱状况将其分为不同的亚组,并比较其(工具性)日常生活活动(iADL 和 ADL)的差异。在烧伤组群中进行了多变量分析,以确定导致虚弱以及 iADL 和 ADL 受损的因素。在参与研究的 1200 名烧伤患者中,有 600 人完成了所需的问卷调查[随访时间:(5.5 ± 2.3)个月],并与来自美国普通人群的 1200 名成年人进行了比对。与普通人群相比,烧伤患者表现出明显更高的前期虚弱(42.3% 对 19.8%,P < 0.0001)或虚弱(13.0% 对 1.0%,P < 0.0001)的可能性。从具体内容来看,烧伤患者更容易出现疲劳(25.8% 对 13.5%,P < 0.0001)、抵抗力受限(34.0% 对 2.7%,P < 0.0001)和行走受限(41.8% 对 3.8%,P < 0.0001)。相反,普通人群的发病率更高(1.2% vs. 2.8%,P = 0.03),而营养不良方面则无明显差异(2.3% vs. 2.6%,P = 0.75)。此外,与体格健壮的烧伤患者相比,虚弱前患者和虚弱患者更有可能在日常活动能力(ADL)和综合日常活动能力(iADL)方面受到影响。虚弱人群报告的限制最为明显。我们的研究结果表明,烧伤幸存者出院后短期内体弱的发生率较高。烧伤幸存者的疲劳度、抵抗力和行动能力受到影响,而患病率和营养不良率则分别较低或保持不变。这些结果突显了烧伤后早期识别虚弱状态的关键需求,并需要包括烧伤和疼痛专家、社区医生、理疗师、营养师和社会工作者在内的多学科团队及时、全面的参与。这种合作可以确保提供全面的护理,以解决和减轻这类患者的体弱问题。
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引用次数: 0
Effectiveness of chest pain center accreditation on the hospital outcome of acute aortic dissection: a nationwide study in China. 胸痛中心认证对急性主动脉夹层住院治疗效果的影响:一项在中国进行的全国性研究。
IF 16.7 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-08-26 DOI: 10.1186/s40779-024-00565-0
Li-Wei Liu, Yi-Kai Cui, Lin Zhang, Dai-Le Jia, Jing Wang, Jia-Wei Gu, Jin-Yan Zhang, Zhen Dong, Xue-Juan Jin, Xiao-Yi Zou, Guo-Li Sun, Yu-Xiang Dai, Ai-Jun Sun, Jun-Bo Ge

Background: The National Chest Pain Center Program (NCPCP) is a nationwide, quality enhancement program aimed at raising the standard of care for patients experiencing acute chest pain in China. The benefits of chest pain center (CPC) accreditation on acute coronary syndrome have been demonstrated. However, there is no evidence to indicate whether CPC accreditation improves outcomes for patients with acute aortic dissection (AAD).

Methods: We conducted a retrospective observational study of patients with AAD from 1671 hospitals in China, using data from the NCPCP spanning the period from January 1, 2016 to December 31, 2022. The patients were divided into 2 groups: pre-accreditation and post-accreditation admissions. The outcomes examined included in-hospital mortality, misdiagnosis, and Stanford type A AAD surgery. Multivariate logistic regression was employed to explore the relationship between CPC accreditation and in-hospital outcomes. Furthermore, we stratified the hospitals based on their geographical location (Eastern/Central/Western regions) or administrative status (provincial/non-provincial capital areas) to assess the impact of CPC accreditation on AAD patients across various regions.

Results: The analysis encompassed a total of 40,848 patients diagnosed with AAD. The post-accreditation group exhibited significantly lower rates of in-hospital mortality and misdiagnosis (12.1% vs. 16.3%, P < 0.001 and 2.9% vs. 5.4%, P < 0.001, respectively) as well as a notably higher rate of Stanford type A AAD surgery (61.1% vs. 42.1%, P < 0.001) compared with the pre-accreditation group. After adjusting for potential covariates, CPC accreditation was associated with substantially reduced risks of in-hospital mortality (adjusted OR 0.644, 95% CI 0.599-0.693) and misdiagnosis (adjusted OR 0.554, 95% CI 0.493-0.624), along with an increase in the proportion of patients undergoing Stanford type A AAD surgery (adjusted OR 1.973, 95% CI 1.797-2.165). Following CPC accreditation, there were significant reductions in in-hospital mortality across various regions, particularly in Western regions (from 21.5 to 14.1%). Moreover, CPC accreditation demonstrated a more pronounced impact on in-hospital mortality in non-provincial cities compared to provincial cities (adjusted OR 0.607 vs. 0.713).

Conclusion: CPC accreditation is correlated with improved management and in-hospital outcomes for patients with AAD.

背景:国家胸痛中心项目(NCPCP)是一项全国性的质量提升项目,旨在提高中国急性胸痛患者的救治水平。胸痛中心(CPC)认证对急性冠脉综合征的益处已得到证实。然而,尚无证据表明胸痛中心认证是否能改善急性主动脉夹层(AAD)患者的预后:方法:我们利用国家卫计委从 2016 年 1 月 1 日至 2022 年 12 月 31 日的数据,对中国 1671 家医院的 AAD 患者进行了回顾性观察研究。患者分为两组:评审前和评审后入院。研究结果包括院内死亡率、误诊率和斯坦福A型AAD手术率。我们采用多变量逻辑回归来探讨 CPC 评审与院内预后之间的关系。此外,我们还根据医院的地理位置(东部/中部/西部地区)或行政地位(省会/非省会地区)对医院进行了分层,以评估 CPC 评审对不同地区 AAD 患者的影响:结果:分析涵盖了40,848名确诊为AAD的患者。通过评审后的一组患者的院内死亡率和误诊率明显降低(12.1% 对 16.3%,P 结论:CPC 评审与 AAD 的治疗效果相关:CPC 评审与改善 AAD 患者的管理和院内预后相关。
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引用次数: 0
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Military Medical Research
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