Pub Date : 2024-10-01DOI: 10.3760/cma.j.cn121430-20240801-00652
Hongyan Zhou, Xiaoting Su, Heng Zhang, Zhongchen Li, Nan Cheng, Bei Zhang, Su Yuan, Juan Du
<p><strong>Objective: </strong>To analyze the effects of preoperative renin-angiotensin system inhibitor (RASi) use on postoperative renal function and short-term and long-term prognosis in patients undergoing coronary artery bypass grafting (CABG).</p><p><strong>Methods: </strong>A retrospective cohort analysis was conducted. Based on the registration study data of CABG patients at Fuwai Hospital, Chinese Academy of Medical Sciences, the clinical data of adult patients who underwent CABG from January 2013 to December 2022 were analyzed. Preoperative use of RASi (PreRASi) was defined as receiving RASi treatment within 48 hours before surgery. Postoperative acute kidney injury (AKI) was defined using the diagnostic criteria of Kidney Disease: Improving Global Outcomes (KDIGO). Demographic characteristics, past medical history, comorbidities, preoperative medication, preoperative laboratory test results, specific information on surgical procedures, and postoperative treatment related data were extracted. The primary endpoint was the incidence of postoperative AKI. Secondary endpoints included in-hospital all-cause mortality and all-cause mortality within the longest follow-up period. According to whether RASi was used before surgery, the patients were divided into PreRASi group and No-PreRASi group. The baseline data of the two groups were balanced by propensity score matching (PSM). Logistic regression model and Cox proportional hazards model were used to assess the correlation between PreRASi and postoperative AKI and clinical outcomes, and analyze the subgroups of hypertension and heart failure with preserved ejection fraction (HFpEF) in the cohort.</p><p><strong>Results: </strong>A total of 33 884 patients who underwent CABG were included, with a mean follow-up duration of (3.0±2.4) years and the longest follow-up duration up to 8.5 years. There were 9 128 cases (26.94%) in the PreRASi group and 24 756 cases (73.06%) in the No-PreRASi group. The incidence of postoperative AKI in the PreRASi group was 47.61% (4 346 cases), compared to 52.37% (12 964 cases) in the No-PreRASi group. Two groups were matched with 5 094 patients each. Compared to the No-PreRASi group, both before and after PSM, PreRASi was associated with a reduction of risk of postoperative AKI [before PSM: odds ratio (OR) = 0.834, 95% confidence interval (95%CI) was 0.793-0.877, P < 0.001; after PSM: OR = 0.875, 95%CI was 0.808-0.948, P = 0.001]. Subgroup analysis of hypertensive and HFpEF patients showed that PreRASi was associated with a decreased risk of postoperative AKI before and after PSM. The in-hospital mortality for the PreRASi and No-PreRASi groups were 0.61% (56 cases) and 0.49% (121 cases), respectively. Analysis of the overall cohort and subgroups with hypertension and HFpEF showed no correlation between PreRASi and in-hospital mortality or longest follow-up mortality.</p><p><strong>Conclusions: </strong>The perioperative use of RASi can reduce the risk of postoperati
{"title":"[Effects of perioperative use of renin-angiotensin system inhibitor on renal function and clinical outcomes in patients undergoing coronary artery bypass grafting surgery].","authors":"Hongyan Zhou, Xiaoting Su, Heng Zhang, Zhongchen Li, Nan Cheng, Bei Zhang, Su Yuan, Juan Du","doi":"10.3760/cma.j.cn121430-20240801-00652","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240801-00652","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the effects of preoperative renin-angiotensin system inhibitor (RASi) use on postoperative renal function and short-term and long-term prognosis in patients undergoing coronary artery bypass grafting (CABG).</p><p><strong>Methods: </strong>A retrospective cohort analysis was conducted. Based on the registration study data of CABG patients at Fuwai Hospital, Chinese Academy of Medical Sciences, the clinical data of adult patients who underwent CABG from January 2013 to December 2022 were analyzed. Preoperative use of RASi (PreRASi) was defined as receiving RASi treatment within 48 hours before surgery. Postoperative acute kidney injury (AKI) was defined using the diagnostic criteria of Kidney Disease: Improving Global Outcomes (KDIGO). Demographic characteristics, past medical history, comorbidities, preoperative medication, preoperative laboratory test results, specific information on surgical procedures, and postoperative treatment related data were extracted. The primary endpoint was the incidence of postoperative AKI. Secondary endpoints included in-hospital all-cause mortality and all-cause mortality within the longest follow-up period. According to whether RASi was used before surgery, the patients were divided into PreRASi group and No-PreRASi group. The baseline data of the two groups were balanced by propensity score matching (PSM). Logistic regression model and Cox proportional hazards model were used to assess the correlation between PreRASi and postoperative AKI and clinical outcomes, and analyze the subgroups of hypertension and heart failure with preserved ejection fraction (HFpEF) in the cohort.</p><p><strong>Results: </strong>A total of 33 884 patients who underwent CABG were included, with a mean follow-up duration of (3.0±2.4) years and the longest follow-up duration up to 8.5 years. There were 9 128 cases (26.94%) in the PreRASi group and 24 756 cases (73.06%) in the No-PreRASi group. The incidence of postoperative AKI in the PreRASi group was 47.61% (4 346 cases), compared to 52.37% (12 964 cases) in the No-PreRASi group. Two groups were matched with 5 094 patients each. Compared to the No-PreRASi group, both before and after PSM, PreRASi was associated with a reduction of risk of postoperative AKI [before PSM: odds ratio (OR) = 0.834, 95% confidence interval (95%CI) was 0.793-0.877, P < 0.001; after PSM: OR = 0.875, 95%CI was 0.808-0.948, P = 0.001]. Subgroup analysis of hypertensive and HFpEF patients showed that PreRASi was associated with a decreased risk of postoperative AKI before and after PSM. The in-hospital mortality for the PreRASi and No-PreRASi groups were 0.61% (56 cases) and 0.49% (121 cases), respectively. Analysis of the overall cohort and subgroups with hypertension and HFpEF showed no correlation between PreRASi and in-hospital mortality or longest follow-up mortality.</p><p><strong>Conclusions: </strong>The perioperative use of RASi can reduce the risk of postoperati","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"36 10","pages":"1056-1062"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717209","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}
Pub Date : 2024-10-01DOI: 10.3760/cma.j.cn121430-20240524-00457
Meng Li, Yulin Mei, Aijun Pan
<p><strong>Objective: </strong>To explore the characteristics of key ferroptosis-related genes as therapeutic targets for sepsis based on bioinformatics analysis, and describe their immune characteristics.</p><p><strong>Methods: </strong>The transcriptome datasets GSE57065, GSE9960, GSE28750, and GSE137340 were downloaded from the Gene Expression Omnibus (GEO) database, immune-related gene (IRG) were obtained from ImmPort and InnateDB databases, and ferroptosis-related gene (FRG) were downloaded from the FerrDb database. The datasets GSE57065, GSE9960, and GSE28750 were integrated into an analysis dataset by the surrogate variable analysis (SVA) package and analyzed this analysis dataset by using the "limma" package to obtain differentially expressed gene (DEG), then the intersection set of DEG, FRG, and IRG were considered as ferroptosis and immune-related DEG (FImDEG). Gene ontology (GO) functional annotation and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed using "ClusterProfiler" to understand the biological function of FImDEG. The key genes were screened by protein-protein interaction (PPI) network, least absolute shrinkage and selection operator (LASSO) regression algorithms, and support vector machine (SVM) analyses, and Logistic regression model was built based on above key genes. Receiver operator characteristics curve (ROC curve) was plotted to evaluate the diagnostic efficacy of the key genes alone or combinative. The degree of infiltration of 22 immune cells was assessed using the "CIBERSORT" package, and the correlation between the expressions of key genes and infiltration degree of immune cells was analyzed. Dataset GSE137340 was used to verify these key genes.</p><p><strong>Results: </strong>A dataset consisting of 146 sepsis samples and 61 healthy control samples was obtained by processing the database and removing batch effect. A total of 4 537 DEG were obtained, including 2 066 up-regulated genes and 2 471 down-regulated genes. 2 519 IRG and 855 FRG were obtained from the relevant database. Using the intersection of DEG, IRG and FRG, 34 FImDEG were obtained, including 20 up-regulated genes and 14 down-regulated genes. GO functional annotation showed that the biological functions of 34 FImDEG were mainly inhibition of transferase activity, regulation of DNA-binding transcription factor activity and cell response to stimulation. In terms of molecular function, it was mainly related to RNA polymerase II-specific DNA-binding transcription factor binding and various protein ligase binding. Changes in cell composition occurred mainly in promyelocytic leukemia protein and chromatin silencing complexes. Enrichment analysis of KEGG pathway showed that the major pathways involved in 34 FImDEG included cell aging, expression of programmed death-ligand 1 (PD-L1) and programmed death-1 (PD-1) checkpoint pathways in cancer, interleukin-17 (IL-17) signaling pathway, lipid and atherosclerosis, and NOD-like re
{"title":"[Exploration of key ferroptosis-related genes as therapeutic targets for sepsis based on bioinformatics and the depiction of their immune profiles characterization].","authors":"Meng Li, Yulin Mei, Aijun Pan","doi":"10.3760/cma.j.cn121430-20240524-00457","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240524-00457","url":null,"abstract":"<p><strong>Objective: </strong>To explore the characteristics of key ferroptosis-related genes as therapeutic targets for sepsis based on bioinformatics analysis, and describe their immune characteristics.</p><p><strong>Methods: </strong>The transcriptome datasets GSE57065, GSE9960, GSE28750, and GSE137340 were downloaded from the Gene Expression Omnibus (GEO) database, immune-related gene (IRG) were obtained from ImmPort and InnateDB databases, and ferroptosis-related gene (FRG) were downloaded from the FerrDb database. The datasets GSE57065, GSE9960, and GSE28750 were integrated into an analysis dataset by the surrogate variable analysis (SVA) package and analyzed this analysis dataset by using the \"limma\" package to obtain differentially expressed gene (DEG), then the intersection set of DEG, FRG, and IRG were considered as ferroptosis and immune-related DEG (FImDEG). Gene ontology (GO) functional annotation and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed using \"ClusterProfiler\" to understand the biological function of FImDEG. The key genes were screened by protein-protein interaction (PPI) network, least absolute shrinkage and selection operator (LASSO) regression algorithms, and support vector machine (SVM) analyses, and Logistic regression model was built based on above key genes. Receiver operator characteristics curve (ROC curve) was plotted to evaluate the diagnostic efficacy of the key genes alone or combinative. The degree of infiltration of 22 immune cells was assessed using the \"CIBERSORT\" package, and the correlation between the expressions of key genes and infiltration degree of immune cells was analyzed. Dataset GSE137340 was used to verify these key genes.</p><p><strong>Results: </strong>A dataset consisting of 146 sepsis samples and 61 healthy control samples was obtained by processing the database and removing batch effect. A total of 4 537 DEG were obtained, including 2 066 up-regulated genes and 2 471 down-regulated genes. 2 519 IRG and 855 FRG were obtained from the relevant database. Using the intersection of DEG, IRG and FRG, 34 FImDEG were obtained, including 20 up-regulated genes and 14 down-regulated genes. GO functional annotation showed that the biological functions of 34 FImDEG were mainly inhibition of transferase activity, regulation of DNA-binding transcription factor activity and cell response to stimulation. In terms of molecular function, it was mainly related to RNA polymerase II-specific DNA-binding transcription factor binding and various protein ligase binding. Changes in cell composition occurred mainly in promyelocytic leukemia protein and chromatin silencing complexes. Enrichment analysis of KEGG pathway showed that the major pathways involved in 34 FImDEG included cell aging, expression of programmed death-ligand 1 (PD-L1) and programmed death-1 (PD-1) checkpoint pathways in cancer, interleukin-17 (IL-17) signaling pathway, lipid and atherosclerosis, and NOD-like re","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"36 10","pages":"1025-1032"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717211","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}
Pub Date : 2024-10-01DOI: 10.3760/cma.j.cn121430-20240229-00180
Bo Lyu, Lan Li, Ruifeng Huang, Xiahui Zhou, Lipeng Han
<p><strong>Objective: </strong>To explore the protective effect and mechanism of Tongfu Lifei decoction (TFL) on human monocytic leukemia cell THP-1 induced by lipopolysaccharide (LPS).</p><p><strong>Methods: </strong>(1) THP-1 cells were cultured in vitro, and incubated with 1 mg/L LPS for 18 hours to construct an in vitro THP-1 cell inflammation model. Other THP-1 cells were taken as blank control group. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of tumor necrosis factor-α(TNF-α) and interleukin-6 (IL-6) secreted by cells. (2) THP-1 cells were divided into seven groups and treated with 0, 0.005, 0.01, 0.02, 0.04, 0.08, and 0.16 mL/mL TFL for 24 hours (added different dosages of TFL solution per milliliter of culture medium, with a crude drug content of 1 kg/L). The cell survival rate was detected using methyl thiazolyl tetrazolium (MTT) colorimetric method, and the intervention dosage of TFL for its non-toxic effect on THP-1 cells was screened. (3) Another THP-1 cells were divide into inflammatory model group and 0.01, 0.02, and 0.04 mL/mL TFL groups according to the intervention dosage of TFL screened by MTT colorimetry. After 24 hours of intervention, the levels of TNF-α and IL-6 secreted by cells were measured using ELISA. Western blotting was used to detect the expressions of programmed death-1/programmed death-ligand 1 (PD-1/PD-L1) signaling pathway proteins in cells. Real time fluorescence quantitative reverse transcription-polymerase chain reaction (RT-PCR) was used to detect the expressions of microRNAs (miR-146a, miR-146b, miR-155) in cells. (4) The maximum non-toxic concentration of TFL (0.04 mL/mL) on the THP-1 cell was selected as the intervention dose. THP-1 cells were divided into inflammation model group, TFL group, TFL+miR-146a inhibitor group, TFL+miR-146b inhibitor group, and TFL+miR-155 inhibitor group. The inflammation model group was not given any drug intervention. The other inhibitor groups were added 100 nmol/L corresponding inhibitor. After 24 hours of intervention, the levels of TNF-α and IL-6 secreted by cells were measured using ELISA. Western blotting was used to detect the expressions of PD-1/PD-L1 signaling pathway proteins in cells.</p><p><strong>Results: </strong>(1) Compared with the blank control group, the levels of TNF-α and IL-6 secreted by cells in the inflammatory model group were significantly increased, indicating the successful construction of the THP-1 inflammatory cell model in vitro. (2) 0-0.04 mL/mL TFL had no toxic effect on THP-1 cells. However, the survival rates of cells in the 0.08 mL/mL and 0.16 mL/mL TFL groups were significantly lower than those in the inflammation model group, indicating that TFL dosages exceeding 0.04 mL/mL had toxic effects on THP-1 cells. (3) Compared with the inflammation model group, 0.01 mL/mL TFL had no significant effect on the levels of TNF-α and IL-6 secreted by THP-1 cells, while intervention with 0.02 mL/mL and 0.04 mL/mL TFL signif
{"title":"[Mechanism of Tongfu Lifei decoction inhibiting the programmed death-1/programmed death-ligand 1 signaling pathway in THP-1 cells by regulating microRNA-146a].","authors":"Bo Lyu, Lan Li, Ruifeng Huang, Xiahui Zhou, Lipeng Han","doi":"10.3760/cma.j.cn121430-20240229-00180","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240229-00180","url":null,"abstract":"<p><strong>Objective: </strong>To explore the protective effect and mechanism of Tongfu Lifei decoction (TFL) on human monocytic leukemia cell THP-1 induced by lipopolysaccharide (LPS).</p><p><strong>Methods: </strong>(1) THP-1 cells were cultured in vitro, and incubated with 1 mg/L LPS for 18 hours to construct an in vitro THP-1 cell inflammation model. Other THP-1 cells were taken as blank control group. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of tumor necrosis factor-α(TNF-α) and interleukin-6 (IL-6) secreted by cells. (2) THP-1 cells were divided into seven groups and treated with 0, 0.005, 0.01, 0.02, 0.04, 0.08, and 0.16 mL/mL TFL for 24 hours (added different dosages of TFL solution per milliliter of culture medium, with a crude drug content of 1 kg/L). The cell survival rate was detected using methyl thiazolyl tetrazolium (MTT) colorimetric method, and the intervention dosage of TFL for its non-toxic effect on THP-1 cells was screened. (3) Another THP-1 cells were divide into inflammatory model group and 0.01, 0.02, and 0.04 mL/mL TFL groups according to the intervention dosage of TFL screened by MTT colorimetry. After 24 hours of intervention, the levels of TNF-α and IL-6 secreted by cells were measured using ELISA. Western blotting was used to detect the expressions of programmed death-1/programmed death-ligand 1 (PD-1/PD-L1) signaling pathway proteins in cells. Real time fluorescence quantitative reverse transcription-polymerase chain reaction (RT-PCR) was used to detect the expressions of microRNAs (miR-146a, miR-146b, miR-155) in cells. (4) The maximum non-toxic concentration of TFL (0.04 mL/mL) on the THP-1 cell was selected as the intervention dose. THP-1 cells were divided into inflammation model group, TFL group, TFL+miR-146a inhibitor group, TFL+miR-146b inhibitor group, and TFL+miR-155 inhibitor group. The inflammation model group was not given any drug intervention. The other inhibitor groups were added 100 nmol/L corresponding inhibitor. After 24 hours of intervention, the levels of TNF-α and IL-6 secreted by cells were measured using ELISA. Western blotting was used to detect the expressions of PD-1/PD-L1 signaling pathway proteins in cells.</p><p><strong>Results: </strong>(1) Compared with the blank control group, the levels of TNF-α and IL-6 secreted by cells in the inflammatory model group were significantly increased, indicating the successful construction of the THP-1 inflammatory cell model in vitro. (2) 0-0.04 mL/mL TFL had no toxic effect on THP-1 cells. However, the survival rates of cells in the 0.08 mL/mL and 0.16 mL/mL TFL groups were significantly lower than those in the inflammation model group, indicating that TFL dosages exceeding 0.04 mL/mL had toxic effects on THP-1 cells. (3) Compared with the inflammation model group, 0.01 mL/mL TFL had no significant effect on the levels of TNF-α and IL-6 secreted by THP-1 cells, while intervention with 0.02 mL/mL and 0.04 mL/mL TFL signif","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"36 10","pages":"1038-1043"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717213","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}
Pub Date : 2024-10-01DOI: 10.3760/cma.j.cn121430-20230326-00217
Aochun Yue, Huiping Song, Xudong Zhou, Wei Han, Qin Li
<p><strong>Objective: </strong>To explore the neuroprotective effect and molecular mechanism of sulforaphane (SFN) on acute carbon monoxide poisoning (ACOP) in rats.</p><p><strong>Methods: </strong>A total of 135 healthy adult male Sprague-Dawley (SD) rats were randomly divided into normal control group, ACOP model group, and SFN intervention group, with 45 rats in each group. The ACOP animal model was reproduced using carbon monoxide (CO) inhalation in a hyperbaric oxygen chamber, while the normal control group was allowed to breathe fresh air freely. The rats in the SFN intervention group received intraperitoneal injection of SFN at a dose of 20 mg/kg once daily starting 2 hours after CO poisoning and continuing until euthanasia. The normal control group and the ACOP model group received equivalent volume of saline injection. Three rats from each group were sacrificed 1 day after intervention to observe the changes in the ultrastructure of neuronal mitochondria in brain tissues under transmission electron microscopy. Six rats from each group were evaluated for cognitive function using neurobehavioral test 7 days after intervention. Brain tissues of 6 rats in each group were collected 1, 3, and 7 days after intervention, and the expressions of phosphorylated-adenosine monophosphate-activated protein kinase (p-AMPK), mitofusin 2 (MFN2), and dynamin-related protein 1 (DRP1) were detected using immunohistochemistry staining and Western blotting. Linear regression analysis was performed to assess the correlations between the expression levels of above proteins.</p><p><strong>Results: </strong>In the normal control group, the rats did not exhibit any abnormalities in cognitive function or the ultrastructure of neuronal mitochondria in brain tissues. ACOP induced cognitive impairment and ultrastructural injury to neuronal mitochondria in rats. However, SFN significantly improved cognitive function in poisoned rats and mitigated the extent of neuronal mitochondrial damage. Over poisoning time, the expression levels of p-AMPK and MFN2 in the brain tissues of ACOP rats were gradually decreased, while the expression level of DRP1 was gradually increased. Compared with the normal control group, the ACOP model group showed significant differences in the expressions of p-AMPK, MFN2, and DRP1. After SFN intervention, the expression levels of above proteins were significantly reversed. Compared with the ACOP model group, the SFN intervention group exhibited a marked increase in the expressions of p-AMPK and MFN2 [p-AMPK positive expression (A value): 0.226±0.003 vs. 0.177±0.033, p-AMPK protein (p-AMPK/GAPDH): 1.41±0.05 vs. 0.89±0.05, MFN2 positive expression (A value): 0.241±0.004 vs. 0.165±0.007, MFN2 protein (MFN2/GAPDH): 1.33±0.04 vs. 0.79±0.03, all P < 0.05], along with a significant decrease in DRP1 expression [DRP1 positive expression (A value): 0.103±0.002 vs. 0.214±0.011, DRP1 protein (DRP1/GAPDH): 1.00±0.03 vs. 1.50±0.03, both P < 0.05]. Linear regres
目的方法：将135只健康成年雄性Sprague-Dawley（SD）大鼠随机分为正常对照组和SFN干预组，每组45只：方法：将135只健康成年雄性Sprague-Dawley（SD）大鼠随机分为正常对照组、ACOP模型组和SFN干预组，每组45只。ACOP 动物模型是在高压氧舱中吸入一氧化碳（CO）再现的，而正常对照组则让大鼠自由呼吸新鲜空气。SFN干预组大鼠在CO中毒后2小时开始腹腔注射SFN，剂量为20毫克/千克，每天一次，直至安乐死。正常对照组和 ACOP 模型组接受等量的生理盐水注射。每组 3 只大鼠在干预 1 天后处死，用透射电子显微镜观察脑组织中神经元线粒体超微结构的变化。干预 7 天后，用神经行为测试评估每组 6 只大鼠的认知功能。干预后1天、3天和7天收集各组6只大鼠的脑组织，采用免疫组化染色和Western印迹法检测磷酸化腺苷单磷酸激活蛋白激酶（p-AMPK）、丝裂霉素2（MFN2）和达因明相关蛋白1（DRP1）的表达。对上述蛋白的表达水平进行线性回归分析，以评估它们之间的相关性：结果：正常对照组大鼠的认知功能和脑组织中神经元线粒体的超微结构未见异常。ACOP 引起大鼠认知功能障碍和神经元线粒体超微结构损伤。然而，SFN 能明显改善中毒大鼠的认知功能，减轻神经元线粒体的损伤程度。随着中毒时间的延长，ACOP 大鼠脑组织中 p-AMPK 和 MFN2 的表达水平逐渐降低，而 DRP1 的表达水平逐渐升高。与正常对照组相比，ACOP模型组在p-AMPK、MFN2和DRP1的表达上有显著差异。SFN干预后，上述蛋白的表达水平明显逆转。与 ACOP 模型组相比，SFN 干预组 p-AMPK 和 MFN2 的表达量明显增加[p-AMPK 阳性表达量（A 值）：0.226±0.00]：0.226±0.003 vs. 0.177±0.033, p-AMPK 蛋白 (p-AMPK/GAPDH): 1.41±0.05 vs. 0.89±0.05, MFN2 阳性表达 (A 值)：0.241±0.004 vs. 0.165±0.007，MFN2 蛋白 (MFN2/GAPDH)：1.33±0.04 vs. 0.79±0.03，所有 P <0.05]，同时 DRP1 表达显著下降[DRP1 阳性表达（A 值）：0.103±0.002 vs. 0.103±0.002，所有 P <0.05]：0.103±0.002 vs. 0.214±0.011，DRP1 蛋白（DRP1/GAPDH）：1.00±0.03 vs. 1.50±0.03，均 P <0.05]。线性回归分析显示，DRP1蛋白表达与MFN2、p-AMPK蛋白表达呈强负相关（R2值分别为0.977和0.971，均P＜0.01），p-AMPK蛋白表达与MFN2蛋白表达呈正相关（R2=0.985，P＜0.01）：SFN可通过激活单磷酸腺苷激活蛋白激酶（AMPK）信号通路来维持神经元线粒体的稳态，从而减轻ACOP对神经元的损伤。
{"title":"[Sulforaphane regulates mitochondrial homeostasis through adenosine monophosphate-activated protein kinase signaling to treat acute carbon monoxide poisoning induced brain injury in rats].","authors":"Aochun Yue, Huiping Song, Xudong Zhou, Wei Han, Qin Li","doi":"10.3760/cma.j.cn121430-20230326-00217","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20230326-00217","url":null,"abstract":"<p><strong>Objective: </strong>To explore the neuroprotective effect and molecular mechanism of sulforaphane (SFN) on acute carbon monoxide poisoning (ACOP) in rats.</p><p><strong>Methods: </strong>A total of 135 healthy adult male Sprague-Dawley (SD) rats were randomly divided into normal control group, ACOP model group, and SFN intervention group, with 45 rats in each group. The ACOP animal model was reproduced using carbon monoxide (CO) inhalation in a hyperbaric oxygen chamber, while the normal control group was allowed to breathe fresh air freely. The rats in the SFN intervention group received intraperitoneal injection of SFN at a dose of 20 mg/kg once daily starting 2 hours after CO poisoning and continuing until euthanasia. The normal control group and the ACOP model group received equivalent volume of saline injection. Three rats from each group were sacrificed 1 day after intervention to observe the changes in the ultrastructure of neuronal mitochondria in brain tissues under transmission electron microscopy. Six rats from each group were evaluated for cognitive function using neurobehavioral test 7 days after intervention. Brain tissues of 6 rats in each group were collected 1, 3, and 7 days after intervention, and the expressions of phosphorylated-adenosine monophosphate-activated protein kinase (p-AMPK), mitofusin 2 (MFN2), and dynamin-related protein 1 (DRP1) were detected using immunohistochemistry staining and Western blotting. Linear regression analysis was performed to assess the correlations between the expression levels of above proteins.</p><p><strong>Results: </strong>In the normal control group, the rats did not exhibit any abnormalities in cognitive function or the ultrastructure of neuronal mitochondria in brain tissues. ACOP induced cognitive impairment and ultrastructural injury to neuronal mitochondria in rats. However, SFN significantly improved cognitive function in poisoned rats and mitigated the extent of neuronal mitochondrial damage. Over poisoning time, the expression levels of p-AMPK and MFN2 in the brain tissues of ACOP rats were gradually decreased, while the expression level of DRP1 was gradually increased. Compared with the normal control group, the ACOP model group showed significant differences in the expressions of p-AMPK, MFN2, and DRP1. After SFN intervention, the expression levels of above proteins were significantly reversed. Compared with the ACOP model group, the SFN intervention group exhibited a marked increase in the expressions of p-AMPK and MFN2 [p-AMPK positive expression (A value): 0.226±0.003 vs. 0.177±0.033, p-AMPK protein (p-AMPK/GAPDH): 1.41±0.05 vs. 0.89±0.05, MFN2 positive expression (A value): 0.241±0.004 vs. 0.165±0.007, MFN2 protein (MFN2/GAPDH): 1.33±0.04 vs. 0.79±0.03, all P < 0.05], along with a significant decrease in DRP1 expression [DRP1 positive expression (A value): 0.103±0.002 vs. 0.214±0.011, DRP1 protein (DRP1/GAPDH): 1.00±0.03 vs. 1.50±0.03, both P < 0.05]. Linear regres","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"36 10","pages":"1075-1081"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717249","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}
Pub Date : 2024-10-01DOI: 10.3760/cma.j.cn121430-20240104-00016
Ping Liu, Guangyan Zhu, Haifa Xia
Inflammation reaction is a host defense mechanism that protects the host from harmful external antigens and microorganisms, and the intensification of inflammation reaction can lead to tissue damage and development of systemic inflammatory diseases. As a representative derivative of ω-3 fatty acids, Maresin-1 has been widely explored for its role in regulating innate immune cells (neutrophils and mononuclear/macrophages) and promoting the resolution of infectious inflammation in acute inflammatory diseases. There is now increasing evidence that Maresin-1 also has a direct effect on the adaptive immune system and prevents the transition from acute inflammation to chronic inflammation. By analyzing the literature related to the effect of Maresin-1 on the regulation of inflammation, this paper summarized the role of various immune cells in inflammatory response and the regulatory mechanism of Maresin-1 on various immune cells, so as to deeply understand the research progress of the role of Maresin-1 in regulating immune cells in inflammatory diseases. This study provides a theoretical basis for the basic research and clinical application of Maresin-1 in inflammatory diseases.
{"title":"[Research progress on the role of immune cells regulated by Maresin-1 in inflammatory diseases].","authors":"Ping Liu, Guangyan Zhu, Haifa Xia","doi":"10.3760/cma.j.cn121430-20240104-00016","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240104-00016","url":null,"abstract":"<p><p>Inflammation reaction is a host defense mechanism that protects the host from harmful external antigens and microorganisms, and the intensification of inflammation reaction can lead to tissue damage and development of systemic inflammatory diseases. As a representative derivative of ω-3 fatty acids, Maresin-1 has been widely explored for its role in regulating innate immune cells (neutrophils and mononuclear/macrophages) and promoting the resolution of infectious inflammation in acute inflammatory diseases. There is now increasing evidence that Maresin-1 also has a direct effect on the adaptive immune system and prevents the transition from acute inflammation to chronic inflammation. By analyzing the literature related to the effect of Maresin-1 on the regulation of inflammation, this paper summarized the role of various immune cells in inflammatory response and the regulatory mechanism of Maresin-1 on various immune cells, so as to deeply understand the research progress of the role of Maresin-1 in regulating immune cells in inflammatory diseases. This study provides a theoretical basis for the basic research and clinical application of Maresin-1 in inflammatory diseases.</p>","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"36 10","pages":"1113-1116"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717243","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}
<p><strong>Objective: </strong>To summarize the best evidence for exercise intervention in elderly patients with sarcopenia in intensive care unit (ICU) through literature search, and provide a reference for clinical implementation of early exercise intervention in this population through evidence-based practice.</p><p><strong>Methods: </strong>(1) Summary of best evidence: relevant literature on exercise intervention for elderly patients with sarcopenia in ICU, including guideline, evidence summary, expert consensus, systematic review, and original study [quasi-experiment and randomized controlled trial (RCT)] from UpToDate Clinical Advisor, Ovid database, National Guideline Clearinghouse (NGC), National Institute for Health and Care Excellence (NICE), Cochrane Library, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed/Medline, SinoMed, CNKI, Wanfang Database, VIP, and Yimai Tong Guideline Network were systematically searched. The search period covered from the establishment of these databases up to August 24, 2023. The quality of the literature was evaluated by two researchers with methodological expertise in evidence-based medicine, and the evidences were extracted and summarized. (2) Evidence-based practice: the elderly patients with high risk of sarcopenia who had been hospitalized in the ICU for more than 7 days from January to April 2024 were enrolled as the research subjects, and they were divided into a control group and an intervention group using convenience sampling method. The control group received routine intensive care nursing. The intervention group implemented exercise intervention based on the actual situation of the patients, the baseline review was conducted before evidence application, and the effectiveness of evidence application at 7 days and 14 days was evaluated.</p><p><strong>Results: </strong>(1) A total of 19 pieces of literature were included, including 4 guidelines, 1 summary of evidence, 4 expert consensuses, 4 systematic reviews, and 6 original studies (1 quasi-experiment, 5 RCT). After literature quality evaluation, all 19 articles were enrolled. Finally, 31 pieces of best evidence were extracted from eight aspects, including assessment and diagnosis, multidisciplinary cooperation, indication, preparation before intervention, intervention program, safety monitoring, post-intervention evaluation, and special task. (2) Finally, a total of 30 patients were enrolled in the intervention group, of which 17 completed 14 days of rehabilitation exercise, and 13 completed 7 days of rehabilitation exercise. Twenty-seven patients were enrolled in the control group, of which 17 completed 14 days of monitoring, and 10 completed 7 days of monitoring. Clinical evidence application results showed that the patients in the intervention group did not experience adverse events such as increased heart rate, extubation, or physical discomfort. The skeletal muscle mass index (SMI) in both groups was gradu
{"title":"[Summary of best evidence and evidence-based practice of exercise intervention in elderly patients with sarcopenia in intensive care unit].","authors":"Haiying Liu, Yue Zhang, Xin Li, Danhua Wang, Dongxue Huang, Xiaowei Zhou, Yuehao Shen","doi":"10.3760/cma.j.cn121430-20240527-00463","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240527-00463","url":null,"abstract":"<p><strong>Objective: </strong>To summarize the best evidence for exercise intervention in elderly patients with sarcopenia in intensive care unit (ICU) through literature search, and provide a reference for clinical implementation of early exercise intervention in this population through evidence-based practice.</p><p><strong>Methods: </strong>(1) Summary of best evidence: relevant literature on exercise intervention for elderly patients with sarcopenia in ICU, including guideline, evidence summary, expert consensus, systematic review, and original study [quasi-experiment and randomized controlled trial (RCT)] from UpToDate Clinical Advisor, Ovid database, National Guideline Clearinghouse (NGC), National Institute for Health and Care Excellence (NICE), Cochrane Library, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed/Medline, SinoMed, CNKI, Wanfang Database, VIP, and Yimai Tong Guideline Network were systematically searched. The search period covered from the establishment of these databases up to August 24, 2023. The quality of the literature was evaluated by two researchers with methodological expertise in evidence-based medicine, and the evidences were extracted and summarized. (2) Evidence-based practice: the elderly patients with high risk of sarcopenia who had been hospitalized in the ICU for more than 7 days from January to April 2024 were enrolled as the research subjects, and they were divided into a control group and an intervention group using convenience sampling method. The control group received routine intensive care nursing. The intervention group implemented exercise intervention based on the actual situation of the patients, the baseline review was conducted before evidence application, and the effectiveness of evidence application at 7 days and 14 days was evaluated.</p><p><strong>Results: </strong>(1) A total of 19 pieces of literature were included, including 4 guidelines, 1 summary of evidence, 4 expert consensuses, 4 systematic reviews, and 6 original studies (1 quasi-experiment, 5 RCT). After literature quality evaluation, all 19 articles were enrolled. Finally, 31 pieces of best evidence were extracted from eight aspects, including assessment and diagnosis, multidisciplinary cooperation, indication, preparation before intervention, intervention program, safety monitoring, post-intervention evaluation, and special task. (2) Finally, a total of 30 patients were enrolled in the intervention group, of which 17 completed 14 days of rehabilitation exercise, and 13 completed 7 days of rehabilitation exercise. Twenty-seven patients were enrolled in the control group, of which 17 completed 14 days of monitoring, and 10 completed 7 days of monitoring. Clinical evidence application results showed that the patients in the intervention group did not experience adverse events such as increased heart rate, extubation, or physical discomfort. The skeletal muscle mass index (SMI) in both groups was gradu","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"36 10","pages":"1095-1011"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717252","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}
Pub Date : 2024-10-01DOI: 10.3760/cma.j.cn121430-20231114-00978
Xiuwen Ling, Jianzhong Yang
Patients with new-onset atrial fibrillation in sepsis have a high mortality rate and poor prognosis. At present, the pathogenesis of new-onset atrial fibrillation in sepsis has not been fully elucidated. Studies have shown that both sepsis and atrial fibrillation are closely related to NOD-like receptor protein 3 (NLRP3). NLRP3 inflammasome can not only induce the activation of caspase-1 and the subsequent release of cellular pro-inflammatory factors, but also participate in the occurrence and development of sepsis and promote the occurrence and development of atrial fibrillation. It is concluded that the NLRP3 inflammasome may play an important role in the occurrence and development of new-onset atrial fibrillation in sepsis. This paper summarized the current research progress on the structure and function of the NLRP3 inflammasome, its role in sepsis, its mechanism in promoting atrial fibrillation, the relationship between the NLRP3 inflammasome and new-onset atrial fibrillation in sepsis, the feasibility of studying new-onset atrial fibrillation in sepsis, and potential therapeutic targets for new-onset atrial fibrillation in sepsis. This review aims to provide a theoretical basis for future research on the mechanisms by which the NLRP3 inflammasome promotes new-onset atrial fibrillation in sepsis and possible therapeutic targets.
{"title":"[Research progress on the mechanism of NLRP3 inflammasome in new-onset fibrillation in sepsis].","authors":"Xiuwen Ling, Jianzhong Yang","doi":"10.3760/cma.j.cn121430-20231114-00978","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20231114-00978","url":null,"abstract":"<p><p>Patients with new-onset atrial fibrillation in sepsis have a high mortality rate and poor prognosis. At present, the pathogenesis of new-onset atrial fibrillation in sepsis has not been fully elucidated. Studies have shown that both sepsis and atrial fibrillation are closely related to NOD-like receptor protein 3 (NLRP3). NLRP3 inflammasome can not only induce the activation of caspase-1 and the subsequent release of cellular pro-inflammatory factors, but also participate in the occurrence and development of sepsis and promote the occurrence and development of atrial fibrillation. It is concluded that the NLRP3 inflammasome may play an important role in the occurrence and development of new-onset atrial fibrillation in sepsis. This paper summarized the current research progress on the structure and function of the NLRP3 inflammasome, its role in sepsis, its mechanism in promoting atrial fibrillation, the relationship between the NLRP3 inflammasome and new-onset atrial fibrillation in sepsis, the feasibility of studying new-onset atrial fibrillation in sepsis, and potential therapeutic targets for new-onset atrial fibrillation in sepsis. This review aims to provide a theoretical basis for future research on the mechanisms by which the NLRP3 inflammasome promotes new-onset atrial fibrillation in sepsis and possible therapeutic targets.</p>","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"36 10","pages":"1108-1112"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717239","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}
Pub Date : 2024-10-01DOI: 10.3760/cma.j.cn121430-20240109-00026
Yanhong Li, Hong Qiu, Haiyin Yang, Li Li
<p><strong>Objective: </strong>To analyze the clinical characteristics of critically ill neonates in the neonatal intensive care unit (NICU) who acquired Serratia marcescens infection for onset or colonization, and to explore the risk factors contributing to the onset of Serratia marcescens infection.</p><p><strong>Methods: </strong>A retrospective case-control study was conducted by collecting clinical data from NICU neonates at the Women and Children's Hospital of Ningbo University between January 2017 and December 2023. Forty-four neonates with clinical signs and/or symptoms consistent with Serratia marcescens infection, and with Serratia marcescens isolated from specimens, would be enrolled as the infection onset group, while 45 neonates who tested positive for Serratia marcescens in rectal and/or pharyngeal cultures during the same period, but had no clinical signs or infection symptoms, were enrolled as the colonization control group. The distribution of bacteria in the neonates infected with Serratia marcescens was observed, and clinical data were subjected to univariate and binary multivariate Logistic regression analyses for screening the independent risk factors for onset of acquired Serratia marcescens infection in NICU.</p><p><strong>Results: </strong>During the 7-year period, 5 972 neonates were admitted to the NICU, of which 297 developed hospital-acquired infections. Among these, 44 neonates were identified with Serratia marcescens infection, accounting for 14.8% of hospital-acquired infections. During the same period, a total of 45 neonates were diagnosed with the colonization of Serratia marcescens, but did not develop any symptoms. The primary infection sites of the neonates in both the colonization control group and infection onset group were respiratory tract, accounting for 86.7% (39/45) and 43.2% (19/44), respectively. The highest rate of infection in the infection onset group was respiratory tract (43.2%), followed by bloodstream infection [29.6% (13/44)], intracranial infection [15.9%, (7/44)], intestinal infection [6.8% (3/44)], and urinary tract infection [4.5% (2/44)]; no deaths were reported. In addition to respiratory tract infection, 13.3% (6/45) of the neonates in the colonization control group had intestinal infection, and no pathogenic bacteria was detected in their blood, cerebrospinal fluid, or urine. Univariate analysis showed that compared with the colonization control group, the neonates in the infection onset group had lower gestational ages [days: 28.5 (26.9, 30.0) vs. 32.0 (30.1, 34.6), P < 0.01], lower birth weights and proportion of probiotic usage [birth weights (kg): 1.20 (0.96, 1.44) vs. 1.75 (1.45, 2.23), probiotic usage: 29.5% (13/44) vs. 57.8% (26/45), both P < 0.01], longer length of NICU stay and duration of antibiotic usage [length of NICU stay (days): 65.11±23.00 vs. 40.31±20.04, duration of antibiotic usage (days): 23.09±9.57 vs. 11.80±7.19, both P < 0.01], and higher proportions of invasive p
目的分析新生儿重症监护室（NICU）重症新生儿感染马氏沙雷氏菌发病或定植的临床特征，探讨导致马氏沙雷氏菌感染发病的危险因素：通过收集2017年1月至2023年12月期间宁波大学附属妇女儿童医院NICU新生儿的临床数据，开展了一项回顾性病例对照研究。将44名临床症状和/或体征符合马氏沙雷氏菌感染并从标本中分离出马氏沙雷氏菌的新生儿作为感染发病组，将同期直肠和/或咽部培养中马氏沙雷氏菌检测呈阳性但无临床症状或感染体征的45名新生儿作为定植对照组。观察感染了马氏沙雷氏菌的新生儿体内细菌的分布情况，并对临床数据进行单变量和二元多变量 Logistic 回归分析，以筛选出新生儿重症监护室内获得性马氏沙雷氏菌感染发病的独立风险因素：7 年间，新生儿重症监护室共接收了 5 972 名新生儿，其中 297 名发生了医院感染。其中，44 名新生儿被确认感染了沙雷氏菌，占医院感染病例的 14.8%。在同一时期，共有 45 名新生儿被诊断出定植了肉豆蔻沙雷氏菌，但没有出现任何症状。定植对照组和感染发病组新生儿的主要感染部位均为呼吸道，分别占 86.7%（39/45）和 43.2%（19/44）。在感染发病组中，呼吸道感染率最高（43.2%），其次是血流感染[29.6%（13/44）]、颅内感染[15.9%，（7/44）]、肠道感染[6.8%（3/44）]和泌尿道感染[4.5%（2/44）]；没有死亡报告。除呼吸道感染外，定植对照组有 13.3%（6/45）的新生儿出现肠道感染，但在他们的血液、脑脊液或尿液中均未检测到致病菌。单变量分析显示，与定植对照组相比，感染发病组的新生儿胎龄较低[天数：28.5（26.9，30.0） vs. 32.0（30.1，34.6），P <0.01]，出生体重和使用益生菌的比例较低[出生体重（千克）：1.20（0.96，0.96），P <0.01]：1.20 (0.96, 1.44) vs. 1.75 (1.45, 2.23)，使用益生菌的比例：29.5% (13/44) vs. 57.8% (26/45)，均 P <0.01]，新生儿重症监护室住院时间和抗生素使用时间更长[新生儿重症监护室住院时间（天）：65.11±23.00 vs. 57.8% (26/45)，均 P <0.01]：65.11±23.00 vs. 40.31±20.04，抗生素使用时间（天）：23.09±9.57 vs. 11.80±7.19，均 P <0.01]，机械通气 > 3 天和中心静脉导管插入 > 7 天等侵入性程序比例较高[机械通气 > 3 天：机械通气 > 3 天：61.4%（27/44） vs. 20.0%（9/45），中心静脉导管插入 > 7 天：81.8%（36/44） vs. 20.0%（9/45）：81.8%（36/44）vs.28.9%（13/45），均 P <0.01]，表明这些因素与新生儿重症监护室感染发病有关。二元多变量逻辑回归分析显示，出生体重≤1.5 千克[几率比（OR）= 5.745，95% 置信区间（95%CI）为 1.345-24.549，P = 0.018]、新生儿重症监护室住院时间大于 45 天（OR = 3.642，95%CI 为 1.102-12.041，P = 0.034）、抗生素使用时间（OR = 0.871，95%CI 为 0.799-0.949，P = 0.002）、未使用益生菌（OR = 3.191，95%CI为1.058-9.627，P=0.039）、机械通气>3天（OR=5.302，95%CI为1.510-18.619，P=0.009）和中心静脉导管插入>7天（OR=3.818，95%CI为1.103-13.212，P=0.034）等侵入性操作是NICU获得性大肠沙雷氏菌感染发病的独立危险因素：结论：新生儿重症监护室获得性沙雷氏菌感染的发病率很高。低出生体重、新生儿重症监护室住院时间过长、长期使用抗生素和侵入性治疗是新生儿重症监护室获得性大肠沙雷氏菌感染的独立风险因素。口服益生菌可能是预防新生儿重症监护室获得性沙雷氏菌感染的一种新方法。
{"title":"[Analysis of risk factors for onset of acquired Serratia marcescens infection in neonatal intensive care unit].","authors":"Yanhong Li, Hong Qiu, Haiyin Yang, Li Li","doi":"10.3760/cma.j.cn121430-20240109-00026","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240109-00026","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the clinical characteristics of critically ill neonates in the neonatal intensive care unit (NICU) who acquired Serratia marcescens infection for onset or colonization, and to explore the risk factors contributing to the onset of Serratia marcescens infection.</p><p><strong>Methods: </strong>A retrospective case-control study was conducted by collecting clinical data from NICU neonates at the Women and Children's Hospital of Ningbo University between January 2017 and December 2023. Forty-four neonates with clinical signs and/or symptoms consistent with Serratia marcescens infection, and with Serratia marcescens isolated from specimens, would be enrolled as the infection onset group, while 45 neonates who tested positive for Serratia marcescens in rectal and/or pharyngeal cultures during the same period, but had no clinical signs or infection symptoms, were enrolled as the colonization control group. The distribution of bacteria in the neonates infected with Serratia marcescens was observed, and clinical data were subjected to univariate and binary multivariate Logistic regression analyses for screening the independent risk factors for onset of acquired Serratia marcescens infection in NICU.</p><p><strong>Results: </strong>During the 7-year period, 5 972 neonates were admitted to the NICU, of which 297 developed hospital-acquired infections. Among these, 44 neonates were identified with Serratia marcescens infection, accounting for 14.8% of hospital-acquired infections. During the same period, a total of 45 neonates were diagnosed with the colonization of Serratia marcescens, but did not develop any symptoms. The primary infection sites of the neonates in both the colonization control group and infection onset group were respiratory tract, accounting for 86.7% (39/45) and 43.2% (19/44), respectively. The highest rate of infection in the infection onset group was respiratory tract (43.2%), followed by bloodstream infection [29.6% (13/44)], intracranial infection [15.9%, (7/44)], intestinal infection [6.8% (3/44)], and urinary tract infection [4.5% (2/44)]; no deaths were reported. In addition to respiratory tract infection, 13.3% (6/45) of the neonates in the colonization control group had intestinal infection, and no pathogenic bacteria was detected in their blood, cerebrospinal fluid, or urine. Univariate analysis showed that compared with the colonization control group, the neonates in the infection onset group had lower gestational ages [days: 28.5 (26.9, 30.0) vs. 32.0 (30.1, 34.6), P < 0.01], lower birth weights and proportion of probiotic usage [birth weights (kg): 1.20 (0.96, 1.44) vs. 1.75 (1.45, 2.23), probiotic usage: 29.5% (13/44) vs. 57.8% (26/45), both P < 0.01], longer length of NICU stay and duration of antibiotic usage [length of NICU stay (days): 65.11±23.00 vs. 40.31±20.04, duration of antibiotic usage (days): 23.09±9.57 vs. 11.80±7.19, both P < 0.01], and higher proportions of invasive p","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"36 10","pages":"1020-1024"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717160","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}
Pub Date : 2024-10-01DOI: 10.3760/cma.j.cn121430-20240617-00512
Ke Wei, Wenwen Zhang, Guang Feng, Xinguang Hu
<p><strong>Objective: </strong>To investigate the effects of Five-Element music intervention on anxiety, depression, and weaning successful rate in intensive care unit (ICU) patients with difficult weaning.</p><p><strong>Methods: </strong>A prospective randomized controlled trial was conducted. Eighty patients with difficulty in weaning accompanied by anxiety and depression disorders admitted to the respiratory intensive care unit (RICU) of Henan Provincial People's Hospital from January 2019 to January 2021 were enrolled as research subjects. They were divided into an observation group and a control group using a random number table method, 40 cases in each group. The patients in the control group received routine respiratory rehabilitation treatment, with daily assessments of weaning and gradual reduction of mechanical ventilation support until weaning was achieved. The patients in the observation group received additional Five-Element music therapy, in addition to routine respiratory rehabilitation treatment. Based on the clinical manifestations of the patients and applying traditional Chinese medicine theory for syndrome differentiation, music therapy was applied accordingly. The intervention used traditional Chinese Five-Element music (composed by Shi Feng, published by China Medical Electronic Audio and Visual Publishing House). Baseline data including the gender, age, etiology of acute respiratory distress syndrome (ARDS), and acute physiology and chronic health evaluation II (APACHE II) score of patients were recorded. A twelve-lead synchronous Holter monitor continuously recorded the R-wave dominant electrocardiogram signal for 24 hours or more. Heart rate variability (HRV) indices [standard deviation of all normal sinus R-R intervals (SDNN), standard deviation of 5-minute average R-R intervals (SDANN), percentage of continuous normal R-R intervals with differences greater than 50 ms (PNN50), and the root mean square of successive differences in adjacent R-R intervals (RMSSD)] were calculated, as well as HRV frequency domain parameters [low-frequency band (LF, 0.05-0.15 Hz), high-frequency band (HF, 0.16-0.50 Hz), and LF/HF ratio]. Additionally, the incidence of delirium, weaning successful rate, reintubation rate within 7 days, length of ICU stay, and hospital mortality were documented.</p><p><strong>Results: </strong>There were 8 cases in the control group dropping out, and resulting in 32 were participated, and the 40 cases in the observation group were all enrolled the analysis. There were no statistically significant differences in terms of gender, age, ARDS etiology, and APACHE II score between the two groups, indicating balanced baseline data for comparison. There were also no significant differences in HRV indices and frequency domain parameters before the intervention between the two groups. After the intervention, the observation group showed significant increases in HRV indices and frequency domain parameters as compared with
目的研究五元素音乐干预对重症监护病房（ICU）困难断奶患者的焦虑、抑郁和断奶成功率的影响：方法：进行了一项前瞻性随机对照试验。以2019年1月至2021年1月入住河南省人民医院呼吸重症监护室（RICU）的80例伴有焦虑和抑郁障碍的断奶困难患者为研究对象。采用随机数字表法将其分为观察组和对照组，每组 40 例。对照组患者接受常规呼吸康复治疗，每日评估断流情况，逐步减少机械通气支持，直至实现断流。观察组患者在常规呼吸康复治疗的基础上，额外接受五行音乐治疗。根据患者的临床表现，运用中医辨证理论，进行相应的音乐治疗。干预采用中国传统五行音乐（石峰作曲，中国医药电子音像出版社出版）。记录患者的性别、年龄、急性呼吸窘迫综合征（ARDS）病因、急性生理学和慢性健康评估 II（APACHE II）评分等基线数据。十二导联同步 Holter 监护仪连续记录 24 小时或更长时间的 R 波主导心电图信号。计算心率变异性（HRV）指数[所有正常窦性 R-R 间期的标准差（SDNN）、5 分钟平均 R-R 间期的标准差（SDANN）、差值大于 50 毫秒的连续正常 R-R 间期的百分比（PNN50）和相邻 R-R 间期连续差值的均方根（RMSSD）]以及 HRV 频域参数[低频段（LF，0.05-0.15赫兹）、高频段（HF，0.16-0.50赫兹）和LF/HF比值]。此外，还记录了谵妄发生率、断奶成功率、7 天内再次插管率、重症监护室住院时间和住院死亡率：结果：对照组有 8 例退出，导致 32 例参与分析，观察组的 40 例全部参与分析。两组患者在性别、年龄、ARDS 病因、APACHE II 评分等方面差异无统计学意义，表明两组患者的基线数据比较均衡。干预前，两组的心率变异指数和频域参数也无明显差异。干预后，与对照组相比，观察组的心率变异指数和频域参数均有明显增加[SDNN（ms）：77.21±11.75 vs. 77.21±11.75 (ms)]：77.21±11.75 vs. 63.81±13.50，SDANN (ms)：83.51±19.45 vs. 50.40±14.55, PNN50: (10.75±3.42)% vs. (7.79±3.13)%, RMSSD (ms)：47.15±6.57 vs. 31.74±6.37，HF（ms2/Hz）：568.50±144.48 vs. 496.94±151.56，低频（ms2/Hz）：840.13±110.76 vs. 587.81±144.51，LF/HF 比值：1.60±0.60 vs. 1.22±0.21，所有 P <0.05]。对照组中有17例患者出现谵妄，其中多动谵妄12例，低动谵妄3例，混合型谵妄2例；观察组中有9例患者出现谵妄，其中多动谵妄7例，低动谵妄1例，混合型谵妄1例。两组患者的谵妄类型无明显差异（P>0.05），但观察组的谵妄发生率明显低于对照组（22.50% 对 53.12%，P<0.01）。观察组的断奶成功率明显高于对照组 [95.00% (38/40) vs. 78.12% (25/32)，P < 0.05]，7 天内再次插管率和住院死亡率略低于对照组 [7 天内再次插管率：5.00% (2/40) vs. 78.12% (25/32)，P < 0.01]：5.00% (2/40) vs. 15.62% (5/32)，住院死亡率：0% (0/40) vs. 3.12% (1/32)，P均>0.05]，ICU住院时间也略短于对照组[天数：18.00 (17.00, 25.75) vs. 22.50 (15.00, 34.50)，P>0.05]：五行音乐疗法有利于改善 ICU 难断奶患者的焦虑和抑郁障碍，降低谵妄发生率，提高断奶成功率。
{"title":"[Effects of Five-Element music intervention on anxiety and depressive disorders and successful rate of extubation in intensive care unit patients with difficult weaning].","authors":"Ke Wei, Wenwen Zhang, Guang Feng, Xinguang Hu","doi":"10.3760/cma.j.cn121430-20240617-00512","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240617-00512","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effects of Five-Element music intervention on anxiety, depression, and weaning successful rate in intensive care unit (ICU) patients with difficult weaning.</p><p><strong>Methods: </strong>A prospective randomized controlled trial was conducted. Eighty patients with difficulty in weaning accompanied by anxiety and depression disorders admitted to the respiratory intensive care unit (RICU) of Henan Provincial People's Hospital from January 2019 to January 2021 were enrolled as research subjects. They were divided into an observation group and a control group using a random number table method, 40 cases in each group. The patients in the control group received routine respiratory rehabilitation treatment, with daily assessments of weaning and gradual reduction of mechanical ventilation support until weaning was achieved. The patients in the observation group received additional Five-Element music therapy, in addition to routine respiratory rehabilitation treatment. Based on the clinical manifestations of the patients and applying traditional Chinese medicine theory for syndrome differentiation, music therapy was applied accordingly. The intervention used traditional Chinese Five-Element music (composed by Shi Feng, published by China Medical Electronic Audio and Visual Publishing House). Baseline data including the gender, age, etiology of acute respiratory distress syndrome (ARDS), and acute physiology and chronic health evaluation II (APACHE II) score of patients were recorded. A twelve-lead synchronous Holter monitor continuously recorded the R-wave dominant electrocardiogram signal for 24 hours or more. Heart rate variability (HRV) indices [standard deviation of all normal sinus R-R intervals (SDNN), standard deviation of 5-minute average R-R intervals (SDANN), percentage of continuous normal R-R intervals with differences greater than 50 ms (PNN50), and the root mean square of successive differences in adjacent R-R intervals (RMSSD)] were calculated, as well as HRV frequency domain parameters [low-frequency band (LF, 0.05-0.15 Hz), high-frequency band (HF, 0.16-0.50 Hz), and LF/HF ratio]. Additionally, the incidence of delirium, weaning successful rate, reintubation rate within 7 days, length of ICU stay, and hospital mortality were documented.</p><p><strong>Results: </strong>There were 8 cases in the control group dropping out, and resulting in 32 were participated, and the 40 cases in the observation group were all enrolled the analysis. There were no statistically significant differences in terms of gender, age, ARDS etiology, and APACHE II score between the two groups, indicating balanced baseline data for comparison. There were also no significant differences in HRV indices and frequency domain parameters before the intervention between the two groups. After the intervention, the observation group showed significant increases in HRV indices and frequency domain parameters as compared with ","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"36 10","pages":"1044-1048"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717205","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}
Pub Date : 2024-10-01DOI: 10.3760/cma.j.cn121430-20230829-00712
Min Xiao, Peng Wang, Baiqiang Li, Weiqin Li, Dadong Liu
<p><strong>Objective: </strong>To evaluate the predictive value of neutrophil free fatty acid receptor 3 (FFAR3) for secondary infection in patients with severe acute pancreatitis (SAP).</p><p><strong>Methods: </strong>(1) Biological information analysis: peripheral blood microarray data sets related to acute pancreatitis (GSE194331) were obtained from the Gene Expression Omnibus (GEO), including data from 32 healthy adults, 52 patients with mild acute pancreatitis, 20 patients with moderate-to-severe acute pancreatitis, and 10 patients with SAP. The original data of GSE194331 dataset were downloaded for quality control, pruning, quantification, annotation and difference analysis, and the different genes were obtained. (2) Clinical study: a prospective observational study was conducted. Forty-five SAP patients admitted to the critical care medicine department of the Eastern Theater Command General Hospital of the Chinese People's Liberation Army from January to November 2022 were enrolled, and they were divided into infected group and non-infected group according to whether secondary infection occurred during intensive care unit (ICU) stay. At the same time, 10 healthy adult volunteers were enrolled as control. Peripheral blood of subjects in each group was collected, neutrophils were isolated, and FFAR3 mRNA expression was detected by real-time fluorescence quantitative reverse transcription-polymerase chain reaction (RT-PCR). Spearman correlation method was used to analyze the correlation between neutrophil FFAR3 mRNA expression and secondary infection in SAP patients. Multivariate Logistic regression analysis was used to evaluate whether neutrophil FFAR3 mRNA expression was a risk factor for secondary infection in SAP patients. Receiver operator characteristic curve (ROC curve) was plotted to evaluate the predictive value of neutrophil FFAR3 mRNA expression on secondary infection in SAP patients.</p><p><strong>Results: </strong>(1) Results of biological information analysis: the analysis of GSE194331 dataset showed that 301 genes were differentially expressed in peripheral blood cells between healthy controls and patients with pancreatitis. By biological function analysis, 8 biological functions involved in immune response were obtained, and 44 differential expressed genes were enriched in these 8 biological functions. The results of cell distribution analysis showed that there were 21 differential expressed genes expressions on neutrophils significantly higher than other immune cells, and the gene related to lipid metabolism was FFAR3. These results indicated that FFAR3 expression was closely related to the occurrence and development of SAP. (2) Clinical study results: out of the 45 SAP patients, 24 developed into secondary infection during ICU stay, 21 did not develop into secondary infection. The expression of neutrophil FFAR3 mRNA in SAP patients with secondary infection was significantly higher than that in SAP patients without secondary
目的方法：（1）生物信息分析：从基因表达总库（Gene Expression Omnibus，GEO）获得急性胰腺炎相关的外周血芯片数据集（GSE194331），包括32名健康成人、52名轻度急性胰腺炎患者、20名中重度急性胰腺炎患者和10名SAP患者的数据。下载GSE194331数据集的原始数据，进行质控、剪枝、量化、注释和差异分析，得到不同基因。(2）临床研究：这是一项前瞻性观察研究。选取2022年1月至11月中国人民解放军东部战区司令部总医院重症医学科收治的45例SAP患者为研究对象，根据患者在重症监护室（ICU）住院期间是否发生继发感染分为感染组和非感染组。同时，10 名健康成年志愿者作为对照。采集各组受试者的外周血，分离中性粒细胞，采用实时荧光定量反转录聚合酶链反应（RT-PCR）检测 FFAR3 mRNA 的表达。采用斯皮尔曼相关法分析 SAP 患者中性粒细胞 FFAR3 mRNA 表达与继发感染的相关性。采用多变量 Logistic 回归分析评估中性粒细胞 FFAR3 mRNA 表达是否是 SAP 患者继发感染的危险因素。结果：（1）生物信息分析结果：对 GSE194331 数据集的分析表明，健康对照组和胰腺炎患者的外周血细胞中有 301 个基因存在差异表达。通过生物功能分析，得到了参与免疫反应的 8 种生物功能，在这 8 种生物功能中富集了 44 个差异表达基因。细胞分布分析结果显示，有 21 个差异表达基因在中性粒细胞上的表达明显高于其他免疫细胞，其中与脂质代谢相关的基因是 FFAR3。这些结果表明，FFAR3 的表达与 SAP 的发生和发展密切相关。(2）临床研究结果：45 例 SAP 患者中，24 例在重症监护室住院期间发展为继发感染，21 例未发展为继发感染。继发感染的 SAP 患者中性粒细胞 FFAR3 mRNA 的表达明显高于未继发感染的 SAP 患者和健康对照组 [2-ΔΔCt: 3.8 (3.0, 4.2) vs. 1.4 (1.1, 2.7), 1.0 (0.8, 1.1), 均 P <0.05]。斯皮尔曼相关分析显示，中性粒细胞 FFAR3 mRNA 表达与 SAP 患者的继发感染呈正相关（r = 0.799，P < 0.001）。多变量逻辑回归分析显示，FFAR3 mRNA 表达增加是 SAP 患者继发感染的独立危险因素[几率比（OR）= 17.212，95% 置信区间（95%CI）为 3.004-98.613，P = 0.001]。ROC曲线分析显示，中性粒细胞FFAR3 mRNA表达预测SAP患者继发感染的ROC曲线下面积（AUC）为0.856（95%CI为0.750-0.981，P＜0.001）。当最佳临界值为 2.37 时，敏感性为 95.83%，特异性为 76.19%。根据 ROC 曲线分析得出的中性粒细胞 FFAR3 mRNA 表达预测 SAP 患者继发感染的最佳临界值（2.37），45 例 SAP 患者被分为两组进行亚组分析。结果表明，FFAR3 mRNA表达水平≥2.37的SAP患者继发感染的发生率明显高于FFAR3 mRNA表达水平<2.37的SAP患者[82.14%（23/28）vs.5.88%（1/17）]，差异有统计学意义（P<0.01）：中性粒细胞中FFAR3 mRNA的表达与SAP患者的继发感染密切相关，监测其表达水平可有效预测SAP患者的继发感染。
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