首页 > 最新文献

Zhonghua wei zhong bing ji jiu yi xue最新文献

英文 中文
[Platelet/white blood cell ratio in the prediction of postoperative acute kidney injury of patients]. [血小板/白细胞比值在预测患者术后急性肾损伤中的应用]。
Q3 Medicine Pub Date : 2024-10-01 DOI: 10.3760/cma.j.cn121430-20240731-00648
Jie Long, Rui Liu, Huan Chen, Pan Lei, Changliang Zhu
<p><strong>Objective: </strong>To investigate the risk factors and predictive value on acute kidney injury (AKI) following surgery, and to elucidate the relationship between platelet/white blood cell ratio (PWR) and AKI.</p><p><strong>Methods: </strong>A retrospective case-control study was conducted. The patients who underwent surgery admitted to Honghui Hospital of Xi'an Jiaotong University from January 2019 to January 2023 were enrolled. The patients who developed AKI during the postoperative hospital stay were categorized as the AKI group, while those with normal renal function or not meeting AKI criteria were categorized as the non-AKI group. Demographic information, clinical characteristics, perioperative medication usage, surgical related information, and preoperative and postoperative laboratory indicators were collected. Binary multivariate Logistic regression analysis was used to identify risk factors for postoperative AKI. Receiver operator characteristic curve (ROC curve) was plotted to assess the predictive efficacy of postoperative PWR for postoperative AKI.</p><p><strong>Results: </strong>A total of 420 patients were enrolled finally, with 72 developing AKI during hospitalization and 348 not developing AKI. Compared with the non-AKI group, the patients in the AKI group had a higher proportion of hypertension and coronary heart disease, a more usage of angiotensin converting enzyme inhibitor (ACEI), mannitol and vancomycin but a less usage of hydroxyethyl starch, a longer duration from injury to surgery and postoperative hospital stay, a greater intraoperative blood transfusion volume, a lower preoperative albumin (Alb), blood sodium, blood chlorine but a higher serum creatinine (SCr), blood urea nitrogen (BUN)/Alb ratio and N-terminal pro-brain natriuretic peptide (NT-proBNP), and a higher postoperative white blood cell count (WBC), BUN, SCr, BUN/Alb ratio, blood potassium, and blood phosphorus but a lower platelet count (PLT), PWR, and Alb. Binary multivariate Logistic regression analysis revealed that perioperative usage of hydroxyethyl starch [odds ratio (OR) = 8.595, 95% confidence interval (95%CI) was 4.112-17.964, P < 0.001], prolonged duration from injury to surgery (OR = 1.084, 95%CI was 1.034-1.137, P = 0.001), increased intraoperative blood transfusion volume (OR = 1.001, 95%CI was 1.000-1.002, P = 0.017) were risk factors for AKI following surgery, and increased postoperative PWR was protective factor (OR = 0.930, 95%CI was 0.894-0.967, P < 0.001). ROC curve analysis indicated that the area under the ROC curve (AUC) of postoperative PWR for predicting postoperative AKI was 0.684 (95%CI was 0.615-0.754); at the optimal cut-off value of 19.34, the sensitivity was 63.8%, and the specificity was 69.8%.</p><p><strong>Conclusions: </strong>Postoperative PWR is an independent risk factor for AKI in patients undergoing surgery. Postoperative PWR reduction in surgical patients can assist in predicting the occurrence of postoperat
目的研究手术后急性肾损伤(AKI)的风险因素和预测价值,并阐明血小板/白细胞比值(PWR)与 AKI 的关系:方法:进行了一项回顾性病例对照研究。方法:本研究为一项回顾性病例对照研究,研究对象为2019年1月至2023年1月在西安交通大学红会医院接受手术治疗的患者。将术后住院期间发生AKI的患者归为AKI组,将肾功能正常或不符合AKI标准的患者归为非AKI组。研究人员收集了患者的人口统计学信息、临床特征、围手术期用药情况、手术相关信息以及术前和术后实验室指标。采用二元多变量逻辑回归分析来确定术后 AKI 的风险因素。绘制接收者操作特征曲线(ROC 曲线)以评估术后脉搏波速度对术后 AKI 的预测效果:最终共有 420 例患者入选,其中 72 例在住院期间发生了 AKI,348 例未发生 AKI。与未发生 AKI 组相比,AKI 组患者的高血压和冠心病比例较高,血管紧张素转换酶抑制剂(ACEI)、甘露醇和万古霉素的用量较多,但羟乙基淀粉的用量较少,从受伤到手术和术后住院的时间较长,术中输血量较大、术前白蛋白(Alb)、血钠、血氯较低,但血清肌酸酐(SCr)、血尿素氮(BUN)/Alb 比值和 N 端前脑钠尿肽(NT-proBNP)较高;术后白细胞计数(WBC)、BUN、SCr、BUN/Alb 比值、血钾和血磷较高,但血小板计数(PLT)、脉搏波速度(PWR)和白蛋白较低。二元多变量逻辑回归分析显示,围手术期使用羟乙基淀粉[几率比(OR)= 8.595,95% 置信区间(95%CI)为 4.112-17.964,P <0.001]、从受伤到手术的时间延长(OR = 1.084,95%CI 为 1.034-1.137, P = 0.001)、术中输血量增加(OR = 1.001, 95%CI 为 1.000-1.002, P = 0.017)是术后发生 AKI 的危险因素,而术后脉搏波速度增加是保护因素(OR = 0.930, 95%CI 为 0.894-0.967, P < 0.001)。ROC曲线分析表明,术后脉搏波速度预测术后AKI的ROC曲线下面积(AUC)为0.684(95%CI为0.615-0.754);最佳临界值为19.34时,敏感性为63.8%,特异性为69.8%:结论:术后脉搏波速度是手术患者发生 AKI 的独立风险因素。结论:术后脉搏波速度是手术患者发生 AKI 的独立风险因素,降低手术患者术后脉搏波速度有助于预测术后 AKI 的发生。
{"title":"[Platelet/white blood cell ratio in the prediction of postoperative acute kidney injury of patients].","authors":"Jie Long, Rui Liu, Huan Chen, Pan Lei, Changliang Zhu","doi":"10.3760/cma.j.cn121430-20240731-00648","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240731-00648","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate the risk factors and predictive value on acute kidney injury (AKI) following surgery, and to elucidate the relationship between platelet/white blood cell ratio (PWR) and AKI.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective case-control study was conducted. The patients who underwent surgery admitted to Honghui Hospital of Xi'an Jiaotong University from January 2019 to January 2023 were enrolled. The patients who developed AKI during the postoperative hospital stay were categorized as the AKI group, while those with normal renal function or not meeting AKI criteria were categorized as the non-AKI group. Demographic information, clinical characteristics, perioperative medication usage, surgical related information, and preoperative and postoperative laboratory indicators were collected. Binary multivariate Logistic regression analysis was used to identify risk factors for postoperative AKI. Receiver operator characteristic curve (ROC curve) was plotted to assess the predictive efficacy of postoperative PWR for postoperative AKI.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 420 patients were enrolled finally, with 72 developing AKI during hospitalization and 348 not developing AKI. Compared with the non-AKI group, the patients in the AKI group had a higher proportion of hypertension and coronary heart disease, a more usage of angiotensin converting enzyme inhibitor (ACEI), mannitol and vancomycin but a less usage of hydroxyethyl starch, a longer duration from injury to surgery and postoperative hospital stay, a greater intraoperative blood transfusion volume, a lower preoperative albumin (Alb), blood sodium, blood chlorine but a higher serum creatinine (SCr), blood urea nitrogen (BUN)/Alb ratio and N-terminal pro-brain natriuretic peptide (NT-proBNP), and a higher postoperative white blood cell count (WBC), BUN, SCr, BUN/Alb ratio, blood potassium, and blood phosphorus but a lower platelet count (PLT), PWR, and Alb. Binary multivariate Logistic regression analysis revealed that perioperative usage of hydroxyethyl starch [odds ratio (OR) = 8.595, 95% confidence interval (95%CI) was 4.112-17.964, P &lt; 0.001], prolonged duration from injury to surgery (OR = 1.084, 95%CI was 1.034-1.137, P = 0.001), increased intraoperative blood transfusion volume (OR = 1.001, 95%CI was 1.000-1.002, P = 0.017) were risk factors for AKI following surgery, and increased postoperative PWR was protective factor (OR = 0.930, 95%CI was 0.894-0.967, P &lt; 0.001). ROC curve analysis indicated that the area under the ROC curve (AUC) of postoperative PWR for predicting postoperative AKI was 0.684 (95%CI was 0.615-0.754); at the optimal cut-off value of 19.34, the sensitivity was 63.8%, and the specificity was 69.8%.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Postoperative PWR is an independent risk factor for AKI in patients undergoing surgery. Postoperative PWR reduction in surgical patients can assist in predicting the occurrence of postoperat","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"36 10","pages":"1063-1068"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Bedside ultrasound monitoring of optic nerve sheath diameter is a predictive factor for 28-day coma, delirium and death in etiologically diverse critically ill patients]. [床旁超声监测视神经鞘直径是不同病因重症患者 28 天昏迷、谵妄和死亡的预测因素]。
Q3 Medicine Pub Date : 2024-10-01 DOI: 10.3760/cma.j.cn121430-20230511-00362
Haijun Zhi, Xiaoya Cui, Fengwei Zhang, Shujuan Wang, Xuezheng Liang, Bo Wang, Jie Cui, Yong Li
<p><strong>Objective: </strong>To explore whether the optic nerve sheath diameter (ONSD) within 24 hours of intensive care unit (ICU) admission is the predictor of 28-day delirium or coma and death in etiologically diverse critically ill patients.</p><p><strong>Methods: </strong>A prospective, observational study was conducted. The critically ill patients admitted to the emergency ICU of Cangzhou Central Hospital from January 2021 to October 2022 were enrolled. Bedside ultrasound monitoring ONSD was performed within 24 hours of ICU admission. The consciousness status was assessed daily during ICU hospitalization. Coma was defined as Glasgow coma scale (GCS) score < 8 or Richmond agitation-sedation scale (RASS) score -4 or -5. Delirium was defined as responsiveness to verbal stimulation and with a positive confusion assessment method-intensive care unit (CAM-ICU). A positive result of CAM-ICU was defined as acute change or fluctuating course of mental status+inattention+altered level of consciousness or disorganized thinking. X-tile software analysis was used to visualize the best cut-off value for creating divisions in predicting 28-day coma or delirium and death, and then Kaplan-Meier curves were plotted. ONSD≥the optimal cut-off value from X-tile analysis was defined as ONSD broadening. ONSD broadening and related indicators were enrolled, and multivariate Cox regression analysis was used to analyze the risk factors of 28-day coma or delirium and 28-day death in etiologically diverse critically ill patients.</p><p><strong>Results: </strong>A total of 321 critically ill patients were enrolled. Of them, 49 had primary brain injury, 54 had hypoxic ischemic brain injury (HIBI) after cardiac arrest, 70 had acute heart failure, 73 had sepsis, and 75 had other causes. Coma affected 184 patients (57.3%), and delirium affected 173 patients (53.9%). At 28 days of follow-up, 100 patients died, 16 patients remained comatose and 20 patients remained delirious. In all patients, as the GCS score decreased upon admission to the ICU, there was a gradually increasing trend in ONSD [GCS score 15 group: 5.20 (4.93, 5.43) mm, GCS score 10-14 group: 5.30 (4.90, 5.65) mm, GCS score 6-9 group: 5.40 (5.10, 5.80) mm, GCS score < 6 group: 5.70 (5.20, 5.96) mm, P < 0.05]. X-tile software analysis showed that in all patients and five etiological subgroups, ONSD broadening was a predictor for 28-day coma or delirium, and the optimal cut-off value was obtained (5.60 mm for all patients, 4.90 mm for primary brain injury, 5.75 mm for HIBI after cardiac arrest, 5.40 mm for acute heart failure, 5.90 mm for sepsis, and 5.75 mm for other causes). The Kaplan-Meier curves were plotted according to the optimal cut-off values, and the results showed that the higher the ONSD, the higher the incidence and duration of coma or delirium within 28 days in above patient population. X-tile software analysis showed that in all patients, and HIBI after cardiac arrest, sepsis and other causes pa
目的探讨重症监护病房(ICU)患者入院 24 小时内的视神经鞘直径(ONSD)是否能预测 28 天内不同病因重症患者的谵妄或昏迷以及死亡:进行了一项前瞻性观察研究。研究对象为 2021 年 1 月至 2022 年 10 月期间入住沧州市中心医院急诊重症监护室的重症患者。在患者入院 24 小时内进行床旁超声监测 ONSD。在重症监护室住院期间,每天评估意识状态。昏迷定义为格拉斯哥昏迷量表(GCS)评分<8分或里士满躁动镇静量表(RASS)评分-4或-5分。谵妄的定义是对言语刺激有反应,且意识模糊评估方法-重症监护室(CAM-ICU)呈阳性。CAM-ICU 阳性结果定义为精神状态急性改变或波动过程+注意力不集中+意识水平改变或思维紊乱。采用X-tile软件分析,以直观的方式确定预测28天昏迷或谵妄和死亡的最佳临界值,然后绘制Kaplan-Meier曲线。ONSD≥X-tile分析得出的最佳临界值被定义为ONSD增宽。对ONSD增宽及相关指标进行登记,并采用多变量Cox回归分析法对不同病因的重症患者28天昏迷或谵妄及28天死亡的风险因素进行分析:共有321名重症患者入选。其中,49 名患者为原发性脑损伤,54 名患者为心脏骤停后缺氧缺血性脑损伤(HIBI),70 名患者为急性心力衰竭,73 名患者为败血症,75 名患者为其他原因。昏迷患者有 184 人(57.3%),谵妄患者有 173 人(53.9%)。在 28 天的随访中,100 名患者死亡,16 名患者仍然昏迷,20 名患者仍然神志不清。所有患者在进入重症监护室后,随着 GCS 评分的降低,ONSD 有逐渐增加的趋势[GCS 评分 15 组:5.20(4.93,4.93);GCS 评分 15 组:5.20(4.93,4.93);GCS 评分 15 组:5.20(4.93,4.93):GCS评分15分组:5.20(4.93,5.43)毫米,GCS评分10-14分组:5.30(4.90,5.43)毫米:5.30(4.90,5.65)毫米,GCS 评分 6-9 组:5.40(5.10,5.80)毫米,GCS 评分小于 6 分组:5.70 (5.20, 5.96) mm,P < 0.05]。X-tile软件分析表明,在所有患者和五个病因亚组中,ONSD增宽是28天昏迷或谵妄的预测因子,并得出了最佳临界值(所有患者为5.60毫米,原发性脑损伤为4.90毫米,心脏骤停后HIBI为5.75毫米,急性心力衰竭为5.40毫米,败血症为5.90毫米,其他原因为5.75毫米)。根据最佳截断值绘制了卡普兰-梅耶曲线,结果显示 ONSD 越高,上述患者人群 28 天内昏迷或谵妄的发生率和持续时间就越长。X-tile软件分析显示,在所有患者、心脏骤停后HIBI患者、败血症患者和其他原因患者中,ONSD是28天内死亡的预测因子,并得出了最佳临界值(所有患者为6.20毫米,心脏骤停后HIBI患者为5.85毫米,败血症患者为5.35毫米,其他原因患者为6.10毫米)。根据最佳临界值绘制了 Kaplan-Meier 曲线,结果显示 ONSD 越高,上述患者人群的 28 天存活率越高,存活时间越短。多变量 Cox 回归分析显示,ONSD 增宽是所有患者 28 天昏迷或谵妄的独立危险因素[危险比(HR)= 1.513,95% 置信区间(95%CI)为 1.093-2.095,P = 0.013],也是原发性脑损伤患者 28 天昏迷或谵妄的独立危险因素(HR = 5.739,95%CI 为 2.112-15.590,P = 0.001)。然而,在所有患者或五个病因亚组中,ONSD扩大与28天死亡并无独立关联:结论:在不同病因的重症患者中,入院 24 小时内的 ONSD 是 28 天昏迷或谵妄的独立风险因素。在原发性脑损伤、心脏骤停后HIBI、急性心力衰竭、败血症和其他病因等5个病因亚组中,它是28天昏迷或谵妄的预测因子,但不是28天死亡的预测因子。
{"title":"[Bedside ultrasound monitoring of optic nerve sheath diameter is a predictive factor for 28-day coma, delirium and death in etiologically diverse critically ill patients].","authors":"Haijun Zhi, Xiaoya Cui, Fengwei Zhang, Shujuan Wang, Xuezheng Liang, Bo Wang, Jie Cui, Yong Li","doi":"10.3760/cma.j.cn121430-20230511-00362","DOIUrl":"10.3760/cma.j.cn121430-20230511-00362","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To explore whether the optic nerve sheath diameter (ONSD) within 24 hours of intensive care unit (ICU) admission is the predictor of 28-day delirium or coma and death in etiologically diverse critically ill patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A prospective, observational study was conducted. The critically ill patients admitted to the emergency ICU of Cangzhou Central Hospital from January 2021 to October 2022 were enrolled. Bedside ultrasound monitoring ONSD was performed within 24 hours of ICU admission. The consciousness status was assessed daily during ICU hospitalization. Coma was defined as Glasgow coma scale (GCS) score &lt; 8 or Richmond agitation-sedation scale (RASS) score -4 or -5. Delirium was defined as responsiveness to verbal stimulation and with a positive confusion assessment method-intensive care unit (CAM-ICU). A positive result of CAM-ICU was defined as acute change or fluctuating course of mental status+inattention+altered level of consciousness or disorganized thinking. X-tile software analysis was used to visualize the best cut-off value for creating divisions in predicting 28-day coma or delirium and death, and then Kaplan-Meier curves were plotted. ONSD≥the optimal cut-off value from X-tile analysis was defined as ONSD broadening. ONSD broadening and related indicators were enrolled, and multivariate Cox regression analysis was used to analyze the risk factors of 28-day coma or delirium and 28-day death in etiologically diverse critically ill patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 321 critically ill patients were enrolled. Of them, 49 had primary brain injury, 54 had hypoxic ischemic brain injury (HIBI) after cardiac arrest, 70 had acute heart failure, 73 had sepsis, and 75 had other causes. Coma affected 184 patients (57.3%), and delirium affected 173 patients (53.9%). At 28 days of follow-up, 100 patients died, 16 patients remained comatose and 20 patients remained delirious. In all patients, as the GCS score decreased upon admission to the ICU, there was a gradually increasing trend in ONSD [GCS score 15 group: 5.20 (4.93, 5.43) mm, GCS score 10-14 group: 5.30 (4.90, 5.65) mm, GCS score 6-9 group: 5.40 (5.10, 5.80) mm, GCS score &lt; 6 group: 5.70 (5.20, 5.96) mm, P &lt; 0.05]. X-tile software analysis showed that in all patients and five etiological subgroups, ONSD broadening was a predictor for 28-day coma or delirium, and the optimal cut-off value was obtained (5.60 mm for all patients, 4.90 mm for primary brain injury, 5.75 mm for HIBI after cardiac arrest, 5.40 mm for acute heart failure, 5.90 mm for sepsis, and 5.75 mm for other causes). The Kaplan-Meier curves were plotted according to the optimal cut-off values, and the results showed that the higher the ONSD, the higher the incidence and duration of coma or delirium within 28 days in above patient population. X-tile software analysis showed that in all patients, and HIBI after cardiac arrest, sepsis and other causes pa","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"36 10","pages":"1088-1094"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Effects of neutrophilic granule protein on the expression of lipocalin 2 in inflammatory macrophages]. [嗜中性粒细胞蛋白对炎性巨噬细胞中脂钙蛋白 2 表达的影响]。
Q3 Medicine Pub Date : 2024-10-01 DOI: 10.3760/cma.j.cn121430-20240104-00015
Jing Wang, Ji Cheng, Quanwei Bao, Junyu Zhu, Huaping Liang

Objective: To explore the effects of neutrophilic granule protein (NGP) on the expression of lipocalin 2 (LCN2) in inflammatory macrophages and its mechanism.

Methods: NGP-high-expressed RAW264.7 cells (NGP/RAW cells) and negative control RAW264.7 cells (NC/RAW cells) were cultured in vitro. Primary peritoneal macrophages of NGP-high-expressed mice and wild-type C57BL/6 mice were extracted, then cultured in vitro. The cell inflammatory model was established by stimulating with 10 mg/L lipopolysaccharide (LPS, LPS group), and the phosphate buffer solution (PBS) control group was set up. Enzyme-linked immunosorbent assay (ELISA) was used to detect the level of LCN2 in different types of cells. The protein expression of phosphorylated signal transduction and activator of transcription 1 (p-STAT1) was detected with Western blotting. Other NGP/RAW cells and NC/RAW cells were treated with 10 mg/L LPS, 5 mg/L STAT1 pathway inhibitor (fludarabine)+10 mg/L LPS, respectively. The PBS control group was set up. ELISA was used to detect the level of LCN2.

Results: In different types of cells, the levels of LCN2 were increased significantly after LPS stimulation in the LPS group as compared with those in the PBS control group, and peaked at 24 hours (μmol/L: 25.61±1.02 vs. 0.46±0.02 in NC/RAW cells, 74.51±2.14 vs. 0.25±0.04 in NGP/RAW cells, 10.13±0.22 vs. 0.01±0.01 in primary macrophages of wild-type C57BL/6 mice, 28.35±0.61 vs. 0.08±0.01 in primary macrophages of NGP-high-expressed mice, all P < 0.05), indicating that the expression of LCN2 in macrophages altered during inflammation reaction. The level of LCN2 in NGP/RAW cells was found significantly increased at different time points after LPS stimulation comparing with that in NC/RAW cells (μmol/L: 8.32±0.22 vs. 3.12±0.11 at 6 hours, 23.12±0.86 vs. 8.12±0.32 at 12 hours, 74.51±2.14 vs. 25.61±1.02 at 24 hours, all P < 0.05), along with the expression of p-STAT1 was significantly up-regulated. The level of LCN2 in the primary macrophages of NGP-high-expressed mice was also significantly increased at 24 hours after LPS stimulation comparing with that in the primary macrophages of wild-type C57BL/6 mice (μmol/L: 28.35±0.61 vs. 10.13±0.22, P < 0.05). However, after pretreated with STAT1 pathway inhibitors, the production of LCN2 in NGP/RAW cells was decreased significantly comparing with that in the LPS group (μmol/L: 6.81±0.19 vs. 22.54±0.58, P < 0.05). But the inhibitors had no significant effect on LCN2 production in NC/RAW cells showing no significant difference as compared with LPS group (μmol/L: 8.04±0.20 vs. 7.86±0.15, P > 0.05), indicating that NGP could up-regulate the expression of LCN2 in macrophages stimulated by LPS by promoting STAT1 activation.

Conclusions: NGP could positively regulate LCN2 expression in inflammatory macrophages by activating STAT1 pathway.

目的探讨中性粒细胞蛋白(NGP)对炎性巨噬细胞中脂钙蛋白2(LCN2)表达的影响及其机制:方法:体外培养高表达 NGP 的 RAW264.7 细胞(NGP/RAW 细胞)和阴性对照 RAW264.7 细胞(NC/RAW 细胞)。提取 NGP 高表达小鼠和野生型 C57BL/6 小鼠的原代腹腔巨噬细胞,然后进行体外培养。用 10 mg/L 脂多糖(LPS,LPS 组)刺激建立细胞炎症模型,并设立磷酸盐缓冲液(PBS)对照组。采用酶联免疫吸附试验(ELISA)检测不同类型细胞中 LCN2 的水平。用 Western 印迹法检测磷酸化信号转导和转录激活因子 1(p-STAT1)的蛋白表达。其他 NGP/RAW 细胞和 NC/RAW 细胞分别接受 10 mg/L LPS、5 mg/L STAT1 通路抑制剂(氟达拉滨)+10 mg/L LPS 处理。另设 PBS 对照组。用 ELISA 检测 LCN2 的水平:结果:与 PBS 对照组相比,LPS 组不同类型细胞在 LPS 刺激后 LCN2 水平显著升高,并在 24 小时达到峰值(μmol/L:NC/RAW 细胞为 25.61±1.02 vs. 0.46±0.02,NGP/RAW 细胞为 74.51±2.14 vs. 0.25±0.04 NGP/RAW 细胞为 74.51±2.14 vs. 0.25±0.04 NGP/RAW 细胞为 74.51±2.1404,野生型 C57BL/6 小鼠原代巨噬细胞 10.13±0.22 vs. 0.01±0.01,NGP-高表达小鼠原代巨噬细胞 28.35±0.61 vs. 0.08±0.01,均 P <0.05),表明巨噬细胞中 LCN2 的表达在炎症反应过程中发生了改变。在 LPS 刺激后的不同时间点,NGP/RAW 细胞中的 LCN2 水平均显著高于 NC/RAW 细胞(μmol/L:6 小时为 8.32±0.22 vs. 3.12±0.11,12 小时为 23.12±0.86 vs. 8.12±0.32,24 小时为 74.51±2.14 vs. 25.61±1.02,均 P <0.05),同时 p-STAT1 的表达也显著上调。与野生型 C57BL/6 小鼠的原代巨噬细胞相比,高表达 NGP 小鼠的原代巨噬细胞在 LPS 刺激后 24 小时的 LCN2 水平也明显升高(μmol/L:28.35±0.61 vs. 10.13±0.22,P <0.05)。然而,在使用 STAT1 通路抑制剂预处理后,NGP/RAW 细胞中 LCN2 的产生量与 LPS 组相比明显减少(μmol/L:6.81±0.19 vs. 22.54±0.58,P <0.05)。但抑制剂对NC/RAW细胞中LCN2的产生无明显影响,与LPS组相比无明显差异(μmol/L:8.04±0.20 vs. 7.86±0.15,P > 0.05),表明NGP可通过促进STAT1活化上调LPS刺激的巨噬细胞中LCN2的表达:结论:NGP 可通过激活 STAT1 通路正向调节炎症巨噬细胞中 LCN2 的表达。
{"title":"[Effects of neutrophilic granule protein on the expression of lipocalin 2 in inflammatory macrophages].","authors":"Jing Wang, Ji Cheng, Quanwei Bao, Junyu Zhu, Huaping Liang","doi":"10.3760/cma.j.cn121430-20240104-00015","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240104-00015","url":null,"abstract":"<p><strong>Objective: </strong>To explore the effects of neutrophilic granule protein (NGP) on the expression of lipocalin 2 (LCN2) in inflammatory macrophages and its mechanism.</p><p><strong>Methods: </strong>NGP-high-expressed RAW264.7 cells (NGP/RAW cells) and negative control RAW264.7 cells (NC/RAW cells) were cultured in vitro. Primary peritoneal macrophages of NGP-high-expressed mice and wild-type C57BL/6 mice were extracted, then cultured in vitro. The cell inflammatory model was established by stimulating with 10 mg/L lipopolysaccharide (LPS, LPS group), and the phosphate buffer solution (PBS) control group was set up. Enzyme-linked immunosorbent assay (ELISA) was used to detect the level of LCN2 in different types of cells. The protein expression of phosphorylated signal transduction and activator of transcription 1 (p-STAT1) was detected with Western blotting. Other NGP/RAW cells and NC/RAW cells were treated with 10 mg/L LPS, 5 mg/L STAT1 pathway inhibitor (fludarabine)+10 mg/L LPS, respectively. The PBS control group was set up. ELISA was used to detect the level of LCN2.</p><p><strong>Results: </strong>In different types of cells, the levels of LCN2 were increased significantly after LPS stimulation in the LPS group as compared with those in the PBS control group, and peaked at 24 hours (μmol/L: 25.61±1.02 vs. 0.46±0.02 in NC/RAW cells, 74.51±2.14 vs. 0.25±0.04 in NGP/RAW cells, 10.13±0.22 vs. 0.01±0.01 in primary macrophages of wild-type C57BL/6 mice, 28.35±0.61 vs. 0.08±0.01 in primary macrophages of NGP-high-expressed mice, all P < 0.05), indicating that the expression of LCN2 in macrophages altered during inflammation reaction. The level of LCN2 in NGP/RAW cells was found significantly increased at different time points after LPS stimulation comparing with that in NC/RAW cells (μmol/L: 8.32±0.22 vs. 3.12±0.11 at 6 hours, 23.12±0.86 vs. 8.12±0.32 at 12 hours, 74.51±2.14 vs. 25.61±1.02 at 24 hours, all P < 0.05), along with the expression of p-STAT1 was significantly up-regulated. The level of LCN2 in the primary macrophages of NGP-high-expressed mice was also significantly increased at 24 hours after LPS stimulation comparing with that in the primary macrophages of wild-type C57BL/6 mice (μmol/L: 28.35±0.61 vs. 10.13±0.22, P < 0.05). However, after pretreated with STAT1 pathway inhibitors, the production of LCN2 in NGP/RAW cells was decreased significantly comparing with that in the LPS group (μmol/L: 6.81±0.19 vs. 22.54±0.58, P < 0.05). But the inhibitors had no significant effect on LCN2 production in NC/RAW cells showing no significant difference as compared with LPS group (μmol/L: 8.04±0.20 vs. 7.86±0.15, P > 0.05), indicating that NGP could up-regulate the expression of LCN2 in macrophages stimulated by LPS by promoting STAT1 activation.</p><p><strong>Conclusions: </strong>NGP could positively regulate LCN2 expression in inflammatory macrophages by activating STAT1 pathway.</p>","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"36 10","pages":"1033-1037"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Construction and application of physical restraint reduction scheme for adult patients after cardiac surgery based on eCASH concept]. [基于 eCASH 概念的心脏手术后成人患者身体约束减少计划的构建和应用]。
Q3 Medicine Pub Date : 2024-10-01 DOI: 10.3760/cma.j.cn121430-20240508-00409
Shanshan Lyu, Jing Zheng, Xianfeng Liu, Xuying Guo, Chuanni Wu, Huihui Wang
<p><strong>Objective: </strong>To construct a physical restraint reduction scheme based on eCASH concept (that is early Comfort using Analgesia, minimal Sedatives and maximal Human care for adult patients after cardiac surgery, and intervene, and to evaluate its effectiveness.</p><p><strong>Methods: </strong>A non-synchronous case-control study was conducted. A total of 486 patients after cardiac surgery admitted to the cardiac surgery intensive care Unit (ICU) of Shandong Provincial Hospital Affiliated to Shandong First Medical University from July to October 2022 were enrolled as subjects. According to the implementation time node of the physical restraint reduction scheme, 250 patients admitted from July to August were served as the control group, and 236 patients admitted from September to October were served as the observation group. The control group adopted the routine physical restraint nursing process, including selecting the appropriate restraint device according to the patient's condition and consciousness and following the doctor's advice, and checking on time to prevent adverse reactions. The observation group implemented the physical restraint reduction scheme based on eCASH concept, including preoperative visit, postoperative assessment of whether patients needed physical restraint according to the restraint decision wheel and the physical restraint flow, and adopted personalized nursing programs. The restraint rate, restraint duration, incidence of restraint-related complication (edema of the limbs, redness and swelling of the skin in the restricted area, skin rupture, etc.), restraint device application standard rate, delirium rate and incidence of unplanned extubation event were compared between the two groups.</p><p><strong>Results: </strong>There was no significant difference in age, gender, cardiopulmonary bypass, endotracheal catheter retention duration and operation type between the two groups with comparability. The restraint rate in the observation group was significantly lower than that in the control group [16.95% (40/236) vs. 84.40% (211/250), P < 0.01], and the restraint duration was significantly shorter than that in the control group [hours: 0 (0, 1.0) vs. 7.0 (5.5, 10.0), P < 0.01], the incidence of restraint-related complication and delirium were significantly lower than those in the control group [restraint-related complication: 0.85% (2/236) vs. 1.60% (4/250), delirium: 0% (0/236) vs. 2.80% (7/250), both P < 0.05], and the restraint device application standard rate was significantly higher than that in the control group [100.00% (40/40) vs. 90.52% (191/211), P < 0.05]. No unplanned extubation event occurred in both groups.</p><p><strong>Conclusions: </strong>The physical restraint reduction scheme based on eCASH concept in adult patients after cardiac surgery can effectively reduce the restraint rate and the incidence of restraint-related complication, shorten the restraint duration, reduce the incidence of deli
目的根据 eCASH 概念(即对心脏手术后的成年患者使用镇痛剂、最少镇静剂和最多人文关怀进行早期舒适)构建减少身体束缚的方案,并对其进行干预和效果评估:方法:进行了一项非同步病例对照研究。以2022年7月至10月入住山东第一医科大学附属省立医院心脏外科重症监护室(ICU)的486例心脏手术后患者为研究对象。根据减少物理约束方案的实施时间节点,将7月至8月收治的250例患者作为对照组,9月至10月收治的236例患者作为观察组。对照组采用常规的物理约束护理流程,包括根据患者的病情和意识选择合适的约束装置,遵医嘱按时检查,防止不良反应的发生。观察组实施基于eCASH理念的减少肢体约束方案,包括术前访视、术后根据约束决策轮和肢体约束流程评估患者是否需要肢体约束,并采取个性化护理方案。比较两组患者的约束率、约束持续时间、约束相关并发症(肢体水肿、禁区皮肤红肿、皮肤破裂等)发生率、约束装置应用达标率、谵妄发生率和非计划拔管事件发生率:结果:两组患者在年龄、性别、心肺旁路、气管导管留置时间、手术类型等方面无明显差异,具有可比性。观察组的约束率明显低于对照组[16.95% (40/236) vs. 84.40% (211/250),P <0.01],约束时间明显短于对照组[小时:0 (0, 1.0) vs. 7.0 (5.5, 10.0),P <0.01],约束相关并发症和谵妄发生率明显低于对照组[约束相关并发症:0.85% (2/236) vs. 84.40% (211/250),P <0.01]:约束相关并发症:0.85% (2/236) vs. 1.60% (4/250),谵妄:0% (0/236) vs. 2.80% (7/250),均 P <0.05],约束装置应用标准率明显高于对照组[100.00% (40/40) vs. 90.52% (191/211),P <0.05]。两组均未发生意外拔管事件:基于 eCASH 理念的减少物理约束方案可有效降低成人心脏手术后患者的约束率和约束相关并发症的发生率,缩短约束持续时间,降低谵妄发生率,提高约束装置应用的标准化程度,同时不会增加意外拔管事件的发生率。
{"title":"[Construction and application of physical restraint reduction scheme for adult patients after cardiac surgery based on eCASH concept].","authors":"Shanshan Lyu, Jing Zheng, Xianfeng Liu, Xuying Guo, Chuanni Wu, Huihui Wang","doi":"10.3760/cma.j.cn121430-20240508-00409","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240508-00409","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To construct a physical restraint reduction scheme based on eCASH concept (that is early Comfort using Analgesia, minimal Sedatives and maximal Human care for adult patients after cardiac surgery, and intervene, and to evaluate its effectiveness.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A non-synchronous case-control study was conducted. A total of 486 patients after cardiac surgery admitted to the cardiac surgery intensive care Unit (ICU) of Shandong Provincial Hospital Affiliated to Shandong First Medical University from July to October 2022 were enrolled as subjects. According to the implementation time node of the physical restraint reduction scheme, 250 patients admitted from July to August were served as the control group, and 236 patients admitted from September to October were served as the observation group. The control group adopted the routine physical restraint nursing process, including selecting the appropriate restraint device according to the patient's condition and consciousness and following the doctor's advice, and checking on time to prevent adverse reactions. The observation group implemented the physical restraint reduction scheme based on eCASH concept, including preoperative visit, postoperative assessment of whether patients needed physical restraint according to the restraint decision wheel and the physical restraint flow, and adopted personalized nursing programs. The restraint rate, restraint duration, incidence of restraint-related complication (edema of the limbs, redness and swelling of the skin in the restricted area, skin rupture, etc.), restraint device application standard rate, delirium rate and incidence of unplanned extubation event were compared between the two groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;There was no significant difference in age, gender, cardiopulmonary bypass, endotracheal catheter retention duration and operation type between the two groups with comparability. The restraint rate in the observation group was significantly lower than that in the control group [16.95% (40/236) vs. 84.40% (211/250), P &lt; 0.01], and the restraint duration was significantly shorter than that in the control group [hours: 0 (0, 1.0) vs. 7.0 (5.5, 10.0), P &lt; 0.01], the incidence of restraint-related complication and delirium were significantly lower than those in the control group [restraint-related complication: 0.85% (2/236) vs. 1.60% (4/250), delirium: 0% (0/236) vs. 2.80% (7/250), both P &lt; 0.05], and the restraint device application standard rate was significantly higher than that in the control group [100.00% (40/40) vs. 90.52% (191/211), P &lt; 0.05]. No unplanned extubation event occurred in both groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The physical restraint reduction scheme based on eCASH concept in adult patients after cardiac surgery can effectively reduce the restraint rate and the incidence of restraint-related complication, shorten the restraint duration, reduce the incidence of deli","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"36 10","pages":"1102-1107"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Research progress on the timing and implementation of early rehabilitation for critically ill patient]. [危重病人早期康复的时机和实施的研究进展]。
Q3 Medicine Pub Date : 2024-09-01 DOI: 10.3760/cma.j.cn121430-20240531-00480
Yan Xu, Dechang Chen

Critical care rehabilitation is an essential component of treating critically ill patients. Implementing early rehabilitation is safe and feasible, with benefits and early rehabilitation is both safe and feasible, with benefits far outweighing potential risks. An individualized rehabilitation plan is necessary for initiating early rehabilitation treatment. This includes identifying the rehabilitation needs of critically ill patients, timely seizing opportunities for rehabilitation intervention, and implementing safe rehabilitation measures through position training, exercise training, respiratory training, and monitoring the rehabilitation process. There remains considerable heterogeneity in the clinical practice of early rehabilitation treatment for critically ill patients. This article provides an updated overview of evidence-based medicine for early rehabilitation treatment of critically ill patients, aiming to offer a reference for clinical medical staff in formulating critical care rehabilitation treatment strategies for these patients.

重症监护康复是治疗重症患者的重要组成部分。实施早期康复治疗既安全又可行,其益处远远大于潜在风险。启动早期康复治疗必须制定个性化的康复计划。这包括明确危重病人的康复需求,及时抓住康复干预的机会,通过体位训练、运动训练、呼吸训练等实施安全的康复措施,并对康复过程进行监测。在危重病人早期康复治疗的临床实践中,仍存在相当大的异质性。本文对重症患者早期康复治疗的循证医学进行了最新概述,旨在为临床医务人员制定重症患者康复治疗策略提供参考。
{"title":"[Research progress on the timing and implementation of early rehabilitation for critically ill patient].","authors":"Yan Xu, Dechang Chen","doi":"10.3760/cma.j.cn121430-20240531-00480","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240531-00480","url":null,"abstract":"<p><p>Critical care rehabilitation is an essential component of treating critically ill patients. Implementing early rehabilitation is safe and feasible, with benefits and early rehabilitation is both safe and feasible, with benefits far outweighing potential risks. An individualized rehabilitation plan is necessary for initiating early rehabilitation treatment. This includes identifying the rehabilitation needs of critically ill patients, timely seizing opportunities for rehabilitation intervention, and implementing safe rehabilitation measures through position training, exercise training, respiratory training, and monitoring the rehabilitation process. There remains considerable heterogeneity in the clinical practice of early rehabilitation treatment for critically ill patients. This article provides an updated overview of evidence-based medicine for early rehabilitation treatment of critically ill patients, aiming to offer a reference for clinical medical staff in formulating critical care rehabilitation treatment strategies for these patients.</p>","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"36 9","pages":"992-996"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Serum Claudin-5 levels facilitate the early prediction of severe acute pancreatitis: a prospective observational study]. [血清 Claudin-5 水平有助于早期预测重症急性胰腺炎:一项前瞻性观察研究]。
Q3 Medicine Pub Date : 2024-09-01 DOI: 10.3760/cma.j.cn121430-20240318-00247
Xinlei Chen, Huihui Wang, Ping Geng, Bingyu Ling, Aiwen Ma, Min Xu, Dingyu Tan
<p><strong>Objective: </strong>To investigate the value of early tight junction protein Claudin-5 levels in predicting the severity of acute pancreatitis (AP).</p><p><strong>Methods: </strong>A prospective observational study was conducted, including patients diagnosed with AP and admitted to the Northern Jiangsu People's Hospital from December 1, 2021 to November 30, 2022. Eligible healthy volunteers were randomly selected to serve as healthy controls during the same period. Patients were classified into mild acute pancreatitis (MAP) group, moderate-severe acute pancreatitis (MSAP) group, and severe acute pancreatitis (SAP) group based on the 2012 Atlanta classification criteria. Patients with SAP were then divided into three subgroups of 1, 3, and 7 days based on the duration of hospitalization. Baseline data, such as gender, age, underlying disease, and probable etiology, was collected from all enrolled individuals. The enzyme-linked immunosorbent assay (ELISA) was employed to detect serum Claudin-5 levels in each cohort of enrollees. Data on additional serologic indicators, including hematocrit (HCT), albumin (Alb), serum Ca<sup>2+</sup>, C-reactive protein (CRP), and procalcitonin (PCT) levels, were obtained via the in-hospital test query system in each group of patients with AP. The modified Marshall score (mMarshall), modified CT severity index (mCTSI) score, bedside severity index of severity in acute pancreatitis (BISAP) score, and acute physiology and chronic health evaluation II (APACHE II) were recorded for each group of patients with AP. Differences in the above indicators between groups were analyzed and compared. Spearman's correlation method was employed to examine the relationship between Claudin-5 levels and each influential factor. The receiver operator characteristic curve (ROC curve) was plotted to analyze the predictive value of each influencing factor on SAP. Ridge regression was used to screen for independent risk factors for SAP.</p><p><strong>Results: </strong>A total of 109 patients with AP were enrolled, comprising 66 in the MAP group, 15 in the MSAP group, and 28 in the SAP group. Additionally, 27 healthy volunteers were enrolled as the healthy control group. No statistically significant differences were observed in gender and age among the enrolled groups, and no statistically significant differences were identified among the three groups of patients with AP in terms of underlying disease and etiologic composition. As the disease progressed, serum Claudin-5 levels exhibited a notable increase across all AP patient groups, and they were all significantly higher than those in the healthy control group [ng/L: 888.58 (574.52, 1 141.59), 3 749.02 (2 784.93, 5 789.92), 4 667.81 (3 935.21, 7 315.66) vs. 291.13 (250.19, 314.75), all P < 0.05]. Subgroup analyses showed that as the disease duration prolonged, patients in the SAP group exhibited a notable decline in Claudin-5 levels at 3 days post-admission, compared with those
目的探讨早期紧密连接蛋白Claudin-5水平在预测急性胰腺炎(AP)严重程度中的价值:方法:开展一项前瞻性观察研究,研究对象包括2021年12月1日至2022年11月30日期间苏北人民医院收治的确诊为急性胰腺炎的患者。同期随机抽取符合条件的健康志愿者作为健康对照。根据2012年亚特兰大分级标准,将患者分为轻度急性胰腺炎(MAP)组、中重度急性胰腺炎(MSAP)组和重度急性胰腺炎(SAP)组。然后根据住院时间将 SAP 患者分为 1 天、3 天和 7 天三个亚组。我们收集了所有入组患者的基线数据,如性别、年龄、基础疾病和可能的病因。采用酶联免疫吸附试验(ELISA)检测每组入选者的血清 Claudin-5 水平。其他血清学指标的数据,包括血细胞比容(HCT)、白蛋白(Alb)、血清 Ca2+、C 反应蛋白(CRP)和降钙素原(PCT)水平,均通过院内检测查询系统获得。记录每组 AP 患者的改良马歇尔评分(mMarshall)、改良 CT 严重程度指数(mCTSI)评分、急性胰腺炎床旁严重程度指数(BISAP)评分和急性生理学和慢性健康评估 II(APACHE II)。分析并比较各组间上述指标的差异。采用斯皮尔曼相关法研究 Claudin-5 水平与各影响因素之间的关系。绘制接收器操作特征曲线(ROC 曲线),分析各影响因素对 SAP 的预测价值。采用岭回归筛选 SAP 的独立危险因素:共纳入 109 名 AP 患者,其中 MAP 组 66 人,MSAP 组 15 人,SAP 组 28 人。此外,还有 27 名健康志愿者作为健康对照组。三组 AP 患者的性别和年龄差异无统计学意义,在基础疾病和病因组成方面也无统计学意义。随着病情的发展,所有 AP 患者组的血清 Claudin-5 水平均出现明显升高,且均显著高于健康对照组 [ng/L: 888.58 (574.52, 1 141.59), 3 749.02 (2 784.93, 5 789.92), 4 667.81 (3 935.21, 7 315.66) vs. 291.13 (250.19, 314.75), 均 P < 0.05]。亚组分析显示,随着病程的延长,SAP 组患者入院后 3 天的 Claudin-5 水平与入院后 1 天的水平相比明显下降 [ng/L: 2 052.59 (1 089.43, 4 006.47) vs. 4 667.81 (3 935.21, 7 315.66),P < 0.05]。斯皮尔曼相关性分析显示,AP 患者血清 Claudin-5 水平与 CRP、PCT、HCT 以及 mMarshall、mCTSI 和 BISAP 评分呈显著正相关(r 值分别为 0.570、0.525、0.323、0.774、0.670、0.652,均 P <0.001),与 Alb 呈显著负相关(r = -0.394,P <0.001)。在 AP 患者中观察到一个明显的趋势,即随着病情的发展,HCT 水平上升,Alb 水平下降(均为 P <0.05)。SAP患者在治疗后上述现象有所改善,间接表明血清Claudin-5水平是血管渗漏的阳性指标。ROC 曲线分析显示,AP 患者血清 Claudin-5 水平对 SAP 早期预测的准确性最高,ROC 曲线下面积(AUC)为 0.948。当血清Claudin-5水平≥2 997 ng/L时,早期筛查SAP的敏感性为100%,特异性为88.89%。多因素脊回归分析表明,血清Claudin-5水平、PCT和APACHE II评分可作为早期预测SAP的独立危险因素(均P<0.05):血清Claudin-5水平有助于早期预测SAP,并与炎症反应和血管渗漏密切相关。
{"title":"[Serum Claudin-5 levels facilitate the early prediction of severe acute pancreatitis: a prospective observational study].","authors":"Xinlei Chen, Huihui Wang, Ping Geng, Bingyu Ling, Aiwen Ma, Min Xu, Dingyu Tan","doi":"10.3760/cma.j.cn121430-20240318-00247","DOIUrl":"10.3760/cma.j.cn121430-20240318-00247","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate the value of early tight junction protein Claudin-5 levels in predicting the severity of acute pancreatitis (AP).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A prospective observational study was conducted, including patients diagnosed with AP and admitted to the Northern Jiangsu People's Hospital from December 1, 2021 to November 30, 2022. Eligible healthy volunteers were randomly selected to serve as healthy controls during the same period. Patients were classified into mild acute pancreatitis (MAP) group, moderate-severe acute pancreatitis (MSAP) group, and severe acute pancreatitis (SAP) group based on the 2012 Atlanta classification criteria. Patients with SAP were then divided into three subgroups of 1, 3, and 7 days based on the duration of hospitalization. Baseline data, such as gender, age, underlying disease, and probable etiology, was collected from all enrolled individuals. The enzyme-linked immunosorbent assay (ELISA) was employed to detect serum Claudin-5 levels in each cohort of enrollees. Data on additional serologic indicators, including hematocrit (HCT), albumin (Alb), serum Ca&lt;sup&gt;2+&lt;/sup&gt;, C-reactive protein (CRP), and procalcitonin (PCT) levels, were obtained via the in-hospital test query system in each group of patients with AP. The modified Marshall score (mMarshall), modified CT severity index (mCTSI) score, bedside severity index of severity in acute pancreatitis (BISAP) score, and acute physiology and chronic health evaluation II (APACHE II) were recorded for each group of patients with AP. Differences in the above indicators between groups were analyzed and compared. Spearman's correlation method was employed to examine the relationship between Claudin-5 levels and each influential factor. The receiver operator characteristic curve (ROC curve) was plotted to analyze the predictive value of each influencing factor on SAP. Ridge regression was used to screen for independent risk factors for SAP.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 109 patients with AP were enrolled, comprising 66 in the MAP group, 15 in the MSAP group, and 28 in the SAP group. Additionally, 27 healthy volunteers were enrolled as the healthy control group. No statistically significant differences were observed in gender and age among the enrolled groups, and no statistically significant differences were identified among the three groups of patients with AP in terms of underlying disease and etiologic composition. As the disease progressed, serum Claudin-5 levels exhibited a notable increase across all AP patient groups, and they were all significantly higher than those in the healthy control group [ng/L: 888.58 (574.52, 1 141.59), 3 749.02 (2 784.93, 5 789.92), 4 667.81 (3 935.21, 7 315.66) vs. 291.13 (250.19, 314.75), all P &lt; 0.05]. Subgroup analyses showed that as the disease duration prolonged, patients in the SAP group exhibited a notable decline in Claudin-5 levels at 3 days post-admission, compared with those","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"36 9","pages":"930-936"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Research progress on median nerve electrical stimulation for awakening comatose patients with brain injury]. [正中神经电刺激唤醒脑损伤昏迷患者的研究进展]。
Q3 Medicine Pub Date : 2024-09-01 DOI: 10.3760/cma.j.cn121430-20240617-00513
Le An, Rui Shao, Xingsheng Wang, Ziren Tang

With the development of medicine, the survival rate of patients with traumatic brain injury has gradually increased, and more lives have been successfully saved. However, the number of comatose patients has also risen, leading to prolonged medical care that increases economic burdens on families and society. The awakening of comatose patients is of great significance. As a non-invasive brain stimulation technique, median nerve electrical stimulation (MNS) has been widely used in clinical awakening therapy, and multiple clinical studies have confirmed the effectiveness of this technology. This article summarizes the research progress of this technology from the aspects of coma mechanism, median nerve pathway, awakening mechanism of MNS, clinical application of MNS, parameter setting of electrical stimulation, and neurological function evaluation.

随着医学的发展,脑外伤患者的存活率逐渐提高,越来越多的生命被成功挽救。然而,昏迷患者的数量也在增加,导致医疗护理时间延长,增加了家庭和社会的经济负担。唤醒昏迷患者意义重大。正中神经电刺激(MNS)作为一种非侵入性脑刺激技术,已广泛应用于临床唤醒治疗,多项临床研究证实了该技术的有效性。本文从昏迷机制、正中神经通路、正中神经电刺激的唤醒机制、正中神经电刺激的临床应用、电刺激参数设置、神经功能评估等方面总结了该技术的研究进展。
{"title":"[Research progress on median nerve electrical stimulation for awakening comatose patients with brain injury].","authors":"Le An, Rui Shao, Xingsheng Wang, Ziren Tang","doi":"10.3760/cma.j.cn121430-20240617-00513","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240617-00513","url":null,"abstract":"<p><p>With the development of medicine, the survival rate of patients with traumatic brain injury has gradually increased, and more lives have been successfully saved. However, the number of comatose patients has also risen, leading to prolonged medical care that increases economic burdens on families and society. The awakening of comatose patients is of great significance. As a non-invasive brain stimulation technique, median nerve electrical stimulation (MNS) has been widely used in clinical awakening therapy, and multiple clinical studies have confirmed the effectiveness of this technology. This article summarizes the research progress of this technology from the aspects of coma mechanism, median nerve pathway, awakening mechanism of MNS, clinical application of MNS, parameter setting of electrical stimulation, and neurological function evaluation.</p>","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"36 9","pages":"997-1000"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Establishment of a risk prediction model for cerebrogenic multiple organ dysfunction syndrome in patients with acute cerebral hemorrhage]. [建立急性脑出血患者脑源性多器官功能障碍综合征风险预测模型]。
Q3 Medicine Pub Date : 2024-09-01 DOI: 10.3760/cma.j.cn121430-20240202-00109
Huaibiao Wu, Hao Zhang, Chengjun Guo
<p><strong>Objective: </strong>To construct and validate a predictive model for the risk of cerebrogenic multiple organ dysfunction syndrome (CMODS) in patients with acute cerebral hemorrhage.</p><p><strong>Methods: </strong>Clinical data of 93 patients with acute cerebral hemorrhage admitted to Wannan Rehabilitation Hospital from January 2019 to June 2023 were retrospectively analyzed. Data included baseline information, disease severity score, laboratory examination indicators, cerebral hemorrhage status, treatment status, etc. Patients were divided into CMODS group and non-CMODS group according to whether CMODS occurred during hospitalization. The clinical data of the two groups were compared. Multivariate Logistic regression was used to analyze the risk factors of CMODS in patients with acute cerebral hemorrhage. A nomogram model was constructed to predict the risk of CMODS in patients with acute cerebral hemorrhage, and the model was validated. Receiver operator characteristic curve (ROC curve) was used to evaluate the predictive efficiency of nomogram model for CMODS in patients with acute cerebral hemorrhage.</p><p><strong>Results: </strong>A total of 93 patients with acute cerebral hemorrhage were enrolled, including 26 patients in CMODS group and 67 patients in non-CMODS group. Compared with the non-CMODS group, the ratio of diabetes, acute physiological and chronic health evaluation II (APACHE II)≥35 score, cerebral hemorrhage volume ≥30 mL, endotoxemia, and national institutes of health stroke scale (NIHSS) and intracranial pressure of patients in the CMODS group were significantly higher, while the Glasgow coma score (GCS) was significantly lower and the length of hospital stay was significantly longer, with statistically significant differences (all P < 0.05). Multivariate Logistic regression analysis showed that diabetes mellitus [odds ratio (OR) = 3.615, 95% confidence interval (95%CI) was 1.487-8.785, P = 0.000], APACHE II score (OR = 4.697, 95%CI was 1.933-11.416, P = 0.000), endotoxemia (OR = 4.577, 95%CI was 1.883-11.123, P = 0.000), and cerebral hemorrhage volume (OR = 4.039, 95%CI was 1.662-9.816, P = 0.000) were the risk factors for CMODS in patients with acute cerebral hemorrhage. Taking the above risk factors as predictive variables, a nomogram prediction model was established. The verification results of the nomogram model showed that the C index was 0.804 (95%CI was 0.768-0.841), and the calibration curve was close to the ideal curve with good fit (P > 0.05). ROC curve results showed that the sensitivity and specificity of the nomogram model in predicting CMODS in patients with acute cerebral hemorrhage were 76.92%, 86.57%, respectively, and the area under the ROC curve (AUC) was 0.855 (95%CI was 0.776-0.935).</p><p><strong>Conclusions: </strong>Diabetes mellitus, APACHE II score, endotoxemia and intracerebral hemorrhage are risk factors for CMODS in patients with acute cerebral hemorrhage. The risk prediction model base
目的构建并验证急性脑出血患者脑源性多器官功能障碍综合征(CMODS)风险预测模型:回顾性分析皖南康复医院2019年1月至2023年6月收治的93例急性脑出血患者的临床资料。数据包括基线资料、病情严重程度评分、实验室检查指标、脑出血情况、治疗情况等。根据住院期间是否发生CMODS,将患者分为CMODS组和非CMODS组。比较两组患者的临床数据。采用多元 Logistic 回归分析急性脑出血患者发生 CMODS 的风险因素。建立了预测急性脑出血患者 CMODS 风险的提名图模型,并对该模型进行了验证。采用接收者操作特征曲线(ROC曲线)评估提名图模型对急性脑出血患者CMODS的预测效率:共纳入 93 例急性脑出血患者,其中 CMODS 组 26 例,非 CMODS 组 67 例。与非CMODS组相比,CMODS组患者的糖尿病、急性生理学和慢性健康评价II(APACHE II)≥35分、脑出血量≥30 mL、内毒素血症、美国国立卫生研究院卒中量表(NIHSS)和颅内压的比例均显著高于非CMODS组,而格拉斯哥昏迷评分(GCS)显著低于非CMODS组,住院时间显著长于非CMODS组,差异有统计学意义(均P<0.05)。多变量 Logistic 回归分析显示,糖尿病[几率比(OR)= 3.615,95% 置信区间(95%CI)为 1.487-8.785,P = 0.000]、APACHE II 评分(OR = 4.697,95%CI 为 1.933-11.416,P = 0.000)、内毒素血症(OR = 4.577,95%CI 为 1.883-11.123,P = 0.000)和脑出血量(OR = 4.039,95%CI 为 1.662-9.816,P = 0.000)是急性脑出血患者发生 CMODS 的危险因素。以上述危险因素为预测变量,建立了一个提名图预测模型。提名图模型的验证结果显示,C指数为0.804(95%CI为0.768-0.841),校准曲线接近理想曲线,拟合良好(P>0.05)。ROC曲线结果显示,提名图模型预测急性脑出血患者CMODS的敏感性和特异性分别为76.92%和86.57%,ROC曲线下面积(AUC)为0.855(95%CI为0.776-0.935):结论:糖尿病、APACHE II评分、内毒素血症和脑出血是急性脑出血患者发生CMODS的危险因素。基于这些风险因素的风险预测模型可有效评估急性脑出血患者发生 CMODS 的风险。
{"title":"[Establishment of a risk prediction model for cerebrogenic multiple organ dysfunction syndrome in patients with acute cerebral hemorrhage].","authors":"Huaibiao Wu, Hao Zhang, Chengjun Guo","doi":"10.3760/cma.j.cn121430-20240202-00109","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240202-00109","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To construct and validate a predictive model for the risk of cerebrogenic multiple organ dysfunction syndrome (CMODS) in patients with acute cerebral hemorrhage.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Clinical data of 93 patients with acute cerebral hemorrhage admitted to Wannan Rehabilitation Hospital from January 2019 to June 2023 were retrospectively analyzed. Data included baseline information, disease severity score, laboratory examination indicators, cerebral hemorrhage status, treatment status, etc. Patients were divided into CMODS group and non-CMODS group according to whether CMODS occurred during hospitalization. The clinical data of the two groups were compared. Multivariate Logistic regression was used to analyze the risk factors of CMODS in patients with acute cerebral hemorrhage. A nomogram model was constructed to predict the risk of CMODS in patients with acute cerebral hemorrhage, and the model was validated. Receiver operator characteristic curve (ROC curve) was used to evaluate the predictive efficiency of nomogram model for CMODS in patients with acute cerebral hemorrhage.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 93 patients with acute cerebral hemorrhage were enrolled, including 26 patients in CMODS group and 67 patients in non-CMODS group. Compared with the non-CMODS group, the ratio of diabetes, acute physiological and chronic health evaluation II (APACHE II)≥35 score, cerebral hemorrhage volume ≥30 mL, endotoxemia, and national institutes of health stroke scale (NIHSS) and intracranial pressure of patients in the CMODS group were significantly higher, while the Glasgow coma score (GCS) was significantly lower and the length of hospital stay was significantly longer, with statistically significant differences (all P &lt; 0.05). Multivariate Logistic regression analysis showed that diabetes mellitus [odds ratio (OR) = 3.615, 95% confidence interval (95%CI) was 1.487-8.785, P = 0.000], APACHE II score (OR = 4.697, 95%CI was 1.933-11.416, P = 0.000), endotoxemia (OR = 4.577, 95%CI was 1.883-11.123, P = 0.000), and cerebral hemorrhage volume (OR = 4.039, 95%CI was 1.662-9.816, P = 0.000) were the risk factors for CMODS in patients with acute cerebral hemorrhage. Taking the above risk factors as predictive variables, a nomogram prediction model was established. The verification results of the nomogram model showed that the C index was 0.804 (95%CI was 0.768-0.841), and the calibration curve was close to the ideal curve with good fit (P &gt; 0.05). ROC curve results showed that the sensitivity and specificity of the nomogram model in predicting CMODS in patients with acute cerebral hemorrhage were 76.92%, 86.57%, respectively, and the area under the ROC curve (AUC) was 0.855 (95%CI was 0.776-0.935).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Diabetes mellitus, APACHE II score, endotoxemia and intracerebral hemorrhage are risk factors for CMODS in patients with acute cerebral hemorrhage. The risk prediction model base","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"36 9","pages":"966-971"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Annexin A1 activates the G protein-coupled formyl peptide receptor type 2-dependent endothelial nitric oxide synthase pathway to alleviate sepsis associated acute lung injury]. [附件素 A1 激活 G 蛋白偶联甲酰肽受体 2 型依赖性内皮一氧化氮合酶途径,减轻与脓毒症相关的急性肺损伤】。]
Q3 Medicine Pub Date : 2024-09-01 DOI: 10.3760/cma.j.cn121430-20240226-00160
Yundi Chen, Yuanxiu He, Han Qin, Song Qin
<p><strong>Objective: </strong>To investigate whether annexin A1 (ANXA1) improves sepsis-induced lung injury by activating G protein-coupled formyl peptide receptor type 2 (FPR2)-dependent endothelial nitric oxide synthase (eNOS) pathway.</p><p><strong>Methods: </strong>Twenty-four male SD rats were randomly divided into normal group (Control group), lipopolysaccharide (LPS) induced lung injury model group (LPS group), LPS+ANXA1 mimetic peptide group (LPS+Ac2-26 group) and LPS+ANXA1 mimetic peptide+FPR2 inhibitor group (LPS+Ac2-26+WRW4 group), with 6 rats in each group. On the third day before modeling, rats of the LPS+Ac2-26 group were injected with 1 mg/kg Ac2-26 by the tail vein and rats of LPS+Ac2-26+WRW4 group were injected with 1 mg/kg Ac2-26 and 2.2 mg/kg WRW4 by the tail vein. The rats of control group and LPS group were injected same volume of physiological saline. After 48 hours of modeling, the rats were anesthetized and the carotid blood was taken to detect the oxygenation index (OI). Lung tissue was taken from the euthanized rats. The wet/dry (W/D) ratio was determined. The pathological changes of lung tissue were observed under light microscope and pathological score was performed. The levels of tumor necrosis factor-α (TNF-α), interleukins (IL-1β, IL-6, IL-10), malondialdehyde (MDA) and myeloperoxidase (MPO) were detected by enzyme-linked immunosorbent assay (ELISA). The protein expressions of eNOS, inducible nitric oxide synthase (iNOS) and nuclear factor-κB (NF-κB) were detected by Western blotting.</p><p><strong>Results: </strong>Under light microscope, compared with LPS group, the infiltration degree of inflammatory cells in the lung tissue of LPS+Ac2-26 group was reduced, and the thickness of the alveolar septum was improved. The degree of inflammatory cell infiltration in the lung tissue of LPS+Ac2-26+WRW4 group was more severe than that of LPS+Ac2-26 group, and the thickness of the alveolar septum increased. These findings suggested that ANXA1 significantly inhibited inflammatory cell infiltration and improved alveolar septal thickness, WRW4 reversed the lung improvement effects of ANXA1. Compared with control group, OI in LPS group was significantly decreased, and W/D ratio, pathological score and TNF-α, IL-1β, IL-6, MDA and MPO levels in lung tissue were significantly increased. Compared with LPS group, OI and IL-10 levels in lung tissue were significantly increased in LPS+Ac2-26 group, while W/D ratio, pathological score, TNF-α, IL-1β, IL-6, MDA and MPO levels in lung tissue were significantly decreased. These results indicated that ANXA1 can improve the oxygenation capacity, improve lung tissue leakage, reduce edema, and inhibit lung tissue inflammation in rats with lung injury. Compared with LPS+Ac2-26 group, the LPS+Ac2-26+WRW4 group showed significant decreases in OI and lung tissue IL-10 level [OI (mmHg, 1 mmHg ≈ 0.133 kPa): 132.16±24.00 vs. 248.67±18.70, IL-10 (ng/L): 27.30±3.04 vs. 36.10±3.92, both P < 0.05], the l
目的研究附件素A1(ANXA1)是否能通过激活G蛋白偶联甲酰肽受体2型(FPR2)依赖的内皮一氧化氮合酶(eNOS)通路改善脓毒症诱导的肺损伤:将24只雄性SD大鼠随机分为正常组(对照组)、脂多糖(LPS)诱导肺损伤模型组(LPS组)、LPS+ANXA1模拟肽组(LPS+Ac2-26组)和LPS+ANXA1模拟肽+FPR2抑制剂组(LPS+Ac2-26+WRW4组),每组6只。造模前第三天,LPS+Ac2-26 组大鼠尾静脉注射 1 mg/kg Ac2-26,LPS+Ac2-26+WRW4 组大鼠尾静脉注射 1 mg/kg Ac2-26 和 2.2 mg/kg WRW4。对照组和 LPS 组大鼠注射相同体积的生理盐水。建模 48 小时后,对大鼠进行麻醉,抽取颈动脉血液检测氧合指数(OI)。从安乐死的大鼠身上提取肺组织。测定干湿比(W/D)。在光学显微镜下观察肺组织的病理变化,并进行病理评分。用酶联免疫吸附试验(ELISA)检测肿瘤坏死因子-α(TNF-α)、白细胞介素(IL-1β、IL-6、IL-10)、丙二醛(MDA)和髓过氧化物酶(MPO)的水平。用 Western 印迹法检测 eNOS、诱导型一氧化氮合酶(iNOS)和核因子-κB(NF-κB)的蛋白表达:光镜下,与 LPS 组相比,LPS+Ac2-26 组肺组织中炎性细胞浸润程度降低,肺泡间隔厚度增加。LPS+Ac2-26+WRW4组的肺组织炎症细胞浸润程度比LPS+Ac2-26组严重,肺泡间隔厚度增加。这些结果表明,ANXA1能显著抑制炎症细胞浸润并改善肺泡间隔厚度,而WRW4能逆转ANXA1的肺改善作用。与对照组相比,LPS组的OI明显降低,W/D比值、病理评分、肺组织中TNF-α、IL-1β、IL-6、MDA和MPO水平明显升高。与LPS组相比,LPS+Ac2-26组肺组织中OI和IL-10水平明显升高,而W/D比值、病理评分、TNF-α、IL-1β、IL-6、MDA和MPO水平明显降低。这些结果表明,ANXA1能提高肺损伤大鼠的氧合能力,改善肺组织渗漏,减轻水肿,抑制肺组织炎症。与 LPS+Ac2-26 组相比,LPS+Ac2-26+WRW4 组的 OI 和肺组织 IL-10 水平明显下降[OI(mmHg,1 mmHg ≈ 0.133 kPa):132.16±24.00 与 LPS+Ac2-26+WRW4 组:132.16±24.00]:132.16±24.00 vs. 248.67±18.70,IL-10(ng/L):27.30±3.04 vs. 36.10±3.92,均P<0.05],肺组织W/D比值、病理评分及TNF-α、IL-1β、IL-6、MDA和MPO水平明显升高[W/D比值:5.29±0.02 vs. 4.83±0.02,病理评分:5.00±0.28 vs. 2.67±0.52,TNF-α(ng/L):39.80±4.36 vs. 32.10±2.15,IL-1β(ng/L):200.00±15.68 vs. 152.60±9.74,IL-6(ng/L):181.50±18.02 vs. 148.50±7.34,MDA(mmol/mg):82.01±8.22 vs. 70.43±5.69,MPO(pg/mg):6.50±0.32 vs. 4.60±0.56,所有 P <0.05]。这些结果表明,WRW4 可以阻断 ANXA1 的上述改善作用。Western blotting 结果显示,与对照组相比,LPS 组 eNOS、iNOS 和 NF-κB 的表达明显上调。与 LPS 组相比,LPS+Ac2-26 组 eNOS 蛋白表达明显上调(eNOS/β-actin:0.25±0.01 vs. 0.14±0.01,P < 0.05),iNOS 和 NF-κB 蛋白表达明显下调(iNOS/β-actin:0.09±0.02 vs. 0.12±0.02,NF-κB/β-actin:0.35±0.06 vs. 0.59±0.13,均 P <0.05)。这些结果表明,ANXA1可能激活了eNOS通路并下调了NF-κB的表达。与 LPS+Ac2-26 组相比,LPS+Ac2-26+WRW4 组 eNOS 蛋白表达明显下调(eNOS/β-actin:0.17±0.02 vs. 0.25±0.01,P < 0.05),而 iNOS 和 NF-κB 蛋白表达明显上调(iNOS/β-actin:0.12±0.02 vs. 0.09±0.02,NF-κB/β-actin:0.52±0.10 vs. 0.35±0.06,均 P <0.05)。这些结果表明,WRW4阻断了ANXA1对eNOS通路的激活:结论:ANXA1可通过激活FPR2依赖的eNOS通路改善脓毒症相关肺损伤。
{"title":"[Annexin A1 activates the G protein-coupled formyl peptide receptor type 2-dependent endothelial nitric oxide synthase pathway to alleviate sepsis associated acute lung injury].","authors":"Yundi Chen, Yuanxiu He, Han Qin, Song Qin","doi":"10.3760/cma.j.cn121430-20240226-00160","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240226-00160","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate whether annexin A1 (ANXA1) improves sepsis-induced lung injury by activating G protein-coupled formyl peptide receptor type 2 (FPR2)-dependent endothelial nitric oxide synthase (eNOS) pathway.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Twenty-four male SD rats were randomly divided into normal group (Control group), lipopolysaccharide (LPS) induced lung injury model group (LPS group), LPS+ANXA1 mimetic peptide group (LPS+Ac2-26 group) and LPS+ANXA1 mimetic peptide+FPR2 inhibitor group (LPS+Ac2-26+WRW4 group), with 6 rats in each group. On the third day before modeling, rats of the LPS+Ac2-26 group were injected with 1 mg/kg Ac2-26 by the tail vein and rats of LPS+Ac2-26+WRW4 group were injected with 1 mg/kg Ac2-26 and 2.2 mg/kg WRW4 by the tail vein. The rats of control group and LPS group were injected same volume of physiological saline. After 48 hours of modeling, the rats were anesthetized and the carotid blood was taken to detect the oxygenation index (OI). Lung tissue was taken from the euthanized rats. The wet/dry (W/D) ratio was determined. The pathological changes of lung tissue were observed under light microscope and pathological score was performed. The levels of tumor necrosis factor-α (TNF-α), interleukins (IL-1β, IL-6, IL-10), malondialdehyde (MDA) and myeloperoxidase (MPO) were detected by enzyme-linked immunosorbent assay (ELISA). The protein expressions of eNOS, inducible nitric oxide synthase (iNOS) and nuclear factor-κB (NF-κB) were detected by Western blotting.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Under light microscope, compared with LPS group, the infiltration degree of inflammatory cells in the lung tissue of LPS+Ac2-26 group was reduced, and the thickness of the alveolar septum was improved. The degree of inflammatory cell infiltration in the lung tissue of LPS+Ac2-26+WRW4 group was more severe than that of LPS+Ac2-26 group, and the thickness of the alveolar septum increased. These findings suggested that ANXA1 significantly inhibited inflammatory cell infiltration and improved alveolar septal thickness, WRW4 reversed the lung improvement effects of ANXA1. Compared with control group, OI in LPS group was significantly decreased, and W/D ratio, pathological score and TNF-α, IL-1β, IL-6, MDA and MPO levels in lung tissue were significantly increased. Compared with LPS group, OI and IL-10 levels in lung tissue were significantly increased in LPS+Ac2-26 group, while W/D ratio, pathological score, TNF-α, IL-1β, IL-6, MDA and MPO levels in lung tissue were significantly decreased. These results indicated that ANXA1 can improve the oxygenation capacity, improve lung tissue leakage, reduce edema, and inhibit lung tissue inflammation in rats with lung injury. Compared with LPS+Ac2-26 group, the LPS+Ac2-26+WRW4 group showed significant decreases in OI and lung tissue IL-10 level [OI (mmHg, 1 mmHg ≈ 0.133 kPa): 132.16±24.00 vs. 248.67±18.70, IL-10 (ng/L): 27.30±3.04 vs. 36.10±3.92, both P &lt; 0.05], the l","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"36 9","pages":"924-929"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Early diagnostic and prognosis prediction of circ_0054633 for acute lung injury/acute respiratory distress syndrome in children with severe pneumonia]. [circ_0054633对重症肺炎患儿急性肺损伤/急性呼吸窘迫综合征的早期诊断和预后预测]。
Q3 Medicine Pub Date : 2024-09-01 DOI: 10.3760/cma.j.cn121430-20240506-00403
Shiyin Mu, Yingxue Zou, Yongsheng Guo, Mei Yu, Bing Huang, Weiwei Gao, Tian Zhang
<p><strong>Objective: </strong>To explore the value of circ_0054633 in early diagnosis and prognosis prediction of acute lung injury/acute respiratory distress syndrome (ALI/ARDS) in children with severe pneumonia.</p><p><strong>Methods: </strong>A retrospective case-control study was conducted on children with diagnosed severe pneumonia admitted to Tianjin Children's Hospital from July 1, 2022, to February 29, 2024. The clinical data was collected by electronic medical record system and clinical follow-up, including gender, age, lung injury prediction score (LIPS), pediatric critical illness score (PCIS), serum circ_0054633, interleukin-6 (IL-6), the indicators of the arterial blood-gas analysis, oxygenation index (PaO<sub>2</sub>/FiO<sub>2</sub>) within 24 hours of admission and the survival status of 28 days. According to whether ALI/ARDS occurred, they were divided into the ALI/ARDS group and the non-ALI/ARDS group. The differences of clinical data between the two groups were compared, and multivariate Logistic regression was used to analyze the risk factors for ALI/ARDS in children with severe pneumonia. The receiver operator characteristic curve (ROC curve) will be used to explore the early diagnostic value of ALI/ARDS in children with severe pneumonia. The patients of ALI/ARDS were divided into mild group, moderate group and severe group according to the level of PaO<sub>2</sub>/FiO<sub>2</sub>. The levels of serum circ_0054633 and IL-6 in various severity ALI/ARDS were compared. The differences of serum circ_0054633, IL-6 levels, PCIS score and LIPS score were compared between the two groups of ALI/ARDS patients according to different prognoses in 28 days, as well as the correlation between various risk factors and circ_0054633.</p><p><strong>Results: </strong>A total 74 children with severe pneumonia were included, with 34 cases in the ALI/ARDS group and 40 cases in the non-ALI/ARDS group. In ALI/ARDS group, there were 9 cases in the mild group, 15 cases in the moderate group and 10 cases in the severe group; while 12 cases died and 22 cases survived after 28 days. The serum circ_0054633, IL-6 level and LIPS score were higher in the ALI/ARDS group than the non-ALI/ARDS group, while the PCIS score was lower, and the two groups had significant difference. Multivariate Logistic regression analysis showed that circ_0054633 was independent predictors of ALI/ARDS in children with severe pneumonia [odds ratio (OR) = 3.853, 95% confidence interval (95%CI) was 1.912-7.805, P = 0.017]. ROC curve analysis showed that the cut-off values for circ_0054633 in the diagnosis of ALI/ARDS were 3.955, sensitivity was 79.4%, specificity was 92.5%, area under the ROC curve (AUC) was 0.892. The serum circ_0054633 and IL-6 levels were higher in the children who died in 28 days than the children who were survived, while the PCIS score was lower, and the two groups had significant difference. Spearman correlation analysis showed that the level of circ_0054633 in
目的探讨circ_0054633在重症肺炎患儿急性肺损伤/急性呼吸窘迫综合征(ALI/ARDS)早期诊断和预后预测中的价值:方法:对2022年7月1日至2024年2月29日期间天津市儿童医院收治的确诊重症肺炎患儿进行回顾性病例对照研究。通过电子病历系统和临床随访收集临床资料,包括性别、年龄、肺损伤预测评分(LIPS)、儿科危重病评分(PCIS)、血清circ_0054633、白细胞介素-6(IL-6)、动脉血气分析指标、入院24小时内氧合指数(PaO2/FiO2)和28天生存状况。根据是否发生 ALI/ARDS,分为 ALI/ARDS 组和非 ALI/ARDS 组。比较两组临床数据的差异,并采用多元 Logistic 回归分析重症肺炎患儿发生 ALI/ARDS 的风险因素。利用接收器操作特征曲线(ROC 曲线)探讨重症肺炎患儿 ALI/ARDS 的早期诊断价值。根据 PaO2/FiO2 水平将 ALI/ARDS 患者分为轻度组、中度组和重度组。比较不同程度 ALI/ARDS 患者血清 circ_0054633 和 IL-6 的水平。根据两组ALI/ARDS患者28天内的不同预后,比较血清circ_0054633、IL-6水平、PCIS评分和LIPS评分的差异,以及各种危险因素与circ_0054633的相关性:共纳入74名重症肺炎患儿,其中ALI/ARDS组34例,非ALI/ARDS组40例。ALI/ARDS组中,轻度组9例,中度组15例,重度组10例;28天后死亡12例,存活22例。ALI/ARDS组血清circ_0054633、IL-6水平和LIPS评分均高于非ALI/ARDS组,而PCIS评分低于非ALI/ARDS组,两组差异显著。多变量逻辑回归分析显示,circ_0054633是重症肺炎患儿ALI/ARDS的独立预测因子[比值比(OR)=3.853,95%置信区间(95%CI)为1.912-7.805,P=0.017]。ROC曲线分析显示,circ_0054633在ALI/ARDS诊断中的临界值为3.955,灵敏度为79.4%,特异度为92.5%,ROC曲线下面积(AUC)为0.892。28天内死亡患儿的血清circ_0054633和IL-6水平高于存活患儿,而PCIS评分较低,两组差异显著。Spearman相关性分析显示,ALI/ARDS患儿的circ_0054633水平与28天死亡率和IL-6水平呈正相关(r值分别为0.675和0.763,P均<0.001),但与PCIS评分呈负相关(r=-0.626,P<0.001),而与LIPS评分无明显相关性(r=0.389,P=0.023):结论:血清circ_0054633水平在重症肺炎患儿ALI/ARDS的早期诊断和预后预测中具有较好的价值。
{"title":"[Early diagnostic and prognosis prediction of circ_0054633 for acute lung injury/acute respiratory distress syndrome in children with severe pneumonia].","authors":"Shiyin Mu, Yingxue Zou, Yongsheng Guo, Mei Yu, Bing Huang, Weiwei Gao, Tian Zhang","doi":"10.3760/cma.j.cn121430-20240506-00403","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240506-00403","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To explore the value of circ_0054633 in early diagnosis and prognosis prediction of acute lung injury/acute respiratory distress syndrome (ALI/ARDS) in children with severe pneumonia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective case-control study was conducted on children with diagnosed severe pneumonia admitted to Tianjin Children's Hospital from July 1, 2022, to February 29, 2024. The clinical data was collected by electronic medical record system and clinical follow-up, including gender, age, lung injury prediction score (LIPS), pediatric critical illness score (PCIS), serum circ_0054633, interleukin-6 (IL-6), the indicators of the arterial blood-gas analysis, oxygenation index (PaO&lt;sub&gt;2&lt;/sub&gt;/FiO&lt;sub&gt;2&lt;/sub&gt;) within 24 hours of admission and the survival status of 28 days. According to whether ALI/ARDS occurred, they were divided into the ALI/ARDS group and the non-ALI/ARDS group. The differences of clinical data between the two groups were compared, and multivariate Logistic regression was used to analyze the risk factors for ALI/ARDS in children with severe pneumonia. The receiver operator characteristic curve (ROC curve) will be used to explore the early diagnostic value of ALI/ARDS in children with severe pneumonia. The patients of ALI/ARDS were divided into mild group, moderate group and severe group according to the level of PaO&lt;sub&gt;2&lt;/sub&gt;/FiO&lt;sub&gt;2&lt;/sub&gt;. The levels of serum circ_0054633 and IL-6 in various severity ALI/ARDS were compared. The differences of serum circ_0054633, IL-6 levels, PCIS score and LIPS score were compared between the two groups of ALI/ARDS patients according to different prognoses in 28 days, as well as the correlation between various risk factors and circ_0054633.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total 74 children with severe pneumonia were included, with 34 cases in the ALI/ARDS group and 40 cases in the non-ALI/ARDS group. In ALI/ARDS group, there were 9 cases in the mild group, 15 cases in the moderate group and 10 cases in the severe group; while 12 cases died and 22 cases survived after 28 days. The serum circ_0054633, IL-6 level and LIPS score were higher in the ALI/ARDS group than the non-ALI/ARDS group, while the PCIS score was lower, and the two groups had significant difference. Multivariate Logistic regression analysis showed that circ_0054633 was independent predictors of ALI/ARDS in children with severe pneumonia [odds ratio (OR) = 3.853, 95% confidence interval (95%CI) was 1.912-7.805, P = 0.017]. ROC curve analysis showed that the cut-off values for circ_0054633 in the diagnosis of ALI/ARDS were 3.955, sensitivity was 79.4%, specificity was 92.5%, area under the ROC curve (AUC) was 0.892. The serum circ_0054633 and IL-6 levels were higher in the children who died in 28 days than the children who were survived, while the PCIS score was lower, and the two groups had significant difference. Spearman correlation analysis showed that the level of circ_0054633 in ","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"36 9","pages":"957-961"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Zhonghua wei zhong bing ji jiu yi xue
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1