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[Analysis of the incidence and risk factors of sarcopenia in elderly intensive care unit patients: a prospective cohort study]. 老年重症监护室患者肌肉减少症发生率及危险因素分析:一项前瞻性队列研究。
Q3 Medicine Pub Date : 2024-11-01 DOI: 10.3760/cma.j.cn121430-20240819-00706
Yuehao Shen, Linlin Li, Haiying Liu, Yue Zhang, Dongxue Huang, Liuqing Duan, Lina Zhao, Keliang Xie
<p><strong>Objective: </strong>To investigate and analysis of the occurrence and influencing factors of sarcopenia in elderly critically ill patients in the intensive care unit (ICU).</p><p><strong>Methods: </strong>A prospective cohort study was conducted. Elderly patients (aged ≥ 60 years) admitted to the ICU of Tianjin Medical University General Hospital from November 2023 to June 2024 were enrolled. Clinical records were collected, and conduct muscle mass and strength measurements, as well as upper arm circumference and calf circumference were measured. Appendicular skeletal muscle index (ASMI) of less than 7.0 kg/m<sup>2</sup> for males and less than 5.7 kg/m<sup>2</sup> for females was defined as reduced muscle mass, grip strength of less than 28 kg for males and less than 18 kg for females was defined as decreased muscle strength, patients meeting both low muscle mass and low muscle strength criteria were diagnosed with sarcopenia. According to the diagnostic criteria for sarcopenia, patients were divided into sarcopenia group and non-sarcopenia group. Multivariate Logistic regression analysis was applied to identify risk factors for sarcopenia in the elderly and to develop a predictive model for the occurrence of sarcopenia. The predictive value of various risk factors for sarcopenia in elderly critically ill patients was evaluated by receiver operator characteristic curve (ROC curve). The Kaplan-Meier curve for the length of ICU stay of two groups patients were drawn.</p><p><strong>Results: </strong>Finally, 540 elderly critically ill patients were included, including 43 patients with sarcopenia, and the incidence of sarcopenia was 8.0%. Univariate analysis showed that there were significantly differences in body mass index (BMI), number of hospitalizations in the past year, the length of ICU stay, ventilation mode, duration of mechanical ventilation, pre-admission exercise habits, nutritional support methods, upper arm circumference, calf circumference, and albumin infusion between the sarcopenia group and the non-sarcopenia group. Multivariate Logistic regression analysis showed that BMI [odds ratio (OR) = 0.79, 95% confidence interval (95%CI) was 0.67-0.93, P = 0.004], calf circumference (OR = 0.64, 95%CI was 0.54-0.76, P < 0.001), and duration of mechanical ventilation (OR = 1.06, 95%CI was 1.01-1.12, P = 0.034) were associated with an increased risk of sarcopenia in elderly critically ill patients. The ROC curve results showed that the area under the curve (AUC) and 95%CI of BMI, calf circumference, and duration of mechanical ventilation for predicting sarcopenia in elderly critically ill patients were 0.828 (0.767-0.888), 0.889 (0.844-0.933), and 0.397 (0.299-0.496), respectively, with cut-off values of 22.95 kg/m<sup>2</sup>, 28.25 cm, and 50.50 days, respectively. The Kaplan-Meier curve showed that the cumulative survival rate of patients with sarcopenia was significantly lower than that of the non-sarcopenia group (Log-Rank test
目的:调查分析重症监护病房(ICU)老年危重患者肌肉减少症的发生情况及影响因素。方法:采用前瞻性队列研究。研究对象为2023年11月至2024年6月天津医科大学总医院ICU收治的老年患者(年龄≥60岁)。收集临床记录,测量肌肉质量和力量,测量上臂围和小腿围。男性阑尾骨骼肌指数(ASMI)小于7.0 kg/m2,女性小于5.7 kg/m2定义为肌肉质量下降,男性握力小于28 kg,女性握力小于18 kg定义为肌肉力量下降,同时满足低肌肉质量和低肌肉力量标准的患者诊断为肌肉减少症。根据肌少症的诊断标准,将患者分为肌少症组和非肌少症组。应用多因素Logistic回归分析确定老年人肌肉减少症的危险因素,并建立肌肉减少症发生的预测模型。采用受试者操作者特征曲线(receiver operator characteristic curve, ROC)评价各种危险因素对老年危重症患者肌肉减少症的预测价值。绘制两组患者ICU住院时间的Kaplan-Meier曲线。结果:最终纳入540例老年危重症患者,其中肌少症43例,肌少症发生率为8.0%。单因素分析显示,肌少症组与非肌少症组在体重指数(BMI)、近一年住院次数、ICU住院时间、通气方式、机械通气持续时间、入院前运动习惯、营养支持方式、上臂围、小腿围、白蛋白输注等方面存在显著差异。多因素Logistic回归分析显示,BMI[比值比(OR) = 0.79, 95%可信区间(95% ci)为0.67 ~ 0.93,P = 0.004]、小腿围(OR = 0.64, 95% ci为0.54 ~ 0.76,P < 0.001)、机械通气时间(OR = 1.06, 95% ci为1.01 ~ 1.12,P = 0.034)与老年危重症患者肌肉减少症发生风险增加相关。ROC曲线结果显示,BMI、小腿围、机械通气时间预测老年危重症患者肌肉减少症的曲线下面积(AUC)、95%CI分别为0.828(0.767-0.888)、0.889(0.844-0.933)、0.397(0.299-0.496),截断值分别为22.95 kg/m2、28.25 cm、50.50天。Kaplan-Meier曲线显示,肌少症患者的累积生存率显著低于非肌少症组(Log-Rank检验:χ 2 = 5.619, P = 0.018)。结论:较低的BMI、较小的小腿围和较长的机械通气时间与危重老年患者肌肉减少症的风险增加有关。
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引用次数: 0
[Survey on the current situation of human resources and basic configuration of the intensive care medicine in Xinjiang Production and Construction Corps from 2019 to 2021]. [2019 - 2021年新疆生产建设兵团重症监护医学人力资源现状及基本配置调查]。
Q3 Medicine Pub Date : 2024-11-01 DOI: 10.3760/cma.j.cn121430-20231029-00920
Xueting Li, Qi Zhang, Mengting Qin, Ling Huang, Hang Xu, Shan Ren
<p><strong>Objective: </strong>To comprehensively understand the basic situation of critical care medicine in Xinjiang Production and Construction Corps in order to promote the standardization, specialization, and systematization of quality control in critical care medicine.</p><p><strong>Methods: </strong>A survey was conducted from January 1, 2019, to December 31, 2021, using a questionnaire to investigate the human resources and basic allocation of comprehensive intensive care medicine departments in Xinjiang Production and Construction Corps division level hospitals and surrounding second-class hospitals. The survey content includes: basic situation of medical units, intensive care unit (ICU) basic information, ICU personnel situation, ICU equipment configuration situation, ICU performance situation, etc. The survey questionnaire was distributed in March 2022, with dedicated ICU attending physicians or above designated by each ICU as the contact person for the survey.</p><p><strong>Results: </strong>Sixteen questionnaires were distributed and returned, all of which were included from 16 comprehensive intensive care medicine departments in the Corps and surrounding areas, including 5 second class first class hospitals and 11 third class first class hospitals. There were 196 beds in 16 ICU units, and the ICU bed ratio (1.99% overall, 1.77% in third class first class hospitals) was lower than the 2%-8% stipulated in the Guidelines for the Construction and Management of Critical Care Medicine (Trial) issued by the National Health Commission. Only ICU beds in second class first class hospitals accounted for 2.65%, meeting this standard. The comprehensive ICU doctor-bed ratio in 16 hospitals was 0.55 : 1, third class first class hospitals was 0.60 : 1, and second class first class hospitals was 0.44 : 1, compared with 0.8 : 1 stipulated in the ministerial guidelines, there was a certain gap. Among the 108 doctors in 16 ICUs, only four have a master's degree or above. Associate senior and above professional and technical titles accounted for 27.78%, less than one third. Among the 334 nursing staff, there were no personnel with a master's degree or above, and only 10 personnel with associate senior or above professional and technical titles. From 2019 to 2021, there were 1 new master's degree personnel, 2 new senior professional and technical personnel, and 12 deputy senior professional and technical personnel. It indicating that the proportion of highly educated and experienced physicians and nurses were lower, team building lags behind, talent introduction were lower, and highly educated talents were scarce. The statistical analysis results of the absolute growth of core technology showed that the growth of core technology was slow, the progressiveness was insufficient, and the professional technical ability was insufficient.</p><p><strong>Conclusions: </strong>The construction of critical care majors and talent echelons in the Xinjiang Production
目的:全面了解新疆生产建设兵团危重医学的基本情况,以促进危重医学质量控制的规范化、专业化、系统化。方法:于2019年1月1日至2021年12月31日,采用问卷调查法,对新疆生产建设兵团师级医院及周边二级医院重症综合医学科的人力资源及基本配置情况进行调查。调查内容包括:医疗单位基本情况、重症监护病房(ICU)基本情况、ICU人员情况、ICU设备配置情况、ICU工作情况等。调查问卷于2022年3月发放,各ICU指定专职ICU主治医师及以上作为调查联系人。结果:共发放并回收问卷16份,全部来自兵团及周边地区16个综合重症医学科,其中二级甲等医院5家,三级甲等医院11家。16个重症监护室共有床位196张,ICU床位数比(整体1.99%,三甲医院1.77%)低于国家卫健委《危重医学建设与管理指导意见(试行)》规定的2%-8%。仅二级甲等医院ICU床位占2.65%,符合该标准。16家医院ICU综合医床比为0.55:1,三级甲等医院为0.60:1,二级甲等医院为0.44:1,与部级指导意见规定的0.8:1相比,存在一定差距。在16个icu的108名医生中,只有4人拥有硕士及以上学位。副高级及以上专业技术职称占27.78%,不足三分之一。334名护理人员中,具有硕士及以上学历的人员无一人,具有副高级及以上专业技术职称的人员仅有10人。2019年至2021年,新增硕士学位人员1人,新增高级专业技术人员2人,副高级专业技术人员12人。说明高学历、经验丰富的医护人员比例偏低,团队建设滞后,人才引进不足,高学历人才稀缺。核心技术绝对增长的统计分析结果显示,核心技术增长缓慢,先进性不足,专业技术能力不足。结论:新疆生产建设兵团区域重症监护专业及人才梯队建设滞后,学科整体专业水平不高,专业人才缺乏。在人才培养、技术开发和培训、医疗质量管理等方面需要进一步完善,确保医疗质量和安全。
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引用次数: 0
[Construction of a prediction model of ultrasound indicators for mortality risk within 7 days in patients with acute myocardial infarction and ventricular septal rupture]. [超声指标对急性心肌梗死室间隔破裂患者7天内死亡风险预测模型的构建]。
Q3 Medicine Pub Date : 2024-11-01 DOI: 10.3760/cma.j.cn121430-20240813-00696
Yunfeng Fu, Zhongshu Liang, Wenchang Feng

Objective: To investigate the risk factors of death within 7 days in patients with acute myocardial infarction (AMI) complicated by ventricular septal rupture (VSR) based on echocardiography indicators, and to construct a nomogram model of ultrasound indicator risk to predict the risk of death in patients with post-infarction ventricular septal rupture (PIVSR).

Methods: The echocardiographic data of 40 patients with PIVSR admitted to the department of cardiology, Xiangya Third Hospital, Central South University from January 2014 to June 2024 were retrospectively analyzed. The patients were divided into death group and survival group based on their 7-day survival status. The risk factors affecting death within 7 days of PIVSR patients were analyzed by univariate and multivariate analyses, and the risk nomogram model of ultrasound indicators predicting death within 7 days of PIVSR patients was constructed by using R software. Calibration curve and receiver operator characteristic curve (ROC curve) were used to verify the prediction effect of the model.

Results: Among the 40 patients with PIVSR, 18 died at 7 days and 22 survived. Univariate analysis showed that, compared with the survival group, patients in the death group were older (years old: 73.7±6.8 vs. 68.1±7.7), had a larger diameter of VSR (mm: 10.4±4.2 vs. 7.7±3.0), and had a higher peak pressure difference (PPG) in the perforation area [mmHg (1 mmHg≈0.133 kPa): 49.0±11.6 vs. 37.0±16.1], left ventricular ejection fraction (LVEF) and stroke volume (SV) were significantly decreased [LVEF: 0.439±0.134 vs. 0.512±0.094, SV (mL): 46.1±15.6 vs. 62.0±14.3], and the differences were statistically significant (all P < 0.05). Multivariate Logistic regression analysis showed that age [odds ratio (OR) = 1.212, 95% confidence interval (95%CI) was 1.034-1.420, P = 0.018] and perforation area PPG (OR = 1.248, 95%CI was 1.069-1.457, P = 0.005) were positively correlated with the occurrence of death events within 7 days in PIVSR patients, while SV was negatively correlated with the occurrence of death events within 7 days in PIVSR patients (OR = 0.851, 95%CI was 0.756-0.957, P = 0.007). The predicted value of the nomogram model for predicting the risk of death within 7 days in patients with PIVSR was basically consistent with the actual value, and the Hosmer-Lemeshow goodness of fit test χ 2 = 10.679, P = 0.220. The area under the curve (AUC) predicted by the model was 0.960, 95%CI was 0.913-0.998.

Conclusions: Age and echocardiographic indicators SV and perforation area PPG are risk factors for mortality within 7 days in PIVSR patients. The nomogram model of mortality risk within 7 days in PIVSR patients constructed using the above indicators has good discrimination and consistency.

目的:基于超声心动图指标探讨急性心肌梗死(AMI)合并室间隔破裂(VSR)患者7天内死亡的危险因素,构建超声指标风险的nomogram模型,预测梗死后室间隔破裂(PIVSR)患者的死亡风险。方法:回顾性分析2014年1月至2024年6月中南大学湘雅第三医院心内科收治的40例PIVSR患者的超声心动图资料。根据患者7 d的生存情况分为死亡组和生存组。通过单因素和多因素分析对影响PIVSR患者7天内死亡的危险因素进行分析,利用R软件构建超声指标预测PIVSR患者7天内死亡的风险模态图模型。采用校正曲线和受试者操作特征曲线(ROC曲线)验证模型的预测效果。结果:40例PIVSR患者中,7 d死亡18例,存活22例。单因素分析显示,与生存组相比,死亡组患者年龄较大(73.7±6.8 vs. 68.1±7.7),VSR直径较大(mm: 10.4±4.2 vs. 7.7±3.0),穿孔区峰值压差(PPG)较高[mmHg (1 mmHg≈0.133 kPa): 49.0±11.6 vs. 37.0±16.1],左室射血分数(LVEF)和卒中容积(SV)显著降低[LVEF: 0.439±0.134 vs. 0.512±0.094,SV (mL)]。46.1±15.6∶62.0±14.3],差异均有统计学意义(P < 0.05)。多因素Logistic回归分析显示,年龄[比值比(OR) = 1.212, 95%可信区间(95% ci)为1.034 ~ 1.420,P = 0.018]、穿孔面积PPG (OR = 1.248, 95% ci为1.069 ~ 1.457,P = 0.005]与PIVSR患者7 d内死亡事件的发生呈正相关,SV与PIVSR患者7 d内死亡事件的发生呈负相关(OR = 0.851, 95% ci为0.756 ~ 0.957,P = 0.007)。预测PIVSR患者7 d内死亡风险的nomogram模型预测值与实际值基本一致,Hosmer-Lemeshow拟合优度检验χ 2 = 10.679, P = 0.220。模型预测的曲线下面积(AUC)为0.960,95%CI为0.913 ~ 0.998。结论:年龄、超声心动图指标SV和穿孔面积PPG是PIVSR患者7天内死亡的危险因素。利用上述指标构建的PIVSR患者7天内死亡风险的nomogram模型具有较好的辨析性和一致性。
{"title":"[Construction of a prediction model of ultrasound indicators for mortality risk within 7 days in patients with acute myocardial infarction and ventricular septal rupture].","authors":"Yunfeng Fu, Zhongshu Liang, Wenchang Feng","doi":"10.3760/cma.j.cn121430-20240813-00696","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240813-00696","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the risk factors of death within 7 days in patients with acute myocardial infarction (AMI) complicated by ventricular septal rupture (VSR) based on echocardiography indicators, and to construct a nomogram model of ultrasound indicator risk to predict the risk of death in patients with post-infarction ventricular septal rupture (PIVSR).</p><p><strong>Methods: </strong>The echocardiographic data of 40 patients with PIVSR admitted to the department of cardiology, Xiangya Third Hospital, Central South University from January 2014 to June 2024 were retrospectively analyzed. The patients were divided into death group and survival group based on their 7-day survival status. The risk factors affecting death within 7 days of PIVSR patients were analyzed by univariate and multivariate analyses, and the risk nomogram model of ultrasound indicators predicting death within 7 days of PIVSR patients was constructed by using R software. Calibration curve and receiver operator characteristic curve (ROC curve) were used to verify the prediction effect of the model.</p><p><strong>Results: </strong>Among the 40 patients with PIVSR, 18 died at 7 days and 22 survived. Univariate analysis showed that, compared with the survival group, patients in the death group were older (years old: 73.7±6.8 vs. 68.1±7.7), had a larger diameter of VSR (mm: 10.4±4.2 vs. 7.7±3.0), and had a higher peak pressure difference (PPG) in the perforation area [mmHg (1 mmHg≈0.133 kPa): 49.0±11.6 vs. 37.0±16.1], left ventricular ejection fraction (LVEF) and stroke volume (SV) were significantly decreased [LVEF: 0.439±0.134 vs. 0.512±0.094, SV (mL): 46.1±15.6 vs. 62.0±14.3], and the differences were statistically significant (all P < 0.05). Multivariate Logistic regression analysis showed that age [odds ratio (OR) = 1.212, 95% confidence interval (95%CI) was 1.034-1.420, P = 0.018] and perforation area PPG (OR = 1.248, 95%CI was 1.069-1.457, P = 0.005) were positively correlated with the occurrence of death events within 7 days in PIVSR patients, while SV was negatively correlated with the occurrence of death events within 7 days in PIVSR patients (OR = 0.851, 95%CI was 0.756-0.957, P = 0.007). The predicted value of the nomogram model for predicting the risk of death within 7 days in patients with PIVSR was basically consistent with the actual value, and the Hosmer-Lemeshow goodness of fit test χ <sup>2</sup> = 10.679, P = 0.220. The area under the curve (AUC) predicted by the model was 0.960, 95%CI was 0.913-0.998.</p><p><strong>Conclusions: </strong>Age and echocardiographic indicators SV and perforation area PPG are risk factors for mortality within 7 days in PIVSR patients. The nomogram model of mortality risk within 7 days in PIVSR patients constructed using the above indicators has good discrimination and consistency.</p>","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"36 11","pages":"1169-1173"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855622","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
[Comparison of the effect of different extubation techniques on extubation in patients with mechanical ventilation in intensive care unit]. [重症监护病房机械通气患者不同拔管技术对拔管效果的比较]。
Q3 Medicine Pub Date : 2024-11-01 DOI: 10.3760/cma.j.cn121430-20231107-00950
Ruru Zhao, Yuanbo Liu, Yihong Huang, Hanming Gao, Debin Huang
<p><strong>Objective: </strong>To compare the application effects of three different extubation techniques in patients with mechanical ventilation in intensive care unit (ICU).</p><p><strong>Methods: </strong>A prospective randomized controlled study was conducted. Mechanical ventilation patients admitted to the critical care department of the First Affiliated Hospital of Guangxi Medical University from July to November 2023 were enrolled. According to the random number table generated by Excel, the patients were divided into negative pressure group, positive pressure group 1 and positive pressure group 2, with 45 cases in each group. On the basis of routine nursing, the negative pressure group used the negative pressure extubation technique to remove the tracheal catheter. In the positive pressure group, the pressure support (PS) and positive end-expiratory pressure (PEEP) of the positive pressure group 1 were 7 cmH<sub>2</sub>O (1 cmH<sub>2</sub>O≈0.098 kPa) and 5 cmH<sub>2</sub>O, and the PS and PEEP of the positive pressure group 2 were 15 cmH<sub>2</sub>O and 10 cmH<sub>2</sub>O. The main outcome measures were extubation related complications, including tachypnea, severe cough, sore throat, upper airway obstruction spasm, extubation failure, hypoxemia, and hypercapnia. The secondary outcome measures were the variation of heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure and blood oxygen saturation before and 1, 15 and 30 minutes after extubation.</p><p><strong>Results: </strong>Finally, 42 patients were included in each group. There were no significant differences in gender, age, catheter retention days, duration of mechanical ventilation, acute physiology and chronic health evaluation II (APACHE II), catheter model and diagnosis among the three groups, which were comparable. There were statistically significant differences in the incidence of tachypnea, severe cough, sore throat, upper airway obstruction spasm, hypoxemia and hypercapnia among the three groups, while there was no statistically significant difference in the failure rate of extubation. The incidence of tachypnea, severe cough, sore throat, upper airway obstruction spasm, hypoxemia and hypercapnia after extubation in positive pressure group 1 and positive pressure group 2 were lower than those in negative pressure group (7.14%, 9.52% vs. 33.33%; 7.14%, 4.76% vs. 28.57%; 61.90%, 52.38% vs. 88.10%; 11.90%, 19.05% vs. 45.24%; 7.14%, 7.14% vs. 30.95%; 4.76%, 2.38% vs. 28.57%; all P < 0.05). There were no significant differences in extubation related complications between group 1 and group 2. There were significant differences in the time effect of heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure and blood oxygen saturation 30 minutes after extubation among three groups (F values were 145.792, 49.749, 22.486, 23.622 and 242.664, respectively, all P < 0.01). The intergroup effect of blood oxygen saturation was s
目的:比较三种不同拔管技术在重症监护病房(ICU)机械通气患者中的应用效果。方法:采用前瞻性随机对照研究。选取广西医科大学第一附属医院2023年7月至11月重症监护室收治的机械通气患者。根据Excel生成的随机数字表将患者分为负压组、正压组1、正压组2,每组45例。负压组在常规护理的基础上,采用负压拔管技术拔除气管导管。正压组中,正压组1的压力支持(PS)和呼气末正压(PEEP)分别为7 cmH2O (1 cmH2O≈0.098 kPa)和5 cmH2O,正压组2的PS和PEEP分别为15 cmH2O和10 cmH2O。主要结局指标为拔管相关并发症,包括呼吸急促、严重咳嗽、喉咙痛、上气道梗阻痉挛、拔管失败、低氧血症和高碳酸血症。次要观察指标为拔管前、拔管后1分钟、15分钟和30分钟的心率、收缩压、舒张压、平均动脉压和血氧饱和度的变化。结果:每组42例。三组患者在性别、年龄、导管留置天数、机械通气时间、急性生理与慢性健康评估II (APACHE II)、导管型号、诊断等方面均无显著差异,具有可比性。三组患者呼吸急促、严重咳嗽、咽喉痛、上气道梗阻痉挛、低氧血症、高碳酸血症发生率比较,差异有统计学意义;拔管失败率比较,差异无统计学意义。正压组1、正压组2拔管后呼吸急促、严重咳嗽、咽喉痛、上气道梗阻痉挛、低氧血症、高碳酸血症发生率均低于负压组(7.14%、9.52% vs. 33.33%;7.14%, 4.76% vs. 28.57%;61.90%, 52.38% vs. 88.10%;11.90%, 19.05% vs. 45.24%;7.14%, 7.14% vs. 30.95%;4.76%, 2.38% vs. 28.57%;P < 0.05)。1组与2组拔管相关并发症无明显差异。三组患者拔管后30min心率、收缩压、舒张压、平均动脉压、血氧饱和度的时间效应差异有统计学意义(F值分别为145.792、49.749、22.486、23.622、242.664,P均< 0.01)。两组间血氧饱和度差异有统计学意义(F = 3.835, P = 0.024),拔管后1分钟、30分钟,正压组1、正压组2血氧饱和度高于负压组(拔管后1分钟:0.97±0.02、0.97±0.02∶0.95±0.02;拔管后30 min: 1.00±0.01,1.00±0.01 vs. 0.99±0.02,P均< 0.05)。心率与血氧饱和度的交互作用有统计学意义(F值分别为3.512、7.226,P均< 0.01)。结论:与负压拔管相比,正压拔管可有效减少ICU机械通气患者拔管相关并发症。有利于拔管后30分钟内维持稳定的血氧饱和度,具有较好的临床应用效果。建议使用低压拔管。
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引用次数: 0
[Research progress on biomarkers of sepsis-associated acute kidney injury]. 脓毒症相关急性肾损伤生物标志物研究进展
Q3 Medicine Pub Date : 2024-11-01 DOI: 10.3760/cma.j.cn121430-20231018-00883
Jiangming Zhang, Minjun Qi, Lumei Ma, Dongmei Liu

Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. Sepsis-associated acute kidney injury (SA-AKI) is a common organ dysfunction of sepsis, and its incidence and mortality are increasing,which brings heavy economic burden to patients and society. Early diagnosis and effective intervention can block the occurrence and progression of SA-AKI effectively, improve prognosis, and reduce medical costs. Diagnosis on SA-AKI relies on urine volume and serum creatinine, which has the disadvantages of being easily disturbed and delaying. The identification of biomarkers in blood and urine can facilitate diagnosis and provide targeted therapy to enhance the management of SA-AKI. This article reviews the characteristics of a variety of SA-AKI biomarkers that have been found and validated, including pre-damage biomarkers, damage biomarkers and functional biomarkers, and explore the clinical value of newly discovered biomarkers related to the diagnosis and treatment of SA-AKI, such as blood uncoupling protein 2 (UCP2), Sestrin 2 protein and pannexin 1 (PANX1), to provide reference for the early diagnosis and effective treatment of SA-AKI.

脓毒症被定义为由宿主对感染反应失调引起的危及生命的器官功能障碍。脓毒症相关性急性肾损伤(SA-AKI)是脓毒症常见的脏器功能障碍,其发病率和死亡率不断上升,给患者和社会带来了沉重的经济负担。早期诊断和有效干预可有效阻断SA-AKI的发生和发展,改善预后,降低医疗费用。SA-AKI的诊断依赖于尿量和血清肌酐,其缺点是容易受到干扰和延误。血液和尿液中生物标志物的识别有助于诊断和提供靶向治疗,以加强SA-AKI的管理。本文综述了目前已发现并验证的多种SA-AKI生物标志物的特点,包括损伤前生物标志物、损伤生物标志物和功能生物标志物,并探讨了新发现的与SA-AKI诊断和治疗相关的生物标志物,如血液解偶联蛋白2 (UCP2)、Sestrin 2蛋白和pannexin 1 (PANX1)的临床价值,为SA-AKI的早期诊断和有效治疗提供参考。
{"title":"[Research progress on biomarkers of sepsis-associated acute kidney injury].","authors":"Jiangming Zhang, Minjun Qi, Lumei Ma, Dongmei Liu","doi":"10.3760/cma.j.cn121430-20231018-00883","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20231018-00883","url":null,"abstract":"<p><p>Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. Sepsis-associated acute kidney injury (SA-AKI) is a common organ dysfunction of sepsis, and its incidence and mortality are increasing,which brings heavy economic burden to patients and society. Early diagnosis and effective intervention can block the occurrence and progression of SA-AKI effectively, improve prognosis, and reduce medical costs. Diagnosis on SA-AKI relies on urine volume and serum creatinine, which has the disadvantages of being easily disturbed and delaying. The identification of biomarkers in blood and urine can facilitate diagnosis and provide targeted therapy to enhance the management of SA-AKI. This article reviews the characteristics of a variety of SA-AKI biomarkers that have been found and validated, including pre-damage biomarkers, damage biomarkers and functional biomarkers, and explore the clinical value of newly discovered biomarkers related to the diagnosis and treatment of SA-AKI, such as blood uncoupling protein 2 (UCP2), Sestrin 2 protein and pannexin 1 (PANX1), to provide reference for the early diagnosis and effective treatment of SA-AKI.</p>","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"36 11","pages":"1216-1220"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855702","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 mechanism and target therapeutic value of pericytes in acute lung injury]. [周细胞在急性肺损伤中的作用机制及靶向治疗价值的研究进展]。
Q3 Medicine Pub Date : 2024-11-01 DOI: 10.3760/cma.j.cn121430-20231022-00892
Zhanshan Zhou, Dong Huang

Acute lung injury (ALI) is a common respiratory disease in clinical practice, which can progress to acute respiratory distress syndrome and endanger the patient's life. Pericytes are a class of cells that directly contact the microvascular basement membrane in the microvascular bed and communicate with endothelial cells, and their distribution and interaction with endothelial cells help to define and maintain local microvascular characteristics. In recent years, pericytes have became one of the most important indicators of ALI. This article reviews the important mechanisms of pericellular function in the physiological functions of the respiratory system, immune inflammatory response in the lungs, microvascular permeability, and signaling pathways related to ALI progression, as well as their effective treatment of ALI as targets, by searching relevant literature at home and abroad. It provides a scientific reference for targeted therapy of ALI.

急性肺损伤(Acute lung injury, ALI)是临床常见的呼吸系统疾病,可发展为急性呼吸窘迫综合征,危及患者生命。周细胞是一类在微血管床上直接接触微血管基底膜并与内皮细胞交流的细胞,它们的分布和与内皮细胞的相互作用有助于确定和维持局部微血管特征。近年来,周细胞已成为ALI最重要的指标之一。本文通过查阅国内外相关文献,综述了细胞周围功能在呼吸系统生理功能、肺免疫炎症反应、微血管通透性、ALI进展相关信号通路中的重要机制,以及它们作为ALI靶点的有效治疗。为ALI的靶向治疗提供科学参考。
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引用次数: 0
[Exploration of key ferroptosis-related genes as therapeutic targets for sepsis based on bioinformatics and the depiction of their immune profiles characterization]. [基于生物信息学及其免疫图谱特征描述的败血症治疗靶点--铁蛋白沉积相关关键基因的探索]。
Q3 Medicine Pub Date : 2024-10-01 DOI: 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
目的基于生物信息学分析,探讨作为败血症治疗靶点的关键铁蛋白沉积相关基因的特征,并描述其免疫特征:转录组数据集 GSE57065、GSE9960、GSE28750 和 GSE137340 从基因表达总库(GEO)数据库中下载,免疫相关基因(IRG)从 ImmPort 和 InnateDB 数据库中获得,铁突变相关基因(FRG)从 FerrDb 数据库中下载。用代理变量分析(SVA)软件包将GSE57065、GSE9960和GSE28750数据集整合为一个分析数据集,并用 "limma "软件包对该分析数据集进行分析,得到差异表达基因(DEG),然后将DEG、FRG和IRG的交集视为铁变态反应和免疫相关DEG(FImDEG)。利用 "ClusterProfiler "进行了基因本体(GO)功能注释和京都基因组百科全书(KEGG)富集分析,以了解 FImDEG 的生物学功能。通过蛋白-蛋白相互作用(PPI)网络、最小绝对收缩和选择算子(LASSO)回归算法和支持向量机(SVM)分析筛选出关键基因,并根据上述关键基因建立了逻辑回归模型。绘制了接收者运算特征曲线(ROC 曲线),以评估关键基因单独或联合应用的诊断效果。使用 "CIBERSORT "软件包评估了22种免疫细胞的浸润程度,并分析了关键基因的表达与免疫细胞浸润程度之间的相关性。数据集 GSE137340 用于验证这些关键基因:结果:通过处理数据库并去除批次效应,得到了由 146 个败血症样本和 61 个健康对照样本组成的数据集。共获得 4 537 个 DEG,包括 2 066 个上调基因和 2 471 个下调基因。从相关数据库中获得了 2 519 个 IRG 和 855 个 FRG。利用 DEG、IRG 和 FRG 的交集,得到 34 个 FImDEG,包括 20 个上调基因和 14 个下调基因。GO功能注释表明,34个FImDEG的生物学功能主要是抑制转移酶活性、调节DNA结合转录因子活性和细胞对刺激的反应。在分子功能方面,主要与RNA聚合酶II特异性DNA结合转录因子结合和各种蛋白连接酶结合有关。细胞组成的变化主要发生在早幼粒细胞白血病蛋白和染色质沉默复合物中。KEGG通路的富集分析表明,34个FImDEG涉及的主要通路包括细胞衰老、程序性死亡配体1(PD-L1)的表达和癌症中的程序性死亡-1(PD-1)检查点通路、白细胞介素-17(IL-17)信号通路、脂质和动脉粥样硬化以及NOD样受体信号通路。通过 PPI 网络、LASSO 和 SVM 机器学习筛选了四个关键基因,包括细胞色素 b-245 β 链(CYBB)、丝裂原活化蛋白激酶 14(MAPK14)、前列腺素内过氧化物合成酶 2(PTGS2)和 V-reticuloendotheliosis virus oncogeneology A(RELA)。ROC曲线分析表明,诊断脓毒症的四个关键基因的ROC曲线下面积(AUC)均大于0.65,其中MAPK14的AUC为0.911。基于四个关键基因构建的逻辑回归模型的AUC为0.956。免疫浸润分析表明,与健康对照样本相比,脓毒症样本中中性粒细胞和巨噬细胞 M0 的浸润度明显升高,而静息自然杀伤细胞(NK 细胞)、幼稚 CD4+ T 细胞和 CD8+ T 细胞的浸润度明显降低。相关性分析表明,MAPK14 表达与中性粒细胞浸润程度的正相关性最高。GSE137340数据集的验证结果显示,与健康对照样本相比,脓毒症样本中CYBB和MAPK14的表达明显上调,但PTGS2和RELA的表达明显下调,与上述分析数据集的表达趋势相似:结论:通过生物信息学分析发现了脓毒症发病过程中的四个关键基因,包括CYBB、MAPK14、PTGS2和RELA,它们在免疫过程中发挥着重要作用,而MAPK14可能是免疫干预的一个重要靶点。
{"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":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To explore the characteristics of key ferroptosis-related genes as therapeutic targets for sepsis based on bioinformatics analysis, and describe their immune characteristics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;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}
引用次数: 0
[Mechanism of Tongfu Lifei decoction inhibiting the programmed death-1/programmed death-ligand 1 signaling pathway in THP-1 cells by regulating microRNA-146a]. [通脉活血汤通过调节 microRNA-146a 抑制 THP-1 细胞中程序性死亡-1/程序性死亡-配体 1 信号通路的机制]。
Q3 Medicine Pub Date : 2024-10-01 DOI: 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
目的:探讨通脉活血汤对脂多糖(LPS)诱导的人单核细胞白血病细胞 THP-1 的保护作用及其机制:方法:(1)体外培养THP-1细胞,用1 mg/L LPS培养18小时,构建体外THP-1细胞炎症模型。其他 THP-1 细胞作为空白对照组。用酶联免疫吸附试验(ELISA)检测细胞分泌的肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)的水平。(2)将 THP-1 细胞分为 7 组,分别用 0、0.005、0.01、0.02、0.04、0.08 和 0.16 mL/mL TFL 处理 24 小时(每毫升培养液中添加不同剂量的 TFL 溶液,粗药物含量为 1 kg/L)。采用甲基噻唑基四氮唑(MTT)比色法检测细胞存活率,筛选出对 THP-1 细胞无毒的 TFL 干预剂量。(3)根据 MTT 比色法筛选出的 TFL 干预剂量,将 THP-1 细胞分为炎症模型组和 0.01、0.02 和 0.04 mL/mL TFL 组。干预 24 小时后,用 ELISA 法测定细胞分泌的 TNF-α 和 IL-6 水平。用 Western 印迹法检测细胞中程序性死亡-1/程序性死亡配体 1(PD-1/PD-L1)信号通路蛋白的表达。实时荧光定量反转录聚合酶链反应(RT-PCR)用于检测细胞中 microRNA(miR-146a、miR-146b、miR-155)的表达。(4)选择对 THP-1 细胞无毒的最大 TFL 浓度(0.04 mL/mL)作为干预剂量。将 THP-1 细胞分为炎症模型组、TFL 组、TFL+miR-146a 抑制剂组、TFL+miR-146b 抑制剂组和 TFL+miR-155 抑制剂组。炎症模型组不进行任何药物干预。其他抑制剂组加入 100 nmol/L 的相应抑制剂。干预 24 小时后,用 ELISA 检测细胞分泌的 TNF-α 和 IL-6 水平。结果:(1)与空白对照组相比,炎症模型组细胞分泌的 TNF-α 和 IL-6 水平显著升高,表明 THP-1 炎症细胞模型在体外构建成功。 2)0-0.04 mL/mL TFL 对 THP-1 细胞无毒性作用。但是,0.08 mL/mL 和 0.16 mL/mL TFL 组细胞的存活率明显低于炎症模型组,说明 TFL 剂量超过 0.04 mL/mL 对 THP-1 细胞有毒性作用。(3)与炎症模型组相比,0.01 mL/mL TFL 对 THP-1 细胞分泌的 TNF-α 和 IL-6 水平无明显影响,而 0.02 mL/mL 和 0.04 mL/mL TFL可明显降低细胞分泌的TNF-α和IL-6水平[TNF-α(ng/L):95.89±8.55、70.73±11.70 vs. 137.10±7.19,IL-6(ng/L):23.03±2.55、16.58±1.72 vs. 32.60±2.55,均P<0.01]。与炎症模型组相比,不同剂量的TFL组THP-1细胞中PD-1/PD-L1信号通路蛋白的表达量明显降低,且呈现一定的剂量依赖性。0.04 mL/mL TFL组的通路蛋白表达量明显低于炎症模型组[PD-1蛋白(PD-1/β-actin):0.28±0.04 vs. 1.00±0.10,PD-L1 蛋白(PD-L1/β-肌动蛋白):0.54±0.05 vs. 1.00±0.10:0.28±0.03 vs. 1.00±0.08、磷酸化蛋白激酶 B(p-Akt)蛋白(p-Akt/Akt):0.38±0.04 vs. 1.00±0.08、磷酸化蛋白激酶 B(p-Akt0.38±0.04 vs. 1.00±0.10,所有 P <0.01]。与炎症模型组相比,0.01、0.02 和 0.04 mL/mL TFL 组 THP-1 细胞中 miR-146a 的表达明显降低(2-ΔΔCt:0.46±0.11、0.31±0.13、0.23±0.14 vs. 1.01±0.18,均 P <0.01),而 miR-146b 和 miR-155 的表达无明显变化。(4)与炎症模型组相比,TFL 组 THP-1 细胞分泌的 TNF-α 和 IL-6 水平明显下降。miR-146a抑制剂能明显逆转TFL对炎症因子的抑制作用,与TFL组相比差异有统计学意义[TNF-α(ng/L):138.55±10.30 vs. 72.33±10.59,IL-6(ng/L):31.35±3.98 vs. 15.75±3.76,P均<0.01]。与炎症模型组相比,TFL 组 THP-1 细胞中 PD-1/PD-L1 信号通路蛋白的表达明显减少。TFL+miR-146a抑制剂组细胞中通路蛋白的表达明显高于TFL组[PD-1蛋白(PD-1/β-actin):0.85±0.09 vs. 0.37±0.04,PD-L1 蛋白(PD-L1/β-肌动蛋白):0.83±0.08 vs. 0.37±0.04:0.83±0.08 vs. 0.55±0.06,PI3K 蛋白 (PI3K/β-actin):0.85±0.09 vs. 0.63±0.
{"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":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To explore the protective effect and mechanism of Tongfu Lifei decoction (TFL) on human monocytic leukemia cell THP-1 induced by lipopolysaccharide (LPS).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;(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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;(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}
引用次数: 0
[Effects of perioperative use of renin-angiotensin system inhibitor on renal function and clinical outcomes in patients undergoing coronary artery bypass grafting surgery]. [围手术期使用肾素-血管紧张素系统抑制剂对冠状动脉旁路移植手术患者肾功能和临床结果的影响]。
Q3 Medicine Pub Date : 2024-10-01 DOI: 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
目的分析术前使用肾素-血管紧张素系统抑制剂(RASi)对冠状动脉旁路移植术(CABG)患者术后肾功能以及短期和长期预后的影响:方法:进行了一项回顾性队列分析。根据中国医学科学院阜外医院 CABG 患者的登记研究数据,分析了 2013 年 1 月至 2022 年 12 月期间接受 CABG 的成年患者的临床数据。术前使用 RASi(PreRASi)是指术前 48 小时内接受 RASi 治疗。术后急性肾损伤(AKI)的定义采用肾脏病诊断标准:改善全球预后》(KDIGO)的诊断标准定义术后急性肾损伤(AKI)。研究人员还提取了人口统计学特征、既往病史、合并症、术前用药、术前实验室检查结果、手术过程的具体信息以及术后治疗相关数据。主要终点是术后 AKI 的发生率。次要终点包括院内全因死亡率和最长随访期内的全因死亡率。根据术前是否使用RASi,患者被分为PreRASi组和No-PreRASi组。两组的基线数据通过倾向得分匹配(PSM)进行平衡。采用逻辑回归模型和Cox比例危险模型评估PreRASi与术后AKI和临床结局之间的相关性,并分析队列中的高血压和射血分数保留型心衰(HFpEF)亚组:共纳入33 884例接受CABG手术的患者,平均随访时间为(3.0±2.4)年,最长随访时间达8.5年。PreRASi组有9 128例(26.94%),无PreRASi组有24 756例(73.06%)。PreRASi组的术后AKI发生率为47.61%(4 346例),而无PreRASi组为52.37%(12 964例)。两组各匹配了 5 094 例患者。与无 PreRASi 组相比,在 PSM 之前和之后,PreRASi 都与术后 AKI 风险的降低相关[PSM 之前:比值比 (OR) = 0.834,95% 置信区间 (95%CI) 为 0.793-0.877,P < 0.001;PSM 之后:OR = 0.875,95%CI 为 0.808-0.948,P = 0.001]。对高血压和 HFpEF 患者进行的亚组分析表明,在 PSM 前后,PreRASi 与术后 AKI 风险降低相关。PreRASi组和无PreRASi组的院内死亡率分别为0.61%(56例)和0.49%(121例)。对整个队列以及高血压和高频心衰亚组的分析表明,PreRASi与院内死亡率或最长随访死亡率之间没有相关性:结论:围手术期使用 RASi 可降低接受 CABG 患者术后发生 AKI 的风险,具有一定的肾脏保护作用,但与术后短期或长期死亡风险无关。
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引用次数: 0
[Research progress on the role of immune cells regulated by Maresin-1 in inflammatory diseases]. [受 Maresin-1 调节的免疫细胞在炎症性疾病中作用的研究进展]。
Q3 Medicine Pub Date : 2024-10-01 DOI: 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.

炎症反应是宿主的一种防御机制,可保护宿主免受外界有害抗原和微生物的侵害,炎症反应的加剧可导致组织损伤和全身性炎症性疾病的发生。作为ω-3 脂肪酸的一种代表性衍生物,Maresin-1 在调节先天性免疫细胞(中性粒细胞和单核/巨噬细胞)和促进急性炎症性疾病中感染性炎症的消退方面的作用已被广泛探讨。现在有越来越多的证据表明,Maresin-1 还能直接影响适应性免疫系统,防止急性炎症向慢性炎症过渡。本文通过分析Maresin-1对炎症调控作用的相关文献,总结了各种免疫细胞在炎症反应中的作用以及Maresin-1对各种免疫细胞的调控机制,从而深入了解Maresin-1在炎症性疾病中调控免疫细胞作用的研究进展。该研究为Maresin-1在炎症性疾病中的基础研究和临床应用提供了理论依据。
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引用次数: 0
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