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Improving T cell therapy: in vivo CRISPR-Cas9 screens tell us how to do 改进T细胞疗法:体内CRISPR-Cas9筛选告诉我们该怎么做
IF 5.3 4区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2021-07-22 DOI: 10.1093/pcmedi/pbab015
Tao Yin
Editor’s note A commentary on “In vivo CD8+ T cell CRISPR screening reveals control by Fli1 in infection and cancer”.
编者注:关于“体内CD8+ T细胞CRISPR筛选揭示Fli1在感染和癌症中的控制作用”的评论。
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引用次数: 1
Applications and challenges of CRISPR-Cas gene-editing to disease treatment in clinics. CRISPR-Cas 基因编辑技术在临床疾病治疗中的应用和挑战。
IF 5.1 4区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2021-07-10 eCollection Date: 2021-09-01 DOI: 10.1093/pcmedi/pbab014
Wenyi Liu, Luoxi Li, Jianxin Jiang, Min Wu, Ping Lin

Clustered regularly interspaced short palindromic repeats (CRISPR)-associated systems (Cas) are efficient tools for targeting specific genes for laboratory research, agricultural engineering, biotechnology, and human disease treatment. Cas9, by far the most extensively used gene-editing nuclease, has shown great promise for the treatment of hereditary diseases, viral infection, cancers, and so on. Recent reports have revealed that some other types of CRISPR-Cas systems may also have surprising potential to join the fray as gene-editing tools for various applications. Despite the rapid progress in basic research and clinical tests, some underlying problems present continuous, significant challenges, such as editing efficiency, relative difficulty in delivery, off-target effects, immunogenicity, etc. This article summarizes the applications of CRISPR-Cas from bench to bedside and highlights the current obstacles that may limit the usage of CRISPR-Cas systems as gene-editing toolkits in precision medicine and offer some viewpoints that may help to tackle these challenges and facilitate technical development. CRISPR-Cas systems, as a powerful gene-editing approach, will offer great hopes in clinical treatments for many individuals with currently incurable diseases.

聚类规则间隔短回文重复序列(CRISPR)相关系统(Cas)是针对特定基因的高效工具,可用于实验室研究、农业工程、生物技术和人类疾病治疗。Cas9 是迄今为止应用最广泛的基因编辑核酸酶,在治疗遗传性疾病、病毒感染、癌症等方面显示出巨大前景。最近的报道显示,其他一些类型的 CRISPR-Cas 系统也可能具有惊人的潜力,加入基因编辑工具的行列,用于各种应用。尽管基础研究和临床试验取得了快速进展,但一些潜在的问题仍带来了持续、重大的挑战,如编辑效率、传递相对困难、脱靶效应、免疫原性等。本文总结了CRISPR-Cas从台前到床边的应用,强调了目前可能限制CRISPR-Cas系统作为基因编辑工具包在精准医疗中应用的障碍,并提出了一些有助于应对这些挑战和促进技术发展的观点。CRISPR-Cas 系统作为一种强大的基因编辑方法,将为许多目前无法治愈的疾病患者的临床治疗带来巨大希望。
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引用次数: 0
COVID-19 has triggered a new century of vaccination and infection control for the benefit of all mankind COVID-19开启了疫苗接种和感染控制的新世纪,造福全人类
IF 5.3 4区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2021-06-01 DOI: 10.1093/pcmedi/pbab010
B. Marshall
Modern safe vaccinations were pioneered in 1796 by Edward Jenner in England, when he noticed that milkmaids had beautiful complexions, clear of the blemishes from smallpox scars. This was attributed to their exposure to ‘cowpox’ in localised blisters, which seemed to protect them from the more severe and often fatal ‘smallpox’. In the twentieth century, the importance of immunity was emphasised by the very first Nobel Prize in Medicine, awarded to Emil Adolf von Bering who recognised the therapeutic role of antibodies in blood,1 using plasma from a recovered human (or horse) to protect and treat diphtheria, and eventually inventing the diphtheria vaccine in 1907. The first vaccines were simply made, being denatured protein extracts of live cultured bacteria, so there was no danger of causing the disease from the vaccination. Diphtheria-Pertussis-Tetanus (DPT) vaccine has long been available and is given to infants, making these three dreaded diseases of children uncommon in Western countries. My first personal experience with vaccination was as a 6-year-old (school grade 1) with my mother and 3-yearold brother attending the town hall in Kalgoorlie, Western Australia, for a mass polio vaccination administering the Salk vaccine. I remember that the vaccine was in a 50 ml multiple use bottle containing an estimated 25 dosages of 2 ml. The hall was pandemonium, with lines of people and numerous crying children. Hygiene in the stuffy, packed hall was less than ideal, the multiuse needles simply being soaked in alcohol for sterilisation between patients, becoming blunt and unsafe for use. But there had been at least a 12-month delay before the Salk vaccine could be used in Australia, as one of the early batches from Cutter Labs USA was withdrawn. The virus antigen made from cultured polio virus had not been sterilised adequately in 1955, resulting in more than 250 cases of actual polio in the USA. This caused the FDA to go on high alert, insisting on more stringent manufacturing and quality control procedures, followed by large-scale phase 1, 2 and 3 testing for all new vaccines. The concept is that, because vaccines are given to healthy people, a one-in-a-million incidence of severe side effects (or death) may be too much, even when preventing a dangerous disease such as polio or more recently COVID-19. Attenuated live polio vaccine replaced the Salk injected vaccine after 1960. Under the umbrella of the school vaccination programme, I received the new format whereby a drop of the pink vaccine was placed on a sugar cube and then eaten. The success of the new Sabin vaccine was its simplicity and oral format. After all, polio is an enterovirus, and I suppose family members could be infected with the live vaccine strain if schoolchildren experienced a very mild gastrointestinal illness at home. The live vaccination trivalent Sabin strain could cause overt polio in very few cases so that, as the actual wild-strain polio became extremely rare, vaccinations
1796年,英国的爱德华·詹纳(Edward Jenner)发现挤牛奶的女工肤色美丽,没有天花疤痕留下的污点,于是开创了现代安全疫苗接种的先河。这是由于他们在局部水泡中暴露于“牛痘”,这似乎可以保护他们免受更严重且往往致命的“天花”的侵害。20世纪,第一个诺贝尔医学奖强调了免疫的重要性,该奖项授予了埃米尔·阿道夫·冯·白令,他认识到血液中抗体的治疗作用,1使用康复的人(或马)的血浆来保护和治疗白喉,并最终在1907年发明了白喉疫苗。第一批疫苗是简单制作的,是由活培养细菌的变性蛋白质提取物制成的,因此接种疫苗没有引起疾病的危险。白喉-百日咳-破伤风(DPT)疫苗很早就有了,而且是给婴儿接种的,这使得这三种可怕的儿童疾病在西方国家并不常见。我第一次接触疫苗是在6岁的时候(小学一年级),当时我的母亲和3岁的弟弟在西澳大利亚州卡尔古利的市政厅参加大规模脊髓灰质炎疫苗接种活动,接种索尔克疫苗。我记得疫苗装在一个50毫升的多次使用的瓶子里,估计每2毫升装25剂。大厅里一片混乱,人们排着队,还有许多哭泣的孩子。在闷热拥挤的大厅里,卫生状况并不理想,多用途针头只是在酒精中浸泡,以便在病人之间消毒,使用起来变得钝钝且不安全。但是,至少在12个月之后,Salk疫苗才能在澳大利亚使用,因为美国卡特实验室的早期批次之一被撤回。1955年,由培养的脊髓灰质炎病毒制成的病毒抗原没有充分消毒,导致美国实际发生250多例脊髓灰质炎病例。这使得FDA保持高度警惕,坚持更严格的生产和质量控制程序,随后对所有新疫苗进行大规模的1、2和3期测试。其理念是,由于疫苗是给健康人接种的,即使在预防脊髓灰质炎或最近的COVID-19等危险疾病时,百万分之一的严重副作用(或死亡)发生率也可能过高。1960年后,脊髓灰质炎减毒活疫苗取代了索尔克注射疫苗。在学校疫苗接种计划的保护下,我接受了一种新的形式,将一滴粉红色的疫苗放在方糖上,然后食用。新Sabin疫苗的成功之处在于它的简单性和口服形式。毕竟,小儿麻痹症是一种肠道病毒,我认为,如果学童在家中出现非常轻微的胃肠道疾病,家庭成员可能会感染这种活疫苗菌株。三价Sabin活疫苗株在极少数情况下会引起明显的脊髓灰质炎,因此,当实际的野生脊髓灰质炎株变得极其罕见时,疫苗株脊髓灰质炎变得相对更常见。因此,大多数脊髓灰质炎疫苗接种再次使用更新的Sabin二价疫苗模型,将疫苗引起的脊髓灰质炎病例减少到接近零1995年,我应莫里斯·希勒曼(Maurice Hilleman)博士的邀请前往费城,他开发了许多目前使用的常见疫苗,最著名的是麻疹、腮腺炎、风疹(MMR)疫苗。为了研制疫苗,他利用他受感染的女儿的非传统来源分离出腮腺炎病毒。那次访问使我看到了生产疫苗的许多可能性,从嵌合减毒病毒到鼻吸入,甚至是转基因香蕉等食品中的疫苗的“圣杯”。早在2005年获得诺贝尔奖(因幽门螺杆菌和消化性溃疡)之前,我就在泰国获得了玛希隆亲王医学奖。这是亚洲
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引用次数: 0
AI based colorectal disease detection using real-time screening colonoscopy 基于人工智能的结直肠疾病实时筛查结肠镜检查
IF 5.3 4区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2021-05-20 DOI: 10.1093/pcmedi/pbab013
Jia-Ling Jiang, Qianrong Xie, Zhuo Cheng, Jianqiang Cai, Tian Xia, Hang Yang, Bo Yang, Hui-min Peng, Xue-song Bai, Mingque Yan, Xue Li, Jun Zhou, Xuan Huang, Liang Wang, Haiyan Long, Pingxi Wang, Yanpeng Chu, Fanwei Zeng, Xiu-wei Zhang, Guangyu Wang, Fanxin Zeng
Abstract Colonoscopy is an effective tool for early screening of colorectal diseases. However, the application of colonoscopy in distinguishing different intestinal diseases still faces great challenges of efficiency and accuracy. Here we constructed and evaluated a deep convolution neural network (CNN) model based on 117 055 images from 16 004 individuals, which achieved a high accuracy of 0.933 in the validation dataset in identifying patients with polyp, colitis, colorectal cancer (CRC) from normal. The proposed approach was further validated on multi-center real-time colonoscopy videos and images, which achieved accurate diagnostic performance on detecting colorectal diseases with high accuracy and precision to generalize across external validation datasets. The diagnostic performance of the model was further compared to the skilled endoscopists and the novices. In addition, our model has potential in diagnosis of adenomatous polyp and hyperplastic polyp with an area under the receiver operating characteristic curve of 0.975. Our proposed CNN models have potential in assisting clinicians in making clinical decisions with efficiency during application.
结肠镜检查是早期筛查结直肠疾病的有效工具。然而,结肠镜检查在区分不同肠道疾病中的应用在效率和准确性方面仍面临很大的挑战。本文基于来自16 004个人的117 055张图像构建并评估了一个深度卷积神经网络(CNN)模型,该模型在验证数据集中对息肉、结肠炎、结直肠癌(CRC)患者与正常人的识别准确率达到0.933。在多中心实时结肠镜检查视频和图像上进一步验证了该方法,在检测结直肠疾病方面取得了准确的诊断性能,具有较高的准确性和精密度,可以跨外部验证数据集进行推广。将该模型的诊断性能与熟练内窥镜医师和新手进行比较。此外,我们的模型在腺瘤性息肉和增生性息肉的诊断中具有潜力,受者工作特征曲线下面积为0.975。我们提出的CNN模型在帮助临床医生在应用过程中有效地做出临床决策方面具有潜力。
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引用次数: 1
Spaceflight decelerates the epigenetic clock orchestrated with a global alteration in DNA methylome and transcriptome in the mouse retina. 太空飞行减缓了小鼠视网膜中与DNA甲基组和转录组整体改变相协调的表观遗传时钟。
IF 5.3 4区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2021-05-17 eCollection Date: 2021-06-01 DOI: 10.1093/pcmedi/pbab012
Zhong Chen, Seta Stanbouly, Nina C Nishiyama, Xin Chen, Michael D Delp, Hongyu Qiu, Xiao W Mao, Charles Wang

Astronauts exhibit an assortment of clinical abnormalities in their eyes during long-duration spaceflight. The purpose of this study was to determine whether spaceflight induces epigenomic and transcriptomic reprogramming in the retina or alters the epigenetic clock. The mice were flown for 37 days in animal enclosure modules on the International Space Station; ground-based control animals were maintained under similar housing conditions. Mouse retinas were isolated and both DNA methylome and transcriptome were determined by deep sequencing. We found that a large number of genes were differentially methylated with spaceflight, whereas there were fewer differentially expressed genes at the transcriptome level. Several biological pathways involved in retinal diseases such as macular degeneration were significantly altered. Our results indicated that spaceflight decelerated the retinal epigenetic clock. This study demonstrates that spaceflight impacts the retina at the epigenomic and transcriptomic levels, and such changes could be involved in the etiology of eye-related disorders among astronauts.

在长时间的太空飞行中,宇航员的眼睛会出现各种临床异常。这项研究的目的是确定太空飞行是否会诱导视网膜的表观基因组和转录组重编程或改变表观遗传时钟。这些老鼠在国际空间站的动物封闭舱中飞行了37天;地面上的对照动物也在类似的饲养条件下饲养。分离小鼠视网膜,采用深度测序法测定DNA甲基组和转录组。我们发现大量基因在太空飞行中被差异甲基化,而在转录组水平上差异表达的基因较少。与黄斑变性等视网膜疾病相关的几种生物学途径发生了显著改变。我们的研究结果表明,太空飞行使视网膜表观遗传时钟减速。这项研究表明,太空飞行在表观基因组和转录组水平上影响视网膜,这种变化可能涉及宇航员眼睛相关疾病的病因学。
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引用次数: 6
EyeHealer: A large-scale anterior eye segment dataset with eye structure and lesion annotations EyeHealer:一个具有眼睛结构和病变注释的大规模眼前段数据集
IF 5.3 4区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2021-04-27 DOI: 10.1093/pcmedi/pbab009
Wenjia Cai, Jie Xu, Ke Wang, Xiaohong Liu, Wenqin Xu, Huimin Cai, Yuanxu Gao, Yuandong Su, Meixia Zhang, Jie Zhu, Charlotte L. Zhang, Edward Zhang, Fangfei Wang, Yun Yin, I. Lai, Guangyu Wang, Kang Zhang, Yingfeng Zheng
ABSTRACT Anterior segment eye diseases account for a significant proportion of presentations to eye clinics worldwide, including diseases associated with corneal pathologies, anterior chamber abnormalities (e.g. blood or inflammation), and lens diseases. The construction of an automatic tool for segmentation of anterior segment eye lesions would greatly improve the efficiency of clinical care. With research on artificial intelligence progressing in recent years, deep learning models have shown their superiority in image classification and segmentation. The training and evaluation of deep learning models should be based on a large amount of data annotated with expertise; however, such data are relatively scarce in the domain of medicine. Herein, the authors developed a new medical image annotation system, called EyeHealer. It is a large-scale anterior eye segment dataset with both eye structures and lesions annotated at the pixel level. Comprehensive experiments were conducted to verify its performance in disease classification and eye lesion segmentation. The results showed that semantic segmentation models outperformed medical segmentation models. This paper describes the establishment of the system for automated classification and segmentation tasks. The dataset will be made publicly available to encourage future research in this area.
前段眼病在全球眼科诊所的就诊中占很大比例,包括与角膜病变、前房异常(如血液或炎症)和晶状体疾病相关的疾病。构建眼前段病变自动分割工具将大大提高临床护理的效率。随着近年来人工智能研究的不断深入,深度学习模型在图像分类和分割方面显示出其优势。深度学习模型的训练和评估应该基于大量的专业知识注释的数据;然而,在医学领域,这样的数据相对较少。在此,作者开发了一种新的医学图像注释系统,称为EyeHealer。它是一个大规模的眼睛前段数据集,在像素水平上标注了眼睛结构和病变。通过综合实验验证了该方法在疾病分类和眼部病变分割方面的性能。结果表明,语义分割模型优于医学分割模型。本文介绍了自动分类和分割任务系统的建立。该数据集将向公众开放,以鼓励未来在这一领域的研究。
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引用次数: 6
The mechanism by which noncoding RNAs regulate muscle wasting in cancer cachexia. 非编码rna调控癌症恶病质中肌肉萎缩的机制。
IF 5.3 4区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2021-04-23 DOI: 10.1093/PCMEDI/PBAB008
Xueer Zhou, Shoushan Hu, Yunan Zhang, Guan-Tao Du, Yi Li
Cancer cachexia (CC) is a complex metabolic syndrome that accelerates muscle wasting and affects up to 80% of patients with cancer; however, timely diagnostic methods and effective cures are lacking. Although a considerable number of studies have focused on the mechanism of CC-induced muscle atrophy, few novel therapies have been applied in the last decade. In recent years, noncoding RNAs (ncRNAs) have attracted great attention as many differentially expressed ncRNAs in cancer cachectic muscles have been reported to participate in the inhibition of myogenesis and activation of proteolysis. In addition, extracellular vesicles (EVs), which function as ncRNA carriers in intercellular communication, are closely involved in changing ncRNA expression profiles in muscle and promoting the development of muscle wasting; thus, EV-related ncRNAs may represent potential therapeutic targets. This review comprehensively describes the process of ncRNA transmission through EVs and summarizes the pathways and targets of ncRNAs that lead to CC-induced muscle atrophy.
癌症恶病质(CC)是一种复杂的代谢综合征,可加速肌肉萎缩,影响多达80%的癌症患者;然而,缺乏及时的诊断方法和有效的治疗方法。尽管相当多的研究集中在cc诱导的肌肉萎缩的机制上,但在过去的十年中,很少有新的治疗方法被应用。近年来,非编码rna (noncoding RNAs, ncRNAs)引起了人们的广泛关注,因为有报道称在癌症病毒质肌肉中有许多差异表达的ncRNAs参与抑制肌肉生成和激活蛋白质水解。此外,细胞外囊泡(EVs)在细胞间通讯中作为ncRNA载体,密切参与改变肌肉中ncRNA的表达谱,促进肌肉萎缩的发生;因此,ev相关的ncrna可能代表潜在的治疗靶点。本文全面介绍了ncRNA通过ev的传递过程,并总结了导致cc诱导肌肉萎缩的ncRNA的途径和靶点。
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引用次数: 5
The fourth scientific discovery paradigm for precision medicine and healthcare: Challenges ahead 精准医学和医疗保健的第四种科学发现范式:未来的挑战
IF 5.3 4区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2021-04-16 DOI: 10.1093/pcmedi/pbab007
Li Shen, Jinwei Bai, Jiao Wang, Bairong Shen
Abstract With the progression of modern information techniques, such as next generation sequencing (NGS), Internet of Everything (IoE) based smart sensors, and artificial intelligence algorithms, data-intensive research and applications are emerging as the fourth paradigm for scientific discovery. However, we face many challenges to practical application of this paradigm. In this article, 10 challenges to data-intensive discovery and applications in precision medicine and healthcare are summarized and the future perspectives on next generation medicine are discussed.
随着新一代测序(NGS)、基于万物互联(IoE)的智能传感器和人工智能算法等现代信息技术的发展,数据密集型研究和应用正在成为科学发现的第四种范式。然而,这一模式的实际应用面临着许多挑战。本文总结了精准医学和医疗保健中数据密集型发现和应用面临的10个挑战,并讨论了下一代医学的未来前景。
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引用次数: 15
EnhFFL: A database of enhancer mediated feed-forward loops for human and mouse EnhFFL:人类和小鼠增强子介导的前馈回路数据库
IF 5.3 4区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2021-04-14 DOI: 10.1093/pcmedi/pbab006
Ran Kang, Zhengtang Tan, Mei Lang, Linqi Jin, Yin Zhang, Yiming Zhang, T. Guo, Zhiyun Guo
Abstract Feed-forward loops (FFLs) are thought to be one of the most common and important classes of transcriptional network motifs involved in various diseases. Enhancers are cis-regulatory elements that positively regulate protein-coding genes or microRNAs (miRNAs) by recruiting DNA-binding transcription factors (TFs). However, a comprehensive resource to identify, store, and analyze the FFLs of typical enhancer and super-enhancer FFLs is not currently available. Here, we present EnhFFL, an online database to provide a data resource for users to browse and search typical enhancer and super-enhancer FFLs. The current database covers 46 280/7000 TF-enhancer-miRNA FFLs, 9997/236 enhancer-miRNA-gene FFLs, 3 561 164/3 193 182 TF-enhancer-gene FFLs, and 1259/235 TF-enhancer feed-back loops (FBLs) across 91 tissues/cell lines of human and mouse, respectively. Users can browse loops by selecting species, types of tissue/cell line, and types of FFLs. EnhFFL supports searching elements including name/ID, genomic location, and the conservation of miRNA target genes. We also developed tools for users to screen customized FFLs using the threshold of q value as well as the confidence score of miRNA target genes. Disease and functional enrichment analysis showed that master miRNAs that are widely engaged in FFLs including TF-enhancer-miRNAs and enhancer-miRNA-genes are significantly involved in tumorigenesis. Database URL:http://lcbb.swjtu.edu.cn/EnhFFL/.
前馈回路(ffl)被认为是参与各种疾病的转录网络基序中最常见和最重要的一类。增强子是通过募集dna结合转录因子(TFs)正向调节蛋白质编码基因或microRNAs (miRNAs)的顺式调控元件。然而,目前还没有一个全面的资源来识别、存储和分析典型增强子和超级增强子ffl的ffl。在这里,我们提出了一个在线数据库EnhFFL,为用户提供浏览和搜索典型增强子和超级增强子ffl的数据资源。目前的数据库涵盖了46 280/7000个tf -增强子- mirna ffl, 9997/236个增强子- mirna基因ffl, 3 561 164/3 193 182个tf -增强子基因ffl和1259/235个tf -增强子反馈回路(FBLs),分别跨越人和小鼠91个组织/细胞系。用户可以通过选择种类、组织/细胞系类型和ffl类型来浏览循环。EnhFFL支持搜索元素,包括名称/ID、基因组位置和miRNA靶基因的保守性。我们还为用户开发了使用q值阈值和miRNA靶基因置信度评分筛选定制ffl的工具。疾病和功能富集分析表明,广泛参与ffl的主要mirna,包括tf -增强mirna和增强mirna -基因,在肿瘤发生过程中具有重要作用。数据库的URL: http://lcbb.swjtu.edu.cn/EnhFFL/。
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引用次数: 3
Blood purification for sepsis: an overview 脓毒症的血液净化:综述
IF 5.3 4区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2021-02-25 DOI: 10.1093/pcmedi/pbab005
Ling Zhang, Yuying Feng, P. Fu
Abstract Sepsis is a life-threatening organ failure exacerbated by a maladaptive infection response from the host, and is one of the major causes of mortality in the intensive care unit. In recent decades, several extracorporeal blood purification techniques have been developed to manage sepsis by acting on both the infectious agents themselves and the host immune response. This research aims to summarize recent progress on extracorporeal blood purification technologies applied for sepsis, discuss unanswered questions on renal replacement therapy for septic patients, and present a decision-making strategy for practitioners.
脓毒症是一种危及生命的器官衰竭,由宿主的不适应感染反应加剧,是重症监护病房死亡的主要原因之一。近几十年来,已经开发了几种体外血液净化技术,通过作用于感染因子本身和宿主免疫反应来控制败血症。本研究旨在总结体外血液净化技术应用于脓毒症的最新进展,讨论脓毒症患者肾脏替代治疗中尚未解决的问题,并为从业者提供决策策略。
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引用次数: 13
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Precision Clinical Medicine
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