Pub Date : 2019-10-10DOI: 10.3760/CMA.J.ISSN.1671-0282.2019.10.019
Jiawei Jiang, Xin Yu, Hua-peng Yu, B. Wang, Yongqing Wang
Objective To study the effect and mechanism of recombinant human thrombopoietin (rhTPO) on platelet activation and pyroptosis in mice with lipopolysaccharide (LPS)- induced thrombocytopenia, and provide a theoretical basis for the clinical use of rhTPO. Methods One hundred C57BL/6 mice were randomly(random number) divided into 5 groups: blank control group (sham group), experimental control group (LPS group), low dose (L group, 1.35 ×103U·kg-1·d-1), medium dose (M group, 2.7 ×103U·kg-1·d-1), and high dose (H group, 5.4 ×103U·kg-1·d-1) rhTPO treatment groups. Continuous observation for 72 h. The positive expression rates of CD61/CD62p, Gasdermin D and Caspase-1 in washed platelets were detected by flow cytometry at 72 h, and the levels of IL-1β and IL-18 in plasma were detected by ELISA. Results Compared with the sham group, the survival rate of the LPS group was significantly lower (P 0.05). There was no significant change in platelet count of the sham group before and after the experiment. The platelet count in the LPS group decreased significantly. The platelet count at 72 h in the L group was significantly higher than those in the LPS, M and H groups (P 0.05). Compared with the sham group, CD61/CD62p and Gasdermin-D protein expressions in the LPS group were significantly increased (P 0.05). Caspase-1 expression was significantly increased in the LPS group compared with the sham group (P 0.05). The levels of platelet-rich plasma IL-1 beta and IL-18 in the LPS group were significantly higher than those in the sham group (P 0.05). Conclusions rhTPO can inhibit platelet activation and pyroptosis in LPS-induced thrombocytopenia mice, which provides basic research basis for the treatment of sepsis thrombocytopenia. Key words: Recombinant human thrombopoietin; Thrombocytopenia; Platelet activation; Pyroptosis; Lipopolysaccharide
{"title":"Effect of recombinant human thrombopoietin on platelet activation and pyroptosis in mice with thrombocytopenia","authors":"Jiawei Jiang, Xin Yu, Hua-peng Yu, B. Wang, Yongqing Wang","doi":"10.3760/CMA.J.ISSN.1671-0282.2019.10.019","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2019.10.019","url":null,"abstract":"Objective \u0000To study the effect and mechanism of recombinant human thrombopoietin (rhTPO) on platelet activation and pyroptosis in mice with lipopolysaccharide (LPS)- induced thrombocytopenia, and provide a theoretical basis for the clinical use of rhTPO. \u0000 \u0000 \u0000Methods \u0000One hundred C57BL/6 mice were randomly(random number) divided into 5 groups: blank control group (sham group), experimental control group (LPS group), low dose (L group, 1.35 ×103U·kg-1·d-1), medium dose (M group, 2.7 ×103U·kg-1·d-1), and high dose (H group, 5.4 ×103U·kg-1·d-1) rhTPO treatment groups. Continuous observation for 72 h. The positive expression rates of CD61/CD62p, Gasdermin D and Caspase-1 in washed platelets were detected by flow cytometry at 72 h, and the levels of IL-1β and IL-18 in plasma were detected by ELISA. \u0000 \u0000 \u0000Results \u0000Compared with the sham group, the survival rate of the LPS group was significantly lower (P 0.05). There was no significant change in platelet count of the sham group before and after the experiment. The platelet count in the LPS group decreased significantly. The platelet count at 72 h in the L group was significantly higher than those in the LPS, M and H groups (P 0.05). Compared with the sham group, CD61/CD62p and Gasdermin-D protein expressions in the LPS group were significantly increased (P 0.05). Caspase-1 expression was significantly increased in the LPS group compared with the sham group (P 0.05). The levels of platelet-rich plasma IL-1 beta and IL-18 in the LPS group were significantly higher than those in the sham group (P 0.05). \u0000 \u0000 \u0000Conclusions \u0000rhTPO can inhibit platelet activation and pyroptosis in LPS-induced thrombocytopenia mice, which provides basic research basis for the treatment of sepsis thrombocytopenia. \u0000 \u0000 \u0000Key words: \u0000Recombinant human thrombopoietin; Thrombocytopenia; Platelet activation; Pyroptosis; Lipopolysaccharide","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"28 1","pages":"1277-1281"},"PeriodicalIF":0.0,"publicationDate":"2019-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41564425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-10DOI: 10.3760/CMA.J.ISSN.1671-0282.2019.10.013
Liang Zhao, Fangchao Mei, Yu-pu Hong, Yu Zhou, Ming-wei Xiang, Teng Zuo, Weixing Wang
Objective To investigate the effect and underlying mechanisms of p38 mitogen-activated protein kinase inhibitor SB203580 on fetal lung injury in a rat model of acute pancreatitis in late pregnancy. Methods Twenty-four pregnant Sprague-Dawley rats in last gestation were randomly(random number) divided into the SO group, APILP group, and SB203580 treatment (SB) group. APILP model was induced by retrograde injection of 5% sodium taurocholate into the biliary-pancreatic duct. SB203580 administration (10 mg/kg body weight, intraperitoneal injection) was performed 0.5 h before surgery. All the rats in the SO and APILP groups received intraperitoneal injection of equivoluminal solvent at the same time point. Animals were sacrificed at 12 h after the induction of APILP, then the blood and tissue samples were harvested. Serum levels of AMY and TNF-α were analyzed. Histopathological changes of maternal pancreas and fetal lung were observed and evaluated. The expression and location of NF-κB in fetal lungs were detected by immunohistochemistry and MPO expression in fetal lungs was examined by immunofluorescence. The expression of p-p38MAPK, p38MAPK, TNF-α and ICAM-1 was determined by Western blot. One-way ANOVA and Tukey's multiple comparison tests were used for statistical analysis. Results The levels of AMY and TNF-α in maternal serum were markedly increased after APILP [(7 871.3±623.5) vs (1 915.3±452.3), (193.8±25.4) vs (107.0±13.3), (P<0.05)]. Obvious pathological changes presented in maternal pancreas and fetal lung after the attack of APILP, and their pathological scores were significantly higher than those of the SO group [(12.44±1.08) vs (1.56±0.56), (2.50±0.53) vs (0.88±0.64), (P<0.05)]. The number of NF-κB and MPO positive cells in fetal lungs were significantly higher than those in the SO group [(150.63±34.58) vs(29.50±8.80), (53.38±8.30) vs (11.75±3.33); P<0.05)]. In addition, the expression and nuclear translocation were pervasive in fetal lungs in the APILP group. Furthermore, the levels of p-p38MAPK [(0.6367±0.0386) vs (0.2282±0.0220)], TNF-α [(0.6313±0.0395) vs (0.0725±0.0076)], ICAM-1 [(0.8958±0.0776) vs (0.1372±0.0388)] and HMGB1 [(0.6478±0.0209) vs (0.2825±0.0533)] expression in fetal lungs were significantly increased after the establishment of APILP model (P<0.05). However, with the pre-administration of SB203580, the pathological scores of maternal pancreases (9.38±1.58) and fetal lungs (1.63±0.52) were decreased significantly (P<0.05), as well as the levels of AMY (4162.1±642.1) and TNF-α (139.6±21.1) in maternal serum (P<0.05). The number of NF-κB (93.00±18.88) and MPO (27.38±4.75) positive cells in fetal lungs were dramatically reduced (P<0.05) and fewer nuclear translocation was observed in the SB group. Interestingly, the expression levels of p-p38MAPK (0.2578±0.0170), TNF-α (0.3240±0.0326), ICAM-1 (0.4177±0.0823) and HMGB1 (0.4923±0.0457) in fetal lungs were markedly decreased with the treatment of SB203580 (P<0.05)
{"title":"Effects of p38MAPK inhibitor on fetal lung injury in a rat model of acute pancreatitis in late pregnancy","authors":"Liang Zhao, Fangchao Mei, Yu-pu Hong, Yu Zhou, Ming-wei Xiang, Teng Zuo, Weixing Wang","doi":"10.3760/CMA.J.ISSN.1671-0282.2019.10.013","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2019.10.013","url":null,"abstract":"Objective \u0000To investigate the effect and underlying mechanisms of p38 mitogen-activated protein kinase inhibitor SB203580 on fetal lung injury in a rat model of acute pancreatitis in late pregnancy. \u0000 \u0000 \u0000Methods \u0000Twenty-four pregnant Sprague-Dawley rats in last gestation were randomly(random number) divided into the SO group, APILP group, and SB203580 treatment (SB) group. APILP model was induced by retrograde injection of 5% sodium taurocholate into the biliary-pancreatic duct. SB203580 administration (10 mg/kg body weight, intraperitoneal injection) was performed 0.5 h before surgery. All the rats in the SO and APILP groups received intraperitoneal injection of equivoluminal solvent at the same time point. Animals were sacrificed at 12 h after the induction of APILP, then the blood and tissue samples were harvested. Serum levels of AMY and TNF-α were analyzed. Histopathological changes of maternal pancreas and fetal lung were observed and evaluated. The expression and location of NF-κB in fetal lungs were detected by immunohistochemistry and MPO expression in fetal lungs was examined by immunofluorescence. The expression of p-p38MAPK, p38MAPK, TNF-α and ICAM-1 was determined by Western blot. One-way ANOVA and Tukey's multiple comparison tests were used for statistical analysis. \u0000 \u0000 \u0000Results \u0000The levels of AMY and TNF-α in maternal serum were markedly increased after APILP [(7 871.3±623.5) vs (1 915.3±452.3), (193.8±25.4) vs (107.0±13.3), (P<0.05)]. Obvious pathological changes presented in maternal pancreas and fetal lung after the attack of APILP, and their pathological scores were significantly higher than those of the SO group [(12.44±1.08) vs (1.56±0.56), (2.50±0.53) vs (0.88±0.64), (P<0.05)]. The number of NF-κB and MPO positive cells in fetal lungs were significantly higher than those in the SO group [(150.63±34.58) vs(29.50±8.80), (53.38±8.30) vs (11.75±3.33); P<0.05)]. In addition, the expression and nuclear translocation were pervasive in fetal lungs in the APILP group. Furthermore, the levels of p-p38MAPK [(0.6367±0.0386) vs (0.2282±0.0220)], TNF-α [(0.6313±0.0395) vs (0.0725±0.0076)], ICAM-1 [(0.8958±0.0776) vs (0.1372±0.0388)] and HMGB1 [(0.6478±0.0209) vs (0.2825±0.0533)] expression in fetal lungs were significantly increased after the establishment of APILP model (P<0.05). However, with the pre-administration of SB203580, the pathological scores of maternal pancreases (9.38±1.58) and fetal lungs (1.63±0.52) were decreased significantly (P<0.05), as well as the levels of AMY (4162.1±642.1) and TNF-α (139.6±21.1) in maternal serum (P<0.05). The number of NF-κB (93.00±18.88) and MPO (27.38±4.75) positive cells in fetal lungs were dramatically reduced (P<0.05) and fewer nuclear translocation was observed in the SB group. Interestingly, the expression levels of p-p38MAPK (0.2578±0.0170), TNF-α (0.3240±0.0326), ICAM-1 (0.4177±0.0823) and HMGB1 (0.4923±0.0457) in fetal lungs were markedly decreased with the treatment of SB203580 (P<0.05)","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"28 1","pages":"1245-1250"},"PeriodicalIF":0.0,"publicationDate":"2019-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41668409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-10DOI: 10.3760/CMA.J.ISSN.1671-0282.2019.10.009
M. Sun, Hua Jiang, Kai Wang, Jian-cheng Zhang, Yu Wang, J. Zeng
The advantages of 5G communication, including large bandwidth, low latency and wide connection, and rapid transmission, have proved to be vital in facilitating emergency medical rescue. On June 17th, 2019, an earthquake occurred in Channing, Yibin, Sichuan Province. Sichuan Provincial People’s Hospital initiated the Emergency Medical Rescue System for the rescue operation in the disastrous area. This was the first use of 5G emergency medical rescue worldwide. Remote consultations, injury assessments and helicopter transfers were carried out for the critical patients. Our rescue system have been effective and efficient in rapid responding, information transmission and the coordination of medical resources, which has led to the best possible medical decisions and treatments. However, there were challenges found in the application of this system: the stability of 5G signal, the optimization of the configuration of 5G ambulances, and the survival rate and self guarantee in the field. In conclusion, this practice of 5G emergency medical system provides a new paradigm and valuable experiences for the improvements in disaster rescue in China and worldwide. Key words: 5G; Emergency Medical Rescue; Earthquake; Disaster Medicine
{"title":"The establishment, practicing and future of a 5G-based emergency medical rescue system","authors":"M. Sun, Hua Jiang, Kai Wang, Jian-cheng Zhang, Yu Wang, J. Zeng","doi":"10.3760/CMA.J.ISSN.1671-0282.2019.10.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2019.10.009","url":null,"abstract":"The advantages of 5G communication, including large bandwidth, low latency and wide connection, and rapid transmission, have proved to be vital in facilitating emergency medical rescue. On June 17th, 2019, an earthquake occurred in Channing, Yibin, Sichuan Province. Sichuan Provincial People’s Hospital initiated the Emergency Medical Rescue System for the rescue operation in the disastrous area. This was the first use of 5G emergency medical rescue worldwide. Remote consultations, injury assessments and helicopter transfers were carried out for the critical patients. Our rescue system have been effective and efficient in rapid responding, information transmission and the coordination of medical resources, which has led to the best possible medical decisions and treatments. However, there were challenges found in the application of this system: the stability of 5G signal, the optimization of the configuration of 5G ambulances, and the survival rate and self guarantee in the field. In conclusion, this practice of 5G emergency medical system provides a new paradigm and valuable experiences for the improvements in disaster rescue in China and worldwide. \u0000 \u0000 \u0000Key words: \u00005G; Emergency Medical Rescue; Earthquake; Disaster Medicine","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"28 1","pages":"1228-1230"},"PeriodicalIF":0.0,"publicationDate":"2019-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43754930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-10DOI: 10.3760/CMA.J.ISSN.1671-0282.2019.10.011
Zhang Minhai, Wang Hui, Y. Hang, Yu Yuhui, Chen Jiang, Zhang Xiaoan, Ao Xinhua, Li Qiang, Zhang Mao
Objective To explore the feasibility and advantage of the drones in a county emergency medical service system. Methods The study was conducted in Changxing County, Zhejiang Province from January to September 2018. The Changxing County People's Hospital and the health centers within its radius of 25 km were included in the study. Three types of indicators were obtained by using commercial drones to transfer simulated first-aid medical supplies from health centers to county people's hospitals: (1)The flight time of the drone; (2) The road traffic time measured by Baidu map and Tencent map software of the above-mentioned route at midnight; (3) The road traffic time measured by Amap software of these routes at 0: 00, 8: 00, 10:00, 12:00, 14:00, 16:00, 18:00, 20:00. The road traffic time at different time points measured by map softwares and drones flight time were compared. Wilcoxon symbolic rank test was used for statistical analysis, and P value of < 0.05 was considered statistically significant. Results (1) A total of 10 health centers were involved in this study, the air straight-line distance between them and the county people's hospital was (10.97±3.59) km, and the road traffic distance was (13.61±4.95) km. (2) The flight time of drone was (16.35±5.15) min, less than road traffic time measured by Amap, Baidu and Tencent map software, which were (21.40±5.15) min, (22.50±6.11) min, (22.00±5.23) min, respectively (P< 0.01). (3)The road traffic time measured by Amap software was longer than that of drones from 0:00 to 20:00 (P< 0.01), with the maximum time of (27.80±6.12) min at 18:00, and the minimum time of (21.40±5.15) min at midnight. Drones could save up 14.07 min at most and 2.8 min at least, with an average save of (7.98±1.32) min. Conclusions Drone might be used to transfer first aid medical supplies between health centers in a county area, which is faster than road transportation. It has a better application prospect and is worth to further study. Key words: Drone; Emergency medical service system; County; Partnership health center
{"title":"Preliminary study on application of drones in a county emergency medical service system","authors":"Zhang Minhai, Wang Hui, Y. Hang, Yu Yuhui, Chen Jiang, Zhang Xiaoan, Ao Xinhua, Li Qiang, Zhang Mao","doi":"10.3760/CMA.J.ISSN.1671-0282.2019.10.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2019.10.011","url":null,"abstract":"Objective \u0000To explore the feasibility and advantage of the drones in a county emergency medical service system. \u0000 \u0000 \u0000Methods \u0000The study was conducted in Changxing County, Zhejiang Province from January to September 2018. The Changxing County People's Hospital and the health centers within its radius of 25 km were included in the study. Three types of indicators were obtained by using commercial drones to transfer simulated first-aid medical supplies from health centers to county people's hospitals: (1)The flight time of the drone; (2) The road traffic time measured by Baidu map and Tencent map software of the above-mentioned route at midnight; (3) The road traffic time measured by Amap software of these routes at 0: 00, 8: 00, 10:00, 12:00, 14:00, 16:00, 18:00, 20:00. The road traffic time at different time points measured by map softwares and drones flight time were compared. Wilcoxon symbolic rank test was used for statistical analysis, and P value of < 0.05 was considered statistically significant. \u0000 \u0000 \u0000Results \u0000(1) A total of 10 health centers were involved in this study, the air straight-line distance between them and the county people's hospital was (10.97±3.59) km, and the road traffic distance was (13.61±4.95) km. (2) The flight time of drone was (16.35±5.15) min, less than road traffic time measured by Amap, Baidu and Tencent map software, which were (21.40±5.15) min, (22.50±6.11) min, (22.00±5.23) min, respectively (P< 0.01). (3)The road traffic time measured by Amap software was longer than that of drones from 0:00 to 20:00 (P< 0.01), with the maximum time of (27.80±6.12) min at 18:00, and the minimum time of (21.40±5.15) min at midnight. Drones could save up 14.07 min at most and 2.8 min at least, with an average save of (7.98±1.32) min. \u0000 \u0000 \u0000Conclusions \u0000Drone might be used to transfer first aid medical supplies between health centers in a county area, which is faster than road transportation. It has a better application prospect and is worth to further study. \u0000 \u0000 \u0000Key words: \u0000Drone; Emergency medical service system; County; Partnership health center","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"28 1","pages":"1237-1241"},"PeriodicalIF":0.0,"publicationDate":"2019-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42470910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-10DOI: 10.3760/CMA.J.ISSN.1671-0282.2019.10.024
叶志辉, Ye Zhihui, 丁洪光, Ding Hong-guang, 叶靖坤, Ye Jingkun, 蔡耿鑫, Cai Gengxin, 曾红科, Zeng Hong-ke, 温妙云, Wen Miaoyun
Objective To compare the effects of various interventions on the incidence of central line-associated bloodstream infection (CLABSI) . Methods The clinical data of 218 patients with central venous catheterization were retrospectively analyzed. Infected patients were treated as CLABSI group and non-infected patients as control group. Results Of the 218 patients, 24 patients were developed CLABSI. There was no significant difference in sex, age, primary infection status and puncture site between CLABSI group and control group. Univariate analysis showed that axillary vein puncture could significantly reduce the incidence of CLABSI (P=0.028), and the infection rate of axillary vein puncture per 1000 days under B-ultrasound was significantly reduced by 0.93‰. The average indwelling days of deep venous catheter in patients with pulse puncture were significantly longer than those in other groups (47.32 days vs 19.90 days). The average indwelling days in patients with axillary vein puncture positioned by B ultrasound were longer than those in patients with other parts of vein puncture positioned by B ultrasound (P < 0.05). Logistic multiple regression analysis showed that the main risk factors for CLABSI were anatomically located puncture (P = 0.031) and non-axillary venous catheterization (P = 0.068). Conclusions Choosing axillary vein as the position of deep venous catheterization and using ultrasound-guided central venous puncture can reduce the incidence of CLABSI and prolong the average catheterization time. Key words: Axillary vein; Ultrasound-guided; Central line-associated bloodstream infection; Case control study
{"title":"The axillary vein puncture can reduce the incidence of central venous catheter-related bloodstream infection","authors":"叶志辉, Ye Zhihui, 丁洪光, Ding Hong-guang, 叶靖坤, Ye Jingkun, 蔡耿鑫, Cai Gengxin, 曾红科, Zeng Hong-ke, 温妙云, Wen Miaoyun","doi":"10.3760/CMA.J.ISSN.1671-0282.2019.10.024","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2019.10.024","url":null,"abstract":"Objective \u0000To compare the effects of various interventions on the incidence of central line-associated bloodstream infection (CLABSI) . \u0000 \u0000 \u0000Methods \u0000The clinical data of 218 patients with central venous catheterization were retrospectively analyzed. Infected patients were treated as CLABSI group and non-infected patients as control group. \u0000 \u0000 \u0000Results \u0000Of the 218 patients, 24 patients were developed CLABSI. There was no significant difference in sex, age, primary infection status and puncture site between CLABSI group and control group. Univariate analysis showed that axillary vein puncture could significantly reduce the incidence of CLABSI (P=0.028), and the infection rate of axillary vein puncture per 1000 days under B-ultrasound was significantly reduced by 0.93‰. The average indwelling days of deep venous catheter in patients with pulse puncture were significantly longer than those in other groups (47.32 days vs 19.90 days). The average indwelling days in patients with axillary vein puncture positioned by B ultrasound were longer than those in patients with other parts of vein puncture positioned by B ultrasound (P < 0.05). Logistic multiple regression analysis showed that the main risk factors for CLABSI were anatomically located puncture (P = 0.031) and non-axillary venous catheterization (P = 0.068). \u0000 \u0000 \u0000Conclusions \u0000Choosing axillary vein as the position of deep venous catheterization and using ultrasound-guided central venous puncture can reduce the incidence of CLABSI and prolong the average catheterization time. \u0000 \u0000 \u0000Key words: \u0000Axillary vein; Ultrasound-guided; Central line-associated bloodstream infection; Case control study","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"28 1","pages":"1305-1308"},"PeriodicalIF":0.0,"publicationDate":"2019-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47022123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-10DOI: 10.3760/CMA.J.ISSN.1671-0282.2019.10.018
Feng Zhang, Hao Sun, Jian Kang, Yuxuan Wu, L. Fan, Lei Jiang, Li Qiao
Objective To establish a mouse model of acute lung injury (ALI) via intratracheal aerosolization of paraquat (PQ). Methods Thirty male C57BL/6J mice of 8-10 weeks old were randomly(random number) divided into the paraquat model group (n = 15) and the saline control group (n = 15). Mice in the paraquat model group were administered PQ solution (0.4 mg/mL) at a single dose of 50 μL per mouse via intratracheal aerosolization. Mice in the saline control group received an equal volume of saline. Mice were sacrificed 72 h post-PQ administration and samples were collected. The general physical condition of mice including body weight as well as mortality was monitored daily. Pulmonary function, cell counting and classification of bronchoalveolar lavage fluid (BALF), proinflammatory cytokines (TNF-α, IL-1β, and IL-6) levels of BALF and serum, MPO activity and total protein concentration of BALF and pathological lung injury scores were obtained. Results The body mass of mice decreased progressively within 72 h after PQ intratracheal administration. The static compliance of lung decreased (P<0.01) and the resistance increased (P<0.01). The number of inflammatory cells in BALF was significantly higher than that of the saline control group (all P<0.01), the levels of proinflammatory cytokines were significantly upregulated in both BALF and serum (all P<0.01), and the activity of MPO in BALF was also remarkedly increased (P<0.01). The total protein concentration of BALF was significantly elevated (P<0.01). The pathological observation of lung tissue showed a large number of inflammatory cells infiltration accompanying pulmonary hemorrhage, alveolar collapse, hyaline membrane formation and alveolar septal thickening, and the lung injury scores significantly increased (P<0.01). Conclusions Intratracheal aerosolization of a single dose of 0.02 mg PQ can successfully induce ALI in mice. Key words: Paraquat; Acute lung injury; Animal model; Intratracheal aerosolization
{"title":"Acute lung injury model induced by single dose of paraquat intratracheal aerosolization in mice","authors":"Feng Zhang, Hao Sun, Jian Kang, Yuxuan Wu, L. Fan, Lei Jiang, Li Qiao","doi":"10.3760/CMA.J.ISSN.1671-0282.2019.10.018","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2019.10.018","url":null,"abstract":"Objective \u0000To establish a mouse model of acute lung injury (ALI) via intratracheal aerosolization of paraquat (PQ). \u0000 \u0000 \u0000Methods \u0000Thirty male C57BL/6J mice of 8-10 weeks old were randomly(random number) divided into the paraquat model group (n = 15) and the saline control group (n = 15). Mice in the paraquat model group were administered PQ solution (0.4 mg/mL) at a single dose of 50 μL per mouse via intratracheal aerosolization. Mice in the saline control group received an equal volume of saline. Mice were sacrificed 72 h post-PQ administration and samples were collected. The general physical condition of mice including body weight as well as mortality was monitored daily. Pulmonary function, cell counting and classification of bronchoalveolar lavage fluid (BALF), proinflammatory cytokines (TNF-α, IL-1β, and IL-6) levels of BALF and serum, MPO activity and total protein concentration of BALF and pathological lung injury scores were obtained. \u0000 \u0000 \u0000Results \u0000The body mass of mice decreased progressively within 72 h after PQ intratracheal administration. The static compliance of lung decreased (P<0.01) and the resistance increased (P<0.01). The number of inflammatory cells in BALF was significantly higher than that of the saline control group (all P<0.01), the levels of proinflammatory cytokines were significantly upregulated in both BALF and serum (all P<0.01), and the activity of MPO in BALF was also remarkedly increased (P<0.01). The total protein concentration of BALF was significantly elevated (P<0.01). The pathological observation of lung tissue showed a large number of inflammatory cells infiltration accompanying pulmonary hemorrhage, alveolar collapse, hyaline membrane formation and alveolar septal thickening, and the lung injury scores significantly increased (P<0.01). \u0000 \u0000 \u0000Conclusions \u0000Intratracheal aerosolization of a single dose of 0.02 mg PQ can successfully induce ALI in mice. \u0000 \u0000 \u0000Key words: \u0000Paraquat; Acute lung injury; Animal model; Intratracheal aerosolization","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"28 1","pages":"1272-1276"},"PeriodicalIF":0.0,"publicationDate":"2019-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49347762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-10DOI: 10.3760/CMA.J.ISSN.1671-0282.2019.10.012
Jun Liu, Yun Xie, Fang Wang
Trauma is an important cause of death in the world, and emergency treatment for severe trauma is a worldwide problem. With the integration of more artificial intelligence into the medical industry, the information platform of intelligent hospital should be established with the help of 5G era, so that patients can enjoy timely, convenient, safe and high-quality diagnosis and treatment services, and solve the problems of low medical work efficiency and lagging internal management mechanism of the hospital. At present, there are few reports on the combined application of serious trauma emergency system and 5G in China. The potential application of 5G in severe trauma treatment system was introduced in this paper. Key words: Severe multiple trauma; Intelligent management; 5 G
{"title":"Application of 5G in the treatment of severe multiple trauma","authors":"Jun Liu, Yun Xie, Fang Wang","doi":"10.3760/CMA.J.ISSN.1671-0282.2019.10.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2019.10.012","url":null,"abstract":"Trauma is an important cause of death in the world, and emergency treatment for severe trauma is a worldwide problem. With the integration of more artificial intelligence into the medical industry, the information platform of intelligent hospital should be established with the help of 5G era, so that patients can enjoy timely, convenient, safe and high-quality diagnosis and treatment services, and solve the problems of low medical work efficiency and lagging internal management mechanism of the hospital. At present, there are few reports on the combined application of serious trauma emergency system and 5G in China. The potential application of 5G in severe trauma treatment system was introduced in this paper. \u0000 \u0000 \u0000Key words: \u0000Severe multiple trauma; Intelligent management; 5 G","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"28 1","pages":"1242-1244"},"PeriodicalIF":0.0,"publicationDate":"2019-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47481945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-10DOI: 10.3760/CMA.J.ISSN.1671-0282.2019.10.023
Zhihui Ye, Hongguang Ding, Jingkun Ye, Gengxin Cai, Hongke Zeng, Miaoyun Wen
Objective To examine whether presepsin level can serve as a distinguishing marker between G- bacteria and G+ bacteria, fungal infection in sepsis patients. Methods A prospective observation study was conducted on the consecutive patients with positive bacterial cultures in intensive care unit (ICU) from June 2017 to November 2018. The patients were divided into the G- group, G+ group and fungal group. Blood samples were collected upon admission to measure the levels of presepsin and procalcitonin (PCT). Results (1) Of the 156 patients met the inclusion criteria. 96 (62% G- rods, 25 (16%) G+ microbes, and 35 (22%) fungi were detected. (2) Presepsin concentrations were significantly higher in the G- group compared with the G+ and fungal groups (P = 0.000). (3) Presepsin level has a higher accuracy in differentiating G- sepsis from Gram+ and fungal sepsis than PCT level [area under the curve (AUC): 0.809 vs 0.712]. The AUC value of a combination of presepsin and PCT level was significantly larger than that of presepsin level alone in differentiating G- sepsis from Gram+ and fungal sepsis (AUC: 0.866 vs 0.809). Conclusions In contrast to PCT, presepsin is a good discriminative biomarker in different infections. Key words: Sepsis; Presepsin; Procalcitonin; Infection
目的探讨presepsin水平是否可作为脓毒症患者G-菌和G+菌真菌感染的鉴别指标。方法对2017年6月至2018年11月连续入住重症监护病房(ICU)的细菌培养阳性患者进行前瞻性观察研究。将患者分为G-组、G+组和真菌组。入院时采集血液样本，测量高血压素和降钙素原(PCT)水平。结果(1)156例患者符合纳入标准。检出G-棒状菌96株(62%)，G+菌25株(16%)，真菌35株(22%)。(2) G-组Presepsin浓度显著高于G+和真菌组(P = 0.000)。(3) Presepsin水平对G-脓毒症与Gram+、真菌脓毒症的鉴别准确率高于PCT水平[曲线下面积(AUC): 0.809 vs 0.712]。在G-脓毒症与Gram+及真菌性脓毒症的鉴别中，presepsin与PCT联合使用的AUC值明显大于单独使用presepsin的AUC值(AUC: 0.866 vs 0.809)。结论与PCT相比，presepsin是一种很好的区分不同感染的生物标志物。关键词:脓毒症;Presepsin;原降钙素;感染
{"title":"The value of serum presepsin in differentiating Gram-negative bacteria from Gram-positive bacteria and fungal infection in sepsis patients","authors":"Zhihui Ye, Hongguang Ding, Jingkun Ye, Gengxin Cai, Hongke Zeng, Miaoyun Wen","doi":"10.3760/CMA.J.ISSN.1671-0282.2019.10.023","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2019.10.023","url":null,"abstract":"Objective \u0000To examine whether presepsin level can serve as a distinguishing marker between G- bacteria and G+ bacteria, fungal infection in sepsis patients. \u0000 \u0000 \u0000Methods \u0000A prospective observation study was conducted on the consecutive patients with positive bacterial cultures in intensive care unit (ICU) from June 2017 to November 2018. The patients were divided into the G- group, G+ group and fungal group. Blood samples were collected upon admission to measure the levels of presepsin and procalcitonin (PCT). \u0000 \u0000 \u0000Results \u0000(1) Of the 156 patients met the inclusion criteria. 96 (62% G- rods, 25 (16%) G+ microbes, and 35 (22%) fungi were detected. (2) Presepsin concentrations were significantly higher in the G- group compared with the G+ and fungal groups (P = 0.000). (3) Presepsin level has a higher accuracy in differentiating G- sepsis from Gram+ and fungal sepsis than PCT level [area under the curve (AUC): 0.809 vs 0.712]. The AUC value of a combination of presepsin and PCT level was significantly larger than that of presepsin level alone in differentiating G- sepsis from Gram+ and fungal sepsis (AUC: 0.866 vs 0.809). \u0000 \u0000 \u0000Conclusions \u0000In contrast to PCT, presepsin is a good discriminative biomarker in different infections. \u0000 \u0000 \u0000Key words: \u0000Sepsis; Presepsin; Procalcitonin; Infection","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"28 1","pages":"1301-1304"},"PeriodicalIF":0.0,"publicationDate":"2019-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69953584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-10DOI: 10.3760/CMA.J.ISSN.1671-0282.2019.10.014
王立明, W. Liming, 牛泽群, Niu Zequn, 孙江利, Su Jiangli, 冯辉, Feng Hui, 裴红红, Pei Honghong, 潘龙飞, Pan Longfei
Objective To explore the role of toll-like receptor 4 (TLR4)/NF-κB signaling pathway in acute necrotizing pancreatitis (ANP)-associated lung injury and the intervention of lipoxin A4 (LXA4) analogue. Methods Forty-five Sprague-Dawley rats were randomly(random number)divided into the sham operation group, experimental group, and intervention group, each group containing 15 rats. ANP animal models were prepared by injecting sodium taurocholate into biliopancreatic tube in the experimental group. No sodium taurocholate was injected into biliopancreatic duct in the sham operation group. After the preparation of ANP animal models in the intervention group, LXA4 was injected through the tail vein. Rats in each group were randomly divided into 3 subgroups (n=5 each subgroup). The serum amylase, TNF- α, IL-1β, IL-6 and endotoxin levels were detected 6, 12 and 24 h after the operation. The lung injury scores were assessed and the lung wet/dry weight ratio was calculated. The expressions of TLR4 and NF-κB p65 in lung tissues were detected by Western blot. Results Serum levels of amylase, TNF-α, IL-1β, IL-6 and endotoxin in the experimental and intervention groups were significantly higher than those in the sham operation group, while the levels of the above indicators in the intervention group was significantly lower than those in the experimental group, and the differences were statistically significant (P 0.05), while lung wet/dry weight ratio in the intervention group 6 h after operation, and lung injury scores and lung wet/dry weight ratio in the intervention group 12 h or 24 h respectively after operation were significantly higher than those in the sham operation group, with statistically significant differences (P<0.05). Postoperative lung injury scores and lung wet/dry weight ratio in the intervention group were significantly lower than those in the experimental group, and the differences were statistically significant (P<0.05). The expressions of TLR4 and p65 in the lung tissues of the experimental and intervention groups were significantly higher than those of the sham operation group, and the expressions of TLR4 and p65 in the lung tissues of the intervention group were significantly lower than those of the experimental group, with statistically significant differences (P<0.05). Conclusions LXA4 can reduce the severity of acute necrotizing pancreatitis-associated lung injury, and its mechanism is related to reducing the stimulation of endotoxin, thus inhibiting TLR4 signaling pathway and the activation of p65 to down-regulate the level of pro-inflammatory cytokines. Key words: TLR4; Lipoxin A4; Acute necrotizing pancreatitis; Acute lung injury
{"title":"Expression of toll-like receptor 4/NF-κB signaling pathway in acute necrotizing pancreatitis-associated lung injury and intervention of lipoxin A4 analogue","authors":"王立明, W. Liming, 牛泽群, Niu Zequn, 孙江利, Su Jiangli, 冯辉, Feng Hui, 裴红红, Pei Honghong, 潘龙飞, Pan Longfei","doi":"10.3760/CMA.J.ISSN.1671-0282.2019.10.014","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2019.10.014","url":null,"abstract":"Objective \u0000To explore the role of toll-like receptor 4 (TLR4)/NF-κB signaling pathway in acute necrotizing pancreatitis (ANP)-associated lung injury and the intervention of lipoxin A4 (LXA4) analogue. \u0000 \u0000 \u0000Methods \u0000Forty-five Sprague-Dawley rats were randomly(random number)divided into the sham operation group, experimental group, and intervention group, each group containing 15 rats. ANP animal models were prepared by injecting sodium taurocholate into biliopancreatic tube in the experimental group. No sodium taurocholate was injected into biliopancreatic duct in the sham operation group. After the preparation of ANP animal models in the intervention group, LXA4 was injected through the tail vein. Rats in each group were randomly divided into 3 subgroups (n=5 each subgroup). The serum amylase, TNF- α, IL-1β, IL-6 and endotoxin levels were detected 6, 12 and 24 h after the operation. The lung injury scores were assessed and the lung wet/dry weight ratio was calculated. The expressions of TLR4 and NF-κB p65 in lung tissues were detected by Western blot. \u0000 \u0000 \u0000Results \u0000Serum levels of amylase, TNF-α, IL-1β, IL-6 and endotoxin in the experimental and intervention groups were significantly higher than those in the sham operation group, while the levels of the above indicators in the intervention group was significantly lower than those in the experimental group, and the differences were statistically significant (P 0.05), while lung wet/dry weight ratio in the intervention group 6 h after operation, and lung injury scores and lung wet/dry weight ratio in the intervention group 12 h or 24 h respectively after operation were significantly higher than those in the sham operation group, with statistically significant differences (P<0.05). Postoperative lung injury scores and lung wet/dry weight ratio in the intervention group were significantly lower than those in the experimental group, and the differences were statistically significant (P<0.05). The expressions of TLR4 and p65 in the lung tissues of the experimental and intervention groups were significantly higher than those of the sham operation group, and the expressions of TLR4 and p65 in the lung tissues of the intervention group were significantly lower than those of the experimental group, with statistically significant differences (P<0.05). \u0000 \u0000 \u0000Conclusions \u0000LXA4 can reduce the severity of acute necrotizing pancreatitis-associated lung injury, and its mechanism is related to reducing the stimulation of endotoxin, thus inhibiting TLR4 signaling pathway and the activation of p65 to down-regulate the level of pro-inflammatory cytokines. \u0000 \u0000 \u0000Key words: \u0000TLR4; Lipoxin A4; Acute necrotizing pancreatitis; Acute lung injury","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"28 1","pages":"1251-1256"},"PeriodicalIF":0.0,"publicationDate":"2019-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43196400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-10DOI: 10.3760/CMA.J.ISSN.1671-0282.2019.10.021
Yuxuan Wu, Jinsong Zhang, Li Qiao, Hao Sun, Jianrong Chen, Lijun Liu, Jiyang Xu, Hong Sun, Yeping Du, Z. Tian, R. Yang
Objective To analyze the relationship between clinical characteristics and prognosis of patients with acute herbicide poisoning marked diquat. Methods A multi-center, retrospective clinical study of patients with acute diquat poisoning admitted into Emergency Department was conducted from June 2015 to August 2018 in 8 hospitals in Jiangsu Province. Results A total of 43 patients (22 males and 21 females) were collected and the peak age of poisoning ranged 20-39 years old. The only route of poisoning was ingestion. Among these cases, suicide was the most common cause of poisoningaccounting for 90.70%. In emergency treatment, the constituent ratios of gastric lavage, hemoperfusion and glucocorticoid were 87.50%, 72.50% and 42.50%, respectively. The total mortality increased to 60.00% after follow-up, while the in-hospital mortality was 18.60%. The mortality of patients with toxic dose < 50 mL was 11.11%. Conclusions The incidence of acute herbicide poisoning with "diquat" as commercial component is gradually increasing. At present, the mortality is very high. Ingestion poisoning dose is the key factor affecting prognosis, and the prognosis of patients with oral dose > 50 mL is poor. Key words: Diquat; Herbicide; Acute poisoning; Multi-center; Retrospective study
{"title":"Clinical observation of 43 cases of acute poisoning caused by herbicide marked diquat","authors":"Yuxuan Wu, Jinsong Zhang, Li Qiao, Hao Sun, Jianrong Chen, Lijun Liu, Jiyang Xu, Hong Sun, Yeping Du, Z. Tian, R. Yang","doi":"10.3760/CMA.J.ISSN.1671-0282.2019.10.021","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2019.10.021","url":null,"abstract":"Objective \u0000To analyze the relationship between clinical characteristics and prognosis of patients with acute herbicide poisoning marked diquat. \u0000 \u0000 \u0000Methods \u0000A multi-center, retrospective clinical study of patients with acute diquat poisoning admitted into Emergency Department was conducted from June 2015 to August 2018 in 8 hospitals in Jiangsu Province. \u0000 \u0000 \u0000Results \u0000A total of 43 patients (22 males and 21 females) were collected and the peak age of poisoning ranged 20-39 years old. The only route of poisoning was ingestion. Among these cases, suicide was the most common cause of poisoningaccounting for 90.70%. In emergency treatment, the constituent ratios of gastric lavage, hemoperfusion and glucocorticoid were 87.50%, 72.50% and 42.50%, respectively. The total mortality increased to 60.00% after follow-up, while the in-hospital mortality was 18.60%. The mortality of patients with toxic dose < 50 mL was 11.11%. \u0000 \u0000 \u0000Conclusions \u0000The incidence of acute herbicide poisoning with \"diquat\" as commercial component is gradually increasing. At present, the mortality is very high. Ingestion poisoning dose is the key factor affecting prognosis, and the prognosis of patients with oral dose > 50 mL is poor. \u0000 \u0000 \u0000Key words: \u0000Diquat; Herbicide; Acute poisoning; Multi-center; Retrospective study","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"28 1","pages":"1287-1291"},"PeriodicalIF":0.0,"publicationDate":"2019-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46242026","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}
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