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Serum procalcitonin levels are associated with rhabdomyolysis following exertional heatstroke: an over 10-year intensive care survey

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World Journal of Emergency Medicine 2024年第1期15卷 23-27页

作者： Li Zhong Feifei Shuai Conglin Wang Lipeng Han Zhifeng Liu ming wu Department of Traditional Chinese Medicine the First Affi liated HospitalGuizhou University of Chinese MedicineGuiyang 550001China Department of Medical Critical Care Medicine General Hospital of Southern Theatre Command of People’s Liberation ArmyGuangzhou 510010China Department of Infection and Critical Care Medicine Shenzhen Second People’s Hospital&First Affi liated Hospital of Shenzhen UniversityHealth Science CenterShenzhen 518035China Department of Nosocomial Infection Prevention and Control Shenzhen Second People’s HospitalShenzhen 518035China Key Laboratory of Hot Zone Trauma Care and Tissue Repair of People's Liberation Army General Hospital of Southern Theatre Command of People's Liberation ArmyGuangzhou 510010China

BACKGROUND:Heatstroke has become a common emergency event in hospitals.Procalcitonin(PCT)is used as a biomarker of infection in the emergency department(ED),but its role in rhabdomyolysis(RM)following exertional heatstroke(EHS)remains unclear.METHODS:A retrospective cohort study enrolled patients with EHS from the intensive care unit(ICU).We collected RM biomarkers,inflammation markers,critical disease scores at admission,24 h,48 h,and discharge,and 90-day mortality.Correlation analysis,linear regression and curve fi tting were used to identify the relationship between PCT and RM.RESULTS:A total of 162 patients were recruited and divided into RM(n=56)and non-RM(n=106)groups.PCT was positively correlated with myoglobin(Mb),acute hepatic injury,disseminated intravascular coagulation(DIC),Sequential Organ Failure Assessment(SOFA)score,and Acute Physiology and Chronic Health Evaluation II(APACHE II)score,with correlation coefficients of 0.214,0.237,0.285,0.454,and 0.368,respectively(all P<0.05).Interestingly,the results of curve fi tting revealed a nonlinear relationship between PCT and RM,and a two-piecewise linear regression model showed that PCT was related to RM with an odds ratio of 1.3 and a cut-off of<4.6 ng/mL.Survival analysis revealed that RM was associated with higher mortality compared to non-RM cases(P=0.0093).CONCLUSION:High serum PCT concentrations are associated with RM after EHS in critically ill patients.Elevated PCT concentrations should be interpreted cautiously in patients with EHS in the ED.

关键词： Procalcitonin Myoglobin Rhabdomyolysis Exertional heatstroke

Risk factors for brain injury in patients with exertional heatstroke:A 5-year experience

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Chinese Journal of Traumatology 2024年第2期27卷 91-96页

作者： Li Zhong ming wu Zhe-Ying Liu Yan Liu Zhi-Feng Liu Department of Traditional Chinese Medicine The First Affiliated HospitalGuizhou University of Chinese MedicineGuiyang550001China Department of Infection and Critical Care Medicine The Second People's Hospital of Shenzhen&First Affiliated Hospital of Shenzhen UniversityHealth Science CenterShenzhenGuangdong province518035China Department of Medical Critical Care Medicine General Hospital of Southem Theatre Command of PLA.Guangzhou510010China Guangdong Branch Center National Clinical Research Center for Geriatric Diseases(Chinese PLA General Hospital)Guangzhou510010China

Purpose:Minimal data exist on brain injury in patients with exertional heatstroke(EHS)in developing country.In this study,we explored the risk factors for brain injury induced by EHS 90-day after onset.Methods:A retrospective cohort study of patients with EHS was conducted in the intensive care unit of the General Hospital of Southern Theater Command of PLA in China from April 2014 to June 2019.Patients were divided into non-brain injury(fully recovered)and brain injury groups(comprising deceased patients or those with neurological sequelae).The brain injury group was further subdivided into a death group and a sequela group for detailed analysis.General information,neurological performance and information on important organ injuries in the acute stage were recorded and analysed.Multivariable logistic regression was used to identify risk factors for brain injury after EHS and mortality risk factors for brain injury,and Kaplan-Meier survival curve was used to evaluate the effect of the neurological dysfunction on survival.Results:Out of the 147 EHS patients,117 were enrolled,of which 96(82.1%)recovered,13(11.1%)died,and 8(6.8%)experienced neurological sequelae.Statistically significant differences were found between non-brain injury and brain injury groups in age,hypotension,duration of consciousness disorders,time to drop core body temperature below 38.5℃,lymphocyte counts,platelet counts,procalcitonin,alanine aminotransferase,aspartate aminotransferase,creatinine,cystatin C,coagulation parameters,international normalized ratio,acute physiology and chronic health evaluation II scores,sequential organ failure assessment(SOFA)scores,and Glasgow coma scale scores(all p<0.05).Multivariate logistic regression showed that age(OR=1.090,95%CI:1.02-1.17,p=0.008),time to drop core temperature(OR=8.223,95%CI:2.30-29.40,p=0.001),and SOFA scores(OR=1.676,95%CI:1.29-2.18,p<0.001)are independent risk factors for brain injury induced by EHS.The Kaplan-Meier curves suggest significantly prolonged survival(p<0.001)in patients with

关键词： Exertional heatstroke Brain injury Sequela Risk factors Disorders of consciousness

Unmanned Ship Identification Based on Improved YOLOv8s Algorithm

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Computers, Materials & Continua 2024年第3期78卷 3071-3088页

作者： Chun-ming wu Jin Lei wu-Kai Liu Mei-Ling Ren Ling-Li Ran Key Laboratory of Modern Power System Simulation and Control&Renewable Energy Technology School of Electrical EngineeringNortheast Electric Power UniversityJilin132012China School of Biomedical Engineering Taiyuan University of TechnologyTaiyuan030600China

Aiming at defects such as low contrast in infrared ship images,uneven distribution of ship size,and lack of texture details,which will lead to unmanned ship leakage misdetection and slow detection,this paper proposes an infrared ship detection model based on the improved YOLOv8 algorithm(R_YOLO).The algorithm incorporates the Efficient Multi-Scale Attention mechanism(EMA),the efficient Reparameterized Generalized-feature extraction module(CSPStage),the small target detection header,the Repulsion Loss function,and the context aggregation block(CABlock),which are designed to improve the model’s ability to detect targets at multiple scales and the speed of model inference.The algorithm is validated in detail on two vessel datasets.The comprehensive experimental results demonstrate that,in the infrared dataset,the YOLOv8s algorithm exhibits improvements in various performance metrics.Specifically,compared to the baseline algorithm,there is a 3.1%increase in mean average precision at a threshold of 0.5(mAP(0.5)),a 5.4%increase in recall rate,and a 2.2%increase in mAP(0.5:0.95).Simultaneously,while less than 5 times parameters,the mAP(0.5)and frames per second(FPS)exhibit an increase of 1.7%and more than 3 times,respectively,compared to the CAA_YOLO algorithm.Finally,the evaluation indexes on the visible light data set have shown an average improvement of 4.5%.

关键词： Unmanned ships R_YOLO EMA CSPStage YOLOv8s

Mechanism of Qili Qiangxin Capsule for Heart Failure Based on miR133a-Endoplasmic Reticulum Stress

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Chinese Journal of Integrative Medicine 2024年第5期30卷 398-407页

作者： JI Xiao-di YANG Ding CUI Xi-yuan LOU Li-xia NIE Bo ZHAO Jiu-li ZHAO ming-jing wu Ai-ming Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine Key Laboratory of Chinese Internal Medicine of Ministry of Education and BeijingBeijing 100700China Department of Traditional Chinese Medicine Fuwai HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100037China

Objective:To investigate the pharmacological mechanism of Qili Qiangxin Capsule(QLQX)improvement of heart failure(HF)based on miR133a-endoplasmic reticulum stress(ERS)pathway.Methods:A left coronary artery ligation-induced HF after myocardial infarction model was used in this study.Rats were randomly assigned to the sham group,the model group,the QLQX group[0.32 g/(kg·d)],and the captopril group[2.25 mg/(kg·d)],15 rats per group,followed by 4 weeks of medication.Cardiac function such as left ventricular ejection fraction(EF),fractional shortening(FS),left ventricular systolic pressure(LVSP),left ventricular end diastolic pressure(LVEDP),the maximal rate of increase of left ventricular pressure(+dp/dt max),and the maximal rate of decrease of left ventricular pressure(–dp/dt max)were monitored by echocardiography and hemodynamics.Hematoxylin and eosin(HE)and Masson stainings were used to visualize pathological changes in myocardial tissue.The m RNA expression of mi R133a,glucose-regulated protein78(GRP78),inositol-requiring enzyme 1(IRE1),activating transcription factor 6(ATF6),X-box binding protein1(XBP1),C/EBP homologous protein(CHOP)and Caspase 12 were detected by RT-PCR.The protein expression of GRP78,p-IRE1/IRE1ratio,cleaved-ATF6,XBP1-s(the spliced form of XBP1),CHOP and Caspase 12 were detected by Western blot.Td T-mediated d UTP nick-end labeling(TUNEL)staining was used to detect the rate of apoptosis.Results:QLQX significantly improved cardiac function as evidenced by increased EF,FS,LVSP,+dp/dt max,-dp/dt max,and decreased LVEDP(P<0.05,P<0.01).HE staining showed that QLQX ameliorated cardiac pathologic damage to some extent.Masson staining indicated that QLQX significantly reduced collagen volume fraction in myocardial tissue(P<0.01).Results from RT-PCR and Western blot showed that QLQX significantly increased the expression of mi R133a and inhibited the m RNA expressions of GRP78,IRE1,ATF6 and XBP1,as well as decreased the protein expressions of GRP78,cleaved-ATF6 and XBP1-s and decreased p-IRE1/IRE1 rati

关键词： heart failure Qili Qiangxin Capsule miR133a endoplasmic reticulum stress apoptosis

From ancient wisdom to modern science:Gut microbiota sheds light on property theory of traditional Chinese medicine

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Journal of Integrative Medicine 2024年第4期22卷 413-444页

作者： Ya-nan Yang Jia-guo Zhan Ying Cao Chong-ming wu School of Chinese Materia Medica Tianjin University of Traditional Chinese Medicine Tianjin Key Laboratory of Therapeutic Substance of Traditional Chinese Medicine

The property theory of traditional Chinese medicine(TCM) has been practiced for thousands of years,playing a pivotal role in the clinical application of TCM. While advancements in energy metabolism,chemical composition analysis, machine learning, ion current modeling, and supercritical fluid technology have provided valuable insight into how aspects of TCM property theory may be measured, these studies only capture specific aspects of TCM property theory in isolation, overlooking the holistic perspective inherent in TCM. To systematically investigate the modern interpretation of the TCM property theory from multidimensional perspectives, we consulted the Chinese Pharmacopoeia(2020 edition) to compile a list of Chinese materia medica(CMM). Then, using the Latin names of each CMM and gut microbiota as keywords, we searched the PubMed database for relevant research on gut microbiota and CMM. The regulatory patterns of different herbs on gut microbiota were then summarized from the perspectives of the four natures, the five flavors and the meridian tropism. In terms of the four natures, we found that warm-natured medicines promoted the colonization of specific beneficial bacteria,while cold-natured medicines boosted populations of some beneficial bacteria while suppressing pathogenic bacteria. Analysis of the five flavors revealed that sweet-flavored and bitter-flavored CMMs positively influenced beneficial bacteria while inhibiting harmful bacteria. CMMs with different meridian tropism exhibited complex modulative patterns on gut microbiota, with Jueyin(Liver) and Taiyin(Lung) meridian CMMs generally exerting a stronger effect. The gut microbiota may be a biological indicator for characterizing the TCM property theory, which not only enhances our understanding of classic TCM theory but also contributes to its scientific advancement and application in healthcare.

关键词： Five flavors Four natures Gut microbiota Meridian tropism Property theory Traditional Chinese medicine

Milk fat globule epidermal growth factor 8 alleviates liver injury in severe acute pancreatitis by restoring autophagy flux and inhibiting ferroptosis in hepatocytes

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World Journal of Gastroenterology 2024年第7期30卷 728-741页

作者： Qing Cui Hang-Cheng Liu wu-ming Liu Feng Ma Yi Lv Jian-Cang Ma Rong-Qian wu Yi-Fan Ren Department of Cardiology Xi’an Central Hospital Affiliated to Xi’an Jiaotong UniversityXi’an 710003Shaanxi ProvinceChina Department of General Surgery The Second Affiliated Hospital of Xi’an Jiaotong UniversityXi’an 710004Shaanxi ProvinceChina National Local Joint Engineering Research Center for Precision Surgery&Regenerative Medicine Shaanxi Provincial Center for Regenerative Medicine and Surgical EngineeringFirst Affiliated Hospital of Xi’an Jiaotong UniversityXi’an 710061Shaanxi ProvinceChina Department of Vascular Surgery The Second Affiliated Hospital of Xi’an Jiaotong UniversityXi’an 710004Shaanxi ProvinceChina

BACKGROUND Liver injury is common in severe acute pancreatitis(SAP).Excessive autophagy often leads to an imbalance of homeostasis in hepatocytes,which induces lipid peroxidation and mitochondrial iron deposition and ultimately leads to ferroptosis.Our previous study found that milk fat globule epidermal growth factor 8(MFG-E8)alleviates acinar cell damage during SAP via binding toαvβ3/5 integrins.MFG-E8 also seems to mitigate pancreatic fibrosis via inhibiting chaperone-mediated autophagy.AIM To speculate whether MFG-E8 could also alleviate SAP induced liver injury by restoring the abnormal autophagy flux.METHODS SAP was induced in mice by 2 hly intraperitoneal injections of 4.0 g/kg L-arginine or 7 hly injections of 50μg/kg cerulein plus lipopolysaccharide.mfge8-knockout mice were used to study the effect of MFG-E8 deficiency on SAPinduced liver injury.Cilengitide,a specificαvβ3/5 integrin inhibitor,was used to investigate the possible mechanism of MFG-E8.RESULTS The results showed that MFG-E8 deficiency aggravated SAP-induced liver injury in mice,enhanced autophagy flux in hepatocyte,and worsened the degree of ferroptosis.Exogenous MFG-E8 reduced SAP-induced liver injury in a dose-dependent manner.Mechanistically,MFG-E8 mitigated excessive autophagy and inhibited ferroptosis in liver cells.Cilengitide abolished MFG-E8’s beneficial effects in SAP-induced liver injury.CONCLUSION MFG-E8 acts as an endogenous protective mediator in SAP-induced liver injury.MFG-E8 alleviates the excessive autophagy and inhibits ferroptosis in hepatocytes by binding to integrinαVβ3/5.

关键词： Autophagy flux Ferroptosis Liver injury Milk fat globule epidermal growth factor 8 αvβ3/5 integrins Acute pancreatitis

Clinical Value of the Quantitative Flow Ratio to Predict Long-term Target Vessel Failure in Patients with In-stent Restenosis after Drug-coated Balloon Angioplasty

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Current Medical Science 2024年第3期44卷 561-567页

作者： Xiang-qi wu Long-bo LI Wei YOU Zhi-ming wu Lei ZHAO Zhi-hui WANG Pei-na MENG Bin LIU Fei YE Department of Cardiology Nanjing First HospitalNanjing Medical UniversityNanjing210006China Department of Cardiology The Second Hospital of Jilin UniversityJilin130000China

Objective The study sought to investigate the clinical predictive value of quantitative flow ratio(QFR)for the long-term target vessel failure(TVF)outcome in patients with in-stent restenosis(ISR)by using drug-coated balloon(DCB)treatment after a long-term follow-up.Methods This was a retrospective study.A total of 186 patients who underwent DCB angioplasty for ISR in two hospitals from March 2014 to September 2019 were enrolled.The QFR of the entire target vessel was measured offline.The primary endpoint was TVF,including target vessel-cardiac death(TV-CD),target vessel-myocardial infarction(TV-MI),and clinically driven-target vessel revascularization(CD-TVR).Results The follow-up time was 3.09±1.53 years,and 50 patients had TVF.The QFR immediately after percutaneous coronary intervention(PCI)was significantly lower in the TVF group than in the no-TVF group.Multivariable Cox regression analysis indicated that the QFR immediately after PCI was an excellent predictor for TVF after the long-term follow-up[hazard ratio(HR):5.15×10−5(6.13×10−8−0.043);P<0.01].Receiver-operating characteristic(ROC)curve analysis demonstrated that the optimal cut-off value of the QFR immediately after PCI for predicting the long-term TVF was 0.925(area under the curve:0.886,95%confidence interval:0.834–0.938;sensitivity:83.40%,specificity:88.00;P<0.01).In addition,QFR≤0.925 post-PCI was strongly correlated with the TVF,including TV-MI and CD-TVR(P<0.01).Conclusion The QFR immediately after PCI showed a high predictive value of TVF after a long-term follow-up in ISR patients who underwent DCB angioplasty.A lower QFR immediately after PCI was associated with a worse TVF outcome.

关键词： percutaneous coronary intervention in-stent restenosis target vessel failure quantitative flow ratio

Microstructure recognition of steels by machine learning based on visual attention mechanism

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Journal of Iron and Steel Research(International) 2024年第4期31卷 909-923页

作者： Xing-yu Chen Lin Cheng Cheng-yang Hu Yu-peng Zhang Kai-ming wu The State Key Laboratory of Refractories and Metallurgy Hubei Province Key Laboratory of Systems Science on Metallurgical ProcessingInternational Research Institute for Steel TechnologyCollaborative Center on Advanced SteelsWuhan University of Science and TechnologyWuhan 430081HubeiChina Metals Valley and Band(Foshan)Metallic Composite Materials Co. Ltd.Foshan 528000GuangdongChina

U-Net has achieved good performance with the small-scale datasets through skip connections to merge the features of the low-level layers and high-level layers and has been widely utilized in biomedical image segmentation as well as recent microstructure image segregation of the materials.Three representative visual attention mechanism modules,named as squeeze-and-excitation networks,convolutional block attention module,and extended calibration algorithm,were intro-duced into the traditional U-Net architecture to further improve the prediction accuracy.It is found that compared with the original U-Net architecture,the evaluation index of the improved U-Net architecture has been significantly improved for the microstructure segmentation of the steels with the ferrite/martensite composite microstructure and pearlite/ferrite composite microstructure and the complex martensite/austenite island/bainite microstructure,which demonstrates the advantages of the utilization of the visual attention mechanism in the microstructure segregation.The reasons for the accuracy improvement were discussed based on the feature maps analysis.

关键词： Microstructure recognition-Steel Machine learning Visual attention mechanism Visualization

Stress corrosion cracking behavior of buried oil and gas pipeline steel under the coexistence of magnetic field and sulfate-reducing bacteria

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Petroleum Science 2024年第2期21卷 1320-1332页

作者： Jian-Yu He Fei Xie Dan Wang Guang-Xin Liu ming wu Yue Qin College of Petroleum Engineering Liaoning Petrochemical UniversityFushun113001LiaoningChina Key Laboratory of Oil and Gas Storage and Transportation Technology in Liaoning Province Fushun113001LiaoningChina State Key Joint Laboratory of Environment Simulation and Pollution Control School of EnvironmentTsinghua UniversityBeijing100084China PipeChina West East Gas Pipeline Company Shanghai200120China

Magnetic field and microorganisms are important factors influencing the stress corrosion cracking(SCC)of buried oil and gas pipelines. Once SCC occurs in buried pipelines, it will cause serious hazards to the soil environment. The SCC behavior of X80 pipeline steel under the magnetic field and sulfate-reducing bacteria(SRB) environment was investigated by immersion tests, electrochemical tests, and slow strain rate tensile(SSRT) tests. The results showed that the corrosion and SCC sensitivity of X80 steel decreased with increasing the magnetic field strength in the sterile environment. The SCC sensitivity was higher in the biotic environment inoculated with SRB, but it also decreased with increasing magnetic field strength, which was due to the magnetic field reduces microbial activity and promotes the formation of dense film layer. This work provided theoretical guidance on the prevention of SCC in pipeline steel under magnetic field and SRB coexistence.

关键词： Magnetic field Sulfate-reducing bacteria Film layer Stress corrosion cracking Oil and gas pipelines