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Severe COVID-19-associated sepsis is different from classical sepsis induced by pulmonary infection with carbapenem-resistant klebsiella pneumonia (CrKP)

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Chinese Journal of Traumatology 2022年第1期25卷 17-24页

作者： Ming Wu Zhi-Ye Zou Yan-Hong Chen Cong-LinWang yong-wen feng Zhi-feng Liu Department of Critical Care Medicine and Hospital Infection Prevention and Control Shenzhen Second People's HospitalShenzhen518035China Department of Critical Care Medicine First Affiliated Hospital of Shenzhen UniversityShenzhen 518035China Department of Critical Care Medicine General Hospital of Southern Theater Command of PLAGuangzhou510010China

Purpose::COVID-19 is also referred to as a typical viral septic pulmonary infection by 2019-nCoV.However,little is known regarding its characteristics in terms of systemic inflammation and organ injury,especially compared with classical bacterial sepsis.This article aims to investigate the clinical characteristics and prognosis between COVID-19-associated sepsis and classic bacterial-induced sepsis.Methods::In this retrospective cohort study,septic patients with COVID-19 in the intensive care unit(ICU)of a government-designed therapy center in Shenzhen,China between January 14,2020 and March 10,2020,and septic patients induced by carbapenem-resistant klebsiella pneumonia(CrKP)admitted to the ICU of the Second People's Hospital of Shenzhen,China between January 1,2014 and October 30,2019 were enrolled.Demographic and clinical parameters including comorbidities,critical illness scores,treatment,and laboratory data,as well as prognosis were compared between the two groups.Risk factors for mortality and survival rate were analyzed using multivariable logistic regression and survival curve,respectively.Results::A total of 107 patients with COVID-19 and 63 patients with CrKP were enrolled.A direct comparison between the two groups demonstrated more serious degrees of primary lung injury following 2019-nCoV infection(indicated by lower PaO 2/FiO 2),but milder systemic inflammatory response,lower sequential organ failure assessment score and better functions of the organs like heart,liver,kidney,coagulation,and circulation.However,the acquired immunosuppression presented in COVID-19 patients was more severe,which presented as lower lymphocyte counts(0.8×109/L vs.0.9×109/L).Moreover,the proportion of COVID-19 patients treated with corticosteroid therapy and extracorporeal membrane oxygenation was larger compared with CrKP patients(78.5%vs.38.1%and 6.5%vs.0,respectively)who required less invasive mechanical ventilation(31.6%vs.54.0%).The incidence of hospitalized mortality and length of ICU stay and total hospital stay wer

关键词： Clinical characteristics Immunosuppression Mortality COVID-19 Carbapenem-resistant klebsiella pneumonia(CrKP)

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Comparison of clinical laboratory tests between bacterial sepsis and SARS-CoV-2-associated viral sepsis

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Military Medical Research 2021年第2期8卷 278-280页

作者： Chao Ren Ren-Qi Yao Di Ren Ying Li yong-wen feng yong-Ming Yao Department of Critical Care Medicine the Second People’s Hospital of ShenzhenShenzhen 518035GuangdongChina Department of Critical Care Medicine the Third People’s Hospital of ShenzhenShenzhen 518020GuangdongChina Trauma Research Center the Fourth Medical Center and Medical Innovation Research Department of the Chinese PLA General HospitalBeijing 100048China

Sepsis is a life-threatening condition that is characterized by multiple organ dysfunction due to abnormal host response to various pathogens,like bacteria,fungi and virus.The differences between viral and bacterial sepsis are indeed of great significance to deepen the understanding of the pathogenesis of sepsis,especially under pandemics of SARS-CoV-2 infection.

关键词： Severe acute respiratory syndrom coronavirus 2 Coronavirus disease 2019 Sepsis Bacteria Virus Infection Host response

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Development of septic shock and prognostic assessment in critically ill patients with coronavirus disease outside Wuhan, China

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World Journal of Emergency Medicine 2021年第4期12卷 293-298页

作者： Ren-qi Yao Chao Ren Di Ren Jin-xiu Li Ying Li Xue-yan Liu Lei Huang yong Liu Mian Peng yong-wen feng yong-ming Yao Department of Critical Care Medicine the Second People’s Hospital of ShenzhenShenzhen 518035China Trauma Research Center the Fourth Medical Center and Medical Innovation Research Department of the Chinese PLA General HospitalBeijing 100048China Department of Critical Care Medicine the Third People’s Hospital of ShenzhenShenzhen 518020China Department of Critical Care Medicine the People’s Hospital of ShenzhenShenzhen 518020China Department of Critical Care Medicine Peking University Shenzhen HospitalShenzhen 518035China Department of Critical Care Medicine Shenzhen Hospital of Southern Medical UniversityShenzhen 518110China Department of Critical Care Medicine the Third Affiliated Hospital of Shenzhen UniversityShenzhen 518001China

BACKGROUND: The study aims to illustrate the clinical characteristics and development of septic shock in intensive care unit(ICU) patients confirmed with severe acute respiratory syndrome coronavirus 2(SARS-Co V-2) infection, and to perform a comprehensive analysis of the association between septic shock and clinical outcomes in critically ill patients with coronavirus disease(COVID-19).METHODS: Patients confirmed with SARS-Co V-2 infection, who were admitted to the ICU of the Third People's Hospital of Shenzhen from January 1 to February 7, 2020, were enrolled. Clinical characteristics and outcomes were compared between patients with and without septic shock.RESULTS: In this study, 35 critically ill patients with COVID-19 were included. Among them, the median age was 64 years(interquartile range [IQR] 59-67 years), and 10(28.4%) patients were female. The median ICU length of stay was 16 days(IQR 8-23 days). Three(8.6%) patients died during hospitalization. Nine(25.7%) patients developed septic shock in the ICU, and these patients had a significantly higher incidence of organ dysfunction and a worse prognosis than patients without septic shock.CONCLUSIONS: Septic shock is associated with a poor outcome in critically ill COVID-19 patients and is one of the hallmarks of the severity of patients receiving ICU care. A dysregulated immune response, uncontrolled infl ammation, and coagulation disorders are strongly associated with the development and progression of COVID-19-related septic shock.

关键词： Severe acute respiratory syndrome coronavirus 2 Coronavirus disease Intensive care unit Septic shock Immune response

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Potential therapy strategy: targeting mitochondrial dysfunction in sepsis

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Military Medical Research 2019年第3期6卷 230-241页

作者： Hui Zhang yong-wen feng yong-Ming Yao Trauma Research Center First Hospital Affiliated to the Chinese PLA General HospitalFucheng Road 51Haidian DistrictBeijing 100048China Department of Critical Care Medicine the Second People’s Hospital of ShenzhenShenzhen 518035China.

Recently, the definition of sepsis was concluded to be a life-threatening organ dysfunction caused by a dysregulated host response to infection. Severe patients always present with uncorrectable hypotension or hyperlactacidemia, which is defined as septic shock. The new definition emphasizes dysregulation of the host response and multiple organ dysfunction, which is partially attributed to metabolic disorders induced by energy crisis and oxidative stress. Mitochondria are a cellular organelle that are well known as the center of energy production, and mitochondrial damage or dysfunction is commonly induced in septic settings and is a predominant factor leading to a worse prognosis. In the present review, we determine the major mitochondrial disorders from morphology to functions in sepsis. In the following, several clinical or pre-clinical assays for monitoring mitochondrial function are demonstrated according to accumulated evidence, which is the first step of specific therapy targeting to modulate mitochondrial function. Accordingly, various reagents used for regulating mitochondrial enzyme activities and promoting biogenesis have been documented, among which mitochondriatargeted cation, TPP-conjugated antioxidants are the most valuable for future trials and clinical treatment to improve mitochondrial function as they may take advantage of the prognosis associated with septic complications.

关键词： Sepsis Mitochondria Electron transfer chain Monitor Therapy strategy

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Clinical diagnosis of severe COVID-19:A derivation and validation of a prediction rule

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World Journal of Clinical Cases 2021年第13期9卷 2994-3007页

作者： Ming Tang Xia-Xia Yu Jia Huang Jun-Ling Gao Fu-Lan Cen Qi Xiao Shou-Zhi Fu Yang Yang Bo Xiong yong-Jun Pan Ying-Xia Liu yong-wen feng Jin-Xiu Li yong Liu Department of Critical Care Medicine Shenzhen Third People’s HospitalThe Second Hospital Affiliated to Southern University of Science and TechnologyShenzhen 518114Guangdong ProvinceChina School of Biomedical Engineering Health Science CenterShenzhen UniversityShenzhen 518060Guangdong ProvinceChina Buddhism and Science Research Laboratory Centre of Buddhist StudiesThe University of Hong KongHong Kong 999077China Department of Critical Care Medicine Wuhan Third HospitalWuhan 433304Hubei ProvinceChina Shenzhen Key Laboratory of Pathogen and Immunity National Clinical Research Center for Infectious DiseaseState Key Discipline of Infectious DiseaseShenzhen Third People's HospitalThe Second Hospital Affiliated to Southern University of Science and TechnologyShenzhen 518114Guangdong ProvinceChina Department of Pediatrics Wuhan Asia General HospitalWuhan 430022Hubei ProvinceChina Department of Critical Care Medicine Southern University of Science and Technology HospitalShenzhen 518055Guangdong ProvinceChina Department of Critical Care Medicine The Second People's Hospital of ShenzhenShenzhen 518035Guangdong ProvinceChina Department of Critical Care Medicine The Second Xiangya HospitalCentral South UniversityChangsha 410011Hunan ProvinceChina Shenzhen Hospital Southern Medical UniversityShenzhen 518000Guangdong ProvinceChina

BACKGROUND The widespread coronavirus disease 2019(COVID-19)has led to high morbidity and mortality.Therefore,early risk identification of critically ill patients remains crucial.AIM To develop predictive rules at the time of admission to identify COVID-19 patients who might require intensive care unit(ICU)care.METHODS This retrospective study included a total of 361 patients with confirmed COVID-19 by reverse transcription-polymerase chain reaction between January 19,2020,and March 14,2020 in Shenzhen Third People’s Hospital.Multivariate logistic regression was applied to develop the predictive model.The performance of the predictive model was externally validated and evaluated based on a dataset involving 126 patients from the Wuhan Asia General Hospital between December 2019 and March 2020,by area under the receiver operating curve(AUROC),goodness-of-fit and the performance matrix including the sensitivity,specificity,and precision.A nomogram was also used to visualize the model.RESULTS Among the patients in the derivation and validation datasets,38 and 9 participants(10.5%and 2.54%,respectively)developed severe COVID-19,respectively.In univariate analysis,21 parameters such as age,sex(male),smoker,body mass index(BMI),time from onset to admission(>5 d),asthenia,dry cough,expectoration,shortness of breath,asthenia,and Rox index<18(pulse oxygen saturation,SpO2)/(FiO2×respiratory rate,RR)showed positive correlations with severe COVID-19.In multivariate logistic regression analysis,only six parameters including BMI[odds ratio(OR)3.939;95%confidence interval(CI):1.409-11.015;P=0.009],time from onset to admission(≥5 d)(OR 7.107;95%CI:1.449-34.849;P=0.016),fever(OR 6.794;95%CI:1.401-32.951;P=0.017),Charlson index(OR 2.917;95%CI:1.279-6.654;P=0.011),PaO2/FiO2 ratio(OR 17.570;95%CI:1.117-276.383;P=0.041),and neutrophil/lymphocyte ratio(OR 3.574;95%CI:1.048-12.191;P=0.042)were found to be independent predictors of COVID-19.These factors were found to be significant risk factors for severe patients confirmed with COVID-

关键词： COVID-19 Communicable diseases Clinical decision rules Prognosis Nomograms

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Efficacy of radiofrequency ablation combined with sorafenib for treating liver cancer complicated with portal hypertension and prognostic factors

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World Journal of Gastroenterology 2024年第11期30卷 1533-1544页

作者： Li-Min Yang Hong-Juan Wang Shan-Lin Li Guan-Hua Gan wen-wen Deng yong-Sheng Chang Lian-feng Zhang Department of Gastroenterology The First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450052Henan ProvinceChina Department of Gastroenterology Zhoukou Central Hospital of Henan ProvinceZhoukou 466000Henan ProvinceChina Department of Gastroenterology The First Affiliated Hospital of Xinxiang Medical CollegeXinxiang 453000Henan ProvinceChina

BACKGROUND Patients with liver cancer complicated by portal hypertension present complex challenges in treatment.AIM To evaluate the efficacy of radiofrequency ablation in combination with sorafenib for improving liver function and its impact on the prognosis of patients with this condition.METHODS Data from 100 patients with liver cancer complicated with portal hypertension from May 2014 to March 2019 were analyzed and divided into a study group(n=50)and a control group(n=50)according to the treatment regimen.The research group received radiofrequency ablation(RFA)in combination with sorafenib,and the control group only received RFA.The short-term efficacy of both the research and control groups was observed.Liver function and portal hypertension were compared before and after treatment.Alpha-fetoprotein(AFP),glypican-3(GPC-3),and AFP-L3 levels were compared between the two groups prior to and after treatment.The occurrence of adverse reactions in both groups was observed.The 3-year survival rate was compared between the two groups.Basic data were compared between the survival and non-surviving groups.To identify the independent risk factors for poor prognosis in patients with liver cancer complicated by portal hypertension,multivariate logistic regression analysis was employed.RESULTS When comparing the two groups,the research group's total effective rate(82.00%)was significantly greater than that of the control group(56.00%;P<0.05).Following treatment,alanine aminotransferase and aspartate aminotransferase levels increased,and portal vein pressure decreased in both groups.The degree of improvement for every index was substantially greater in the research group than in the control group(P<0.05).Following treatment,the AFP,GPC-3,and AFP-L3 levels in both groups decreased,with the research group having significantly lower levels than the control group(P<0.05).The incidence of diarrhea,rash,nausea and vomiting,and fatigue in the research group was significantly greater than that in the control group(P<0.05).The 1-

关键词： Radiofrequency ablation Sorafenib Liver cancer Portal hypertension Efficacy Prognosis analysis

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Mechanism of selective laser trabeculoplasty:a systemic review

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International Journal of Ophthalmology(English edition) 2024年第5期17卷 963-968页

作者： Yu-feng Chen wen Zeng Department of Ophthalmology Zhongnan Hospital of Wuhan UniversityWuhan 430071Hubei ProvinceChina

Although selective laser trabeculoplasty(SLT)is a recognized method for the treatment of glaucoma,the exact changes in the target tissue and mechanism for its intraocular pressure lowing effect are still unclear.The purpose of this review is to summarize the potential mechanisms of SLT on trabecular meshwork both in vivo and in vitro,so as to reveal the potential mechanism of SLT.SLT may induce immune or inflammatory response in trabecular meshwork(TM)induced by possible oxidative damage etc,and remodel extracellular matrix.It may also induce monocytes to aggregate in TM tissue,increase Schlemm’s canal(SC)cell conductivity,disintegrate cell junction and promote permeability through autocrine and paracrine forms.This provides a theoretical basis for SLT treatment in glaucoma.

关键词： mechanisms selective laser trabeculoplasty glaucoma trabecular meshwork

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Multi-omics analyses provide insights into the evolutionary history and the synthesis of medicinal components of the Chinese wingnut

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Plant Diversity 2024年第3期46卷 309-320页

作者： Zi-Yan Zhang He-Xiao Xia Meng-Jie Yuan feng Gao wen-Hua Bao Lan Jin Min Li yong Li College of Life Science and Technology Inner Mongolia Normal UniversityHohhot 010020China Key Laboratory of Biodiversity Conservation and Sustainable Utilization in Mongolian Plateau for College and University of Inner Mongolia Autonomous Region Hohhot 010022China College of Landscape and Art Henan Agricultural UniversityZhengzhou 450002China State Key Laboratory of Tree Genetics and Breeding Chinese Academy of ForestryBeijing 100091China

Chinese wingnut(Pterocarya stenoptera)is a medicinally and economically important tree species within the family Juglandaceae.However,the lack of high-quality reference genome has hindered its in-depth research.In this study,we successfully assembled its chromosome-level genome and performed multiomics analyses to address its evolutionary history and synthesis of medicinal components.A thorough examination of genomes has uncovered a significant expansion in the Lateral Organ Boundaries Domain gene family among the winged group in Juglandaceae.This notable increase may be attributed to their frequent exposure to flood-prone environments.After further differentiation between Chinese wingnut and Cyclocarya paliurus,significant positive selection occurred on the genes of NADH dehydrogenase related to mitochondrial aerobic respiration in Chinese wingnut,enhancing its ability to cope with waterlogging stress.Comparative genomic analysis revealed Chinese wingnut evolved more unique genes related to arginine synthesis,potentially endowing it with a higher capacity to purify nutrient-rich water bodies.Expansion of terpene synthase families enables the production of increased quantities of terpenoid volatiles,potentially serving as an evolved defense mechanism against herbivorous insects.Through combined transcriptomic and metabolomic analysis,we identified the candidate genes involved in the synthesis of terpenoid volatiles.Our study offers essential genetic resources for Chinese wingnut,unveiling its evolutionary history and identifying key genes linked to the production of terpenoid volatiles.

关键词： Genome Medicinal components Metabolome Pterocarya stenoptera Transcriptome

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Automatic velocity picking based on optimal key points tracking algorithm

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Petroleum Science 2024年第2期21卷 903-917页

作者： yong-Hao Wang wen-Kai Lu Song-Bai Jin Yang Li Yu-Xuan Li Xiao-feng Gu The Institute for Artificial Intelligence(THUAI) Tsinghua UniversityBeijing100084China State Key Laboratory of Intelligent Technology and Systems Tsinghua UniversityBeijing100084China Beijing National Research Center for Information Science and Technology(BNRist) Beijing100084China The Department of Automation Tsinghua UniversityBeijing100084China

Picking velocities from semblances manually is laborious and necessitates experience. Although various methods for automatic velocity picking have been developed, there remains a challenge in efficiently incorporating information from nearby gathers to ensure picked velocity aligns with seismic horizons while also improving picking accuracy. The conventional method of velocity picking from a semblance volume is computationally demanding, highlighting a need for a more efficient strategy. In this study, we introduce a novel method for automatic velocity picking based on multi-object tracking. This dynamic tracking process across different semblance panels can integrate information from nearby gathers effectively while maintaining computational efficiency. First, we employ accelerated density clustering on the velocity spectrum to discern cluster centers without the requirement for prior knowledge regarding the number of clusters. These cluster centers embody the maximum likelihood velocities of the main subsurface structures. Second, our proposed method tracks key points within the semblance volume. Kalman filter is adopted to adjust the tracking process, followed by interpolation on these tracked points to construct the final velocity model. Our synthetic data example demonstrates that our proposed algorithm can effectively rectify the picking errors of the clustering algorithm. We further compare the performances of the clustering method(CM), the proposed tracking method(TM), and the variational method(VM) on a field dataset from the Gulf of Mexico. The results attest that our method offers superior accuracy than CM, achieves comparable accuracy with VM, and benefits from a reduced computational cost.

关键词： Velocity picking Multi-object tracking Density clustering Kalman filter

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Relationship Between Short-chain Fatty Acids and Parkinson’s Disease:A Review from Pathology to Clinic

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Neuroscience Bulletin 2024年第4期40卷 500-516页

作者： wen-Xiang Duan Fen Wang Jun-Yi Liu Chun-feng Liu Department of Neurology and Clinical Research Center of Neurological Disease The Second Affiliated Hospital of Soochow UniversitySuzhou215004China Department of Neurology Dushu Lake Hospital affiliated to Soochow UniversitySuzhou215125China Jiangsu Key Laboratory of Neuropsychiatric Diseases and Institute of Neuroscience Soochow UniversitySuzhou215123China

Parkinson’s disease(PD)is a complicated neurodegenerative disease,characterized by the accumulation ofα-synuclein(α-syn)in Lewy bodies and neurites,and massive loss of midbrain dopamine neurons.Increasing evidence suggests that gut microbiota and microbial metabolites are involved in the development of PD.Among these,short-chain fatty acids(SCFAs),the most abundant microbial metabolites,have been proven to play a key role in brain-gut communication.In this review,we analyze the role of SCFAs in the pathology of PD from multiple dimensions and summarize the alterations of SCFAs in PD patients as well as their correlation with motor and non-motor symptoms.Future research should focus on further elucidating the role of SCFAs in neuroinflammation,as well as developing novel strategies employing SCFAs and their derivatives to treat PD.

关键词： Parkinson’s disease Short-chain fatty acids Microbial metabolites Brain-gut-microbiota axis

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