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World Journal of Emergency Medicine 2024年第2期15卷 147-149页

作者： Fangfang Qiu Weixing Dai Tengyue Huang Min Li department of intensive care Unit the Fourth Affiliated Hospital of Zhejiang University School of MedicineYiwu 322000China department of intensive care Unit the Second Affiliated Hospital of Zhejiang University School of MedicineHangzhou 310009China

Thiamine deficiency is characterized by a deficiency of thiamine(vitamin B1),lactic acidosis,pulmonary arterial hypertension(PAH),right-sided heart failure,and peripheral nerve *** deficiency is easily misdiagnosed and missed during clinical practice and is associated with death in severe cases.[1,2]Here we reported a patient who was admitted to the hospital with severe metabolic acidosis and pulmonary hypertension and finally diagnosed with thiamine deficiency by detecting plasma vitamin B1 *** clinically obvious thiamine deficiency is rare,and cases of thiamine deficiency requiring extracorporeal membrane oxygenation(ECMO)treatment are rarer,we believe that our case will be helpful for emergency clinicians.

关键词： vitamin hypertension arterial

Characteristics and Risk Factors for Pediatric Sepsis

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Current Medical Science 2024年第3期44卷 648-656页

作者： Yong-bing ZHU Tong-lin LIU Qi DAI Shu-fan LIU Peng XIONG Hao HUANG Yi YUAN Tian-nan ZHANG Yu CHEN department of Pediatric intensive care Unit Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430030China

Objective Sepsis is considered a major cause of health loss in children and had high mortality and ***,there is no reliable model for predicting the prognosis of pediatric patients with *** study aimed to analyze the clinical characteristics of sepsis in children and assess the risk factors associated with poor prognosis in pediatric sepsis patients to identify timely interventions and improve their *** This study analyzed the clinical indicators and laboratory results of septic patients hospitalized in the Pediatric intensive care Unit of Tongji Hospital,Tongji Medical College,Huazhong university of Science and Technology,China,from January 1,2019,to December 31,*** factors for sepsis were identified by logistic regression *** A total of 355 children with sepsis were enrolled,with 333 children(93.8%)in the good prognosis group,and 22 children(6.2%)in the poor prognosis *** them,there were 255 patients(71.8%)in the sepsis group,and 100 patients(28.2%)in the severe sepsis *** length of hospital stay in the poor prognosis group was longer than that in the good prognosis group(P0.05),and the platelet(PLT),albumin(ALB),and hemoglobin(Hb)levels were lower in the poor prognosis group(P<0.01).The IL-8 levels in the severe sepsis group were higher than those in the sepsis group(P<0.05).Multiple logistic regression analysis suggested that lower Hb levels,ALB levels,peak PLT counts,and higher IL-1βlevels were independent risk factors for poor prognosis in children with *** Lower Hb,ALB,and PLT counts and elevated IL-1βare independent risk factors for poor prognosis in children with sepsis.

关键词： pediatric sepsis inflammation severity prognosis risk factors

Calcineurin inhibitors-related posterior reversible encephalopathy syndrome in liver transplant recipients: Three case reports and review of literature

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World Journal of Hepatology 2024年第9期16卷 1297-1307页

作者： Yu Gong department of intensive care Unit Fudan University Affiliated Zhongshan HospitalShanghai 200032China

BACKGROUND Posterior reversible encephalopathy syndrome(PRES),characterized by acute neurological deterioration and extensive white matter lesions on T2-fluid attenuated inversion recovery magnetic resonance imaging(MRI),is increasingly associated with calcineurin inhibitors(CNI)-related *** diagnosis is crucial,as early intervention,including the modification or discontinuation of CNI therapy,strict blood pressure management,corticosteroid treatment,and supportive care can significantly improve patient outcomes and *** growing clinical recognition of CNI-related PRES underscores the importance of identifying and managing this condition in patients presenting with acute neurological *** SUMMARY This report describes three cases of liver transplant recipients who developed *** first case involves a 60-year-old woman who experienced seizures,aphasia,and hemiplegia on postoperative day(POD)9,with MRI revealing ischemic foci followed by extensive white matter *** replacing tacrolimus,her symptoms improved,and no significant MRI abnormalities were observed after three years of *** second case concerns a 54-year-old woman with autoimmune hepatitis who developed headaches,seizures,and extensive white matter demyelination on MRI on *** the switch to rapamycin and the initiation of corticosteroids,her symptoms resolved,and she was discharged on *** third case details a 60-year-old woman with hepatocellular carcinoma who developed PRES,evidenced by brain MRI abnormal-ities on *** to rapamycin and corticosteroid therapy led to her full recovery,and she was discharged on *** cases highlight the critical importance of early diagnosis,CNI modification,and stringent management in improving outcomes for liver transplant recipients with CNI related *** Clinical manifestations,combined with characteristic MRI findings,are crucial in diagnosing PRES among organ transplan

关键词： Posterior reversible encephalopathy syndrome Calcineurin inhibitors Liver transplantation Prognosis Case report

Effects of strengthening prospective nursing practice on sleep quality,anxiety,and depression of awake patients in intensive care unit

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World Journal of Psychiatry 2024年第5期14卷 735-741页

作者： Fei Lin Lei Liu department of intensive care Unit Dushu Lake Hospital Affiliated to Soochow UniversitySuzhou 215000Jiangsu ProvinceChina

BACKGROUND The intensive care unit(ICU)is a specialized hospital *** patients in the ICU frequently encounter adverse psychological states,such as anxiety and fear,often accompanied by poor sleep *** situation has garnered significant attention within the medical *** To investigate the impact of prospective nursing intervention strategies on the sleep quality and negative emotional state of conscious ICU *** One hundred and twenty ICU awake patients admitted to our hospital were selected and randomly divided into control(n=60)and observation(n=60)*** in the control group were cared for using the conventional nursing model,while patients in the observation group were cared for using the prospective nursing *** improvement was assessed using the International Standardized Sleep Efficiency Formula and Pittsburgh Sleep Quality Index(PSQI).The PSQI,Generalized Anxiety Disorder 7-item(GAD-7)scale,Self-Depression Scale(SDS),and satisfaction before and after treatment were used to assess the negative emotional states of patients under the two care *** Patient satisfaction in the observation group was significantly higher than in the control *** GAD-7 and SDS scores in the observation group were significantly lower than those in the control group,and the total effective rate of sleep improvement in the observation group was significantly higher than in the control *** treatment,the PSQI scores of the two groups significantly decreased(P<0.05).The decrease in the observation group was more significan than that in the control group,and the difference between the two groups was statistically *** Prospective nursing interventions can improve sleep quality and psychological levels and significantly affect conscious patients in the ICU,which is worthy of clinical application.

关键词： Prospective nursing intensive care unit Sobriety Mental health sleep quality Anxiety and depression

A case of post traumatic mitral chordae rupture mimicking acute respiratory distress syndrome

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World Journal of Emergency Medicine 2024年第4期15卷 322-324页

作者： Hülya Deniz Misir Nalan Demir Ferit Kasimzade Cansu Yahşi intensive care department Ankara Bilkent City HospitalAnkara 06800Turkiye intensive care department University of Health Sciences Ankara Bilkent City HospitalAnkara 06800Turkiye Cardiovascular Surgery department Ankara Bilkent City HospitalAnkara 06800Turkiye Pulmonary Medicine department University of Health Sciences Ankara Bilkent City HospitalAnkara 06800Turkiye

Traumatic mitral chordae rupture is a rare and known cause of acute mitral valve regurgitation and de novo heart *** pathologies in a trauma patient may mask the findings of de novo heart failure due to mitral chordae *** patients may also have other potential pre-diagnoses that could explain symptoms related to heart failure,such as tachycardia,circulatory shock,and acute *** possibility of traumatic chordae tendinea rupture being a preventable cause of mortality should be carefully evaluated.

关键词： rupture mitral acute

Early peripheral perfusion index predicts 28-day outcome in patients with septic shock

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World Journal of Emergency Medicine 2024年第5期15卷 372-378页

作者： Cheng Chi Hao Gong Kai Yang Peng Peng Xiaoxia Zhang department of Emergency Peking University People's HospitalBeijing 100044China department of Emergency intensive care Unit the First Affi liated Hospital of Xinjiang Medical UniversityUrumqi 830000China

BACKGROUND:To investigate the prognostic value of the peripheral perfusion index(PPI)in patients with septic ***:This prospective cohort study,conducted at the emergency intensive care unit of Peking university People's Hospital,recruited 200 patients with septic shock between January 2023 and August *** patients were divided into survival(n=84)and death(n=116)groups based on 28-day *** evaluations included laboratory tests and clinical scores,with lactate and PPI values assessed upon admission to the emergency room and at 6 h and 12 h after *** factors associated with mortality were analyzed using univariate and multivariate Cox regression *** operator characteristic(ROC)curve was used to assess predictive *** rates were compared,and Kaplan-Meier survival plots were ***:Compared to the survival group,patients in the death group were older and had more severe liver damage and coagulation dysfunction,necessitating higher norepinephrine doses and increased fl uid *** lactate levels and lower PPI levels at 0 h,6 h,and 12 h were observed in the death *** Cox regression identifi ed prolonged prothrombin time(PT),decreased 6-h PPI and 12-h PPI as independent risk factors for *** area under the curves for 6-h PPI and 12-h PPI were 0.802(95%CI 0.742-0.863,P<0.001)and 0.945(95%CI 0.915-0.974,P<0.001),respectively,which were superior to Glasgow Coma Scale(GCS),Sequential Organ Failure Assessment(SOFA)scores(0.864 and 0.928).Cumulative mortality in the low PPI groups at 6 h and 12 h was signifi cantly higher than in the high PPI groups(6-h PPI:77.52%vs.22.54%;12-h PPI:92.04%vs.13.79%,P<0.001).CONCLUSION:PPI may have value in predicting 28-day mortality in patients with septic shock.

关键词： Peripheral perfusion index Septic shock Prognosis Predictive value

New strategy for distal limb perfusion in veno-arterial extracorporeal membrane oxygenation treatment: application of continuous renal replacement therapy tubing

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World Journal of Emergency Medicine 2024年第4期15卷 311-312页

作者： Zhaokun Fan Zhirong Zhang department of intensive care Unit the First Affiliated Hospital of Zhejiang Chinese Medical University(Zhejiang Provincial Hospital of Chinese Medicine)Hangzhou 310006China

Extracorporeal membrane oxygenation(ECMO)is a technology that can temporarily take over the functions of the heart and *** kidney injury is a common issue in patients receiving ECMO treatment,with reported incidence rates ranging from 70%to 85%.[1]To maintain the balance of fluids and electrolytes in patients,continuous renal replacement therapy(CRRT)is frequently employed.

关键词： Acute treatment perfusion

Brain development in newborns and infants after ECMO

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World Journal of Pediatrics 2024年第6期20卷 556-568页

作者： Kai Yan Lu-Kun Tang Fei-Fan Xiao Peng Zhang Guo-Qiang Cheng Lai-Shuan Wang Chun-Mei Lu Meng-Meng Ge Li-Yuan Hu Yuan-Feng Zhou Tian-Tian Xiao Yan Xu Zhao-Qing Yin Gang-Feng Yan Guo-Ping Lu Qi Li Wen-Hao Zhou department of Neonatology Children Hospital of Fudan UniversityShanghai 201102China Kunming Medical university Affiliated Dehong Hospital DehongYunnanChina Graduate School Kunming Medical UniversityKunmingYunnanChina department of Neurology Children's Hospital of Fudan UniversityShanghaiChina School of Medicine Chengdu Women's and Children's Central HospitalUniversity of Electronic Science and Technology of ChinaChengduSichuanChina department of intensive care Medicine Children's Hospital of Fudan UniversityShanghaiChina department of intensive care Medicine The Sixth Medical Center of PLA General HospitalBeijingChina Key Laboratory of Neonatology National Health Care CommissionShanghaiChina

Background Extracorporeal membrane oxygenation(ECMO)not only significantly improves survival rates in severely ill neonates but also is associated with long-term neurodevelopmental *** systematically review the available literature on the neurodevelopmental outcomes of neonates and infants who have undergone ECMO treatment,with a focus on motor deficits,cognitive impairments,sensory impairments,and developmental *** review aims to understand the incidence,prevalence,and risk factors for these problems and to explore current nursing care and management *** sources A comprehensive literature search was performed across PubMed,EMBASE,and Web of Science using a wide array of keywords and phrases pertaining to ECMO,neonates,infants,and various facets of *** initial screening involved reviewing titles and abstracts to exclude irrelevant articles,followed by a full-text assessment of potentially relevant *** quality of each study was evaluated based on its research methodology and statistical ***,citation searches were conducted to identify potentially overlooked *** the focus was primarily on neonatal ECMO,studies involving children and adults were also included due to the limited availability of neonate-specific *** About 50%of neonates post-ECMO treatment exhibit varying degrees of brain injury,particularly in the frontal and temporoparietal white matter regions,often accompanied by neurological *** occur in 18%–23%of neonates within the first 24 hours,and bleeding events occur in 27%–60%of ECMO procedures,with up to 33%potentially experiencing ischemic *** some studies suggest that ECMO may negatively impact hearing and visual development,other studies have found no significant differences;hence,the influence of ECMO remains *** terms of cognitive,language,and intellectual development,ECMO treatment may be associated with potential deve

关键词： Brain development Extracorporeal membrane oxygenation Infants Neonates Neurological outcomes

Small extracellular vesicles from hypoxia-preconditioned bone marrow mesenchymal stem cells attenuate spinal cord injury via miR-146a-5p-mediated regulation of macrophage polarization

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Neural Regeneration Research 2024年第10期19卷 2259-2269页

作者： Zeyan Liang Zhelun Yang Haishu Xie Jian Rao Xiongjie Xu Yike Lin Chunhua Wang Chunmei Chen department of Neurosurgery Fujian Medical University Union HospitalFuzhouFujian ProvinceChina Fujian neurosurgical Institute FuzhouFujian ProvinceChina

Spinal cord injury is a disabling condition with limited treatment *** studies have provided evidence suggesting that small extracellular vesicles(SEVs)secreted by bone marrow mesenchymal stem cells(MSCs)help mediate the beneficial effects conferred by MSC transplantation following spinal cord ***,hypoxia-preconditioned bone marrow mesenchymal stem cell-derived SEVs(HSEVs)exhibit increased therapeutic *** thus explored the role of HSEVs in macrophage immune regulation after spinal cord injury in rats and their significance in spinal cord *** or HSEVs were isolated from bone marrow MSC supernatants by density gradient *** administration to rats via tail vein injection after spinal cord injury reduced the lesion area and attenuated spinal cord *** regulate macrophage polarization towards the M2 phenotype in vivo and in *** RNA sequencing and bioinformatics analyses of SEVs and HSEVs revealed that mi R-146a-5p is a potent mediator of macrophage polarization that targets interleukin-1 receptor-associated kinase *** mi R-146a-5p expression in HSEVs partially attenuated macrophage *** data suggest that HSEVs attenuate spinal cord inflammation and injury in rats by transporting mi R-146a-5p,which alters macrophage *** study provides new insights into the application of HSEVs as a therapeutic tool for spinal cord injury.

关键词： bone marrow mesenchymal stem cells hypoxia preconditioning interleukin-1 receptor-associated kinase 1 macrophages mesenchymal stem cells small extracellular vesicles spinal cord injury

Neuroprotective effects of chaperone-mediated autophagy in neurodegenerative diseases

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Neural Regeneration Research 2024年第6期19卷 1291-1298页

作者： Qi Jia Jin Li Xiaofeng Guo Yi Li You Wu Yuliang Peng Zongping Fang Xijing Zhang department of Anesthesiology and Perioperative Medicine and department of intensive care Unit Xijing HospitalThe Fourth Military Medical UniversityXi’anShaanxi ProvinceChina department of Critical care Medicine Air Force Medical CenterBeijingChina Translational Research Institute of Brain and Brain-Like Intelligence Shanghai Fourth People’s HospitalSchool of MedicineTongji UniversityShanghaiChina

Chaperone-mediated autophagy is one of three types of autophagy and is characterized by the selective degradation of ***-mediated autophagy contributes to energy balance and helps maintain cellular homeostasis,while providing nutrients and support for cell ***-mediated autophagy activity can be detected in almost all cells,including *** to the extreme sensitivity of neurons to their environmental changes,maintaining neuronal homeostasis is critical for neuronal growth and ***-mediated autophagy dysfunction is closely related to central nervous system *** has been shown that neuronal damage and cell death are accompanied by chaperone-mediated autophagy *** certain conditions,regulation of chaperone-mediated autophagy activity attenuates *** this paper,we review the changes in chaperone-mediated autophagy in neurodegenerative diseases,brain injury,glioma,and autoimmune *** also summarize the most recent research progress on chaperone-mediated autophagy regulation and discuss the potential of chaperone-mediated autophagy as a therapeutic target for central nervous system diseases.

关键词： chaperone-mediated autophagy neurodegenerative disease neuronal homeostasis neuroprotection