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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

Identification prognostic features related to sphingolipid metabolism and experimental validation of TRIM47 in hepatocellular carcinoma

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BIOCELL 2024年第4期48卷 639-651页

作者： JIAN TANG CHENQIANG ZHU YUN CHEN YUNLONG WU MING HE YI ZHOU MINGHUA XIE department of intensive care Unit The First People’s Hospital of Linping DistrictHangzhouChina department of Pharmacy The First People’s Hospital of Linping DistrictHangzhouChina

Background:The speciﬁc impact of sphingolipid metabolism on developing hepatocellular Carcinoma(HCC)remains *** study aims to explore the relationship between sphingolipid metabolism and HCC prognosis,immune response,and drug ***:Data were obtained from The Cancer Genome Atlas(TCGA)-Hepatocellular Carcinoma(LIHC)and Gene Expression Omnibus(GEO,GSE14520 datasets).47 sphingolipid metabolism genes were obtained from the Kyoto Encyclopedia of Genes and Genomes(KEGG)*** classifying HCC samples using the Non-negative Matrix Factorization(NMF)clustering method,differentially expressed genes were ***,8 risk genes were obtained by univariate analysis,survival random forest reduction and lasso *** expression of 8 risk genes was veriﬁed in ***:8 risk genes were used to construct the Sphingolipid score ***-Sphingolipid score predicted poor prognosis of HCC *** score was associated with immune checkpoints(IL-1B,TLR4,TGFB1,and IL-10),immune cells(Th2,Treg,MDSC,Neutrophil,Fibroblasts and macrophage),and MAPK *** the High-Sphingolipid score group,a signiﬁcantly higher proportion of patients with TP53(p53)mutations was signiﬁcantly higher(56%).Furthermore,patients with a high-Sphingolipid score were predicted to have a higher sensitivity to chemotherapy *** vitro validation showed that compared with normal liver cells LX-2,TRIM47,and S100A9 signiﬁcantly increased in liver cancer cells Hep G2,MHCC-97H,and Hep3B2.1-7,while SLC1A7,LPCAT1,and CFHR4 signiﬁcantly *** TRIM47 reduced the proliferation and promoted *** levels of ceramide synthesis-related indexes(CERS1,CERS6,CERS5,and SPTLC2)increased,and the ACER3 related to catalytic hydrolysis ***:We constructed a sphingolipid metabolism-related prognostic signature(Sphingolipid score)based on 8 risk ***47 may affect the development of liver cancer by regulating the relevant indicators of

关键词： Hepatocellular carcinoma Sphingolipid metabolism TRIM47 Prognosis

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

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

Left ventricular thrombosis caused cerebral embolism during venoarterial extracorporeal membrane oxygenation support: A case report

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World Journal of Clinical Cases 2024年第5期12卷 973-979页

作者： Yao-Bang Bai Feng Zhao Zhen-Hua Wu Guo-Ning Shi Nan Jiang intensive care Unit Department of Cardiac SurgeryTianjin Chest HospitalTianjin 300222China department of Cardiac Surgery Tianjin Chest HospitalTianjin 300222China

BACKGROUND Venoarterial(VA)extracorporeal membrane oxygenation(ECMO),an effective short-term circulatory support method for refractory cardiogenic shock,is widely ***,retrospective analyses have shown that VA-ECMO-assisted cases were associated with a relatively high mortality rate of approximately 60%.Embolization in important organs caused by complications of left ventricular thrombosis(LVT)during VA-ECMO is also an important *** the incidence of LVT during VA-ECMO is not high,the consequences of embolization are *** SUMMARY A 37-year-old female patient was admitted to hospital because of fever for 4 d and palpitations for 3 *** excluding the diagnosis of coronary heart disease,we established a diagnosis of“clinically explosive myocarditis”.The patient still had unstable hemodynamics after drug treatment supported by VA-ECMO,with heparin for *** day 4 of ECMO support,a left ventricular thro-mbus attached to the papillary muscle root of the mitral valve was found by transthoracic *** ventricular decompression was performed and ECMO was successfully removed,but the patient eventually died of multiple cerebral *** LVT with high mobility during VA-ECMO may cause embolism in important ***,a"wait and see"strategy should be avoided.

关键词： Venoarterial extracorporeal membrane oxygenation Left ventricular thrombosis Cerebral embolism Magnetic Resonance Imaging Therapy Case report

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

Clinical analysis of colistin sulfate in the treatment of pneumonia caused by carbapenem-resistant Gram-negative bacteria

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World Journal of Clinical Cases 2024年第13期12卷 2173-2181页

作者： Hai-Chang Xu Yan Cui Xue-Ying Wang Hai-Bo Wu Wei Li Dan Wang Na Lin Lin Lin Ying-Hui Zhang department of intensive care medicine The General Hospital of the Northern Theater Command of the People's Liberation Army of ChinaShenyang 110016Liaoning ProvinceChina

BACKGROUND Multidrug-resistant Gram-negative bacteria,exacerbated by excessive use of antimicrobials and immunosuppressants,are a major health *** To study the clinical efficacy and safety of colistin sulfate in the treatment of carbapenem-resistant Gram-negative bacilli-induced pneumonia,and to provide theoretical reference for clinical diagnosis and *** This retrospective analysis involved 54 patients with Gram-negative bacilli pneumonia admitted to intensive care unit of The General Hospital of the Northern Theater Command of the People's Liberation Army of China from August 2020 to June *** bacteriological culture,the patients'airway secretions were collected to confirm the presence of Gram-negative *** patients were divided into the experimental and control groups according to the medication *** research group consisted of 28 patients who received polymyxin sulfate combined with other drugs through intravenous,nebulization,or intravenous combined with nebulization,with a daily dosage of 1.5–3.0 million *** control group consisted of 26 patients who received standard dosages of other antibiotics(including sulbactam sodium for injection,cefoperazone sodium sulbactam for injection,tigecycline,meropenem,or vaborbactam).RESULTS Of the 28 patients included in the research group,26 patients showed improvement,treatment was ineffective for two patients,and one patient died,with the treatment efficacy rate of 92.82%.Of the 26 patients in the control group,18 patients improved,treatment was ineffective for eight patients,and two patients died,with the treatment efficacy rate of 54.9%;significant difference was observed between the two groups(P<0.05).The levels of white blood cell(WBC),procalcitonin(PCT),and C-reactive protein(CRP)in both groups were significantly lower after treatment than before treatment(P<0.05),and the levels of WBC,PCT,and CRP in the research group were significantly lower than those in the control group

关键词： Colistin sulfate Extensively drug-resistant Pneumonia Intravenous combined with nebulization Sepsis Nephrotoxicity Neurotoxicity