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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

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Animal models of hepatitis E infection: Advances and challenges

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Hepatobiliary & Pancreatic Diseases International 2024年第2期23卷 171-180页

作者： Ze Xiang Xiang-Lin He Chuan-Wu Zhu Jia-Jia Yang Lan Huang Chun Jiang Jian Wu Chinese Consortium for the Study of Hepatitis E(CCSHE) Zhejiang University School of Medicine Hangzhou 310030China department of Infectious Diseases The Fifth People’s Hospital of SuzhouSuzhou 215007China department of infection management The Affiliated Suzhou Hospital of Nanjing Medical UniversitySuzhou Municipal HospitalGusu SchoolNanjing Medical UniversitySuzhou 215008China department of Clinical Laboratory The Affiliated Suzhou Hospital of Nanjing Medical UniversitySuzhou Municipal HospitalGusu SchoolNanjing Medical UniversitySuzhou 215008China 不详

Hepatitis E virus(HEV)is one of the leading causes of acute viral hepatitis worldwide.Although most of HEV infections are asymptomatic,some patients will develop the symptoms,especially pregnant women,the elderly,and patients with preexisting liver diseases,who often experience anorexia,nausea,vom-iting,malaise,abdominal pain,and jaundice.HEV infection may become chronic in immunosuppressed individuals.In addition,HEV infection can also cause several extrahepatic manifestations.HEV exists in a wide range of hosts in nature and can be transmitted across species.Hence,animals susceptible to HEV can be used as models.The establishment of animal models is of great significance for studying HEV transmission,clinical symptoms,extrahepatic manifestations,and therapeutic strategies,which will help us understand the pathogenesis,prevention,and treatment of hepatitis E.This review summarized the animal models of HEV,including pigs,monkeys,rabbits,mice,rats,and other animals.For each animal species,we provided a concise summary of the HEV genotypes that they can be infected with,the cross-species transmission pathways,as well as their role in studying extrahepatic manifestations,prevention,and treatment of HEV infection.The advantages and disadvantages of these animal models were also emphasized.This review offers new perspectives to enhance the current understanding of the research landscape surrounding HEV animal models.

关键词： Hepatitis E virus Animal models Pathogenesis Prevention Treatment

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Ability of Helicobacter pylori to internalize into Candida

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World Journal of Gastroenterology 2024年第16期30卷 2281-2284页

作者： Zheng-Hong Chen Jian-Chao Sun Ting-Xiu Yang Gu-Zhen Cui Key Laboratory of Microbiology and Parasitology of Education department of Guizhou Guizhou Medical UniversityGuiyang 561113Guizhou ProvinceChina Key Laboratory of Endemic and Ethnic Diseases of Ministry of Education Guizhou Medical UniversityGuiyang 561113Guizhou ProvinceChina Joint Laboratory of Helicobacter Pylori and Intestinal Microecology Affiliated Hospital of Guizhou Medical UniversityGuiyang 550009Guizhou ProvinceChina department of Quality Control Guizhou Provincial Center for Clinical LaboratoryGuiyang 550002Guizhou ProvinceChina department of Hospital infection and management Guizhou Provincial People’s HospitalGuiyang 550002Guizhou ProvinceChina

The following are our views regarding the“letter to the editor”(Helicobacter is preserved in yeast vacuoles!Does Koch’s postulates confirm it?)by Alipour and Gaeini,and the response“letter to the editor”(Candida accommodates nonculturable Helicobacter pylori in its vacuole-Koch’s postulates aren’t applicable)by Siavoshi and Saniee.Alipour and Gaeini rejected the methods,results,discussion,and conclusions summarized in a review article by Siavoshi and Saniee.The present article reviews and discusses evidence on the evolutionary adaptation of Helicobacter pylori(H.pylori)to thrive in Candida cell vacuoles and concludes that Candida could act as a Trojan horse,transporting potentially infectious H.pylori into the stomach of humans.

关键词： Helicobacter pylori Candida yeast Intracellular presence Helicobacter pylori-specific gene Helicobacter pylori transmission

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Current understanding of ELF4 deficiency:a novel inborn error of immunity

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World Journal of Pediatrics 2024年第5期20卷 444-450页

作者： Hong-Qiang Du Xiao-Dong Zhao department of Rheumatology&Immunology National Clinical Research Center for Child Health and DisordersMinistry of Education Key Laboratory of Child Development and DisordersChongqing Key Laboratory of Child Rare Diseases in Infection and ImmunityChildren’s Hospital of Chongqing Medical UniversityZhongshan Er Road 136Yuzhong DistrictChongqingChina

Background ELF4 deficiency has been recently recognized as a novel disorder within the spectrum of inborn errors of immunity(IEIs),specifically categorized as a“disease of immune dysregulation.”Cases of this condition,reported by our team and others,are very limited worldwide.As such,our current knowledge of this new disease remains preliminary.This review aims to provide a brief overview of the clinical manifestations,pathogenesis,and treatment strategies for this novel IEI.Data sources A comprehensive review was conducted after an extensive literature search in the PubMed/Medline database and websites concerning transcriptional factor ELF4 and reports concerning patients with ELF4 deficiency.Our search strategy was“ELF4 OR ETS-related transcription factor Elf-4 OR EL4-like factor 4 OR myeloid Elf-1-like factor”as of the time of manuscript submission.Results The current signature manifestations of ELF4 deficiency disorder are recurrent and prolonged oral ulcer,abdominal pain,and diarrhea in pediatric males.In some cases,immunodeficiency and autoimmunity can also be prominent.Targeted Sanger sequencing or whole exome sequencing can be used to detect variation in ELF4 gene.Western blotting for ELF4 expression of the patient’s cells can confirm the pathogenic effect of the variant.To fully confirm the pathogenicity of the variant,further functional test is strongly advised.Glucocorticoid and biologics are the mainstream management of ELF4 deficiency disorder.Conclusions Pediatric males presenting with recurring ulcerations in digestive tract epithelium with or without recurrent fever should be suspected of DEX.When atypical presentations are prominent,variations in ELF4 gene should be carefully evaluated functionally due to the complex nature of ELF4 function.Experience of treating DEX includes use of glucocorticoid and biologics and more precise treatment needs more patients to identify and further mechanistic study.

关键词： ELF4 transcription factor Immune dysregulation Inborn errors of immunity Mechanism Recurrent infections

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Expression of cyclin-dependent kinase 9 is positively correlated with the autophagy level in colon cancer

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World Journal of Gastrointestinal Oncology 2024年第2期16卷 314-330页

作者： Lei Zheng Jia Lu Da-Lu Kong department of Colorectal Cancer Surgery National Clinical Research Center for CancerKey Laboratory of Cancer Immunology and Biotherapy of TianjinTianjin Key Laboratory of Digestive CancerKey Laboratory of Cancer Prevention and Therapy of TianjinTianjin’s Clinical Research Center for CancerTianjin Medical University Cancer Institute and HospitalTianjin 300060China department of infection management National Clinical Research Center for CancerKey Laboratory of Cancer Immunology and Biotherapy of TianjinTianjin Key Laboratory of Digestive CancerKey Laboratory of Cancer Prevention and Therapy of TianjinTianjin’s Clinical Research Center for CancerTianjin Medical University Cancer Institute and HospitalTianjin 300060China

BACKGROUND Cyclin-dependent kinase 9(CDK9)expression and autophagy in colorectal cancer(CRC)tissues has not been widely studied.CDK9,a key regulator of transcription,may influence the occurrence and progression of CRC.The expression of auto-phagy-related genes BECN1 and drug resistance factor ABCG2 may also play a role in CRC.Under normal physiological conditions,autophagy can inhibit tumorigenesis,but once a tumor forms,autophagy may promote tumor growth.Therefore,understanding the relationship between autophagy and cancer,partic-ularly how autophagy promotes tumor growth after its formation,is a key motivation for this research.AIM To investigate the relationship between CDK9 expression and autophagy in CRC,assess differences in autophagy between left and right colon cancer,and analyze the associations of autophagy-related genes with clinical features and prognosis.METHODS We collected tumor tissues and paracarcinoma tissues from colon cancer patients with liver metastasis to observe the level of autophagy in tissues with high levels of CDK9 and low levels of CDK9.We also collected primary tissue from left and right colon cancer patients with liver metastasis to compare the autophagy levels and the expression of BECN1 and ABCG2 in the tumor and paracarcinoma tissues.RESULTS The incidence of autophagy and the expression of BECN1 and ABCG2 were different in left and right colon cancer,and autophagy might be involved in the occurrence of chemotherapy resistance.Further analysis of the rela-tionship between the expression of autophagy-related genes CDK9,ABCG2,and BECN1 and the clinical features and prognosis of colorectal cancer showed that the high expression of CDK9 indicated a poor prognosis in colorectal cancer.CONCLUSION This study laid the foundation for further research on the combination of CDK9 inhibitors and autophagy inhibitors in the treatment of patients with CRC.

关键词： Autophagy Tumorigenesis Tumor tissue Paracarcinoma tissue Expression Left/right colon cancer

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Burden of routine orthopedic implant removal a single center retrospective study

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World Journal of Orthopedics 2024年第2期15卷 139-146页

作者： Ammar K AlOmran Nader Alosaimi Ahmed A Alshaikhi Omar M Bakhurji Khalid J Alzahrani Basil Ziyad Salloot Tamim Omar Alabduladhem Ahmed I AlMulhim Arwa Alumran department of Orthopedic College of MedicineImam Abdulrahman Bin Faisal UniversityDammam 31441Saudi Arabia Health Information management and Technology department Imam Abdulrahman Bin Faisal UniversityDammam 31441Saudi Arabia

BACKGROUND Open reduction and internal fixation represent prevalent orthopedic procedures,sparking ongoing discourse over whether to retain or remove asymptomatic implants.Achieving consensus on this matter is paramount for orthopedic surgeons.This study aims to quantify the impact of routine implant removal on patients and healthcare facilities.A retrospective analysis of implant removal cases from 2016 to 2022 at King Fahad Hospital of the University(KFHU)was conducted and subjected to statistical scrutiny.Among these cases,44%necessitated hospitalization exceeding one day,while 56%required only a single day.Adults exhibited a 55%need for extended hospital stays,contrasting with 22.8%among the pediatric cohort.The complication rate was 6%,with all patients experiencing at least one complication.Notably,34.1%required sick leave and 4.8%exceeded 14 d.General anesthesia was predominant(88%).Routine implant removal introduces unwarranted complications,particularly in adults,potentially prolonging hospitalization.This procedure strains hospital resources,tying up the operating room that could otherwise accommodate critical surgeries.Clearly defined institutional guidelines are imperative to regulate this practice.AIM To measure the burden of routine implant removal on the patients and hospital.METHODS This is a retrospective analysis study of 167 routine implant removal cases treated at KFHU,a tertiary hospital in Saudi Arabia.Data were collected in the orthopedic department at KFHU from February 2016 to August 2022,which includes routine asymptomatic implant removal cases across all age categories.Nonroutine indications such as infection,pain,implant failure,malunion,nonunion,restricted range of motion,and prominent hardware were excluded.Patients who had external fixators removed or joints replaced were also excluded.RESULTS Between February 2016 and August 2022,360 implants were retrieved;however,only 167 of those who met the inclusion criteria were included in this study.The remaining implants were rejected due

关键词： Implant removal Healed fracture Orthopedic implant Complications Healthcare system

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Impact of inhaled corticosteroid use on elderly chronic pulmonary disease patients with community acquired pneumonia

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Chinese Medical Journal 2024年第2期137卷 241-243页

作者： Xiudi Han Hong Wang Liang Chen Yimin Wang Hui Li Fei Zhou Xiqian Xing Chunxiao Zhang Lijun Suo Jinxiang Wang Guohua Yu Guangqiang Wang Xuexin Yao Hongxia Yu Lei Wang Meng Liu Chunxue Xue Bo Liu Xiaoli Zhu Yanli Li Ying Xiao Xiaojing Cui Lijuan Li Xuedong Liu Bin Cao department of Pulmonary and Critical Care Medicine Qingdao Municipal HospitalQingdaoShandong 266011China department of nosocomial infection Qingdao Municipal HospitalQingdaoShandong 266011China department of Infectious Diseases Nanjing Lishui People’s HospitalNanjingJiangsu 211213China department of Pulmonary and Critical Care Medicine National Clinical Research Center of Respiratory DiseasesCenter for Respiratory DiseasesChina-Japan Friendship HospitalBeijing 100020China department of Respiratory Medicine Yan’an Hospital Affiliated to Kunming Medical UniversityKunmingYunnan 652199China department of Respiratory Medicine Beijing Huimin HospitalBeijing 100054China department of Pulmonary and Critical Care Medicine Zibo Municipal HospitalZiboShandong 255000China department of Respiratory Medicine Beijing Luhe HospitalCapital Medical UniversityBeijing 101149China department of Pulmonary and Critical Care Medicine Weifang No.2 People’s HospitalWeifangShandong 261599China department of Respiratory Medicine Shandong University Affiliated Qilu Hospital(Qingdao)QingdaoShandong 266035China department of Respiratory Medicine the 2nd Hospital of Beijing CorpsChinese Armed Police ForcesBeijing 100044China department of Infectious Disease Qingdao University Medical College Affiliated Yantai Yuhuangding HospitalYantaiShandong 100191China department of Respiratory Medicine Rizhao Chinese Medical Hospital Affiliated to Shandong Chinese Medical UniversityRizhaoShandong 276800China department of Respiratory Medicine Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical UniversityBeijing 100010China department of Occupational Medicine and Toxicology Beijing Chao-Yang HospitalCapital Medical UniversityBeijing 100020China

To the Editor:With an aging global population,the incidences of community-acquired pneumonia(CAP)and chronic obstructive pulmonary disease(COPD)have signicantly increased.[1]Previous studies have conrmed that COPD and asthma are independently associated with the prevalence of CAP.The use of inhaled corticosteroid(ICS),the cornerstone of treatment for asthma,COPD with frequent acute exacerbations,and asthma-COPD overlap(ACO)may induce changes in the local lung microbiome and abnormal lung immunity,ultimately,causing a signicantly increased risk of pneumonia.However,in cases of pneumonia,the effect of the use of ICS on CAP mortality remains controversial.While data from one study favored the prior use of ICS,which was associated with a signicantly lower short-term mortality rate,[2]other studies have identied no impact on mortality.To date,data on the impact of the use of ICS on mortality,prehospitalization or during hospitalization,are scarce,particularly in the older population.Therefore,this multicenter,retrospective study explored the association between the use of ICS during hospitalization and short-term mortality in older patients with CAP and those with chronic pulmonary disease(CPD).

关键词： pneumonia patients immunity

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Epidemiology and control measures of an outbreak of neonatal echovirus 11 infections in Guangdong, China: A retrospective analysis

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生物安全与健康(英文) 2023年第4期5卷 227-232页

作者： Chunxiao Fang Xiaoming Zhang Xuemin Huang Fengqin Xu Danyang Zhao department of nosocomial infection Control Guangzhou Women and Children’s Medical CenterGuangzhou 510623China department of nosocomial infection Control Heyuan Women and Children’s Hospital and Health InstituteHeyuan 517000China department of nosocomial infection Control Sun Yat-sen Memorial HospitalSun Yat-sen UniversityGuangzhou 510120China

The objective of this study was to investigate the outbreak of echovirus 11 (ECHO 11) infection in newborns at a hospital in Guangdong Province, China, and to study the effectiveness of prevention and control measures to infer the epidemiological characteristics of ECHO 11 and explore the effective measures for its prevention and control. We performed retrospective analyses of hospital records and laboratory test data. In this outbreak, ten cases of ECHO 11 infection were identified, of which nine cases were nosocomial infections. Most of the cases (90%) were severe, and three died. The onset time interval of 10 patients was 1-4 days, most of which occur in 1-2 days. There were eight (80%) males and two females (20%). The gestational age of the patients was 31 to 40 weeks (mean, 35+4 weeks;median, 35+4 weeks). The onset time was 3-26 days (average 9 days;median 8 days). The birth weights of the patients ranged from 1,650 g to 3,450 g (mean 2,385 g;median 2,250 g). We concluded that neonatal infection with ECHO 11 will lead to serious symptoms and high mortality, and is prone to outbreaks of nosocomial infection. We speculate that ECHO 11 is most likely to spread via contact transmission;however, we do not rule out the possibility of droplet transmission. Prevention and control measures can effectively prevent and control hospital enteroviral infections.

关键词： Echovirus 11 nosocomial infection Outbreak Epidemiology Control measures

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Application of artificial intelligence in diagnosis of pulmonary tuberculosis

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Chinese Medical Journal 2024年第5期137卷 559-561页

作者： Jingli Du Yue Su Juan Qiao Shang Gao Enjun Dong Ruilan Wang Yanhui Nie Jing Ji Zhendong Wang Jianqin Liang Wenping Gong Tuberculosis Control Team Senior Department of TuberculosisThe Eighth Medical Center of PLA General HospitalBeijing 100091China department of Computer Science and Technology College of Management Science and EngineeringCapital University of Economics and BusinessBeijing 100071China The Second Ward of Tuberculosis department Senior Department of TuberculosisThe Eighth Medical Center of PLA General HospitalBeijing 100091China Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment Senior Department of TuberculosisThe Eighth Medical Center of PLA General HospitalBeijing 100091China

Tuberculosis(TB)is an infectious disease caused by Mycobacterium tuberculosis.Although the diagnostic technology of pulmonary tuberculosis(PTB)has advanced,accurate and differential diagnoses of PTB are still challenging.In recent years,the rapid development of artificial intelligence(AI)and its wide application in the medical field have provided new opportunities for diagnosing and treating TB and PTB.The machine learning model of AI has not only helped physicians improve diagnostic accuracy,but also enabled them to make early preventive diagnoses for individuals at increased risk of infection.Furthermore,AI can guide physicians to formulate targeted treatment strategies for PTB patients with different conditions.

关键词： tuberculosis diagnosis artificial

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Experts’Consensus on the management of Respiratory Disease Syndemic

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China CDC weekly 2024年第8期6卷 131-138页

作者： Weizhong Yang Zhongjie Li Ting Yang Yanming Li Zhengde Xie Luzhao Feng Zhibin Peng Jue Liu School of Population Medicine and Public Health Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina State Key Laboratory of Respiratory Health and Multimorbidity BeijingChina Key Laboratory of Pathogen infection Prevention and Control Peking Union Medical CollegeMinistry of EducationBeijingChina National Center for Respiratory Diseases State Key Laboratory of Respiratory Health and MultimorbidityNational Clinical Research Center for Respiratory DiseasesInstitute of Respiratory MedicineChinese Academy of Medical SciencesDepartment of Pulmonary and Critical Care MedicineCenter of Respiratory MedicineChina-Japan Friendship HospitalBeijingChina department of Pulmonary and Critical Care Medicine National Center of GerontologyBeijing HospitalInstitute of Geriatric MedicineChinese Academy of Medical SciencesBeijingChina Beijing Key Laboratory of Pediatric Respiratory infection Diseases Key Laboratory of Major Diseases in ChildrenMinistry of EducationNational Clinical Research Center for Respiratory DiseasesResearch Unit of Critical Infection in ChildrenChinese Academy of Medical Sciences2019RU016National Key Discipline of Pediatrics(Capital Medical University)Beijing Pediatric Research InstituteBeijing Children's HospitalCapital Medical UniversityNational Center for Children's HealthBeijingChina Chinese Center for Disease Control and Prevention BeijingChina department of Epidemiology and Biostatistics School of PublicHealthKey Laboratory of Epidemiology of Major DiseasesMinistry of EducationPeking University Health Science Center-Weifang Joint Research Center for Maternal and Child HealthPeking UniversityBeijingChina

The global burden of respiratory diseases is a significant and increasing threat to individuals worldwide.In 2017,there were 544.9 million cases of chronic respiratory diseases,a 39.8%increase since 1990(1).These diseases were the third leading cause of global mortality in 2017,accounting for 7.0%of all deaths,an 18.0%increase compared to 1990.

关键词： diseases respiratory mortality

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