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Causal relationship between feelings and cognitive decline:An univariable and multivariable Mendelian randomization study

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World Journal of Psychiatry 2024年第3期14卷 421-433页

作者： Juan Liu Lin Liu Yi-Xin Hu Jian-Hua Li Xiao Zou Hao-Yun Zhang Li Fan department of Cardiology The Second Medical Center&National Clinical Research Center for Geriatric DiseasesChinese PLA General HospitalBeijing 100853China department of Pulmonary and critical care medicine The Second Medical Center&National Clinical Research Center for Geriatric DiseasesChinese PLA General HospitalBeijing 100853China The Fourth department of geriatric Health care The Second Medical Center&National Clinical Research Center for Geriatric DiseasesChinese PLA General HospitalBeijing 100853China department of Anesthesiology First Medical Center of Chinese PLA General HospitalBeijing 100853China

BACKGROUND While the impact of depression on cognition is well-documented,the relationship between feelings and cognition has received limited *** To explore the potential association between feelings and cognition with a twosample Mendelian randomization(MR)*** Our analysis utilized genome-wide association data on various feelings(fed-up feelings,n=453071;worrier/anxious feelings,n=450765;guilty feelings,n=45-0704;nervous feelings,n=450700;sensitivity/hurt feelings,n=449419;miserableness,n=454982;loneliness/isolation,n=455364;happiness,n=152348)in the European population and their impact on cognitive functions(intelligence,n=269867).Conducting a univariable MR(UVMR)analysis to assess the relationship between feelings and *** this analysis,we applied the inverse variance weighting(IVW),weighted median,and MR Egger ***,we performed sensitivity analysis(leave-one-out analysis),assessed heterogeneity(using MR-PRESSO and Cochran’s Q test),and conducted multiple validity test(employing MR-Egger regression).Subsequently,a multivariable MR(MVMR)analysis was employed to examine the impact of feelings on *** served as the primary method in the multivariable analysis,complemented by median-based and MR-Egger *** In this study,UVMR indicated that sensitivity/hurt feelings may have a negative causal effect on cognition(OR=0.63,95%CI:0.43-0.92,P=0.017).After adjustment of other feelings using MVMR,a direct adverse causal effect on cognition was observed(OR_(MVMR)=0.39,95%CI:0.17-0.90,P_(MVMR)=0.027).While a potential increased risk of cognitive decline was observed for fed-up feelings in the UVMR analysis(ORUVMR=0.64,95%CI:0.42-0.97,PUVMR=0.037),this effect disappeared after adjusting for other feelings(OR_(MVMR)=1.42,95%CI:0.43-4.74,P_(MVMR)=0.569).These findings were generally consistent across MV-IVW,median-based,and MR-Egger ***-Egger regression revealed pleiotropy in the impact of worrier/anxious

关键词： Mendelian randomization analysis Feelings Cognition Intelligence

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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 *** 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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clinical and molecular significance of homologous recombination deficiency positive non-small cell lung cancer in Chinese population:An integrated genomic and transcriptional analysis

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Chinese Journal of Cancer research 2024年第3期36卷 282-297页

作者： Yifei Wang Yidan Ma Lei He Jun Du Xiaoguang Li Peng Jiao Xiaonan Wu Xiaomao Xu Wei Zhou Li Yang Jing Di Changbin Zhu Liming Xu Tianlin Sun Lin Li Dongge Liu Zheng Wang department of Pathology department of Minimally Invasive Tumor Therapies center department of Thoracic Surgery department of Oncology department of respiratory and critical care medicine Beijing HospitalNational Center of GerontologyInstitute of Geriatric MedicineChinese Academy of Medical SciencesBeijing 100730China Amoy Diagnostics Co. Ltd.Xiamen 361027China

Objective:The clinical significance of homologous recombination deficiency(HRD)in breast cancer,ovarian cancer,and prostate cancer has been established,but the value of HRD in non-small cell lung cancer(NSCLC)has not been fully *** study aimed to systematically analyze the HRD status of untreated NSCLC and its relationship with patient prognosis to further guide clinical ***:A total of 355 treatment-naïve NSCLC patients were retrospectively *** status was assessed using the AmoyDx Genomic Scar Score(GSS),with a score of≥50 considered ***,transcriptomic,tumor microenvironmental characteristics and prognosis between HRD-positive and HRDnegative patients were ***:Of the patients,25.1%(89/355)were *** to HRD-negative patients,HRDpositive patients had more somatic pathogenic homologous recombination repair(HRR)mutations,higher tumor mutation burden(TMB)(P<0.001),and fewer driver gene mutations(P<0.001).Furthermore,HRD-positive NSCLC had more amplifications in PI3K pathway and cell cycle genes,MET and MYC in epidermal growth factor receptor(EGFR)/anaplastic lymphoma kinase(ALK)mutant NSCLC,and more PIK3CA and AURKA in EGFR/ALK wild-type ***-positive NSCLC displayed higher tumor proliferation and immunosuppression ***-negative NSCLC showed activated signatures of major histocompatibility complex(MHC)-II,interferon(IFN)-γand effector memory CD8+T ***-positive patients had a worse prognosis and shorter progressionfree survival(PFS)to targeted therapy(first-and third-generation EGFR-TKIs)(P=0.042).Additionally,HRDpositive,EGFR/ALK wild-type patients showed a numerically lower response to platinum-free immunotherapy ***:Unique genomic and transcriptional characteristics were found in HRD-positive *** prognosis and poor response to EGFR-TKIs and immunotherapy were observed in HRD-positive *** study highlights potential actionable alterations in HRD

关键词： Non-small cell lung cancer homologous recombination deficiency genetic alterations transcriptional analysis tumor microenvironment prognosis

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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 *** this study,we explored the risk factors for brain injury induced by EHS 90-day after ***: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 *** 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 *** information,neurological performance and information on important organ injuries in the acute stage were recorded and *** 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 ***: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 *** 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 *** Kaplan-Meier curves suggest significa

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

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Study on myocardial infarction based on nationwide inpatient sample database:a bibliometric analysis from 2000 to 2022

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Emergency and critical care medicine 2024年第1期4卷 22-27页

作者： Tianyi Zhang Xue Yang Qian Zhuang Yuhua Liu Huajuan Bai Jianchao Liu Zhouheng Ye Institution of Hospital Management Department of Medical Innovation and ResearchChinese PLA General HospitalBeijingChina Outpatient department The Second Medical Center and National Clinical Research Center for Geriatric DiseasesChinese PLA General HospitalBeijingChina department of Special Operations medicine The Sixth Medical CenterChinese PLA General HospitalBeijingChina.

Background:Studies on myocardial infarction(MI)based on large medical databases have become popular in recent *** influence of the national Inpatient Sample(NIS),the largest collection of administrative healthcare data across the United States,on the field of MI has not been well *** study aimed to quantify the contribution of NIS to MI research using bibliometric ***:We searched the Web of Science Core Collection database to identify publications on MI using NIS from 2000 to *** indicators,such as the number of publications,citations,and Hirsch index(H-index),were summarized by years,authors,organizations,and *** and CiteSpace software were used to analyze the keywords and trends of the hot ***:A total of 342 articles on MI based on NIS were included.A significant growth in outputs related to MI using the NIS from 2000 to 2020 was *** publications were mainly from the United *** Mayo Clinic was the most prolific institution and had the most citations and the highest *** American Journal of Cardiology ranked first among journals with the highest number of publications,citations,and *** and healthcare management are the main focuses of this *** risks and care are receiving increased ***:This study suggests that NIS significantly contributes to high-quality output in MI *** efforts are needed to improve the impact of knowledge gained from the NIS on MI.

关键词： Administrative healthcare database Bibliometrics Big data Myocardial infarction national Inpatient Sample

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评价散寒化湿颗粒与奈玛特韦-利托那韦对照治疗轻型/中型新型冠状病毒感染有效性和安全性的随机、开放、多中心临床研究

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Science Bulletin 2024年第12期69卷 1954-1963页

作者：邹晓辉常康范国辉郑欢伟神和正唐亮杨映映王业明赵林华吕红周昕沈小明陈利强仝小林曹彬 national center for respiratory medicine State Key Laboratory of Respiratory Health and MultimorbidityNational Clinical Research Center for Respiratory DiseasesInstitute of Respiratory MedicineChinese Academy of Medical SciencesLaboratory of Clinical Microbiology and Infectious DiseasesDepartment of Pulmonary and Critical Care MedicineCenter of Respiratory MedicineChina-Japan Friendship HospitalBeijing 100029China national center for respiratory medicine State Key Laboratory of Respiratory Health and MultimorbidityNational Clinical Research Center for Respiratory DiseasesInstitute of Respiratory MedicineChinese Academy of Medical SciencesDepartment of Clinical Research and Data Management Center of Respiratory MedicineCenter of Respiratory MedicineChina-Japan Friendship HospitalBeijing 100029China Shijiazhuang Hospital of Traditional Chinese medicine Shijiazhuang 050051China Linyi Traditional Chinese medicine Hospital Linyi 276000China Wuxi Traditional Chinese medicine Hospital Wuxi 214071China national center for respiratory medicine State Key Laboratory of Respiratory Health and MultimorbidityNational Clinical Research Center for Respiratory DiseasesInstitute of Respiratory MedicineChinese Academy of Medical SciencesDepartment of Traditional Chinese Medicine for Pulmonary DiseasesCenter of Respiratory MedicineChina-Japan Friendship HospitalBeijing 100029China Institute of Metabolic diseases Guang’anmen Hospital of ChinaAcademy of Chinese Medical SciencesBeijing 100053China Taicang Traditional Chinese medicine Hospital Taicang 215400China The First Hospital of Qiqihar Qiqihar 161005China The second Affiliated Hospital of Jiaxing University Jiaxing 314000China Huizhou First Hospital Huizhou 516003China national center for Integrated Traditional Chinese medicine and Western medicine China-Japan Friendship HospitalBeijing 100029China

Sanhan Huashi granules(SHG)demonstrated therapeutic effects against coronavirus disease 2019(COVID-19)in observational *** order to compare the effectiveness and safety of SHG and nirmatrelvir–ritonavir in treating adults with mild-to-moderate COVID-19,we conducted a randomized,activecontrolled,open-label,multi-center trial conducted between February and July in *** patients were randomized in a 1:1 ratio to the SHG group and the nirmatrelvir–ritonavir group.A total of 400participants were randomized,among which 200 participants ultimately received SHG and 198 received nirmatrelvir–*** primary outcome was time to sustained clinical recovery through day *** significantly shortened the median time to sustained clinical recovery compared to nirmatrelvir–ritonavir(6.0(95%CI,5.0 to 6.0)vs.8.0(95%CI,6.0 to 9.0)d;P=0.001),particularly for individual symptoms including fever,sore throat,cough and *** participants in either group died and incidence of severe COVID-19 showed no difference between two *** who received nirmatrelvir–ritonavir demonstrated a higher rate of virus clearance on day 5 compared to those received SHG(46.4%(95%CI,39.1 to 53.7)vs.65.6%(95%CI,58.3 to 72.4);Pclinical recovery in participants with mild-to-moderate COVID-19,despite a lower virus clearance rate observed after 5 d of treatment(Chinese clinical Trial Registry Identifier:Chi CTR2300067872).

关键词： Traditional Chinese medicine COVID-19 Nirmatrelvir-Ritonavir Sustained clinical recovery

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Single-cell transcriptomics reveals the ameliorative effect of rosmarinic acid on diabetic nephropathy-induced kidney injury by modulating oxidative stress and inflammation

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Acta Pharmaceutica Sinica B 2024年第4期14卷 1661-1676页

作者： Junhui Chen Qian Zhang Jinan Guo Di Gu Jing Liu Piao Luo Yunmeng Bai Jiayun Chen Xinzhou Zhang Sheng Nie Chunbo Chen Yulin Feng Jigang Wang national Pharmaceutical Engineering center for Solid Preparation of Chinese Herbal medicine Jiangxi University of Chinese MedicineNanchang 330006China department of Pulmonary and critical care medicine Shenzhen Institute of Respiratory Diseasesand Shenzhen Clinical Research Centre for GeriatricsShenzhen People's HospitalFirst Affiliated Hospital of Southern University of Science and TechnologySecond Clinical Medical College of Jinan UniversityShenzhen 518020China School of Traditional Chinese medicine and School of Pharmaceutical Sciences Southern Medical UniversityGuangzhou 510515China department of Urology and Shenzhen Clinical Research Centre for GeriatricsShenzhen People's Hospitalthe First Affiliated HospitalSouthern University of Science and TechnologyShenzhen 518020China department of Urology the First Affiliated Hospital of Guangzhou Medical UniversityGuangzhou 510230China department of Nephrology Shenzhen Key Laboratory of Kidney Diseasesand Shenzhen Clinical Research Centre for GeriatricsShenzhen People's Hospitalthe First Affiliated HospitalSouthern University of Science and TechnologyShenzhen 518020China department of Nephrology Nanfang Hospitalthe First Affiliated Hospital of Southern Medical UniversityGuangzhou 510515China department of critical care medicine Shenzhen People's Hospital(the Second Clinical Medical CollegeJinan Universitythe First Affiliated HospitalSouthern University of Science and Technology)Shenzhen 518020China State Key Laboratory for Quality Esurance and Sustainable Use of Dao-di Herbs Artemisinin Research Centerand Institute of Chinese Materia MedicaChina Academy of Chinese Medical SciencesBeijing 100700China department of Oncology the Affiliated Hospital of Southwest Medical UniversityLuzhou 646000China

Diabetic nephropathy(DN)is a severe complication of diabetes,characterized by changes in kidney structure and *** natural product rosmarinic acid(RA)has demonstrated therapeutic effects,including anti-inflammation and anti-oxidative-stress,in renal damage or *** this study,we characterized the heterogeneity of the cellular response in kidneys to DN-induced injury and RA treatment at single cell *** results demonstrated that RA significantly alleviated renal tubular epithelial injury,particularly in the proximal tubular S1 segment and on glomerular epithelial cells known as podocytes,while attenuating the inflammatory response of macrophages,oxidative stress,and cytotox-icity of natural killer *** findings provide a comprehensive understanding of the mechanisms by which RA alleviates kidney damage,oxidative stress,and inflammation,offering valuable guidance for the clinical application of RA in the treatment of DN.

关键词： Rosmarinic acid Diabetic nephropathy scRNA sequencing Injury Oxidative stress Infiammation Proteomics

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A Cullin 5-based complex serves as an essential modulator of ORF9b stability in SARS-CoV-2 replication

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Signal Transduction and Targeted Therapy 2024年第7期9卷 3112-3129页

作者： Yuzheng Zhou Zongpeng Chen Sijie Liu Sixu Liu Yujie Liao Ashuai Du Zijun Dong Yongxing Zhang Xuan Chen Siyi Tao Xin Wu Aroona Razzaq Gang Xu De-an Tan Shanni Li Youwen Deng Jian Peng Shuyan Dai Xu Deng Xianwen Zhang Taijiao Jiang Zheng Zhang Gong Cheng Jincun Zhao Zanxian Xia department of Cell Biology School of Life SciencesCentral South University410013 ChangshaChina Institute for Hepatology National Clinical Research Center for Infectious DiseaseShenzhen Third People’s HospitalThe Second Affiliated HospitalSchool of MedicineSouthern University of Science and Technology518112 ShenzhenChina department of Basic medicine School of MedicineHunan Normal University410081 ChangshaChina department of spine surgery The Third Xiangya HospitalCentral South University410013 ChangshaChina School of Basic medical Sciences Anhui Medical University230032 HefeiChina Hunan Key Laboratory of Neurorestoratology 921 Hospital of Joint Logistics Support Force People’s Liberation Army of China(The Second Affiliated Hospital of Hunan Normal University)410003 ChangshaHunanChina department of geriatric Surgery Xiangya HospitalCentral South University410008 ChangshaChina Xiangya School of Pharmaceutical Sciences Central South University410013 ChangshaChina Institute of Infectious diseases Shenzhen Bay Laboratory518132 ShenzhenChina Guangzhou Laboratory 510005 GuangzhouChina Tsinghua University-Peking University Joint center for Life Sciences School of MedicineTsinghua University100084 BeijingChina State Key Laboratory of respiratory Disease National Clinical Research Center for Respiratory DiseaseGuangzhou Institute of Respiratory HealthThe First Affiliated Hospital of Guangzhou Medical University510120 GuangzhouChina Hunan Key Laboratory of Animal Models for Human diseases Hunan Key Laboratory of Medical Genetics&Center for Medical GeneticsSchool of Life SciencesCentral South University410008 ChangshaChina

The ORF9b protein,derived from the nucleocapsid’s open-reading frame in both SARS-CoV and SARS-CoV-2,serves as an accessory protein crucial for viral immune evasion by inhibiting the innate immune *** its significance,the precise regulatory mechanisms underlying its function remain *** the present study,we unveil that the ORF9b protein of SARS-CoV-2,including emerging mutant strains like Delta and Omicron,can undergo ubiquitination at the K67 site and subsequent degradation via the proteasome pathway,despite certain mutations present among these ***,our investigation further uncovers the pivotal role of the translocase of the outer mitochondrial membrane 70(TOM70)as a substrate receptor,bridging ORF9b with heat shock protein 90 alpha(HSP90α)and Cullin 5(CUL5)to form a *** this complex,CUL5 triggers the ubiquitination and degradation of ORF9b,acting as a host antiviral factor,while HSP90αfunctions to stabilize ***,treatment with HSP90 inhibitors such as GA or 17-AAG accelerates the degradation of ORF9b,leading to a pronounced inhibition of SARS-CoV-2 ***-cell sequencing data revealed an up-regulation of HSP90αin lung epithelial cells from COVID-19 patients,suggesting a potential mechanism by which SARS-CoV-2 may exploit HSP90αto evade the host *** study identifies the CUL5-TOM70-HSP90αcomplex as a critical regulator of ORF9b protein stability,shedding light on the intricate host–virus immune response dynamics and offering promising avenues for drug development against SARS-CoV-2 in clinical settings.

关键词： stability modulator offering

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Severe pediatric COVID‑19:a review from the clinical and immunopathophysiological perspectives

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World Journal of Pediatrics 2024年第4期20卷 307-324页

作者： Yi‑Kan Sun Can Wang Pei‑Quan Lin Lei Hu Jing Ye Zhi‑Gang Gao Ru Lin Hao‑Min Li Qiang Shu Li‑Su Huang Lin‑Hua Tan Children's Hospital Zhejiang University School of MedicineHangzhou 310052China The second Affiliated Hospital Zhejiang University School of MedicineHangzhou 310030China Surgical Intensive care Unit Children’s HospitalZhejiang University School of MedicineHangzhou 310052China department of General Surgery Children’s HospitalZhejiang University School of MedicineHangzhou 310052China department of Cardiopulmonary and Extracorporeal Life Support Children’s HospitalZhejiang University School of MedicineHangzhou 310052China clinical Data center Children’s HospitalZhejiang University School of MedicineHangzhou 310052China department of Cardiac Surgery Children’s HospitalZhejiang University School of MedicineHangzhou 310052China national clinical research center for Child Health Children’s HospitalZhejiang University School of MedicineHangzhou 310052China department of Infectious diseases Children’s HospitalZhejiang University School of MedicineHangzhou 310052China

Background Coronavirus disease 2019(COVID-19)tends to have mild presentations in ***,severe and critical cases do arise in the pediatric population with debilitating systemic impacts and can be fatal at times,meriting further attention from ***,the intricate interactions between the pathogen virulence factors and host defense mechanisms are believed to play indispensable roles in severe COVID-19 pathophysiology but remain incompletely *** sources A comprehensive literature review was conducted for pertinent publications by reviewers independently using the PubMed,Embase,and Wanfang *** keywords included“COVID-19 in children”,“severe pediatric COVID-19”,and“critical illness in children with COVID-19”.Results Risks of developing severe COVID-19 in children escalate with increasing numbers of co-morbidities and an unvaccinated *** respiratory distress stress and necrotizing pneumonia are prominent pulmonary manifestations,while various forms of cardiovascular and neurological involvement may also be *** immunological processes are implicated in the host response to COVID-19 including the type I interferon and inflammasome pathways,whose dysregulation in severe and critical diseases translates into adverse clinical *** inflammatory syndrome in children(MIS-C),a potentially life-threatening immune-mediated condition chronologically associated with COVID-19 exposure,denotes another scientific and clinical conundrum that exemplifies the complexity of pediatric *** the considerable dissimilarities between the pediatric and adult immune systems,clinical trials dedicated to children are lacking and current management recommendations are largely adapted from adult *** Severe pediatric COVID-19 can affect multiple organ *** dysregulated immune pathways in severe COVID-19 shape the disease course,epitomize the vast functional diversity of the

关键词： Immunopathophysiology MIS-C Pediatric critical care Severe pediatric COVID-19

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Klebsiella pneumoniae infections after liver transplantation:Drug resistance and distribution of pathogens,risk factors,and influence on outcomes

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World Journal of Hepatology 2024年第4期16卷 612-624页

作者： Long Guo Peng Peng Wei-Ting Peng Jie Zhao Qi-Quan Wan department of respiratory and critical care medicine The Third Xiangya Hospital of Central South UniversityChangsha 410013Hunan ProvinceChina clinical Laboratory medicine center Zhuzhou Hospital Affiliated to Xiangya School of MedicineCentral South UniversityZhuzhou 421007Hunan ProvinceChina The second Affiliated Hospital Class Xiangya School of MedicineCentral South UniversityChangsha 410013Hunan ProvinceChina department of Liver Surgery Renji HospitalShanghai Jiaotong University School of MedicineShanghai 200127China department of Transplant Surgery The Third Xiangya Hospital of Central South UniversityChangsha 410013Hunan ProvinceChina Engineering and Technology research center for Transplantation medicine of national Health Commission The Third Xiangya Hospital of Central South UniversityChangsha 410013Hunan ProvinceChina

BACKGROUND Liver transplantation(LT)is the only curative treatment for end-stage liver ***,LT recipients are susceptible to infection,which is the leading cause of early mortality after *** pneumoniae infections(KPIs)in the bloodstream are common in LT *** hypothesized that KPIs and carbapenemresistant Klebsiella pneumoniae(CRKP)infections may affect the outcomes of LT *** To assess KPI incidence,timing,distribution,drug resistance,and risk factors following LT and its association with *** This retrospective study included 406 patients undergoing LT at The Third Xiangya Hospital of Central South University,a tertiary hospital,from January 2015 to January *** investigated the risk factors for KPIs and assessed the impact of KPIs and CRKP infections on the prognosis of LT recipients using logistic regression *** KPI incidence was 7.9%(n=32),with lung/thoracic cavity the most frequent site of infection;the median time from LT to KPI onset was 7.5 *** 44 Klebsiella pneumoniae isolates,43(97.7%)and 34(77.3%)were susceptible to polymyxin B or ceftazidime/avibactam and tigecycline,respectively;>70%were resistant to piperacillin/tazobactam,ceftazidime,cefepime,aztreonam,meropenem,and *** sex[odds ratio(OR)=2.827,95%confidence interval(CI):1.256-6.364;P=0.012],pre-LT diabetes(OR=2.794,95%CI:1.070-7.294;P=0.036),day 1 post-LT alanine aminotransferase(ALT)levels≥1500 U/L(OR=3.645,95%CI:1.671-7.950;P=0.001),and post-LT urethral catheter duration over 4 d(OR=2.266,95%CI:1.016-5.054;P=0.046)were risk factors for *** infections,but not KPIs,were risk factors for 6-month all-cause mortality *** KPIs occur frequently and rapidly after *** factors include female sex,pre-LT diabetes,increased post-LT ALT levels,and urethral catheter *** infections,and not KPIs,affect mortality.

关键词： Liver transplantation Klebsiella pneumoniae infections Carbapenem-resistant Klebsiella pneumoniae Risk factors Outcomes

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