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A rat model of multicompartmental traumatic injury and hemorrhagic shock induces bone marrow dysfunction and profound anemia

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Animal Models and Experimental Medicine 2024年第3期7卷 367-376页

作者： Lauren S.Kelly Jennifer A.Munley Erick E.Pons Kolenkode B.Kannan Elizabeth M.Whitley Letitia E.Bible Philip A.Efron Alicia M.Mohr department of surgery and sepsis and critical illness research center University of Florida College of MedicineGainesvilleFloridaUSA Pathogenesis LLCGainesvilleFloridaUSA

Background:Severe trauma is associated with systemic inflammation and organ *** rodent trauma models are the mainstay of postinjury research but have been criticized for not fully replicating severe human *** aim of this study was to create a rat model of multicompartmental injury which recreates profound traumatic ***:Male Sprague-Dawley rats were subjected to unilateral lung contusion and hemorrhagic shock(LCHS),multicompartmental polytrauma(PT)(unilateral lung contusion,hemorrhagic shock,cecectomy,bifemoral pseudofracture),or na?ve ***,plasma toll-l ike receptor 4(TLR4),hemoglobin,spleen to body weight ratio,bone marrow(BM)erythroid progenitor(CFU-GEMM,BFU-E,and CFU-E)growth,plasma granulocyte colony-stimulating factor(G-CSF)and right lung histologic injury were assessed on day 7,with significance defined as p values<0.05(*).Results:Polytrauma resulted in markedly more profound inhibition of weight gain compared to LCHS(p=0.0002)along with elevated plasma TLR4(p<0.0001),lower hemoglobin(p<0.0001),and enlarged spleen to body weight ratios(p=0.004).Both LCHS and PT demonstrated suppression of CFU-E and BFU-E growth compared to naive(p<0.03,p<0.01).Plasma G-CSF was elevated in PT compared to both na?ve and LCHS(p<0.0001,p=0.02).LCHS and PT demonstrated significant histologic right lung injury with poor alveolar wall integrity and interstitial ***:Multicompartmental injury as described here establishes a reproducible model of multicompartmental injury with worsened anemia,splenic tissue enlargement,weight loss,and increased inflammatory activity compared to a less severe *** may serve as a more effective model to recreate profound traumatic injury to replicate the human inflammatory response postinjury.

关键词： anemia i nflammation polytrauma pseudofracture shock

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Efficacy and safety of clarithromycin for patients with sepsis or septic shock:a systematic review and meta-analysis

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Emergency and critical Care Medicine 2024年第2期4卷 90-96页

作者： Pengyue Zhao Renqi Yao Jiaqi Yang Wei Wen Yongming Yao Xiaohui Du department of General surgery First Medical Center of the Chinese PLA General HospitalBeijingChina Translational Medicine research center Medical Innovation Research Division and Fourth Medical Center of the Chinese PLA General HospitalBeijingChina department of Burn surgery the First Affiliated Hospital of Naval Medical UniversityShanghaiChina department of General surgery Hainan Hospital of Chinese PLA General HospitalSanyaHainanChina

Background:Clarithromycin exerts an immunomodulatory role in several human ***,whether this effect improves the prognosis in patients with sepsis remains controversial,and higher levels of clinical evidence are urgently *** the best of our knowledge,no meta-analysis to date has reported the clinical efficacy and safety of clarithromycin in ***:A comprehensive literature search of PubMed,EMBASE,and the Cochrane Library was conducted up to December 31,*** randomized controlled trials comparing the clinical efficacy and safety of clarithromycin with controls among patients with sepsis or septic shock were *** were pooled by applying a fixed-effects model and a relative risk(RR)estimate with 95%confidence intervals(CIs)using Review Manager(version 5.3;Cochrane Collaboration,Copenhagen,Denmark).Results:Three randomized controlled trials involving a total of 910 patients were *** pooled results confirmed that clarithromycin had no beneficial effect on progression to multiple organ dysfunction syndrome(RR:1.51;95%CI:1.02-2.25;P=0.04;I^(2)=0%),28-day mortality(RR:1.09;95%CI:0.87-1.36;P=0.46;I^(2)=0%),and 90-day mortality(RR:0.86;95%CI:0.71-1.03;P=0.10;I^(2)=81%)in patients with sepsis or septic ***,there was no difference in other serious adverse events between patients who received clarithromycin and those in the control group(RR:1.02;95%CI:0.87-1.19;P=0.83;I^(2)=18%).Conclusion:Our meta-analysis did not reveal an improvement to short-term outcomes in patients with sepsis treated with ***,administration of clarithromycin did not increase the risk of adverse events.

关键词： Clarithromycin Meta-analysis Outcomes sepsis Septic shock

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Clinical practice guidelines for nutritional assessment and monitoring of adult ICU patients in China

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Journal of Intensive Medicine 2024年第2期4卷 137-159页

作者： Xiangdong Guan Dechang Chen Yuan Xu Chinese Society of critical Care Medicine department of critical Care Medicine The First Affiliated Hospital of Sun Yat-sen UniversityGuangzhouChina department of critical Care Medicine Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina department of critical Care Medicine Beijing Tsinghua Changgung HospitalBeijingChina 不详

The Chinese Society of critical Care Medicine(CSCCM)has developed clinical practice guidelines for nutrition assessment and monitoring for patients in adult intensive care units(ICUs)in *** guideline focuses on nutrition evaluation and metabolic monitoring to achieve optimal and personalized nutrition therapy for critically ill *** guideline was developed by experts in critical care medicine and evidence-based medicine methodology and was developed after a thorough review of the system and a summary of relevant trials or studies published from 2000 to July 2023.A total of 18 recommendations were formed and consensus was reached through discussions and reviews by expert groups in critical care medicine,parenteral and enteral nutrition,and *** recommendations are based on currently available evidence and cover several key fields,including screening and assessment,evaluation and assessment of enteral feeding intolerance,metabolic and nutritional measurement and monitoring during nutrition therapy,and organ function evaluation related to nutrition *** question was analyzed according to the Population,Intervention,Comparison,and Outcome(PICO)*** addition,interpretations were provided for four questions that did not reach a consensus but may have potential clinical and research *** plan is to update this nutrition assessment and monitoring guideline using the international guideline update method within 3–5 years.

关键词： Adults critical illness Intensive care unit Nutriti on Nutriti on assessment and monitoring Guideline Recommendations Chinese Society of critical Care Medicine-Chinese Medical Association(CSCCM-CMA)

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Epidemiology and risk factors for mortality in critically ill patients with pancreatic infection

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Journal of Intensive Medicine 2024年第1期4卷 81-93页

作者： Marie Dejonckheere Massimo Antonelli Kostoula Arvaniti Koen Blot Ben CreaghBrown Dylan Wde Lange Jan De Waele Mieke Deschepper Yalim Dikmen George Dimopoulos Christian Eckmann Guy Francois Massimo Girardis Despoina Koulenti Sonia Labeau Jeffrey Lipman Fernando Lipovestky Emilio Maseda Philippe Montravers Adam Mikstacki JoseArtur Paiva Cecilia Pereyra Jordi Rello JeanFrancois Timsit Dirk Vogelaers Stijn Blot the Abdominal sepsis Study(AbSeS)group on behalf of the Trials Group of the European Society of Intensive Care Medicine department of Internal Medicine and Pediatrics Faculty of Medicine and Health SciencesGhent UniversityGhentBelgium department of Anesthesiology Intensive Care and Emergency MedicineFondazione Policlinico Universitario A.Gemelli IRCCSRomeItaly UniversitàCattolica del Sacro Cuore RomeItaly Intensive Care Unit Papageorgiou University Affiliated HospitalThessaloníkiGreece department of Epidemiology and Public Health SciensanoIxellesBelgium Surrey Perioperative Anaesthetic critical Care Collaborative research Group(SPACeR) Royal Surrey County HospitalGuildfordUK department of Clinical and Experimental Medicine University of SurreyGuildfordUK department of Intensive Care Medicine University Medical Center UtrechtUniversity UtrechtUtrechtthe Netherlands department of Intensive Care Medicine Ghent University HospitalGhentBelgium Data Science Institute Ghent University HospitalGhentBelgium department of Anesthesiology and Reanimation Cerrahpasa School of MedicineIstanbul University-CerrahpasaIstanbulTurkey rd department of critical Care “EVGENIDIO”HospitalNational and Kapodistrian University of AthensAthensGreece department of General Visceral and Thoracic SurgeryKlinikum Hannoversch-MuendenGoettingen UniversityGöttingenGermany Division of Scientific Affairs-research European Society of Intensive Care MedicineBrusselsBelgium Anesthesia and Intensive Care department University Hospital of ModenaModenaItaly UQ Centre for Clinical research Faculty of MedicineThe University of QueenslandBrisbaneQLDAustralia nd critical Care department Attikon University HospitalAthensGreece department of Nursing Faculty of EducationHealth and Social WorkUniversity College GhentGhentBelgium Jamieson Trauma Institute The University of QueenslandBrisbaneQLDAustralia Nimes University Hospital University of MontpellierNimesFrance critical Care department Hospital of the Interamerican Open University(UAI)Buenos AiresArgentina Surgical critical Care Department of AnesthesiaHospital Universitario

Background:The AbSeS-classification defines specific phenotypes of patients with intra-abdominal infection based on the(1)setting of infection onset(community-acquired,early onset,or late-onset hospital-acquired),(2)presence or absence of either localized or diffuse peritonitis,and(3)severity of disease expression(infection,sepsis,or septic shock).This classification system demonstrated reliable risk stratification in intensive care unit(ICU)patients with intra-abdominal *** study aimed to describe the epidemiology of ICU patients with pancreatic infection and assess the relationship between the components of the AbSeS-classification and ***:This was a secondary analysis of an international observational study(“AbSeS”)investigating ICU patients with intra-abdominal *** patients with pancreatic infection were included in this analysis(n=165).Mortality was defined as ICU mortality within 28 days of observation for patients discharged earlier from the *** with mortality were assessed using logistic regression analysis and reported as odds ratio(OR)and 95%confidence interval(CI).Results:The overall mortality was 35.2%(n=58).The independent risk factors for mortality included older age(OR=1.03,95%CI:1.0 to 1.1 P=0.023),localized peritonitis(OR=4.4,95%CI:1.4 to 13.9 P=0.011),and persistent signs of inflammation at day 7(OR=9.5,95%CI:3.8 to 23.9,P<0.001)or after the implementation of additional source control interventions within the first week(OR=4.0,95%CI:1.3 to 12.2,P=0.013).Gramnegative bacteria were most frequently isolated(n=58,49.2%)without clinically relevant differences in microbial etiology between survivors and ***:In pancreatic infection,a challenging source/damage control and ongoing pancreatic inflammation appear to be the strongest contributors to an unfavorable short-term *** this limited series,essentials of the AbSeS-classification,such as the setting of infection onset,diffuse

关键词： Pancreatic infection Intensive care unit Mortality Intra-abdominal infection sepsis

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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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Computerized tomography-guided therapeutic percutaneous puncture catheter drainage-combined with somatostatin for severe acute pancreatitis: An analysis of efficacy and safety

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World Journal of Gastrointestinal surgery 2024年第1期16卷 59-66页

作者： Xue-Lan Zheng Wan-Ling Li Yan-Ping Lin Ting-Long Huang department of critical Care Medicine The Second Affiliated Hospital of Fujian Medical UniversityQuanzhou 362000Fujian ProvinceChina CT Room The Second Affiliated Hospital of Fujian Medical UniversityQuanzhou 362000Fujian ProvinceChina

BACKGROUND Severe acute pancreatitis(SAP),a condition with rapid onset,critical condition and unsatisfactory prognosis,poses a certain threat to human health,warranting optimization of relevant treatment plans to improve treatment *** To evaluate the efficacy and safety of computerized tomography-guided the-rapeutic percutaneous puncture catheter drainage(CT-TPPCD)combined with somatostatin(SS)in the treatment of *** Forty-two SAP patients admitted to The Second Affiliated Hospital of Fujian Medical University from June 2020 to June 2023 were *** the basis of routine treatment,20 patients received SS therapy(control group)and 22 patients were given CT-TPPCD plus SS intervention(research group).The efficacy,safety(pancreatic fistula,intra-abdominal hemorrhage,sepsis,and organ dysfunction syndrome),abdominal bloating and pain relief time,bowel recovery time,hospital stay,inflammatory indicators(C-reactive protein,interleukin-6,and pro-calcitonin),and Acute Physiology and Chronic Health Evaluation(APACHE)II score of both groups were evaluated for *** Compared with the control group,the research group had a markedly higher total effective rate,faster abdominal bloating and pain relief and bowel recovery,INTRODUCTION Pancreatitis,an inflammatory disease occurring in the pancreatic tissue,is classified as either acute or chronic and is associated with high morbidity and mortality,imposing a socioeconomic burden[1,2].The pathogenesis of this disease involves early protease activation,activation of nuclear factor kappa-B-related inflammatory reactions,and infiltration of immune cells[3].Severe acute pancreatitis(SAP)is a serious condition involving systemic injury and subsequent possible organ failure,accounting for 20%of all acute pancreatitis cases[4].SAP is also characterized by rapid onset,critical illness and unsatisfactory prognosis and is correlated with serious adverse events such as systemic inflammatory response syn-drome an

关键词： Computerized tomography guidance Therapeutic percutaneous puncture catheter drainage Somatostatin Severe acute pancreatitis Efficacy and safety

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Identification of clinical subphenotypes of sepsis after laparoscopic surgery

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Laparoscopic, Endoscopic and Robotic surgery 2024年第1期7卷 16-26页

作者： Jie Yang Bo Zhang Chaomin Hu Xiaocong Jiang Pengfei Shui Jiajie Huang Yucai Hong Hongying Ni Zhongheng Zhang department of Emergency Medicine Sir Run Run Shaw HospitalZhejiang University School of MedicineHangzhou 310016China department of Emergency Medicine Huzhou Central HospitalHuzhou 313000China department of critical Care Medicine Affiliated Jinhua HospitalZhejiang University School of MedicineJinhua 321000China

Objective:Some patients exhibit septic symptoms following laparoscopic surgery,leading to a poor *** clinical subphenotyping is critical for guiding tailored therapeutic strategies in these *** identifying predisposing factors for postoperative sepsis,clinicians can implement targeted interventions,potentially improving *** study outlines a workflow for the subphenotype methodology in the context of laparoscopic surgery,along with its practical ***:This study utilized data routinely available in clinical case systems,enhancing the applicability of our *** data included vital signs,such as respiratory rate,and laboratory measures,such as blood sodium *** process of categorizing clinical routine data involved technical complexities.A correlation heatmap was used to visually depict the relationships between *** points were used to identify the clustering structure and combined with Consensus K clustering methods to determine the optimal ***:Our study highlighted the intricacies of identifying clinical subphenotypes following laparoscopic surgery,and could thus serve as a valuable resource for clinicians and researchers seeking to explore disease heterogeneity in clinical *** simplifying complex methodologies,we aimed to bridge the gap between technical expertise and clinical application,fostering an environment where professional medical knowledge is effectively utilized in subphenotyping ***:This tutorial could primarily serve as a guide for beginners.A variety of clustering approaches were explored,and each step in the process contributed to a comprehensive understanding of clinical subphenotypes.

关键词： Laparoscopic surgery Phenotype Precision medicine sepsis

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Malvidin Mitigates sepsis-induced Cardiac Injury by Modulating the TLR4-iNOS-COX-2 Inflammatory Pathway and the Bax/Bcl-2/Cyto-C Mitochondrial Apoptosis Pathway in a p38 MAPK-dependent Manner

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Biomedical and Environmental Sciences 2024年第2期37卷 221-227页

作者： ZHANG Wei YUAN Si Long QIANG Jing Chao HUANG He LI Da SUN Ying ZHANG Hong Gang department of Vascular surgery The First People’s Hospital of LianyungangLianyungang 222005JiangsuChina Jiangsu Key Laboratory of Marine Pharmaceutical Compound Screening College of PharmacyJiangsu Ocean UniversityLianyungang 222005JiangsuChina Jinzhou Medical University postgraduate training base(Lianyungang First People’s Hospital) Lianyungang 222005JiangsuChina

In critical care medicine,sepsis is a dangerous systemic condition that is highly prevalent and is associated with high morbidity and mortality rates^([1]).The high mortality rate associated with sepsis is closely related to multi-organ dysfunction,with heart injury being particularly critical and considered the starting point of multi-organ injury^([2]).

关键词： mortality Apoptosis TLR4

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Expert consensus on the monitoring and treatment of sepsis-induced immunosuppression

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Military Medical research 2023年第3期10卷 281-298页

作者： Fei Pei Ren‑Qi Yao Chao Ren Soheyl Bahrami Timothy RBilliar Irshad HChaudry De‑Chang Chen Xu‑Lin Chen Na Cui Xiang‑Ming Fang Yan Kang Wei‑Qin Li Wen‑Xiong Li Hua‑Ping Liang Hong‑Yuan Lin Ke‑Xuan Liu Ben Lu Zhong‑Qiu Lu Marc Maegele Tian‑Qing Peng You Shang Lei Su Bing‑Wei Sun Chang‑Song Wang Jian Wang Jiang‑Huai Wang Ping Wang Jian‑Feng Xie Li‑Xin Xie Li‑Na Zhang Basilia Zingarelli Xiang‑Dong Guan Jian‑Feng Wu Yong‑Ming Yao department of critical Care Medicine the First Affiliated Hospital of Sun Yat-Sen University58 Zhongshan Er RoadYuexiu DistrictGuangzhou 510080GuangdongChina Translational Medicine research center Medical Innovation Research Division and Fourth Medical Center of the Chinese PLA General Hospital28 Fuxing RoadHaidian DistrictBeijing 100853China department of Burn surgery the First Affiliated Hospital of Naval Medical UniversityShanghai 200433China Ludwig-Boltzmann Institute for Experimental and Clinical Traumatology 1200 ViennaAustria department of surgery University of Pittsburgh Medical CenterPittsburghPA 15213USA center for Surgical research and department of surgery University of Alabama at BirminghamBirminghamAL 35294USA department of critical Care Medicine Ruijin HospitalShanghai Jiaotong UniversityShanghai 200025China department of Burns the First Affiliated Hospital of Anhui Medical UniversityHefei 230022China department of critical Care Medicine Peking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijing 100730China department of Anesthesiology the First Affiliated HospitalZhejiang University School of MedicineHangzhou 31003China department of critical Care Medicine West China Hospital of Sichuan UniversityChengdu 610041China department of critical Care Medicine General Hospital of Eastern Theater Command of Chinese PLANanjing 210002China department of Surgical Intensive critical Unit Beijing Chao‑Yang HospitalCapital Medical UniversityBeijing 100020China State Key Laboratory of Trauma Burns and Combined InjuryResearch Institute of SurgeryDaping HospitalArmy Medical UniversityChongqing 400042China department of critical Care Medicine Fourth Medical Center of the Chinese PLA General HospitalBeijing 100048China department of Anesthesiology Nanfang HospitalSouthern Medical UniversityGuangzhou 510515China department of critical Care Medicine and Hematology the Third Xiangya HospitalCentral South UniversityChangs

Emerged evidence has indicated that immunosuppression is involved in the occurrence and development of *** provide clinical practice recommendations on the immune function in sepsis,an expert consensus focusing on the monitoring and treatment of sepsis-induced immunosuppression was *** related to the immune monitoring and treatment of sepsis were retrieved from PubMed,Web of Science,and Chinese National Knowledge Infrastructure to design items and expert opinions were collected through an online ***,the Delphi method was used to form consensus opinions,and RAND appropriateness method was developed to provide consistency evaluation and recommendation levels for consensus *** consensus achieved satisfactory results through two rounds of questionnaire survey,with 2 statements rated as perfect consistency,13 as very good consistency,and 9 as good *** summarizing the results,a total of 14 strong recommended opinions,8 weak recommended opinions and 2 non-recommended opinions were ***,a face-to-face discussion of the consensus opinions was performed through an online meeting,and all judges unanimously agreed on the content of this *** summary,this expert consensus provides a preliminary guidance for the monitoring and treatment of immunosuppression in patients with sepsis.

关键词： sepsis Immune function monitoring Immunomodulatory therapy Immunosuppression

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Potential roles of vitamin D binding protein in attenuating liver injury in sepsis

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Military Medical research 2022年第5期9卷 543-552页

作者： Kun Xiao Du-Chao Zhang Ye Hu Li-Cheng Song Jian-Qiao Xu Wan-Xue He Pan Pan Yu-Wei Wang Li-Xin Xie center of Pulmonary and critical Care Medicine Chinese People's Liberation Army(PLA)General HospitalNo.28Fuxing StreetHaidian DistrictBeijing 100853China department of Pulmonary and critical Care Medicine Beijing Shijitan HospitalBeijing 100071China Medical School of Chinese People's Liberation Army(PLA) Chinese PLA General HospitalBeijing 100853China department of Geriatric Comprehensive surgery the Second Medical Center and National Clinical Research Center for Geriatric DiseasesChinese PLA General HospitalNo.28Fuxing StreetHaidian DistrictBeijing 100853China

Background:In sepsis,vitamin D binding protein(VDBP)has been shown to be *** current study examined the relationship between serum VDBP level and liver injury in sepsis patients,as well as in a mouse model for sepsis and in cultured liver epithelial cell line exposed to lipopolysaccharide(LPS).Methods:The human study included 78 sepsis patients and 50 healthy *** patients were categorized into sepsis survivor group(n=43)and sepsis non-survivor group(n=35)based on 28-day mortality for data *** male C57BL/6 mice were subjected to cecal ligation and puncture(CLP).Serum samples were collected on day 1,3,5 and 7 to determine the levels of VDBP,25-hydroxyvitamin D[25(OH)D_(3)],1,25-dihydroxyvitamin D[1,25(OH)_(2)D_(3)],interleukin-6(IL-6)and tumor necrosis factor alpha(TNF-α).Potential protective effects of VDBP overexpression against LPS-induced liver damage were examined in cultured THLE2 ***:Serum levels of VDBP,25(OH)D_(3),and 1,25(OH)_(2)D_(3)were significantly lower in sepsis patients *** healthy control(Psepsis non-survivor group *** sepsis survivor group(Psepsis-induced liver injury.

关键词： Vitamin D binding protein sepsis Human Mouse Liver Injury c-Jun N-terminal kinase

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