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Research progress of viral sepsis:etiology,pathophysiology,diagnosis,and treatment

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Emergency and critical care medicine 2024年第2期4卷 74-81页

作者： Jianping Li Yiqi Luo Hao Li Yunhong Yin Yi Zhang department of pulmonary and critical care medicine Qilu Hospital of Shandong UniversityJinanShandongChina

Sepsis is a common systemic disease characterized by various physiological and pathological *** can result from infection by various pathogens,such as bacteria,viruses,and *** rate of culture-negative sepsis is almost 42%,indicating that most patients may have nonbacterial *** the outbreak of coronavirus disease 2019,viral sepsis has attracted growing attention because many critically ill patients develop *** sepsis can be caused by viral infections and combined with,or secondary to,bacterial *** the common types of viral sepsis and the main characteristics of its pathogenesis will be helpful for effective diagnosis and treatment,thereby reducing *** identification of the causative agent of viral sepsis can help reduce the overuse of broad-spectrum *** this article,we reviewed the common viruses of sepsis,their potential pathophysiology,targets of diagnosis,and remedies for viral sepsis.

关键词： Acute gastrointestinal injury Acute kidney injury Acute lung injury Cytokine storm Diagnosis Treatment of viral sepsis Viral sepsis

DNA of neutrophil extracellular traps promote NF-κBdependent autoimmunity via cGAS/TLR9 in chronic obstructive pulmonary disease

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Signal Transduction and Targeted Therapy 2024年第7期9卷 3040-3055页

作者： Jun Chen Tao Wang Xiaoou Li Lijuan Gao Ke Wang Mengxin Cheng Zijian Zeng Lei Chen Yongchun Shen Fuqiang Wen department of Respiratory and critical care medicine West China HospitalWest China School of Medicineand Division of Pulmonary DiseasesState Key Laboratory of BiotherapySichuan UniversityChengduSichuan 610041China

Chronic obstructive pulmonary disease(COPD)is characterised by persistent airway inflammation even after cigarette smoking *** extracellular traps(NETs)have been implicated in COPD severity and acute airway inflammation induced by short-term cigarette smoke(CS).However,whether and how NETs contribute to sustained airway inflammation in COPD remain *** study aimed to elucidate the immunoregulatory mechanism of NETs in COPD,employing human neutrophils,airway epithelial cells(AECs),dendritic cells(DCs),and a long-term CS-induced COPD mouse model,alongside cyclic guanosine monophosphate-adenosine monophosphate synthase and toll-like receptor 9 knockout mice(cGAS-^(−/−)TLR9^(−/−));Additionally,bronchoalveolar lavage fluid(BALF)of COPD patients was *** from COPD patients released greater cigarette smoke extract(CSE)-induced NETs(CSE-NETs)due to mitochondrial respiratory chain *** CSE-NETs,containing oxidatively-damaged DNA(NETs-DNA),promoted AECs proliferation,nuclear factor kappa B(NF-κB)activation,NF-κB-dependent cytokines and type-I interferons production,and DC maturation,which were ameliorated/reversed by silencing/inhibition of cGAS/*** the COPD mouse model,blocking NETs-DNA-sensing via cGAS^(−/−)and TLR9^(−/−)mice,inhibiting NETosis using mitoTEMPO,and degrading NETs-DNA with DNase-I,respectively,reduced NETs infiltrations,airway inflammation,NF-κB activation and NF-κBdependent cytokines,but not type-I interferons due to IFN-α/βreceptor *** NETs components(myeloperoxidase and neutrophil elastase activity)in BALF of COPD smokers correlated with disease severity and NF-κB-dependent cytokine levels,but not type-I interferon *** conclusion,NETs-DNA promotes NF-κB-dependent autoimmunity via cGAS/TLR9 in long-term CS exposure-induced ***,targeting NETs-DNA and cGAS/TLR9 emerges as a potential strategy to alleviate persistent airway inflammation in COPD.

关键词： inflammation TLR9 neutrophil

Malignant pleural mesothelioma:The disdained member of thoracic oncology!

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World Journal of Experimental medicine 2024年第3期14卷 1-10页

作者： Divya Khosla Pawan Kumar Singh Bharath A Chhabria Vaishali Kataria Navneet Singh Rakesh Kapoor department of Radiotherapy and Oncology Postgraduate Institute of Medical Education and ResearchChandigarh 160012India department of pulmonary and critical care medicine Pandit Bhagwat Dayal Sharma Postgraduate Institute of Medical SciencesRohtak 124001India department of pulmonary and critical care medicine Ramaiah Memorial HospitalBengaluru 560054India department of pulmonary medicine Postgraduate Institute of Medical Education and ResearchChandigarh 160012India

Pleural mesothelioma is a very aggressive malignancy that arises from the pleural mesothelial cell lining and is linked strongly to prior asbestos *** ban on asbestos has helped to lower the incidence,but in developing countries like India,it is expected to *** has an extended latency period usually progressing over decades and presents with nonspecific *** has a median survival ranging between 10-22 *** diagnosis of malignant pleural mesothelioma is challenging and is done using computed tomography(CT),magnetic resonance imaging,or positron emission tomography-CT,with the last two predicting the resectability of the tumor better than CT alone.A pleural biopsy along with an array of immunohistochemical markers,such as p16,BRCA1 associated protein 1,and claudin-4,are required for a definitive *** genetic alterations have prognostic significance as *** current histological subtype identification is indispensable for decision making because of the new therapeutic avenues being *** combination of nivolumab and ipilimumab-based immunotherapy outperformed platinum and pemetrexed-based chemotherapy in terms of survival benefit and improved quality of life especially for non-epithelioid ***,the latter continues to be a robust treatment option for patients with the epithelioid *** is recommended for resectable cases with radiotherapy being indicated in neoadjuvant,adjuvant,and palliative settings along with systemic *** review article provides an overview of epidemiology,etiology,clinical manifestations,diagnostic approaches(including immunohistochemical and genetic markers),staging,and multidisciplinary approaches to current treatment for malignant pleural mesothelioma using surgery,chemotherapy,immunotherapy,and *** also sheds light on some recent studies(EMPHACIS,CALGB30901,Checkmate-743,etc.)that have led to significant developments in recent years with clinically mean

关键词： Chemotherapy Diagnosis Immunotherapy Malignant pleural mesothelioma Radiotherapy

Fangji Fuling Decoction Alleviates Sepsis by Blocking MAPK14/FOXO3A Signaling Pathway

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Chinese Journal of Integrative medicine 2024年第3期30卷 230-242页

作者： WANG Yi CHEN Ming-qi DAI Lin-feng ZHANG Hai-dong WANG Xing department of critical care medicine Changzhou Hospital of Traditional of Chinese Medicine Affiliated to Nanjing University of Chinese MedicineChangzhouJiangsu Province213000China department of critical care medicine Jiangsu Province Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese MedicineNanjing210029China

Objective:To examine the therapeutic effect of Fangji Fuling Decoction(FFD) on sepsis through network pharmacological analysis combined with in vitro and in vivo ***:A sepsis mouse model was constructed through intraperitoneal injection of 20 mg/kg lipopolysaccharide(LPS).RAW264.7 cells were stimulated by 250 ng/m L LPS to establish an in vitro cell *** pharmacology analysis identified the key molecular pathway associated with FFD in *** ectopic expression and depletion experiments,the effect of FFD on multiple organ damage in septic mice,as well as on cell proliferation and apoptosis in relation to the mitogen-activated protein kinase 14/Forkhead Box O 3A(MAPK14/FOXO3A) signaling pathway,was ***:FFD reduced organ damage and inflammation in LPS-induced septic mice and suppressed LPS-induced macrophage apoptosis and inflammation in vitro(P<0.05).Network pharmacology analysis showed that FFD could regulate the MAPK14/FOXO signaling pathway during *** confirmed by in vitro cell experiments,FFD inhibited the MAPK14 signaling pathway or FOXO3A expression to relieve LPS-induced macrophage apoptosis and inflammation(P<0.05).Furthermore,FFD inhibited the MAPK14/FOXO3A signaling pathway to inhibit LPS-induced macrophage apoptosis in the lung tissue of septic mice(P<0.05).Conclusion:FFD could ameliorate the LPS-induced inflammatory response in septic mice by inhibiting the MAPK14/FOXO3A signaling pathway.

关键词： sepsis Fangji Fuling Decoction mitogen-activated protein kinase 14/Forkhead Box O 3A signaling pathway inflammatory response apoptosis lung injury Chinese medicine

Nasogastric tube syndrome:A Meta-summary of case reports

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World Journal of Clinical Cases 2024年第1期12卷 119-129页

作者： Deven Juneja Prashant Nasa Gunjan Chanchalani Ravi Jain department of critical care medicine Max Super Speciality HospitalNew Delhi 110017India department of critical care medicine NMC Specialty HospitalDubai 7832United Arab Emirates department of critical care medicine Karamshibhai Jethabhai Somaiya Hospital and Research CentreMumbai 400022India department of critical care medicine Mahatma Gandhi Medical College and HospitalJaipur 302022RajasthanIndia

BACKGROUND Since its description in 1790 by Hunter,the nasogastric tube(NGT)is commonly used in any healthcare setting for alleviating gastrointestinal symptoms or enteral ***,the risks associated with its placement are often *** airway obstruction with a NGT is an uncommon but potentially life-threatening *** syndrome is characterized by the presence of an NGT,throat pain and vocal cord(VC)paralysis,usually *** is poten-tially life–threatening,and early diagnosis is the key to the prevention of fatal upper airway ***,fewer cases may have been reported than might have occurred,primarily due to the clinicians'*** lack of specific signs and symptoms and the inability to prove temporal relation with NGT insertion has made diagnosing the syndrome quite *** To review and collate the data from the published case reports and case series to understand the possible risk factors,early warning signs and symptoms for timely detection to prevent the manifestation of the complete syndrome with life-threatening airway *** We conducted a systematic search for this meta-summary from the database of PubMed,EMBASE,Reference Citation Analysis(https://***/)and Google scholar,from all the past studies till August *** search terms included major MESH terms"Nasogastric tube","Intubation,Gastrointestinal","Vocal Cord Paralysis",and“Syndrome”.All the case reports and case series were evaluated,and the data were extracted for patient demographics,clinical symptomatology,diagnostic and therapeutic interventions,clinical course and outcomes.A datasheet for evaluation was further *** Twenty-seven cases,from five case series and 13 case reports,of NGT syndrome were retrieved from our *** was male predominance(17,62.96%),and age at presentation ranged from 28 to 86 *** patients had diabetes mellitus(37.04%),and nine were hyperte

关键词： Nasogastric tube Nasogastric tube syndrome Ryle’s tube Sofferman syndrome Vocal cord paralysis

Gastrointestinal manifestations of critical ill heatstroke patients and their associations with outcomes:A multicentre,retrospective,observational study

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World Journal of Gastroenterology 2024年第4期30卷 346-366页

作者： Yu-Cong Wang Xin-Yang Jin Zheng Lei Xiao-Jiao Liu Yu Liu Bang-Guo Zhang Jian Gong Lie-Tao Wang Lv-Yuan Shi Ding-Yuan Wan Xin Fu Lu-Ping Wang Ai-Jia Ma Yi-Song Cheng Jing Yang Min He Xiao-Dong Jin Yan Kang Bo Wang Zhong-Wei Zhang Qin Wu department of critical care medicine West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina School of Pharmacy Macao University of Science and TechnologyMacao 999078China department of critical care medicine The First People's Hospital of Ziyang CityZiyang 641399Sichuan ProvinceChina department of critical care medicine The First People's Hospital of Guanghan CityChengdu 618399Sichuan ProvinceChina department of critical care medicine Lezhi County Traditional Chinese Medicine HospitalChengdu 641599Sichuan ProvinceChina department of critical care medicine Chengdu Qingbaijiang District People's HospitalChengdu 610399Sichuan ProvinceChina department of critical care medicine Ziyang People's HospitalChengdu 641399Sichuan ProvinceChina

BACKGROUND Extreme heat exposure is a growing health problem,and the effects of heat on the gastrointestinal(GI)tract is *** study aimed to assess the incidence of GI symptoms associated with heatstroke and its impact on *** To assess the incidence of GI symptoms associated with heatstroke and its impact on *** Patients admitted to the intensive care unit(ICU)due to heatstroke were included from 83 *** history,laboratory results,and clinically relevant outcomes were recorded at ICU admission and daily until up to day 15,ICU discharge,or *** symptoms,including nausea/vomiting,diarrhoea,flatulence,and bloody stools,were *** characteristics of patients with heatstroke concomitant with GI symptoms were *** regression analyses were performed to determine significant predictors of GI *** A total of 713 patients were included in the final analysis,of whom 132(18.5%)patients had at least one GI symptom during their ICU stay,while 26(3.6%)suffered from more than one *** with GI symptoms had a significantly higher ICU stay compared with those *** mortality of patients who had two or more GI symptoms simultaneously was significantly higher than that in those with one GI *** logistic regression analysis revealed that older patients with a lower GCS score on admission were more likely to experience GI *** The GI manifestations of heatstroke are common and appear to impact clinically relevant hospitalization outcomes.

关键词： Extreme heat Flatulence Sunstroke Intensive care units Diarrhea

Bibliometric study of sepsis-associated liver injury from 2000 to 2023

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World Journal of Gastroenterology 2024年第30期30卷 3609-3624页

作者： Zheng Zhang Xiao-Jiao Tan Hai-Qing Shi Huan Zhang Jian-Bo Li Xue-Lian Liao department of critical care medicine West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina department of critical care medicine West China Tianfu Hospital of Sichuan UniversityChengdu 610200Sichuan ProvinceChina

BACKGROUND Sepsis-associated liver injury(SLI)is a severe and prevalent complication of *** To explore the literature on SLI via a bibliometric *** Reviews and articles correlated with SLI published from January 1,2000 to October 28,2023 were searched from the Web of Science Core ***,the searched data were analyzed using VOSviewer,CiteSpace,and R *** There were 787 publications involved in this paper,comprising 745 articles and 42 ***,the United States,and Germany are the primary publication sources in this *** related to SLI primarily focused on mechanisms of pathogenesis,as evidenced by analyzing keywords,references,and the counting of original *** studies mainly involved tumor necrosis factor alpha,inflammation,oxidative stress,and nuclear factor-kappa *** There is significant growth in the research on *** investigations primarily involve basic experiments that aimed at uncovering pathogenic *** to the analyzed literature,the identified pathogenic mechanisms and potential therapeutic targets serve as the foundation for translating findings from basic research to clinical applications.

关键词： Sepsis Liver injury Bibliometric analysis Cite space VOS viewer

Bronchoalveolar lavage fluid metagenomic next-generation sequencing assay for identifying pathogens in lung cancer patients

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BIOCELL 2024年第4期48卷 623-637页

作者： JIYU WANG HUIXIA LI DEYUAN ZHOU LIHONG BAI KEJING TANG Division of pulmonary and critical care medicine The First Affiliated HospitalSun Yat-sen UniversityGuangzhouChina Institute of pulmonary Diseases Sun Yat-sen UniversityGuangzhouChina department of Pharmacy The First Affiliated HospitalSun Yat-sen UniversityGuangzhouChina

Background:For patients with lung cancer,timely identiﬁcation of new lung lesions as infectious or non-infectious,and accurate identiﬁcation of pathogens is very important in improving OS of *** a new auxiliary examination,metagenomic next-generation sequencing(mNGS)is believed to be more accurate in diagnosing infectious diseases in patients without underlying diseases,compared with conventional microbial tests(CMTs).We designed this study toﬁnd out whether mNGS has better performance in distinguishing infectious and non-infectious diseases in lung cancer patients using bronchoalveolar lavageﬂuid(BALF).Materials and Methods:This study was a real-world retrospective review based on electronic medical records of lung cancer patients with bronchoalveolar lavage(BAL)and BALF commercial mNGS testing as part of clinical care from 1 April 2019 through 30 April 2022 at The First Afﬁliated Hospital of Sun Yat-sen University.164 patients were included in this *** were categorized into the pulmonary non-infectious disease(PNID)group(n=64)and the pulmonary infectious disease(PID)group(n=100)groups based onﬁnal ***:BALF mNGS increased the sensitivity rate by 60%compared to CMTs(81%vs.21%,p0.1).Among the patients with PID,bacteria were the most common cause of *** infections occurred in 32%of patients,and Pneumocystis Yersini was most *** with Tyrosine kinase inhibitors(TKIs)therapy possess longer overall survival(OS)than other anti-cancer agents,the difference between TKIs and immuno-checkpoint inhibitors(ICIs)was insigniﬁcant(median OS TKIs *** ***-angiogenic *** ***=76 vs.84 vs.61 vs.58 vs.60).Conclusions:our study indicates that BALF mNGS can add value by improving overall sensitivity in lung cancer patients with potential pulmonary infection,and was outstanding in identifying Pneumocystis *** could be able

关键词： Lung cancer Bronchoalveolar lavage fluid Metagenomic next-generation sequencing Infectious diseases

Early systemic anticoagulation reduces hospital readmission in acute necrotizing pancreatitis patients:A retrospective cohort study

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Hepatobiliary & Pancreatic Diseases International 2024年第1期23卷 77-82页

作者： Wen-Jian Mao Jing Zhou Guo-Fu Zhang Fa-Xi Chen Jing-Zhu Zhang Bai-Qiang Li Lu Ke Wei-Qin Li department of critical care medicine Jinling HospitalNanjing Medical UniversityNanjing 210002China department of critical care medicine Jinling HospitalMedical School of Nanjing UniversityNanjing 210002China National Institute of Healthcare Data Science Nanjing UniversityNanjing 210010China

Background:Early systemic anticoagulation(SAC)is a common practice in acute necrotizing pancreatitis(ANP),and its impact on in-hospital clinical outcomes had been ***,whether it affects long-term outcomes is *** study aimed to evaluate the effect of SAC on 90-day readmission and other long-term outcomes in ANP ***:During January 2013 and December 2018,ANP patients admitted within 7 days from the onset of abdominal pain were *** primary outcome was 90-day readmission after *** proportional-hazards regression model and mediation analysis were used to define the relationship between early SAC and 90-day ***:A total of 241 ANP patients were enrolled,of whom 143 received early SAC during their hospitalization and 98 did *** who received early SAC experienced a lower incidence of splanchnic venous thrombosis(SVT)[risk ratio(RR)=0.40,95%CI:0.26-0.60,P<0.01]and lower 90-day readmission with an RR of 0.61(95%CI:0.41-0.91,P=0.02)than those who did *** the quality of life,patients who received early SAC had a significantly higher score in the subscale of vitality(P=0.03)while the other subscales were all comparable between the two *** Cox regression model showed that early SAC was an independent protective factor for 90-day readmission after adjusting for potential confounders with a hazard ratio of 0.57(95%CI:0.34-0.96,P=0.04).Mediation analysis showed that SVT mediated 37.0%of the early SAC-90-day readmission ***:The application of early SAC may reduce the risk of 90-day readmission in the survivors of ANP patients,and reduced SVT incidence might be the primary contributor.

关键词： Anticoagulation Splanchnic venous thrombosis Acute necrotizing pancreatitis Readmission Long-term outcomes