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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

The blood lactate/serum albumin ratio might represent a good prognostic indicator of 28-day mortality in patients with acute respiratory distress syndrome:a retrospective observational study

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Emergency and critical care Medicine 2024年第2期4卷 52-59页

作者： Jiahao Chen Chang Gao Ling Yang Lijuan Yang Ying He Shiqi Guo Yuanxiao Sun Siyu He Qiang Guo Department of critical care Medicine The First Affiliated Hospital of Soochow UniversitySuzhouJiangsuChina Department of Emergency and critical care Medicine Dushu Lake Hospital Affiliated to Soochow University(Suzhou Dushu Lake Hospital)SuzhouJiangsuChina

Background:Acute respiratory distress syndrome(ARDS)is an acute inflammatory lung injury with a high mortality ***,previous ARDS prognostic scoring systems or predictors have been limited by complex formulas that are relatively expensive and inconvenient to ***,this study aimed to explore the clinical significance of the blood lactate/serum albumin ratio(LAR)in assessing the prognosis of ARDS patients and compare it with other indicators related to 28-day mortality in ARDS ***:We conducted a single-center retrospective study involving patients who fulfilled the Berlin definition of ARDS between 2016 and *** data were collected from medical records within 24 hours after ARDS *** LAR,neutrophil-to-lymphocyte ratio,and monocyteto-lymphocyte ratio(MLR)were *** primary clinical outcome was 28-day *** risk factors for 28-day mortality were determined using conditional logistic regression *** receiver operating characteristic curve was used to evaluate the area under the curve(AUC).Results:A total of 276 ARDS patients met the inclusion criteria and were divided into surviving and nonsurviving groups according to 28-day *** were significant differences in the Acute Physiologic Assessment and Chronic Health Evaluation II scores,Sequential Organ Failure Assessment scores,MLRs,and LARs between the surviving and nonsurviving *** AUC for the LAR was 0.790(P<0.001),whereas the AUCs for the Acute Physiologic Assessment and Chronic Health Evaluation II score,Sequential Organ Failure Assessment score,neutrophil-to-lymphocyte ratio,and MLR were 0.584,0.599,0.524,and 0.587,*** grouping according to an LAR optimal cutoff value of 0.07,28-day mortality was significantly higher in the high-LAR group than in the low-LAR group(47.18 vs.12.69,P<0.001).Conclusion:The LAR is an independent risk factor for 28-day mortality in ARDS patients and can be used to assess the severity of

关键词： Acute respiratory distress syndrome Albumin Lactate Mortality Predictor

Postoperative delirium:A tragedy for elderly cancer patients

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World Journal of Gastrointestinal Oncology 2024年第9期16卷 3765-3770页

作者： Oguzhan Arun Funda Arun Department of anesthesiology and Reanimation Selcuk University Faculty of MedicineKonya 42130Türkiye Department of Pedodontics Division of AnesthesiologySelcuk University Faculty of DentistryKonya 42130Türkiye

In this editorial,we comment on the article by Hu et al entitled“Predictive modeling for postoperative delirium in elderly patients with abdominal malignancies using synthetic minority oversampling technique”.We wanted to draw attention to the general features of postoperative delirium(POD)as well as the areas where there are uncertainties and *** can be defined as acute neurocognitive dysfunction that occurs in the first week after *** is a severe postoperative complication,especially for elderly oncology *** the underlying pathophysiological mechanism is not fully understood,various neuroinflammatory mechanisms and neurotransmitters are thought to be *** assessment scales and diagnostic methods have been proposed for the early diagnosis of *** delirium is considered a preventable clinical entity in about half of the cases,various early prediction models developed with the support of machine learning have recently become a hot scientific ***,a model with high sensitivity and specificity for the prediction of POD has not yet been *** situation reveals that all health personnel who provide health care services to elderly patients should approach patients with a high level of awareness in the perioperative period regarding POD.

关键词： Delirium Anesthesia Neurocognitive dysfunction Postoperative cognitive dysfunction Prevention Risk management Synthetic minority oversampling technique Postoperative delirium Elderly patients Abdominal cancer

Association between Gene Polymorphisms and SNP-SNP Interactions of the Matrix Metalloproteinase 2 Signaling Pathway and the Risk of Vascular Senescence

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Biomedical and Environmental Sciences 2024年第2期37卷 146-156页

作者： LIAO Zhen Yu YANG Shuo HU Song LIU Jia MAO Yong Jun SUN Shu Qin Department of Geriatrics the Affiliated Hospital of Qingdao UniversityQingdao 266000ShandongChina Department of critical care Medicine the Affiliated Hospital of Qingdao UniversityQingdao 266000ShandongChina

Objective This study aimed to explore the association of single nucleotide polymorphisms(SNP)in the matrix metalloproteinase 2(MMP-2)signaling pathway and the risk of vascular senescence(VS).Methods In this cross-sectional study,between May and November 2022,peripheral venous blood of151 VS patients(case group)and 233 volunteers(control group)were *** SNPs were identified in five genes encoding the components of the MMP-2 signaling pathway,assessed through carotid-femoral pulse wave velocity(cf PWV),and analyzed using multivariate logistic *** multigene influence on the risk of VS was assessed using multifactor dimensionality reduction(MDR)and generalized multifactor dimensionality regression(GMDR)*** Within the multivariate logistic regression models,four SNPs were screened to have significant associations with VS:chemokine(C-C motif)ligand 2(CCL2)rs4586,MMP2 rs14070,MMP2rs7201,and MMP2 *** of the T/C genotype of MMP2 rs14070 had a 2.17-fold increased risk of developing VS compared with those of the C/C genotype,and those of the T/T genotype had a19.375-fold increased ***2 rs4586 and MMP-2 rs14070 exhibited the most significant *** CCL2 rs4586,MMP-2 rs14070,MMP-2 rs7201,and MMP-2 rs1053605 polymorphisms were significantly associated with the risk of VS.

关键词： Vascular senescence Pulse wave velocity(PWV) Single nucleotide polymorphism(SNP) Matrix metalloproteinase 2(MMP-2) Extracellular matrix(ECM) Structural degradation Multifactor dimensionality reduction(MDR)

Liver Characterization of a Cohort of Alpha-1 Antitrypsin Deficiency Patients with and without Lung Disease

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Journal of Clinical and Translational Hepatology 2024年第10期12卷 845-856页

作者： Naweed Mohammad Regina Oshins Tongjun Gu Virginia Clark Jorge Lascano Naziheh Assarzadegan George Marek Mark Brantly Nazli Khodayari division of Pulmonary Critical Care and Sleep MedicineCollege of MedicineUniversity of FloridaGainesvilleFLUSA Interdisciplinary Center for Biotechnology Research Bioinformatics CoreUniversity of FloridaGainesvilleFLUSA division of Gastroenterology Hepatology and NutritionCollege of MedicineUniversity of FloridaGainesvilleFLUSA division of Pathology Immunologyand Laboratory MedicineCollege of MedicineUniversity of FloridaGainesvilleFLUSA division of Gastroenterology and Hepatology Mayo ClinicRochesterMNUSA

Background and Aims:Alpha-1 antitrypsin deficiency(AATD)is a genetic disorder characterized by the misfolding and accumulation of the mutant variant of alpha-1 antitrypsin(AAT)within hepatocytes,which limits its access to the circulation and exposes the lungs to protease-mediated tissue *** results in progressive liver disease secondary to AAT polymerization and accumulation,and chronic obstructive pulmonary disease(COPD)due to deficient levels of AAT within the *** goal was to characterize the unique effects of COPD secondary to AATD on liver disease and gene ***:A subcohort of AATD individuals with COPD(n=33)and AATD individuals without COPD(n=14)were evaluated in this study from our previously reported cross-sectional *** used immunohistochemistry to assess the AATD liver phenotype,and RNA sequencing to explore liver *** observed a distinct transcriptomic profile in liver tissues from AATD individuals with COPD compared to those ***:A total of 339 genes were differentially *** pathways related to fibrosis,extracellular matrix remodeling,collagen deposition,hepatocellular damage,and inflammation were significantly upregulated in the livers of AATD individuals with *** analysis also revealed higher levels of fibrosis and hepatocellular damage in these ***:Our data supports a relationship between the development of COPD and liver disease in AATD and introduces genes and pathways that may play a role in AATD liver disease when COPD is *** believe addressing lung impairment and airway inflammation may be an approach to managing AATD-related liver disease.

关键词： Alpha-1 antitrypsin deficiency Chronic obstructive pulmonary disease Liver fibrosis Liver biopsy Liver histology Transcriptomics

Effects of high-dose glucose-insulin-potassium on acute coronary syndrome patients receiving reperfusion therapy:a meta-analysis

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World Journal of Emergency Medicine 2024年第3期15卷 181-189页

作者： Zeyu Yang Huiruo Liu Dazhou Lu Shengchuan Cao Feng Xu Chuanbao Li Department of Emergency Medicine Qilu Hospital of Shandong UniversityJinan 250012China Shandong Provincial Clinical Research Center for Emergency and critical care Medicine Institute of Emergency and Critical Care Medicine of Shandong UniversityChest Pain CenterQilu Hospital of Shandong UniversityJinan 250012China Key Laboratory of Emergency and critical care Medicine of Shandong Province Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong ProvinceShandong Provincial Engineering Laboratory for Emergency and Critical Care MedicineQilu Hospital of Shandong UniversityJinan 250012China Shandong Key Laboratory:Magnetic Field-free Medicine&Functional Imaging(MF) Qilu Hospital of Shandong UniversityJinan 250012China National Medical Products Administration(NMPA)Key Laboratory for Clinical Research and Evaluation of Innovative Drug Qilu Hospital of Shandong UniversityJinan 250012China

BACKGROUND:This meta-analysis aimed to assess the efficacy of high-dose glucose-insulinpotassium(GIK) therapy on clinical outcomes in acute coronary syndrome(ACS) patients receiving reperfusion ***:We searched the PubMed,Web of Science,MEDLINE,Embase,and Cochrane Library databases from inception to April 26,2022,for randomized controlled trials(RCTs) that compared high-dose GIK and placebos in ACS patients receiving reperfusion *** primary endpoint was major adverse cardiovascular events(MACEs).RESULTS:Eleven RCTs with 884 patients were ultimately *** with placebos,high-dose GIK markedly reduced MACEs(risk ratio [RR] 0.57,95% confidence interval [95% CI]:0.35 to 0.94,P=0.03) and the risk of heart failure(RR 0.48,95% CI:0.25 to 0.95,P=0.04) and improved the left ventricular ejection fraction(LVEF)(mean difference [MD] 2.12,95% CI:0.40 to 3.92,P=0.02) at 6 ***,no difference was observed in all-cause mortality at 30 d or 1 ***,high-dose GIK was significantly associated with increased incidences of phlebitis(RR 4.78,95% CI:1.36 to 16.76,P=0.01),hyperglycemia(RR 9.06,95% CI:1.74 to 47.29,P=0.009) and hypoglycemia(RR 6.50,95% CI:1.28 to 33.01,P=0.02) but not reinfarction,hyperkalemia or secondary *** terms of oxidative stress-lowering function,high-dose GIK markedly reduced superoxide dismutase(SOD) activity but not glutathione peroxidase(GSH-Px) or catalase(CAT) ***:Patients with ACS receiving reperfusion therapy exhibited a reduction in MACEs and good oxidative stress-lowering eflcacy in response to high-dose ***,with a higher incidence of complications such as phlebitis,hyperglycemia,and ***,there were no observed survival benefits associated with high-dose *** trials with long-term follow-up are still needed.

关键词： Acute coronary syndrome High-dose Glucose-insulin-potassium treatment Reperfusion therapy Meta-analysis

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

Alectinib-Induced Immune Hemolytic Anemia in a Patient with Lung Adenocarcinoma: Case Report and Literature Review

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Case Reports in Clinical Medicine 2024年第8期13卷 321-327页

作者： Chai Young Lee Yon Ju Ryu division of Pulmonary and critical care Medicine College of Medicine Ewha Womans University Seoul Republic of Korea

Alectinib is a selective Anaplastic Lymphoma Kinase (ALK) tyrosine kinase inhibitor used as standard therapy for ALK-rearranged lung adenocarcinoma. Hemolytic anemia is considered a rare but significant adverse event of alectinib. Here, we report the case of a 78-year-old female with advanced ALK rearrangement-positive lung adenocarcinoma who developed grade 4 drug-induced hemolytic anemia after receiving alectinib as first-line therapy. We discontinued alectinib treatment and switched to brigatinib. As a result, anemia improved without recurrence of lung adenocarcinoma over one year.

关键词： Non-Small Cell Lung Cancer Alectinib Brigatinib Hemolytic Anemia Drug-Induced Hemolytic Anemia

Microvesicles derived from mesenchymal stem cells inhibit acute respiratory distress syndrome-related pulmonary fibrosis in mouse partly through hepatocyte growth factor

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World Journal of Stem Cells 2024年第8期16卷 811-823页

作者： Qi-Hong Chen Ying Zhang Xue Gu Peng-Lei Yang Jun Yuan Li-Na Yu Jian-Mei Chen Department of critical care Medicine Jiangdu People’s Hospital of YangzhouJiangdu People’s Hospital Affiliated to Yangzhou UniversityYangzhou 225200Jiangsu ProvinceChina Department of critical care Medicine Jiangdu People’s Hospital of YangzhouYangzhou 225200Jiangsu ProvinceChina Institute of Translational Medicine Medical CollegeYangzhou UniversityYangzhou 225000Jiangsu ProvinceChina

BACKGROUND Pulmonary fibrosis is one of the main reasons for the high mortality rate among acute respiratory distress syndrome(ARDS)*** stromal cell-derived microvesicles(MSC-MVs)have been shown to exert antifibrotic effects in lung *** To investigate the effects and mechanisms of MSC-MVs on pulmonary fibrosis in ARDS mouse *** MSC-MVs with low hepatocyte growth factor(HGF)expression(siHGF-MSC-MVs)were obtained via lentivirus transfection and used to establish the ARDS pulmonary fibrosis mouse *** intubation,respiratory mechanics-related indicators were measured via an experimental small animal lung function *** of MSC-MVs in lung tissues was investigated by near-infrared live ***,western blotting,ELISA and other methods were used to detect expression of pulmonary fibrosis-related proteins and to compare effects on pulmonary fibrosis and fibrosis-related *** The MSC-MVs gradually migrated and homed to damaged lung tissues in the ARDS model *** with MSC-MVs significantly reduced lung injury and pulmonary fibrosis ***,low expression of HGF(siHGF-MSC-MVs)significantly inhibited the effects of MSC-MVs(P<0.05).Compared with the ARDS pulmonary fibrosis group,the MSC-MVs group exhibited suppressed expression of type I collagen antigen,type III collagen antigen,and the proteins transforming growth factor-βandα-smooth muscle actin,whereas the siHGF-MVs group exhibited significantly increased expression of these *** addition,pulmonary compliance and the pressure of oxygen/oxygen inhalation ratio were significantly lower in the MSC-MVs group,and the effects of the MSC-MVs were significantly inhibited by low HGF expression(all P<0.05).CONCLUSION MSC-MVs improved lung ventilation functions and inhibited pulmonary fibrosis in ARDS mice partly via HGF mRNA transfer.

关键词： Microvesicles derived from mesenchymal stem cells Acute respiratory distress syndrome Pulmonary fibrosis Hepatocyte growth factor Mesenchymal stromal cells