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Tissue-resident macrophages exacerbate lung injury after remote sterile damage

Cellular & Molecular Immunology 2024年第4期21卷 332-348页

作者： Hanhui Zhong Jingjing Ji Jinling Zhuang Ziying Xiong Pengyun Xie Xiaolei Liu Jundi Zheng Wangli Tian Xiaoyang Hong Jing Tang The Department of Anesthesiology Affiliated Hospital of Guangdong Medical UniversityZhanjiangGuangdongChina The Department of Critical care Medicine General Hospital of Southern Theater Command of PLAGuangzhouChina The Department of Respiratory Medicine Guangdong Provincial Hospital of Integrated Chinese and Western MedicineFoshanChina Pediatric intensive care Unit Senior Department of Pediatricsthe Seventh Medical Center of PLA General HospitalBeijingChina

Remote organ injury,which is a common secondary complication of sterile tissue damage,is a major cause of poor prognosis and is difficult to ***,we report the critical role of tissue-resident macrophages in lung injury after trauma or stroke through the inflammatory *** found that depleting tissue-resident macrophages rather than disrupting the recruitment of monocyte-derived macrophages attenuated lung injury after trauma or *** findings revealed that the release of circulating alarmins from sites of distant sterile tissue damage triggered an inflammatory response in lung-resident macrophages by binding to receptor for advanced glycation end products(RAGE)on the membrane,which activated epidermal growth factor receptor(EGFR).Mechanistically,ligand-activated RAGE triggered EGFR activation through an interaction,leading to Rab5-mediated RAGE internalization and EGFR phosphorylation,which subsequently recruited and activated P38;this,in turn,promoted RAGE translation and trafficking to the plasma membrane to increase the cellular response to RAGE ligands,consequently exacerbating *** study also showed that the loss of RAGE or EGFR expression by adoptive transfer of macrophages,blocking the function of RAGE with a neutralizing antibody,or pharmacological inhibition of EGFR activation in macrophages could protect against trauma-or stroke-induced remote lung ***,our study revealed that targeting the RAGE-EGFR signaling pathway in tissue-resident macrophages is a potential therapeutic approach for treating secondary complications of sterile damage.

关键词： tissue-resident macrophage RAGE remote sterile damage

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Severe acute respiratory syndrome coronavirus-2-related and imputable deaths in children:results from the French pediatric national registry

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World Journal of Pediatrics 2024年第6期20卷 611-620页

作者： Marguerite Lockhart-Bouron Noemie Vanel Michael Levy Anais R.Briant Etienne Javouhey Sophie Breinig Julia Dina Marion Caseris Francois Angoulvant Stephane Leteurtre Morgan Recher David W.Brossier Univ.Lille CHU LilleULR 2694-METRICS:Evaluation Des Technologies de Sante Et Des Pratiques Medicales59000LilleFrance Pediatric intensive care Unit CHU de MarseilleMarseilleFrance Pediatric intensive care Unit CHU Robert-DebreAssistance Publique Hopitaux de ParisParisFrance UniversitéParis-Cite ParisFrance Biostatistics and Clinical Research Unit CHU de Caen Normandie14000CaenFrance Pediatric intensive care Hospices Civils de LyonLyonFrance Neonatal andPediatric intensivecare Unit Children's HospitalToulouseFrance Virology Department INSERM U1311 DynamicureUniv CAEN NormandieCHU de Caen14000 CaenFrance Medical School Universite Caen Normandie14000 CaenFrance Department of Pediatrics CHU Robert-DebréAssistance Publique Hopitaux de ParisParisFrance Department Women-Mother-Child Service of PediatricsLausanne University Hospital(CHUV)LausanneSwitzerland Pediatric intensive care Unit Réanimation Et Soins Intensifs PéediatriquesCHU de CAENAvenue de La Cote de Nacre14000 CaenFrance CHU Sainte Justine Research Center MontréalCanada

Background Severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)is responsible for an important mortality rate *** aimed to evaluate the actual imputability of SARS-CoV-2 on the mortality rate associated with SARS-CoV-2-related illnesses in the pediatric intensive care unit(PICU).Secondary objectives were to identify risk factors for *** This national multicenter comparative study comprised all patients under 18 years old with positive SARS-CoV-2 polymerase chain reactions(PCRs)[acute corona virus disease 2019(COVID-19)or incidental SARS-CoV-2 infection]and/or pediatric inflammatory multisystem syndrome(PIMS)recorded in the French PICU registry(PICURe)between September 1,2021,and August 31,*** patients were classified and compared according to their living status at the end of their PICU *** patients were evaluated by four experts in the field of pediatric infectiology and/or pediatric intensive *** imputability of SARS-CoV-2 as the cause of death was classified into four categories:certain,very probable,possible,or unlikely,and was defined by any of the first three *** There were 948 patients included of which 43 died(4.5%).From this,26 deaths(67%)could be attributed to SARS-CoV-2 infection,with an overall mortality rate of 2.8%.The imputability of death to SARS-CoV-2 was considered certain in only one case(O.1%).Deceased patients suffered more often from comorbidities,especially heart disease,neurological disorders,hematological disease,cancer,and *** of the deceased patients were admitted for pediatric inflam-matory multisystem syndrome(PIMS).Mortality risk factors were male gender,cardiac comorbidities,cancer,and acute respiratorydistress *** SARS-CoV-2 mortality in the French pediatric population was *** though the imputability of SARS-Cov-2 on mortality was considered in almost two-thirds of cases,this imputability was considered certain in only one case.

关键词： Death Pediatric intensive care unit SARS-CoV-2

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Safety and effectiveness of neuromuscular electrical stimulation in cardiac surgery:A systematic review

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World Journal of Cardiology 2024年第1期16卷 27-39页

作者： Christos Kourek Marios Kanellopoulos Vasiliki Raidou Michalis Antonopoulos Eleftherios Karatzanos Irini Patsaki Stavros Dimopoulos Medical School of Athens National and Kapodistrian University of AthensAthens 15772Greece Clinical Ergospirometry Exercise and Rehabilitation LaboratoryEvangelismos HospitalAthens 10676Greece intensive care Unit Onassis Cardiac Surgery CenterKallithea 17674Greece Department of Physiotherapy University of West AtticaAthens 12243Greece

BACKGROUND Lack of mobilization and prolonged stay in the intensive care unit(ICU)are major factors resulting in the development of ICU-acquired muscle weakness(ICUAW).ICUAW is a type of skeletal muscle dysfunction and a common complication of patients after cardiac surgery,and may be a risk factor for prolonged duration of mechanical ventilation,associated with a higher risk of readmission and higher *** mobilization in the ICU after cardiac surgery has been found to be low with a significant trend to increase over ICU stay and is also associated with a reduced duration of mechanical ventilation and ICU length of *** electrical stimulation(NMES)is an alternative modality of exercise in patients with muscle weakness.A major advantage of NMES is that it can be applied even in sedated patients in the ICU,a fact that might enhance early mobilization in these *** To evaluate safety,feasibility and effectiveness of NMES on functional capacity and muscle strength in patients before and after cardiac *** We performed a search on Pubmed,Physiotherapy Evidence Database(PEDro),Embase and CINAHL databases,selecting papers published between December 2012 and April 2023 and identified published randomized controlled trials(RCTs)that included implementation of NMES in patients before after cardiac *** were assessed for methodological rigor and risk of bias via the *** primary outcomes were safety and functional capacity and the secondary outcomes were muscle strength and *** Ten studies were included in our systematic review,resulting in 703 *** half of them performed NMES and the other half were included in the control group,treated with usual *** studies investigated patients after cardiac surgery and 1 study before cardiac *** capacity was assessed in 8 studies via 6MWT or other indices,and improved only in 1 study before and in 1 after cardiac *** studies

关键词： Neuromuscular electrical stimulation Cardiac surgery coronary artery bypass grafting Heart valve replacement Peak VO2 Safety

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A Bibliometric Study on The Application of Progressive Muscle Relaxation Training in The Nursing Field in China

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Journal of Clinical and Nursing Research 2024年第4期8卷 14-21页

作者： Chengwen Shi Feifan Zhao Yingshuo Wang Chengxuan Liu Aiyu Mao Siqi Ji Ruixiao Lu Surgical intensive care Unit Peking University People’s HospitalBeijing 100000China

Objective:To systematically analyze the research status and application of progressive muscle relaxation training(PMRT)in the nursing field in China,and provide a reference basis for scientific research in this ***:The bibliometric method was adopted in“progressive muscle relaxation training”or“PMRT,”and“nursing.”The established database was included in the China national Knowledge Infrastructure(CNKI)and the Wanfang Medical *** relevant articles in the Chinese Science and Technology Periodical Database(VIP)were ***:A total of 169 literatures were *** journals,years,and regions of literature publication were uneven,mainly originating from the eastern region(43.19%),and listed the application of progressive muscle relaxation training in the field of nursing in *** literature information was mainly dominated by experimental studies(97%).Conclusion:The related research and application of progressive muscle relaxation training in nursing in China is increasing,but there is a lack of objective evaluation of outcome indicators and a short intervention *** research should be conducted in the future to effectively guide the development of PMRT in the field of nursing in China.

关键词： Progressive muscle relaxation training Nursing practice Bibliometrics

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Tumor budding is a meaningful prognostic marker in patients with hepatocellular carcinoma after curative hepatectomy

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Portal Hypertension & Cirrhosis 2024年第2期3卷 86-95页

作者： Kaibo Yang Kunjin Wu Zitong Lei Tong Liu Xing Zhang Jing Li Kun Yang Qiuting Peng Ting Lin Chang Liu Kai Qu Department of Hepatobiliary Surgery and Liver Transplantation The Second Affiliated Hospital of Xi'an Jiaotong UniversityXi'anShaanxiChina Key Laboratory of Surgical Critical care and Life Support(Xi'an Jiaotong University) Ministry of EducationXi'anShaanxiChina Department of Critical care Nephrology and Blood Purification The First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anShaanxiChina Hangzhou Institute of national Extremelyweak Magnetic Field Infrastructure HangzhouZhejiangChina Department of Surgical intensive care Units The First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anShaanxiChina

Aim:Tumor budding(TB)has excellent prognostic value in many solid tumors,but there is little research on it in hepatocellular carcinoma(HCC).This study assessed the prognostic value of TB in patients with HCC who received ***:This retrospective study included 210 patients with HCC who received curative hepatectomy at the First Affiliated Hospital of Xi'an Jiaotong University,between 2016 and *** was evaluated on hematoxylin-and eosin-stained slides according to the criteria established by the 2016 International Tumor Budding Consensus Conference.t-tests,Chi-squared tests,and rank-sum tests were used to correlate the extent of TB with clinicopathological *** analysis was performed using Cox regression models and the Kaplan–Meier ***:The positive detection rate of TB was 45.2%(95/210)in 210 patients with *** positive for TB always exhibit lower tumor differentiation,higher hepatitis B virus DNA levels,and more severe liver *** Cox analysis identified TB(hazard ratio[HR]:2.232,95%confidence interval[CI]:1.479–3.368,p<0.001)as an independent prognostic factor for patients'recurrence-free survival(RFS),similar to tumor size(HR:1.070,95%CI:1.070–1.142,p=0.042)and satellite nodule(HR:2.266,95%CI:1.298–3.956,p=0.004).Kaplan–Meier analysis also demonstrated that TB-positive patients had a significantly worse ***,subgroup analysis revealed that among HCC patients with negative microvascular invasion(MVI),TB was also strongly associated with RFS(HR:3.206,95%CI:1.667–6.168,p<0.001).These findings suggest that TB may serve as a supplemental prognostic biomarker for HCC-negative ***:TB is an adverse prognostic biomarker for HCC,particularly in patients negative for *** evaluation should be considered in the postoperative pathological examination of HCC in clinical practice.

关键词： hepatocellular carcinoma microvascular invasion prognosis tumor budding

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Natural long-chain saturated fatty acids doped LNPs enabling spleen selective mRNA translation and potent cancer immunotherapy

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Nano Research 2024年第3期17卷 1804-1817页

作者： Fazhan Wang Meng Zhang Meiling Tian Jia Lou Longze Pan Xiaoke Gao Lijing Zhang Xiaohan Lou Linyu Zhu Yuqiao Sheng Ming Wang Rui Xue Wenjing Deng Shuai Shao Zhihai Qin Medical Research Center The First Affiliated Hospital of Zhengzhou UniversityZhengzhou UniversityZhengzhou 450052China Translational Medical Center The First Affiliated Hospital of Zhengzhou UniversityZhengzhou UniversityZhengzhou 450052China Department of Neuro-intensive care Unit The First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450052China Academy of Medical Sciences Zhengzhou UniversityZhengzhou 450052China

Rationally tailored lipid nanoparticles(LNPs)with efficient and tunable delivery of mRNA in vivo are crucial for mRNA *** expression of antigenic protein in lymphoid tissues/organs could improve the immunostimulatory efficacy and safety of LNPs-based mRNA *** by the metabolic behavior that long-chain saturated fatty acids tending to enter lymphoid tissue rather than the liver,we developed fatty acid-doped LNPs capable of mediating differential protein expressions in the liver and spleen when administered *** the molar ratio of saturated fatty acid located 60%–70%,the doped LNPs achieved the spleen selective mRNA *** mechanism could be attributed to the different cellular uptake behaviors of saturated fatty acids in *** with a model antigen(ovalbumin)mRNA-loaded spleen selective LNPs,we observed enhanced antigen-specific T cell immune responses,and potent immunotherapeutic and immunoprophylactic efficacy in the mouse lymphoma *** natural long-chain saturated fatty acids metabolic characteristics-inspired design of LNPs for spleen-selective mRNA vaccines delivery will provide references for designing mRNA vaccines with high efficacy and safety for tumor immunotherapy.

关键词： mRNA vaccine lipid nanoparticles spleen long-chain saturated fatty acid cancer immunotherapy

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Porta Hepatis Tuberculous Lymphadenopathy: Clinical and Imaging Features of 10 Cases

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Infectious Microbes & Diseases 2024年第1期6卷 29-35页

作者： Wenjuan Hu Ming Hu Jiafeng Xia Shengyue Chen Xiaomeng Li Chengmin Sheng Wanru Guo Xuewen Feng Yanwan Shangguan Bin Lu Yunzhen Shi Junke Qiu Kaijin Xu State Key Laboratory for Diagnosis and Treatment of Infectious Diseases National Clinical Research Center for Infectious DiseasesCollaborative Innovation Center for Diagnosis and Treatment of Infectious DiseasesThe First Affiliated HospitalZhejiang University School of MedicineHangzhouChina Department of Cardiology the Second Affiliated Hospital of Dalian Medical UniversityDalianChina Department of Infectious Diseases Affiliated Dongyang Hospital of Wenzhou Medical UniversityDongyangChina Department of Tuberculosis intensive care Unit Hangzhou Red Cross HospitalHangzhouChina

Porta hepatis tuberculous lymphadenopathy(TL)is rare,and the clinical and imaging manifestations often mimic *** offer a bet-ter understanding of porta hepatis TL and thus improve its diagnosis and treatment,here,we retrospectively reviewed and analyzed 10 porta hepatis TL cases between May 2017 and November *** this study,porta hepatis TL occurred predominantly in women(70%),with a mean age of 43.1 years(range,16-70 years).Among the patients,60%were initially suspected of malignancy(metastatic lymphadenopathy and lymphoma).The clinical manifestations were nonspecific,such as fever and weight loss,without overt abdominal *** patients showed high concentrations of serum C-reactive protein,erythrocyte sedimentation rate,alkaline phosphatase,γ-glutamyl transpeptidase and carbohydrate antigen *** rim-like enhancement was a characteristic finding on contrast-enhanced CT for all the *** examination confirmed the diagnosis in 90%of patients with caseous granulo-matous inflammation and positive results of Xpert MTB/RIF,quantitative real-time PCR and/or metagenomic next-generation sequenc-ing *** patients underwent antituberculosis therapy with a median treatment duration of 13.5 months(range,1-43 months).They all showed satisfactory therapeutic responses with improved symptoms and resolution on imaging after *** examination by biopsy remains the primary diagnostic method.A combination of the characteristic epidemiologic,clinical,imaging fea-tures and lesion biopsy for histopathology are essential for the diagnosis and treatment of TL.

关键词： porta hepatis tuberculous lymphadenopathy misdiagnosis tumor mimicking

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Cerebral autoregulation-directed optimal blood pressure management reduced the risk of delirium in patients with septic shock

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Journal of intensive Medicine 2024年第3期4卷 376-383页

作者： Qianyi Peng Xia Liu Meilin Ai Li Huang Li Li Wei Liu Chunguang Zhao Chenghuan Hu Lina Zhang Department of Critical care Medicine Xiangya HospitalCentral South UniversityChangshaHunanChina Hunan Provincial Clinical Research Center for Critical care Medicine Xiangya HospitalCentral South UniversityChangshaHunanChina national Clinical Research Center for Geriatric Disorders Xiangya HospitalCentral South UniversityChangshaHunanChina

Background When resuscitating patients with septic shock,cerebrovascular reactivity parameters are calculated by monitoring regional cerebral oxygen saturation(rSO_(2))using near-infrared spectroscopy to determine the optimal blood ***,we aimed to analyze the impact of cerebral autoregulation-directed optimal blood pressure management on the incidence of delirium and the prognosis of patients with septic *** This prospective randomized controlled clinical study was conducted in the Xiangya Hospital of Central South University,***-one patients with septic shock(December 2020–May 2022)were enrolled and randomly allocated to the experimental(n=26)or control group(n=25).Using the ICM+software,we monitored the dynamic changes in rSO_(2) and mean arterial pressure(MAP)and calculated the cerebrovascular reactivity parameter tissue oxygen reactivity index to determine the optimal blood pressure to maintain normal cerebral autoregulation function during resuscitation in the experimental *** control group was treated according to the Surviving Sepsis Campaign *** in the incidence of delirium and 28-day mortality between the two groups were compared,and the risk factors were *** The 51 patients,including 39 male and 12 female,had a mean age of(57.0±14.9)*** incidence of delirium was 40.1%(23/51),and the 28-day mortality rate was 29.4%(15/51).The mean MAP during the first 24 h of intensive care unit(ICU)admission was higher([84.5±12.2]mmHg vs.[77.4±11.8]mmHg,P=0.040),and the incidence of delirium was lower(30.8%vs.60.0%,P=0.036)in the experimental group than in the control *** use of cerebral autoregulation-directed optimal blood pressure(odds ratio[OR]=0.090,95%confidence interval[CI]:0.009 to 0.923,P=0.043)and length of ICU stay(OR=1.473,95%CI:1.093 to 1.985,P=0.011)were risk factors for delirium during septic *** drug dose(OR=8.445,95%CI:1.26 to 56.576,P=0.028)and partial pressure of o

关键词： Septic shock Cerebral regional oxygen saturation Optimal blood pressure Delirium Mortality

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Impact of next-generation sequencing on antimicrobial treatment in immunocompromised adults with suspected infections

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World Journal of Emergency Medicine 2024年第2期15卷 105-110页

作者： Jia Li Jiazhen Luo Tao Hu Ling Cheng Weiwei Shang Li Yan Department of intensive care Unit Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China Department of Emergency Medicine Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China Tongji Medical College Huazhong University of Science and TechnologyWuhan 430030China Department of Geriatrics Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China

BACKGROUND:Prompt pathogen identification can have a substantial impact on the optimization of antimicrobial *** objective of the study was to assess the diagnostic value of next-generation sequencing(NGS)for identifying pathogen and its clinical impact on antimicrobial intervention in immunocompromised patients with suspected ***:This was a retrospective *** January and August 2020,47 adult immunocompromised patients underwent NGS testing under the following clinical conditions:1)prolonged fever and negative conventional cultures;2)new-onset fever despite empiric antimicrobial treatment;and 3)afebrile with suspected infections on *** data,including conventional microbial test results and antimicrobial treatment before and after NGS,were *** were analyzed according to documented changes in antimicrobial treatment(escalated,no change,or deescalated)after the NGS ***:The median time from hospitalization to NGS sampling was 19 *** relevant pathogens were detected via NGS in 61.7% of patients(29/47),more than half of whom suffered from fungemia(n=17),resulting in an antimicrobial escalation in 53.2% of patients(25/47)and antimicrobial de-escalation in 0.2% of patients(1/47).Antimicrobial changes were mostly due to the identification of fastidious organisms such as Legionella,Pneumocystis jirovecii,and *** the remaining three cases,NGS detected clinically relevant pathogens also detected by conventional cultures a few days *** antimicrobial treatment was subsequently adjusted according to the susceptibility test ***,NGS changed antimicrobial management in 55.3%(26/47)of patients,and conventional culture detected clinically relevant pathogens in 14.9% of the patients(7/47).CONCLUSION:With its rapid identification and high sensitivity,NGS could be a promising tool for identifying relevant pathogens and enabling rapid appropriate treatment in immunocompromised patients w

关键词： Immunocompromised patients Next-generation sequencing Antimicrobial management

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Protective eff ect and mechanism of nanoantimicrobial peptide ND-C14 against Streptococcus pneumoniae infection

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World Journal of Emergency Medicine 2024年第1期15卷 28-34页

作者： Yangyang Guo Yaqi Sun Hongxia Wu Jian Lu Yuan Lin Jiaqing Zhu Meihong Lai Meiqi Zhang Jun Wang Jungang Zheng Department of intensive care Medicine Hangzhou Traditional Chinese Medicine Hospital Affi liated to Zhejiang Chinese Medical UniversityHangzhou 310021China national Children’s Regional Medical Center National Clinical Research Center for Child HealthChildren’s HospitalZhejiang University School of MedicineHangzhou 310052China Department of Spleen and Stomach Diseases Hangzhou Traditional Chinese Medicine Hospital Affi liated to Zhejiang Chinese Medical UniversityHangzhou 310021China Department of Ultrasonic Medicine the First Affi liated Hospital of Ningbo UniversityNingbo 315010China Department of Anesthesiology the First Affi liated Hospital of Ningbo UniversityNingbo 315010China Zhejiang University School of Medicine Hangzhou 310058China The First People’s Hospital of Yuexi County Yuexi 616650China

BACKGROUND:Streptococcus pneumoniae(***)is a common pathogen that causes bacterial ***,with increasing bacterial resistance,there is an urgent need to develop new drugs to treat *** *** with a 14-carbon saturated fatty acid(ND-C14)is a novel nanoantimicrobial peptide designed by modifying myristic acid at the C-terminus of humanα-defensin 5(HD5)via an amide ***,it is unclear whether ND-C14 is effective against lung infections caused by ***:In vitro,three groups were established,including the control group,and the HD5 and ND-C14 treatment groups.A virtual colony-count assay was used to evaluate the antibacterial activity of HD5 and ND-C14 against *** morphological changes of *** treated with HD5 or ND-C14 were observed by scanning electron *** vivo,mice were divided into sham,vehicle,and ND-C14 treatment *** in the sham group were treated with 25μL of phosphate-buffered saline(PBS).Mice in the vehicle and ND-C14 treatment groups were treated with intratracheal instillation of 25μL of bacterial suspension with 2×108 CFU/mL(total bacterial count:5×10^(6) CFU),and then the mice were given 25μL PBS or intratracheally injected with 25μL of ND-C14(including 20μg or 50μg),*** rates were evaluated in the vehicle and ND-C14 treatment *** burden in the blood and bronchoalveolar lavage fluid were *** lung histology of the mice was assessed.A propidium iodide uptake assay was used to clarify the destructive eff ect of ND-C14 against ***:Compared with HD5,ND-C14 had a better bactericidal eff ect against *** because of its stronger ability to destroy the membrane structure of *** in *** vivo,ND-C14 significantly delayed the death time and improved the survival rate of mice infected with ***-C14 reduced bacterial burden and lung tissue ***,ND-C14 had a membrane per

关键词： Streptococcus pneumoniae Antimicrobial peptides Humanα-defensin 5 Infection

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