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The neuro-prognostic value of the ion shift index in cardiac arrest patients following extracorporeal cardiopulmonary resuscitation

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World Journal of emergency Medicine 2023年第5期14卷 354-359页

作者： Gannan Wang Zhe Wang Yi Zhu Zhongman Zhang Wei Li Xufeng Chen Yong Mei Department of emergency the First Affi liated Hospital of Nanjing Medical UniversityNanjing 210029China Key Laboratory of Emergency and Trauma of Ministry of Education College of Emergency and TraumaHainan Medical UniversityHaikou 571199China

BACKGROUND:The ion shift index(ISI) as a prognostic indicator that can show the severity of hypoxic-ischemic injury.We aimed to evaluate the performance of the ISI in predicting unfavorable neurological outcomes at hospital discharge in cardiac arrest(CA) patients following extracorporeal cardiopulmonary resuscitation(ECPR) and to compare its performance to other prognostic predictors.METHODS:This was a retrospective observational study including adult CA patients treated with ECPR between January 2018 and December 2022 in a tertiary hospital.Data regarding clinical characteristics and laboratory parameters were collected from medical records.The ISI was determined based on the first available serum electrolyte levels after ECPR.The primary outcome was unfavorable neurological status at hospital discharge,defined as Cerebral Performance Categories 3–5.Comparisons of the characteristics between the two groups were made using the χ2 test for categorical variables and the t-test or non-parametric Mann-Whitney U-test for continuous variables,as appropriate.Correlation analysis was performed using Spearman’s rank correlation coeficient.A two-tailed P-value 3.12 predicted unfavorable outcomes with a sensitivity and specificity of 74.6% and 85.2%,respectively(P<0.001).The prognostic performance of ISI(area under the curve [AUC]=0.887) was similar to that of other predictors,such as gray-to-white matter ratio(AUC=0.850,P=0.433) and neuronspecific enolase(AUC=0.925,P=0.394).CONCLUSION:ISI may be used as a prognostic biomarker to predict neurological outcomes in CA patients

关键词： Cardiac arrest Ion shift index Extracorporeal cardiopulmonary resuscitation

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Autopsy results from a COVID-19 patient treated in a tropical area,and a review of the epidemiological history

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Forensic Sciences Research 2022年第3期7卷 560-565页

作者： Jie Cai Bo Wang Tao Song Peng Zhang Ren Long Xiaoran Liu Jianqiang Deng Jianhua Chen Department of Forensic Medicine Hainan Tropical Forensic Engineering Research CenterHainan Medical UniversityHaikouChina Key Laboratory of Emergency and Trauma of Ministry of Education Emergency and Trauma CollegeHainan Medical UniversityHaikouChina

Since the start of the COVID-19 pandemic,there has been an urgent need to produce accurate and sensitive tests.However,there have been instances where a positive nucleic acid test turns negative after treatment,and then positive again.This case report describes such an instance from the tropical region of Hainan,China.The patient was a 61-year-old female who went to Hainan on vacation from Wuhan during the COVID-19 pandemic in 2020.Symptoms appeared 9 d after arriving in Hainan,and it was confirmed that the nucleic acid test was positive after 4 repeats.Her condition declined rapidly,her heart stopped beating,and she was admitted in a coma to the ICU.After treatment,the SARS-CoV-2 virus nucleic acid test of several nasopharyngeal swabs were negative,and tests on whole blood,anal swabs,and urine were also negative.Later,however,nucleic acid tests on a lower respiratory tract sputum swab and lower respiratory tract lavage fluid were positive.An autopsy examination was carried out 12h after her death,and multi-organ secretions were extracted for nucleic acid testing.The SARS-CoV-2 virus nucleic acid was only detected in the swabs from the end of the bronchus,which was confirmed by the visualization of the coronavirus by electron microscopy.Autopsy confirmed that the damage was mainly concentrated in the lungs and immune organs and tissues throughout the body.Epidemiology indicated that none of the people she came into contact with after arriving in Hainan,including close contacts,were infected.This is in sharp contrast to the highly contagious virus in Wuhan in the temperate zone during the same period.This case report indicates:(1)The high temperatures in tropical areas may have an impact on the spread and harm of COVID-19,and(2)The reason why nucleic acid testing for COVID-19 was initially negative and then positive after treatment may be related to the survival of the SARS-CoV-2 virus in deep lung tissues.

关键词： Forensic sciences forensic pathology COVID-19 SARS-CoV-2 autopsy tropical area epidemiological history

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Glycolysis and acute lung injury:A review

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Asian Pacific Journal of Tropical Medicine 2023年第11期16卷 490-497页

作者： Yang Yi Jun Chen Nan Li Yue Huang Jichao Peng Xiaoran Liu College of emergency trauma Hainan Medical UniversityHaikouChina key laboratory of Hainan trauma and Disaster Rescue the First Affiliated Hospital of Hainan Medical UniversityHaikouChina Key Laboratory of Emergency and Trauma Ministry of Education Hainan Medical UniversityHaikouChina Danzhou People’s Hospital DanzhouChina

Acute lung injury is featured as diffuse pulmonary edema and persistent hypoxemia caused by lung or systemic injury.It is believed that these pathological changes are associated with damage to the alveolar epithelium and vascular endothelium,recruitment of inflammatory cells,and inflammatory factor storms.In recent years,the metabolic reprogramming of lung parenchymal cells and immune cells,particularly alterations in glycolysis,has been found to occur in acute lung injury.Inhibition of glycolysis can reduce the severity of acute lung injury.Thus,this review focuses on the interconnection between acute lung injury and glycolysis and the mechanisms of interaction,which may bring hope for the treatment of acute lung injury.

关键词： Acute lung injury Glycolysis Hypoxia-inducible factor 1 Endothelium Macrophages

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Development of bioorthogonal SERS imaging probe in biological and biomedical applications

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Chinese Chemical Letters 2021年第8期32卷 2369-2379页

作者： Chonggui Qiu Ziyi Cheng Chuanzhu Lv Rui Wang Fabiao Yu The First Affiliated Hospital of Hainan Medical University Key Laboratory of Emergency and TraumaMinistry of EducationKey Laboratory of Hainan Trauma and Disaster RescueInstitute of Functional Materials and Molecular ImagingCollege of PharmacyCollege of Emergency and TraumaHainan Medical UniversityHaikou 571199China

Living-cell imaging demands high specificity,sensitivity,and minimal background interference to the targets of interest.However,developing a desirable imaging probe that can possess all the above features is still challenging.The bioorthogonal surface-enhanced Raman scattering(SERS) imaging has been recently emerged through utilizing Raman reporters with characteristic peaks in Raman-silent region of cells(1800-2800 cm^(-1)),which opens a revolutionary avenue for living-cell imaging with multiplexing capability.In this review,we focus on the recent advances in the technology development and the biological and biomedical applications of the living-cell bioorthogonal SERS imaging technique.After introduction of fundamental principles for bioorthogonal tag or label,we present applications for visualization of various intracellular components and environment including proteins,nucleic acids,lipids,pH and hypoxia,even for cancer diagnosis in tissue samples.Then,various bioorthogonal SERS imaging-guided thera py strategies have been discussed such as photothera py and surge ry.In conclusion,this strategy has great potential to be a flexible and robust tool for visualization detection and diseases diagnosis.

关键词： Surface-enhanced Raman scattering(SERS) Bioorthogonal molecule Visualization Disease diagnosis Therapy

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Evaluation of erastin synergized cisplatin anti-nasopharyngeal carcinoma effect with a glutathione-activated near-infrared fluorescent probe

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Chinese Chemical Letters 2024年第2期35卷 311-316页

作者： Rong He Dandan Tang Ningge Xu Heng Liu Kun Dou Xuejun Zhou Fabiao Yu Department of Otolaryngology Head and Neck SurgeryThe First Affiliated Hospital of Hainan Medical UniversityHaikou 570102China key laboratory of Hainan trauma and Disaster Rescue Key Laboratory of Emergency and TraumaMinistry of EducationEngineering Research Center for Hainan Bio-Smart Materials and Bio-Medical DevicesCollege of Emergency and TraumaHainan Medical UniversityHaikou 571199China Sichuan Provincial General Hospital of Judicial Police Chengdu 610225China

Nasopharyngeal carcinoma(NPC),a malignant tumor originating from the nasopharynx,is one of the common malignant tumors of the head and neck.There are significant geographical differences in the incidence of nasopharyngeal carcinoma,with a high incidence in China and Southeast Asian countries.Herein,we designed and synthesized a novel near-infrared fluorescent(NIRF)probe to detect glutathione(GSH)in cellular and tumor environments using semi-naphthofluorescein(SNAFL)as the fluorescent molecular backbone and 2-fluoro-4-nitrobenzenesulfonate as the recognition moiety.Upon reaction with GSH,SNAFL-GSH emitted a fluorescence signal,and its emission wavelength at 650 nm was remarkably enhanced.The results of selectivity experiments indicated that SNAFL-GSH was able to discriminate GSH from Cys,Hcy,and H_(2) S.Moreover,SNAFL-GSH could image both endogenous and exogenous GSH and distinguish normal and cancer cells by fluorescence signal difference.At the cellular level,cisplatin(DDP)-induced ferroptosis and inhibition of proliferation of various NPC cell lines(CNE2,CNE1,5-8F cells)by erastin combined with DDP were visualized with the help of SNAFL-GSH.In a mouse tumor xenograft model,we successfully employed SNAFL-GSH for the evaluation of the efficacy of erastin combined with DDP in the treatment of NPC.More importantly,the probe could image cancerous tissue sections from NPC patients with an imaging depth of approximately 80µm.It was foreseen that SNAFL-GSH offered great potential for application in the diagnosis and evaluation of the therapeutic efficacy of NPC,and these results would also provide new ideas for the clinical treatment of NPC.

关键词： Glutathione NIRF probe Ferroptosis Anti-tumor therapy evaluation Bioimaging

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MMAE-loaded PLGA nanomedicine with improved biosafety to achieve efficient antitumor treatment

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Journal of Innovative Optical Health Sciences 2024年第2期17卷 79-93页

作者： Changqiang Xie Yan Wang Zhenzhen Cai Jianghai Du Zhengyu Chen Junjie Wang Xingzhou Peng State key laboratory of Digital Medical Engineering School of Biomedical Engineering Hainan University Haikou 570228P.R.China key laboratory of Biomedical Engineering of Hainan Province One Health Institute Hainan University Haikou 570228P.R.China key laboratory of Hainan trauma and Disaster Rescue The First Affiliated Hospital of Hainan Medical University Hainan Medical University Haikou 571199P.R.China Engineering Research Center for Hainan Bio.Smart Materials and Bio-Medical Devices Key Laboratory of Emergency and Trauma Ministry of EducationKey Laboratory of Hainan Functional Materials and Molecular ImagingCollege of Emergency and Trauma Hainan Medical UniversityHaikou 571199P.R.China

Monomethyl auristatin E(MMAE)is a derivative of the marine peptide Dolastatin 10,which has therapeutic effects against various cancers according to its antimitotic activity in multiple clinical trials.The antibody drug conjugate(ADC)of MMAE is currently used in clinical practice.However,the safety issues of MMAE-based ADC,such as high drug toxicity and poor bioavailability,still exist when using it for anticancer therapy.A sustained release of drug delivery approach should be used to reduce toxicity and achieve sufficient anticancer effects.Herein,PLGA-b-PEG 2000 with excellent biocompatibility and slow degradation ability was adopted to construct MMAE-loaded nanoparticles for safe and effective chemotherapy.The sustained release effect and the immunogenic cell death(ICD)effect of PLGA-MMAE nanoparticles were assessed by in vitro experiments.The PLGA-MMAE nanoparticles effectively accumulated in the tumor through the enhanced permeability and retention(EPR)effect,inducing cell apoptosis and causing a certain degree of immune response.The sustained drug release of PLGA-MMAE improved the bioavailability and effectively reduced the toxicity and development of the tumor compared to the effect of free MMAE or ADC.Overall,this study provides a safe and effective chemotherapeutic approach,as well as a simple and effective synthetic process for MMAE-based nanoparticles,improving their therapeutic efficacy and safety.

关键词： Monomethyl auristatin E poly(lactic-co-glycolic acid)nanoparticles sustained release chemotherapy immunogenic cell death

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Effect of SAM junctional tourniquet on respiration when applied in the axilla: A swine model

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Chinese Journal of traumatology 2023年第3期26卷 131-138页

作者： Dong-Chu Zhao Hua-Yu Zhang Yong Guo Hao Tang Yang Li Lian-Yang Zhang Center of trauma and War Injury Daping HospitalArmy Medical UniverstyState Key Laboratory of TraumaBurns and Combined InjuryChongqing400042China Department of emergency Medicine Third Afliated Hospital of Chongqing Medical UniversityChongqing400042China

Purpose:SAM junctional tourniquet(SJT)has been applied to control junctional hemorrhage.However,there is limited information about its safety and efficacy when applied in the axilla.This study aims to investigate the effect of SJT on respiration when used in the axilla in a swine model.Methods:Eighteen male Yorkshire swines,aged 6-month-old and weighing 55-72 kg,were randomized into 3 groups,with 6 in each.An axillary hemorrhage model was established by cutting a 2 mm transverse incision in the axillary artery.Hemorrhagic shock was induced by exsanguinating through the left carotid artery to achieve a controlled volume reduction of 30% of total blood volume.Vascular blocking bands were used to temporarily control axillary hemorrhage before SJT was applied.In Group I,the swine spontaneously breathed,while SJT was applied for 2 h with a pressure of 210 mmHg.In Group II,the swine were mechanically ventilated,and SJT was applied for the same duration and pressure as Group I.In Group III,the swine spontaneously breathed,but the axillary hemorrhage was controlled using vascular blocking bands without SJT compression.The amount of free blood loss was calculated in the axillary wound during the 2 h of hemostasis by SJT application or vascular blocking bands.After then,a temporary vascular shunt was performed in the 3 groups to achieve resuscitation.Pathophysiologic state of each swine was monitored for 1 h with an infusion of 400 mL of autologous whole blood and 500 mL of lactated ringer solution.Tb and T0 represent the time points before and immediate after the 30% volume-controlled hemorrhagic shock,respectively.T30,T60,T90 and T120,denote 30,60,90,and 120 min after T0(hemostasis period),while T150,and T180 denote 150 and 180 min after T0(resuscitation period).The mean arterial pressure and heart rate were monitored through the right carotid artery catheter.Blood samples were collected at each time point for the analysis of blood gas,complete cell count,serum chemistry,standard coagulation tests,etc.,and thromboelastog

关键词： Junctional hemorrhage Tourniquet Swine model Axilla Respiration

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PDGFR kinase inhibitor protects against septic death via regulation of BTLA

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Science China(Life Sciences) 2022年第10期65卷 1917-1928页

作者： Qiang Wang Jin Deng Jianhui Sun Huacai Zhang Di Liu Chu Gao Jinchao Qiu Wenyi Liu Guoxin Qu Dalin Wen Juan Du Anqiang Zhang Ling Zeng Jianxin Jiang Department of trauma Medical Center Daping HospitalState Key Laboratory of TraumaBurns and Combined InjuryArmy Medical UniversityChongqing 400042China Department of emergency the Affiliated Hospital of Guizhou Medical UniversityGuizhou Medical UniversityGuiyang 550001China

Sepsis,defined as life-threatening organ failure caused by a dysregulated host response to severe infection,is a major cause of death among intensive care unit patients.Therapies targeting on immunomodulatory is a new research field in sepsis treatment.B-and T-lymphocyte attenuator(BTLA)is an inhibitory costimulatory factor molecule of B and T lymphocytes.Studies have shown that elevated expression of BTLA in lymphocytes can reduce mortality in sepsis,but its regulatory compounds and the underlying mechanism remains to be elucidated.Here,we show that treatment with CP-673451 significantly decreases mortality of septic mouse.CP-673451 is a PDGFR kinase inhibitor which can promote the expression of BTLA,inhibit the release of chemokines such as CXCL13,and reduce first the chemotaxis of B cells to the peripheral blood and vital organs.CP-673451 also inhibits both the release of cytokines and chemokines such as IL-1β,IL-6,IL-10,TNF-α,CCL1,CCL2 and CCL7 and reduces both the chemotactic ability of T cells.This suggests that CP-673451 may prevent septic death by inhibiting lymphocyte chemotaxis and alleviating“cytokine storm”.In conclusion,our study provides a new therapeutic target and an effective compound for sepsis treatment.

关键词： sepsis B-and T-lymphocyte attenuator platelet-derived growth factor receptor CP-673451 cytokine storm

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An online survey of non-compressible torso hemorrhage:training is needed

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World Journal of emergency Medicine 2022年第4期13卷 297-300页

作者： Hua-yu Zhang Yong Guo Xiao-ying Huang Yang Li Lian-yang Zhang Department of trauma Surgery War Trauma Medical CenterState Key Laboratory of TraumaBurn and Combined InjuryDaping HospitalArmy Medical UniversityChongqing 400042China

Hemorrhage is the leading cause of combat deaths,which is a primary lesson learned from modern warfare.[1]If temporary hemostasis is not available,the mortality of non-compressible torso hemorrhage(NCTH),a potentially... 详细信息

关键词： survey tor lesson

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PANoptosis-like cell death in ischemia/reperfusion injury of retinal neurons

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Neural Regeneration Research 2023年第2期18卷 357-363页

作者： Wei-Tao Yan Wen-Juan Zhao Xi-Min Hu Xiao-Xia Ban Wen-Ya Ning Hao Wan Qi Zhang Kun Xiong Department of Human Anatomy and Neurobiology School of Basic Medical ScienceCentral South UniversityChangshaHunan ProvinceChina Department of Dermatology Xiangya HospitalCentral South UniversityChangshaHunan ProvinceChina Department of Human Resources Third Xiangya Hospital of Central South UniversityChangshaHunan ProvinceChina Hunan key laboratory of Ophthalmology ChangshaHunan ProvinceChina Key Laboratory of Emergency and Trauma Ministry of EducationCollege of Emergency and TraumaHainan Medical UniversityHaikouHainan ProvinceChina

PANoptosis is a newly identified type of regulated cell death that consists of pyroptosis,apoptosis,and nec roptosis,which simultaneously occur during the pathophysiological process of infectious and inflammatory diseases.Although our previous lite rature mining study suggested that PANoptosis might occur in neuronal ischemia/repe rfusion injury,little experimental research has been reported on the existence of PANoptosis.In this study,we used in vivo and in vitro retinal neuronal models of ischemia/repe rfusion injury to investigate whether PAN optosis-like cell death(simultaneous occurrence of pyroptosis,apo ptosis,and necroptosis)exists in retinal neuronal ischemia/repe rfusion injury.Our results showed that ischemia/repe rfusion injury induced changes in morphological features and protein levels that indicate PANoptosis-like cell death in retinal neurons both in vitro and in vivo.Ischemia/repe rfusion inju ry also significantly upregulated caspase-1,caspase-8,and NLRP3 expression,which are important components of the PANoptosome.These results indicate the existence of PANoptosis-like cell death in ischemia/reperfusion injury of retinal neurons and provide preliminary experimental evidence for future study of this new type of regulated cell death.

关键词： apoptosis gasdermin-D(GSDMD) ischemia/reperfusion mixed lineage kinase domain-like protein(MLKL) necroptosis NOD-like receptor protein 3(NLRP3) PANoptosis pyroptosis receptor-interacting protein kinase 3(RIPK3) retinal neuron

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