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Risk factors for 90-day readmission in veterans with inflammatory bowel disease——Does post-discharge follow-up matter?

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Military Medical Research 2018年第3期5卷 216-221页

作者： Ashish Malhotra Parkpoom Phatharacharukul Charat Thongprayoon center of Innovation Minneapolis VA Health Care System Division of Gastroenterology Department of Medicine Minneapolis VA Medical Center Department of Medicine University of Minnesota School of Medicine Department of Internal Medicine Bassett Medical Center

Background: Repeat hospitalizations in veterans with inflammatory bowel disease(IBD) are under studied. The early readmission rate and potentially modifiable risk-factors for 90-day readmission in veterans with IBD were studied to avert avoidable ***: A retrospective cohort study was conducted using the data from veterans who were admitted to the Minneapolis VA Medical center(MVMC) between January 1, 2007, and December 31, 2013, for an IBD-related problem. All-cause readmissions within 30 and 90 days were recorded to calculate early readmission rates. The multivariate logistic regression was used to identify the potential risk factors for 90-day ***: There were 130 unique patients(56.9% with Crohn's disease and 43.1% with ulcerative colitis) with 202 IBD-related index admissions. The mean age at the time of index admission was 59.8±15.2 years. The median time to re-hospitalization was 26 days(IQR 10-49), with 30-and 90-day readmission rates of 17.3%(35/202) and 29.2%(59/202), respectively. Reasons for all-cause readmission were IBD-related(71.2%), scheduled surgery(3.4%) and non-gastrointestinal causes(25.4%). The following reasons were independently associated with 90-day readmission: Crohn's disease(OR 3.90; 95% CI 1.82-8.90), use of antidepressants(OR 2.19; 95% CI 1.12-4.32), and lack of follow-up within 90 days with a primary care physician(PCP)(OR 2.63; 95% CI 1.32-5.26) or a gastroenterologist(GI)(OR 2.44; 95% CI 1.20-5.00). 51.0% and 49.0% of patients had documentation of a recommended outpatient follow-up with PCP and/or GI, ***: Early readmission in IBD is common. Independent risk factors for 90-day readmission included Crohn's disease, use of antidepressants and lack of follow-up visit with PCP or GI. Further research is required to determine if the appropriate timing of post-discharge follow-up can reduce IBD readmissions.

关键词： Inflammatory bowel disease Readmission rates Veterans affairs

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Serelaxin increases the antifibrotic action of rosiglitazone in a model of hepatic fibrosis

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World Journal of Gastroenterology 2017年第22期23卷 3999-4006页

作者： Robert G Bennett Ronda L Simpson Frederick G Hamel Research Service Nebraska-Western Iowa Health Care System Department of Internal Medicine University of Nebraska Medical Center

To determine the effect of combined serelaxin and rosiglitazone treatment on established hepatic *** fibrosis was induced in mice by carbon tetrachloride administration for 6 wk, or vehicle alone (nonfibrotic mice). For the final 2 wk, mice were treated with rosiglitazone, serelaxin, or both rosiglitazone and serelaxin. Serum liver enzymes and relaxin levels were determined by standard methods. The degree of liver collagen content was determined by histology and immunohistochemistry. Expression of type I collagen was determined by quantitative PCR. Activation of hepatic stellate cells was assessed by alpha-smooth muscle actin (SMA) levels. Liver peroxisome proliferator activated receptor-gamma coactivator 1 alpha (PGC1α) was determined by Western *** of mice with CCl4 resulted in hepatic fibrosis as evidenced by increased liver enzyme levels (ALT and AST), and increased liver collagen and SMA. Monotherapy with either serelaxin or rosiglitazone for 2 wk was generally without effect. In contrast, the combination of serelaxin and rosiglitazone resulted in significantly improved ALT levels (P < 0.05). Total liver collagen content as determined by Sirius red staining revealed that only combination treatment was effective in reducing total liver collagen (P < 0.05). These results were supported by immunohistochemistry for type I collagen, in which only combination treatment reduced fibrillar collagen levels (P < 0.05). The level of hepatic stellate cell activation was modestly, but significantly, reduced by serelaxin treatment alone, but combination treatment resulted in significantly lower SMA levels. Finally, while hepatic fibrosis reduced liver PGC1α levels, the combination of serelaxin and rosiglitazone resulted in restoration of PGC1α protein *** combination of serelaxin and rosiglitazone treatment for 2 wk was effective in significantly reducing established hepatic fibrosis, providing a potential

关键词： Relaxin Peroxisome proliferator-activated receptors Liver cirrhosis Liver diseases Fibrosis

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COVID-19 and liver dysfunction:What nutritionists need to know

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World Journal of Gastroenterology 2022年第15期28卷 1526-1535页

作者： Ming-Ke Wang Xue-Lu Yu Li-Yun Zhou Hong-Mei Si Ju-Fen Hui Deng-Yong Hou Wei-Peng Li Ji-Shun Yang Department of Disease Control and Prevention Naval Medical Center of PLANaval Medical UniversityShanghai 200052China Medical care center Naval Medical Center of PLANaval Medical UniversityShanghai 200052China

The coronavirus disease 2019(COVID-19)pandemic caused by severe acute respiratory syndrome coronavirus-2 has brought serious challenges for the medical *** with COVID-19 usually have respiratory ***,liver dysfunction is not an uncommon ***,the degree of liver dysfunction is associated with the severity and prognosis of ***,diagnosis,and treatment of malnutrition should be routinely recommended in the management of patients with COVID-19,especially in those with liver ***,a large number of studies have reported that nutrition therapy measures,including natural dietary supplements,vitamins,minerals and trace elements,and probiotics,might have potential hepatoprotective effects against COVID-19-related liver dysfunction via their antioxidant,antiviral,anti-inflammatory,and positive immunomodulatory *** review mainly focuses on the possible relationship between COVID-19 and liver dysfunction,nutritional and metabolic characteristics,nutritional status assessment,and nutrition therapy to provide a reference for the nutritionists while making evidence-based nutritional decisions during the COVID-19 pandemic.

关键词： COVID-19 SARS-CoV-2 Liver dysfunction Nutritional status assessment Nutrition therapy

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Reliability of the ocular trauma score for the predictability of traumatic and post-traumatic retinal detachment after open globe injury

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International Journal of Ophthalmology(English edition) 2021年第10期14卷 1589-1594页

作者： Simon Dulz Vasilis Dimopoulos Toam Katz Robert Kromer Eileen Bigdon Martin Stephan Spitzer Christos Skevas Department of Ophthalmology University Medical Center Hamburg-EppendorfHamburg 20246Germany care-Vision Hamburg 20246Germany

AIM: To elucidate the question of whether the ocular trauma score(OTS) and the zones of injury could be used as a predictive model of traumatic and post traumatic retinal detachment(RD) in patients with open globe injury(OGI).METHODS: A retrospective observational chart analysis of OGI patients was performed. The collected variables consisted of age, date, gender, time of injury, time until repair, mechanism of injury, zone of injury, injury associated vitreous hemorrhage, trauma associated RD, post traumatic RD, aphakia at injury, periocular trauma and OTS in cases of OGI. RESULTS: Totally 102 patients with traumatic OGI with a minimum of 12 mo follow-up and a median age at of 48.6 y(range: 3-104 y) were identified. Final best corrected visual acuity(BCVA) was independent from the time of repair, yet a statistically significant difference was present between the final BCVA and the zone of injury. Severe trauma presenting with an OTS score Ⅰ(PⅢ. OGI associated RD was observed in 36/102 patients(35.3%), whereas post traumatic RD(defined as RD following 14 d after OGI) occurred in 37 patients(36.3%). OGI associated RD did not correlate with the OTS and the zone of injury(P=0.193), yet post traumatic RD correlated significantly with zone Ⅲ injuries(P=0.013). CONCLUSION: The study shows a significant association between lower OTS score and zone Ⅲ injury with lower final BCVA and a higher number of surgeries, but only zone Ⅲ could be significantly associated with a higher rate of RD.

关键词： intraocular foreign body ocular trauma score open globe injury retina retinal and vitreous surgery retinal detachment trauma

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A case of diffuse alveolar hemorrhage following synthetic cathinone inhalation

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World Journal of Emergency Medicine 2020年第3期11卷 182-184页

作者： Masakazu Nitta Taro Tamakawa Natsuo Kamimura Tadayuki Honda Hiroshi Endoh Advanced Emergency and Critical care center Niigata University Medical and Dental HospitalChuo-kuNiigataJapan

Dear editor,Diffuse alveolar hemorrhage(DAH)sometimes causes a life-threatening condition;thus,prompt diagnosis and treatment for DAH is ***,a variety of diseases(e.g.,systemic autoimmune diseases,infectious diseases,drugs)are associated with the development of DAH,which occasionally causes diffi culty with identifying the specifi c etiology.

关键词： alveolar diseases diagnosis

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Short-term prone positioning for severe acute respiratory distress syndrome after cardiopulmonary bypass:A case report and literature review

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World Journal of Clinical Cases 2022年第36期10卷 13435-13442页

作者： Jian-Hua Yang Shu Wang Yuan-Xiu Gan Xuan-Yun Feng Bai-Lin Niu Department of Intensive care Medicine Chongqing University Central HospitalChongqing Emergency Medical CenterChongqing Key Laboratory of Emergency MedicineChongqing 400016China Department of Intensive care Medicine Chongqing University Central HospitalChongqing Emergency Medical CenterChongqing 400016China

BACKGROUND Aortic dissection is a complex and dangerous cardiovascular disease,with many complications in the perioperative period,including severe acute respiratory distress syndrome(ARDS),which affects prognosis and increases *** the effect of prone positioning(PP)in improving oxygenation in patients with severe ARDS,reports about PP early after cardiac surgery are few and such an opt-ion may be an issue in cardiac surgery patients because of the recent *** SUMMARY A 40-year-old male patient diagnosed with acute type A aortic dissection on October 22,2021 underwent ascending artery replacement plus total aortic arch replacement plus stent elephant trunk implantation under cardiopulmonary ***,he developed ARDS on postoperative day *** comprehensive treatment with aggressive pulmonary protective ventilation,fluid management with continuous renal replacement therapy,the condition continued to deteriorate and rapidly progressed to severe ARDS with a minimum oxygenation index of *** are ready to implement salvage therapy,including PP and extracorporeal membrane oxygenation(ECMO).Due to the large amount of pericardial mediastinal and thoracic drainage after thoracotomy,ECMO may result in massive postoperative *** prone ventilation is often inappropriate after ***,we chose short-term PP for<6 ***,the oxygenation index greatly improved and the diffuse exudation in both lungs of the patient was significantly reduced with short-term prone *** Intermittent short-term PP can improve early postoperative severe ARDS after acute aortic dissection.

关键词： Aortic dissection Short-term prone positioning Acute respiratory distress syndrome Oxygenation index Cardiopulmonary bypass Case report

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Next-Generation Tools to Study Autonomic Regulation In Vivo

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Neuroscience Bulletin 2019年第1期35卷 113-123页

作者： Snigdha Mukerjee Eric Lazartigues Department of Pharmacology and Experimental Therapeutics Louisiana State University Health Sciences Center Neuroscience and Cardiovascular centers of Excellence Louisiana State University Health Sciences Center Southeast Louisiana Veterans Health care System

The recent development of tools to decipher the intricacies of neural networks has improved our understanding of brain function. Optogenetics allows one to assess the direct outcome of activating a geneticallydistinct population of neurons. Neurons are tagged with light-sensitive channels followed by photo-activation with an appropriate wavelength of light to functionally activate or silence them, resulting in quantifiable changes in the periphery. Capturing and manipulating activated neuron ensembles, is a recently-designed technique to permanently label activated neurons responsible for a physiological function and manipulate them. On the other hand, neurons can be transfected with genetically-encoded Ca2^+ indicators to capture the interplay between them that modulates autonomic end-points or somatic behavior. These techniques work with millisecond temporal precision. In addition, neurons can be manipulated chronically to simulate physiological aberrations by transfecting designer G-protein-coupled receptors exclusively activated by designer drugs. In this review, we elaborate on the fundamental concepts and applications of these techniques in research.

关键词： Autonomic regulation Optogenetics Calcium sensors DREADD

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Development of septic shock and prognostic assessment in critically ill patients with coronavirus disease outside Wuhan, China

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World Journal of Emergency Medicine 2021年第4期12卷 293-298页

作者： Ren-qi Yao Chao Ren Di Ren Jin-xiu Li Ying Li Xue-yan Liu Lei Huang Yong Liu Mian Peng Yong-wen Feng Yong-ming Yao Department of Critical care Medicine the Second People’s Hospital of ShenzhenShenzhen 518035China Trauma Research center the Fourth Medical Center and Medical Innovation Research Department of the Chinese PLA General HospitalBeijing 100048China Department of Critical care Medicine the Third People’s Hospital of ShenzhenShenzhen 518020China Department of Critical care Medicine the People’s Hospital of ShenzhenShenzhen 518020China Department of Critical care Medicine Peking University Shenzhen HospitalShenzhen 518035China Department of Critical care Medicine Shenzhen Hospital of Southern Medical UniversityShenzhen 518110China Department of Critical care Medicine the Third Affiliated Hospital of Shenzhen UniversityShenzhen 518001China

BACKGROUND: The study aims to illustrate the clinical characteristics and development of septic shock in intensive care unit(ICU) patients confirmed with severe acute respiratory syndrome coronavirus 2(SARS-Co V-2) infection, and to perform a comprehensive analysis of the association between septic shock and clinical outcomes in critically ill patients with coronavirus disease(COVID-19).METHODS: Patients confirmed with SARS-Co V-2 infection, who were admitted to the ICU of the Third People's Hospital of Shenzhen from January 1 to February 7, 2020, were enrolled. Clinical characteristics and outcomes were compared between patients with and without septic ***: In this study, 35 critically ill patients with COVID-19 were included. Among them, the median age was 64 years(interquartile range [IQR] 59-67 years), and 10(28.4%) patients were female. The median ICU length of stay was 16 days(IQR 8-23 days). Three(8.6%) patients died during hospitalization. Nine(25.7%) patients developed septic shock in the ICU, and these patients had a significantly higher incidence of organ dysfunction and a worse prognosis than patients without septic ***: Septic shock is associated with a poor outcome in critically ill COVID-19 patients and is one of the hallmarks of the severity of patients receiving ICU care. A dysregulated immune response, uncontrolled infl ammation, and coagulation disorders are strongly associated with the development and progression of COVID-19-related septic shock.

关键词： Severe acute respiratory syndrome coronavirus 2 Coronavirus disease Intensive care unit Septic shock Immune response

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Extracorporeal membrane oxygenation in curing a young man after modified Fontan operation:A case report

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World Journal of Clinical Cases 2022年第29期10卷 10614-10621页

作者： He-Bing Guo Jian-Bo Tan Yong-Chao Cui Hao-Feng Xiong Chuan-Sheng Li Yu-Feng Liu Yao Sun Lin Pu Pan Xiang Ming Zhang Jing-Jing Hao Ning-Ning Yin Xiao-Tong Hou Jing-Yuan Liu Department of Critical care Medicine Beijing Ditan HospitalCapital Medical UniversityBeijing 100015China center for Cardiac Intensive care Beijing Anzhen HospitalCapital Medical UniversityBeijing 100029China

BACKGROUND The Fontan operation is the only treatment option to change the anatomy of the heart and help improve patients’ *** successful operation,patients typically recover the ability to engage in general physical *** a better ventilatory strategy,extracorporeal membrane oxygenation(ECMO) provides gas exchange via an extracorporeal circuit,and is increasingly being used to improve respiratory and circulatory *** the modified Fontan operation,circulation is different from that of patients who are not subjected to the *** paper describe a successful case using ECMO in curing influenza A infection in a young man,who was diagnosed with Tausing-Bing syndrome and underwent Fontan operation 13 years *** special cardiac structure and circulatory characteristics are explored in this *** SUMMARY We report a successful case using ECMO in curing influenza A infection in a 23-year-old man,who was diagnosed with Tausing-Bing syndrome and underwent Fontan operation 13 years *** man was admitted to the intensive care unit with severe acute respiratory distress syndrome as a result of influenza A *** was initially treated by veno-venous(VV) ECMO,which was switched to veno-venous-arterial ECMO(VVA ECMO) 5 d *** circulation and respiratory function gradually improved,the VVA ECMO equipment was removed on May 1,*** patient was successfully withdrawn from artificial ventilation on May 28,2018 and then discharged from hospital on May 30,*** After the modified Fontan operation,circulation is different compared with that of patients who are not subjected to the *** are certainly many differences between them when they receive the treatment of *** to the special cardiac structure and circulatory characteristics,an individualized liquid management strategy is necessary and it might be better for them to choose an active circulation support earlier.

关键词： Acute respiratory distress syndrome Extracorporeal membrane oxygenation Modified Fontan operation Tausing-Bing syndrome Case report

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Pharmacological effects of denervated muscle atrophy due to metabolic imbalance in different periods

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BIOCELL 2023年第11期47卷 2351-2359页

作者： JIAYING QIU YAN CHANG WENPENG LIANG MENGSI LIN HUI XU WANQING XU QINGWEN ZHU HAIBO ZHANG ZHENYU ZHANG Department of Prenatal Screening and Diagnosis center Affiliated Maternity and Child Health Care Hospital of Nantong UniversityNantong226001China Nantong Institute of Genetics and Reproductive Medicine Affiliated Maternity and Child Health Care Hospital of Nantong UniversityNantong226001China Department of Emergency Medicine Affiliated Maternity and Child Health Care Hospital of Nantong UniversityNantong226001China Medical School of Nantong University Nantong UniversityNantong226001China School of life Sciences Nantong UniversityNantong226001China

Denervation-induced skeletal muscle atrophy can potentially cause the decline in the quality of life of patients and an increased risk of *** pathophysiological mechanisms with dynamic alterations have been documented in skeletal muscle atrophy resulting from innervation ***,an in-depth comprehension of the key mechanisms and molecules governing skeletal muscle atrophy at varying stages,along with targeted treatment and protection,becomes essential for effective atrophy *** preliminary research categorizes the skeletal muscle atrophy process into four stages using microarray *** review extensively discusses the pathways and molecules potentially implicated in regulating the four stages of denervation and muscle ***,drugs targeting the reactivare oxygen species stage and the inflammation stage assume critical *** intervention during the initial atrophy stages can expedite protection against skeletal muscle ***,pharmaceutical intervention in the ubiquitin-proteasome pathway associated with atrophy and autophagy lysosomes can effectively slow down skeletal muscle *** molecules within this stage encompass MuRF1,MAFbx,LC3II,p62/SQSTM1,*** review also compiles a profile of drugs with protective effects against skeletal muscle atrophy at distinct postdenervation stages,thereby augmenting the evidence base for denervation-induced skeletal muscle atrophy treatment.

关键词： Pharmacological effects Denervated muscle atrophy Metabolic imbalance

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