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Successful treatment of gastrointestinal infection-induced septic shock using the oXiris■ hemofilter: A case report

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World Journal of Clinical Cases 2021年第27期9卷 8157-8163页

作者： Yu Li Xiao-Jun Ji Dan-Yang Jing Zheng-Hui Huang Mei-Li Duan Department of intensive care unit Beijing Friendship HospitalCapital Medical UniversityBeijing 100050China

BACKGROUND Septic shock leads to multiple organ failure,and bacterial endotoxins and endogenous cytokines play essential roles in the *** oXiris■hemofilter can efficiently adsorb endotoxins and *** SUMMARY We admitted a critically ill 59 year-old male patient with gastrointestinal septic shock due to infection by a Gram-negative bacterium and septic acute kidney injury(AKI).Prior to intensive care unit admission,the patient reported intermittent diarrhea and decreased urine *** blood pressure was 70/40 mmHg,necessitating fluid resuscitation and large doses of *** on the results of a blood culture and the presence of hypotension,oliguria,and hypoxemia,we diagnosed septic shock,AKI,and multiple organ *** administered continuous renal replacement therapy(CRRT)with an oXiris■hemofilter for 72 h with intermittent continuous veno-venous hemodiafiltration(CVVHDF),and changed the filter every 12 *** his hemodynamic parameters were stable,we used a traditional filter(AN69 hemofilter)with intermittent *** 72 h CRRT with the oXiris■hemofilter led to stabilization of his vital signs,marked reductions in disease severity scores,and decreased levels of procalcitonin,endotoxin,and inflammatory *** 8 d of CRRT,his kidney function had completely *** We conclude that the oXiris■hemofilter combined with appropriate antibacterial therapy was an effective treatment for this patient with gastrointestinal septic shock.

关键词： Sepsis Septic shock Acute kidney injury Continuous renal replacement therapy oXiris■ Case report

Congenital fiber-type disproportion presenting with type II respiratory failure after delivery:A case report

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World Journal of Clinical Cases 2021年第7期9卷 1748-1754页

作者： Hong-Mei Yang Jian-Xing Guo Yi-Min Yang Department of intensive care unit The First Hospital of Jilin UniversityChangchun 130021Jilin ProvinceChina

BACKGROUND Congenital fiber-type disproportion(CFTD)is a form of congenital *** is rare,especially when presenting in patients with critical ***,we report a case of CFTD presenting with type II respiratory failure after delivery and provide a review of the literature on *** SUMMARY A 30-year-old woman was admitted to the obstetrics department of our hospital with premature rupture of the fetal membrane and with 7 h of regular *** delivery,the patient experienced a refractory type II respiratory *** examination along with diagnostic procedures such as electromyography and biopsy confirmed *** of invasive ventilator followed by intermittent use of noninvasive ventilator attenuated her *** patient recovered after ventilator-assisted respiration and was weaned off the noninvasive ventilator on the seventh day *** Congenital myopathy should be considered a differential diagnosis for type II respiratory failures that cannot be attributed to other diseases.

关键词： Congenital fiber-type disproportion Congenital myopathy Type II respiratory failure Delivery Systematic review Case report

Upregulated IRF9 promotes cell apoptosis of hyperlipidemia acute pancreatitis with heart injury by regulating SIRT1

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BIOCELL 2021年第1期45卷 129-138页

作者： YUN SUN YI LIU BINHUA XUE XIAODIE WANG WEILI YU Department of intensive care unit The Second Affiliated Hospital of Anhui Medical UniversityHefei230601China

Hyperlipidemia acute pancreatitis(HLAP)is a significant cause of AP,characterized by recurrent attacks,more complications and high incidence and *** is often accompanied by single or multiple organ *** regulation of interferon-regulatory factor 9(IRF9)on sirtuin-1(SIRT1)contributes to a range of ***,the function of IRF9 and SIRT1,and the relationship of the two in HLAP with heart injury remain to be illustrated so *** models of HLAP were set up by feeding with high-fat chow and subsequently injecting 20%L-arginine *** degree of pancreas and heart tissue injury was *** cell apoptosis was assayed by the TUNEL ***9,SIRT1,p53 and acetylated p53(Ac-p53)expression levels were measured by qRT-PCR and western *** correlation between SIRT1 and IRF9 expression levels was *** showed that the damage degree in rat pancreas and heart tissues of AP and HLAP group was more distinctly and heart cell apoptosis was ***,heart injury and cell apoptosis of the HLAP group were more remarkable than that of the AP *** increases of IRF9 and Ac-p53/p53 expression and a marked drop of SIRT1 expression were observed in the AP and HLAP group rather than NC and HLNC ***9 and Ac-p53/p53 expression levels of the HLAP group were markedly raised compared with the AP ***1 expression of the HLAP group was obviously lower than that of the AP *** was an inverse correlation between the decrease of SIRT1 and the increase of IRF9 in AP and HLAP *** on the above findings,we drew a conclusion that in pancreatitis with heart injury,upregulated IRF9 inhibited SIRT1 expression,elevated the acetylation of p53,and increased myocardial cell *** further exacerbated pancreas and heart injury and accelerated myocardial cell *** results would furnish an experimental and theoretical basis to diagnose and therapy diseases.

关键词： IRF9 SIRT1 HLAP Cardiac injury Apoptosis

PROTECTION OF CARBON MONOXIDE INHALATION ON LIPOPOLY-SACCHARIDE-INDUCED MULTIPLE ORGAN INJURY IN RATS

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Chinese Medical Sciences Journal 2007年第3期22卷 169-176页

作者： Shao-hua Liu Xin-rong Xu Ke Ma Bing Xu intensive care unit the First Affiliated Hospital of Nanjing Medicial University Nanjing 210029

Objective To observe the protection of carbon monoxide （CO） inhalation on lipopolysaccharide （LPS）-induced rat multiple organ injury. Methods Sprague-Dawley rats with multiple organ injury induced by 5 mg/kg LPS intravenous injection were exposed to room air or 2.5 × 10 ^-4 （V/V） CO for 3 hours. The lung and intestine tissues of rats were harvested to measure the expression of heme oxygenase-1 （ HO-1 ） with reverse transcription-polymerase chain reaction, the levels of pulmonary tumor necrosis factor-or （ TNF-α）, interleukin-6 （ IL-6）, and intestinal platelet activator factor （ PAF）, intercellular adhesion molecule-1 （ICAM-1） with enzyme-linked immunosorbent assay, the content of maleic dialdehyde （MDA） and the activity of myeloperoxidase （MPO） with chemical method, the cell apoptosis rate with flow cytometry, and the pathological changes with light microscope. Results CO inhalation obviously up-regulated the expression of HO-1 in lung （5.43 ± 0. 92） and intestine （6. 29 ± 1.56） in LPS ＋ CO group compared with （ 3.08 ± 0. 82） and （ 3.97 ± 1.16 ） in LPS group （ both P 〈 0. 05 ）. The levels of TNF-ot, IL-6 in lung and PAF, ICAM-1 in intestine ofLPS ＋ CO group were 0. 91 ±0. 25,0. 64 ±0.05, 1. 19 ± 0. 52, and 1.83 ±0. 35 pg/mg, respectively, significantly lower than the corresponding values in LPS group （ 1.48 ± 0. 23, 1.16 ± 0. 26, 1.84 ± 0. 73, and 3.48 ± 0. 36 pg/mg, all P 〈 0. 05 ）. The levels of MDA, MPO, and cell apoptosis rate in lung and intestine of LPS ＋ CO group were 1.02 ± 0. 23 nmol/mg, 1.74 ± 0. 17 nmol/mg, 7.18 ± 1.62 U/mg, 6. 30 ±0. 97 U/mg, 1.60% ±0. 34%, and 30. 56% ±6. 33%, respectively, significantly lower than the corresponding values in LPS group （ 1.27 ± 0. 33 nmol/mg, 2. 75 ± 0. 39 nmol/mg, 8. 16 ± 1.49 U/mg, 7. 72 ± 1.07 U/mg, 3.18% ±0. 51%, and 41.52% -＋3.36%, all P 〈0.05）. In addition, injury of lung and intestine induced by LPS was attenuated at presence of CO inhalation. Conclusion CO inhalation protects rat lung and intestine from LP

关键词： carbon monoxide lung intestine multiple organ injury

COVID-19 managed with early non-invasive ventilation and a bundle pharmacotherapy: A case report

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World Journal of Clinical Cases 2020年第9期8卷 1705-1712页

作者： Mian Peng Di Ren Xue-Yan Liu Jin-Xiu Li Rong-Lin Chen Bao-Jun Yu Yong-Feng Liu Xi Meng Yan-Si Lyu Department of intensive care unit the Third Affiliated Hospital of Shenzhen UniversityShenzhen 518001Guangdong ProvinceChina Department of intensive care unit the Second People’s Hospital of ShenzhenShenzhen 518001Guangdong ProvinceChina Department of intensive care unit Shenzhen People's HospitalFirst Affiliated Hospital of Southern University of Science and Technologythe Second Affiliated Hospital of Jinan UniversityShenzhen 518020Guangdong ProvinceChina Department of intensive care unit the Third People’s Hospital of ShenzhenShenzhen 518001Guangdong ProvinceChina Department of intensive care unit Shenzhen Longgang Central HospitalShenzhen 518001Guangdong ProvinceChina Department of intensive care unit Shenzhen Baoan District People’s HospitalShenzhen 518001Guangdong ProvinceChina Department of Dermatology Shenzhen University General HospitalShenzhen 518067Guangdong ProvinceChina

BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has become an immense public health burden,first in China and subsequently *** effective control measures for COVID-19,especially measures that can halt the worsening of severe cases to a critical status is of urgent *** SUMMARY A 52-year-old woman presented with a high fever(38.8°C),chills,dizziness,and ***,she had not been to Wuhan where COVID-19 emerged and did not have a family history of a disease cluster.A blood test yielded a white blood cell count of 4.41×109/L(60.6±2.67%neutrophils and 30.4±1.34%lymphocytes).Chest imaging revealed bilateral ground-glass lung *** on a positive nasopharyngeal swab nucleic acid test result and clinical characteristics,the patient was diagnosed with *** treatment with early non-invasive ventilation and a bundle pharmacotherapy,she recovered with a good *** Early non-invasive ventilation with a bundle pharmacotherapy may be an effective treatment regimen for the broader population of patients with COVID-19.

关键词： COVID-19 Non-invasive ventilation Bundle pharmacotherapy Case report Pneumonia Coronavirus

Maternal peripartum bacteremia caused by intrauterine infection with Comamonas kerstersii:A case report

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World Journal of Clinical Cases 2022年第21期10卷 7585-7591页

作者： Hai Qu Yi-Hong Zhao Wen-Mei Zhu Lu Liu Ming Zhu intensive care unit Yan’an Hospital Affiliated to Kunming Medical UniversityKunming 650051Yunnan ProvinceChina

BACKGROUND Comamonas kerstersii(***)infections have considered as non-pathogenic to humans,however due to new techniques such as matrix-assisted laser desorption ionization-time of flight mass spectrometry(MALDI-TOF-MS),more cases have been *** SUMMARY This is the first report of a maternal patient with a *** bacteremia following caesarean *** to the severity of the patient’s condition;high fever and rapidly progressing organ damage,the patient was transferred to the intensive care *** was detected by metagenomic next-generation sequencing *** on the drug sensitivity test,appropriate antibiotic treatment was given and the patient recovered *** This case report confirms that the detection via MALDI-TOF-MS and metagenomic next-generation sequencing testing provides a reliable basis for the diagnosis of this rare bacterial infection.

关键词： Comamonas kerstersii Bacteremia Matrix-assisted laser desorption ionization-time of flight mass spectrometry Metagenomic next-generation sequencing testing Caesarean section Case report

Acute myocardial infarction induced by eosinophilic granulomatosis with polyangiitis:A case report

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World Journal of Clinical Cases 2021年第34期9卷 10702-10707页

作者： Xuan-Dong Jiang Shan Guo Wei-Min Zhang intensive care unit Affiliated Dongyang Hospital of Wenzhou Medical UniversityJinhua 322100Zhejiang ProvinceChina

BACKGROUND Eosinophilic granulomatosis with polyangiitis(EGPA)is a multisystem disease characterized by allergic rhinitis,asthma,and a significantly high eosinophil count in the peripheral *** mainly involves the arterioles and *** the coronary arteries are invaded,it can lead to acute myocardial infarction(AMI),acute heart failure,and other manifestations that often lead to death in the absence of timely *** SUMMARY A 69-year-old man was admitted to the emergency department due to chest pain for more than 1 *** had a past history of bronchial asthma and chronic obstructive pulmonary disease and was diagnosed with AMI and heart *** aspiration of the left circumflex artery and percutaneous transluminal coronary angioplasty were performed *** surgery,the patient was admitted to the intensive care *** patient developed eosinophilia,and medical history taking revealed fatigue of both thighs 1 mo *** skin numbness and manifestations of peripheral nerve involvement were found on the lateral side of the right *** biopsy of the lower limbs pathologically confirmed *** patient was treated with methylprednisolone combined with intravenous immunoglobulin and was discharged after 21 *** follow-up at 7 d after discharge,heart failure *** condition improved after cardiotonic and diuretic treatment,and the patient was *** Asthma,impaired cardiac function,and eosinophilia are indicative of *** diagnosis often leads to heart involvement and death.

关键词： Acute myocardial infarction Eosinophilic granulomatosis with polyangiitis Churg-Strauss syndrome Heart failure Asthma Case report

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World Journal of Clinical Cases 2022年第7期10卷 2216-2221页

作者： Yi-Xia Huang Guo-Xin He Wen-Jing Zhang Bo-Wu Li Hai-Xu Weng Wen-Chao Luo intensive care unit The Third Affiliated HospitalWenzhou Medical UniversityRuian 330381Zhejiang ProvinceChina

BACKGROUND Quetiapine,known as a non-classical antipsychotic drug,is frequently used for the treatment of mental diseases,such as schizophrenia,bipolar disorder,and major depressive *** lung injury,a rarely reported side effect of quetiapine,is described in this case *** SUMMARY Due to terminal delirium,a 66-year-old man took a large dose of quetiapine and then developed severe pulmonary *** symptoms were not resolved after routine treatment,such as antibiotics,diuretic,and supportive ***-related acute lung injury was therefore suspected and hormonal therapy was ***,his symptoms were alleviated and the radiological results improved *** Our findings in the present report highlight a potential adverse effect of quetiapine,drug-related acute lung injury,which deserves awareness in clinical practice.

关键词： Quetiapine Acute lung injury Side effect Case report

Antibiotics management in severe acute pancreatitis

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Hepatobiliary & Pancreatic Diseases International 2023年第6期22卷 653-654页

作者： Fu-Zheng Tao Rong-Lin Jiang intensive care unit Taizhou Integrated Traditional Chinese and Western Medicine HospitalTaizhou 310075China intensive care unit the First Affiliated Hospital of Zhejiang Chinese Medical University(Zhejiang Provincial Hospital of Chinese Medicine)Hangzhou 310006China

Severe acute pancreatitis(SAP)is a common and critical *** is life-threatening at any time if multiple organ dysfunction *** may develop secondary infection,often iatrogenic[1].To treat infected SAP,appropriate antibiotic use and nosocomial management is critical,along with adequate drainage of the infected foci and optimizing the immune *** only is the use of powerful antibiotics necessary to minimize mortality,but early use is also necessary to reduce the occurrence of drug-resistant ***,antibiotic management is clinically important and requires careful attention.

关键词： pancreatitis acute function