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A novel predictor of unsustained return of spontaneous circulation in cardiac arrest patients through a combination of capnography and pulse oximetry: a multicenter observational study

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World Journal of Emergency Medicine 2024年第1期15卷 16-22页

作者： Jing Yang Hanqi Tang shihuan shao Feng Xu Yangyang Fu shengyong Xu Chen Li Yan Li Yang Liu Joseph Harold Walline Huadong Zhu Yuguo Chen Xuezhong Yu Jun Xu Emergency Department State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijing 100730China Emergency Department Peking University People’s HospitalBeijing 100044China Department of Emergency and Chest Pain center Shandong Provincial Clinical Research Center for Emergency and Critical Care MedicineKey Laboratory of Emergency and Critical Care Medicine of Shandong ProvinceQilu Hospital of Shandong UniversityJinan 250012China Emergency Department Beijing Jishuitan HospitalBeijing 100035China Emergency Department Tianjin Medical University General HospitalTianjin 300052China Department of Emergency Medicine Penn State Health Milton S.Hershey Medical Center and Penn State College of MedicineHershey 17033USA

BACKGROUND:Unsustained return of spontaneous circulation(ROsC)is a critical barrier to survival in cardiac arrest *** study examined whether end-tidal carbon dioxide(ETCO_(2))and pulse oximetry photoplethysmogram(POP)parameters can be used to identify unsustained ***:We conducted a multicenter observational prospective cohort study of consecutive patients with cardiac arrest from 2013 to ***’general information,ETCO_(2),and POP parameters were collected and statistically ***:The included 105 ROsC episodes(from 80 cardiac arrest patients)comprised 51 sustained ROsC episodes and 54 unsustained ROsC *** 24-hour survival rate was significantly higher in the sustained ROsC group than in the unsustained ROsC group(29.2%vs.9.4%,Pstic regression analysis showed that the difference between after and before ROsC in ETCO_(2)(ΔETCO_(2))and the difference between after and before ROCs in area under the curve of POP(ΔAUCp)were independently associated with sustained ROsC(odds ratio[OR]=0.931,95%confi dence interval[95%CI]0.881-0.984,P=0.011 and OR=0.998,95%CI 0.997-0.999,Pstic curve ofΔETCO_(2),ΔAUCp,and the combination of both to predict unsustained ROsC were 0.752(95%CI 0.660-0.844),0.883(95%CI 0.818-0.948),and 0.902(95%CI 0.842-0.962),***:Patients with unsustained ROsC have a poor *** combination ofΔETCO_(2) andΔAUCp showed signifi cant predictive value for unsustained ROsC.

关键词： Return of spontaneous circulation Pulse oximetry photoplethysmogram End-tidal carbon dioxide Cardiac arrest Cardiopulmonary resuscitation

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General anesthetic agents induce neurotoxicity through astrocytes

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Neural Regeneration Research 2024年第6期19卷 1299-1307页

作者： Yanchang Yang Tiantian Liu Jun Li Dandan Yan Yuhan Hu Pin Wu Fuquan Fang Patrick M.McQuillan Wenxin Hang Jianhang Leng Zhiyong Hu Department of Anesthesiology The First Affiliated HospitalZhejiang University School of MedicineHangzhouZhejiang ProvinceChina Department of Anesthesiology Ningbo Women and Children’s HospitalNingboZhejiang ProvinceChina Department of Anesthesiology Shulan(Hangzhou)Hospital Affiliated to Zhejiang Shuren University Shulan International Medical CollegeHangzhouZhejiang ProvinceChina Cell Biology Department Yale UniversityNew HavenCTUSA Department of Anesthesiology Penn State Hershey Medical CentrePenn State College of MedicineHersheyPAUSA Department of Central Laboratory Affiliated Hangzhou First People’s HospitalZhejiang University School of MedicineHangzhouZhejiang ProvinceChina

Neuroscientists have recognized the importance of astrocytes in regulating neurological function and their influence on the release of glial *** studies,however,have focused on the effects of general anesthetic agents on neuroglia or *** can also be an important target of general anesthetic agents as they exert not only sedative,analgesic,and amnesic effects but also mediate general anesthetic-induced neurotoxicity and postoperative cognitive ***,we analyzed recent advances in understanding the mechanism of general anesthetic agents on astrocytes,and found that exposure to general anesthetic agents will destroy the morphology and proliferation of astrocytes,in addition to acting on the receptors on their surface,which not only affect Ca^(2+)signaling,inhibit the release of brain-derived neurotrophic factor and lactate from astrocytes,but are even involved in the regulation of the pro-and anti-inflammatory processes of *** would obviously affect the communication between astrocytes as well as between astrocytes and neighboring neurons,other neuroglia,and vascular *** this review,we summarize how general anesthetic agents act on neurons via astrocytes,and explore potential mechanisms of action of general anesthetic agents on the nervous *** hope that this review will provide a new direction for mitigating the neurotoxicity of general anesthetic agents.

关键词： astrocytes brain-derived neurotrophic factor general anesthetic agents neuron neurotoxicity N-methyl-D-aspartate receptor perioperative neurocognition Toll-like receptor γ-aminobutyric acid receptor

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Radiographical findings in patients with liver cirrhosis and hepatic encephalopathy

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Gastroenterology Report 2016年第3期4卷 221-225,I0002页

作者： saleh Elwir Hassan Hal Joshua Veith Ian schreibman Zakiyah Kadry Thomas Riley Department of Internal Medicine Penn State Milton S.Hershey Medical CenterHersheyPennsylvania(PA)USA Department of Radiology Penn State Milton S.Hershey Medical CenterHersheyPAUSA penn state milton s.hershey medical center and school of Medicine HersheyPAUSA Division of Gastroenterology and Hepatology Penn State Milton S.Hershey Medical CenterHersheyPAUSA Division of Transplant surgery Penn State Milton S.Hershey Medical CenterHershey PAUSA

Background and aims:Hepatic encephalopathy is a common complication encountered in patients with liver *** encephalopathy is not reflected in the current liver transplant allocation *** was sought between hepatic encephalopathy with findings detected on radiographic imaging studies and the patient’s clinical ***:A retrospective analysis was conducted of patients with cirrhosis,who presented for liver transplant evaluation in 2009 and *** with hepatocellular carcinoma,ejection fraction less than 60%and who had a TIPs(transjugular intrahepatic portosystemic shunting)procedure or who did not complete the evaluation were *** analysis was performed and variables found to be significant on univariate analysis(Psed by a multivariate logistic regression ***:A total of 117 patients met the inclusion criteria and were divided into a hepatic encephalopathy group(n=58)and a control group(n=59).Univariate analysis found that a smaller portal vein diameter,smaller liver antero-posterior diameter,liver nodularity and use of diuretics or centrally acting medications showed significant correlation with hepatic *** association was confirmed for smaller portal vein,use of diuretics and centrally acting medications in the multivariate ***:A decrease in portal vein diameter was associated with increased risk of *** patients with smaller portal vein diameter may warrant screening for encephalopathy by more advanced psychometric testing,and more aggressive control of constipation and other factors that may precipitate encephalopathy.

关键词： hepatic encephalopathy cirrhosis portal vein diameter computed tomography(CT)

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Acute myeloid leukemia in the era of precision medicine:recent advances in diagnostic classification and risk stratification

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Cancer Biology & Medicine 2016年第1期13卷 41-54页

作者： Rina Kansal Department of Pathology and Laboratory Medicine Milton S.Hershey Medical Center Penn State College of Medicine

Acute myeloid leukemia(AML) is a genetically heterogeneous myeloid malignancy that occurs more commonly in adults, and has an increasing incidence, most likely due to increasing age. Precise diagnostic classification of AML requires clinical and pathologic information, the latter including morphologic, immunophenotypic, cytogenetic and molecular genetic analysis. Risk stratification in AML requires cytogenetics evaluation as the most important predictor, with genetic mutations providing additional necessary information. AML with normal cytogenetics comprises about 40%-50% of all AML, and has been intensively investigated. The currently used 2008 World Health Organization classification of hematopoietic neoplasms has been proposed to be updated in2016, also to include an update on the classification of AML, due to the continuously increasing application of genomic techniques that have led to major advances in our knowledge of the pathogenesis of AML. The purpose of this review is to describe some of these recent major advances in the diagnostic classification and risk stratification of AML.

关键词： Acute myeloid leukemia myeloid neoplasms genomics precision medicine next-generation sequencing cytogenetics mutations

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General anesthetic agents induce neurotoxicity through oligodendrocytes in the developing brain

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Zoological Research 2024年第3期45卷 691-703页

作者： Wen-Xin Hang Yan-Chang Yang Yu-Han Hu Fu-Quan Fang Lang Wang Xing-Hua Qian Patrick M.McQuillan Hui Xiong Jian-Hang Leng Zhi-Yong Hu Department of Anesthesiology First Affiliated HospitalZhejiang University School of MedicineHangzhouZhejiang 310003China Department of Cell Biology Yale UniversityNew HavenCT 06520USA Department of Neurology of the First Affiliated Hospital Interdisciplinary Institute of Neuroscience and TechnologySchool of Brain Science and Brain MedicineZhejiang University School of MedicineHangzhouZhejiang 310027China Department of Anesthesiology Jiaxing Maternity and Childcare Health HospitalJiaxingZhejiang 314009China Department of Anesthesiology Penn State Hershey Medical CentrePenn State College of MedicineHersheyPA 17033USA Department of Central Laboratory Affiliated Hangzhou First People’s HospitalWestlake University School of MedicineHangzhouZhejiang 310006China

General anesthetic agents can impact brain function through interactions with neurons and their effects on glial *** perform essential roles in the central nervous system,including myelin sheath formation,axonal metabolism,and neuroplasticity *** are particularly vulnerable to the effects of general anesthetic agents resulting in impaired proliferation,differentiation,and *** are increasingly interested in the effects of general anesthetic agents on *** agents not only act on the surface receptors of oligodendrocytes to elicit neuroinflammation through modulation of signaling pathways,but also disrupt metabolic processes and alter the expression of genes involved in oligodendrocyte development and *** this review,we summarize the effects of general anesthetic agents on *** anticipate that future research will continue to explore these effects and develop strategies to decrease the incidence of adverse reactions associated with the use of general anesthetic agents.

关键词： Oligodendrocytes General anesthetic agents Neurotoxicity Central nervous system Perioperative neurocognitive disorders

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Redeploying gastroenterologists during the COVID-19 pandemic:early experience with telehealth including clinical access and financial implications

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Gastroenterology Report 2021年第3期9卷 276-278,I0003页

作者： Nauroz syed Meeta Desai Deborah Bethards sanam Razeghi Kofi Clarke Division of Gastroenterology and Hepatology Penn State Milton S.Hershey Medical CenterHersheyPAUSA

Introduction The global healthcare community has been confronted with challenges in providing patient care in a manner that limits the risk of patient and provider exposure during the COVID-19 *** has resulted in sign... 详细信息

关键词：远程医疗医疗费用消化科

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Diabetic retinopathy: recent advances towards understanding neurodegeneration and vision loss

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science China(Life sciences) 2015年第6期58卷 541-549页

作者： BARBER Alistair J. penn state hershey Eye center Penn State Hershey College of Medicine Milton S. Hershey Medical Center

Diabetic retinopathy （DR） is one of the most common retinal diseases world-wide. It has a complex pathology that involves the vasculature of the inner retina and breakdown of the blood-retinal barrier. Extensive research has determined that DR is not only a vascular disease but also has a neurodegenerative component and that essentially all types of ceils in the retina are affected, leading to chronic loss of visual function. A great deal of work using animal models of DR has established the loss of neurons and pathology of other cell types, including supporting glial cells. There has also been an increased emphasis on measuring retinal function in the models, as well as further validation and extension of the animal studies by clinical and translational research. This article will attempt to summarize the more recent developments in research towards understanding the complexities of retinal neurodegeneration and functional vision loss in DR.

关键词： retina diabetes neurodegeneration visual function vascular function apoptosis synapse dendrite

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Mex-3 RNA binding family member A(MEX3A)/circMPP6 complex promotes colorectal cancer progression by inhibiting autophagy

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signal Transduction and Targeted Therapy 2024年第5期9卷 2091-2103页

作者： Ri-Xin Chen shui-Dan Xu Min-Hua Deng shi-Hui Hao Jie-Wei Chen Xiao-Dan Ma Wei-Tao Zhuang Jing-Hua Cao Yong-Rui Lv Jin-Long Lin si-Yu Li Gui-Bin Qiao Dan Xie Feng-Wei Wang Department of Thoracic surgery Guangdong Provincial People’s Hospital(Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhou 510080China state Key Laboratory of Oncology in south China Guangdong Provincial Clinical Research Center for CancerSun Yat-sen University Cancer CenterGuangzhou 510060China medical Research Institute Guangdong Provincial People’s Hospital(Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhou 510080China Department of Pathology Sun Yat-sen University Cancer CenterGuangzhou 510060China

RNA-binding proteins(RBPs)-RNA networks have contributed to cancer *** RNAs(circRNAs)are considered as protein recruiters;nevertheless,the patterns of circRNA-protein interactions in colorectal cancer(CRC)are still *** bodies(PBs)formed through liquid-liquid phase separation(LLPs)are membrane-less organelles(MLOs)consisting of RBPs and *** evidence suggests a connection between PBs dynamics and cancer *** the increasingly acknowledged crucial role of RBPs and RNA in the accumulation and maintenance of MLOs,there remains a lack of specific research on the interactions between PBs-related RBPs and circRNAs in ***,we identify that MEX-3 RNA binding family member A(MEX3A),frequently upregulated in CRC tissues,predicts poorer patient *** MEX3A accelerates malignance and inhibits autophagy of CRC ***,MEX3A undergoes intrinsically disordered regions(IDRs)-dependent LLPs in the ***,circMPP6 acts as a scaffold to facilitate the interaction between MEX3A and PBs *** MEX3A/circMPP6 complex modulates PBs dynamic and promotes UPF-mediated phosphodiesterase 5A(PDE5A)mRNA degradation,consequently leading to the aggressive properties of CRC ***,CRC patients exhibiting high MEX3A expression and low PDE5A expression have the poorest overall *** findings reveal a collaboration between MEX3A and circMPP6 in the regulation of mRNA decay through triggering the PBs aggregation,which provides prognostic markers and/or therapeutic targets for CRC.

关键词： colorectal inhibiting MPP

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significant methodologic variations in calculating renal function changes following kidney tumor surgery:A quality reporting issue?

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World Journal of Clinical Oncology 2015年第5期6卷 89-91页

作者： Ruth D Blum Jay D Raman Division of Urology Penn State Milton S.Hershey Medical Center

Renal tumor surgery places patients at increased risk for chronic kidney disease(CKD). Accurate quantification of kidney function changes before and after surgery is essential to determine the magnitude of decline attributable to an index procedure. Current literature, however, highlights heterogeneity and inconsistencies in measurement techniques thereby contributing to ambiguity amongst studies. Further efforts are necessary to standardize reporting of kidney function outcomes related to renal surgery.

关键词： Radical nephrectomy Partial nephrectomy Nephroureterectomy Glomerular filtration rate Chronic kidney disease

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A Blood Hepatocellular Carcinoma signature Recognizes Very small Tumor Nodules with Metastatic Traits

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Journal of Clinical and Translational Hepatology 2024年第6期12卷 551-561页

作者： Kun Chen Junxiao Wang Liping Jiang Fei Zhao Ruochan Zhang Zhiyuan Wu Dongmei Wang Yuchen Jiao Hui Xie Chunfeng Qu state Key Lab of Molecular Oncology Department of ImmunologyNational Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina senior Department of Oncology Fifth Medical Center of Chinese PLA General HospitalBeijingChina Aerospace medical center/Aerospace center Hospital Peking University Aerospace Clinical CollegeBeijingChina state Key Lab of Molecular Oncology National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina

Background and Aims:Hepatocellular carcinoma(HCC)cases with small nodules are commonly treated with radi-ofrequency ablation(RFA),but the recurrence rate remains *** study aimed to establish a blood signature for identifying HCC with metastatic traits ***:Data from HCC patients treated between 2010 and 2017 were retrospectively collected.A blood signature for meta-static HCC was established based on blood levels of alpha-fetoprotein and des-γ-carboxy-prothrombin,cell-free DNA(cfDNA)mutations,and methylation changes in target genes in frozen-stored plasma samples that were collected before RFA *** HCC blood signature was validated in patients prospectively enrolled ***:Of 251 HCC patients in the retrospective study,33.9% experienced recurrence within 1 year *** HCC blood signature identified from these patients included des-γ-carboxy-prothrombin≥40mAU/mL with cfDNA mutation score,where cfDNA mutations occurred in the genes of TP53,CTNNB1,and TERT *** signature effectively predicted 1-year post-RFArecurrence of HCC with 92% specificity and 91% sensitivity in the retrospective dataset,and with 87% specificity and 76% sensitivity in the prospective dataset(n=32 patients).Among 14 cases in the prospective study with biopsy tissues available,positivity for the HCC blood signature was associated with a higher HCC tissue score and shorter distance between HCC cells and ***:This study established an HCC blood signature in pre-RFA blood that potentially reflects HCC with metastatic traits and may be valuable for predicting the disease’s early recurrence post-RFA.

关键词： Liquid biopsy Liver dysplastic nodules Radiofrequency ablation Hepatocellular carcinoma Recurrence prediction Metastatic nodules

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