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Comparing 11 early warning scores and three shock indices in early sepsis prediction in the emergency department

World Journal of Emergency medicine 2024年第4期15卷 273-282页

作者： Rex Pui Kin Lam Zonglin Dai Eric Ho Yin Lau Carrie Yuen Ting Ip Ho Ching Chan Lingyun Zhao Tat ChiTsang Matthew Sik Hon Tsui Timothy Hudson Rainer department of Emergency medicine School of Clinical MedicineLi Ka Shing Faculty of Medicinethe University of Hong KongHong KongChina School of Public Health Li Ka Shing Faculty of Medicinethe University of Hong KongHong KongChina Accident and Emergency department Queen Mary HospitalHong KongChina

BACKGROUND:This study aimed to evaluate the discriminatory performance of 11 vital sign-based early warning scores(EWSs)and three shock indices in early sepsis prediction in the emergency department(ED).METHODS:We performed a retrospective study on consecutive adult patients with an infection over 3 months in a public ED in Hong *** primary outcome was sepsis(Sepsis-3 definition)within 48 h of ED *** c-statistics and the DeLong test,we compared 11 EWSs,including the National Early Warning Score 2(NEWS2),Modified Early Warning Score,and Worthing Physiological Scoring System(WPS),etc.,and three shock indices(the shock index[SI],modified shock index[MSI],and diastolic shock index[DSI]),with Systemic Inflammatory Response Syndrome(SIRS)and quick Sequential Organ Failure Assessment(qSOFA)in predicting the primary outcome,intensive care unit admission,and mortality at different time ***:We analyzed 601 patients,of whom 166(27.6%)developed ***2 had the highest point estimate(area under the receiver operating characteristic curve[AUROC]0.75,95%CI 0.70-0.79)and was significantly better than SIRS,qSOFA,other EWSs and shock indices,except WPS,at predicting the primary ***,the pooled sensitivity and specificity of NEWS2≥5 for the prediction of sepsis were 0.45(95%CI 0.37-0.52)and 0.88(95%CI 0.85-0.91),*** discriminatory performance of all EWSs and shock indices declined when used to predict mortality at a more remote time ***:NEWS2 compared favorably with other EWSs and shock indices in early sepsis prediction but its low sensitivity at the usual cut-off point requires further modification for sepsis screening.

关键词： Sepsis Emergency department Clinical prediction rule Early warning score Shock index

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Influence of blood glucose fluctuations on chemotherapy efficacy and safety in type 2 diabetes mellitus patients complicated with lung carcinoma

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World Journal of Diabetes 2024年第4期15卷 645-653页

作者： Tian-Zheng Fang Xian-Qiao Wu Ting-Qi Zhao Shan-Shan Wang Guo-Mei-Zhi Fu Qing-Long Wu Cheng-Wei Zhou department of Thoracic Surgery The First Affiliated Hospital of Ningbo UniversityNingbo 315020Zhejiang ProvinceChina department of Endocrine The First Affiliated Hospital of Ningbo UniversityNingbo 315020Zhejiang ProvinceChina department of Respiratory and Critical Care medicine The First Affiliated Hospital of Ningbo UniversityNingbo 315020Zhejiang ProvinceChina

BACKGROUND Patients with type 2 diabetes mellitus(T2DM)have large fluctuations in blood glucose(BG),abnormal metabolic function and low immunity to varying degrees,which increases the risk of malignant tumor diseases and affects the efficacy of tumor *** hyperglycemia may have important therapeutic implications for cancer *** To clarify the influence of BG fluctuations on chemotherapy efficacy and safety in T2DM patients complicated with lung carcinoma(LC).METHODS The clinical data of 60 T2DM+LC patients who presented to the first Affiliated Hospital of Ningbo University between January 2019 and January 2021 were retrospectively *** patients underwent chemotherapy and were grouped as a control group(CG;normal BG fluctuation with a mean fluctuation<3.9 mmol/L)and an observation group(OG;high BG fluctuation with a mean fluctuation≥3.9 mmol/L)based on their BG fluctuations,with 30 cases *** indices,tumor markers,serum inflammatory cytokines and adverse reactions were comparatively *** correlation analysis was performed to analyze the correlation between BG fluctuations and tumor *** The fasting blood glucose and 2-hour postprandial blood glucose levels in the OG were notably elevated compared with those in the CG,together with markedly higher mean amplitude of glycemic excursions(MAGE),mean of daily differences,largest amplitude of glycemic excursions and standard deviation of blood glucose(P<0.05).In addition,the OG exhibited evidently higher levels of carbohydrate antigen 19-9,carbohydrate antigen 125,carcinoembryonic antigen,neuron-specific enolase,cytokeratin 19,tumor necrosis factor-α,interleukin-6,and highsensitivity C-reactive protein than the CG(P<0.05).Pearson analysis revealed a positive association of MAGE with serum tumor *** incidence of adverse reactions was significantly higher in the OG than in the CG(P<0.05).CONCLUSION The greater the BG fluctuation in LC patients after

关键词： Blood glucose fluctuation Type 2 diabetes mellitus Lung carcinoma Tumor markers

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Complement C1q induces the M2-polarization of tumor-associated macrophages in lung adenocarcinoma

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Genes & Diseases 2024年第4期11卷 145-148页

作者： Yuxiao Song Yang Fu Jun Wang Jiazhuo Tang Jiaxin Yin Zhimin Zhang Qibin Song Bicheng Zhang Cancer Center Renmin Hospital of Wuhan UniversityWuhanHubei 430061China department of Oncology Xiangyang HospitalHubei University of Chinese MedicineXiangyangHubei 441100China department of Oncology The First Affiliated Hospital of Shandong First Medical UniversityJinanShandong 250000China

Complement C1q was proved to be able to regulate the polarization of macrophages to the anti-inflammatory phenotype(M2 polarized),acting as an anti-inflammation molecule independent of the classical complement pathway.A high level of C1q expression has been detected in the tumor microenvironment(TME)of diverse tumors,including non-small cell lung cancer,in which C1q could be considered a predictor of poor prognosis.

关键词： C1q lung inflammation

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Soluble ST2:A Novel Biomarker for Diagnosis and Prognosis of Cardiovascular Disease

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当代医学科学（英文） 2024年第4期44卷 669-679页

作者： Yin FENG Li-qun HE department of cardiology Traditional Chinese and Western Medicine Hospital of WuhanTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China

The increasing incidence of cardiovascular disease(CVD)is a significant global health concern,affecting millions of individuals each *** diagnosis of acute CVD poses a formidable challenge,as misdiagnosis can significantly decrease patient survival *** biomarkers have played a vital role in the diagnosis and prognosis of CVDs,but they can be influenced by various factors,such as age,sex,and renal *** ST2(sST2)is a novel biomarker that is closely associated with different *** low reference change value makes it suitable for continuous measurement,unaffected by age,kidney function,and other confounding factors,facilitating risk stratification of ***,the combination of sST2 with other biomarkers can enhance diagnostic accuracy and prognostic *** review aims to provide a comprehensive overview of sST2,focusing on its diagnostic and prognostic value as a myocardial marker for different types of CVDs and discussing the current limitations of sST2.

关键词： cardiovascular disease combined biomarker diagnosis and prognosis limitations soluble ST2

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Advances in the application of hydrogel-based scaffolds for tendon repair

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Genes & Diseases 2024年第4期11卷 296-313页

作者： Renqiang Chen Fanglin Chen Kenian Chen Jian Xu department of Orthopedics The First Affiliated HospitalZhejiang University School of MedicineHangzhouZhejiang 310003China department of Orthopedics The Fourth Affiliated Hospital of Guangxi Medical UniversityLiuzhou Guangxi 545005China

Tendon injuries often lead to joint dysfunction due to the limited self-regeneration capacity of *** tendons is a major challenge for surgeons and imposes a signif-icant financial burden on ***,there is an urgent need to develop effective stra-tegies for repairing injured *** tissue engineering using hydrogels has emerged as a promising approach that has attracted considerable *** possess excellent biocompatibility and biodegradability,enabling them to create an extracellular matrix-like growth environment for *** can also serve as a carrier for cells or other substances to accelerate tendon *** the past decade,numerous studies have made significant prog-ress in the preparation of hydrogel scaffolds for tendon *** review aims to provide an overview of recent research on the materials of hydrogel-based scaffolds used for tendon tis-sue engineering and discusses the delivery systems based on them.

关键词： Application Hydrogel-based Repairscaffolds Review Tendon injury Tissue engineering

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Efficacy of ginseng-based Renshenguben oral solution for cancer-related fatigue among patients with advanced-stage hepatocellular carcinoma:A prospective multicenter cohort study

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Hepatobiliary & Pancreatic Diseases International 2024年第3期23卷 249-256页

作者： Ming-Da Wang Chen Yuan Ke-Chun Wang Nan-Ya Wang Ying-Jian Liang Hong Zhu Xiang-Min Tong Tian Yang department of Hepatobiliary and Pancreatic Surgery General Surgery CenterFirst Hospital of Jilin UniversityChangchun 130021China department of Hepatobiliary Surgery Eastern Hepatobiliary Surgery HospitalSecond Military Medical University(Naval Medical University)Shanghai 200438China department of Clinical Laboratory Laboratory Medicine CenterZhejiang Provincial People’s HospitalHangzhou Medical CollegeHangzhou 310000China department of Hepatobiliary Surgery First Affiliated Hospital of Harbin Medical UniversityHarbin 150007China department of Medical Oncology First Affiliated Hospital of Soochow UniversitySuzhou 215006China fdepartment of Central Laboratory Affiliated Hangzhou First People’s HospitalWestlake University School of MedicineHangzhou 310006China

Background:Cancer-related fatigue(CRF)is a common and debilitating symptom experienced by patients with advanced-stage cancer,especially those undergoing antitumor *** study aimed to evaluate the efficacy and safety of Renshenguben(RSGB)oral solution,a ginseng-based traditional Chinese medicine,in alleviating CRF in patients with advanced hepatocellular carcinoma(HCC)receiving antitumor ***:In this prospective,open-label,controlled,multicenter study,patients with advanced HCC at BCLC stage C and a brief fatigue inventory(BFI)score of≥4 were *** were assigned to the RSGB group(RSGB,10 mL twice daily)or the control group(with supportive care).Primary and secondary endpoints were the change in multidimensional fatigue inventory(MFI)score,and BFI and functional assessment of cancer therapy-hepatobiliary(FACT-Hep)scores at weeks 4 and 8 after *** events(AEs)and toxicities were ***:A total of 409 participants were enrolled,with 206 assigned to the RSGB *** week 4,there was a trend towards improvement,but the differences were not statistically *** week 8,the RSGB group exhibited a significantly lower MFI score(P<0.05)compared to the control group,indicating improved fatigue ***,the RSGB group showed significantly greater decrease in BFI and FACT-Hep scores at week 8(P<0.05).Subgroup analyses among patients receiving various antitumor treatments showed similar *** linear regression analyses revealed that the RSGB group experienced a significantly substantial decrease in MFI,BFI,and FACT-Hep scores at week *** serious drug-related AEs or toxicities were ***:RSGB oral solution effectively reduced CRF in patients with advanced HCC undergoing antitumor therapy over an eight-week period,with no discernible *** findings support the potential of RSGB oral solution as an adjunctive treatment for managing CRF in this patient population.

关键词： Cancer-related fatigue Hepatocellular carcinoma Renshenguben oral solution Efficacy Safety Ginseng

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Correlation between heart rate variables and the incidence of cardiovascular adverse events in patients with heart failure

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South China Journal of cardiology 2024年第3期 135-141页

作者：付兰兰李美玲潘志琼周佳 department of Ultrasound medicine The First Affiliated Hospital Hengyang Medical School University of South China department of cardiology The First Affiliated Hospital Hengyang Medical School University of South China

Background Chronic heart failure(CHF) is the end-stage manifestation and main cause of death of cardiovascular system diseases. Ventricular arrhythmia is a common complication, which can increase myocardial oxygen consumption, aggravate the disease, and even cause sudden death due to malignant arrhythmia. As a quantitative method to evaluate cardiac autonomic nervous function, heart rate variability is non-invasive and reproducible, and can quantify the risk associated with various cardiac and non-cardiac diseases. The purpose of this study was to analyze the correlation between heart rate variability and the incidence of cardiovascular adverse events in patients with heart failure. Methods 80 patients with heart failure who were treated in our hospital from May 2020 to May 2022 were selected as the study objects. After 3 months of follow-up, patients were divided into occurrence group(n=44) and nonoccurrence group(n=36) according to the occurrence of adverse cardiovascular events(angina pectoris, myocardial infarction, arrhythmia). The index of heart rate variability and the indicators of cardiac function in patients with heart failure was analyzed by one-way analysis of variance(ANOVA). The Key indicators of heart rate variability include standard deviation of normal RR interval(SDNN), mean standard deviation of consecutive 5-minute heartbeat interval(SDANN), square root of mean square of difference between adjacent heartbeat intervals(RMSSD), and percentage of RR intervals differing more than 50 ms from the preceding one(PNN50). The indicators of cardiac function include the New York Heart Association(NYHA) functional classification, left ventricular ejection fraction(LVEF), brain natriuretic peptide(BNP) and cardiac troponin I(c Tn I). Multivariate logistic regression was used to analyze the incidence of cardiovascular adverse events in patients with heart failure. Receiver operating characteristic(ROC) curve was used to analyze the predictive value of heart rat

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Effect of perioperative chemotherapy on resection of isolated pulmonary metastases from colorectal cancer:A single center experience

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World Journal of Gastrointestinal Oncology 2024年第8期16卷 3457-3470页

作者： Zhao Gao Xuan Jin Ying-Chao Wu Shi-Jie Zhang Shi-Kai Wu Xin Wang department of Medical Oncology Peking University First HospitalBeijing 10000China department of General Surgery Peking University First HospitalBeijing 10000China department of Thoracic Surgery Peking University First HospitalBeijing 10000China

BACKGROUND Numerous studies have assessed surgical resection as a standard treatment option for patients with colorectal cancer(CRC)and resectable pulmonary metastases(PM).However,the role of perioperative chemotherapy after complete resection of isolated PM from patients with CRC patients remains *** hypothesize that perioperative chemotherapy does not provide significant survival benefits for patients undergoing resection of PM from *** To determine whether perioperative chemotherapy affects survival after radical resection of isolated PM from *** We retrospectively collected demographic,clinical,and pathologic data on patients who underwent radical surgery for isolated PM from *** survival(CSS)and disease-free survival were calculated using Kaplan-Meier ***-group differences were compared using the log-rank *** multivariate analysis,Cox regression was utilized when *** This study included 120 patients with a median age of 61.6 *** 5-year CSS rate was 78.2%,with 36.7% experiencing *** resection for isolated PM resulted in a 5-year CSS rate of 50.0% for second *** chemotherapy(P=0.079)did not enhance survival *** associated with improved survival included fewer metastatic lesions[hazard ratio(HR):2.51,P=0.045],longer disease-free intervals(HR:0.35,P=0.016),and wedge lung resections(HR:0.42,P=0.035).Multiple PM predicted higher recurrence risk(HR:2.22,P=0.022).The log-rank test showed no significant difference in CSS between single and repeated metastasectomy(P=0.92).CONCLUSION Perioperative chemotherapy shows no survival benefit post-PM resection in ***-free intervals and fewer metastatic lesions predict better *** metastasectomy is warranted for eligible patients.

关键词： Pulmonary metastasis Colorectal cancer Perioperative chemotherapy Survival Repeated pulmonary metastasectomy

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Antiviral treatment standards for hepatitis B:An urgent need for expansion

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World Journal of Gastroenterology 2024年第4期30卷 418-420页

作者： Zi-Hong Bao Zhi-Kun Dai Hao-Xian Tang department of Infectious Diseases The First Affiliated Hospital of Shantou University Medical CollegeShantou 515041Guangdong ProvinceChina Medical College Shantou University Medical CollegeShantou 515041Guangdong ProvinceChina department of cardiology The First Affiliated Hospital of Shantou University Medical CollegeShantou 515041Guangdong ProvinceChina

The present letter to the editor is related to the review with the title“Past,present,and future of long-term treatment for hepatitis B virus.”Chronic hepatitis B(CHB)represents an important and pressing public health *** identification and effective antiviral therapy hold the potential to reduce liver-related mortality attributable to chronic infection with hepatitis B virus(HBV)***,the current global treatment rates for CHB remain conspicuously low,with the excessively stringent treatment criteria advocated by national CHB guidelines being a contributing factor to these low ***,recent strides in comprehending this malady and the emergence of novel antiviral agents prompt the imperative re-evaluation of treatment standards to extend the sphere of potential *** impending need arises for a novel paradigm for the classification of patients with CHB,the expansion of antiviral treatment eligibility for HBV-infected individuals,and even the streamlining of the diagnostic process for CHB to amplify cost-effectiveness and augment survival prospects.

关键词： Hepatitis B virus Chronic hepatitis B Antiviral treatment criteria Serum alanine aminotransferase Liver-related mortality Letter to the Editor

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Interferon-gamma regulates the progression of neuroblastoma cells through interferon-regulatory factor-1

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BIOCELL 2024年第9期48卷 1343-1353页

作者： JING WANG JUNFENG XU YINGRAN YANG YOUZHENG QIU SHANSHAN ZHANG NING WANG School of Clinical medicine Dali UniversityDali671000China department of Radiology The First Affiliated Hospital of Dali UniversityDali UniversityDali671000China department of Pediatric Surgery The First Affiliated Hospital of Dali UniversityDali UniversityDali671000China

Objective:This study aimed to elucidate the influence of IFN-gamma(IFN-γ)in neuroblastoma(NB)cells and reveal its potential underlying molecular ***:The Cell Counting Kit-8,Transwell apparatus,and flow cytometry were employed to assess cellular viability,migratory capacity,invasive potential,and apoptotic rates,***-seq combined with bioinformatics analysis revealed differentially expressed genes(DEGs)and their possible biological *** levels were determined by western blot ***:IFN-γtreatment resulted in diminished cell viability,mitigated migratory and invasive capabilities,and augmented apoptotic activity in the SK-N-BE(2)cell line,whereas it exhibited the opposite effect in SH-SY5Y ***,interferon regulatory factor 1(IRF-1)was the common DEG in both IFN-γ-treated SK-N-BE(2)and SH-SY5Y ***,we found that it was underexpressed in NB *** depletion of IRF-1 promoted the progression of both SK-N-BE(2)and SH-SY5Y ***,IRF-1 knockdown effectively counteracted the effects of IFN-γon SK-N-BE(2)cells,while exacerbating them in SH-SY5Y ***:This study verified that IFN-γexerted a distinct role in both N-Myc-and non-N-Myc-amplified NB cells,partially by mediating the expression of IRF-1,suggesting that it may serve as a potent agent for treating patients with NB.

关键词： Neuroblastoma N-Myc-amplified Non-N-Myc-amplified IFN-γ IRF-1

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