BACKGROUND The mortality rate from septic shock in patients with hematological malignancies(HMs)remains significantly higher than that in patients without HMs.A longer resuscitation time would definitely be harmful be...BACKGROUND The mortality rate from septic shock in patients with hematological malignancies(HMs)remains significantly higher than that in patients without HMs.A longer resuscitation time would definitely be harmful because of the irreversibly immunocompromised status of the patients.Shortening the resuscitation time through continuous renal replacement therapy(CRRT)with oXiris^(■)would be an attractive strategy in managing such patients.AIM To explore the effects of CRRT and oXiris^(■)in shortening the resuscitation time and modifying the host response by reducing inflammation mediator levels.METHODS Forty-five patients with HM were diagnosed with septic shock and underwent CRRT between 2018 and 2022.Patients were divided into two groups based on the hemofilter used for CRRT(oXiris^(■)group,n=26;M150 group,n=19).We compared the number of days of negative and total fluid balance after 7 d of CRRT between the groups.The heart rate,norepinephrine dose,Sequential Organ Failure Assessment(SOFA)score,and blood lactic acid levels at different time points in the two groups were also compared.Blood levels of inflammatory mediators in the 26 patients in the oXiris^(■)group were measured to further infer the possible mechanism.RESULTS The average total fluid balance after 7 d of CRRT in the oXiris^(■)group was significantly lower than that of patients in the M150 hemofilter group.The SOFA scores of patients after CRRT with oXiris^(■)therapy were significantly lower than those before treatment on day 1(d1),d3 and d7 after CRRT;these parameters were also significantly lower than those of the control group on d7.The lac level after oXiris^(■)therapy was significantly lower than that before treatment on d3 and d7 after CRRT.There were no significant differences in the above parameters between the two groups at the other time points.In the oXiris^(■)group,procalcitonin levels decreased on d7,whereas interleukin-6 and tumor necrosis factor levels decreased significantly on d3 and d7 after treatment.CONCLUSION CRRT with oXiris^(■)hemofilter may improve hemodynamics by reducing inflammatory mediators and playing a role in shortening the resuscitation period and decreasing total fluid balance in the resuscitation phases.展开更多
Efficient initiation and resolution of inflammation are crucial for wound repair.However,with using tissue adhesives for wound repair,patients occasionally suffered from delayed healing process because slow eliminatio...Efficient initiation and resolution of inflammation are crucial for wound repair.However,with using tissue adhesives for wound repair,patients occasionally suffered from delayed healing process because slow elimination of those exogenous adhesives generally leads to chronic inflammation.As the demand for minimal invasive therapy continues to rise,desire for adhesive materials that can effectively reconnect surgical gaps and promote wound regeneration becomes increasingly urgent.Herein,by exploiting the inherent porous structure and performance of adhesion to tissue of mesoporous silica nanoparticles(MSNs),we demonstrate a tissue adhesive that can elicit acute inflammatory response and get eliminated after tissue reformation.With formation of nanocomposites in wound gaps,the injured tissues can get reconnected conveniently.The resultant accelerated healing process verifty that the strategy of exploiting unique properties of nanomaterials can effectively promote inflammation resolution and wound repair.This design strategy will inspire more innovative tissue adhesives for clinical applications.展开更多
基金Hebei Health Science and Education Project,No.20200852.
文摘BACKGROUND The mortality rate from septic shock in patients with hematological malignancies(HMs)remains significantly higher than that in patients without HMs.A longer resuscitation time would definitely be harmful because of the irreversibly immunocompromised status of the patients.Shortening the resuscitation time through continuous renal replacement therapy(CRRT)with oXiris^(■)would be an attractive strategy in managing such patients.AIM To explore the effects of CRRT and oXiris^(■)in shortening the resuscitation time and modifying the host response by reducing inflammation mediator levels.METHODS Forty-five patients with HM were diagnosed with septic shock and underwent CRRT between 2018 and 2022.Patients were divided into two groups based on the hemofilter used for CRRT(oXiris^(■)group,n=26;M150 group,n=19).We compared the number of days of negative and total fluid balance after 7 d of CRRT between the groups.The heart rate,norepinephrine dose,Sequential Organ Failure Assessment(SOFA)score,and blood lactic acid levels at different time points in the two groups were also compared.Blood levels of inflammatory mediators in the 26 patients in the oXiris^(■)group were measured to further infer the possible mechanism.RESULTS The average total fluid balance after 7 d of CRRT in the oXiris^(■)group was significantly lower than that of patients in the M150 hemofilter group.The SOFA scores of patients after CRRT with oXiris^(■)therapy were significantly lower than those before treatment on day 1(d1),d3 and d7 after CRRT;these parameters were also significantly lower than those of the control group on d7.The lac level after oXiris^(■)therapy was significantly lower than that before treatment on d3 and d7 after CRRT.There were no significant differences in the above parameters between the two groups at the other time points.In the oXiris^(■)group,procalcitonin levels decreased on d7,whereas interleukin-6 and tumor necrosis factor levels decreased significantly on d3 and d7 after treatment.CONCLUSION CRRT with oXiris^(■)hemofilter may improve hemodynamics by reducing inflammatory mediators and playing a role in shortening the resuscitation period and decreasing total fluid balance in the resuscitation phases.
基金Project supported by the National Basic Research Program(973 Program)of China(No.2012CB215303)the Science Research Foundation of Shandong Entry-Exit Inspection and Quarantine Bureau of China(No.SK201042)
基金This work was supported by the National Natural Science Foundation of China(Nos.51732011,21431006,21761132008,51471157,21401183,and 21771168)the Foundation for Innovative Research Groups of the National Natural Science Foundation of China(No.21521001)+3 种基金Key Research Program of Frontier Sciences,CAS(No.QYZDJ-SSW-SLH036)the National Basic Research Program of China(No.2014CB931800)the Users with Excellence and Scientific Research Grant of Hefei Science Center of CAS(No.2015HSC-UE007)the Youth Innovation Promotion Association of CAS(No.2014298).
文摘Efficient initiation and resolution of inflammation are crucial for wound repair.However,with using tissue adhesives for wound repair,patients occasionally suffered from delayed healing process because slow elimination of those exogenous adhesives generally leads to chronic inflammation.As the demand for minimal invasive therapy continues to rise,desire for adhesive materials that can effectively reconnect surgical gaps and promote wound regeneration becomes increasingly urgent.Herein,by exploiting the inherent porous structure and performance of adhesion to tissue of mesoporous silica nanoparticles(MSNs),we demonstrate a tissue adhesive that can elicit acute inflammatory response and get eliminated after tissue reformation.With formation of nanocomposites in wound gaps,the injured tissues can get reconnected conveniently.The resultant accelerated healing process verifty that the strategy of exploiting unique properties of nanomaterials can effectively promote inflammation resolution and wound repair.This design strategy will inspire more innovative tissue adhesives for clinical applications.
