BACKGROUND:This study aims to explore whether Xuebijing(XBJ) can improve intestinal microcirculation dysfunction in sepsis and its mechanism.METHODS:A rat model of sepsis was established by cecal ligation and puncture...BACKGROUND:This study aims to explore whether Xuebijing(XBJ) can improve intestinal microcirculation dysfunction in sepsis and its mechanism.METHODS:A rat model of sepsis was established by cecal ligation and puncture(CLP).A total of 30 male SD rats were divided into four groups:sham group,CLP group,XBJ + axitinib group,and XBJ group.XBJ was intraperitoneally injected 2 h before CLP.Hemodynamic data(blood pressure and heart rate) were recorded.The intestinal microcirculation data of the rats were analyzed via microcirculation imaging.Enzyme-linked immunosorbent assay(ELISA) kits were used to detect the serum levels of interleukin-6(IL-6),C-reactive protein(CRP),and tumor necrosis factor-α(TNF-α) in the rats.Histological analysis and transmission electron microscopy were used to analyze the injury of small intestinal microvascular endothelial cells and small intestinal mucosa in rats.The expression of vascular endothelial growth factor A(VEGF-A),phosphoinositide 3-kinase(PI3K),phosphorylated PI3K(p-PI3K),protein kinase B(Akt),and phosphorylated Akt(p-Akt) in the small intestine was analyzed via Western blotting.RESULTS:XBJ improved intestinal microcirculation dysfunction in septic rats,alleviated the injury of small intestinal microvascular endothelial cells and small intestinal mucosa,and reduced the systemic inflammatory response.Moreover,XBJ upregulated the expression of VEGF-A,p-PI3K/total PI3K,and p-Akt/total Akt in the rat small intestine.CONCLUSION:XBJ may improve intestinal microcirculation dysfunction in septic rats possibly through the VEGF-A/PI3K/Akt signaling pathway.展开更多
BACKGROUND This report delves into the diagnostic and therapeutic journey undertaken by a patient with high-dose cantharidin poisoning and multiorgan dysfunction syndrome(MODS).Particular emphasis is placed on the com...BACKGROUND This report delves into the diagnostic and therapeutic journey undertaken by a patient with high-dose cantharidin poisoning and multiorgan dysfunction syndrome(MODS).Particular emphasis is placed on the comprehensive elucidation of the clinical manifestations of high-dose cantharidin poisoning,the intricate path to diagnosis,and the exploration of potential underlying mechanisms.CASE SUMMARY A patient taking 10 g of cantharidin powder orally subsequently developed MODS.The patient was treated with supportive care,fluid hydration and antibiotics,and hemoperfusion and hemofiltration therapy for 24 h and successfully recovered 8 d after hospital admission.Cantharidin poisoning can cause lifethreatening MODS and is rare clinically.This case underscores the challenge in diagnosis and highlights the need for early clinical differentiation to facilitate accurate assessment and prompt intervention.CONCLUSION This article has reported and analyzed the clinical data,diagnosis,treatment,and prognosis of a case of high-dose cantharidin poisoning resulting in MODS and reviewed the relevant literature to improve the clinical understanding of this rare condition.展开更多
BACKGROUND:Sepsis-induced liver injury is a fatal complication of sepsis.Trichostatin A(TSA)regulates inflammation and autophagy in some human diseases,and forkhead box O3a(FoxO3a)has been shown to regulate autophagy....BACKGROUND:Sepsis-induced liver injury is a fatal complication of sepsis.Trichostatin A(TSA)regulates inflammation and autophagy in some human diseases,and forkhead box O3a(FoxO3a)has been shown to regulate autophagy.The present study aims to investigate whether TSA exerts its effects on septic liver injury through the FoxO3a/autophagy signaling pathway.METHODS:A sepsis mouse model was constructed by the cecal ligation and puncture(CLP)method,and AML12 cells were pretreated with lipopolysaccharide(LPS)(1μg/mL)to establish a sepsis cell model.Forty mice were divided into four groups,namely control group,TSA group,CLP group,and CLP+TSA group,with 10 mice in each group.Cells were divided into control group,TSA group,LPS group,and LPS+TSA group.Hematoxylin-eosin(H&E)staining and biochemical methods were used to evaluate liver tissue injury.Enzyme-linked immunosorbent assay(ELISA)was applied to detect the expression of proinflammatory cytokines,and Western blotting and immunofluorescence were used to measure autophagy-related protein expression.RESULTS:Compared with the CLP group(mice),the proinflammatory cytokines(interleukin-β[IL-β]2,665.27±324.90 pg/mL to 2,080.26±373.66 pg/mL;interleukin-6[IL-6]399.01±60.98 pg/mL to 221.90±46.89 pg/mL)and the hepatocyte injury markers(aspartate transaminase[AST]from 198.18±27.07 U/L to 128.42±20.55 U/L;alanine aminotransferase[ALT]from 634.98±74.10 U/L to 478.60±32.56 U/L)were notably decreased after TSA intervention.Moreover,LC3 II and FoxO3a showed an obvious increase and P62 showed an obvious decrease in the CLP+TSA group.Cell experiment results showed the similar trend.After Fox O3a gene was knocked down in AML12 cells,the promotion of autophagy and the improvement of liver enzyme index and inflammation by TSA were weakened.CONCLUSION:TSA may improve the inflammatory response and liver injury in septic mice through Fox O3a/autophagy.展开更多
BACKGROUND Primary biliary cholangitis(PBC)and autoimmune hepatitis(AIH)are two unexplained immune diseases.The golden standard for diagnosis of these diseases requires a liver biopsy.Liver biopsy is not widely accept...BACKGROUND Primary biliary cholangitis(PBC)and autoimmune hepatitis(AIH)are two unexplained immune diseases.The golden standard for diagnosis of these diseases requires a liver biopsy.Liver biopsy is not widely accepted by patients because of its invasive nature,and atypical liver histology can confuse diagnosis.In view of the lack of effective diagnostic markers for PBC and AIH,combined with the increasingly mature metabolomics technologies,including full-contour metabolomics and target.AIM To determine non-invasive,reliable,and sensitive biochemical markers for the differential diagnosis of PBC and AIH.METHODS Serum samples from 54 patients with PBC,26 patients with AIH and 30 healthy controls were analyzed by Ultra-high performance liquid chromatographytandem mass spectrometry serum metabolomics.The metabolites and metabolic pathways were identified,and the metabolic changes,metabolic pathways and inter-group differences between PBC and AIH were analyzed.Fifteen kinds of target metabolites of bile acids(BAs)were quantitatively analyzed by SRM,and the differential metabolites related to the diagnosis of PBC were screened by receiver operating characteristic curve analysis.RESULTS We found the changes in the levels of amino acids,BAs,organic acids,phospholipids,choline,sugar,and sugar alcohols in patients with PBC and AIH.Furthermore,the SRM assay of BAs revealed the increased levels of chenodeoxycholic acid,lithocholic acid(LCA),taurolithocholic acid(TLCA),and LCA+TLCA in the PBC group compared with those in the AIH group.The levels of BAs may be used as biomarkers to differentiate PBC from AIH diseases.The levels of glycochenodeoxycholic acid,glycochenodeoxycholic sulfate,and taurodeoxycholic acid were gradually elevated with the increase of Child-Pugh class,which was correlated with the severity of disease.CONCLUSION The results demonstrated that the levels of BAs could serve as potential biomarkers for the early diagnosis and assessment of the severity of PBC and AIH.展开更多
Dear editor,Spontaneous pneumomediastinum(SPM,also known as Hamman’s syndrome)is an uncommon finding.SPM is induced without any comorbidities and is secondary to underlying factors,such as smoke,asthma,esophageal rup...Dear editor,Spontaneous pneumomediastinum(SPM,also known as Hamman’s syndrome)is an uncommon finding.SPM is induced without any comorbidities and is secondary to underlying factors,such as smoke,asthma,esophageal rupture,or labor and delivery.[1,2]The frequency of idiopathic pneumomediastinum is 1 of 32,000 hospitalized persons.[3]Awareness of SPM and appropriate examination play a key role in the early diagnosis and intervention for SPM to avoid potentially serious complications.SPM in diabetic ketoacidosis(DKA)has been described in several case reports.[4-6]However,most data are described from isolated cases,and these cases have varying clinical symptoms.This study presents a case series of ten patients diagnosed with SPM complicating DKA to assess their characteristics,treatment,and prognosis.展开更多
Dear editor,Eggerthelle lenta(E.lenta)is a gram-positive non-spore-bearing anaerobic bacilli that was first isolated from human feces by Arnold Eggerth in 1935.[1]It is classified as an anaerobic eubacterium that cann...Dear editor,Eggerthelle lenta(E.lenta)is a gram-positive non-spore-bearing anaerobic bacilli that was first isolated from human feces by Arnold Eggerth in 1935.[1]It is classified as an anaerobic eubacterium that cannot decompose glucose and tryptophan[2]but can synthesize diff erent kinds of steroid metabolism enzymes.[3]On the basis of the high content of guanine+cytosine detected by 16S ribosomal RNA gene sequencing,its original name Eubacterium lentum was changed to E.lenta and concurrently transferred to its own distinct genus Eggerthella.[4]E.lenta often exists in the gastrointestinal tract.[5]Previous reports on E.lenta-induced sepsis were rare.Herein,we present a case of E.lenta-induced sepsis with abdominal pain as the main symptom.展开更多
Objective:To systematically evaluate the effect and safety of additional Yupingfeng powder combined with western medicine for the stable period of chronic obstructive pulmonary disease(COPD).Method:Databases including...Objective:To systematically evaluate the effect and safety of additional Yupingfeng powder combined with western medicine for the stable period of chronic obstructive pulmonary disease(COPD).Method:Databases including Pubmed、Web of Science、Cochrane Library、CNKI、VIP、CBM and Wanfang Data base,were searched for relevant randomized controlled trials.for Chinese and English literature about randomized controlled trials of additional Yupingfeng in the treatment of COPD on stable stage which were published from the establishment of the database to December 2019.Two researchers independently screened for,selected studies according to the inclusion and exclusion criteria and extracted data.Methodological quality was evaluated using the Cochrane Risk of Bias tool.Meta-analysis was performed using Revman 5.3 software.Results:Ninetine randomized controlled trials including 1511 patients with COPD were meta-analyzed.The total sample size was 1511.The results showed that the treatment grop with additional Yupingfeng powder could improve the clinical efficacy[OR=0.26,95%CI(0.18,0.37)],FEV1 percentage of the estimated value[MD=4.61,95%CI(2.43,6.79)],6MWD[MD=43.90,95%CI(29.48,58.32)]and patient's immunity IgA[MD=0.25,95%CI(0.17,0.34)]and can mitigate cough effectively[MD=-0.34,95%CI(-0.46,-0.23)].Conclusion:Additional Yupingfeng powder combined with routine treatment for COPD has more advantages than conventional treatment alone in improving the clinical efficacy,lung function,immune function and have less adverse events.As most of the included studies in this systematic evaluation had poor quality,the evidence to support conclusion was weak,so it was necessary to conduct more multi-center clinical trials with high quality methods and rigorous design.展开更多
基金supported by a grant from National Natural Science Foundation of China (82272196)。
文摘BACKGROUND:This study aims to explore whether Xuebijing(XBJ) can improve intestinal microcirculation dysfunction in sepsis and its mechanism.METHODS:A rat model of sepsis was established by cecal ligation and puncture(CLP).A total of 30 male SD rats were divided into four groups:sham group,CLP group,XBJ + axitinib group,and XBJ group.XBJ was intraperitoneally injected 2 h before CLP.Hemodynamic data(blood pressure and heart rate) were recorded.The intestinal microcirculation data of the rats were analyzed via microcirculation imaging.Enzyme-linked immunosorbent assay(ELISA) kits were used to detect the serum levels of interleukin-6(IL-6),C-reactive protein(CRP),and tumor necrosis factor-α(TNF-α) in the rats.Histological analysis and transmission electron microscopy were used to analyze the injury of small intestinal microvascular endothelial cells and small intestinal mucosa in rats.The expression of vascular endothelial growth factor A(VEGF-A),phosphoinositide 3-kinase(PI3K),phosphorylated PI3K(p-PI3K),protein kinase B(Akt),and phosphorylated Akt(p-Akt) in the small intestine was analyzed via Western blotting.RESULTS:XBJ improved intestinal microcirculation dysfunction in septic rats,alleviated the injury of small intestinal microvascular endothelial cells and small intestinal mucosa,and reduced the systemic inflammatory response.Moreover,XBJ upregulated the expression of VEGF-A,p-PI3K/total PI3K,and p-Akt/total Akt in the rat small intestine.CONCLUSION:XBJ may improve intestinal microcirculation dysfunction in septic rats possibly through the VEGF-A/PI3K/Akt signaling pathway.
基金Supported by Jilin Province Science and Technology Agency Project,No.20210101350JCProject of Jilin Provincial Finance Department,No.JLSWSRCZX2023-60Beijing iGandan Foundation Fund for Artificial Liver,No.iGandanF-1082023-RGG025.
文摘BACKGROUND This report delves into the diagnostic and therapeutic journey undertaken by a patient with high-dose cantharidin poisoning and multiorgan dysfunction syndrome(MODS).Particular emphasis is placed on the comprehensive elucidation of the clinical manifestations of high-dose cantharidin poisoning,the intricate path to diagnosis,and the exploration of potential underlying mechanisms.CASE SUMMARY A patient taking 10 g of cantharidin powder orally subsequently developed MODS.The patient was treated with supportive care,fluid hydration and antibiotics,and hemoperfusion and hemofiltration therapy for 24 h and successfully recovered 8 d after hospital admission.Cantharidin poisoning can cause lifethreatening MODS and is rare clinically.This case underscores the challenge in diagnosis and highlights the need for early clinical differentiation to facilitate accurate assessment and prompt intervention.CONCLUSION This article has reported and analyzed the clinical data,diagnosis,treatment,and prognosis of a case of high-dose cantharidin poisoning resulting in MODS and reviewed the relevant literature to improve the clinical understanding of this rare condition.
基金This study was supported by a grant from National Natural Science Foundation of China (81871600)
文摘BACKGROUND:Sepsis-induced liver injury is a fatal complication of sepsis.Trichostatin A(TSA)regulates inflammation and autophagy in some human diseases,and forkhead box O3a(FoxO3a)has been shown to regulate autophagy.The present study aims to investigate whether TSA exerts its effects on septic liver injury through the FoxO3a/autophagy signaling pathway.METHODS:A sepsis mouse model was constructed by the cecal ligation and puncture(CLP)method,and AML12 cells were pretreated with lipopolysaccharide(LPS)(1μg/mL)to establish a sepsis cell model.Forty mice were divided into four groups,namely control group,TSA group,CLP group,and CLP+TSA group,with 10 mice in each group.Cells were divided into control group,TSA group,LPS group,and LPS+TSA group.Hematoxylin-eosin(H&E)staining and biochemical methods were used to evaluate liver tissue injury.Enzyme-linked immunosorbent assay(ELISA)was applied to detect the expression of proinflammatory cytokines,and Western blotting and immunofluorescence were used to measure autophagy-related protein expression.RESULTS:Compared with the CLP group(mice),the proinflammatory cytokines(interleukin-β[IL-β]2,665.27±324.90 pg/mL to 2,080.26±373.66 pg/mL;interleukin-6[IL-6]399.01±60.98 pg/mL to 221.90±46.89 pg/mL)and the hepatocyte injury markers(aspartate transaminase[AST]from 198.18±27.07 U/L to 128.42±20.55 U/L;alanine aminotransferase[ALT]from 634.98±74.10 U/L to 478.60±32.56 U/L)were notably decreased after TSA intervention.Moreover,LC3 II and FoxO3a showed an obvious increase and P62 showed an obvious decrease in the CLP+TSA group.Cell experiment results showed the similar trend.After Fox O3a gene was knocked down in AML12 cells,the promotion of autophagy and the improvement of liver enzyme index and inflammation by TSA were weakened.CONCLUSION:TSA may improve the inflammatory response and liver injury in septic mice through Fox O3a/autophagy.
基金Supported by Health and Family Planning Commission Project of Jilin Province,No.2016Q043Health and Hygiene Committee Project of Jilin Province,No.2021LC082。
文摘BACKGROUND Primary biliary cholangitis(PBC)and autoimmune hepatitis(AIH)are two unexplained immune diseases.The golden standard for diagnosis of these diseases requires a liver biopsy.Liver biopsy is not widely accepted by patients because of its invasive nature,and atypical liver histology can confuse diagnosis.In view of the lack of effective diagnostic markers for PBC and AIH,combined with the increasingly mature metabolomics technologies,including full-contour metabolomics and target.AIM To determine non-invasive,reliable,and sensitive biochemical markers for the differential diagnosis of PBC and AIH.METHODS Serum samples from 54 patients with PBC,26 patients with AIH and 30 healthy controls were analyzed by Ultra-high performance liquid chromatographytandem mass spectrometry serum metabolomics.The metabolites and metabolic pathways were identified,and the metabolic changes,metabolic pathways and inter-group differences between PBC and AIH were analyzed.Fifteen kinds of target metabolites of bile acids(BAs)were quantitatively analyzed by SRM,and the differential metabolites related to the diagnosis of PBC were screened by receiver operating characteristic curve analysis.RESULTS We found the changes in the levels of amino acids,BAs,organic acids,phospholipids,choline,sugar,and sugar alcohols in patients with PBC and AIH.Furthermore,the SRM assay of BAs revealed the increased levels of chenodeoxycholic acid,lithocholic acid(LCA),taurolithocholic acid(TLCA),and LCA+TLCA in the PBC group compared with those in the AIH group.The levels of BAs may be used as biomarkers to differentiate PBC from AIH diseases.The levels of glycochenodeoxycholic acid,glycochenodeoxycholic sulfate,and taurodeoxycholic acid were gradually elevated with the increase of Child-Pugh class,which was correlated with the severity of disease.CONCLUSION The results demonstrated that the levels of BAs could serve as potential biomarkers for the early diagnosis and assessment of the severity of PBC and AIH.
文摘Dear editor,Spontaneous pneumomediastinum(SPM,also known as Hamman’s syndrome)is an uncommon finding.SPM is induced without any comorbidities and is secondary to underlying factors,such as smoke,asthma,esophageal rupture,or labor and delivery.[1,2]The frequency of idiopathic pneumomediastinum is 1 of 32,000 hospitalized persons.[3]Awareness of SPM and appropriate examination play a key role in the early diagnosis and intervention for SPM to avoid potentially serious complications.SPM in diabetic ketoacidosis(DKA)has been described in several case reports.[4-6]However,most data are described from isolated cases,and these cases have varying clinical symptoms.This study presents a case series of ten patients diagnosed with SPM complicating DKA to assess their characteristics,treatment,and prognosis.
文摘Dear editor,Eggerthelle lenta(E.lenta)is a gram-positive non-spore-bearing anaerobic bacilli that was first isolated from human feces by Arnold Eggerth in 1935.[1]It is classified as an anaerobic eubacterium that cannot decompose glucose and tryptophan[2]but can synthesize diff erent kinds of steroid metabolism enzymes.[3]On the basis of the high content of guanine+cytosine detected by 16S ribosomal RNA gene sequencing,its original name Eubacterium lentum was changed to E.lenta and concurrently transferred to its own distinct genus Eggerthella.[4]E.lenta often exists in the gastrointestinal tract.[5]Previous reports on E.lenta-induced sepsis were rare.Herein,we present a case of E.lenta-induced sepsis with abdominal pain as the main symptom.
基金National Science and Technology Major Projects of Sudden Severe Acute Respiratory Infectious Diseases Treatment New Technology research and the New Scheme(No.2017 zx10204401)。
文摘Objective:To systematically evaluate the effect and safety of additional Yupingfeng powder combined with western medicine for the stable period of chronic obstructive pulmonary disease(COPD).Method:Databases including Pubmed、Web of Science、Cochrane Library、CNKI、VIP、CBM and Wanfang Data base,were searched for relevant randomized controlled trials.for Chinese and English literature about randomized controlled trials of additional Yupingfeng in the treatment of COPD on stable stage which were published from the establishment of the database to December 2019.Two researchers independently screened for,selected studies according to the inclusion and exclusion criteria and extracted data.Methodological quality was evaluated using the Cochrane Risk of Bias tool.Meta-analysis was performed using Revman 5.3 software.Results:Ninetine randomized controlled trials including 1511 patients with COPD were meta-analyzed.The total sample size was 1511.The results showed that the treatment grop with additional Yupingfeng powder could improve the clinical efficacy[OR=0.26,95%CI(0.18,0.37)],FEV1 percentage of the estimated value[MD=4.61,95%CI(2.43,6.79)],6MWD[MD=43.90,95%CI(29.48,58.32)]and patient's immunity IgA[MD=0.25,95%CI(0.17,0.34)]and can mitigate cough effectively[MD=-0.34,95%CI(-0.46,-0.23)].Conclusion:Additional Yupingfeng powder combined with routine treatment for COPD has more advantages than conventional treatment alone in improving the clinical efficacy,lung function,immune function and have less adverse events.As most of the included studies in this systematic evaluation had poor quality,the evidence to support conclusion was weak,so it was necessary to conduct more multi-center clinical trials with high quality methods and rigorous design.
