Objective:To assess the correlation between atmospheric pollutants,meteorological factors,and emergency department visits for respiratory diseases in Haikou City.Methods:Daily data on atmospheric pollutants,meteorolog...Objective:To assess the correlation between atmospheric pollutants,meteorological factors,and emergency department visits for respiratory diseases in Haikou City.Methods:Daily data on atmospheric pollutants,meteorological factors,and emergency department visits for respiratory diseases in Haikou City from 2018 to 2021 were collected.The Spearman rank correlation test was used to analyze the correlation,and a distributed lag non-linear model was employed to analyze the health effects and lag impacts of environmental factors.Subgroup analyses were conducted based on sex and age.Results:According to the criteria of International Classification of Diseases(ICD-10:J00-J99),a total of 221913 cases were included,accounting for 21.3%of the total emergency department visits in Haikou City.For every 1℃increase in temperature,the risk of emergency department visits increased by 1.029%(95%CI 1.016%-1.042%).Relative humidity greater than 80%reduced the risk of visits,while higher atmospheric pressure(>1010 hpa)also decreased the likelihood of daily emergency department visits.Higher concentrations of PM_(2.5)(30-50μg/m^(3)),PM10(>60μg/m^(3)),and O_(3)(75-125μg/m^(3))were associated with increased visits.Higher temperatures(>25℃)have a greater impact on females and children aged 0-14 years,while males are more sensitive to low atmospheric pressure.Individuals aged 65 and above exhibited increased sensitivity to O_(3)concentration,and the effects of PM2.5,PM10,and O_(3)are more pronounced in individuals over 14 years old.Conclusions:Short-term exposure to high temperatures,particulate matter pollutants(PM_(2.5)and PM_(10)),and ozone(O_(3))is associated with increased emergency department visits for respiratory diseases.展开更多
To further improve the ability of pre-hospital and in-hospital collaborative treatment, strengthen emergency multidisciplinary cooperation and construct a scientific, rational and efficient emergency system, under the...To further improve the ability of pre-hospital and in-hospital collaborative treatment, strengthen emergency multidisciplinary cooperation and construct a scientific, rational and efficient emergency system, under the support of former chairman Yu Xue-zhong, Dr. Li Chun-sheng and numerous colleagues in the industry, the Emergency Medicine Society of the Chinese Medical Association appeal to us to draft Construction of Emergency and Pre-hospital Platform. Based on this background, the platform of emergency and pre-hospital first aid helps to build a 'one horizontal and one Longitudinal' treatment model, using the horizontal and longitudinal patterns to integrate emergency medical resources to satisfy the automatic information integration and intelligent analysis sharing, realizing the emergency management visualization and medical information digitization, simplifying the medical process and establishing a perfect standard for the emergent diseases, thereby ultimately achieving efficient diagnosis and scientific treatment.展开更多
Objective:To investigate the effect of levosimendan on 28-day mortality in patients with sepsis.Methods:The English databases including Embase,PubMed,Web of Science,Cochrane Library and Chinese databasesincluding Chin...Objective:To investigate the effect of levosimendan on 28-day mortality in patients with sepsis.Methods:The English databases including Embase,PubMed,Web of Science,Cochrane Library and Chinese databasesincluding China National Knowledge Infrastructure(NKI),Wan fang Data,VIP,CBM were searched with levosimendan,sepsis and septic shock is as search terms.The published clinical randomized controlled trials of levosimendan injection were searched and the primary outcome measures of 28-day and 30-day mortality were included.Secondary outcome measures were left ventricular ejection fraction,left ventricular work index,cardiac index,and lactic acid.The literature retrieved is from the establishment of the database to October 2022.Stata 14.0 software was used for all data consolidation,publication bias monitoring and sensitivity analysis.Results:A total of 15 studies with 1337 patients were included in this meta-analysis.The results showed that at the 28-day mortality of patients with sepsis in the levosimendan group was not statistically superior to the 28-day mortality in the control group[RR=0.91,95%CI(0.78~1.06),Z=1.24,P=0.22].However,levosimendan can increase left ventricular ejection fraction,decrease left ventricular function index,increase cardiac index and decrease lactic acid in patients with sepsis.Conclusion:There is insufficient evidence to support a reduction in 28-day mortality in sepsis patients with levosimendan.However,levosimendan showed positive results on hemodynamic parameters,and more clinical trials are needed to verify the application of levosimendan in hemodynamic parameters of sepsis.展开更多
Sepsis is a syndrome characterized by systemic inflammatory response caused by infection or toxin, with high morbidity and mortality. Different infection microflora and environment have great influence on the occurren...Sepsis is a syndrome characterized by systemic inflammatory response caused by infection or toxin, with high morbidity and mortality. Different infection microflora and environment have great influence on the occurrence, development and prognosis of sepsis, but individual genetic factors also play an extremely important role. It was reported that the polymorphisms of mannose-binding lectin 2 gene were closely relevant to the occurrence and development of sepsis, but the conclusions in different studies were inconsistent. Therefore, we performed this reviews on the relevance of mannose-binding lectin 2 gene polymorphisms and sepsis.展开更多
1.Introduction Sudden cardiac death(SCD)refers to sudden death due to a variety of cardiac causes.It is manifested as a sudden loss of consciousness,cardiac arrest,and respiratory arrest and generally shows early symp...1.Introduction Sudden cardiac death(SCD)refers to sudden death due to a variety of cardiac causes.It is manifested as a sudden loss of consciousness,cardiac arrest,and respiratory arrest and generally shows early symptoms that are atypical and not easily detected[1].According to a recent study,nearly 544?000 patients suffer from SCD every year in China[2].Rescue of SCD patients in the shortest time is important as the survival rate will decrease by 7%-10%if the rescue is delayed for one minute[3].However,SCD mostly occurs in public places outside the hospital,including public sports places,transportation hubs(such as airports,railway stations,and subway stations),shopping centers,factories,and so on.Therefore,out-of-hospital cardiac arrest(OHCA)is a huge threat to people's lives."Chain of survival"proposed by the American Heart Association in 2015 emphasized the importance of early call for help,rapid implementation of high-quality cardiopulmonary resuscitation(CPR),and immediate use of an automated external defibrillator(AED)in improving the survival rate of OHCA patients.Studies have shown that conducting CPR within 1 min and AEDs defibrillation within 3 to 5 min can achieve a 50%to 70%survival rate for cardiac arrest patients[4].Therefore,early defibrillation of OHCA patients will markedly increase the survival rate.展开更多
Objective:To systematically evaluate the incidence of adverse reactions to coronavirus disease 2019(COVID-19)vaccination.Methods:We systematically searched PubMed,Embase,The Cochrane Library,Web of Science,CNKI,WanFan...Objective:To systematically evaluate the incidence of adverse reactions to coronavirus disease 2019(COVID-19)vaccination.Methods:We systematically searched PubMed,Embase,The Cochrane Library,Web of Science,CNKI,WanFang Data,and VIP Database from the inception of each database to August 31,2021.Randomized controlled clinical trials(RCTs)on the safety of different types of COVID-19 vaccines were retrieved and analyzed.A random or fixed-effects model was used with an odds ratio as the effect size.The quality of each reference was evaluated.The incidence of the adverse reactions of the placebo group and the vaccination group was compared.Heterogeneity and publication bias were taken care of by meta-regression and sub-group analyses.Results:A total of 13 articles were included,with 81287 subjects.Compared with the placebo group,the vaccination group showed a higher combined risk ratio(RR)of total adverse reactions(RR=1.67,95%CI:1.46-1.91,P<0.01),local adverse reactions(RR=2.86,95%CI:2.11-3.87,P<0.01),systemic adverse reactions(RR=1.25,95%CI:0.92-1.72,P=0.16),pain(RR=2.55,95%CI:1.75-3.70,P<0.01),swelling(RR=4.16,95%CI:1.71-10.17,P=0.002),fever(RR=2.34,95%CI:1.84-2.97,P<0.01),fatigue(RR=1.36,95%CI:1.32-1.41,P<0.01)and headache(RR=1.22,95%CI:1.18-1.26,P<0.01).The subgroup analysis showed the incidence of adverse reactions of the vaccination group after injection of the three COVID-19 vaccines(inactivated viral vaccines,mRNA vaccines and adenovirus vector vaccines)was higher than that of the placebo group,and the difference between the placebo group and the vaccination group in the mRNA vaccine subgroup and the adenovirus vector vaccine subgroup was statistically significant(P<0.01).The incidence of adverse reactions after injection of COVID-19 vaccine in subgroups of different ages was significantly higher than that in the placebo group(P<0.01).Conclusions:COVID-19 vaccines have a good safety,among which adenovirus vector vaccine has the highest incidence of adverse reactions.Both adolescents and adults vaccinated with novel coronavirus vaccine have a certain proportion of adverse reactions,but the symptoms are mild and can be relieved by themselves.Our meta-analysis can help boost global awareness of vaccine safety,promote mass vaccination,help build regional and global immune barriers and effectively curb the recurrency of COVID-19.展开更多
1.Introduction Sudden cardiac death(SCD)refers to sudden death due to a variety of cardiac causes.It is manifested as a sudden loss of consciousness,cardiac arrest,and respiratory arrest and generally shows early symp...1.Introduction Sudden cardiac death(SCD)refers to sudden death due to a variety of cardiac causes.It is manifested as a sudden loss of consciousness,cardiac arrest,and respiratory arrest and generally shows early symptoms that are atypical and not easily detected[1].According to a recent study,nearly 544000 patients suffer from SCD every year in China[2].展开更多
Objective:To predict and analyze the interaction between mannose-binding lectin 2(MBL2)protein and mannan-binding lectin-related serine proteases(MASPs)family proteins by bioinformatics.Methods:Homology modeling(Swiss...Objective:To predict and analyze the interaction between mannose-binding lectin 2(MBL2)protein and mannan-binding lectin-related serine proteases(MASPs)family proteins by bioinformatics.Methods:Homology modeling(Swiss-model)and fold recognition(Phyre 2)were used to construct the structure of MBL2 protein and MASPs family proteins,respectively.STRING database and ZDOCK 3.02 were used to predict and analyze the interaction between MBL2 and MASP1 and MASP2 proteins.Results:MBL2 had direct interaction with MASP1 and MASP2,and formed an interaction network with COLEEC11,COLEC10,FCN2,and C4B.The binding sites of MBL2 and MASP1 and MASP2 overlapped highly.MBL2 participated in the binding of MASP1 residues,and most of them(77%)were also involved in the binding of MASP2,suggesting that MBL2 interacted with the proteins of MASPs family through the same region.Conclusion:MBL2 and MASPs family proteins play an important role in the activation of the complement system and immune defense of the body.展开更多
Wounds in diabetic patients,especially diabetic foot ulcers,are more difficult to heal compared with normal wounds and can easily deteriorate,leading to amputation.Common treatments cannot heal diabetic wounds or cont...Wounds in diabetic patients,especially diabetic foot ulcers,are more difficult to heal compared with normal wounds and can easily deteriorate,leading to amputation.Common treatments cannot heal diabetic wounds or control their many complications.Growth factors are found to play important roles in regulating complex diabetic wound healing.Different growth factors such as transforming growth factor beta 1,insulin-like growth factor,and vascular endothelial growth factor play different roles in diabetic wound healing.This implies that a therapeutic modality modulating different growth factors to suit wound healing can significantly improve the treatment of diabetic wounds.Further,some current treatments have been shown to promote the healing of diabetic wounds by modulating specific growth factors.The purpose of this study was to discuss the role played by each growth factor in therapeutic approaches so as to stimulate further therapeutic thinking.展开更多
Objective:To investigate the predictive value of controlling nutritional status(CONUT)score for progression to chronic critical illness sepsis in elderly patients,and to construct a predictive model based on CONUT sco...Objective:To investigate the predictive value of controlling nutritional status(CONUT)score for progression to chronic critical illness sepsis in elderly patients,and to construct a predictive model based on CONUT score histogram.Methods:739 elderly patients with sepsis admitted from January 2020 to December 2022 were selected as the study objects,and were divided into chronic critical illness group(n=188)and non-chronic critical illness group(n=551)according to whether chronic critical illness disease occurred.Clinical data of the patients were collected and compared.The predictive value of CONUT score,PNI and NLR in the progression of senile sepsis to chronic severe disease was compared,and the optimal threshold value was determined,which was used to convert the numerical variables into binary variables.Through univariate analysis and multivariate Logistic regression analysis,the risk factors affecting the progression of elderly sepsis patients to chronic critical illness disease were screened out,and the prediction model was built based on the nomogram.The efficacy and clinical utility of the prediction model were evaluated by the area under the ROC curve(AUC),calibration curve and decision curve analysis(DCA).Results:The best cut-off value for CONUT score in predicting elderly sepsis progressing to chronic critical illness was 4 points.The predictive performance of CONUT score(AUC=0.739)was better than that of PNI(AUC=0.609)and NLR(AUC=0.582)in elderly sepsis progressing to chronic critical illness(CONUT score vs PNI:Z=5.960,P<0.001;CONUT score vs NLR:Z=6.119,P<0.001).Univariate analysis showed that age,CCI score,SOFA score,sepsis shock,serum Lac,CONUT score,mechanical ventilation(MV),and continuous renal replacement therapy(CRRT)treatment were related to elderly sepsis progressing to chronic critical illness(P<0.05).Multivariate logistic regression analysis showed that CONUT score≥4 points,age≥75 years,CCI score≥3 points,SOFA score>5 points,sepsis shock,and serum Lac≥4 mmol/L were independent risk factors for elderly sepsis progressing to chronic critical illness(P<0.05).The nomogram showed that CONUT score had the greatest contribution value in predicting elderly sepsis progressing to chronic critical illness.Based on this,the nomogram prediction model had an AUC of 0.846[95%CI(0.812~0.879)],with a sensitivity of 75.5%and specificity of 81.3%,indicating good predictive performance.The calibration curve was close to the ideal curve,and the DCA threshold had clinical utility advantages when ranging from 0.1 to 0.9.Conclusion:The nomographic prediction model based on CONUT score can effectively predict the risk probability of senile sepsis progressing to chronic critical illness,helpful for clinicians to identify the high risk group of chronic and severe senile sepsis,which is helpful for clinicians to identify high-risk populations of elderly sepsis with chronic critical illness.展开更多
Objective:To explore the possible mechanism of neutrophil exosomes regulating macrophage apoptosis.Methods:neutrophils were induced by lipopolysaccharide,inflammatory factors were detected by ELISA,the morphology of e...Objective:To explore the possible mechanism of neutrophil exosomes regulating macrophage apoptosis.Methods:neutrophils were induced by lipopolysaccharide,inflammatory factors were detected by ELISA,the morphology of exosomes was identified by electron microscope,and the expression of mir-15a-5p in exosomes was detected by RT-PCR;Raw267.4 macrophages was treated with neutrophil exosomes and mir-15a-5p mimic respectively,CCK8 to detect cell viability,flow cytometry to detect apoptosis;The binding sites of mir-15a-5p and BCL2L2 were predicted and verified by double luciferase experiment;RT-PCR and Western blot verified that mir-15a-5p regulate the expression of BCL2L2.Results:lipopolysaccharide induced neutrophil inflammatory factors IL-2,IL-6,IL-10 and TNF-α.The morphological characteristics of exosomes were observed by electron microscope.Mir-15a-5p was significantly overexpressed in neutrophil exosomes induced by lipopolysaccharide;Lipopolysaccharide-induced neutrophil exosomes and mir-15a-5p simulants can promote raw267.4 macrophage apoptosis and inhibit its cell viability;Targetscan database predicted that mir-15a-5p and BCL2L2 had binding sites.Double-luciferase experiment verified that mir-15a-5p and BCL2L2 bound through binding sites;Mir-15a-5p mimic was transfected into raw267.4 macrophages which inhibit the expression of BCL2L2 mRNA and protein.Conclusion:inflammatory neutrophils may promote raw267.4 by secreting exosomes containing mir-15a-5p and inhibiting BCL2L2 by targeting macrophage apoptosis.This may provide a theoretical basis for further understanding the molecular mechanism of inflammatory regulation of neutrophils and macrophages.展开更多
BACKGROUND:The high morbidity,high mortality and low survival rate of cardiac arrest(CA)cause a heavy global burden.We aimed to analyze the changes in scientific output related to CA over the past two decades.METHODS:...BACKGROUND:The high morbidity,high mortality and low survival rate of cardiac arrest(CA)cause a heavy global burden.We aimed to analyze the changes in scientific output related to CA over the past two decades.METHODS:We analyzed the scientific output related to CA from 2000 to 2020 via the Web of Science.The data were analyzed using CiteSpace software.RESULTS:In total,28,312 articles relating to CA were identified in the Web of Science.The volume of scientific research output in the field of global CA research was mainly distributed in the Americas,Europe and Asia,covering a wide range.Of the 28,312 articles,the research content of the highly cited literature mainly focused on CA,mild hypothermia treatment,and prognosis of CA patients.CONCLUSION:Various scientific methods were applied to reveal scientific productivity,collaboration,and research hotspots in the CA research field.Cardiopulmonary resuscitation(CPR),extracorporeal membrane oxygenation(ECMO),survival and target temperature management are research hotspots.Future research on CA will continue to focus on its treatment and prognosis to improve the survival rate of CA patients.展开更多
Objective:To evaluate the effect of midkine on lipopolysaccharide(LPS)-induced airway smooth muscle cells(ASMCs).Methods:LPS-stimulated acute lung injury model was used to analyze the effect of midkine on ASMCs in vit...Objective:To evaluate the effect of midkine on lipopolysaccharide(LPS)-induced airway smooth muscle cells(ASMCs).Methods:LPS-stimulated acute lung injury model was used to analyze the effect of midkine on ASMCs in vitro.Recombinant midkine and midkine siRNA were used to investigate the role of Notch2 signaling pathway.Cell proliferation was assessed using Cell Counting Kit-8 assay.Additionally,apoptosis was measured by flow cytometry and protein and mRNA expression of midkine and Notch2 was assessed by Western blotting and qPCR,respectively.Immunofluorescence analysis was also conducted.Results:LPS increased the mRNA and protein expression of midkine and Notch2.Midkine silencing reduced LPS-induced midkine and Notch2 expression.In addition,midkine silencing further reduced the viability and increased apoptosis of ASMCs induced by LPS,which was attenuated by recombinant midkine.Conclusions:The midkine/Notch2 signaling pathway plays a regulatory role in ASMC proliferation and apoptosis in airway inflammation.展开更多
Paraquat is a bipyridine dichloride non-selective herbicide,which was widely used in the world in the last century.Now,paraquat is banned in most countries because of the extremely high lethality and the lack of speci...Paraquat is a bipyridine dichloride non-selective herbicide,which was widely used in the world in the last century.Now,paraquat is banned in most countries because of the extremely high lethality and the lack of specific detoxification drugs.However,death due to paraquat poisoning still occurs frequently,thus it is of great clinical significance to explore the molecular mechanism of paraquat poisoning and the detoxification drugs.Paraquat poisoning causes multiple dysfunction of the lung,liver,kidney,heart,and brain through complex molecular mechanisms.About the mechanism there are excessive inflammatory reaction theory,REDOX reaction imbalance theory,oxidative stress free radical damage theory,calcium overload theory,NO molecular damage and cell apoptosis theory,etc.For the treatment of paraquat poisoning,paraquat antibody,pathway target blocker and related factor antibody have been developed in recent years.Although certain effects have been achieved,the treatment efficiency has not been significantly improved.This paper summarized the mechanism of signal transduction pathways involved in lung injury induced by paraquat poisoning in order to provide a theoretical basis for further research.展开更多
Since the start of the COVID-19 pandemic,there has been an urgent need to produce accurate and sensitive tests.However,there have been instances where a positive nucleic acid test turns negative after treatment,and th...Since the start of the COVID-19 pandemic,there has been an urgent need to produce accurate and sensitive tests.However,there have been instances where a positive nucleic acid test turns negative after treatment,and then positive again.This case report describes such an instance from the tropical region of Hainan,China.The patient was a 61-year-old female who went to Hainan on vacation from Wuhan during the COVID-19 pandemic in 2020.Symptoms appeared 9 d after arriving in Hainan,and it was confirmed that the nucleic acid test was positive after 4 repeats.Her condition declined rapidly,her heart stopped beating,and she was admitted in a coma to the ICU.After treatment,the SARS-CoV-2 virus nucleic acid test of several nasopharyngeal swabs were negative,and tests on whole blood,anal swabs,and urine were also negative.Later,however,nucleic acid tests on a lower respiratory tract sputum swab and lower respiratory tract lavage fluid were positive.An autopsy examination was carried out 12h after her death,and multi-organ secretions were extracted for nucleic acid testing.The SARS-CoV-2 virus nucleic acid was only detected in the swabs from the end of the bronchus,which was confirmed by the visualization of the coronavirus by electron microscopy.Autopsy confirmed that the damage was mainly concentrated in the lungs and immune organs and tissues throughout the body.Epidemiology indicated that none of the people she came into contact with after arriving in Hainan,including close contacts,were infected.This is in sharp contrast to the highly contagious virus in Wuhan in the temperate zone during the same period.This case report indicates:(1)The high temperatures in tropical areas may have an impact on the spread and harm of COVID-19,and(2)The reason why nucleic acid testing for COVID-19 was initially negative and then positive after treatment may be related to the survival of the SARS-CoV-2 virus in deep lung tissues.展开更多
Sepsis is an infection-induced systemic inflammatory syndrome.The immune response in sepsis is characterized by the activation of both proinflammatory and anti-inflammatory pathways.When sepsis occurs,the expression a...Sepsis is an infection-induced systemic inflammatory syndrome.The immune response in sepsis is characterized by the activation of both proinflammatory and anti-inflammatory pathways.When sepsis occurs,the expression and activity of many inflammatory cytokines are markedly affected.Xenobiotic receptors are chemical-sensing transcription factors that play essential roles in the transcriptional regulation of drug-metabolizing enzymes(DMEs).Xenobiotic receptors mediate the functional crosstalk between sepsis and drug metabolism because the inflammatory cytokines released during sepsis can affect the expression and activity of xenobiotic receptors and thus impact the expression and activity of DMEs.Xenobiotic receptors in turn may affect the clinical outcomes of sepsis.Thisreview focuses on the sepsis-induced inflammatory response and xenobiotic receptors such as pregnane X receptor(PXR),aryl hydrocarbon receptor(AHR),glucocorticoid receptor(GR),and constitutive androstane receptor(CAR),DMEs such as CYP1A,CYP2B6,CYP2C9,and CYP3A4,and drug transporters such as p-glycoprotein(P-gp),and multidrug resistance-associated protein(MRPs)that are affected by sepsis.Understanding the xenobiotic receptor-mediated effect of sepsis on drug metabolism will help to improve the safe use of drugs in sepsis patients and the development of new xenobiotic receptor-based therapeutic strategies for sepsis.展开更多
基金the National Natural Science Foundation of China(No:81960351)Research Foundation for Advanced Talents of Hainan(No:822RC835)Province Natural Science Key Foundation of Hainan(No:ZDYF 2019125).
文摘Objective:To assess the correlation between atmospheric pollutants,meteorological factors,and emergency department visits for respiratory diseases in Haikou City.Methods:Daily data on atmospheric pollutants,meteorological factors,and emergency department visits for respiratory diseases in Haikou City from 2018 to 2021 were collected.The Spearman rank correlation test was used to analyze the correlation,and a distributed lag non-linear model was employed to analyze the health effects and lag impacts of environmental factors.Subgroup analyses were conducted based on sex and age.Results:According to the criteria of International Classification of Diseases(ICD-10:J00-J99),a total of 221913 cases were included,accounting for 21.3%of the total emergency department visits in Haikou City.For every 1℃increase in temperature,the risk of emergency department visits increased by 1.029%(95%CI 1.016%-1.042%).Relative humidity greater than 80%reduced the risk of visits,while higher atmospheric pressure(>1010 hpa)also decreased the likelihood of daily emergency department visits.Higher concentrations of PM_(2.5)(30-50μg/m^(3)),PM10(>60μg/m^(3)),and O_(3)(75-125μg/m^(3))were associated with increased visits.Higher temperatures(>25℃)have a greater impact on females and children aged 0-14 years,while males are more sensitive to low atmospheric pressure.Individuals aged 65 and above exhibited increased sensitivity to O_(3)concentration,and the effects of PM2.5,PM10,and O_(3)are more pronounced in individuals over 14 years old.Conclusions:Short-term exposure to high temperatures,particulate matter pollutants(PM_(2.5)and PM_(10)),and ozone(O_(3))is associated with increased emergency department visits for respiratory diseases.
文摘To further improve the ability of pre-hospital and in-hospital collaborative treatment, strengthen emergency multidisciplinary cooperation and construct a scientific, rational and efficient emergency system, under the support of former chairman Yu Xue-zhong, Dr. Li Chun-sheng and numerous colleagues in the industry, the Emergency Medicine Society of the Chinese Medical Association appeal to us to draft Construction of Emergency and Pre-hospital Platform. Based on this background, the platform of emergency and pre-hospital first aid helps to build a 'one horizontal and one Longitudinal' treatment model, using the horizontal and longitudinal patterns to integrate emergency medical resources to satisfy the automatic information integration and intelligent analysis sharing, realizing the emergency management visualization and medical information digitization, simplifying the medical process and establishing a perfect standard for the emergent diseases, thereby ultimately achieving efficient diagnosis and scientific treatment.
基金This study was supported by National Natural Foundation Project of China(No81760341)。
文摘Objective:To investigate the effect of levosimendan on 28-day mortality in patients with sepsis.Methods:The English databases including Embase,PubMed,Web of Science,Cochrane Library and Chinese databasesincluding China National Knowledge Infrastructure(NKI),Wan fang Data,VIP,CBM were searched with levosimendan,sepsis and septic shock is as search terms.The published clinical randomized controlled trials of levosimendan injection were searched and the primary outcome measures of 28-day and 30-day mortality were included.Secondary outcome measures were left ventricular ejection fraction,left ventricular work index,cardiac index,and lactic acid.The literature retrieved is from the establishment of the database to October 2022.Stata 14.0 software was used for all data consolidation,publication bias monitoring and sensitivity analysis.Results:A total of 15 studies with 1337 patients were included in this meta-analysis.The results showed that at the 28-day mortality of patients with sepsis in the levosimendan group was not statistically superior to the 28-day mortality in the control group[RR=0.91,95%CI(0.78~1.06),Z=1.24,P=0.22].However,levosimendan can increase left ventricular ejection fraction,decrease left ventricular function index,increase cardiac index and decrease lactic acid in patients with sepsis.Conclusion:There is insufficient evidence to support a reduction in 28-day mortality in sepsis patients with levosimendan.However,levosimendan showed positive results on hemodynamic parameters,and more clinical trials are needed to verify the application of levosimendan in hemodynamic parameters of sepsis.
基金National Natural Science Foundation of China(81860347)Hainan Provincial Natural Science Foundation of China(818MS140)+2 种基金Young Talents'Science and Technology Innovation Project of Hainan Association for Science and Technology(QCXM201816)Hainan Provincial Health and Family Planning Commission Project(18A200178)Undergraduate Innovative Experiment Project of Hainan Medical University(HYCX2018122).
文摘Sepsis is a syndrome characterized by systemic inflammatory response caused by infection or toxin, with high morbidity and mortality. Different infection microflora and environment have great influence on the occurrence, development and prognosis of sepsis, but individual genetic factors also play an extremely important role. It was reported that the polymorphisms of mannose-binding lectin 2 gene were closely relevant to the occurrence and development of sepsis, but the conclusions in different studies were inconsistent. Therefore, we performed this reviews on the relevance of mannose-binding lectin 2 gene polymorphisms and sepsis.
基金This study was supported by Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(2019-I2M-5-023)Hainan Provincial Science and Technology Major Project(ZDKJ201804)+2 种基金National Natural Science Foundation of China(81871611)National Natural Science Foundation of China(81760352)Project of Hainan Provincial Department of Education(Hnjg2019ZD-16).
文摘1.Introduction Sudden cardiac death(SCD)refers to sudden death due to a variety of cardiac causes.It is manifested as a sudden loss of consciousness,cardiac arrest,and respiratory arrest and generally shows early symptoms that are atypical and not easily detected[1].According to a recent study,nearly 544?000 patients suffer from SCD every year in China[2].Rescue of SCD patients in the shortest time is important as the survival rate will decrease by 7%-10%if the rescue is delayed for one minute[3].However,SCD mostly occurs in public places outside the hospital,including public sports places,transportation hubs(such as airports,railway stations,and subway stations),shopping centers,factories,and so on.Therefore,out-of-hospital cardiac arrest(OHCA)is a huge threat to people's lives."Chain of survival"proposed by the American Heart Association in 2015 emphasized the importance of early call for help,rapid implementation of high-quality cardiopulmonary resuscitation(CPR),and immediate use of an automated external defibrillator(AED)in improving the survival rate of OHCA patients.Studies have shown that conducting CPR within 1 min and AEDs defibrillation within 3 to 5 min can achieve a 50%to 70%survival rate for cardiac arrest patients[4].Therefore,early defibrillation of OHCA patients will markedly increase the survival rate.
基金funded the Province Natural Science key Foundation of Hainan(No:ZDYFXGFY2020004 and No:ZDYF 2019125)the National Natural Science Foundation of China(No:81960351)Hainan Province Clinical Medical Center.
文摘Objective:To systematically evaluate the incidence of adverse reactions to coronavirus disease 2019(COVID-19)vaccination.Methods:We systematically searched PubMed,Embase,The Cochrane Library,Web of Science,CNKI,WanFang Data,and VIP Database from the inception of each database to August 31,2021.Randomized controlled clinical trials(RCTs)on the safety of different types of COVID-19 vaccines were retrieved and analyzed.A random or fixed-effects model was used with an odds ratio as the effect size.The quality of each reference was evaluated.The incidence of the adverse reactions of the placebo group and the vaccination group was compared.Heterogeneity and publication bias were taken care of by meta-regression and sub-group analyses.Results:A total of 13 articles were included,with 81287 subjects.Compared with the placebo group,the vaccination group showed a higher combined risk ratio(RR)of total adverse reactions(RR=1.67,95%CI:1.46-1.91,P<0.01),local adverse reactions(RR=2.86,95%CI:2.11-3.87,P<0.01),systemic adverse reactions(RR=1.25,95%CI:0.92-1.72,P=0.16),pain(RR=2.55,95%CI:1.75-3.70,P<0.01),swelling(RR=4.16,95%CI:1.71-10.17,P=0.002),fever(RR=2.34,95%CI:1.84-2.97,P<0.01),fatigue(RR=1.36,95%CI:1.32-1.41,P<0.01)and headache(RR=1.22,95%CI:1.18-1.26,P<0.01).The subgroup analysis showed the incidence of adverse reactions of the vaccination group after injection of the three COVID-19 vaccines(inactivated viral vaccines,mRNA vaccines and adenovirus vector vaccines)was higher than that of the placebo group,and the difference between the placebo group and the vaccination group in the mRNA vaccine subgroup and the adenovirus vector vaccine subgroup was statistically significant(P<0.01).The incidence of adverse reactions after injection of COVID-19 vaccine in subgroups of different ages was significantly higher than that in the placebo group(P<0.01).Conclusions:COVID-19 vaccines have a good safety,among which adenovirus vector vaccine has the highest incidence of adverse reactions.Both adolescents and adults vaccinated with novel coronavirus vaccine have a certain proportion of adverse reactions,but the symptoms are mild and can be relieved by themselves.Our meta-analysis can help boost global awareness of vaccine safety,promote mass vaccination,help build regional and global immune barriers and effectively curb the recurrency of COVID-19.
基金Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(No.2019-I2M-5-023)Hainan Provincial Science and Technology Major Project(No.ZDKJ201804)+2 种基金National Natural Science Foundation of China(No.81871611)National Natural Science Foundation of China(No.81760352)Project of Hainan Provincial Department of Education(No.Hnjg2019ZD-16)
文摘1.Introduction Sudden cardiac death(SCD)refers to sudden death due to a variety of cardiac causes.It is manifested as a sudden loss of consciousness,cardiac arrest,and respiratory arrest and generally shows early symptoms that are atypical and not easily detected[1].According to a recent study,nearly 544000 patients suffer from SCD every year in China[2].
基金This study was supported by National Natural Science Foundation of China(Grant No.81860347)Hainan Provincial Natural Science Foundation of China(Grant No.818MS140)+2 种基金Young Talents’Science and Technology Innovation Project of Hainan Association for Science and Technology(Grant No.QCXM201816)Hainan Provincial Health and Family Planning Commission Project(Grant No.18A200178)Military Medical Innovation Project(Grant No.18CXZ002).
文摘Objective:To predict and analyze the interaction between mannose-binding lectin 2(MBL2)protein and mannan-binding lectin-related serine proteases(MASPs)family proteins by bioinformatics.Methods:Homology modeling(Swiss-model)and fold recognition(Phyre 2)were used to construct the structure of MBL2 protein and MASPs family proteins,respectively.STRING database and ZDOCK 3.02 were used to predict and analyze the interaction between MBL2 and MASP1 and MASP2 proteins.Results:MBL2 had direct interaction with MASP1 and MASP2,and formed an interaction network with COLEEC11,COLEC10,FCN2,and C4B.The binding sites of MBL2 and MASP1 and MASP2 overlapped highly.MBL2 participated in the binding of MASP1 residues,and most of them(77%)were also involved in the binding of MASP2,suggesting that MBL2 interacted with the proteins of MASPs family through the same region.Conclusion:MBL2 and MASPs family proteins play an important role in the activation of the complement system and immune defense of the body.
基金Supported by the National Natural Science Foundation of China,No.81971891 and No.82172196Key Laboratory of Emergency and Trauma(Hainan Medical University)of Ministry of Education,No.KLET-202108the College Students’Innovation and Entrepreneurship Project,No.S20210026020013.
文摘Wounds in diabetic patients,especially diabetic foot ulcers,are more difficult to heal compared with normal wounds and can easily deteriorate,leading to amputation.Common treatments cannot heal diabetic wounds or control their many complications.Growth factors are found to play important roles in regulating complex diabetic wound healing.Different growth factors such as transforming growth factor beta 1,insulin-like growth factor,and vascular endothelial growth factor play different roles in diabetic wound healing.This implies that a therapeutic modality modulating different growth factors to suit wound healing can significantly improve the treatment of diabetic wounds.Further,some current treatments have been shown to promote the healing of diabetic wounds by modulating specific growth factors.The purpose of this study was to discuss the role played by each growth factor in therapeutic approaches so as to stimulate further therapeutic thinking.
基金Natural Science Foundation of Hainan Provincial(No.819MS128)。
文摘Objective:To investigate the predictive value of controlling nutritional status(CONUT)score for progression to chronic critical illness sepsis in elderly patients,and to construct a predictive model based on CONUT score histogram.Methods:739 elderly patients with sepsis admitted from January 2020 to December 2022 were selected as the study objects,and were divided into chronic critical illness group(n=188)and non-chronic critical illness group(n=551)according to whether chronic critical illness disease occurred.Clinical data of the patients were collected and compared.The predictive value of CONUT score,PNI and NLR in the progression of senile sepsis to chronic severe disease was compared,and the optimal threshold value was determined,which was used to convert the numerical variables into binary variables.Through univariate analysis and multivariate Logistic regression analysis,the risk factors affecting the progression of elderly sepsis patients to chronic critical illness disease were screened out,and the prediction model was built based on the nomogram.The efficacy and clinical utility of the prediction model were evaluated by the area under the ROC curve(AUC),calibration curve and decision curve analysis(DCA).Results:The best cut-off value for CONUT score in predicting elderly sepsis progressing to chronic critical illness was 4 points.The predictive performance of CONUT score(AUC=0.739)was better than that of PNI(AUC=0.609)and NLR(AUC=0.582)in elderly sepsis progressing to chronic critical illness(CONUT score vs PNI:Z=5.960,P<0.001;CONUT score vs NLR:Z=6.119,P<0.001).Univariate analysis showed that age,CCI score,SOFA score,sepsis shock,serum Lac,CONUT score,mechanical ventilation(MV),and continuous renal replacement therapy(CRRT)treatment were related to elderly sepsis progressing to chronic critical illness(P<0.05).Multivariate logistic regression analysis showed that CONUT score≥4 points,age≥75 years,CCI score≥3 points,SOFA score>5 points,sepsis shock,and serum Lac≥4 mmol/L were independent risk factors for elderly sepsis progressing to chronic critical illness(P<0.05).The nomogram showed that CONUT score had the greatest contribution value in predicting elderly sepsis progressing to chronic critical illness.Based on this,the nomogram prediction model had an AUC of 0.846[95%CI(0.812~0.879)],with a sensitivity of 75.5%and specificity of 81.3%,indicating good predictive performance.The calibration curve was close to the ideal curve,and the DCA threshold had clinical utility advantages when ranging from 0.1 to 0.9.Conclusion:The nomographic prediction model based on CONUT score can effectively predict the risk probability of senile sepsis progressing to chronic critical illness,helpful for clinicians to identify the high risk group of chronic and severe senile sepsis,which is helpful for clinicians to identify high-risk populations of elderly sepsis with chronic critical illness.
基金National Natural Science Foundation of China (No.82060357)Hainan Natural Science Foundation (No.2019RC370,820RC757)Research Project of Hainan Provincial Health Commission (No.20A200021)。
文摘Objective:To explore the possible mechanism of neutrophil exosomes regulating macrophage apoptosis.Methods:neutrophils were induced by lipopolysaccharide,inflammatory factors were detected by ELISA,the morphology of exosomes was identified by electron microscope,and the expression of mir-15a-5p in exosomes was detected by RT-PCR;Raw267.4 macrophages was treated with neutrophil exosomes and mir-15a-5p mimic respectively,CCK8 to detect cell viability,flow cytometry to detect apoptosis;The binding sites of mir-15a-5p and BCL2L2 were predicted and verified by double luciferase experiment;RT-PCR and Western blot verified that mir-15a-5p regulate the expression of BCL2L2.Results:lipopolysaccharide induced neutrophil inflammatory factors IL-2,IL-6,IL-10 and TNF-α.The morphological characteristics of exosomes were observed by electron microscope.Mir-15a-5p was significantly overexpressed in neutrophil exosomes induced by lipopolysaccharide;Lipopolysaccharide-induced neutrophil exosomes and mir-15a-5p simulants can promote raw267.4 macrophage apoptosis and inhibit its cell viability;Targetscan database predicted that mir-15a-5p and BCL2L2 had binding sites.Double-luciferase experiment verified that mir-15a-5p and BCL2L2 bound through binding sites;Mir-15a-5p mimic was transfected into raw267.4 macrophages which inhibit the expression of BCL2L2 mRNA and protein.Conclusion:inflammatory neutrophils may promote raw267.4 by secreting exosomes containing mir-15a-5p and inhibiting BCL2L2 by targeting macrophage apoptosis.This may provide a theoretical basis for further understanding the molecular mechanism of inflammatory regulation of neutrophils and macrophages.
基金This study was supported by the National Natural Science Foundation of China(8216120150)Hainan Provincial Key Research and Development Project(ZDYF2020112)+2 种基金Hainan Provincial Science and Technology Major Project(ZDKJ202004)Key Laboratory of Emergency and Trauma(Hainan Medical University)Ministry of Education(Grant.KLET-202002).
文摘BACKGROUND:The high morbidity,high mortality and low survival rate of cardiac arrest(CA)cause a heavy global burden.We aimed to analyze the changes in scientific output related to CA over the past two decades.METHODS:We analyzed the scientific output related to CA from 2000 to 2020 via the Web of Science.The data were analyzed using CiteSpace software.RESULTS:In total,28,312 articles relating to CA were identified in the Web of Science.The volume of scientific research output in the field of global CA research was mainly distributed in the Americas,Europe and Asia,covering a wide range.Of the 28,312 articles,the research content of the highly cited literature mainly focused on CA,mild hypothermia treatment,and prognosis of CA patients.CONCLUSION:Various scientific methods were applied to reveal scientific productivity,collaboration,and research hotspots in the CA research field.Cardiopulmonary resuscitation(CPR),extracorporeal membrane oxygenation(ECMO),survival and target temperature management are research hotspots.Future research on CA will continue to focus on its treatment and prognosis to improve the survival rate of CA patients.
基金supported by the National Natural Science Foundation of China(NO.81660011,81960351)Hainan Provincial Social Development Foundation(NO.ZDYFXGFY2020004)Hainan Provincial Medical and Health Research Project(NO.22A200036).
文摘Objective:To evaluate the effect of midkine on lipopolysaccharide(LPS)-induced airway smooth muscle cells(ASMCs).Methods:LPS-stimulated acute lung injury model was used to analyze the effect of midkine on ASMCs in vitro.Recombinant midkine and midkine siRNA were used to investigate the role of Notch2 signaling pathway.Cell proliferation was assessed using Cell Counting Kit-8 assay.Additionally,apoptosis was measured by flow cytometry and protein and mRNA expression of midkine and Notch2 was assessed by Western blotting and qPCR,respectively.Immunofluorescence analysis was also conducted.Results:LPS increased the mRNA and protein expression of midkine and Notch2.Midkine silencing reduced LPS-induced midkine and Notch2 expression.In addition,midkine silencing further reduced the viability and increased apoptosis of ASMCs induced by LPS,which was attenuated by recombinant midkine.Conclusions:The midkine/Notch2 signaling pathway plays a regulatory role in ASMC proliferation and apoptosis in airway inflammation.
基金Natural Science Foundation of China-Regional Project(No.81960351)Social development key project of Hainan province(No.ZDYF2019125).
文摘Paraquat is a bipyridine dichloride non-selective herbicide,which was widely used in the world in the last century.Now,paraquat is banned in most countries because of the extremely high lethality and the lack of specific detoxification drugs.However,death due to paraquat poisoning still occurs frequently,thus it is of great clinical significance to explore the molecular mechanism of paraquat poisoning and the detoxification drugs.Paraquat poisoning causes multiple dysfunction of the lung,liver,kidney,heart,and brain through complex molecular mechanisms.About the mechanism there are excessive inflammatory reaction theory,REDOX reaction imbalance theory,oxidative stress free radical damage theory,calcium overload theory,NO molecular damage and cell apoptosis theory,etc.For the treatment of paraquat poisoning,paraquat antibody,pathway target blocker and related factor antibody have been developed in recent years.Although certain effects have been achieved,the treatment efficiency has not been significantly improved.This paper summarized the mechanism of signal transduction pathways involved in lung injury induced by paraquat poisoning in order to provide a theoretical basis for further research.
基金supported by grants from the National Natural Science Foundation of China(grand numbers 81560304 and 82060341).
文摘Since the start of the COVID-19 pandemic,there has been an urgent need to produce accurate and sensitive tests.However,there have been instances where a positive nucleic acid test turns negative after treatment,and then positive again.This case report describes such an instance from the tropical region of Hainan,China.The patient was a 61-year-old female who went to Hainan on vacation from Wuhan during the COVID-19 pandemic in 2020.Symptoms appeared 9 d after arriving in Hainan,and it was confirmed that the nucleic acid test was positive after 4 repeats.Her condition declined rapidly,her heart stopped beating,and she was admitted in a coma to the ICU.After treatment,the SARS-CoV-2 virus nucleic acid test of several nasopharyngeal swabs were negative,and tests on whole blood,anal swabs,and urine were also negative.Later,however,nucleic acid tests on a lower respiratory tract sputum swab and lower respiratory tract lavage fluid were positive.An autopsy examination was carried out 12h after her death,and multi-organ secretions were extracted for nucleic acid testing.The SARS-CoV-2 virus nucleic acid was only detected in the swabs from the end of the bronchus,which was confirmed by the visualization of the coronavirus by electron microscopy.Autopsy confirmed that the damage was mainly concentrated in the lungs and immune organs and tissues throughout the body.Epidemiology indicated that none of the people she came into contact with after arriving in Hainan,including close contacts,were infected.This is in sharp contrast to the highly contagious virus in Wuhan in the temperate zone during the same period.This case report indicates:(1)The high temperatures in tropical areas may have an impact on the spread and harm of COVID-19,and(2)The reason why nucleic acid testing for COVID-19 was initially negative and then positive after treatment may be related to the survival of the SARS-CoV-2 virus in deep lung tissues.
基金supported by grants from the National Natural Science Foundation of China(8140130969and 8176130232)Hainan Provincial Science and Technology Major Project(ZDKJ201804,China).
文摘Sepsis is an infection-induced systemic inflammatory syndrome.The immune response in sepsis is characterized by the activation of both proinflammatory and anti-inflammatory pathways.When sepsis occurs,the expression and activity of many inflammatory cytokines are markedly affected.Xenobiotic receptors are chemical-sensing transcription factors that play essential roles in the transcriptional regulation of drug-metabolizing enzymes(DMEs).Xenobiotic receptors mediate the functional crosstalk between sepsis and drug metabolism because the inflammatory cytokines released during sepsis can affect the expression and activity of xenobiotic receptors and thus impact the expression and activity of DMEs.Xenobiotic receptors in turn may affect the clinical outcomes of sepsis.Thisreview focuses on the sepsis-induced inflammatory response and xenobiotic receptors such as pregnane X receptor(PXR),aryl hydrocarbon receptor(AHR),glucocorticoid receptor(GR),and constitutive androstane receptor(CAR),DMEs such as CYP1A,CYP2B6,CYP2C9,and CYP3A4,and drug transporters such as p-glycoprotein(P-gp),and multidrug resistance-associated protein(MRPs)that are affected by sepsis.Understanding the xenobiotic receptor-mediated effect of sepsis on drug metabolism will help to improve the safe use of drugs in sepsis patients and the development of new xenobiotic receptor-based therapeutic strategies for sepsis.
