Objective To investigate the effects of the pre-shock state on the mortality of patients with sepsis.Methods We enrolled patients with sepsis admitted to the medical intensive care unit of a tertiary care university h...Objective To investigate the effects of the pre-shock state on the mortality of patients with sepsis.Methods We enrolled patients with sepsis admitted to the medical intensive care unit of a tertiary care university hospital. These patients were then classified into three groups: sepsis, pre-shock state,and septic shock. The primary outcome was the 28-day mortality rate. The secondary outcomes were the 90-day, 180-day, and 1-year mortality rates.Results A total of 303 patients(groups: sepsis 135 [44.6%]), pre-shock state(93 [30.7%]), and septic shock(75 [24.8%]) completed the 1-year follow-up. The mortality rates at 28 days, 90 days, and 180days and 1 year were significantly higher in the pre-shock state group than those of the sepsis group,but significantly lower than those in the septic shock group, especially among older patients. When compared with the pre-shock state group, the sepsis group had significantly lower mortality risks at 28days, 90 days, and 180 days and 1 year, whereas the sepsis shock group had higher mortality risks at these time points.Conclusion The mortality rates of patients in the pre-shock state were notably different from those of patients with sepsis or septic shock. The introduction of a modified sepsis severity classification, which includes sepsis, pre-shock state, and septic shock, could offer valuable additional prognostic information.展开更多
AIM: To determine the incidence, etiology, risk factors and outcome of ventilator-associated pneumonia(VAP) in patients undergoing orthotopic liver transplantation(OLT).METHODS: This retrospective study considered 242...AIM: To determine the incidence, etiology, risk factors and outcome of ventilator-associated pneumonia(VAP) in patients undergoing orthotopic liver transplantation(OLT).METHODS: This retrospective study considered 242 patients undergoing deceased donor OLT. VAP was diagnosed according to clinical and microbiological criteria. RESULTS: VAP occurred in 18(7.4%) patients, with an incidence of 10 per 1000 d of mechanical ventilation(MV). Isolated bacterial etiologic agents were mainly Enterobacteriaceae(79%). Univariate logistic analysis showed that model for end-stage liver disease(MELD) score, pre-operative hospitalization, treatment with terlipressin, Child-Turcotte-Pugh score, days of MV and red cell transfusion were risk factors for VAP. Multivariateanalysis, considering significant risk factors in univariate analysis, demonstrated that pneumonia was strongly associated with terlipressin usage, pre-operative hospitalization, days of MV and red cell transfusion. Mortality rate was 22% in the VAP group vs 4% in the group without VAP. CONCLUSION: Our data suggest that VAP is an important cause of nosocomial infection during postoperative period in OLT patients. MELD score was a significant risk factor in univariate analysis. Multiple transfusions, treatment with terlipressin, preoperative hospitalization rather than called to the hospital while at home and days of MV constitute important risk factors for VAP development.展开更多
Objective: To study the treatmaient of non-small cell lung cancer, we established the HU-Prim allograft transplantation tumor model. Methods: The fresh tumor samples were transplanted in the right scapular subcutaneou...Objective: To study the treatmaient of non-small cell lung cancer, we established the HU-Prim allograft transplantation tumor model. Methods: The fresh tumor samples were transplanted in the right scapular subcutaneous layer of the severe combined immunodeficient Non-obese diabetic/severe combined immunodeficient(NOD/SCID) mice. The pathological features of the tumors were observed. Nonnecrotic tissue was inoculated subcutaneously into the right axillary. When the tumor in burdened rat grew approximately 100 mm3, according to the tumor size all the animals were divided into the following four groups, eight rats in each group: solvent control group, gefitinib group(100 mg/kg), erlotinib group(50 mg/kg), afatinib group(20 mg/kg). Aniamals were treated with drugs by intragastric(i.g.) administrated, once daily, for consecutively 14 days. Measure the tumor size 2-3 times every week. Results: Hu Prime1-NSCLC mutant sensitive xenograft model research data showed that reversible tyrosine kinase inhibitors gefitinib, erlotinib and irreversible tyrosine kinase inhibitor afatinib could effectively inhibit tumor growth in EGFR positive NSCLC allografts model. The pharmacodynamic activity of irreversible inhibitor was better than that of the reversible inhibitor. Specimens from clinical anthropogenic tumor retain characteristics of the human primary malignancy, histopathology, biological characteristics, and tumor markers, etc., which can more accurately reflect the characteristics of the tumor and the impact of interventions. Conclusion: The model is not only a good antitumor drug experimental platform, but also a new evaluation tool of individualized medication.展开更多
To improve the identification of cardiac regions in Electrical impedance tomography (EIT) pulmonary perfusion images, a model of wavelet transform was developed. The main goal was to generate maps of the heart using E...To improve the identification of cardiac regions in Electrical impedance tomography (EIT) pulmonary perfusion images, a model of wavelet transform was developed. The main goal was to generate maps of the heart using EIT images in a controlled animal experiment using a healthy pig and in two human volunteers. The model was capable of identifying the heart regions, demonstrated robustness and generated satisfactory results. The pig images were compared to perfusion images obtained using injection of a hypertonic solution and achieved an average area of the ROC curve of 0.88. The human images were qualitatively compared with Computerized Tomography scan (CT-scan) images.展开更多
Objective:The current study aims to identify the effects of exogenous application of pulsed electromagnetic fields on skin wound healing in diabetic rats, and thus provides experimental evidence for its more scientifi...Objective:The current study aims to identify the effects of exogenous application of pulsed electromagnetic fields on skin wound healing in diabetic rats, and thus provides experimental evidence for its more scientific clinical application in the future.Methods: The diabetic animal models were established via intraperitoneal injection of streptozotocin in 4-month-old male rats. Fourth eight rats were randomly assigned into the diabetes group (DM) and diabetes coupled with pulsed electromagnetic fields (DM+PEMF) group. Another 24 normal rats were used as the blank control group (Control). Then, all the rats in the three groups were subjected to dorsal surgery for the establishment of soft tissue wound model (circular wound with the diameter of 2 cm). Then, the rats in the DM+PEMF group were subjected to pulsed electromagnetic fields stimulation. Then, 6 rats in each group were sacrificed at Day 5, 12 and 19 post surgery. The glucose levels, wound closure, wound healing time and tissue tensile strength were examined and analyzed.Results: Pulsed electromagnetic fields significantly increased the wound closure rate in diabetic rats at Day 5, 12 and 19 post surgery, decreased overall wound healing period in diabetic rats, and also enhanced tissue tensile strength in diabetic rats at Day 5, 12 and 19 post surgery.Conclusion: Low-intensity pulsed electromagnetic fields can significantly accelerate diabetic wound healing process, and also improve diabetic tissue repair capacity. This study may be helpful for providing more scientific and reasonable experimental evidence for the treatment of pulsed electromagnetic fields on diabetic wound healing in clinics.展开更多
Background Since early December 2019,the 2019 novel coronavirus disease(COVID-19)has caused pneumonia epidemic in Wuhan,Hubei province of China.This study aimed to investigate the factors affecting the progression of ...Background Since early December 2019,the 2019 novel coronavirus disease(COVID-19)has caused pneumonia epidemic in Wuhan,Hubei province of China.This study aimed to investigate the factors affecting the progression of pneumonia in COVID-19 patients.Associated results will be used to evaluate the prognosis and to find the optimal treatment regimens for COVID-19 pneumonia.Methods Patients tested positive for the COVID-19 based on nucleic acid detection were included in this study.Patients were admitted to 3 tertiary hospitals in Wuhan between December 30,2019,and January 15,2020.Individual data,laboratory indices,imaging characteristics,and clinical data were collected,and statistical analysis was performed.Based on clinical typing results,the patients were divided into a progression group or an improvement/stabilization group.Continuous variables were analyzed using independent samples t-test or Mann-Whitney U test.Categorical variables were analyzed using Chi-squared test or Fisher’s exact test.Logistic regression analysis was performed to explore the risk factors for disease progression.Results Seventy-eight patients with COVID-19-induced pneumonia met the inclusion criteria and were included in this study.Efficacy evaluation at 2 weeks after hospitalization indicated that 11 patients(14.1%)had deteriorated,and 67 patients(85.9%)had improved/stabilized.The patients in the progression group were significantly older than those in the disease improvement/stabilization group(66[51,70]vs.37[32,41]years,U=4.932,P=0.001).The progression group had a significantly higher proportion of patients with a history of smoking than the improvement/stabilization group(27.3%vs.3.0%,χ^2=9.291,P=0.018).For all the 78 patients,fever was the most common initial symptom,and the maximum body temperature at admission was significantly higher in the progression group than in the improvement/stabilization group(38.2[37.8,38.6]vs.37.5[37.0,38.4]°C,U=2.057,P=0.027).Moreover,the proportion of patients with respiratory failure(54.5%vs.20.9%,χ^2=5.611,P=0.028)and respiratory rate(34[18,48]vs.24[16,60]breaths/min,U=4.030,P=0.004)were significantly higher in the progression group than in the improvement/stabilization group.C-reactive protein was significantly elevated in the progression group compared to the improvement/stabilization group(38.9[14.3,64.8]vs.10.6[1.9,33.1]mg/L,U=1.315,P=0.024).Albumin was significantly lower in the progression group than in the improvement/stabilization group(36.62±6.60 vs.41.27±4.55 g/L,U=2.843,P=0.006).Patients in the progression group were more likely to receive high-level respiratory support than in the improvement/stabilization group(χ^2=16.01,P=0.001).Multivariate logistic analysis indicated that age(odds ratio[OR],8.546;95%confidence interval[CI]:1.628-44.864;P=0.011),history of smoking(OR,14.285;95%CI:1.577-25.000;P=0.018),maximum body temperature at admission(OR,8.999;95%CI:1.036-78.147,P=0.046),respiratory failure(OR,8.772,95%CI:1.942-40.000;P=0.016),albumin(OR,7.353,95%CI:1.098-50.000;P=0.003),and C-reactive protein(OR,10.530;95%CI:1.224-34.701,P=0.028)were risk factors for disease progression.Conclusions Several factors that led to the progression of COVID-19 pneumonia were identified,including age,history of smoking,maximum body temperature at admission,respiratory failure,albumin,and C-reactive protein.These results can be used to further enhance the ability of management of COVID-19 pneumonia.展开更多
Background:ARNTL2 is a core component of the circadian clock genes and plays regulatory roles in the cell cycle and immune infiltration,but its mechanism in lung cancer(LC)remains unclear.Objective:To investigate the ...Background:ARNTL2 is a core component of the circadian clock genes and plays regulatory roles in the cell cycle and immune infiltration,but its mechanism in lung cancer(LC)remains unclear.Objective:To investigate the clinical and therapeutic value of ARNTL2 in LC.Methods:The Oncomine and Cancer Cell Line Encyclopedia(CCLE)databases were adopted for assessing the ARNTL2 expression,after which the Kaplan-Meier plotter and Gene Expression Profiling Interactive Analysis 2(GEPIA2)databases were used to assess the correlation of ARNTL2 with prognosis.The univariate and multi-variate Cox regression analyses were utilized to identify independent prognostic factors.Also,we explored how ARNTL2 expression is related to immune infiltration,and immunomodulators in non-small lung cancer(NSCLC)using the Tumor Immune Estimation Resource(TIMER)database,TISIDB database and Gene Set Enrichment Analysis(GSEA).Finally,coexpression of ARNTL2 and PD-L1 in lung adenocarcinoma(LUAD)was verified via immunofluorescence staining and COXPRESdb v7 database.Results:Our study demonstrated a remarkable upregulated expression of ARNTL2 in multiple cell lines and can-cers,including NSCLC.Prognostic analysis displayed a remarkable correlation between high ARNTL2 expression and unfavorable overall survival(OS)and first progressive(FP)survival among patients ailing from LUAD,and ARNTL2 was an independent predictor of prognosis for LUAD patients.GSEA analysis showed that overexpres-sion of ARNTL2 was significantly linked with cell cycle and immunity.Furthermore,we reported a correlation of ARNTL2 expression with immunomodulators and lymphocytes.Immunofluorescence staining revealed that ARNTL2 and PD-L1 were elevated relative to normal tissue for LUAD,and colocalization of them was observed.Conclusion:Elevated ARNTL2 expression in LUAD revealed the prognostic values and its prospective role as a target for cell cycle and immune therapy.展开更多
基金funded by the Clinical Cohort Construction Program of Peking University Third Hospital [No.BYSYDL2021019]the National Natural Science Foundation of China [Grant No. 82272197]。
文摘Objective To investigate the effects of the pre-shock state on the mortality of patients with sepsis.Methods We enrolled patients with sepsis admitted to the medical intensive care unit of a tertiary care university hospital. These patients were then classified into three groups: sepsis, pre-shock state,and septic shock. The primary outcome was the 28-day mortality rate. The secondary outcomes were the 90-day, 180-day, and 1-year mortality rates.Results A total of 303 patients(groups: sepsis 135 [44.6%]), pre-shock state(93 [30.7%]), and septic shock(75 [24.8%]) completed the 1-year follow-up. The mortality rates at 28 days, 90 days, and 180days and 1 year were significantly higher in the pre-shock state group than those of the sepsis group,but significantly lower than those in the septic shock group, especially among older patients. When compared with the pre-shock state group, the sepsis group had significantly lower mortality risks at 28days, 90 days, and 180 days and 1 year, whereas the sepsis shock group had higher mortality risks at these time points.Conclusion The mortality rates of patients in the pre-shock state were notably different from those of patients with sepsis or septic shock. The introduction of a modified sepsis severity classification, which includes sepsis, pre-shock state, and septic shock, could offer valuable additional prognostic information.
文摘AIM: To determine the incidence, etiology, risk factors and outcome of ventilator-associated pneumonia(VAP) in patients undergoing orthotopic liver transplantation(OLT).METHODS: This retrospective study considered 242 patients undergoing deceased donor OLT. VAP was diagnosed according to clinical and microbiological criteria. RESULTS: VAP occurred in 18(7.4%) patients, with an incidence of 10 per 1000 d of mechanical ventilation(MV). Isolated bacterial etiologic agents were mainly Enterobacteriaceae(79%). Univariate logistic analysis showed that model for end-stage liver disease(MELD) score, pre-operative hospitalization, treatment with terlipressin, Child-Turcotte-Pugh score, days of MV and red cell transfusion were risk factors for VAP. Multivariateanalysis, considering significant risk factors in univariate analysis, demonstrated that pneumonia was strongly associated with terlipressin usage, pre-operative hospitalization, days of MV and red cell transfusion. Mortality rate was 22% in the VAP group vs 4% in the group without VAP. CONCLUSION: Our data suggest that VAP is an important cause of nosocomial infection during postoperative period in OLT patients. MELD score was a significant risk factor in univariate analysis. Multiple transfusions, treatment with terlipressin, preoperative hospitalization rather than called to the hospital while at home and days of MV constitute important risk factors for VAP development.
基金National Natural Science Foundation of Tianjin,China(16JCYBJC27500)
文摘Objective: To study the treatmaient of non-small cell lung cancer, we established the HU-Prim allograft transplantation tumor model. Methods: The fresh tumor samples were transplanted in the right scapular subcutaneous layer of the severe combined immunodeficient Non-obese diabetic/severe combined immunodeficient(NOD/SCID) mice. The pathological features of the tumors were observed. Nonnecrotic tissue was inoculated subcutaneously into the right axillary. When the tumor in burdened rat grew approximately 100 mm3, according to the tumor size all the animals were divided into the following four groups, eight rats in each group: solvent control group, gefitinib group(100 mg/kg), erlotinib group(50 mg/kg), afatinib group(20 mg/kg). Aniamals were treated with drugs by intragastric(i.g.) administrated, once daily, for consecutively 14 days. Measure the tumor size 2-3 times every week. Results: Hu Prime1-NSCLC mutant sensitive xenograft model research data showed that reversible tyrosine kinase inhibitors gefitinib, erlotinib and irreversible tyrosine kinase inhibitor afatinib could effectively inhibit tumor growth in EGFR positive NSCLC allografts model. The pharmacodynamic activity of irreversible inhibitor was better than that of the reversible inhibitor. Specimens from clinical anthropogenic tumor retain characteristics of the human primary malignancy, histopathology, biological characteristics, and tumor markers, etc., which can more accurately reflect the characteristics of the tumor and the impact of interventions. Conclusion: The model is not only a good antitumor drug experimental platform, but also a new evaluation tool of individualized medication.
文摘To improve the identification of cardiac regions in Electrical impedance tomography (EIT) pulmonary perfusion images, a model of wavelet transform was developed. The main goal was to generate maps of the heart using EIT images in a controlled animal experiment using a healthy pig and in two human volunteers. The model was capable of identifying the heart regions, demonstrated robustness and generated satisfactory results. The pig images were compared to perfusion images obtained using injection of a hypertonic solution and achieved an average area of the ROC curve of 0.88. The human images were qualitatively compared with Computerized Tomography scan (CT-scan) images.
基金National Natural Science Foundation of China,No.81471806.
文摘Objective:The current study aims to identify the effects of exogenous application of pulsed electromagnetic fields on skin wound healing in diabetic rats, and thus provides experimental evidence for its more scientific clinical application in the future.Methods: The diabetic animal models were established via intraperitoneal injection of streptozotocin in 4-month-old male rats. Fourth eight rats were randomly assigned into the diabetes group (DM) and diabetes coupled with pulsed electromagnetic fields (DM+PEMF) group. Another 24 normal rats were used as the blank control group (Control). Then, all the rats in the three groups were subjected to dorsal surgery for the establishment of soft tissue wound model (circular wound with the diameter of 2 cm). Then, the rats in the DM+PEMF group were subjected to pulsed electromagnetic fields stimulation. Then, 6 rats in each group were sacrificed at Day 5, 12 and 19 post surgery. The glucose levels, wound closure, wound healing time and tissue tensile strength were examined and analyzed.Results: Pulsed electromagnetic fields significantly increased the wound closure rate in diabetic rats at Day 5, 12 and 19 post surgery, decreased overall wound healing period in diabetic rats, and also enhanced tissue tensile strength in diabetic rats at Day 5, 12 and 19 post surgery.Conclusion: Low-intensity pulsed electromagnetic fields can significantly accelerate diabetic wound healing process, and also improve diabetic tissue repair capacity. This study may be helpful for providing more scientific and reasonable experimental evidence for the treatment of pulsed electromagnetic fields on diabetic wound healing in clinics.
文摘Background Since early December 2019,the 2019 novel coronavirus disease(COVID-19)has caused pneumonia epidemic in Wuhan,Hubei province of China.This study aimed to investigate the factors affecting the progression of pneumonia in COVID-19 patients.Associated results will be used to evaluate the prognosis and to find the optimal treatment regimens for COVID-19 pneumonia.Methods Patients tested positive for the COVID-19 based on nucleic acid detection were included in this study.Patients were admitted to 3 tertiary hospitals in Wuhan between December 30,2019,and January 15,2020.Individual data,laboratory indices,imaging characteristics,and clinical data were collected,and statistical analysis was performed.Based on clinical typing results,the patients were divided into a progression group or an improvement/stabilization group.Continuous variables were analyzed using independent samples t-test or Mann-Whitney U test.Categorical variables were analyzed using Chi-squared test or Fisher’s exact test.Logistic regression analysis was performed to explore the risk factors for disease progression.Results Seventy-eight patients with COVID-19-induced pneumonia met the inclusion criteria and were included in this study.Efficacy evaluation at 2 weeks after hospitalization indicated that 11 patients(14.1%)had deteriorated,and 67 patients(85.9%)had improved/stabilized.The patients in the progression group were significantly older than those in the disease improvement/stabilization group(66[51,70]vs.37[32,41]years,U=4.932,P=0.001).The progression group had a significantly higher proportion of patients with a history of smoking than the improvement/stabilization group(27.3%vs.3.0%,χ^2=9.291,P=0.018).For all the 78 patients,fever was the most common initial symptom,and the maximum body temperature at admission was significantly higher in the progression group than in the improvement/stabilization group(38.2[37.8,38.6]vs.37.5[37.0,38.4]°C,U=2.057,P=0.027).Moreover,the proportion of patients with respiratory failure(54.5%vs.20.9%,χ^2=5.611,P=0.028)and respiratory rate(34[18,48]vs.24[16,60]breaths/min,U=4.030,P=0.004)were significantly higher in the progression group than in the improvement/stabilization group.C-reactive protein was significantly elevated in the progression group compared to the improvement/stabilization group(38.9[14.3,64.8]vs.10.6[1.9,33.1]mg/L,U=1.315,P=0.024).Albumin was significantly lower in the progression group than in the improvement/stabilization group(36.62±6.60 vs.41.27±4.55 g/L,U=2.843,P=0.006).Patients in the progression group were more likely to receive high-level respiratory support than in the improvement/stabilization group(χ^2=16.01,P=0.001).Multivariate logistic analysis indicated that age(odds ratio[OR],8.546;95%confidence interval[CI]:1.628-44.864;P=0.011),history of smoking(OR,14.285;95%CI:1.577-25.000;P=0.018),maximum body temperature at admission(OR,8.999;95%CI:1.036-78.147,P=0.046),respiratory failure(OR,8.772,95%CI:1.942-40.000;P=0.016),albumin(OR,7.353,95%CI:1.098-50.000;P=0.003),and C-reactive protein(OR,10.530;95%CI:1.224-34.701,P=0.028)were risk factors for disease progression.Conclusions Several factors that led to the progression of COVID-19 pneumonia were identified,including age,history of smoking,maximum body temperature at admission,respiratory failure,albumin,and C-reactive protein.These results can be used to further enhance the ability of management of COVID-19 pneumonia.
基金This research was supported by Doctor’s Science Project Foundation of Liaoning Province (No.20021033), and by Young Science and Development Foundation of Shenyang City (No.2003-48).
基金We got support through grants from the Zhejiang Provincial Natural Science Foundation of China(LQ20H290004)Zhejiang Provincial Chinese Medicine Research Program of China(2020ZQ039).
文摘Background:ARNTL2 is a core component of the circadian clock genes and plays regulatory roles in the cell cycle and immune infiltration,but its mechanism in lung cancer(LC)remains unclear.Objective:To investigate the clinical and therapeutic value of ARNTL2 in LC.Methods:The Oncomine and Cancer Cell Line Encyclopedia(CCLE)databases were adopted for assessing the ARNTL2 expression,after which the Kaplan-Meier plotter and Gene Expression Profiling Interactive Analysis 2(GEPIA2)databases were used to assess the correlation of ARNTL2 with prognosis.The univariate and multi-variate Cox regression analyses were utilized to identify independent prognostic factors.Also,we explored how ARNTL2 expression is related to immune infiltration,and immunomodulators in non-small lung cancer(NSCLC)using the Tumor Immune Estimation Resource(TIMER)database,TISIDB database and Gene Set Enrichment Analysis(GSEA).Finally,coexpression of ARNTL2 and PD-L1 in lung adenocarcinoma(LUAD)was verified via immunofluorescence staining and COXPRESdb v7 database.Results:Our study demonstrated a remarkable upregulated expression of ARNTL2 in multiple cell lines and can-cers,including NSCLC.Prognostic analysis displayed a remarkable correlation between high ARNTL2 expression and unfavorable overall survival(OS)and first progressive(FP)survival among patients ailing from LUAD,and ARNTL2 was an independent predictor of prognosis for LUAD patients.GSEA analysis showed that overexpres-sion of ARNTL2 was significantly linked with cell cycle and immunity.Furthermore,we reported a correlation of ARNTL2 expression with immunomodulators and lymphocytes.Immunofluorescence staining revealed that ARNTL2 and PD-L1 were elevated relative to normal tissue for LUAD,and colocalization of them was observed.Conclusion:Elevated ARNTL2 expression in LUAD revealed the prognostic values and its prospective role as a target for cell cycle and immune therapy.
