BACKGROUND At present,large-scale studies on the clinical characteristics of sepsis-induced cardiomyopathy(SIC)are lacking.AIM To investigate the clinical characteristics of SIC.METHODS Based on the analysis of the MI...BACKGROUND At present,large-scale studies on the clinical characteristics of sepsis-induced cardiomyopathy(SIC)are lacking.AIM To investigate the clinical characteristics of SIC.METHODS Based on the analysis of the MIMIC-III public database,we performed a largescale retrospective study involving sepsis patients who were admitted to the intensive care unit(ICU)and had no concomitant cardiac disease.We used propensity score matching analysis and multivariate logistic regression to ensure the robustness of the results.The primary outcome was hospital mortality,and the secondary outcomes included the number of patients who received mechanical ventilation or renal replacement therapy during their hospital stay,the number of patients administered with vasopressors,the length of ICU stay,and the length of hospital stay.RESULTS In the present study,after screening 38605 patients,3530 patients with sepsis were included.A total of 997 patients met the SIC diagnostic criteria,and the incidence of SIC was 28.20%(95%confidence interval[CI]:26.80%-29.70%).Compared to patients in the non-SIC group,patients in the SIC group were of older age and had a higher Simplified Acute Physiology Score(SAPS)-Ⅰ score,SAPS-Ⅱ score,and Elixhauser comorbidity index(ECI).A total of 367(36.8%)of 997 patients in the SIC group and 818(32.3%)of 2533 patients in the non-SIC group died in the hospital,which resulted in a significant between-group difference(odds ratios=1.22,95%CI:1.05-1.42;P=0.011).For the secondary outcomes,more patients in the SIC group received mechanical ventilation and vasopressors.Multivariate logistic regression analysis showed that age,male sex,ECI,hemoglobin level,diabetes,and mechanical ventilation use on the first day of ICU admission were risk factors for SIC.CONCLUSION Compared with non-SIC patients,hospital mortality is higher in SIC patients.展开更多
Background SARS-CoV-2 continues to mutate over time,and reports on children infected with Omicron BA.5 are limited.We aimed to analyze the specific symptoms of Omicron-infected children and to improve patient care.Met...Background SARS-CoV-2 continues to mutate over time,and reports on children infected with Omicron BA.5 are limited.We aimed to analyze the specific symptoms of Omicron-infected children and to improve patient care.Methods We selected 315 consecutively hospitalized children with Omicron BA.5 and 16,744 non-Omicron-infected febrile children visiting the fever clinic at our hospital between December 8 and 30,2022.Specific convulsions and body temperatures were compared between the two cohorts.We analyzed potential associations between convulsions and vaccination,and additionally evaluated the brain damage among severe Omicron-infected children.Results Convulsion rates(97.5%vs.4.3%,P<0.001)and frequencies(median:2.0 vs.1.6,P<0.001)significantly differed between Omicron-infected and non-Omicron-infected febrile children.The body temperatures of Omicron-infected children were significantly higher during convulsions than when they were not convulsing and those of non-Omicron-infected febrile children during convulsions(median:39.5 vs.38.2 and 38.6℃,both P<0.001).In the three Omicron-subgroups,the temperature during convulsions was proportional to the percentage of patients and significantly differed(P<0.001),while not in the three non-Omicron-subgroups(P=0.244).The convulsion frequency was lower in the 55 vaccinated children compared to the 260 non-vaccinated children(average:1.8 vs.2.1,P<0.001).The vaccination dose and convulsion frequency in Omicron-infected children were significantly correlated(P<0.001).Fifteen of the 112 severe Omicron cases had brain damage.Conclusions Omicron-infected children experience higher body temperatures and frequencies during convulsions than those of non-Omicron-infected febrile children.We additionally found evidence of brain damage caused by infection with omicron BA.5.Vaccination and prompt fever reduction may relieve symptoms.展开更多
To the Editor：Autophagy is reported to play a critical role in low shear stress （LSS）-induced endothelial cell injury and the formation of atherosclerotic plaques.[1] However,the corresponding mechanisms remain unc...To the Editor：Autophagy is reported to play a critical role in low shear stress （LSS）-induced endothelial cell injury and the formation of atherosclerotic plaques.[1] However,the corresponding mechanisms remain unclear.[2-8] This study was to investigate the changes and mechanism of LSS-induced autophagy in human umbilical vein endothelial cells （HUVECs）.HUVECs were treated with LSS of 5 dyn/cm2 for 0,5,15,30,and 60 min in a parallel plate flow chamber system.Light chain （LC） Ⅱ,LC3 Ⅰ,and p62,p38 mitogen-activated protein kinase （MAPK） and their protein of phosphorylation of p38 （p-p38） were detected with Western blot analysis.The protein levels of p-p53 （ser15） and their distribution were detected by immunofluorescence （IF）.展开更多
基金Supported by Science and Technology Program of Guangzhou Science,Technology,and Innovation Commission,No.201904010258.
文摘BACKGROUND At present,large-scale studies on the clinical characteristics of sepsis-induced cardiomyopathy(SIC)are lacking.AIM To investigate the clinical characteristics of SIC.METHODS Based on the analysis of the MIMIC-III public database,we performed a largescale retrospective study involving sepsis patients who were admitted to the intensive care unit(ICU)and had no concomitant cardiac disease.We used propensity score matching analysis and multivariate logistic regression to ensure the robustness of the results.The primary outcome was hospital mortality,and the secondary outcomes included the number of patients who received mechanical ventilation or renal replacement therapy during their hospital stay,the number of patients administered with vasopressors,the length of ICU stay,and the length of hospital stay.RESULTS In the present study,after screening 38605 patients,3530 patients with sepsis were included.A total of 997 patients met the SIC diagnostic criteria,and the incidence of SIC was 28.20%(95%confidence interval[CI]:26.80%-29.70%).Compared to patients in the non-SIC group,patients in the SIC group were of older age and had a higher Simplified Acute Physiology Score(SAPS)-Ⅰ score,SAPS-Ⅱ score,and Elixhauser comorbidity index(ECI).A total of 367(36.8%)of 997 patients in the SIC group and 818(32.3%)of 2533 patients in the non-SIC group died in the hospital,which resulted in a significant between-group difference(odds ratios=1.22,95%CI:1.05-1.42;P=0.011).For the secondary outcomes,more patients in the SIC group received mechanical ventilation and vasopressors.Multivariate logistic regression analysis showed that age,male sex,ECI,hemoglobin level,diabetes,and mechanical ventilation use on the first day of ICU admission were risk factors for SIC.CONCLUSION Compared with non-SIC patients,hospital mortality is higher in SIC patients.
基金supported by the Science and Technology Planning Project of Guangdong Province(No.2020B1111170001)The funder had no role in the study design,data collection and analysis,decision to publish,or preparation of the manuscript.
文摘Background SARS-CoV-2 continues to mutate over time,and reports on children infected with Omicron BA.5 are limited.We aimed to analyze the specific symptoms of Omicron-infected children and to improve patient care.Methods We selected 315 consecutively hospitalized children with Omicron BA.5 and 16,744 non-Omicron-infected febrile children visiting the fever clinic at our hospital between December 8 and 30,2022.Specific convulsions and body temperatures were compared between the two cohorts.We analyzed potential associations between convulsions and vaccination,and additionally evaluated the brain damage among severe Omicron-infected children.Results Convulsion rates(97.5%vs.4.3%,P<0.001)and frequencies(median:2.0 vs.1.6,P<0.001)significantly differed between Omicron-infected and non-Omicron-infected febrile children.The body temperatures of Omicron-infected children were significantly higher during convulsions than when they were not convulsing and those of non-Omicron-infected febrile children during convulsions(median:39.5 vs.38.2 and 38.6℃,both P<0.001).In the three Omicron-subgroups,the temperature during convulsions was proportional to the percentage of patients and significantly differed(P<0.001),while not in the three non-Omicron-subgroups(P=0.244).The convulsion frequency was lower in the 55 vaccinated children compared to the 260 non-vaccinated children(average:1.8 vs.2.1,P<0.001).The vaccination dose and convulsion frequency in Omicron-infected children were significantly correlated(P<0.001).Fifteen of the 112 severe Omicron cases had brain damage.Conclusions Omicron-infected children experience higher body temperatures and frequencies during convulsions than those of non-Omicron-infected febrile children.We additionally found evidence of brain damage caused by infection with omicron BA.5.Vaccination and prompt fever reduction may relieve symptoms.
基金This study was supported by grants from the Natural Science Foundation of Guangdong Province （No. 2016A030313430）, the Scientific and Technological Program of Guangzhou City （No. 201510010024）, and the Natural Science Foundation of Guangdong Province （No. 2014A030310049）.
文摘To the Editor：Autophagy is reported to play a critical role in low shear stress （LSS）-induced endothelial cell injury and the formation of atherosclerotic plaques.[1] However,the corresponding mechanisms remain unclear.[2-8] This study was to investigate the changes and mechanism of LSS-induced autophagy in human umbilical vein endothelial cells （HUVECs）.HUVECs were treated with LSS of 5 dyn/cm2 for 0,5,15,30,and 60 min in a parallel plate flow chamber system.Light chain （LC） Ⅱ,LC3 Ⅰ,and p62,p38 mitogen-activated protein kinase （MAPK） and their protein of phosphorylation of p38 （p-p38） were detected with Western blot analysis.The protein levels of p-p53 （ser15） and their distribution were detected by immunofluorescence （IF）.
