Background:Zoonotic diseases originating in animals pose a significant threat to global public health.Recent outbreaks,such as coronavirus disease 2019(COVID-19),have caused widespread illness,death,and socioeconomic ...Background:Zoonotic diseases originating in animals pose a significant threat to global public health.Recent outbreaks,such as coronavirus disease 2019(COVID-19),have caused widespread illness,death,and socioeconomic disruptions worldwide.To cope with these diseases effectively,it is crucial to strengthen surveillance capabilities and establish rapid response systems.Aim:The aim of this review is to examine the modern technologies and solutions that have the potential to enhance zoonotic disease surveillance and outbreak responses and provide valuable insights into how cuttingedge innovations could be leveraged to prevent,detect,and control emerging zoonotic disease outbreaks.Herein,we discuss advanced tools including big data analytics,artificial intelligence,the Internet of Things,geographic information systems,remote sensing,molecular diagnostics,point-of-care testing,telemedicine,digital contact tracing,and early warning systems.Results:These technologies enable real-time monitoring,the prediction of outbreak risks,early anomaly detection,rapid diagnosis,and targeted interventions during outbreaks.When integrated through collaborative partnerships,these strategies can significantly improve the speed and effectiveness of zoonotic disease control.However,several challenges persist,particularly in resource-limited settings,such as infrastructure limitations,costs,data integration and training requirements,and ethical implementation.Conclusion:With strategic planning and coordinated efforts,modern technologies and solutions offer immense potential to bolster surveillance and outbreak responses,and serve as a critical resource against emerging zoonotic disease threats worldwide.展开更多
BACKGROUND Gastric cancer(GC)has a relatively high incidence and mortality rate.Surgery is the primary treatment;however,the survival rate of patients remains low.Therefore,there is an urgent need to identify simple a...BACKGROUND Gastric cancer(GC)has a relatively high incidence and mortality rate.Surgery is the primary treatment;however,the survival rate of patients remains low.Therefore,there is an urgent need to identify simple and feasible prognostic indicators for GC.As an inflammation-related biomarker,the systemic inflammation response index(SIRI),platelet-to-lymphocyte ratio(PLR),and SIRI-PLR can be obtained from routine blood tests.Compared with existing prognostic indicators,which are expensive and rely on complex analyses,SIRI-PLR offers extremely high convenience and cost-effectiveness.AIM To explore the impact of SIRI-PLR on the prognosis of patients with stage I–III GC after surgery and construct a nomogram.METHODS We retrospectively analyzed the clinical and pathological data of patients with GC who underwent radical surgery at The First Affiliated Hospital of Anhui Medical University between January 2014 and December 2017.A total of 1071 patients with clear clinical prognoses were selected.Univariate and multivariate Cox regression analyses were performed to identify independent prognostic factors associated with overall survival in patients with GC,and a nomogram prediction model was constructed.RESULTS Multivariate Cox regression analysis revealed that age,tumor size,T stage,N stage,SIRI-PLR,and carcinoembryonic antigen were independent prognostic factors.The areas under the curve of the nomogram for training and validation sets were 0.821 and 0.848,respectively.Calibration plots and decision curve analyses demonstrated that the nomogram exhibited good predictive performance and clinical utility in training and validation cohorts.CONCLUSION Preoperative SIRI-PLR was significantly associated with the prognosis of patients with stage I–III GC following radical gastrectomy.Our nomogram could serve as an essential tool for clinicians to predict the postoperative prognosis of patients with stage I–III GC.展开更多
Background The association of systemic inflammatory response index(SIRI)with prognosis of coronary artery disease(CAD)patients has never been investigated in a large sample with long-term follow-up.This study aimed to...Background The association of systemic inflammatory response index(SIRI)with prognosis of coronary artery disease(CAD)patients has never been investigated in a large sample with long-term follow-up.This study aimed to explore the association of SIRI with all-cause and cause-specific mortality in a nationally representative sample of CAD patients from United States.Methods A total of 3386 participants with CAD from the National Health and Nutrition Examination Survey(NHANES)1999-2018 were included in this study.Cox proportional hazards model,restricted cubic spline(RCS),and receiver operating characteristic curve(ROC)were performed to investigate the association of SIRI with all-cause and cause-specific mortality.Piecewise linear regression and sensitivity analyses were also performed.Results During a median follow-up of 7.7 years,1454 all-cause mortality occurred.After adjusting for confounding factors,higher lnSIRI was significantly associated with higher risk of all-cause(HR=1.16,95%CI:1.09-1.23)and CVD mortality(HR=1.17,95%CI:1.05-1.30)but not cancer mortality(HR=1.17,95%CI:0.99-1.38).The associations of SIRI with all-cause and CVD mortality were detected as J-shaped with threshold values of 1.05935 and 1.122946 for SIRI,respectively.ROC curves showed that lnSIRI had robust predictive effect both in short and long terms.Conclusions SIRI was independently associated with all-cause and CVD mortality,and the dose-response relationship was Jshaped.SIRI might serve as a valid predictor for all-cause and CVD mortality both in the short and long terms.展开更多
The peer-reviewed journal Infectious Diseases of Poverty provides a new platform to engage with,and disseminate in an open-access format,science outside traditional disciplinary boundaries.The current piece reviews a ...The peer-reviewed journal Infectious Diseases of Poverty provides a new platform to engage with,and disseminate in an open-access format,science outside traditional disciplinary boundaries.The current piece reviews a thematic series on surveillance-response systems for elimination of tropical diseases.Overall,22 contributions covering a broad array of diseases are featured–i.e.clonorchiasis,dengue,hepatitis,human immunodeficiency virus/acquired immune deficiency syndrome(HIV/AIDS),H7N9 avian influenza,lymphatic filariasis,malaria,Middle East respiratory syndrome(MERS),rabies,schistosomiasis and tuberculosis(TB).There are five scoping reviews,a commentary,a letter to the editor,an opinion piece and an editorial pertaining to the theme“Elimination of tropical disease through surveillance and response”.The remaining 13 articles are original contributions mainly covering(i)drug resistance;(ii)innovation and validation in the field of mathematical modelling;(iii)elimination of infectious diseases;and(iv)social media reports on disease outbreak notifications released by national health authorities.Analysis of the authors’affiliations reveals that scientists from the People’s Republic of China(P.R.China)are prominently represented.Possible explanations include the fact that the 2012 and 2014 international conferences pertaining to surveillance-response mechanisms were both hosted by the National Institute of Parasitic Diseases(NIPD)in Shanghai,coupled with P.R.China’s growing importance with regard to the control of infectious diseases.Within 4 to 22 months of publication,three of the 22 contributions were viewed more than 10000 times each.With sustained efforts focusing on relevant and strategic information towards control and elimination of infectious diseases,Infectious Diseases of Poverty has become a leading journal in the field of surveillance and response systems in infectious diseases and beyond.展开更多
The epidemic of the Ebola virus infection in West Africa in 2014 has become a worldwide concern.Due to the nature of the disease,which has an extremely high mortality potential,this outbreak has received much attentio...The epidemic of the Ebola virus infection in West Africa in 2014 has become a worldwide concern.Due to the nature of the disease,which has an extremely high mortality potential,this outbreak has received much attention from researchers and public health workers.An article entitled“Need of surveillance response systems to combat Ebola outbreaks and other emerging infectious diseases in African countries,”published in the journal Infectious Diseases of Poverty in August 2014,concluded that a good surveillance system to monitor disease transmission dynamics is essential and needs to be implemented to combat the outbreak.Issues regarding the limitation of the passive surveillance system have been raised by Professor Viroj Wiwanitkit,who emphasizes the need for an active disease detection system such as mass screening in this letter to editor.The different function between passive and active surveillance system in combating the disease outbreak has been agreed upon by Ernest Tambo et al.There have also been discussions between Wiwanitkit and Tambo et al.on the following issues:(i)the extreme resource limitations in outbreak areas,(ii)new technology to improve the available systems.Further recommendations echoed in this letter to editor by Wiwanitkit,who outlined the research priorities on the development of appropriate combined disease monitoring systems and good policy to allocate available tools and technology in resource-limited settings for epidemic scenarios.The journal’s editor,Professor Xiao-Nong Zhou,has therefore collated all parts of these discussions between authors in this letter to editor paper,in order to further promote research on a combined active and passive system to combat the present extending Ebola outbreak.展开更多
Hepatocellular carcinoma(HCC)is a leading cause of morbidity and mortality worldwide,with rising clinical and economic burden as incidence increases.There are a multitude of evolving treatment options,including locore...Hepatocellular carcinoma(HCC)is a leading cause of morbidity and mortality worldwide,with rising clinical and economic burden as incidence increases.There are a multitude of evolving treatment options,including locoregional therapies which can be used alone,in combination with each other,or in combination with systemic therapy.These treatment options have shown to be effective in achieving remission,controlling tumor progression,improving disease free and overall survival in patients who cannot undergo resection and providing a bridge to transplant by debulking tumor burden to downstage patients.Following locoregional therapy(LRT),it is crucial to provide treatment response assessment to guide management and liver transplant candidacy.Therefore,Liver Imaging Reporting and Data Systems(LI-RADS)Treatment Response Algorithm(TRA)was created to provide a standardized assessment of HCC following LRT.LIRADS TRA provides a step by step approach to evaluate each lesion independently for accurate tumor assessment.In this review,we provide an overview of different locoregional therapies for HCC,describe the expected post treatment imaging appearance following treatment,and review the LI-RADS TRA with guidance for its application in clinical practice.Unique to other publications,we will also review emerging literature supporting the use of LI-RADS for assessment of HCC treatment response after LRT.展开更多
The exact solutions for stationary responses of one class of the second order and three classes of higher order nonlinear systems to parametric and/or external while noise excitations are constructed by using Fokkcr-P...The exact solutions for stationary responses of one class of the second order and three classes of higher order nonlinear systems to parametric and/or external while noise excitations are constructed by using Fokkcr-Planck-Kolmogorov et/ualion approach. The conditions for the existence and uniqueness and the behavior of the solutions are discussed. All the systems under consideration are characterized by the dependence ofnonconservative fqrces on the first integrals of the corresponding conservative systems and arc catted generalized-energy-dependent f G.E.D.) systems. It is shown taht for each of the four classes of G.E.D. nonlinear stochastic systems there is a family of non-G.E.D. systems which are equivalent to the G.E.D. system in the sense of having identical stationary solution. The way to find the equivalent stochastic systems for a given G.E.D. system is indicated and. as an example, the equivalent stochastic systems for the second order G.E. D. nonlinear stochastic system are given. It is pointed out and illustrated with example that the exact stationary solutions for many non-G.E.D. nonlinear stochastic systems may he found by searching the equivalent G.E.D. systems.展开更多
Objective Venous thromboembolism is a highly prevalent condition after polytrauma,and recognized as an important factor contributing to poor prognosis.The aim of this study was to investigate the risk factors for lowe...Objective Venous thromboembolism is a highly prevalent condition after polytrauma,and recognized as an important factor contributing to poor prognosis.The aim of this study was to investigate the risk factors for lower extremity deep venous thrombosis(LEDVT)in a severely traumatized population and to evaluate their predictive value for LEDVT.Methods This was a retrospective,single-center observational study.All subjects were severely traumatized patients who were admitted to the Traumatic Intensive Care Unit from January 2021 to May 2024.Based on Doppler ultrasound findings of both lower extremities from the time of injury to 30 days post-injury,patients who developed LEDVT were enrolled in the LEDVT group,and those who did not develop LEDVT were enrolled in the NLEDVT group.Demographic,clinical,and laboratory data were collected upon admission.Multivariable logistic regression analysis was performed to identify risk factors for LEDVT.Receiver operating characteristic(ROC)curve was used to evaluate the overall fit of the final model.Results There were 56 patients enrolled in the LEDVT group and 81 patients in the NLEDVT group.Age,Aggregate Index of Systemic Inflammation(AISI),Systemic Inflammation Response Index(SIRI),ICU length of stay,and albumin were identified as independent risk factors for LEDVT(all P<0.05).The area under their ROC curves were 0.604,0.657,0.694,0.668,and 0.405,respectively.Combined model for early clinical prediction of LEDVT in severely traumatized patients by age,SIRI,AISI,and albumin resulted in an area under the ROC curve of 0.805(95%CI:0.73-0.88,SE=0.037).Conclusion The combination of age,SIRI,AISI,and albumin has a predictive value for LEDVT in severely traumatized patients.展开更多
BACKGROUND The prognosis of colorectal cancer(CRC)patients is notably influenced by both inflammation and nutritional status.The prognostic nutritional index(PNI)and systemic inflammatory response index(SIRI)have been...BACKGROUND The prognosis of colorectal cancer(CRC)patients is notably influenced by both inflammation and nutritional status.The prognostic nutritional index(PNI)and systemic inflammatory response index(SIRI)have been reported in prognostic studies of various tumors.However,the efficacy of the combination of the two in predicting the prognosis of CRC patients has not been studied.AIM To evaluate the effectiveness of PNI and SIRI in predicting the prognosis of patients with CRC.METHODS We retrospectively gathered data from 470 CRC patients who underwent feasible radical surgery at Xinjiang Cancer Hospital.The optimal cut-off values for SIRI and PNI,along with their predictive power for survival,were determined through area under the receiver operating characteristic curve using time-dependent receiver operating characteristic analysis.The Kaplan-Meier method and log-rank test were applied to assess prognostic impact,and a multifactorial Cox proportional hazards model was employed for analysis.Additionally,a new model,PSIRI,was developed and assessed for its survival prediction capability.RESULTS The optimal cutoff values for PNI and SIRI were determined to be 47.80 and 1.38,respectively.Based on these values,patients were categorized into high PNI and low PNI groups,as well as high SIRI and low SIRI groups.Significant differences in age,T stage,neutrophil to lymphocyte ratio(NLR),monocyte to lymphocyte ratio(MLR),and platelet-to-lymphocyte ratio(PLR)subgroups were observed between the PNI groups in the baseline profile.In the SIRI group,notable differences were found in gender,T stage,nerve invasion,intravascular tumor emboli,NLR,MLR,and PLR subgroups.Both low PNI and high SIRI were identified as independent risk factors for poor prognosis in CRC patients.When combined into the PSIRI model,it was shown that patients with a PSIRI≤1 had a higher risk of death compared to those with a PSIRI of 2.CONCLUSION We assessed the impact of PNI and SIRI on the prognostic survival of CRC patients and developed a new model,PSIRI.This model demonstrated superior predictive accuracy,with a concordance index of 0.767.展开更多
BACKGROUND The prognostic value of the Systemic Inflammation Response Index(SIRI)in advanced pancreatic cancer is recognized,but its correlation with patients´nutritional status and outcomes remains unexplored.AI...BACKGROUND The prognostic value of the Systemic Inflammation Response Index(SIRI)in advanced pancreatic cancer is recognized,but its correlation with patients´nutritional status and outcomes remains unexplored.AIM To study the prognostic significance of SIRI and weight loss in metastatic pancreatic cancer.METHODS The PANTHEIA-Spanish Society of Medical Oncology(SEOM)study is a multicentric(16 Spanish hospitals),observational,longitudinal,non-interventional initiative,promoted by the SEOM Real World-Evidence work group.This pilot study sought to analyze the association between weight loss and inflammatory status as defined by SIRI.The cohort stems from a proof-of-concept pilot study conducted at one of the coordinating centers.Patients with pathologically confirmed metastatic pancreatic adenocarcinoma,treated from January 2020 to January 2023,were included.The index was calculated using the product of neutrophil and monocyte counts,divided by lymphocyte counts,obtained within 15 days before initiation chemotherapy.This study evaluated associations between overall survival(OS),SIRI and weight loss.RESULTS A total of 50 patients were included.66%of these patients were male and the median age was 66 years.Metastasis sites:36%liver,12%peritoneal carcinomatosis,10%lung,and 42%multiple locations.Regarding the first line palliative chemotherapy treatments:50%received gemcitabine plus nab-paclitaxel;28%,modified fluorouracil,leucovorin,irinotecan and oxaliplatin,and 16%were administered gemcitabine.42%had a weight loss>5%in the three months(mo)preceding diagnosis.21 patients with a SIRI≥2.3×10^(3)/L exhibited a trend towards a lower median OS compared to those with a SIRI<2.3×10^(3)/L(4 vs 18 mo;P<0.000).Among 21 patients with>5%weight loss before diagnosis,the median OS was 6 mo,in contrast to 19 mo for those who did not experience such weight loss(P=0.003).Patients with a weight loss>5%showed higher SIRI levels.This difference was statistically significant(P<0.000).For patients with a SIRI<2.3×10^(3)/L,those who did not lose>5%of their weight had an OS of 20 mo,compared to 11 mo for those who did(P<0.001).No association was found between carbohydrate antigen 19-9 levels≥1000 U/mL and weight loss.CONCLUSION A higher SIRI was correlated with decreased survival rates in patients with metastatic pancreatic cancer and associated with weight loss.An elevated SIRI is suggested as a predictor of survival,emphasizing the need for prospective validation in the upcoming PANTHEIA-SEOM study.展开更多
BACKGROUND The relationship between preoperative inflammation status and tumorigenesis as well as tumor progression is widely acknowledged.AIM To assess the prognostic significance of preoperative inflammatory biomark...BACKGROUND The relationship between preoperative inflammation status and tumorigenesis as well as tumor progression is widely acknowledged.AIM To assess the prognostic significance of preoperative inflammatory biomarkers in patients with distal cholangiocarcinoma(dCCA)who underwent pancreat-oduodenectomy(PD).METHODS This single-center study included 216 patients with dCCA after PD between January 1,2011,and December 31,2022.The individuals were categorized into two sets based on their systemic inflammatory response index(SIRI)levels:A low SIRI group(SIRI<1.5,n=123)and a high SIRI group(SIRI≥1.5,n=93).Inflam-matory biomarkers were evaluated for predictive accuracy using receiver operating characteristic curves.Both univariate and multivariate Cox proportional hazards analyses were performed to estimate SIRI for overall survival(OS)and recurrence-free survival(RFS).RESULTS The study included a total of 216 patients,with 58.3%being male and a mean age of 65.6±9.6 years.123 patients were in the low SIRI group and 93 were in the high SIRI group after PD for dCCA.SIRI had an area under the curve value of 0.674 for diagnosing dCCA,showing better performance than other inflammatory biomarkers.Multivariate analysis indicated that having a SIRI greater than 1.5 independently increased the risk of dCCA following PD,leading to lower OS[hazard ratios(HR)=1.868,P=0.006]and RFS(HR=0.949,P<0.001).Additionally,survival analysis indicated a significantly better prognosis for patients in the low SIRI group(P<0.001).CONCLUSION It is determined that a high SIRI before surgery is a significant risk factor for dCCA after PD.展开更多
BACKGROUND The systemic inflammatory response index(SIRI)has been demonstrated to make a significant difference in assessing the prognosis of patients with different solid neoplasms.However,research is needed to ascer...BACKGROUND The systemic inflammatory response index(SIRI)has been demonstrated to make a significant difference in assessing the prognosis of patients with different solid neoplasms.However,research is needed to ascertain the accuracy and reliability of applying the SIRI to patients who undergo robotic radical gastric cancer sur-gery.AIM To validate the applicability of the SIRI in assessing the survival of gastric cancer patients and evaluate the clinical contribution of preoperative SIRI levels to predicting long-term tumor outcomes in patients,who received robotic radical gastric cancer surgery.METHODS Initially,an exhaustive retrieval was performed in the PubMed,the Cochrane Library,EMBASE,Web of Science,and Scopus databases to identify relevant studies.Subsequently,a meta-analysis was executed on 6 cohort studies iden-tifying the value of the SIRI in assessing the survival of gastric cancer patients.Additionally,the clinical data of 161 patients undergoing robotic radical gastric cancer surgery were retrospectively analyzed to evaluate their clinicopathological characteristics and relevant laboratory indicators.The association between preoperative SIRI levels and 5-year overall survival(OS)and disease-free survival(DFS)was assessed.RESULTS The findings demonstrated an extensive connection between SIRI values and the outcome of patients with gastric cancer.Preoperative SIRI levels were identified as an independent hazard feature for both OS and DFS among those who received robotic surgery for gastric cancer.SIRI levels in gastric cancer patients were observed to be associated with the presence of comorbidities,T-stage,carcinoembryonic antigen levels,the development of early serious postoperative complications,and the rate of lymph node metastasis.CONCLUSION SIRI values are correlated with adverse in the gastric cancer population and have the potential to be utilized in predicting long-term oncological survival in patients who undergo robotic radical gastric cancer surgery.展开更多
I. THE COMPLEXITY OFBIOLOGICAL RESPONSESFor an organism, to be living or notdepends on its response to foreign matters.Facing the increasing amount and diversi-ty of chemicals, natural and synthetic, tounderstand the ...I. THE COMPLEXITY OFBIOLOGICAL RESPONSESFor an organism, to be living or notdepends on its response to foreign matters.Facing the increasing amount and diversi-ty of chemicals, natural and synthetic, tounderstand the principles of the biologicalresponses becomes extremely importantin pursuing the way of rational utiliza-tion and governing the foreign matters.However, most biological responses aretoo complex to explore their nature. Forinstance, the risk to human beings andorganisms related to the application ofrare earths in agriculture, forestation, fish-ery and husbandry has been argued展开更多
BACKGROUND:The lack of a stable,easy-to-operate animal model for severe trauma has hindered the research progress.The aim of this study is to develop a mouse model that replicates the pathophysiological conditions of ...BACKGROUND:The lack of a stable,easy-to-operate animal model for severe trauma has hindered the research progress.The aim of this study is to develop a mouse model that replicates the pathophysiological conditions of severe trauma,providing a reliable research tool.METHODS:Male C57BL/6J mice(aged 8-10 weeks and weighting approximately 20 g)were used to establish the severe trauma model.Under anesthesia,a midshaft femoral fracture was created and packed with sterile cotton.A midline incision was made from the inguinal region to the sternum,exposing the abdominal organs for 30 min.The right femoral artery was cannulated to induce controlled blood loss at 30%,35%,40%,and 50%of the total blood volume.Survival rates were monitored for 24 h post-induction.In the mice that experienced 30%blood loss,the mean arterial pressure,body temperature,blood gas parameters,peripheral blood inflammatory markers,and major organ pathological changes were assessed.RESULTS:Mice with femoral fractures,soft tissue injuries,abdominal organ exposure,and 30%blood loss exhibited stable survival rates.Increased blood loss significantly reduced survival rates.Mean arterial pressure decreased initially,recovering within 0-15 min and returning to baseline by 50 min.Similarly,the body temperature decreased initially and gradually recovered to baseline within 50 min.Levels of peripheral blood inflammatory markers remained elevated for 12 h post-injury.Distant organs,including intestines,lungs,liver,spleen and kidneys,displayed varying degrees of injury.CONCLUSION:The established mouse model replicates the pathophysiological responses to severe trauma,indicating stability and reproducibility,which could be an useful tool for further trauma research.展开更多
Introduction When the body is infected,pathogenic microorganisms and their toxins can enter the blood circulation and grow and proliferate in the blood,producing more toxins.These toxins and pathogens activate the bod...Introduction When the body is infected,pathogenic microorganisms and their toxins can enter the blood circulation and grow and proliferate in the blood,producing more toxins.These toxins and pathogens activate the body's immune system,leading to the release of a varieties of cytokines and inflammatory mediators,resulting in systemic inflammatory response syndrome[1].展开更多
Acute cardiomyocyte necrosis in the infarcted heart generates damage-associated molecular patterns, activating complement and toll-like receptor/interleukin-1 signaling, and triggering an intense inflammatory response...Acute cardiomyocyte necrosis in the infarcted heart generates damage-associated molecular patterns, activating complement and toll-like receptor/interleukin-1 signaling, and triggering an intense inflammatory response. Iuflammasomes also recognize danger signals and mediate sterile inflammatory response following acute myocardial infarction （AMI）, Inflammatory response serves to repair the heart, but excessive inflammation leads to adverse left ventricular remodeling and heart failure. In addition to local inflammation, profound systemic inflammation response has been documented in patients with AMI, which includes elevation of circulating inflammatory cytokines, chemokines and cell adhesion molecules, and activation of peripheral leukocytes and platelets. The excessive inflammatory response could be caused by a deregulated immune system. AMI is also associated with bone marrow activation and spleen monocytopoiesis, which sustains a continuous supply of monocytes at the site of inflammation. Accumulating evidence has shown that systemic inflammation aggravates atherosclerosis and markers for systemic inflammation are predictors of adverse clinical outcomes （such as death, recurrent myocardial in- farction, and heart failure） in patients with AMI.展开更多
Intraspinal inflammatory and immune responses are considered to play central roles in the pathological development of spinal cord injury.This study aimed to decipher the dynamics of systemic immune responses,initiated...Intraspinal inflammatory and immune responses are considered to play central roles in the pathological development of spinal cord injury.This study aimed to decipher the dynamics of systemic immune responses,initiated by spinal cord injury.The spinal cord in mice was completely transected at T8.Changes in the in vivo inflammatory response,between the acute and subacute stages,were observed.A rapid decrease in C-reactive protein levels,circulating leukocytes and lymphocytes,spleen-derived CD4~+interferon-γ+T-helper cells,and inflammatory cytokines,and a marked increase in neutrophils,monocytes,and CD4~+CD25~+FOXP3~+regulatory T-cells were observed during the acute phase.These systemic immune alterations were gradually restored to basal levels during the sub-acute phase.During the acute phase of spinal cord injury,systemic immune cells and factors showed significant inhibition;however,this inhibition was transient,and the indicators of these serious disorders gradually returned to baseline levels during the subacute phase.All experiments were performed in accordance with the institutional animal care guidelines,approved by the Institutional Animal Care and Use Committee of Experimental Animal Center of Drum Tower Hospital,China(approval No.2019 AE01040)on June 25,2019.展开更多
BACKGROUND:Periplaneta americana extract is recognized to have a positive effect on gastrointestinal mucosa.This study aimed to investigate the effects of periplaneta americana extract on immune function,nutrition sta...BACKGROUND:Periplaneta americana extract is recognized to have a positive effect on gastrointestinal mucosa.This study aimed to investigate the effects of periplaneta americana extract on immune function,nutrition status and gastrointestinal complications of early enteral nutrition patients with systemic inflammatory response syndrome(SIRS).METHODS:Patients with SIRS were randomly divided into two groups:treatment and control groups.All patients in the two groups received conventional therapy including enteral nutrition,but periplaneta americana extract,an additional Chinese medicine,was given to the patients in the treatment group.At the beginning of treatment(0 day)and 1,3,and 7 days after treatment,the levels of immunoglobulin(Ig A),total lymphocyte count(TLC),total protein(TP)and prealbumin(PA)were respectively tested in patients'venous blood.The incidences of bloating,diarrhea,aspiration pneumonia and high blood sugar at 7 days after treatment were recorded.The mortality of the patients in 28 days was recorded.RESULTS:At 3 and 7 days after treatment,the levels of Ig A and TLC in the treatment group were higher than those in the control group(P<0.05).At 7 days after treatment,the levels of TP and PA in the treatment group were higher than those in the control group(P<0.05).The incidences of bloating and diarrhea in the treatment group were lower than those in the control group,the differences were significant(P<0.05).The mortality of treatment group was lower than that of the control group(P>0.05).CONCLUSION:Periplaneta americana extract could reduce gastrointestinal complications and improve immune function and nutritional status in patients with systemic inflammatory response syndrome.展开更多
The changes of Toll-like receptor （TLR） 2, 4 of peripheral blood mononuclear cells （PBMCs） in the acute abdomen patients associated with systemic inflammatory response syndrome （SIRS） and their potential signifi...The changes of Toll-like receptor （TLR） 2, 4 of peripheral blood mononuclear cells （PBMCs） in the acute abdomen patients associated with systemic inflammatory response syndrome （SIRS） and their potential significance were explored. A clinical study was performed on 103 acute abdomen patients in whom 65 were associated with SIRS. Forty healthy individuals served as normal controls. The mRNA expression of TLR2, 4 was detected by RT-PCR, and the expression of TNF-α and IL-6 by ELISA. The level of plasma endotoxin, hospital stay and mortality were measured. It was found that the endotoxin level was increased to varying degrees in all the acute abdomen patients, and the endotoxin level was and hospital stay longer in SIRS group than in non-SIRS group （P〈0.01）. TLR2 mRNA, TLR4 mRNA, IL-6 and TNF-ct could be detected with low value in normal controls, but they were up-regulated markedly on the 1 st day after admission. Then TLR4 mRNA, IL-6 and TNF-α were decreased gradually, but TLR2 mRNA maintained at a high level till the 5th day. These indexes above in SIRS group were higher than those in non-SIRS group （P〈0.01）. The results of correlation analysis revealed the expression of TLR2, 4 mRNA was positively correlated with the levels of TNF-α and IL-6, and the hospital stay, The results of Logistic regression demonstrated that overexpression of TLR2, 4 mRNA might result in higher risk of multiple organ dysfunction syndrome （MODS）. It was concluded that in the acute abdomen patients associated with SIRS, the expression of TLR2, 4 in PBMCs was increased markedly, suggesting that TLR might play an important role in the pathogenesis of acute abdomen associated with SIRS.展开更多
BACKGROUND： This study aimed to determine the plasma levels of urokinase-type plasminogen activator （uPA）, urokinase-type plasminogen activator receptor （uPAR）, D-dimer, IL-6 and TNF-α, and observe the relations...BACKGROUND： This study aimed to determine the plasma levels of urokinase-type plasminogen activator （uPA）, urokinase-type plasminogen activator receptor （uPAR）, D-dimer, IL-6 and TNF-α, and observe the relations among uPA, uPAR, D-dimer, IL-6 and TNF-α in patients with systemic inflammatory response syndrome （SIRS）.METHODS： A prospective, clinical case-control study was conducted in patients with SIRS at age of more than 55 years old treated during 2008-2010 at Wuhan Central Hospital. Venous blood samples were collected by routine venipuncture. Eighty-five patients were divided into two groups according to diagnostic criteria of SIRS： SIRS patients from intensive care units （n=50）, and non- SIRS patients from medical wards （n=35）. Thirty healthy blood donors who visited the General Health Check-up Division at Wuhan Central Hospital served as controls. Excluded from the study were （1） those patients with pregnancy; （2） those with cancer; （3） those died after admission into the ICU in 7 days; （4） those received cardiopulmonary resuscitation; （5） those who had previous blood system diseases; and （6） those with SIRS before admission into the ICU. The levels of uPA, uPAR, D-D, IL-6 and TNF-a in blood were detected by commercial enzyme-linked immunosorbent assay （ELISA） kit. The data were analyzed using SPSS version 17.0 and expressed as mean ＋ standard. Student＇s t test and the Mann-Whitney U test were used in the analysis. The relations of uPA, uPAR and D-dimer, IL-6 TNF-α levels were analyzed using Spearman＇s rank-order correlation coefficient test. RESULTS： The plasma levels of uPA, uPAR, D-dimer, lL-6 and TNF-α in the patients with SIRS were obviously higher than those in the non-SIRS patients and controls （P〈0.001）. Correlation analysis showed a positive correlation between uPAR and IL-6 levels （r=0.395, P=0.004） and between uPAR and TNF-a levels （r=0.606, P〈0.001）, but no correlation between uPAR and D-dimer levels （r=0.069, P=0.632）. No correlation was observed between uPA, D-dimer, IL-6 and TNF-α levels （P〉0.05）. The establishment of ROC curve was based on the levels of uPAR, D-dimer, IL-6 and TNF-α in 24 hours for the diagnosis of multiple organ dysfunction syndrome （MODS）, and the ROC areas under the curve were 0.76, 0.58, 0.86 and 0.83, respectively. CONCLUSIONS：uPA and uPAR play a major role in patients with SIRS in the process of coagulation disorder, but the mechanism of SIRS is not the same. uPAR may play a central role in the development of SIRS to MODS.展开更多
文摘Background:Zoonotic diseases originating in animals pose a significant threat to global public health.Recent outbreaks,such as coronavirus disease 2019(COVID-19),have caused widespread illness,death,and socioeconomic disruptions worldwide.To cope with these diseases effectively,it is crucial to strengthen surveillance capabilities and establish rapid response systems.Aim:The aim of this review is to examine the modern technologies and solutions that have the potential to enhance zoonotic disease surveillance and outbreak responses and provide valuable insights into how cuttingedge innovations could be leveraged to prevent,detect,and control emerging zoonotic disease outbreaks.Herein,we discuss advanced tools including big data analytics,artificial intelligence,the Internet of Things,geographic information systems,remote sensing,molecular diagnostics,point-of-care testing,telemedicine,digital contact tracing,and early warning systems.Results:These technologies enable real-time monitoring,the prediction of outbreak risks,early anomaly detection,rapid diagnosis,and targeted interventions during outbreaks.When integrated through collaborative partnerships,these strategies can significantly improve the speed and effectiveness of zoonotic disease control.However,several challenges persist,particularly in resource-limited settings,such as infrastructure limitations,costs,data integration and training requirements,and ethical implementation.Conclusion:With strategic planning and coordinated efforts,modern technologies and solutions offer immense potential to bolster surveillance and outbreak responses,and serve as a critical resource against emerging zoonotic disease threats worldwide.
基金Supported by Key Projects of Anhui Provincial Department of Education,No.2023AH053330.
文摘BACKGROUND Gastric cancer(GC)has a relatively high incidence and mortality rate.Surgery is the primary treatment;however,the survival rate of patients remains low.Therefore,there is an urgent need to identify simple and feasible prognostic indicators for GC.As an inflammation-related biomarker,the systemic inflammation response index(SIRI),platelet-to-lymphocyte ratio(PLR),and SIRI-PLR can be obtained from routine blood tests.Compared with existing prognostic indicators,which are expensive and rely on complex analyses,SIRI-PLR offers extremely high convenience and cost-effectiveness.AIM To explore the impact of SIRI-PLR on the prognosis of patients with stage I–III GC after surgery and construct a nomogram.METHODS We retrospectively analyzed the clinical and pathological data of patients with GC who underwent radical surgery at The First Affiliated Hospital of Anhui Medical University between January 2014 and December 2017.A total of 1071 patients with clear clinical prognoses were selected.Univariate and multivariate Cox regression analyses were performed to identify independent prognostic factors associated with overall survival in patients with GC,and a nomogram prediction model was constructed.RESULTS Multivariate Cox regression analysis revealed that age,tumor size,T stage,N stage,SIRI-PLR,and carcinoembryonic antigen were independent prognostic factors.The areas under the curve of the nomogram for training and validation sets were 0.821 and 0.848,respectively.Calibration plots and decision curve analyses demonstrated that the nomogram exhibited good predictive performance and clinical utility in training and validation cohorts.CONCLUSION Preoperative SIRI-PLR was significantly associated with the prognosis of patients with stage I–III GC following radical gastrectomy.Our nomogram could serve as an essential tool for clinicians to predict the postoperative prognosis of patients with stage I–III GC.
基金National Key Research and Development Program of China(2022YFC2503500 and 2022YFC2503504)。
文摘Background The association of systemic inflammatory response index(SIRI)with prognosis of coronary artery disease(CAD)patients has never been investigated in a large sample with long-term follow-up.This study aimed to explore the association of SIRI with all-cause and cause-specific mortality in a nationally representative sample of CAD patients from United States.Methods A total of 3386 participants with CAD from the National Health and Nutrition Examination Survey(NHANES)1999-2018 were included in this study.Cox proportional hazards model,restricted cubic spline(RCS),and receiver operating characteristic curve(ROC)were performed to investigate the association of SIRI with all-cause and cause-specific mortality.Piecewise linear regression and sensitivity analyses were also performed.Results During a median follow-up of 7.7 years,1454 all-cause mortality occurred.After adjusting for confounding factors,higher lnSIRI was significantly associated with higher risk of all-cause(HR=1.16,95%CI:1.09-1.23)and CVD mortality(HR=1.17,95%CI:1.05-1.30)but not cancer mortality(HR=1.17,95%CI:0.99-1.38).The associations of SIRI with all-cause and CVD mortality were detected as J-shaped with threshold values of 1.05935 and 1.122946 for SIRI,respectively.ROC curves showed that lnSIRI had robust predictive effect both in short and long terms.Conclusions SIRI was independently associated with all-cause and CVD mortality,and the dose-response relationship was Jshaped.SIRI might serve as a valid predictor for all-cause and CVD mortality both in the short and long terms.
基金supported by the National S&T Major Program(grant no.2012ZX10004220)the fourth round of Three-year Public Health Action Plan of Shanghai(2015-2017,No.GWIV-29).
文摘The peer-reviewed journal Infectious Diseases of Poverty provides a new platform to engage with,and disseminate in an open-access format,science outside traditional disciplinary boundaries.The current piece reviews a thematic series on surveillance-response systems for elimination of tropical diseases.Overall,22 contributions covering a broad array of diseases are featured–i.e.clonorchiasis,dengue,hepatitis,human immunodeficiency virus/acquired immune deficiency syndrome(HIV/AIDS),H7N9 avian influenza,lymphatic filariasis,malaria,Middle East respiratory syndrome(MERS),rabies,schistosomiasis and tuberculosis(TB).There are five scoping reviews,a commentary,a letter to the editor,an opinion piece and an editorial pertaining to the theme“Elimination of tropical disease through surveillance and response”.The remaining 13 articles are original contributions mainly covering(i)drug resistance;(ii)innovation and validation in the field of mathematical modelling;(iii)elimination of infectious diseases;and(iv)social media reports on disease outbreak notifications released by national health authorities.Analysis of the authors’affiliations reveals that scientists from the People’s Republic of China(P.R.China)are prominently represented.Possible explanations include the fact that the 2012 and 2014 international conferences pertaining to surveillance-response mechanisms were both hosted by the National Institute of Parasitic Diseases(NIPD)in Shanghai,coupled with P.R.China’s growing importance with regard to the control of infectious diseases.Within 4 to 22 months of publication,three of the 22 contributions were viewed more than 10000 times each.With sustained efforts focusing on relevant and strategic information towards control and elimination of infectious diseases,Infectious Diseases of Poverty has become a leading journal in the field of surveillance and response systems in infectious diseases and beyond.
文摘The epidemic of the Ebola virus infection in West Africa in 2014 has become a worldwide concern.Due to the nature of the disease,which has an extremely high mortality potential,this outbreak has received much attention from researchers and public health workers.An article entitled“Need of surveillance response systems to combat Ebola outbreaks and other emerging infectious diseases in African countries,”published in the journal Infectious Diseases of Poverty in August 2014,concluded that a good surveillance system to monitor disease transmission dynamics is essential and needs to be implemented to combat the outbreak.Issues regarding the limitation of the passive surveillance system have been raised by Professor Viroj Wiwanitkit,who emphasizes the need for an active disease detection system such as mass screening in this letter to editor.The different function between passive and active surveillance system in combating the disease outbreak has been agreed upon by Ernest Tambo et al.There have also been discussions between Wiwanitkit and Tambo et al.on the following issues:(i)the extreme resource limitations in outbreak areas,(ii)new technology to improve the available systems.Further recommendations echoed in this letter to editor by Wiwanitkit,who outlined the research priorities on the development of appropriate combined disease monitoring systems and good policy to allocate available tools and technology in resource-limited settings for epidemic scenarios.The journal’s editor,Professor Xiao-Nong Zhou,has therefore collated all parts of these discussions between authors in this letter to editor paper,in order to further promote research on a combined active and passive system to combat the present extending Ebola outbreak.
文摘Hepatocellular carcinoma(HCC)is a leading cause of morbidity and mortality worldwide,with rising clinical and economic burden as incidence increases.There are a multitude of evolving treatment options,including locoregional therapies which can be used alone,in combination with each other,or in combination with systemic therapy.These treatment options have shown to be effective in achieving remission,controlling tumor progression,improving disease free and overall survival in patients who cannot undergo resection and providing a bridge to transplant by debulking tumor burden to downstage patients.Following locoregional therapy(LRT),it is crucial to provide treatment response assessment to guide management and liver transplant candidacy.Therefore,Liver Imaging Reporting and Data Systems(LI-RADS)Treatment Response Algorithm(TRA)was created to provide a standardized assessment of HCC following LRT.LIRADS TRA provides a step by step approach to evaluate each lesion independently for accurate tumor assessment.In this review,we provide an overview of different locoregional therapies for HCC,describe the expected post treatment imaging appearance following treatment,and review the LI-RADS TRA with guidance for its application in clinical practice.Unique to other publications,we will also review emerging literature supporting the use of LI-RADS for assessment of HCC treatment response after LRT.
基金Project Supported by The National Natural Science Foundation of China
文摘The exact solutions for stationary responses of one class of the second order and three classes of higher order nonlinear systems to parametric and/or external while noise excitations are constructed by using Fokkcr-Planck-Kolmogorov et/ualion approach. The conditions for the existence and uniqueness and the behavior of the solutions are discussed. All the systems under consideration are characterized by the dependence ofnonconservative fqrces on the first integrals of the corresponding conservative systems and arc catted generalized-energy-dependent f G.E.D.) systems. It is shown taht for each of the four classes of G.E.D. nonlinear stochastic systems there is a family of non-G.E.D. systems which are equivalent to the G.E.D. system in the sense of having identical stationary solution. The way to find the equivalent stochastic systems for a given G.E.D. system is indicated and. as an example, the equivalent stochastic systems for the second order G.E. D. nonlinear stochastic system are given. It is pointed out and illustrated with example that the exact stationary solutions for many non-G.E.D. nonlinear stochastic systems may he found by searching the equivalent G.E.D. systems.
基金Basic Research Spe-cial Project of Suzhou Science and Technology Bureau(SSD2024050).
文摘Objective Venous thromboembolism is a highly prevalent condition after polytrauma,and recognized as an important factor contributing to poor prognosis.The aim of this study was to investigate the risk factors for lower extremity deep venous thrombosis(LEDVT)in a severely traumatized population and to evaluate their predictive value for LEDVT.Methods This was a retrospective,single-center observational study.All subjects were severely traumatized patients who were admitted to the Traumatic Intensive Care Unit from January 2021 to May 2024.Based on Doppler ultrasound findings of both lower extremities from the time of injury to 30 days post-injury,patients who developed LEDVT were enrolled in the LEDVT group,and those who did not develop LEDVT were enrolled in the NLEDVT group.Demographic,clinical,and laboratory data were collected upon admission.Multivariable logistic regression analysis was performed to identify risk factors for LEDVT.Receiver operating characteristic(ROC)curve was used to evaluate the overall fit of the final model.Results There were 56 patients enrolled in the LEDVT group and 81 patients in the NLEDVT group.Age,Aggregate Index of Systemic Inflammation(AISI),Systemic Inflammation Response Index(SIRI),ICU length of stay,and albumin were identified as independent risk factors for LEDVT(all P<0.05).The area under their ROC curves were 0.604,0.657,0.694,0.668,and 0.405,respectively.Combined model for early clinical prediction of LEDVT in severely traumatized patients by age,SIRI,AISI,and albumin resulted in an area under the ROC curve of 0.805(95%CI:0.73-0.88,SE=0.037).Conclusion The combination of age,SIRI,AISI,and albumin has a predictive value for LEDVT in severely traumatized patients.
基金Supported by the Natural Science Foundation of Xinjiang Uygur Autonomous Region,No.2022D01C297.
文摘BACKGROUND The prognosis of colorectal cancer(CRC)patients is notably influenced by both inflammation and nutritional status.The prognostic nutritional index(PNI)and systemic inflammatory response index(SIRI)have been reported in prognostic studies of various tumors.However,the efficacy of the combination of the two in predicting the prognosis of CRC patients has not been studied.AIM To evaluate the effectiveness of PNI and SIRI in predicting the prognosis of patients with CRC.METHODS We retrospectively gathered data from 470 CRC patients who underwent feasible radical surgery at Xinjiang Cancer Hospital.The optimal cut-off values for SIRI and PNI,along with their predictive power for survival,were determined through area under the receiver operating characteristic curve using time-dependent receiver operating characteristic analysis.The Kaplan-Meier method and log-rank test were applied to assess prognostic impact,and a multifactorial Cox proportional hazards model was employed for analysis.Additionally,a new model,PSIRI,was developed and assessed for its survival prediction capability.RESULTS The optimal cutoff values for PNI and SIRI were determined to be 47.80 and 1.38,respectively.Based on these values,patients were categorized into high PNI and low PNI groups,as well as high SIRI and low SIRI groups.Significant differences in age,T stage,neutrophil to lymphocyte ratio(NLR),monocyte to lymphocyte ratio(MLR),and platelet-to-lymphocyte ratio(PLR)subgroups were observed between the PNI groups in the baseline profile.In the SIRI group,notable differences were found in gender,T stage,nerve invasion,intravascular tumor emboli,NLR,MLR,and PLR subgroups.Both low PNI and high SIRI were identified as independent risk factors for poor prognosis in CRC patients.When combined into the PSIRI model,it was shown that patients with a PSIRI≤1 had a higher risk of death compared to those with a PSIRI of 2.CONCLUSION We assessed the impact of PNI and SIRI on the prognostic survival of CRC patients and developed a new model,PSIRI.This model demonstrated superior predictive accuracy,with a concordance index of 0.767.
文摘BACKGROUND The prognostic value of the Systemic Inflammation Response Index(SIRI)in advanced pancreatic cancer is recognized,but its correlation with patients´nutritional status and outcomes remains unexplored.AIM To study the prognostic significance of SIRI and weight loss in metastatic pancreatic cancer.METHODS The PANTHEIA-Spanish Society of Medical Oncology(SEOM)study is a multicentric(16 Spanish hospitals),observational,longitudinal,non-interventional initiative,promoted by the SEOM Real World-Evidence work group.This pilot study sought to analyze the association between weight loss and inflammatory status as defined by SIRI.The cohort stems from a proof-of-concept pilot study conducted at one of the coordinating centers.Patients with pathologically confirmed metastatic pancreatic adenocarcinoma,treated from January 2020 to January 2023,were included.The index was calculated using the product of neutrophil and monocyte counts,divided by lymphocyte counts,obtained within 15 days before initiation chemotherapy.This study evaluated associations between overall survival(OS),SIRI and weight loss.RESULTS A total of 50 patients were included.66%of these patients were male and the median age was 66 years.Metastasis sites:36%liver,12%peritoneal carcinomatosis,10%lung,and 42%multiple locations.Regarding the first line palliative chemotherapy treatments:50%received gemcitabine plus nab-paclitaxel;28%,modified fluorouracil,leucovorin,irinotecan and oxaliplatin,and 16%were administered gemcitabine.42%had a weight loss>5%in the three months(mo)preceding diagnosis.21 patients with a SIRI≥2.3×10^(3)/L exhibited a trend towards a lower median OS compared to those with a SIRI<2.3×10^(3)/L(4 vs 18 mo;P<0.000).Among 21 patients with>5%weight loss before diagnosis,the median OS was 6 mo,in contrast to 19 mo for those who did not experience such weight loss(P=0.003).Patients with a weight loss>5%showed higher SIRI levels.This difference was statistically significant(P<0.000).For patients with a SIRI<2.3×10^(3)/L,those who did not lose>5%of their weight had an OS of 20 mo,compared to 11 mo for those who did(P<0.001).No association was found between carbohydrate antigen 19-9 levels≥1000 U/mL and weight loss.CONCLUSION A higher SIRI was correlated with decreased survival rates in patients with metastatic pancreatic cancer and associated with weight loss.An elevated SIRI is suggested as a predictor of survival,emphasizing the need for prospective validation in the upcoming PANTHEIA-SEOM study.
文摘BACKGROUND The relationship between preoperative inflammation status and tumorigenesis as well as tumor progression is widely acknowledged.AIM To assess the prognostic significance of preoperative inflammatory biomarkers in patients with distal cholangiocarcinoma(dCCA)who underwent pancreat-oduodenectomy(PD).METHODS This single-center study included 216 patients with dCCA after PD between January 1,2011,and December 31,2022.The individuals were categorized into two sets based on their systemic inflammatory response index(SIRI)levels:A low SIRI group(SIRI<1.5,n=123)and a high SIRI group(SIRI≥1.5,n=93).Inflam-matory biomarkers were evaluated for predictive accuracy using receiver operating characteristic curves.Both univariate and multivariate Cox proportional hazards analyses were performed to estimate SIRI for overall survival(OS)and recurrence-free survival(RFS).RESULTS The study included a total of 216 patients,with 58.3%being male and a mean age of 65.6±9.6 years.123 patients were in the low SIRI group and 93 were in the high SIRI group after PD for dCCA.SIRI had an area under the curve value of 0.674 for diagnosing dCCA,showing better performance than other inflammatory biomarkers.Multivariate analysis indicated that having a SIRI greater than 1.5 independently increased the risk of dCCA following PD,leading to lower OS[hazard ratios(HR)=1.868,P=0.006]and RFS(HR=0.949,P<0.001).Additionally,survival analysis indicated a significantly better prognosis for patients in the low SIRI group(P<0.001).CONCLUSION It is determined that a high SIRI before surgery is a significant risk factor for dCCA after PD.
基金Supported by National Natural Science Foundation of China,No.8236110677Natural Science Foundation of Gansu Province,No.18JR2RA033Gansu Da Vinci Robot High-End Diagnosis and Treatment Team Construction Project,National Key Research and Development Program,No.2020RCXM076.
文摘BACKGROUND The systemic inflammatory response index(SIRI)has been demonstrated to make a significant difference in assessing the prognosis of patients with different solid neoplasms.However,research is needed to ascertain the accuracy and reliability of applying the SIRI to patients who undergo robotic radical gastric cancer sur-gery.AIM To validate the applicability of the SIRI in assessing the survival of gastric cancer patients and evaluate the clinical contribution of preoperative SIRI levels to predicting long-term tumor outcomes in patients,who received robotic radical gastric cancer surgery.METHODS Initially,an exhaustive retrieval was performed in the PubMed,the Cochrane Library,EMBASE,Web of Science,and Scopus databases to identify relevant studies.Subsequently,a meta-analysis was executed on 6 cohort studies iden-tifying the value of the SIRI in assessing the survival of gastric cancer patients.Additionally,the clinical data of 161 patients undergoing robotic radical gastric cancer surgery were retrospectively analyzed to evaluate their clinicopathological characteristics and relevant laboratory indicators.The association between preoperative SIRI levels and 5-year overall survival(OS)and disease-free survival(DFS)was assessed.RESULTS The findings demonstrated an extensive connection between SIRI values and the outcome of patients with gastric cancer.Preoperative SIRI levels were identified as an independent hazard feature for both OS and DFS among those who received robotic surgery for gastric cancer.SIRI levels in gastric cancer patients were observed to be associated with the presence of comorbidities,T-stage,carcinoembryonic antigen levels,the development of early serious postoperative complications,and the rate of lymph node metastasis.CONCLUSION SIRI values are correlated with adverse in the gastric cancer population and have the potential to be utilized in predicting long-term oncological survival in patients who undergo robotic radical gastric cancer surgery.
文摘I. THE COMPLEXITY OFBIOLOGICAL RESPONSESFor an organism, to be living or notdepends on its response to foreign matters.Facing the increasing amount and diversi-ty of chemicals, natural and synthetic, tounderstand the principles of the biologicalresponses becomes extremely importantin pursuing the way of rational utiliza-tion and governing the foreign matters.However, most biological responses aretoo complex to explore their nature. Forinstance, the risk to human beings andorganisms related to the application ofrare earths in agriculture, forestation, fish-ery and husbandry has been argued
基金supported by the National Natural Science Foundation of China(82102315).
文摘BACKGROUND:The lack of a stable,easy-to-operate animal model for severe trauma has hindered the research progress.The aim of this study is to develop a mouse model that replicates the pathophysiological conditions of severe trauma,providing a reliable research tool.METHODS:Male C57BL/6J mice(aged 8-10 weeks and weighting approximately 20 g)were used to establish the severe trauma model.Under anesthesia,a midshaft femoral fracture was created and packed with sterile cotton.A midline incision was made from the inguinal region to the sternum,exposing the abdominal organs for 30 min.The right femoral artery was cannulated to induce controlled blood loss at 30%,35%,40%,and 50%of the total blood volume.Survival rates were monitored for 24 h post-induction.In the mice that experienced 30%blood loss,the mean arterial pressure,body temperature,blood gas parameters,peripheral blood inflammatory markers,and major organ pathological changes were assessed.RESULTS:Mice with femoral fractures,soft tissue injuries,abdominal organ exposure,and 30%blood loss exhibited stable survival rates.Increased blood loss significantly reduced survival rates.Mean arterial pressure decreased initially,recovering within 0-15 min and returning to baseline by 50 min.Similarly,the body temperature decreased initially and gradually recovered to baseline within 50 min.Levels of peripheral blood inflammatory markers remained elevated for 12 h post-injury.Distant organs,including intestines,lungs,liver,spleen and kidneys,displayed varying degrees of injury.CONCLUSION:The established mouse model replicates the pathophysiological responses to severe trauma,indicating stability and reproducibility,which could be an useful tool for further trauma research.
基金supported by the Sichuan Science and Technology Program(2022NSFSC1936)Doctoral Scientific Research Start-up Foundation of China West Normal University(412984).
文摘Introduction When the body is infected,pathogenic microorganisms and their toxins can enter the blood circulation and grow and proliferate in the blood,producing more toxins.These toxins and pathogens activate the body's immune system,leading to the release of a varieties of cytokines and inflammatory mediators,resulting in systemic inflammatory response syndrome[1].
文摘Acute cardiomyocyte necrosis in the infarcted heart generates damage-associated molecular patterns, activating complement and toll-like receptor/interleukin-1 signaling, and triggering an intense inflammatory response. Iuflammasomes also recognize danger signals and mediate sterile inflammatory response following acute myocardial infarction （AMI）, Inflammatory response serves to repair the heart, but excessive inflammation leads to adverse left ventricular remodeling and heart failure. In addition to local inflammation, profound systemic inflammation response has been documented in patients with AMI, which includes elevation of circulating inflammatory cytokines, chemokines and cell adhesion molecules, and activation of peripheral leukocytes and platelets. The excessive inflammatory response could be caused by a deregulated immune system. AMI is also associated with bone marrow activation and spleen monocytopoiesis, which sustains a continuous supply of monocytes at the site of inflammation. Accumulating evidence has shown that systemic inflammation aggravates atherosclerosis and markers for systemic inflammation are predictors of adverse clinical outcomes （such as death, recurrent myocardial in- farction, and heart failure） in patients with AMI.
基金the National Natural Science Foundation of China,Nos.81571213(to BW),81800583(to YYX),81601539(to DM)and 81601084(to YC)+3 种基金the National Key Research and Development Program of China,No.2017YFA0104304(to BW)the Nanjing Medical Science and Technique Development Foundation of China,Nos.QRX17006(to BW),QRX17057(to DM)the Key Project Medical Science and Technology Development Foundation,Nanjing Department of Health and the Nanjing Medical Science of China,No.201803024(to TYG)Innovation Platform,No.ZDX16005(to BW)。
文摘Intraspinal inflammatory and immune responses are considered to play central roles in the pathological development of spinal cord injury.This study aimed to decipher the dynamics of systemic immune responses,initiated by spinal cord injury.The spinal cord in mice was completely transected at T8.Changes in the in vivo inflammatory response,between the acute and subacute stages,were observed.A rapid decrease in C-reactive protein levels,circulating leukocytes and lymphocytes,spleen-derived CD4~+interferon-γ+T-helper cells,and inflammatory cytokines,and a marked increase in neutrophils,monocytes,and CD4~+CD25~+FOXP3~+regulatory T-cells were observed during the acute phase.These systemic immune alterations were gradually restored to basal levels during the sub-acute phase.During the acute phase of spinal cord injury,systemic immune cells and factors showed significant inhibition;however,this inhibition was transient,and the indicators of these serious disorders gradually returned to baseline levels during the subacute phase.All experiments were performed in accordance with the institutional animal care guidelines,approved by the Institutional Animal Care and Use Committee of Experimental Animal Center of Drum Tower Hospital,China(approval No.2019 AE01040)on June 25,2019.
基金supported by Tangshan City Science and Technology Development Project(No.15130219a)
文摘BACKGROUND:Periplaneta americana extract is recognized to have a positive effect on gastrointestinal mucosa.This study aimed to investigate the effects of periplaneta americana extract on immune function,nutrition status and gastrointestinal complications of early enteral nutrition patients with systemic inflammatory response syndrome(SIRS).METHODS:Patients with SIRS were randomly divided into two groups:treatment and control groups.All patients in the two groups received conventional therapy including enteral nutrition,but periplaneta americana extract,an additional Chinese medicine,was given to the patients in the treatment group.At the beginning of treatment(0 day)and 1,3,and 7 days after treatment,the levels of immunoglobulin(Ig A),total lymphocyte count(TLC),total protein(TP)and prealbumin(PA)were respectively tested in patients'venous blood.The incidences of bloating,diarrhea,aspiration pneumonia and high blood sugar at 7 days after treatment were recorded.The mortality of the patients in 28 days was recorded.RESULTS:At 3 and 7 days after treatment,the levels of Ig A and TLC in the treatment group were higher than those in the control group(P<0.05).At 7 days after treatment,the levels of TP and PA in the treatment group were higher than those in the control group(P<0.05).The incidences of bloating and diarrhea in the treatment group were lower than those in the control group,the differences were significant(P<0.05).The mortality of treatment group was lower than that of the control group(P>0.05).CONCLUSION:Periplaneta americana extract could reduce gastrointestinal complications and improve immune function and nutritional status in patients with systemic inflammatory response syndrome.
基金This project was supported by a grant from National Natural Sciences Foundation of China (No. 30200272).
文摘The changes of Toll-like receptor （TLR） 2, 4 of peripheral blood mononuclear cells （PBMCs） in the acute abdomen patients associated with systemic inflammatory response syndrome （SIRS） and their potential significance were explored. A clinical study was performed on 103 acute abdomen patients in whom 65 were associated with SIRS. Forty healthy individuals served as normal controls. The mRNA expression of TLR2, 4 was detected by RT-PCR, and the expression of TNF-α and IL-6 by ELISA. The level of plasma endotoxin, hospital stay and mortality were measured. It was found that the endotoxin level was increased to varying degrees in all the acute abdomen patients, and the endotoxin level was and hospital stay longer in SIRS group than in non-SIRS group （P〈0.01）. TLR2 mRNA, TLR4 mRNA, IL-6 and TNF-ct could be detected with low value in normal controls, but they were up-regulated markedly on the 1 st day after admission. Then TLR4 mRNA, IL-6 and TNF-α were decreased gradually, but TLR2 mRNA maintained at a high level till the 5th day. These indexes above in SIRS group were higher than those in non-SIRS group （P〈0.01）. The results of correlation analysis revealed the expression of TLR2, 4 mRNA was positively correlated with the levels of TNF-α and IL-6, and the hospital stay, The results of Logistic regression demonstrated that overexpression of TLR2, 4 mRNA might result in higher risk of multiple organ dysfunction syndrome （MODS）. It was concluded that in the acute abdomen patients associated with SIRS, the expression of TLR2, 4 in PBMCs was increased markedly, suggesting that TLR might play an important role in the pathogenesis of acute abdomen associated with SIRS.
文摘BACKGROUND： This study aimed to determine the plasma levels of urokinase-type plasminogen activator （uPA）, urokinase-type plasminogen activator receptor （uPAR）, D-dimer, IL-6 and TNF-α, and observe the relations among uPA, uPAR, D-dimer, IL-6 and TNF-α in patients with systemic inflammatory response syndrome （SIRS）.METHODS： A prospective, clinical case-control study was conducted in patients with SIRS at age of more than 55 years old treated during 2008-2010 at Wuhan Central Hospital. Venous blood samples were collected by routine venipuncture. Eighty-five patients were divided into two groups according to diagnostic criteria of SIRS： SIRS patients from intensive care units （n=50）, and non- SIRS patients from medical wards （n=35）. Thirty healthy blood donors who visited the General Health Check-up Division at Wuhan Central Hospital served as controls. Excluded from the study were （1） those patients with pregnancy; （2） those with cancer; （3） those died after admission into the ICU in 7 days; （4） those received cardiopulmonary resuscitation; （5） those who had previous blood system diseases; and （6） those with SIRS before admission into the ICU. The levels of uPA, uPAR, D-D, IL-6 and TNF-a in blood were detected by commercial enzyme-linked immunosorbent assay （ELISA） kit. The data were analyzed using SPSS version 17.0 and expressed as mean ＋ standard. Student＇s t test and the Mann-Whitney U test were used in the analysis. The relations of uPA, uPAR and D-dimer, IL-6 TNF-α levels were analyzed using Spearman＇s rank-order correlation coefficient test. RESULTS： The plasma levels of uPA, uPAR, D-dimer, lL-6 and TNF-α in the patients with SIRS were obviously higher than those in the non-SIRS patients and controls （P〈0.001）. Correlation analysis showed a positive correlation between uPAR and IL-6 levels （r=0.395, P=0.004） and between uPAR and TNF-a levels （r=0.606, P〈0.001）, but no correlation between uPAR and D-dimer levels （r=0.069, P=0.632）. No correlation was observed between uPA, D-dimer, IL-6 and TNF-α levels （P〉0.05）. The establishment of ROC curve was based on the levels of uPAR, D-dimer, IL-6 and TNF-α in 24 hours for the diagnosis of multiple organ dysfunction syndrome （MODS）, and the ROC areas under the curve were 0.76, 0.58, 0.86 and 0.83, respectively. CONCLUSIONS：uPA and uPAR play a major role in patients with SIRS in the process of coagulation disorder, but the mechanism of SIRS is not the same. uPAR may play a central role in the development of SIRS to MODS.
