Persistent postsurgical pain is a major clinical concern,especially in the aging population,who represent a growing proportion of surgical patients.Although age is a known pain risk factor,the mechanisms driving age-r...Persistent postsurgical pain is a major clinical concern,especially in the aging population,who represent a growing proportion of surgical patients.Although age is a known pain risk factor,the mechanisms driving age-related vulnerability to chronic postoperative pain remain poorly understood.This study aims to investigate how aging influences the resolution of postoperative pain and to elucidate the roles of microglial activation and synaptic remodeling in the spinal dorsal horn.A plantar incision model in young(3-month-old)and aged(18-month-old)male and female mice was used to mimic postoperative pain conditions.Mechanical and thermal hypersensitivity at various postoperative intervals were assessed by von Frey and Hargreaves tests.Microglial activation and inhibitory/excitatory synaptic densities in the spinal dorsal horn were evaluated using immunofluorescence and 3D reconstruction with Imaris software.On postoperative day(POD)3,both age groups exhibited reduced pain thresholds on the ipsilateral side,along with microglial activation in the dorsal horn.On POD 7,pain thresholds in young mice had returned to baseline with no significant microglial activation,while aged mice showed sustained reduction in pain thresholds,continuous microglial activation,and significant loss of inhibitory synapses without detectable changes in excitatory synapse density.These findings are consistent across both sexes,with no sex-related differences.Collectively,these results suggest that aging is associated with persistent postoperative pain,which correlates with microglial activation and inhibitory synapse loss.These insights advance our understanding of age-related pain vulnerability and may inform the development of more effective,targeted,and age-specific therapeutic strategies to prevent or alleviate persistent postoperative pain in elderly patients.展开更多
Global brain ischemia and neurological deficit are consequences of cardiac arrest that lead to high mortality.Despite advancements in resuscitation science,our limited understanding of the cellular and molecular mecha...Global brain ischemia and neurological deficit are consequences of cardiac arrest that lead to high mortality.Despite advancements in resuscitation science,our limited understanding of the cellular and molecular mechanisms underlying post-cardiac arrest brain injury have hindered the development of effective neuroprotective strategies.Previous studies primarily focused on neuronal death,potentially overlooking the contributions of non-neuronal cells and intercellular communication to the pathophysiology of cardiac arrest-induced brain injury.To address these gaps,we hypothesized that single-cell transcriptomic analysis could uncover previously unidentified cellular subpopulations,altered cell communication networks,and novel molecular mechanisms involved in post-cardiac arrest brain injury.In this study,we performed a single-cell transcriptomic analysis of the hippocampus from pigs with ventricular fibrillation-induced cardiac arrest at 6 and 24 hours following the return of spontaneous circulation,and from sham control pigs.Sequencing results revealed changes in the proportions of different cell types,suggesting post-arrest disruption in the blood-brain barrier and infiltration of neutrophils.These results were validated through western blotting,quantitative reverse transcription-polymerase chain reaction,and immunofluorescence staining.We also identified and validated a unique subcluster of activated microglia with high expression of S100A8,which increased over time following cardiac arrest.This subcluster simultaneously exhibited significant M1/M2 polarization and expressed key functional genes related to chemokines and interleukins.Additionally,we revealed the post-cardiac arrest dysfunction of oligodendrocytes and the differentiation of oligodendrocyte precursor cells into oligodendrocytes.Cell communication analysis identified enhanced post-cardiac arrest communication between neutrophils and microglia that was mediated by neutrophil-derived resistin,driving pro-inflammatory microglial polarization.Our findings provide a comprehensive single-cell map of the post-cardiac arrest hippocampus,offering potential novel targets for neuroprotection and repair following cardiac arrest.展开更多
Objective Sepsis patients exhibit diverse immune states,making it crucial to identify subtypes with distinct inflammatory profiles through Th1/Th2 cytokine data for personalized treatment and improved prognosis.Method...Objective Sepsis patients exhibit diverse immune states,making it crucial to identify subtypes with distinct inflammatory profiles through Th1/Th2 cytokine data for personalized treatment and improved prognosis.Methods We retrieved data from sepsis patients who underwent Th1/Th2 cytokine testing in Nanfang Hospital,Southern Medical University from June 1,2020,to February 1,2022.An unsupervised K-means clustering method classified participants based on Th1/Th2 cytokine levels,with the primary outcome being the 7-day mortality rate post-ICU admission.Cox proportional hazards and Restricted Mean Survival Time(RMST)analyses were utilized to explore survival outcomes.Results A total of 321 sepsis patients were included.IL-6(HR 1.69,95%CI:1.22,2.34)and IL-10(HR 1.81,95%CI:1.37,2.40)emerged as independent predictors of 7-day mortality.Unsupervised K-means clustering revealed 3 inflammatory/immune subgroups:Cluster 1(n=166,low inflammatory response),Cluster 2(n=99,moderate inflammatory response with immune suppression),and Cluster 3(n=56,strong inflammatory and immune suppression).Compared to Cluster 1,Clusters 2 and 3 had higher 7-day mortality risks(14.4%vs 23.2%,HR=4.30,95%CI:1.51-12.26;14.4%vs 35.7%,HR=7.32,95%CI:2.57-20.79).Conclusion Septic patients in a protective immune response state(Cluster 1)exhibit better short-term prognoses,suggesting the importance of understanding inflammatory/immune states for precise treatment and improved outcomes.展开更多
Metabolic dysfunction-associated steatotic liver disease(MASLD),formerly known as nonalcoholic fatty liver disease,is a chronic liver disease characterized by hepatic lipid deposition and hepatocellular steatosis,resu...Metabolic dysfunction-associated steatotic liver disease(MASLD),formerly known as nonalcoholic fatty liver disease,is a chronic liver disease characterized by hepatic lipid deposition and hepatocellular steatosis,resulting from nonalcoholic causes and closely linked to metabolic dysfunction[1].It is strongly associated with metabolic abnormalities,including type 2 diabetes,overweight,and obesity.The global prevalence of MASLD is estimated to be approximately 25%−33%,and its incidence is rising rapidly,particularly among younger populations,due to increasingly prevalent unhealthy lifestyle behaviors such as sleep deprivation,sedentary habits,and diets rich in calories.展开更多
Psittacosis pneumonia is a zoonotic disease caused by Chlamydia psittaci infection,with the lungs being the most affected organ.[1]Rhabdomyolysis is a clinical syndrome characterized by the massive release of intracel...Psittacosis pneumonia is a zoonotic disease caused by Chlamydia psittaci infection,with the lungs being the most affected organ.[1]Rhabdomyolysis is a clinical syndrome characterized by the massive release of intracellular components—such as myoglobin and creatine kinase—into the bloodstream due to skeletal muscle injury or necrosis.Common causes include trauma,medications,metabolic disorders,and infections.When psittacosis pneumonia is complicated by rhabdomyolysis,patients often develop multiple organ dysfunction and have a poor prognosis,necessitating early clinical intervention.展开更多
BACKGROUND:Sepsis is a prevalent and severe condition,with microcirculation disruptions playing a crucial role in its progression.Endothelial cell(EC)injury is the primary factor behind microcirculatory issues.This re...BACKGROUND:Sepsis is a prevalent and severe condition,with microcirculation disruptions playing a crucial role in its progression.Endothelial cell(EC)injury is the primary factor behind microcirculatory issues.This review is to outline the pathomechanism,organ heterogeneity,biomarkers,and therapeutic implications of endothelial dysfunction in sepsis,off ering references and insights for the clinical management of sepsis.METHODS:A systematic search of Web of Science and PubMed from inception to June 10,2025,limited to English publications,was conducted.Two reviewers independently identifi ed studies on EC injury in patients with septic microcirculatory dysfunction.Duplicate articles based on multiple search criteria were excluded.RESULTS:Fifty-nine articles,including cell,animal,and clinical studies,were included.These studies reported the effects of EC injury on the microcirculation in sepsis,including changes in vascular permeability,coagulation dysfunction,vasomotor regulation,and infl ammatory responses.These pathways interact and ultimately lead to septic microcirculation disorders.CONCLUSION:Sepsis-induced endothelial dysfunction involves various interconnected mechanisms,which collectively compromise ECs and impede microcirculatory perfusion.Future research should enhance current understanding of endothelial injury mechanisms,develop synergistic multi-target strategies to disrupt this cycle,and facilitate the clinical application of endothelial markers for early intervention and dynamic assessment.展开更多
Objective:To observe the efficacy of LIU’s infantile Tuina(Chinese therapeutic massage)combined with Bi Yan Gao in treating allergic rhinitis(AR)in kids and the impact on serum inflammatory factors.Methods:A total of...Objective:To observe the efficacy of LIU’s infantile Tuina(Chinese therapeutic massage)combined with Bi Yan Gao in treating allergic rhinitis(AR)in kids and the impact on serum inflammatory factors.Methods:A total of 120 kids with AR were recruited and divided into a Tuina group,a Bi Yan Gao group,and a combined group using the random number table method,with 40 cases in each group.The three groups all received oral desloratadine syrup as the basic intervention.In addition,the Tuina group was treated with LIU’s infantile Tuina therapy once daily;the BI Yan Gao group received external application of Bi Yan Gao,once every morning and night;the combined group was intervened by LIU’s infantile Tuina plus Bi Yan Gao external application.The intervention lasted for 8 weeks.Before and after the intervention,the total nasal symptom score(TNSS)was compared,and the serum levels of interleukin(IL)-4,IL-6,IL-8,and immunoglobulin E(IgE)were detected.The total effective rate was also compared among the three groups.Results:After 8 weeks of treatment,the total effective rate was 87.2%in the combined group,60.5%in the Tuina group,and 57.5%in the Bi Yan Gao group,showing significant between-group differences(P<0.05).The contents of serum IL-6,IL-8,and IgE were lower in the combined group compared to the Tuina and Bi Yan Gao groups,presenting statistical significance(P<0.05).The level of IL-4 was statistically parallel across the three groups(P>0.05).Conclusion:The combined use of LIU’s infantile Tuina and Bi Yan Gao can improve nasal symptoms and lower the levels of serum inflammatory factors and IgE in kids with AR,producing a higher total effective rate compared to the separate use of the two approaches.展开更多
Microglia are the macrophages that populate the brain parenchyma.Research in the past decades has identified them as both essential guardians of the brain and significant contributors to various neurological diseases....Microglia are the macrophages that populate the brain parenchyma.Research in the past decades has identified them as both essential guardians of the brain and significant contributors to various neurological diseases.A highly versatile cell type,microglia have been shown to fulfill a multitude of critical roles in the central nervous system,including facilitating neurogenesis and myelination,pruning synapses,removing debris and waste,modulating neuronal activity,supporting the blood-brain barrier,repairing tissue damage,and surveilling against microbial invasions under physiological conditions(Prinz et al.,2021;Paolicelli et al.,2022).展开更多
Immunotherapy has brought unprecedented breakthroughs to advanced malignant tumors,yet the immune microenvironment shaped by the tumor stroma has often been underestimated in the traditional focus on the“immune check...Immunotherapy has brought unprecedented breakthroughs to advanced malignant tumors,yet the immune microenvironment shaped by the tumor stroma has often been underestimated in the traditional focus on the“immune checkpoint-T cell”axis.Collagen not only constitutes a mechanical barrier that distinguishes between the periphery and core of solid tumors but also systematically remodels the orientation of metabolism,vasculature,and immune cell phenotypic plasticity through its spatial density,fiber arrangement,and crosslinking patterns(F igure 1)[1,2].Abundant evidence suggests that over-accumulated types I and III collagen drive CD8+T cell exhaustion,NK cell functional inhibition,and tumor-associated macrophage polarization through ligand-receptor networks involving LAIR-1,DDR2,andβ1/β3 integrins[3-6].Mechanistically,collagen engagement of LAIR-1 delivers inhibitory signals in effector lymphocytes,promoting dysfunctional or exhausted states[7-9].In parallel,collagen-β1/β3 integrin signaling activates mechanotransduction pathways(e.g.,FAK/SRC),reducing T-cell motility and immune-tumor contact,while DDR2 activation supports matrix-remodeling programs that limit lymphocyte trafficking.展开更多
BACKGROUND:Individualized positive end-expiratory pressure(PEEP)titration is a crucial technique in mechanical ventilation therapy for acute respiratory distress syndrome(ARDS)patients with intra-abdominal hypertensio...BACKGROUND:Individualized positive end-expiratory pressure(PEEP)titration is a crucial technique in mechanical ventilation therapy for acute respiratory distress syndrome(ARDS)patients with intra-abdominal hypertension(IAH).This study aimed to evaluate the eff ectiveness of electrical impedance tomography(EIT)-guided PEEP titration in this population.METHODS:This prospective study enrolled 36 ARDS patients,including 22 patients with IAH and 14 without IAH.All the patients underwent EIT-guided PEEP titration at the intersection point between alveolar overdistension and collapse during a decremental PEEP trial.The changes in pulmonary ventilation distribution,respiratory mechanics and hemodynamics during the titration process were observed.RESULTS:After EIT-guided PEEP titration was performed,the PEEP,peak inspiratory pressure and plateau pressure increased significantly(P<0.05).Furthermore,no significant differences were observed in respiratory system compliance,tidal volume,driving pressure,or the 4*DP+RR index between the two groups(P>0.05).The mechanical power increased in the non-IAH(NIAH)group after PEEP titration(P<0.05).Ventilation in gravity-dependent lung regions significantly increased(P<0.05),and the oxygenation index(PaO2/FiO2)improved signifi cantly(P<0.05)in both groups.However,blood pressure,heart rate,respiratory rate,central venous pressure,and lactate levels did not signifi cantly change.In the IAH group,the PaO2/FiO2 ratio improved less than that in the NIAH group did(P<0.05).CONCLUSION:In our study,individualized PEEP titration guided by EIT improved oxygenation in ARDS patients with concomitant IAH without signifi cantly aff ecting hemodynamics.The presence of IAH may limit the improvement of oxygenation during EIT-guided PEEP titration.展开更多
This paper summarizes the nursing experience of a child with acute fulminant myocarditis.Key nursing measures include establishing a multidisciplinary team to jointly formulate diagnosis and treatment plans;implementi...This paper summarizes the nursing experience of a child with acute fulminant myocarditis.Key nursing measures include establishing a multidisciplinary team to jointly formulate diagnosis and treatment plans;implementing refined volume management,anticoagulation management,and ventilator management during extracorporeal membrane oxygenation;providing personalized nutritional support for the child;and strengthening the prevention and management of complications.After active treatment and nursing care,the child recovered well and was successfully transferred out of the intensive care unit.展开更多
This article reviews the research advances in traditional Chinese medicine rhubarb and its compound formulations in the treatment of sepsis,with particular emphasis on elucidating their mechanisms of action and clinic...This article reviews the research advances in traditional Chinese medicine rhubarb and its compound formulations in the treatment of sepsis,with particular emphasis on elucidating their mechanisms of action and clinical application value.Research has demonstrated that rhubarb and its compound formulations exert therapeutic effects via multiple targets and mechanisms,including anti-inflammatory actions,protection of the intestinal barrier,modulation of immune balance,inhibition of oxidative stress,and regulation of associated signaling pathways.Clinically,rhubarb has shown distinct advantages in enhancing gastrointestinal function,mitigating systemic inflammatory responses,and reducing mortality rates among patients with sepsis.These findings provide a foundational reference for the integrated prevention and treatment of sepsis through the combined use of traditional Chinese and Western medicine.展开更多
Spinal cord injury is a severe neurological condition with limited neuronal regeneration and functional recovery.Currently,no effective treatments exist to improve spinal cord injury prognosis.Neuronal guidance protei...Spinal cord injury is a severe neurological condition with limited neuronal regeneration and functional recovery.Currently,no effective treatments exist to improve spinal cord injury prognosis.Neuronal guidance proteins are a diverse group of molecules that play crucial roles in axon and dendrite growth during nervous system development.Increasing evidence highlights their regulatory functions in spinal cord injury.This review provides a brief overview of the modulation patterns of key neuronal guidance proteins in neuronal axon growth during nervous system formation and subsequently focuses on their roles in neuronal regeneration and functional recovery following spinal cord injury.Neuronal guidance proteins include,but are not limited to,semaphorins and their receptors,plexins;netrins and their receptors,deleted in colorectal cancer and UNC5;Eph receptors and their ligands,ephrins;Slit and its receptor,Robo;repulsive guidance molecules and their receptor,neogenin;Wnt proteins and their receptor,Frizzled;and protocadherins.Localized Netrin-1 at the injury site inhibits motor axon regeneration after adult spinal cord injury while promoting oligodendrocyte growth.Slit2 enhances synapse formation in the injured spinal cord of rats.EphA7 regulates acute apoptosis in the early pathophysiological stages of spinal cord injury,while ephrinA1 plays a role in the nervous system’s injury response,with its reduced expression leading to impaired motor function in rats.EphA3 is upregulated following spinal cord injury,promoting an inhibitory environment for axonal regeneration.After spinal cord injury,bidirectional activation of ephrinB2 and EphB2 in astrocytes and fibroblasts results in the formation of a dense astrocyte-meningeal fibroblast scar.EphB1/ephrinB1 signaling mediates pain processing in spinal cord injury by regulating calpain-1 and caspase-3 in neurons.EphB3 expression increases in white matter after spinal cord injury,further inhibiting axon regeneration.Sema3A,expressed by neurons and fibroblasts in the scar surrounding the injury,inhibits motor neuron and sensory nerve growth after spinal cord injury.Sema4D suppresses neuronal axon myelination and axon regeneration,while its inhibition significantly enhances axon regeneration and motor recovery.Sema7A is involved in glial scar formation and may influence serotonin channel remodeling,thereby affecting motor coordination.Given these findings,the local or systemic application of neuronal guidance proteins represents a promising avenue for spinal cord injury treatment.展开更多
BACKGROUND:To provide a comprehensive analysis of the landscape of artifi cial intelligence(AI)applications in cardiac arrest(CA).METHODS:Comprehensive searches were conducted in PubMed,the Cochrane Library,Webof Scie...BACKGROUND:To provide a comprehensive analysis of the landscape of artifi cial intelligence(AI)applications in cardiac arrest(CA).METHODS:Comprehensive searches were conducted in PubMed,the Cochrane Library,Webof Science,and EMBASE from database inception through 10 June 2025.Studies that applied AI inboth in-hospital cardiac arrest(IHCA)and out-of-hospital cardiac arrest(OHCA)populations acrossthe following domains were included:prediction of cardiac arrest occurrence,prognostication ofCA outcomes,applications of large language models(LLMs),and evaluation of cardiopulmonaryresuscitation(CPR)and other AI-driven interventions related to CA.RESULTS:The scoping review included 114 studies,encompassing data from 9,574,462patients in total.AI was most commonly applied to the prediction of CA(overall,n=40;IHCA,n=30;OHCA,n=4;and both,n=6),CPR-related decision support during CA(n=16),and post-arrestprognosis and rehabilitation outcomes(overall,n=38;OHCA,n=21;IHCA,n=3;and both,n=14).Additional application areas included LLM-based applications(n=8),emergency call handling(n=4),wearable device-based detection(n=3),heart rhythm identification(n=2),education(n=2),and extracorporeal cardiopulmonary resuscitation(ECPR)candidate identifi cation(n=1).Across allapplication scenarios,the highest area under the receiver operating characteristic curve(AUROC)value for pre-arrest CA prediction in IHCA patients was 0.998 using a multilayer perceptron(MLP)model,whereas the optimal AUROC for pre-arrest CA prediction in OHCA patients was 0.950 usingextreme gradient boosting(XGBoost)or random forest(RF)models.For CPR-related decisionsupport during CA,the highest AUROC achieved was 0.990 with a convolutional neural network(CNN)model.In prognostic prediction,the optimal AUROC for IHCA patients was 0.960 usingXGBoost,while for OHCA patients it reached 0.976 using an MLP model.CONCLUSION:This review shows that AI is most commonly used for the prediction of CA andCPR-related support,as well as post-arrest and rehabilitation outcomes.Future research directions includedrug discovery,post-resuscitation management,neurorehabilitation,and clinical trial innovation.Furtherstudies should prioritize multicenter clinical trials to evaluate AI models in real-world settings and validatetheir eff ectiveness across diverse patient populations.Overall,AI has signifi cant potential to improve clinicalpractice,and its role in CA application is increasingly important.展开更多
Severe acute pancreatitis(SAP)can induce acute respiratory distress syndrome(ARDS)and abdominal compartment syndrome(ACS).Although prone position ventilation(PPV)can improve outcomes in patients with ARDS,there is sig...Severe acute pancreatitis(SAP)can induce acute respiratory distress syndrome(ARDS)and abdominal compartment syndrome(ACS).Although prone position ventilation(PPV)can improve outcomes in patients with ARDS,there is significant controversy regarding its concurrent use with ACS owing to concerns of increased risk of intra-abdominal pressure(IAP).[1]We present a case of successful PPV application without adverse eff ects.展开更多
BACKGROUND Edwardsiella tarda(E.tarda)belongs to the family Enterobacteriaceae and is generally seen to cause infections mainly in fish,but is also capable of infecting humans.Extraintestinal infections occur in patie...BACKGROUND Edwardsiella tarda(E.tarda)belongs to the family Enterobacteriaceae and is generally seen to cause infections mainly in fish,but is also capable of infecting humans.Extraintestinal infections occur in patients with certain risk factors,including immunocompromised status.We recently diagnosed a case of spontaneous bacterial peritonitis(SBP)due to E.tarda in an immuno-compromised dialysis patient.CASE SUMMARY Patient was a 55-year-old male,with a history of diabetic nephropathy being treated with hemodialysis three times a week.He was referred to our hospital due to an increased volume of ascites,and blood examination revealed increased inflammatory reaction.At our emergency department,he developed fever,disturbance of consciousness,abdominal distension,and abdomen-wide pain.In addition,a dialysis shunt was confirmed in his right forearm,and the shunt site showed no signs of inflammation.No wounds were confirmed on or in his body.A blood examination revealed increased values of white blood cells,C-reactive protein,and creatinine.Plain chest and abdominal computed tomography scanning revealed increased ascites volume.Abdominal paracentesis was performed and a Gram stain revealed Gramnegative bacillus.These findings prompted diagnosis of SBP.The patient was admitted and treated with cefmetazole,causing fever resolution and symptom improvements.Later,E.tarda was identified in ascites culture.The patient improved with decreased inflammatory response and was discharged on the 12th day of hospitalization.The antibiotic was terminated after 14 days of treatment.SBP in this case may have developed from chronic renal failure and diabetes mellitus.CONCLUSION We report the first known case of SBP due to E.tarda in an immuno-compromised dialysis patient.展开更多
Citrus is the world's most produced fruit.With the rapid growth of citrus cultivation and processing industries globally,the volume of by-products,including dropped fruits,defective fruits,and waste generated duri...Citrus is the world's most produced fruit.With the rapid growth of citrus cultivation and processing industries globally,the volume of by-products,including dropped fruits,defective fruits,and waste generated during processing,has surged.Consequently,resource wastage and environmental pollution due to the low utilization rate of these by-products have become increasingly prominent issues.Currently,citrus by-products are directly utilized as seasonings,tea,and traditional Chinese medicine,or for the extraction of pectin,flavonoids,carotenoids,limonoids,essential oils,synephrine,and other functional ingredients.They are also processed into ethanol,citric acid,feed,and organic fertilizer through biomass fermentation.Despite these applications,the overall utilization rate of citrus by-products remains low.Additionally,there is a lack of key technologies and core equipment,and the production of high value-added functional products is limited.The future direction for citrus by-product utilization lies in green,low-carbon,high-efficiency,and high-value comprehensive recycling.To address the serious environmental pollution and recycling challenges posed by citrus rotting,it is proposed for the first time to develop new products and mold prevention strategies throughout the entire citrus supply chain-"Planting-field management-harvesting-transportation-storage"-to achieve a circular economy approach.This strategy aims to"Take from citrus and give back to citrus"effectively preventing and reducing citrus rotting.Furthermore,it can mitigate the significant economic losses caused by fruit decay and provide insights into the high-quality development of comprehensive citrus by-product utilization.展开更多
Background:Ex vivo lung perfusion(EVLP)has emerged as a critical technique for lung preservation and evaluation prior to transplantation.While conventional rat EVLP systems utilize closed-loop dual cannulation of pulm...Background:Ex vivo lung perfusion(EVLP)has emerged as a critical technique for lung preservation and evaluation prior to transplantation.While conventional rat EVLP systems utilize closed-loop dual cannulation of pulmonary artery(PA)and vein,the effect of the simplified model using single PA cannulation with passive venous drainage is unknown.Methods:We developed two EVLP models in rats:a semi-closed circuit with PA-only cannulation and left atrial incision for passive venous drainage(SC-EVLP),and a closed circuit employing both arterial and venous cannulation(C-EVLP).Donor lungs were perfused for a defined duration and subsequently orthotopically transplanted.We evaluated pulmonary function parameters,histopathological injury scores,inflammatory cytokine levels,and apoptotic marker expression at the end of perfusion and posttransplantation.Results:Compared to the conventional EVLP,the SC-EVLP group exhibited significantly lower PA pressure and improved dynamic lung compliance throughout perfusion.Although the levels of tumor necrosis factor-αin the perfusate were higher in the SC-EVLP group,other cytokine levels in the perfusate and bronchoalveolar lavage fluid exhibited no significant differences.Pulmonary edema was reduced in the SC-EVLP group,as indicated by a lower lung wet-to-dry ratio.After transplantation,lungs from the SC-EVLP group exhibited lower histological injury scores,reduced apoptosis,and decreased serum cytokine levels,suggesting attenuated inflammation and tissue damage.Conclusions:In a rat model,single PA cannulation with passive venous drainage reduced pulmonary edema during EVLP and reduced lung injury and systemic inflammation after transplantation.展开更多
Objective:To analyze the application effectiveness of the integrated medical-nursing comprehensive care model in cases of cerebral infarction and clarify its clinical practical value for the patient rehabilitation pro...Objective:To analyze the application effectiveness of the integrated medical-nursing comprehensive care model in cases of cerebral infarction and clarify its clinical practical value for the patient rehabilitation process.Methods:A total of 60 patients with cerebral infarction admitted from June 2024 to December 2024 were selected as the research subjects and randomly divided into a control group and a research group,with 30 cases in each group.Patients in the control group received routine clinical nursing measures,while those in the study group underwent collaborative healthcare intervention in addition to routine nursing.The intervention included joint disease assessment,personalized rehabilitation training guidance,psychological counseling,and continuous nursing services after discharge.A comparative study was conducted by evaluating indicators such as the scores on adverse emotion scales,the extent of neurological recovery,the effectiveness rate of clinical rehabilitation treatment,and the level of satisfaction with nursing services between the two groups.Results:After the intervention,the scores on the Self-Rating Anxiety Scale(SAS)and the Self-Rating Depression Scale(SDS)in the study group decreased to(40.12±5.01)and(41.36±5.20),respectively,both significantly lower than those in the control group,which were(47.36±5.82)and(48.95±5.63),respectively.The differences between the two groups were statistically significant(p<0.05).The improvement in the neurological deficit scores of patients in the study group reached(9.18±2.04),higher than that in the control group,which was(5.17±1.82)(p<0.05).The overall clinical rehabilitation effectiveness rate in the study group was 93.3%,significantly higher than that in the control group,which was 73.3%.The satisfaction rate with nursing services in the study group reached 96.7%,also higher than that in the control group,which was 83.3%.The differences between the two groups were statistically significant(p<0.05).Conclusion:The integrated healthcare nursing model can effectively alleviate adverse emotional states in patients with cerebral infarction,facilitate the repair and reconstruction of neurological function,improve the effectiveness of clinical rehabilitation treatment and satisfaction with nursing services,and thus holds high value for clinical promotion and application.展开更多
In recent years,development of strategies to treat central nervous system(CNS) diseases has attracted extensive attention.A major obstacle in this field is the blood-brain barrier(BBB),which significantly limits the e...In recent years,development of strategies to treat central nervous system(CNS) diseases has attracted extensive attention.A major obstacle in this field is the blood-brain barrier(BBB),which significantly limits the efficient delivery of therapeutic agents to the brain and hinders the treatment of CNS diseases.Overcoming the restrictive nature of the BBB has thus emerged as a key objective in CNS drug development.Nanomaterials have garnered growing interest due to their unique physicochemical properties and potential to traverse the BBB,enabling targeted drug delivery to brain tissue and improving therapeutic efficacy.In this review,we present current insights into the structure and function of the BBB and highlight a range of nanomaterial-based strategies for BBB penetration,including receptor-mediated transport(RMT),adsorptive-mediated transcytosis,reversible BBB disruption,and intranasal administration.Finally,we summarize recent advances in enhancing BBB permeability for CNS therapeutics and discuss persisting challenges,offering perspectives for future research in this field.展开更多
基金supported by the National Natural Science Foundation of China(No.82401445 and 82271249)the China Postdoctoral Science Foundation(No.2024M752251)+3 种基金the Postdoctoral Fellowship Program of CPSF(No.GZC20241141)the Sichuan Science and Technology Program(No.2024NSFSC1636 and 2025ZNSFSC1645)the Postdoctoral Research Fund of West China Hospital of Sichuan University(No.2024HXBH013)1-3-5 Project for Disciplines of Excellence of West China Hospital of Sichuan University(No.ZYYC23002)。
文摘Persistent postsurgical pain is a major clinical concern,especially in the aging population,who represent a growing proportion of surgical patients.Although age is a known pain risk factor,the mechanisms driving age-related vulnerability to chronic postoperative pain remain poorly understood.This study aims to investigate how aging influences the resolution of postoperative pain and to elucidate the roles of microglial activation and synaptic remodeling in the spinal dorsal horn.A plantar incision model in young(3-month-old)and aged(18-month-old)male and female mice was used to mimic postoperative pain conditions.Mechanical and thermal hypersensitivity at various postoperative intervals were assessed by von Frey and Hargreaves tests.Microglial activation and inhibitory/excitatory synaptic densities in the spinal dorsal horn were evaluated using immunofluorescence and 3D reconstruction with Imaris software.On postoperative day(POD)3,both age groups exhibited reduced pain thresholds on the ipsilateral side,along with microglial activation in the dorsal horn.On POD 7,pain thresholds in young mice had returned to baseline with no significant microglial activation,while aged mice showed sustained reduction in pain thresholds,continuous microglial activation,and significant loss of inhibitory synapses without detectable changes in excitatory synapse density.These findings are consistent across both sexes,with no sex-related differences.Collectively,these results suggest that aging is associated with persistent postoperative pain,which correlates with microglial activation and inhibitory synapse loss.These insights advance our understanding of age-related pain vulnerability and may inform the development of more effective,targeted,and age-specific therapeutic strategies to prevent or alleviate persistent postoperative pain in elderly patients.
基金supported by the National Science Foundation of China,Nos.82325031(to FX),82030059(to YC),82102290(to YG),U23A20485(to YC)Noncommunicable Chronic Diseases-National Science and Technology Major Project,No.2023ZD0505504(to FX),2023ZD0505500(to YC)the Key R&D Program of Shandong Province,No.2022ZLGX03(to YC).
文摘Global brain ischemia and neurological deficit are consequences of cardiac arrest that lead to high mortality.Despite advancements in resuscitation science,our limited understanding of the cellular and molecular mechanisms underlying post-cardiac arrest brain injury have hindered the development of effective neuroprotective strategies.Previous studies primarily focused on neuronal death,potentially overlooking the contributions of non-neuronal cells and intercellular communication to the pathophysiology of cardiac arrest-induced brain injury.To address these gaps,we hypothesized that single-cell transcriptomic analysis could uncover previously unidentified cellular subpopulations,altered cell communication networks,and novel molecular mechanisms involved in post-cardiac arrest brain injury.In this study,we performed a single-cell transcriptomic analysis of the hippocampus from pigs with ventricular fibrillation-induced cardiac arrest at 6 and 24 hours following the return of spontaneous circulation,and from sham control pigs.Sequencing results revealed changes in the proportions of different cell types,suggesting post-arrest disruption in the blood-brain barrier and infiltration of neutrophils.These results were validated through western blotting,quantitative reverse transcription-polymerase chain reaction,and immunofluorescence staining.We also identified and validated a unique subcluster of activated microglia with high expression of S100A8,which increased over time following cardiac arrest.This subcluster simultaneously exhibited significant M1/M2 polarization and expressed key functional genes related to chemokines and interleukins.Additionally,we revealed the post-cardiac arrest dysfunction of oligodendrocytes and the differentiation of oligodendrocyte precursor cells into oligodendrocytes.Cell communication analysis identified enhanced post-cardiac arrest communication between neutrophils and microglia that was mediated by neutrophil-derived resistin,driving pro-inflammatory microglial polarization.Our findings provide a comprehensive single-cell map of the post-cardiac arrest hippocampus,offering potential novel targets for neuroprotection and repair following cardiac arrest.
文摘Objective Sepsis patients exhibit diverse immune states,making it crucial to identify subtypes with distinct inflammatory profiles through Th1/Th2 cytokine data for personalized treatment and improved prognosis.Methods We retrieved data from sepsis patients who underwent Th1/Th2 cytokine testing in Nanfang Hospital,Southern Medical University from June 1,2020,to February 1,2022.An unsupervised K-means clustering method classified participants based on Th1/Th2 cytokine levels,with the primary outcome being the 7-day mortality rate post-ICU admission.Cox proportional hazards and Restricted Mean Survival Time(RMST)analyses were utilized to explore survival outcomes.Results A total of 321 sepsis patients were included.IL-6(HR 1.69,95%CI:1.22,2.34)and IL-10(HR 1.81,95%CI:1.37,2.40)emerged as independent predictors of 7-day mortality.Unsupervised K-means clustering revealed 3 inflammatory/immune subgroups:Cluster 1(n=166,low inflammatory response),Cluster 2(n=99,moderate inflammatory response with immune suppression),and Cluster 3(n=56,strong inflammatory and immune suppression).Compared to Cluster 1,Clusters 2 and 3 had higher 7-day mortality risks(14.4%vs 23.2%,HR=4.30,95%CI:1.51-12.26;14.4%vs 35.7%,HR=7.32,95%CI:2.57-20.79).Conclusion Septic patients in a protective immune response state(Cluster 1)exhibit better short-term prognoses,suggesting the importance of understanding inflammatory/immune states for precise treatment and improved outcomes.
文摘Metabolic dysfunction-associated steatotic liver disease(MASLD),formerly known as nonalcoholic fatty liver disease,is a chronic liver disease characterized by hepatic lipid deposition and hepatocellular steatosis,resulting from nonalcoholic causes and closely linked to metabolic dysfunction[1].It is strongly associated with metabolic abnormalities,including type 2 diabetes,overweight,and obesity.The global prevalence of MASLD is estimated to be approximately 25%−33%,and its incidence is rising rapidly,particularly among younger populations,due to increasingly prevalent unhealthy lifestyle behaviors such as sleep deprivation,sedentary habits,and diets rich in calories.
文摘Psittacosis pneumonia is a zoonotic disease caused by Chlamydia psittaci infection,with the lungs being the most affected organ.[1]Rhabdomyolysis is a clinical syndrome characterized by the massive release of intracellular components—such as myoglobin and creatine kinase—into the bloodstream due to skeletal muscle injury or necrosis.Common causes include trauma,medications,metabolic disorders,and infections.When psittacosis pneumonia is complicated by rhabdomyolysis,patients often develop multiple organ dysfunction and have a poor prognosis,necessitating early clinical intervention.
文摘BACKGROUND:Sepsis is a prevalent and severe condition,with microcirculation disruptions playing a crucial role in its progression.Endothelial cell(EC)injury is the primary factor behind microcirculatory issues.This review is to outline the pathomechanism,organ heterogeneity,biomarkers,and therapeutic implications of endothelial dysfunction in sepsis,off ering references and insights for the clinical management of sepsis.METHODS:A systematic search of Web of Science and PubMed from inception to June 10,2025,limited to English publications,was conducted.Two reviewers independently identifi ed studies on EC injury in patients with septic microcirculatory dysfunction.Duplicate articles based on multiple search criteria were excluded.RESULTS:Fifty-nine articles,including cell,animal,and clinical studies,were included.These studies reported the effects of EC injury on the microcirculation in sepsis,including changes in vascular permeability,coagulation dysfunction,vasomotor regulation,and infl ammatory responses.These pathways interact and ultimately lead to septic microcirculation disorders.CONCLUSION:Sepsis-induced endothelial dysfunction involves various interconnected mechanisms,which collectively compromise ECs and impede microcirculatory perfusion.Future research should enhance current understanding of endothelial injury mechanisms,develop synergistic multi-target strategies to disrupt this cycle,and facilitate the clinical application of endothelial markers for early intervention and dynamic assessment.
基金supported by the Foshan City’s Selffunded Science and Technology Innovation Project in 2022(2022年佛山市自筹经费类科技创新项目,No.2220001005034).
文摘Objective:To observe the efficacy of LIU’s infantile Tuina(Chinese therapeutic massage)combined with Bi Yan Gao in treating allergic rhinitis(AR)in kids and the impact on serum inflammatory factors.Methods:A total of 120 kids with AR were recruited and divided into a Tuina group,a Bi Yan Gao group,and a combined group using the random number table method,with 40 cases in each group.The three groups all received oral desloratadine syrup as the basic intervention.In addition,the Tuina group was treated with LIU’s infantile Tuina therapy once daily;the BI Yan Gao group received external application of Bi Yan Gao,once every morning and night;the combined group was intervened by LIU’s infantile Tuina plus Bi Yan Gao external application.The intervention lasted for 8 weeks.Before and after the intervention,the total nasal symptom score(TNSS)was compared,and the serum levels of interleukin(IL)-4,IL-6,IL-8,and immunoglobulin E(IgE)were detected.The total effective rate was also compared among the three groups.Results:After 8 weeks of treatment,the total effective rate was 87.2%in the combined group,60.5%in the Tuina group,and 57.5%in the Bi Yan Gao group,showing significant between-group differences(P<0.05).The contents of serum IL-6,IL-8,and IgE were lower in the combined group compared to the Tuina and Bi Yan Gao groups,presenting statistical significance(P<0.05).The level of IL-4 was statistically parallel across the three groups(P>0.05).Conclusion:The combined use of LIU’s infantile Tuina and Bi Yan Gao can improve nasal symptoms and lower the levels of serum inflammatory factors and IgE in kids with AR,producing a higher total effective rate compared to the separate use of the two approaches.
基金funded by NIH grants HL154720-03S1, AG057587, AG074283, DK122708-03S1, BrightFocus ADR A20183775Brown Foundation 2020 Healthy Aging Initiative (to WC)
文摘Microglia are the macrophages that populate the brain parenchyma.Research in the past decades has identified them as both essential guardians of the brain and significant contributors to various neurological diseases.A highly versatile cell type,microglia have been shown to fulfill a multitude of critical roles in the central nervous system,including facilitating neurogenesis and myelination,pruning synapses,removing debris and waste,modulating neuronal activity,supporting the blood-brain barrier,repairing tissue damage,and surveilling against microbial invasions under physiological conditions(Prinz et al.,2021;Paolicelli et al.,2022).
基金supported by the National Natural Science Foundation of China(82472842 and 82473350)and Wuxi Double-Hundred Talent Fund Project(BJ2023075).
文摘Immunotherapy has brought unprecedented breakthroughs to advanced malignant tumors,yet the immune microenvironment shaped by the tumor stroma has often been underestimated in the traditional focus on the“immune checkpoint-T cell”axis.Collagen not only constitutes a mechanical barrier that distinguishes between the periphery and core of solid tumors but also systematically remodels the orientation of metabolism,vasculature,and immune cell phenotypic plasticity through its spatial density,fiber arrangement,and crosslinking patterns(F igure 1)[1,2].Abundant evidence suggests that over-accumulated types I and III collagen drive CD8+T cell exhaustion,NK cell functional inhibition,and tumor-associated macrophage polarization through ligand-receptor networks involving LAIR-1,DDR2,andβ1/β3 integrins[3-6].Mechanistically,collagen engagement of LAIR-1 delivers inhibitory signals in effector lymphocytes,promoting dysfunctional or exhausted states[7-9].In parallel,collagen-β1/β3 integrin signaling activates mechanotransduction pathways(e.g.,FAK/SRC),reducing T-cell motility and immune-tumor contact,while DDR2 activation supports matrix-remodeling programs that limit lymphocyte trafficking.
基金PEEP titration in ARDS patients using EIT combined with lung ultrasound,Key Laboratory of Emergency Trauma Research,Ministry of Education (KLET-202201)airway clearance protocol in ICU mechanically ventilated patients based on electrical impedance imaging technology,Natural Science Foundation of Hunan Province (2024JJ9148)effects of end expiratory positive pressure on lung re-expansion in patients with ARDS and intra-abdominal hypertension monitored using lung ultrasound,Natural Science Foundation of Hunan Province (2023JJ60308)
文摘BACKGROUND:Individualized positive end-expiratory pressure(PEEP)titration is a crucial technique in mechanical ventilation therapy for acute respiratory distress syndrome(ARDS)patients with intra-abdominal hypertension(IAH).This study aimed to evaluate the eff ectiveness of electrical impedance tomography(EIT)-guided PEEP titration in this population.METHODS:This prospective study enrolled 36 ARDS patients,including 22 patients with IAH and 14 without IAH.All the patients underwent EIT-guided PEEP titration at the intersection point between alveolar overdistension and collapse during a decremental PEEP trial.The changes in pulmonary ventilation distribution,respiratory mechanics and hemodynamics during the titration process were observed.RESULTS:After EIT-guided PEEP titration was performed,the PEEP,peak inspiratory pressure and plateau pressure increased significantly(P<0.05).Furthermore,no significant differences were observed in respiratory system compliance,tidal volume,driving pressure,or the 4*DP+RR index between the two groups(P>0.05).The mechanical power increased in the non-IAH(NIAH)group after PEEP titration(P<0.05).Ventilation in gravity-dependent lung regions significantly increased(P<0.05),and the oxygenation index(PaO2/FiO2)improved signifi cantly(P<0.05)in both groups.However,blood pressure,heart rate,respiratory rate,central venous pressure,and lactate levels did not signifi cantly change.In the IAH group,the PaO2/FiO2 ratio improved less than that in the NIAH group did(P<0.05).CONCLUSION:In our study,individualized PEEP titration guided by EIT improved oxygenation in ARDS patients with concomitant IAH without signifi cantly aff ecting hemodynamics.The presence of IAH may limit the improvement of oxygenation during EIT-guided PEEP titration.
文摘This paper summarizes the nursing experience of a child with acute fulminant myocarditis.Key nursing measures include establishing a multidisciplinary team to jointly formulate diagnosis and treatment plans;implementing refined volume management,anticoagulation management,and ventilator management during extracorporeal membrane oxygenation;providing personalized nutritional support for the child;and strengthening the prevention and management of complications.After active treatment and nursing care,the child recovered well and was successfully transferred out of the intensive care unit.
基金Supported by National Natural Science Foundation of China(82374346)Double Hundred Outstanding Young and Middle-aged Medical and Health Talents of Wuxi City(BJ2023071)Scientific Research Project of Wuxi Municipal Health Commission(Q202358).
文摘This article reviews the research advances in traditional Chinese medicine rhubarb and its compound formulations in the treatment of sepsis,with particular emphasis on elucidating their mechanisms of action and clinical application value.Research has demonstrated that rhubarb and its compound formulations exert therapeutic effects via multiple targets and mechanisms,including anti-inflammatory actions,protection of the intestinal barrier,modulation of immune balance,inhibition of oxidative stress,and regulation of associated signaling pathways.Clinically,rhubarb has shown distinct advantages in enhancing gastrointestinal function,mitigating systemic inflammatory responses,and reducing mortality rates among patients with sepsis.These findings provide a foundational reference for the integrated prevention and treatment of sepsis through the combined use of traditional Chinese and Western medicine.
基金supported by Shenzhen University General Hospital Scientific Research Project,No.SUGH2019QD002Shenzhen Science and Technology Development Foundation,No.20220810173216001(both to ZS).
文摘Spinal cord injury is a severe neurological condition with limited neuronal regeneration and functional recovery.Currently,no effective treatments exist to improve spinal cord injury prognosis.Neuronal guidance proteins are a diverse group of molecules that play crucial roles in axon and dendrite growth during nervous system development.Increasing evidence highlights their regulatory functions in spinal cord injury.This review provides a brief overview of the modulation patterns of key neuronal guidance proteins in neuronal axon growth during nervous system formation and subsequently focuses on their roles in neuronal regeneration and functional recovery following spinal cord injury.Neuronal guidance proteins include,but are not limited to,semaphorins and their receptors,plexins;netrins and their receptors,deleted in colorectal cancer and UNC5;Eph receptors and their ligands,ephrins;Slit and its receptor,Robo;repulsive guidance molecules and their receptor,neogenin;Wnt proteins and their receptor,Frizzled;and protocadherins.Localized Netrin-1 at the injury site inhibits motor axon regeneration after adult spinal cord injury while promoting oligodendrocyte growth.Slit2 enhances synapse formation in the injured spinal cord of rats.EphA7 regulates acute apoptosis in the early pathophysiological stages of spinal cord injury,while ephrinA1 plays a role in the nervous system’s injury response,with its reduced expression leading to impaired motor function in rats.EphA3 is upregulated following spinal cord injury,promoting an inhibitory environment for axonal regeneration.After spinal cord injury,bidirectional activation of ephrinB2 and EphB2 in astrocytes and fibroblasts results in the formation of a dense astrocyte-meningeal fibroblast scar.EphB1/ephrinB1 signaling mediates pain processing in spinal cord injury by regulating calpain-1 and caspase-3 in neurons.EphB3 expression increases in white matter after spinal cord injury,further inhibiting axon regeneration.Sema3A,expressed by neurons and fibroblasts in the scar surrounding the injury,inhibits motor neuron and sensory nerve growth after spinal cord injury.Sema4D suppresses neuronal axon myelination and axon regeneration,while its inhibition significantly enhances axon regeneration and motor recovery.Sema7A is involved in glial scar formation and may influence serotonin channel remodeling,thereby affecting motor coordination.Given these findings,the local or systemic application of neuronal guidance proteins represents a promising avenue for spinal cord injury treatment.
基金supported by grant from the National Natural Science Foundation of China(82372207).
文摘BACKGROUND:To provide a comprehensive analysis of the landscape of artifi cial intelligence(AI)applications in cardiac arrest(CA).METHODS:Comprehensive searches were conducted in PubMed,the Cochrane Library,Webof Science,and EMBASE from database inception through 10 June 2025.Studies that applied AI inboth in-hospital cardiac arrest(IHCA)and out-of-hospital cardiac arrest(OHCA)populations acrossthe following domains were included:prediction of cardiac arrest occurrence,prognostication ofCA outcomes,applications of large language models(LLMs),and evaluation of cardiopulmonaryresuscitation(CPR)and other AI-driven interventions related to CA.RESULTS:The scoping review included 114 studies,encompassing data from 9,574,462patients in total.AI was most commonly applied to the prediction of CA(overall,n=40;IHCA,n=30;OHCA,n=4;and both,n=6),CPR-related decision support during CA(n=16),and post-arrestprognosis and rehabilitation outcomes(overall,n=38;OHCA,n=21;IHCA,n=3;and both,n=14).Additional application areas included LLM-based applications(n=8),emergency call handling(n=4),wearable device-based detection(n=3),heart rhythm identification(n=2),education(n=2),and extracorporeal cardiopulmonary resuscitation(ECPR)candidate identifi cation(n=1).Across allapplication scenarios,the highest area under the receiver operating characteristic curve(AUROC)value for pre-arrest CA prediction in IHCA patients was 0.998 using a multilayer perceptron(MLP)model,whereas the optimal AUROC for pre-arrest CA prediction in OHCA patients was 0.950 usingextreme gradient boosting(XGBoost)or random forest(RF)models.For CPR-related decisionsupport during CA,the highest AUROC achieved was 0.990 with a convolutional neural network(CNN)model.In prognostic prediction,the optimal AUROC for IHCA patients was 0.960 usingXGBoost,while for OHCA patients it reached 0.976 using an MLP model.CONCLUSION:This review shows that AI is most commonly used for the prediction of CA andCPR-related support,as well as post-arrest and rehabilitation outcomes.Future research directions includedrug discovery,post-resuscitation management,neurorehabilitation,and clinical trial innovation.Furtherstudies should prioritize multicenter clinical trials to evaluate AI models in real-world settings and validatetheir eff ectiveness across diverse patient populations.Overall,AI has signifi cant potential to improve clinicalpractice,and its role in CA application is increasingly important.
文摘Severe acute pancreatitis(SAP)can induce acute respiratory distress syndrome(ARDS)and abdominal compartment syndrome(ACS).Although prone position ventilation(PPV)can improve outcomes in patients with ARDS,there is significant controversy regarding its concurrent use with ACS owing to concerns of increased risk of intra-abdominal pressure(IAP).[1]We present a case of successful PPV application without adverse eff ects.
文摘BACKGROUND Edwardsiella tarda(E.tarda)belongs to the family Enterobacteriaceae and is generally seen to cause infections mainly in fish,but is also capable of infecting humans.Extraintestinal infections occur in patients with certain risk factors,including immunocompromised status.We recently diagnosed a case of spontaneous bacterial peritonitis(SBP)due to E.tarda in an immuno-compromised dialysis patient.CASE SUMMARY Patient was a 55-year-old male,with a history of diabetic nephropathy being treated with hemodialysis three times a week.He was referred to our hospital due to an increased volume of ascites,and blood examination revealed increased inflammatory reaction.At our emergency department,he developed fever,disturbance of consciousness,abdominal distension,and abdomen-wide pain.In addition,a dialysis shunt was confirmed in his right forearm,and the shunt site showed no signs of inflammation.No wounds were confirmed on or in his body.A blood examination revealed increased values of white blood cells,C-reactive protein,and creatinine.Plain chest and abdominal computed tomography scanning revealed increased ascites volume.Abdominal paracentesis was performed and a Gram stain revealed Gramnegative bacillus.These findings prompted diagnosis of SBP.The patient was admitted and treated with cefmetazole,causing fever resolution and symptom improvements.Later,E.tarda was identified in ascites culture.The patient improved with decreased inflammatory response and was discharged on the 12th day of hospitalization.The antibiotic was terminated after 14 days of treatment.SBP in this case may have developed from chronic renal failure and diabetes mellitus.CONCLUSION We report the first known case of SBP due to E.tarda in an immuno-compromised dialysis patient.
基金supported by the National Natural Science Foundation of China(82104340)。
文摘Citrus is the world's most produced fruit.With the rapid growth of citrus cultivation and processing industries globally,the volume of by-products,including dropped fruits,defective fruits,and waste generated during processing,has surged.Consequently,resource wastage and environmental pollution due to the low utilization rate of these by-products have become increasingly prominent issues.Currently,citrus by-products are directly utilized as seasonings,tea,and traditional Chinese medicine,or for the extraction of pectin,flavonoids,carotenoids,limonoids,essential oils,synephrine,and other functional ingredients.They are also processed into ethanol,citric acid,feed,and organic fertilizer through biomass fermentation.Despite these applications,the overall utilization rate of citrus by-products remains low.Additionally,there is a lack of key technologies and core equipment,and the production of high value-added functional products is limited.The future direction for citrus by-product utilization lies in green,low-carbon,high-efficiency,and high-value comprehensive recycling.To address the serious environmental pollution and recycling challenges posed by citrus rotting,it is proposed for the first time to develop new products and mold prevention strategies throughout the entire citrus supply chain-"Planting-field management-harvesting-transportation-storage"-to achieve a circular economy approach.This strategy aims to"Take from citrus and give back to citrus"effectively preventing and reducing citrus rotting.Furthermore,it can mitigate the significant economic losses caused by fruit decay and provide insights into the high-quality development of comprehensive citrus by-product utilization.
基金Key Science and Technology Program of Shaanxi Province,Grant/Award Number:2024SF2-GJHX-45National Natural Science Foundation of China,Grant/Award Number:82472191The Natural Science Foundation of Shaanxi Province,Grant/Award Number:2024JC-ZDXM-49。
文摘Background:Ex vivo lung perfusion(EVLP)has emerged as a critical technique for lung preservation and evaluation prior to transplantation.While conventional rat EVLP systems utilize closed-loop dual cannulation of pulmonary artery(PA)and vein,the effect of the simplified model using single PA cannulation with passive venous drainage is unknown.Methods:We developed two EVLP models in rats:a semi-closed circuit with PA-only cannulation and left atrial incision for passive venous drainage(SC-EVLP),and a closed circuit employing both arterial and venous cannulation(C-EVLP).Donor lungs were perfused for a defined duration and subsequently orthotopically transplanted.We evaluated pulmonary function parameters,histopathological injury scores,inflammatory cytokine levels,and apoptotic marker expression at the end of perfusion and posttransplantation.Results:Compared to the conventional EVLP,the SC-EVLP group exhibited significantly lower PA pressure and improved dynamic lung compliance throughout perfusion.Although the levels of tumor necrosis factor-αin the perfusate were higher in the SC-EVLP group,other cytokine levels in the perfusate and bronchoalveolar lavage fluid exhibited no significant differences.Pulmonary edema was reduced in the SC-EVLP group,as indicated by a lower lung wet-to-dry ratio.After transplantation,lungs from the SC-EVLP group exhibited lower histological injury scores,reduced apoptosis,and decreased serum cytokine levels,suggesting attenuated inflammation and tissue damage.Conclusions:In a rat model,single PA cannulation with passive venous drainage reduced pulmonary edema during EVLP and reduced lung injury and systemic inflammation after transplantation.
基金Science and Technology Support Program Project of Baoding City,Hebei Province(Project No.:2541ZF107)。
文摘Objective:To analyze the application effectiveness of the integrated medical-nursing comprehensive care model in cases of cerebral infarction and clarify its clinical practical value for the patient rehabilitation process.Methods:A total of 60 patients with cerebral infarction admitted from June 2024 to December 2024 were selected as the research subjects and randomly divided into a control group and a research group,with 30 cases in each group.Patients in the control group received routine clinical nursing measures,while those in the study group underwent collaborative healthcare intervention in addition to routine nursing.The intervention included joint disease assessment,personalized rehabilitation training guidance,psychological counseling,and continuous nursing services after discharge.A comparative study was conducted by evaluating indicators such as the scores on adverse emotion scales,the extent of neurological recovery,the effectiveness rate of clinical rehabilitation treatment,and the level of satisfaction with nursing services between the two groups.Results:After the intervention,the scores on the Self-Rating Anxiety Scale(SAS)and the Self-Rating Depression Scale(SDS)in the study group decreased to(40.12±5.01)and(41.36±5.20),respectively,both significantly lower than those in the control group,which were(47.36±5.82)and(48.95±5.63),respectively.The differences between the two groups were statistically significant(p<0.05).The improvement in the neurological deficit scores of patients in the study group reached(9.18±2.04),higher than that in the control group,which was(5.17±1.82)(p<0.05).The overall clinical rehabilitation effectiveness rate in the study group was 93.3%,significantly higher than that in the control group,which was 73.3%.The satisfaction rate with nursing services in the study group reached 96.7%,also higher than that in the control group,which was 83.3%.The differences between the two groups were statistically significant(p<0.05).Conclusion:The integrated healthcare nursing model can effectively alleviate adverse emotional states in patients with cerebral infarction,facilitate the repair and reconstruction of neurological function,improve the effectiveness of clinical rehabilitation treatment and satisfaction with nursing services,and thus holds high value for clinical promotion and application.
基金funded by the Fundamental Research Funds for the Central Universities (No.2242022R42012)。
文摘In recent years,development of strategies to treat central nervous system(CNS) diseases has attracted extensive attention.A major obstacle in this field is the blood-brain barrier(BBB),which significantly limits the efficient delivery of therapeutic agents to the brain and hinders the treatment of CNS diseases.Overcoming the restrictive nature of the BBB has thus emerged as a key objective in CNS drug development.Nanomaterials have garnered growing interest due to their unique physicochemical properties and potential to traverse the BBB,enabling targeted drug delivery to brain tissue and improving therapeutic efficacy.In this review,we present current insights into the structure and function of the BBB and highlight a range of nanomaterial-based strategies for BBB penetration,including receptor-mediated transport(RMT),adsorptive-mediated transcytosis,reversible BBB disruption,and intranasal administration.Finally,we summarize recent advances in enhancing BBB permeability for CNS therapeutics and discuss persisting challenges,offering perspectives for future research in this field.
