Background Patients with acute brain injury(ABI)are a peculiar population because ABI does not only affect the brain but also other organs such as the lungs,as theorized in brain–lung crosstalk models.ABI patients of...Background Patients with acute brain injury(ABI)are a peculiar population because ABI does not only affect the brain but also other organs such as the lungs,as theorized in brain–lung crosstalk models.ABI patients often require mechanical ventilation(MV)to avoid the complications of impaired respiratory function that can follow ABI;MV should be settled with meticulousness owing to its effects on the intracranial compartment,especially regarding positive end-expiratory pressure(PEEP).This scoping review aimed to(1)describe the physiological basis and mechanisms related to the effects of PEEP in ABI;(2)examine how clinical research is conducted on this topic;(3)identify methods for setting PEEP in ABI;and(4)investigate the impact of the application of PEEP in ABI on the outcome.Methods The five-stage paradigm devised by Peters et al.and expanded by Arksey and O'Malley,Levac et al.,and the Joanna Briggs Institute was used for methodology.We also adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)extension criteria.Inclusion criteria:we compiled all scientific data from peer-reviewed journals and studies that discussed the application of PEEP and its impact on intracranial pressure,cerebral perfusion pressure,and brain oxygenation in adult patients with ABI.Exclusion criteria:studies that only examined a pediatric patient group(those under the age of 18),experiments conducted solely on animals;studies without intracranial pressure and/or cerebral perfusion pressure determinations,and studies with incomplete information.Two authors searched and screened for inclusion in papers published up to July 2023 using the PubMed-indexed online database.Data were presented in narrative and tubular form.Results The initial search yielded 330 references on the application of PEEP in ABI,of which 36 met our inclusion criteria.PEEP has recognized beneficial effects on gas exchange,but it produces hemodynamic changes that should be predicted to avoid undesired consequences on cerebral blood flow and intracranial pressure.Moreover,the elastic properties of the lungs influence the transmission of the forces applied by MV over the brain so they should be taken into consideration.Currently,there are no specific tools that can predict the effect of PEEP on the brain,but there is an established need for a comprehensive monitoring approach for these patients,acknowledging the etiology of ABI and the measurable variables to personalize MV.Conclusion PEEP can be safely used in patients with ABI to improve gas exchange keeping in mind its potentially harmful effects,which can be predicted with adequate monitoring supported by bedside non-invasive neuromonitoring tools.展开更多
Background： This study characterized the cardiac telocyte （TC） population both in vivo and in vitro, and investigated its telomerase activity related to mitosis. Methods： Using transmission electron microscopy and...Background： This study characterized the cardiac telocyte （TC） population both in vivo and in vitro, and investigated its telomerase activity related to mitosis. Methods： Using transmission electron microscopy and a phase contrast microscope, the typical morphological features of cardiac TCs were observed; by targeting the cell surface proteins CD1 17 and CD34, CD 117^＋CD34^＋ cardiac TCs wcrc sorted via flow cytomctry and validated by immunofluorescence based on the primary cell culture. Then the optimized basal nutrient medium for selected population was examined with the cell counting kit 8. Under this conditioned medium, the process of cell division was captured, and the telomerase activity of CD117^＋ CD34^＋ cardiac TCs was detected in comparison with bone mesenchymal stem cells （BMSCs）, cardiac fibroblasts （CFBs）, cardiomyocytes （CMs）. Results： Cardiac TCs projected characteristic telopodes with thin segments （podomers） in alternation with dilation （podoms）. In addition, 64% of the primary cultured cardiac TCs were composed of CD117^＋CD34^＋ cardiac TCs： which was verified by immunofluorescence. In a live cell imaging system, CD117^＋CD34^＋ cardiac TCs were observed to enter into cell division in a short time. followed by an significant invagination forming across the middle of the cell body. Using a real-time quantitative telomeric-repeat amplification assay, the telomerase concentration in CD117^＋CD34^＋ cardiac TCs was obviously lower than in BMSCs and CFBs, and significantly higher than in CMs. Conclusions： Cardiac TCs represent a unique cell population and CD11 7^＋CD34^＋ cardiac TCs have relative low telomerase activity that differs from BMSCs, CFBs and CMs and thus they might play an important role in maintaining cardiac homeostasis.展开更多
INTRODUCTIONThe prognosis of patients who suffer from coma after cardiopulmonary resuscitation （CPR） may be poor （defined as cerebral performance categories scores from 3 to 5） Thus, an accurate prediction of thei...INTRODUCTIONThe prognosis of patients who suffer from coma after cardiopulmonary resuscitation （CPR） may be poor （defined as cerebral performance categories scores from 3 to 5） Thus, an accurate prediction of their neurological outcomes is an essential component of post-cardiac arrest evaluation, especially for decisions to limit or withdraw life-sustaining care. Since the 1960s, a series of domestic and foreign studies began to focus on the evaluation of coma patients after CPR, and considerable progress has been achieved in this field.展开更多
文摘Background Patients with acute brain injury(ABI)are a peculiar population because ABI does not only affect the brain but also other organs such as the lungs,as theorized in brain–lung crosstalk models.ABI patients often require mechanical ventilation(MV)to avoid the complications of impaired respiratory function that can follow ABI;MV should be settled with meticulousness owing to its effects on the intracranial compartment,especially regarding positive end-expiratory pressure(PEEP).This scoping review aimed to(1)describe the physiological basis and mechanisms related to the effects of PEEP in ABI;(2)examine how clinical research is conducted on this topic;(3)identify methods for setting PEEP in ABI;and(4)investigate the impact of the application of PEEP in ABI on the outcome.Methods The five-stage paradigm devised by Peters et al.and expanded by Arksey and O'Malley,Levac et al.,and the Joanna Briggs Institute was used for methodology.We also adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)extension criteria.Inclusion criteria:we compiled all scientific data from peer-reviewed journals and studies that discussed the application of PEEP and its impact on intracranial pressure,cerebral perfusion pressure,and brain oxygenation in adult patients with ABI.Exclusion criteria:studies that only examined a pediatric patient group(those under the age of 18),experiments conducted solely on animals;studies without intracranial pressure and/or cerebral perfusion pressure determinations,and studies with incomplete information.Two authors searched and screened for inclusion in papers published up to July 2023 using the PubMed-indexed online database.Data were presented in narrative and tubular form.Results The initial search yielded 330 references on the application of PEEP in ABI,of which 36 met our inclusion criteria.PEEP has recognized beneficial effects on gas exchange,but it produces hemodynamic changes that should be predicted to avoid undesired consequences on cerebral blood flow and intracranial pressure.Moreover,the elastic properties of the lungs influence the transmission of the forces applied by MV over the brain so they should be taken into consideration.Currently,there are no specific tools that can predict the effect of PEEP on the brain,but there is an established need for a comprehensive monitoring approach for these patients,acknowledging the etiology of ABI and the measurable variables to personalize MV.Conclusion PEEP can be safely used in patients with ABI to improve gas exchange keeping in mind its potentially harmful effects,which can be predicted with adequate monitoring supported by bedside non-invasive neuromonitoring tools.
基金Source of Support： This study was supported by a grant from the Young Scientists Fund of the National Natural Science Foundation of China （No, 81300232）. Conflict of Interest： None dec ared.
文摘Background： This study characterized the cardiac telocyte （TC） population both in vivo and in vitro, and investigated its telomerase activity related to mitosis. Methods： Using transmission electron microscopy and a phase contrast microscope, the typical morphological features of cardiac TCs were observed; by targeting the cell surface proteins CD1 17 and CD34, CD 117^＋CD34^＋ cardiac TCs wcrc sorted via flow cytomctry and validated by immunofluorescence based on the primary cell culture. Then the optimized basal nutrient medium for selected population was examined with the cell counting kit 8. Under this conditioned medium, the process of cell division was captured, and the telomerase activity of CD117^＋ CD34^＋ cardiac TCs was detected in comparison with bone mesenchymal stem cells （BMSCs）, cardiac fibroblasts （CFBs）, cardiomyocytes （CMs）. Results： Cardiac TCs projected characteristic telopodes with thin segments （podomers） in alternation with dilation （podoms）. In addition, 64% of the primary cultured cardiac TCs were composed of CD117^＋CD34^＋ cardiac TCs： which was verified by immunofluorescence. In a live cell imaging system, CD117^＋CD34^＋ cardiac TCs were observed to enter into cell division in a short time. followed by an significant invagination forming across the middle of the cell body. Using a real-time quantitative telomeric-repeat amplification assay, the telomerase concentration in CD117^＋CD34^＋ cardiac TCs was obviously lower than in BMSCs and CFBs, and significantly higher than in CMs. Conclusions： Cardiac TCs represent a unique cell population and CD11 7^＋CD34^＋ cardiac TCs have relative low telomerase activity that differs from BMSCs, CFBs and CMs and thus they might play an important role in maintaining cardiac homeostasis.
文摘INTRODUCTIONThe prognosis of patients who suffer from coma after cardiopulmonary resuscitation （CPR） may be poor （defined as cerebral performance categories scores from 3 to 5） Thus, an accurate prediction of their neurological outcomes is an essential component of post-cardiac arrest evaluation, especially for decisions to limit or withdraw life-sustaining care. Since the 1960s, a series of domestic and foreign studies began to focus on the evaluation of coma patients after CPR, and considerable progress has been achieved in this field.
