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1.
Biosensors (Basel) ; 14(10)2024 Oct 09.
Artículo en Inglés | MEDLINE | ID: mdl-39451703

RESUMEN

Liquid metal, as a novel material, has become ideal for the fabrication of flexible conductive fibers and has shown great potential in the field of biomedical sensing. This paper presents a comprehensive review of the unique properties of liquid metals such as gallium-based alloys, including their excellent electrical conductivity, mobility, and biocompatibility. These properties make liquid metals ideal for the fabrication of flexible and malleable biosensors. The article explores common preparation methods for liquid metal conductive fibers, such as internal liquid metal filling, surface printing with liquid metal, and liquid metal coating techniques, and their applications in health monitoring, neural interfaces, and wearable devices. By summarizing and analyzing the current research, this paper aims to reveal the current status and challenges of liquid metal conductive fibers in the field of biosensors and to look forward to their development in the future, which will provide valuable references and insights for researchers in the field of biomedical engineering.


Asunto(s)
Técnicas Biosensibles , Metales , Dispositivos Electrónicos Vestibles , Humanos , Metales/química , Conductividad Eléctrica , Galio/química
2.
Chem Sci ; 2024 Sep 25.
Artículo en Inglés | MEDLINE | ID: mdl-39360006

RESUMEN

Donor-acceptor Stenhouse adducts (DASAs), derived from bio-based furfural, demonstrate reversible isomerization when exposed to light and heat, positioning them as attractive candidates for sustainable smart materials. However, achieving efficient and rapid isomerization in high bio-content solid-state matrices, especially under mild conditions, remains a significant hurdle due to restricted molecular mobility and limited matrix options. To address this, we developed a novel solid matrix in the form of sustainable nano/micro capsules, which boast the highest bio-content reported to date (57%). Composed of polymethylmethacrylate (PMMA) and a lauric-stearic acid eutectic mixture (L-SEM), these capsules facilitate highly efficient and rapid reversible isomerization of a third-generation DASA (DASA-1). Remarkably, the system achieves 84% forward and 90% reverse isomerization under mild temperatures, significantly enhancing the material's photo-switching capabilities. This advancement not only addresses the critical challenge of isomerization within high bio-content solid matrices but also opens broader possibilities for the application of bio-based DASAs in environmentally friendly technologies, such as color-rich rewritable papers. By innovating in the design of sustainable smart materials, this work has the potential to extend the utility of DASAs across various scientific fields, contributing to the global shift towards a low-carbon, environmentally sustainable society.

3.
Front Cardiovasc Med ; 11: 1431875, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39309601

RESUMEN

Introduction: Intra-aortic balloon pump (IABP) is sometimes coupled with Venoarterial extracorporeal membrane oxygenation (VA-ECMO) to treat patients with cardiogenic shock. In this study, we attempted to evaluate the association of the IABP approach on survival and vascular complication rates in adults with cardiogenic shock undergoing VA-ECMO. Methods: We performed a systematic search of original studies on VA-ECMO with and without IABP in PubMed, EMBASE, and the Cochrane Library. Results: A total of 42 studies with 8,759 patients were included. The pooled in-hospital deaths of patients on VA-ECMO with and without IABP were 2,962/4,807 (61.61%) versus 2,666/3,952 (67.45%). VA-ECMO with IABP presents lower in-hospital mortality (risk ratio, 0.88; 95% CI, 0.86-0.91; P < 0.00001). In addition, IABP was associated with lower in-hospital mortality of patients with postcardiotomy cardiogenic shock and ischaemic heart disease. (risk ratio, 0.93; 95% CI, 0.87-0.98; P = 0.01; risk ratio, 0.85; 95% CI, 0.82-0.89; P < 0.00001). There was no significant difference in in-hospital morbidity in neurological, gastrointestinal, limb-related, bleeding, and infection complications between patients on VA-ECMO with and without IABP. Discussion: In these observational studies, concomitant use of IABP and VA-ECMO in adult patients with cardiogenic shock was associated with reduced in-hospital mortality. Systematic Review Registration: PROSPERO [CRD42017069259].

4.
Front Public Health ; 12: 1382343, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39267646

RESUMEN

Background: In recent years, the development of global public health has become a matter of great concern and importance for governments worldwide. China, as the largest developing country, plays a crucial role in shaping the development of the public health and its ability to respond to sudden public health emergencies through the fairness of its human resource allocation in center for disease control and prevention (CDC). Objective: This study aims to analyze the situation of health human resource allocation in the China Centers for Disease Control and Prevention (China CDCs), assess the fairness of the allocation, and provide reference for the rational allocation of human resources. Methods: We selected data from the China Health Statistics Yearbook on healthcare technical personnel, other technical personnel, managerial personnel, and workforce technical personnel of China CDCs for the period of 2016-2020. We utilized the Health Resource Density Index to evaluate the level of human resource allocation in China CDCs. Additionally, we used the Gini coefficient and Theil index to assess the fairness of human resource allocation in China CDCs from both a population and geographical perspective. Results: Firstly, the educational qualifications and professional titles of CDC staff have improved, but the workforce is aging. Secondly, HRDI development trends vary among different personnel types and regions with varying levels of economic development. Finally, the results of the Gini coefficient and Theil index indicate that population distribution fairness is better than geographical distribution fairness. Overall, the unfair population distribution is primarily due to regional disparities. Conclusion: The China CDCs should tailor different standards for the allocation of health human resources based on regional characteristics, aiming to enhance the accessibility of health human resources in various regions and achieve equitable allocation.


Asunto(s)
Asignación de Recursos , China , Humanos , Salud Pública , Equidad en Salud , Personal de Salud/estadística & datos numéricos , Fuerza Laboral en Salud/estadística & datos numéricos
5.
BMJ Open ; 14(9): e083891, 2024 Sep 13.
Artículo en Inglés | MEDLINE | ID: mdl-39277198

RESUMEN

OBJECTIVE: Unintentional injuries constitute a significant global public health issue with significant social and economic costs. Previous evidence suggests ambient temperatures are associated with unintentional injury occurrences. However, the impacts of ambient temperature on unintentional injury economic burden have received little research attention. The objective of the study was to examine the association between ambient temperature and economic burden of unintentional injury. DESIGN: Time-stratified case-crossover study. SETTING: This study was performed at Tianjin Hospital, the largest trauma centre in Tianjin, by applying a hospital-based time-stratified case-crossover study. PARTICIPANTS: The 12 241 patients admitted with unintentional injuries and meteorological data were collected in Tianjin, China in 2021. PRIMARY AND SECONDARY OUTCOME: The association between ambient temperature and unintentional injury hospitalisation was evaluated with a distributed lag non-linear model, further temperature-attributable economic burden of unintentional injuries was quantified, and adjusted for demographic characteristics, injury mechanism and injury location of injury. RESULTS: The temperatures below 11.5°C were significantly associated with the increased risk of unintentional injury hospitalisation in Tianjin, in 2021. The effect was maximised on the current day. The relatively low temperature was responsible for 25.44% (95% CI 13.74, 33.09) of unintentional injury patients, and was associated with the number of unintentional injury patients (3114, 95% CI 1608, 4036). The relatively low temperature was associated with the excess economic burden for unintentional injury (¥197.52 million, 95% CI 102.00, 256.00; about 27.10 million dollars), accounting for 26.49% of the total economic burden. The cold temperatures generally had greater impacts on males (¥136.46 million, 95% CI 83.28, 172.42; about 18.67 million dollars) and the elderly (¥74.35 million, 95% CI 14.87, 102.14; about 10.24 million dollars). CONCLUSION: The temperature was associated with approximately 3000 unintentional injury patients and ¥200 million (27 million dollars), accounting for 26% of the total economic burden in Tianjin, 2021.


Asunto(s)
Lesiones Accidentales , Estudios Cruzados , Hospitalización , Heridas y Lesiones , Humanos , China/epidemiología , Masculino , Femenino , Persona de Mediana Edad , Adulto , Hospitalización/economía , Hospitalización/estadística & datos numéricos , Anciano , Heridas y Lesiones/economía , Heridas y Lesiones/epidemiología , Lesiones Accidentales/epidemiología , Lesiones Accidentales/economía , Adolescente , Adulto Joven , Niño , Lactante , Preescolar , Temperatura , Costo de Enfermedad
6.
ACS Appl Mater Interfaces ; 16(38): 51565-51574, 2024 Sep 25.
Artículo en Inglés | MEDLINE | ID: mdl-39276071

RESUMEN

A three-dimensional (3D) hierarchical microfiber bundle-based scaffold integrated with silver nanowires (AgNWs) and porous polyurethane (PU) was designed for the Joule heater via a facile dip-coating method. The interconnected micrometer-sized voids and unique hierarchical structure benefit uniform AgNWs anchored and the formation of a high-efficiency 3D conductive network. As expected, this composite exhibits a superior electrical conductivity of 1586.4 S/m and the best electrothermal conversion performance of 118.6 °C at 2.0 V compared to reported wearable Joule heaters to date. Moreover, the durable microfiber bundle-PU network provides strong mechanical properties, allowing for the stable and durable electrothermal performance of such a composite to resist twisting, bending, abrasion, and washing. Application studies show that this kind of Joule heater is suitable for a wide range of applications, such as seat heating, a heating jacket, personal thermal management, etc.

7.
J Med Internet Res ; 26: e54874, 2024 Aug 30.
Artículo en Inglés | MEDLINE | ID: mdl-39213025

RESUMEN

BACKGROUND: The mpox pandemic has caused widespread public concern around the world. The spread of misinformation through the internet and social media could lead to an infodemic that poses challenges to mpox control. OBJECTIVE: This review aims to summarize mpox-related infodemiology studies to determine the characteristics, influence, prevention, and control measures of the mpox infodemic and propose prospects for future research. METHODS: The scoping review was conducted based on a structured 5-step methodological framework. A comprehensive search for mpox-related infodemiology studies was performed using PubMed, Web of Science, Embase, and Scopus, with searches completed by April 30, 2024. After study selection and data extraction, the main topics of the mpox infodemic were categorized and summarized in 4 aspects, including a trend analysis of online information search volume, content topics of mpox-related online posts and comments, emotional and sentiment characteristics of online content, and prevention and control measures for the mpox infodemic. RESULTS: A total of 1607 articles were retrieved from the databases according to the keywords, and 61 studies were included in the final analysis. After the World Health Organization's declaration of an mpox public health emergency of international concern in July 2022, the number of related studies began growing rapidly. Google was the most widely used search engine platform (9/61, 15%), and Twitter was the most used social media app (32/61, 52%) for researchers. Researchers from 33 countries were concerned about mpox infodemic-related topics. Among them, the top 3 countries for article publication were the United States (27 studies), India (9 studies), and the United Kingdom (7 studies). Studies of online information search trends showed that mpox-related online search volume skyrocketed at the beginning of the mpox outbreak, especially when the World Health Organization provided important declarations. There was a large amount of misinformation with negative sentiment and discriminatory and hostile content against gay, bisexual, and other men who have sex with men. Given the characteristics of the mpox infodemic, the studies provided several positive prevention and control measures, including the timely and active publishing of professional, high-quality, and easy-to-understand information online; strengthening surveillance and early warning for the infodemic based on internet data; and taking measures to protect key populations from the harm of the mpox infodemic. CONCLUSIONS: This comprehensive summary of evidence from previous mpox infodemiology studies is valuable for understanding the characteristics of the mpox infodemic and for formulating prevention and control measures. It is essential for researchers and policy makers to establish prediction and early warning approaches and targeted intervention methods for dealing with the mpox infodemic in the future.


Asunto(s)
Infodemia , Mpox , Medios de Comunicación Sociales , Humanos , Internet , Pandemias/prevención & control , Medios de Comunicación Sociales/estadística & datos numéricos , Mpox/epidemiología
8.
Shock ; 62(5): 612-619, 2024 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-39158535

RESUMEN

ABSTRACT: Pelvic fractures are severe traumatic injuries often accompanied by potentially fatal massive bleeding. Rapid control of hemorrhages in prehospital emergency settings is critical for improving outcomes in traumatic bleeding. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a promising technique for controlling active bleeding from pelvic fractures. By inserting a balloon catheter into the aorta, REBOA helps maintain blood flow to vital organs such as the brain and heart. This paper provides a comprehensive overview of the initial management of noncompressive trunk hemorrhage caused by pelvic fractures, introduces the technical principles and developments of REBOA, and explores its extensive application in prehospital emergency care. It delves into the operational details and outlines strategies for effectively managing potential complications. We aim to offer a theoretical framework for the future utilization of REBOA in managing uncontrollable hemorrhage associated with pelvic fractures in prehospital emergencies.


Asunto(s)
Aorta , Oclusión con Balón , Servicios Médicos de Urgencia , Fracturas Óseas , Hemorragia , Huesos Pélvicos , Resucitación , Oclusión con Balón/métodos , Humanos , Fracturas Óseas/terapia , Resucitación/métodos , Huesos Pélvicos/lesiones , Servicios Médicos de Urgencia/métodos , Hemorragia/terapia , Hemorragia/etiología , Procedimientos Endovasculares/métodos
9.
Int Immunopharmacol ; 141: 112986, 2024 Nov 15.
Artículo en Inglés | MEDLINE | ID: mdl-39182266

RESUMEN

Smoke inhalation injury (SII) is the leading cause of death in fire burn patients. The inflammatory response induced by smoke inhalation is a significant factor in the development of acute lung injury or acute respiratory distress syndrome (ALI/ARDS). Mesenchymal stem cells (MSCs) can alleviate various inflammatory diseases by regulating the polarization of macrophages from the M1 to the M2 phenotype. Moreover, MSCs can facilitate the inflammatory response by regulating Th17/Treg homeostasis. However, little is known about the associations among MSCs, M1/M2 macrophages and Th17/Treg homeostasis. Therefore, the purpose of this study was to evaluate whether MSCs affect subsequent Th17/Treg differentiation and immune homeostasis by regulating M1/M2 polarization in SII. Our results showed that bone marrow mesenchymal stem cells (BMSCs) ameliorated lung inflammatory injury and fibrosis after SII by affecting the polarization of alveolar macrophages (AMs) from the M1 to the M2 phenotype. Moreover, BMSCs maintain Th17/Treg immune homeostasis by increasing the proportion of Treg cells and decreasing the proportion of Th17 cells. In vitro, we further demonstrated that BMSCs promoted the polarization of AMs from the M1 to the M2 phenotype and decreased IL-23 levels. Reduced IL-23 decreased Th17 differentiation and promoted Th17/Treg balance. Therefore, BMSCs ameliorate the inflammatory response and lung damage after SII through regulating M1/M2 polarization and subsequent Th17/Treg immune homeostasis, which are linked to alveolar macrophage-derived IL-23. These findings provide novel insight into how BMSCs regulate the M1/M2-Th17/Treg immune homeostasis axis and provide new therapeutic targets for more effective control of the inflammatory response after SII.


Asunto(s)
Homeostasis , Células Madre Mesenquimatosas , Ratones Endogámicos C57BL , Lesión por Inhalación de Humo , Linfocitos T Reguladores , Células Th17 , Animales , Linfocitos T Reguladores/inmunología , Células Th17/inmunología , Células Madre Mesenquimatosas/inmunología , Lesión por Inhalación de Humo/inmunología , Lesión por Inhalación de Humo/terapia , Masculino , Diferenciación Celular , Células Cultivadas , Trasplante de Células Madre Mesenquimatosas , Ratones , Macrófagos Alveolares/inmunología , Humanos , Interleucina-23/metabolismo , Pulmón/patología , Pulmón/inmunología
10.
ACS Appl Mater Interfaces ; 16(27): 35613-35625, 2024 Jul 10.
Artículo en Inglés | MEDLINE | ID: mdl-38949183

RESUMEN

Anti/deicing coatings that combine active and passive methods can utilize various energy sources to achieve anti/deicing effects. However, poor photothermal or electrothermal performance and inevitable heat loss often reduce their anti/deicing efficiency. Herein, copper sulfide loaded activated biochar (AC@CuS) as photo/electric material, polydimethylsiloxane as hydrophobic component, thermally expandable microspheres as foaming agent, and an anti/deicing coating integrating thermal insulation, superhydrophobicity, photo/electrothermal effects was successfully constructed. Benefiting from the synergistic effect of superhydrophobicity and thermal insulation, the freezing time of water droplets on the coating surface is extended from 150 to 2140 s, showing excellent passive anti-icing performance. AC@CuS exhibits photo/electrothermal effects, and porous expanded microspheres reduce heat loss, which endows the coating with desirable photo/electrothermal conversion performance. Under the conditions of 0.2 W/cm2 electric power density (EPD) and 0.1 W/cm2 optical power density (OPD), the temperature of the coating increases from 24 to 96.4 and 113 °C, respectively. Interestingly, with a coheating of 0.05 W/cm2 weaker OPD and 0.05 W/cm2 lower EPD, the ice on the coating surface can be quickly melted in 2.5 min, showing synergistic deicing performance. In addition, the WCA of the prepared coating remains above 150° after mechanical damage, rain impact, UV irradiation, chemical corrosion, and high-temperature treatment, and good superhydrophobic durability ensures the anti/deicing durability of the coating.

12.
iScience ; 27(5): 109713, 2024 May 17.
Artículo en Inglés | MEDLINE | ID: mdl-38746668

RESUMEN

This study systematically reviewed the application of large language models (LLMs) in medicine, analyzing 550 selected studies from a vast literature search. LLMs like ChatGPT transformed healthcare by enhancing diagnostics, medical writing, education, and project management. They assisted in drafting medical documents, creating training simulations, and streamlining research processes. Despite their growing utility in assisted diagnosis and improving doctor-patient communication, challenges persisted, including limitations in contextual understanding and the risk of over-reliance. The surge in LLM-related research indicated a focus on medical writing, diagnostics, and patient communication, but highlighted the need for careful integration, considering validation, ethical concerns, and the balance with traditional medical practice. Future research directions suggested a focus on multimodal LLMs, deeper algorithmic understanding, and ensuring responsible, effective use in healthcare.

13.
Front Pharmacol ; 15: 1381954, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38803437

RESUMEN

Background: Crush Syndrome (CS), a severe trauma resulting from prolonged muscle compression, is commonly seen in large-scale disasters such as earthquakes. It not only causes localized tissue damage but also triggers electrolyte imbalances, particularly hyperkalemia, increasing the risk of early mortality. This study aims to assess the early intervention effects of Sodium Zirconium Cyclosilicate (SZC) on hyperkalemia in rat CS model. Methods: A rat CS model was established using a self-developed multi-channel intelligent small-animal crush injury platform. Rats in the experimental groups were treated with varying doses of SZC before compression and immediately post-decompression. The efficacy of SZC was evaluated by continuous monitoring of blood potassium levels and survival rates. Serum creatinine (Cre) and blood urea nitrogen (BUN) levels were analyzed, and renal damage was assessed through histopathological examination. Results: SZC treatment significantly reduced blood potassium levels and improved survival rates in rats. Compared to the placebo group, the SZC-treated rats showed a significant decrease in blood potassium levels at 6 and 12 h post-decompression, maintaining lower levels at 24 h. Biochemical analysis indicated no significant impact of SZC on renal function, with no notable differences in Cre and BUN levels between groups. Histopathological findings revealed similar levels of renal damage in both groups. Conclusion: SZC demonstrates significant early intervention effects on hyperkalemia in a rat model of crush injury, effectively improving survival rates without adverse effects on renal function. These results provide a new strategic direction for the clinical treatment of Crush Syndrome and lay the foundation for future clinical applications.

14.
Int J Public Health ; 69: 1606913, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38572495

RESUMEN

Objective: Identification of SCD risk is important in the general population from a public health perspective. The objective is to summarize and appraise the available prediction models for the risk of SCD among the general population. Methods: Data were obtained searching six electronic databases and reporting prediction models of SCD risk in the general population. Studies with duplicate cohorts and missing information were excluded from the meta-analysis. Results: Out of 8,407 studies identified, fifteen studies were included in the systematic review, while five studies were included in the meta-analysis. The Cox proportional hazards model was used in thirteen studies (96.67%). Study locations were limited to Europe and the United States. Our pooled meta-analyses included four predictors: diabetes mellitus (ES = 2.69, 95%CI: 1.93, 3.76), QRS duration (ES = 1.16, 95%CI: 1.06, 1.26), spatial QRS-T angle (ES = 1.46, 95%CI: 1.27, 1.69) and factional shortening (ES = 1.37, 95%CI: 1.15, 1.64). Conclusion: Risk prediction model may be useful as an adjunct for risk stratification strategies for SCD in the general population. Further studies among people except for white participants and more accessible factors are necessary to explore.


Asunto(s)
Muerte Súbita Cardíaca , Humanos , Muerte Súbita Cardíaca/epidemiología , Medición de Riesgo/métodos , Factores de Riesgo , Modelos de Riesgos Proporcionales , Estados Unidos/epidemiología , Electrocardiografía
15.
Comput Biol Med ; 173: 108366, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38554661

RESUMEN

BACKGROUND: Gender carries important information related to male and female characteristics, and a large number of studies have attempted to use physiological measurement methods for gender classification. Although previous studies have shown that there exist statistical differences in some Electroencephalographic (EEG) microstate parameters between males and females, it is still unknown that whether these microstate parameters can be used as potential biomarkers for gender classification based on machine learning. METHODS: We used two independent resting-state EEG datasets: the first dataset included 74 females and matched 74 males, and the second one included 42 males and matched 42 females. EEG microstate analysis based on modified k-means clustering method was applied, and temporal parameter and nonlinear characteristics (sample entropy and Lempel-Ziv complexity) of EEG microstate sequences were extracted to compare between males and females. More importantly, these microstate temporal parameters and complexity were tried to train six machine learning methods for gender classification. RESULTS: We obtained five common microstates for each dataset and each group. Compared with the male group, the female group has significantly higher temporal parameters of microstate B, C, E and lower temporal parameters of microstate A and D, and higher complexity of microstate sequence. When using combination of microstate temporal parameters and complexity or only microstate temporal parameters as classification features in an independent test set (the second dataset), we achieved 95.2% classification accuracy. CONCLUSION: Our research findings indicate that the dynamics of microstate have considerable Gender-specific alteration. EEG microstates can be used as neurophysiological biomarkers for gender classification.


Asunto(s)
Mapeo Encefálico , Encéfalo , Masculino , Humanos , Femenino , Encéfalo/fisiología , Mapeo Encefálico/métodos , Electroencefalografía/métodos , Análisis por Conglomerados , Biomarcadores
16.
Polymers (Basel) ; 16(3)2024 Jan 29.
Artículo en Inglés | MEDLINE | ID: mdl-38337258

RESUMEN

In recent years, polyurethane has drawn great attention because of its many advantages in physical and chemical performance. In this work, firstly, polyurethane was impregnated in a non-woven fabric (NWF). Then, polyurethane-impregnated NWF was coagulated utilizing a wet phase inversion. Finally, after alkali treatment, microfiber non-woven fabrics with a porous polyurethane matrix (PNWF) were fabricated and used as substrates. SnIn4S8 (SIS) prepared by a microwave-assisted method was used as a photocatalyst and a novel SIS/PNWF substrate with multiple uses and highly efficient catalytic degradation ability under visible light was successfully fabricated. The surface morphology, chemical and crystal structures, optical performance, and wettability of SIS/PNWF substrates were observed. Subsequently, the photocatalytic performance of SIS/PNWF substrates was investigated by the decomposition of rhodamine B (RhB) under visible light irradiation. Compared with SIS/PNWF-2% (2%, the weight ratio of SIS and PNWF, same below), SIS/PNWF-5% as well as SIS/PNWF-15%, SIS/PNWF-10% substrates exhibited superior photocatalytic efficiency of 97% in 2 h. This may be due to the superior photocatalytic performance of SIS and the inherent hierarchical porous structure of PNWF substrates. Additionally, the hydrophobicity of SIS/PNWF substrates can enable them to float on the solution and further be applied on an open-water surface. Furthermore, tensile strength and recycle experiments demonstrated that SIS/PNWF substrates possessed superior mechanical strength and excellent recycle stability. This work provides a facile and efficient pathway to prepare SIS/PNWF substrates for the degradation of organic pollutants with enhanced catalytic efficiency.

17.
Respir Res ; 25(1): 27, 2024 Jan 12.
Artículo en Inglés | MEDLINE | ID: mdl-38217010

RESUMEN

BACKGROUND: Venovenous extracorporeal membrane oxygenation (VV ECMO) has been widely used for severe acute respiratory distress syndrome (ARDS) in recent years. However, the role of hemoadsorption in ARDS patients requiring VV ECMO is unclear. METHODS: Therefore, we conducted a systematic review to describe the effect of hemoadsorption on outcomes of ARDS patients requiring VV ECMO and elucidate the risk factors for adverse outcomes. We conducted and reported a systematic literature review based on the principles derived from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The systematic review searched Embase, CINHAL, and Pubmed databases for studies on ARDS patients receiving hemoadsorption and VV ECMO. The demographic data, clinical data and biological data of the patients were collected. RESULTS: We ultimately included a total of 8 articles including 189 patients. We characterized the population both clinically and biologically. Our review showed most studies described reductions in inflammatory markers and fluid resuscitation drug dosage in ARDS patients with Coronavirus disease 2019 (COVID-19) or sepsis after hemoadsorption. CONCLUSION: Because most of the studies have the characteristics of high heterogeneity, we could only draw very cautious conclusions that hemoadsorption therapy may enhance hemodynamic stability in ARDS patients with COVID-19 or sepsis receiving VV ECMO support. However, our results do not allow us to draw conclusions that hemoadsorption could reduce inflammation and mortality. Prospective randomized controlled studies with a larger sample size are needed in the future to verify the role of hemoadsorption in ARDS patients requiring VV ECMO.


Asunto(s)
COVID-19 , Oxigenación por Membrana Extracorpórea , Síndrome de Dificultad Respiratoria , Sepsis , Humanos , Oxigenación por Membrana Extracorpórea/métodos , Estudios Prospectivos , COVID-19/complicaciones , Síndrome de Dificultad Respiratoria/diagnóstico , Síndrome de Dificultad Respiratoria/terapia , Síndrome de Dificultad Respiratoria/etiología , Sepsis/complicaciones , Estudios Retrospectivos
18.
Shock ; 61(4): 509-519, 2024 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-37878487

RESUMEN

ABSTRACT: Hemorrhagic shock (HS) is a common complication after traumatic injury. Early identification of HS can reduce patients' risk of death. Currently, the identification of HS relies on macrocirculation indicators such as systolic blood pressure and heart rate, which are easily affected by the body's compensatory functions. Recently, the independence of the body's overall macrocirculation from microcirculation has been demonstrated, and microcirculation indicators have been widely used in the evaluation of HS. In this study, we reviewed the progress of research in the literature on the use of microcirculation metrics to monitor shock. We analyzed the strengths and weaknesses of each metric and found that microcirculation monitoring could not only indicate changes in tissue perfusion before changes in macrocirculation occurred but also correct tissue perfusion and cell oxygenation after the macrocirculation index returned to normal following fluid resuscitation, which is conducive to the early prediction and prognosis of HS. However, microcirculation monitoring is greatly affected by individual differences and environmental factors. Therefore, the current limitations of microcirculation assessments mean that they should be incorporated as part of an overall assessment of HS patients. Future research should explore how to better combine microcirculation and macrocirculation monitoring for the early identification and prognosis of HS patients.


Asunto(s)
Choque Hemorrágico , Humanos , Microcirculación/fisiología , Frecuencia Cardíaca , Fluidoterapia , Resucitación
19.
Shock ; 61(2): 274-282, 2024 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-38010288

RESUMEN

ABSTRACT: Crush syndrome (CS), alternatively termed traumatic rhabdomyolysis, is a paramount posttraumatic complication. Given the infeasibility of conducting direct simulation research in humans, the role of animal models is pivotal. Regrettably, the dearth of standardized animal models persists. The objective of this study was to construct a repeatable standardized rat CS models and, based on this, simulate specific clinical scenarios. Methods: Using a self-developed multichannel intelligent small-animal crush injury platform, we applied a force of 5 kg to the hind limbs of 8-week-old rats (280-300 g), subjecting them to a continuous 12 h compression to establish the CS model. Continuous monitoring was conducted for both the lower limbs and the overall body status. After decompression, biochemical samples were collected at 3, 6, 12, and 24 h. In addition, we created a CS model after resection of the left kidney (UNx-CS), which was conceptualized to simulate a more challenging clinical scenario to investigate the physiological and pathological responses rats with renal insufficiency combined with crush injury. The results were compared with those of the normal CS model group. Results : Our experiments confirm the stability of the crush injury platform. We defined the standardized conditions for modeling and successfully established rats CS model in bulk. After 12 h of compression, only 40% of the rats in the CS group survived for 24 h. Systemically, there was clear evidence of insufficient perfusion, reflecting the progression of CS from localized to generalized. The injured limbs displayed swelling, localized perfusion deficits, and severe pathological alterations. Significant changes were observed in blood biochemical markers: aspartate transaminase, lactate dehydrogenase, K+, creatine kinase, creatinine, and blood urea nitrogen levels rose rapidly after decompression and were significantly higher than the sham group. The kidney demonstrated characteristic pathological changes consistent with established CS diagnostic criteria. Although the UNx-CS rat model did not exhibit significant biochemical differences and pathological scores when compared with the standard CS model, it did yield intriguing results with regard to kidney morphology. The UNx-CS group manifested a higher incidence of cortical and medullary protein casts compared with the NC-CS group. Conclusion: We developed and iteratively refined a novel digital platform, addressing the multiple uncontrollable variables that plagued prior models. This study validated the stability of the platform, defined the standardized conditions for modeling and successfully established the CS model with good repeatability in bulk. In addition, our innovative approach to model a clinically challenging scenario, the UNx-CS rat model. This offers an opportunity to delve deeper into understanding the combined effects of preexisting renal compromise and traumatic injury. In summary, the development of a standardized, reproducible CS model in rats represents a significant milestone in the study of Crush syndrome. This study is of paramount significance as it advances the standardization of the CS model, laying a solid foundation for subsequent studies in related domains, especially in CS-AKI.


Asunto(s)
Síndrome de Aplastamiento , Rabdomiólisis , Animales , Humanos , Síndrome de Aplastamiento/complicaciones , Modelos Animales de Enfermedad , Riñón/metabolismo , Rabdomiólisis/complicaciones , Biomarcadores
20.
Toxics ; 11(12)2023 Dec 10.
Artículo en Inglés | MEDLINE | ID: mdl-38133412

RESUMEN

Radiation-induced intestinal injury (RIII) is one of the most common intestinal complications caused by radiotherapy for pelvic and abdominal tumors and it seriously affects the quality of life of patients. However, the treatment of acute RIII is essentially symptomatic and nutritional support treatment and an ideal means of prevention and treatment is lacking. Researchers have conducted studies at the cellular and animal levels and found that some chemical or biological agents have good therapeutic effects on RIII and may be used as potential candidates for clinical treatment. This article reviews the injury mechanism and potential treatment strategies based on cellular and animal experiments to provide new ideas for the diagnosis and treatment of RIII in clinical settings.

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