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Severe trauma can lead to numerous serious complications, threating the well-being and vitality of the afflicted. The quantity and functionality of PMNs undergo rapid transformations in response to severe trauma, playing a pivotal role in the trauma response. The absence of CCAAT/enhancer-binding protein ε (C/EBPε) profoundly impairs the functionality of polymorphonuclear neutrophils (PMNs), a function of paramount importance in trauma. In this study, by generating mice with C/EBPε knocked out or overexpressed, we substantiate that C/EBPε ensures the restoration of PMN function, enhancing the expression of antimicrobial proteins and thereby promoting trauma recovery. Furthermore, diminished expression of C/EBPε is observed in trauma patients, with levels displaying a negative correlation with ISS and APACHE II scores, suggesting its potential as a prognostic indicator for clinical treatment. Mechanistically, we uncover the upregulation of SIRT1 and the inhibition of P300 participating in the suppression of C/EBPε acetylation, consequently reducing the resilience of mice to trauma. As therapeutic interventions, whether through the sole administration of PMN, NAM treatment, or their combination, all result in an increased survival rate in traumatic mice. In conclusion, our study elucidates the role of C/EBPε in enhancing the resilience to trauma and identifies C/EBPε acetylation as a critical regulatory mechanism, offering potential therapeutic approaches involving PMN transfusion and NAM treatment.
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OBJECTIVE: The objective was to explore the possible relationship between the serum vitamin D level and olfactory impairment in a population of multiple sclerosis (MS) patients in Guizhou, China. METHODS: We included 25 patients with MS and 18 healthy controls (HCs) who were recruited from the Affiliated Hospital of Guizhou Medical University from February 2021 to September 2021. The University of Pennsylvania Smell Identification Test (UPSIT) was used to test the patients' sense of smell, and the level of serum 25-hydroxyethylene polyprotein D was measured. RESULTS: Serum vitamin D levels and UPSIT scores were significantly different between the MS group and the control group (both p < 0.001). Moreover, a significant positive correlation emerged between vitamin D levels and UPSIT scores in MS patients (r = 0.537, p = 0.021). CONCLUSIONS: The serum vitamin D level may be involved in the regulation of olfactory dysfunction in MS patients in Guizhou, China.
Multiple sclerosis is a rare disease in China.Compared with that of healthy controls, the olfactory function of MS patients was severely impaired.Compared with healthy controls, MS patients had low vitamin D levels.A significant positive correlation emerged between vitamin D levels and UPSIT scores in MS patients.The vitamin D levels of MS patients may be associated with olfactory impairment, which may have implications for future mechanistic studies.
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The accurate voltage measurement of distribution networks is of great significance in power dispatching and fault diagnosis. Voltage sensors based on the spatial electric field effect do not require grounding, which provides the possibility for the distributed measurement of transmission line voltages. However, the divider ratio of suspension grounding voltage sensors is affected by the height between the sensor and the ground, as well as the distance between the sensor and the telegraph pole. In this paper, a self-calibration method based on internal capacitance transformation is proposed to realize the on-line calibration of suspension grounding voltage sensors. The calibration is accomplished by switching different parameters in the conditioning circuit, and the calibration process does not require power failure or known input excitation. In addition, the impact of electric fields in the other two phases of three-phase transmission lines on measurement through simulation research is quantified in this paper. In order to reduce the impact of interference electric fields, an equipotential shielding structure is designed. The circuit topology and probe prototype have been developed and testing has been conducted in laboratory conditions; the experimental results show that the maximum relative error of voltage amplitude is 1.65%, and the phase relative error is 0.94%. The measurement accuracy is not limited by the height to ground or the distance to the telegraph pole. In addition, in the application of an equipotential shielding probe, the maximum deviation of measured voltage is 0.7% with and without interference electric fields.
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Three-phase four-wire power cables are a primary kind of power transmission method in low-voltage distribution networks. This paper addresses the problem that calibration currents are not easily electrified during the transporting of three-phase four-wire power cable measurements, and proposes a method for obtaining the magnetic field strength distribution in the tangential direction around the cable, finally enabling online self-calibration. The simulation and experimental results show that this method can self-calibrate the sensor arrays and reconstruct the phase current waveforms in three-phase four-wire power cables without calibration currents, and this method is not affected by disturbances such as wire diameter, current amplitudes, and high-frequency harmonics. This study reduces the time and equipment costs required to calibrate the sensing module compared to related studies using calibration currents. This research offers the possibility of fusing sensing modules directly with running primary equipment, and the development of hand-held measurement devices.
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BACKGROUND Sepsis has emerged as a leading cause of death in the intensive care unit. A growing number of studies have shown that genetic variants, especially single nucleotide polymorphisms, are key determinants of inter-individual variation in sepsis response. Therefore, early prediction of the onset and progression of sepsis, along with early intervention in high-risk patients, should be performed to effectively reduce the morbidity and mortality of the disease. MATERIAL AND METHODS A total of 581 Chinese patients were enrolled in this study, including 271 patients with sepsis and 310 patients without. We measured gene polymorphisms of MBL2 and serum levels of MBL2, tumor necrosis factor (TNF-alpha), interleukin (IL)-6, IL-4, and IL-10 in all patients. The effects of site mutations on the binding of MBL2 to mannose-associated serine protease 1 (MASP1) and MASP2 were also analyzed. RESULTS Of 3 site mutations in the MBL2 gene (rs5030737, rs1800450, and rs1800451), only rs1800450 had a mutant (G/A) genotype. The frequency of the GA genotype and A allele in the sepsis group was higher than that in the non-sepsis group. Furthermore, rs1800450G/A was associated with decreased serum MBL2 and IL-10 levels and decreased MBL2-MASP1 and MBL2-MASP2 interactions. Bioinformatics analysis showed that rs1800450G/A reduced the structural stability of the MBL2 protein and affected its function. CONCLUSIONS MBL2 rs1800450G/A was associated with a higher risk of sepsis, which possibly involved a decreased level of serum MBL2 that broke the balance of inflammation and weakened the binding of MBL2 to MASP1 and MASP2.
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Lectina de Ligação a Manose , Sepse , China , Predisposição Genética para Doença , Genótipo , Humanos , Interleucina-10/genética , Lectina de Ligação a Manose/genética , Serina Proteases Associadas a Proteína de Ligação a Manose/genética , Polimorfismo de Nucleotídeo Único/genética , Sepse/genéticaRESUMO
Chromatographic fractionation of the EtOH extracts of the marine-derived fungus Aspergillus versicolor A18 has led to the isolation of 11 homo/hetero-dimers of aromatic bisabolane sesquiterpenoids including eight diphenyl ether-coupled aromatic bisabolanes (1a/1b and 5−10) and three homodimers (2−4), together with their monomers including three aromatic bisabolanes (11−13) and two diphenyl ethers (14 and 15). Their structures and absolute configurations were elucidated by extensive spectroscopic analysis including HRESIMS, 1D/2D NMR, calculated ECD, and the optical rotatory data. Among the four new compounds, (+/−)-asperbisabol A (1a/1b), asperbisabol B (2), and asperbisabol C (3), the enantiomers 1a and 1b represent an unprecedented skeleton of diphenyl ether-coupled aromatic bisabolane sesquiterpenoids with a spiroketal core moiety. The neuroprotective effects of selected compounds against sodium nitroprusside (SNP)-induced injury were evaluated in PC12 cells by the MTT assay. Five compounds (1a, 6, and 8−10) showed remarkable neuroprotective activities at 10 µM, being more active than the positive control edaravone.
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Aspergillus , Sesquiterpenos , Aspergillus/química , China , Estrutura Molecular , Sesquiterpenos Monocíclicos , Sesquiterpenos/químicaRESUMO
AIM: This study aimed to investigate the effect of different probe placements on the ventral and dorsal sides of the same finger using pulse oxygen saturation monitoring. METHODS: This clinical trial used a convenience sampling method in patients admitted to the Second Hospital of Hebei Medical University. We enrolled 1330 patients from March to July 2018, including patients who were hospitalized in the intensive care unit (n = 258) and in the general ward (n = 1072). Pulse oxygen saturation measurements obtained from the ventral and dorsal sides of the same finger were compared. This work adhered to the STROBE checklist requirements. RESULTS: We found that pulse oxygen saturation measurements between the dorsal and ventral sides of a finger were not affected by different fingers, disease types, the application of a ventilator, vasoactive drugs, the conscious state of the patient or the instrument model. CONCLUSION: Our findings suggested no significant difference in saturation measurements with variation in the placement of the pulse oxygen saturation measurement instrument between the dorsal and ventral sides of a finger, regardless of illness severity. We believe that these results could simplify the monitoring procedures performed by nurses and eliminate worries concerning the inaccuracy of data because of varied probe positions.
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Oximetria , Saturação de Oxigênio , Dedos , Humanos , Unidades de Terapia Intensiva , Monitorização Fisiológica , Oximetria/métodosRESUMO
The cellulose content in vegetable waste (VW) is high and cannot be directly digested by black soldier fly larvae (BSFL). In this study, in order to treat VW using BSFL composting, kitchen waste (KW) is used as the only nutritional supplement for VW to analyze the effects of the different contents of crude protein (CP), crude fat (EE), carbohydrate (3C), compost thickness (CT), and treatment time on the larval weight (LW), survival rate (SR), dry matter reduction rate (DMR), bioconversion rate (BCR), physical and chemical properties of BSFL sand and changes in the microbial community. Our results showed that when the average 3C content increased by 40%, the average LW increased by 47.6%, and the SR, DMR, BCR, and organic matter (OM) content increased by 16.82%, 8.5%, 4.77%, and 3.86%, respectively. In contrast, when the average compost thickness increased by 5 cm, the average weight of BSFL decreased by 22.64%, while the SR of larvae, DMR, BCR, OM, and total nutrients (TN + P2O5 + K2O) decreased by 5%, 5.2%, 4.42%, 9.6%, and 0.78%, respectively. Germination test showed that BSFL sand alone could not be used as soilless culture substrate. After BSFL treatment, we found that the dominant phyla in BSFL sand were Firmicutes (95.77%), Proteobacteria (2.54%), Actinobacteria (0.74%), and Chloroflexi (0.6%). Our results indicate that BSFL composting is an effective method of treating VW, and 3C content and CT have a significant effect on BSFL composting.
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Compostagem , Dípteros , Microbiota , Animais , Larva , NutrientesRESUMO
The tracking and positioning of transmission lines is a key element for UAVs (Unmanned Aerial Vehicles) to achieve autonomous inspection of transmission lines. Current methods are vulnerable to weather and environmental factors, have high costs, and have difficulties in data processing. Therefore, this paper proposes a transmission line tracking and localization method based on the electric field sensor array, which calculates the current UAV's heading angle deflection angle, the distance between the transmission line and the UAV, and the elevation angle, providing a new idea to solve the problem of UAV inspection of transmission lines. At the same time, the electric field distribution of different arrangements of three-phase transmission lines was analyzed using COMSOL to determine the flight area of the UAV. By comparing the electric field distribution of the UAV flight area and single-phase transmission lines, it was verified that the current method is also applicable in the three-phase transmission line scenario, and it was further verified that the sensor array used can sense the change of the UAV position in the flight area, indicating that the electric field sensor array can realize the transmission line tracking and localization of transmission lines. The experimental results showed that, in the three-phase transmission line scenario, when the sensor array moves along the transmission straight wire, the maximum absolute error of the heading angle deflection angle calculated according to this method was 8.2°, the maximum absolute error of the distance between the array and the transmission line was 19.3 cm, and the maximum absolute error of the elevation angle was 11.37°; the error was within a reasonable range and can be used for the UAV to realize autonomous inspection.
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OBJECTIVE: To determine the association of post-traumatic acute respiratory distress syndrome (ARDS) on poor prognosis, and provide a theoretical basis for the treatment of patients with post-traumatic ARDS in clinical practice. Methods: This was a retrospective study including trauma victims in the intensive care unit (ICU) of Daping Hospital. The patients were classified as having ARDS or non-ARDS, according to the Berlin definition. Subsequently, these patients were divided into subgroups, according to age, gender and injury site. The relationship between ARDS and prognosis was analyzed, including mechanical ventilation days, length of ICU stay, length of hospital stay, infection, sepsis, multiple organ dysfunction syndrome (MODS) and death. RESULTS: There were 507 trauma patients, out of which 287 (56.61%) cases were with ARDS. The duration of mechanical ventilation, ICU stay and hospital stay in the ARDS group was significantly longer than that in the non-ARDS group (5 days vs 3 days, 10 days vs 4 days, 30 days vs 27 days, respectively). In addition, ARDS was associated with an increased risk of nfection (p<0.05; OR=4.17; 95%CI=2.72-6.41), sepsis (p<0.05; OR=3.45; 95%CI=2.28-5.22), and MODS (p<0.05; OR=2.82; 95% CI=1.67-4.72), but had no significant association with mortality (p>0.05). Similar results were found in the subgroup analyses. Conclusion: In conclusion, the prognosis of the patients with post-traumatic ARDS was worse; however, ARDS had little effect on death.
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Síndrome do Desconforto Respiratório , Humanos , Unidades de Terapia Intensiva , Prognóstico , Respiração Artificial , Síndrome do Desconforto Respiratório/epidemiologia , Síndrome do Desconforto Respiratório/etiologia , Estudos RetrospectivosRESUMO
OBJECTIVES: The knowledge that agmatine is found in the human body has existed for several years; however, its role in sepsis has not yet been studied. In the present study, we investigate the role of agmatine in the progression and treatment of sepsis. DESIGN: Clinical/laboratory investigations. SETTING: Medical centers/University-based research laboratory. SUBJECTS: Elective ICU patients with severe sepsis and healthy volunteers; C57BL/6 mice weighing 18-22 g. INTERVENTIONS: Serum agmatine level and its associations with inflammatory markers were assessed in patients with sepsis. Agmatine was administered intraperitoneally to mice before a lipopolysaccharide challenge. Human peripheral blood mononuclear cells and murine macrophages were pretreated with agmatine followed by lipopolysaccharide stimulation. MEASUREMENTS AND MAIN RESULTS: Serum agmatine levels were significantly decreased in patients with sepsis and lipopolysaccharide-induced mice, and correlated with Acute Physiology and Chronic Health Evaluation II score, procalcitonin, tumor necrosis factor-α, and interleukin-6 levels. In a therapeutic experiment, exogenous agmatine attenuated the cytokine production of peripheral blood mononuclear cells from patients with sepsis and healthy controls. Agmatine also exerted a significant beneficial effect in the inflammatory response and organ damage and reduced the death rate in lipopolysaccharide-induced mice. Imidazoline I2 receptor agonist 2-benzofuran-2-yl blocked the pharmacological action of agmatine; whereas, other imidazoline receptor ligands did not. Furthermore, agmatine significantly impaired the inflammatory response by inactivating nuclear factor-κB, but not protein 38 mitogen-activated protein kinase, c-Jun N-terminal kinase, extracellular signal-regulated kinase, and inducible nitric oxide synthase signaling in macrophages. Activation of imidazoline I2 receptor or knockdown of ribosomal S6 kinase 2 counteracted the effects of agmatine on phosphorylation and degradation of inhibitor of nuclear factor-κBα. CONCLUSIONS: Endogenous agmatine metabolism correlated with the progression of sepsis. Supplemental exogenous agmatine could ameliorate the lipopolysaccharide-induced systemic inflammatory responses and multiple organ injuries through the imidazoline I2 receptor-ribosomal S6 kinase 2-nuclear factor-κB pathway. Agmatine could be used as both a clinical biomarker and a promising pharmaconutrient in patients with severe sepsis.
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Agmatina/uso terapêutico , Receptores de Imidazolinas/fisiologia , NF-kappa B/fisiologia , Proteínas Quinases S6 Ribossômicas 90-kDa/fisiologia , Sepse/tratamento farmacológico , Transdução de Sinais/fisiologia , Agmatina/farmacologia , Animais , Células Cultivadas , Progressão da Doença , Humanos , Receptores de Imidazolinas/efeitos dos fármacos , Leucócitos Mononucleares/efeitos dos fármacos , Leucócitos Mononucleares/fisiologia , Macrófagos/efeitos dos fármacos , Macrófagos/fisiologia , Camundongos , Camundongos Endogâmicos C57BL , NF-kappa B/efeitos dos fármacos , Proteínas Quinases S6 Ribossômicas 90-kDa/efeitos dos fármacos , Transdução de Sinais/efeitos dos fármacosRESUMO
The polarization of macrophages is critical to inflammation and tissue repair, with unbalanced macrophage polarization associated with critical dysfunctions of the immune system. Cytochrome P450 1A1 (CYP1A1) is a hydroxylase mainly controlled by the inflammation-limiting aryl hydrocarbon receptor (AhR), which plays a critical role in mycoplasma infection, oxidative stress injury, and cancer. Arginase-1 (Arg-1) is a surrogate for polarized alternative macrophages and is important to the production of nitric oxide (NO) by the modulation of arginine. In the present study, we found CYP1A1 to be upregulated in IL-4-stimulated mouse peritoneal macrophages (PMs) and human peripheral blood monocytes. Using CYP1A1-overexpressing RAW264.7 cells (CYP1A1/RAW) we found that CYP1A1 augmented Arg-1 expression by strengthening the activation of the JAK1/STAT6 signaling pathway in macrophages treated with IL-4. 15(S)-HETE, a metabolite of CYP1A1 hydroxylase, was elevated in IL-4-induced CYP1A1/RAW cells. Further, in macrophages, the loss-of-CYP1A1-hydroxylase activity was associated with reduced IL-4-induced Arg-1 expression due to impaired 15(S)-HETE generation. Of importance, CYP1A1 overexpressing macrophages reduced the inflammation associated with LPS-induced peritonitis. Taken together, these findings identified a novel signaling axis, CYP1A1-15(S)-HETE-JAK1-STAT6, that may be a promising target for the proper maintenance of macrophage polarization and may also be a means by which to treat immune-related disease due to macrophage dysfunction.
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Arginase/biossíntese , Citocromo P-450 CYP1A1/fisiologia , Janus Quinase 1/antagonistas & inibidores , Macrófagos Peritoneais/efeitos dos fármacos , Peritonite/prevenção & controle , Fator de Transcrição STAT6/antagonistas & inibidores , Transdução de Sinais/efeitos dos fármacos , Ácido 12-Hidroxi-5,8,10,14-Eicosatetraenoico/farmacologia , Transferência Adotiva , Animais , Araquidonato 15-Lipoxigenase/fisiologia , Arginase/genética , Citocromo P-450 CYP1A1/biossíntese , Citocromo P-450 CYP1A1/genética , Endotoxinas/toxicidade , Humanos , Ácidos Hidroxieicosatetraenoicos/biossíntese , Ácidos Hidroxieicosatetraenoicos/genética , Ácidos Hidroxieicosatetraenoicos/farmacologia , Interleucina-4/farmacologia , Leucócitos Mononucleares/efeitos dos fármacos , Leucócitos Mononucleares/metabolismo , Leucócitos Mononucleares/transplante , Macrófagos Peritoneais/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Peritonite/induzido quimicamente , Células RAW 264.7 , Interferência de RNA , RNA Mensageiro/biossíntese , RNA Mensageiro/genética , Receptores Citoplasmáticos e Nucleares/biossíntese , Receptores Citoplasmáticos e Nucleares/genética , Células THP-1 , Regulação para Cima/efeitos dos fármacosRESUMO
An amendment to this paper has been published and can be accessed via the original article.
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The hydroxylase cytochrome P450 1A1 (CYP1A1) is regulated by the inflammation-limiting aryl hydrocarbon receptor (AhR), but CYP1A1 immune functions remain unclear. We observed CYP1A1 overexpression in peritoneal macrophages (PMs) isolated from mice following LPS or heat-killed Escherichia. coli (E. coli) challenge. CYP1A1 overexpression augmented TNF-α and IL-6 production in RAW264.7 cells (RAW) by enhancing JNK/AP-1 signalling. CYP1A1 overexpression also promoted 12S-hydroxy-5Z,8Z,10E,14Z-eicosatetraenoic acid (12(S)-HETE) production in activated RAW, while a 12(S)-HETE antibody attenuated and 12(S)-HETE alone induced inflammatory responses. Macrophages harbouring hydroxylase-deficient CYP1A1 demonstrated reduced 12(S)-HETE generation and LPS-induced TNF-α/IL-6 secretion. CYP1A1 overexpression also impaired phagocytosis of bacteria via decreasing the expression of scavenger receptor A (SR-A) in PMs. Mice injected with CYP1A1-overexpressing PMs were more susceptible to CLP- or E. coli-induced mortality and bacteria invading, while Rhapontigenin, a selective CYP1A1 inhibitor, improved survival and bacteria clearance of mice in sepsis. CYP1A1 and 12(S)-HETE were also elevated in monocytes and plasma of septic patients and positively correlated with SOFA scores. Macrophage CYP1A1 disruption could be a promising strategy for treating sepsis. Video abstract.
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Citocromo P-450 CYP1A1/fisiologia , MAP Quinase Quinase 4/metabolismo , Macrófagos Peritoneais , Fagocitose , Sepse/metabolismo , Ácido 12-Hidroxi-5,8,10,14-Eicosatetraenoico/metabolismo , Adulto , Idoso , Animais , Escherichia coli , Humanos , Inflamação , Macrófagos Peritoneais/metabolismo , Macrófagos Peritoneais/microbiologia , Macrófagos Peritoneais/patologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Pessoa de Meia-Idade , Células RAW 264.7 , Adulto JovemRESUMO
To endow montmorillonite with excellent flame retardancy, montmorillonite (Mt) intercalation iron compounds (Fe-Mt) were synthesized and modified by phosphorylated chitosan (PCTS) to prepare PCTS modified Fe-Mt (PCTS-Fe-OMt). PCTS-Fe-OMt was further incorporated into epoxy resin (EP) for improving the fire safety of EP. The results revealed that the interlayer spacing of Fe-Mt was expanded by PCTS, which resulted in well dispersion of PCTS-Fe-OMt in EP matrix. The TGA results showed that EP/PCTS-Fe-OMt nanocomposites exhibited much higher residues due to the excellent charring performance of PCTS-Fe-OMt. According to the cone calorimeter tests, the addition of 5 wt% PCTS-Fe-OMt made peak heat release rate, total heat release, peak smoke production rate, total smoke production values of EP observably decrease by 40.2%, 17.1%, 33.9% and 19.0%. Based on the above results, the improved flame retardancy and smoke suppression properties of EP/PCTS-Fe-OMt nanocomposites were attributed to the combination of iron compounds and phosphorylated chitosan on catalytic charring, thereby promoting the formation of swollen, continuous and compact char layers on the surface of polymer during combustion, eventually restraining the decomposition of polymers.
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Efficient data dissemination in vehicular ad hoc networks (VANETs) is a challenging issue due to the dynamic nature of the network. To improve the performance of data dissemination, we study distributed data replication algorithms in VANETs for exchanging information and computing in an arbitrarily-connected network of vehicle nodes. To achieve low dissemination delay and improve the network performance, we control the number of message copies that can be disseminated in the network and then propose an efficient distributed data replication algorithm (EDDA). The key idea is to let the data carrier distribute the data dissemination tasks to multiple nodes to speed up the dissemination process. We calculate the number of communication stages for the network to enter into a balanced status and show that the proposed distributed algorithm can converge to a consensus in a small number of communication stages. Most of the theoretical results described in this paper are to study the complexity of network convergence. The lower bound and upper bound are also provided in the analysis of the algorithm. Simulation results show that the proposed EDDA can efficiently disseminate messages to vehicles in a specific area with low dissemination delay and system overhead.
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BACKGROUND AND STUDY AIMS: Although peroral endoscopic myotomy (POEM) is credited with high success rates in the treatment of achalasia, persistent/recurrent symptoms may occasionally develop afterwards. Our purpose was to evaluate the feasibility, safety, and efficacy of repeat peroral endoscopic myotomy (Re-POEM) as salvage therapy after initial POEM failure. PATIENTS AND METHODS: Fifteen patients with persistence/recurrence of symptoms after previous POEM (Eckardt symptom score ≥â4) were retrospectively selected from a prospectively maintained database housing a total of 1454 consecutive patients with achalasia. The primary endpoint was symptom relief during follow-up, defined by an Eckardt score of ≤â3.âSecondary outcome measures were procedure-related adverse events, change in manometric lower esophageal sphincter (LES) pressure, and reflux symptoms before and after Re-POEM. RESULTS: All patients underwent successful Re-POEM a mean of 13.5 months (range 4â-â37 months) after execution of their primary POEM procedures. Mean operative time was 41.5 minutes (range 28â-â62 minutes). One instance of submucosal tunnel infection was successfully managed with conservative treatment. During a mean follow-up period of 11.3 months (range 3â-â18 months), therapeutic success was achieved in all patients. The mean symptom score pretreatment was 5.6 (range 4â-â8), compared with a post-treatment mean of 1.2 (range 0â-â3; Pâ<â0.001). Mean LES pressure also declined from 25.0âmmHg to 9.5âmmHg after Re-POEM (Pâ<â0.001). The overall clinical reflux complication rate of Re-POEM was 33.3â%. CONCLUSIONS: Re-POEM appears safe and effective as a salvage option after initial POEM failure, conferring short-term symptom relief and being free of serious complications in all patients.
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Acalasia Esofágica/cirurgia , Junção Esofagogástrica/cirurgia , Cirurgia Endoscópica por Orifício Natural/métodos , Terapia de Salvação/métodos , Adulto , Acalasia Esofágica/diagnóstico , Acalasia Esofágica/fisiopatologia , Junção Esofagogástrica/patologia , Junção Esofagogástrica/fisiopatologia , Feminino , Seguimentos , Humanos , Masculino , Manometria , Pessoa de Meia-Idade , Boca , Pressão , Recidiva , Reoperação , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Infection is a common medical problem at present. Different pathogens can lead to different infections. Severe infections can ultimately lead to sepsis, resulting in multiple organ dysfunction and the high mortality of patients. Therefore, studying the occurrence and development of severe infections is essential to improve the survival rate of patients. More and more studies have revealed the important role of connection between intestine and liver in infectious diseases. The maintenance of intestinal mechanical barrier and biological barrier function and the regulation of intestinal flora metabolites can reduce infectious liver injury. Bile acids are important metabolites in the liver, which can inhibit the progression of certain infectious intestinal injuries and promote intestinal damage caused by certain pathogens. In this article, the mechanism of action of the intestinal-liver axis in infection was reviewed to find a new target for the treatment of clinical infection.
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Intestinos , Fígado , Humanos , Fígado/metabolismo , Ácidos e Sais Biliares/metabolismo , Hepatopatias/metabolismo , Hepatopatias/etiologia , Mucosa Intestinal/metabolismo , Microbioma GastrointestinalRESUMO
INTRODUCTION: In recent years, hypervirulent Klebsiella pneumoniae (hvKp) has attracted increasing attention. It usually causes liver abscesses, which spread through the bloodstream to other parts such as the eyes, brain, lungs. 5.5% of all paroxysmal sympathetic hyperactivity syndrome are associated with infection, hydrocephalus, brain tumors, and some unknown causes. Younger patients with focal lesions of the brain parenchyma are at higher risk of paroxysmal sympathetic hyperactivity (PSH). CASE PRESENTATION: This case report details the clinical features of Klebsiella pneumoniae diagnosed in a healthy individual. In addition to liver abscesses, bacteremia, and hyperglycemia, there are also brain abscesses, hernias, and postoperative paroxysmal sympathetic hyperactivity, an unexpected association between diseases or symptoms. The patient stabilized after comprehensive treatment, including early drainage of abscesses, rapid pathogen diagnosis, and timely and appropriate antibiotics. At a two-month follow-up, no signs of infection recurrence were noted, and the patient regained neurological function and could participate in regular physical activity. DISCUSSION: Symptoms of Klebsiella pneumoniae infection usually appear gradually, and misdiagnosis is common. When young patients suddenly develop high fever and abscess at a particular site, Klebsiella pneumoniae infection should be considered routine. Paroxysmal sympathetic hyperactivity syndrome caused by infection is rare, but a clinical score (PSH assessment measure, PSH-AM score) should be performed when clinical features appear. Early diagnosis and treatment can improve the prognosis.