Are you using the third definition to diagnose sepsis in clinic?-A survey among Chinese intensivists.

BACKGROUND: Since sepsis-3 definition is more accurate and sensitive than previous sepsis definition, implementation the newest diagnosis criteria could definitely bring more benefit to sepsis patients. This study was done to identify the level of current intensivists' knowledge regarding the third international consensus definitions for sepsis and septic shock and its implementation for the diagnosis of sepsis among Chinese adult intensive care units (ICUs). METHODS: A nationwide survey amongst critical care physicians was designed. The questionnaires measured the understanding and the frequency of diagnosis of sepsis and septic shock according to the third international consensus definitions for sepsis and septic shock. One thousand random physician members of Chinese Society of Critical Care Medicine were involved in the survey. A 5-point Likert scale (totally understand, partially understand, understand, hardly understand, do not understand) was used to elicit answers about the degree of understanding the sepsis-3 definition. The other 5-point Likert scale (always, often, sometimes, rarely, never) was used to elicit answers about the frequency of diagnosing sepsis according to the sepsis-3 definition. RESULTS: There were 59 (16.1%) intensivists who could completely understand the sepsis-3 definition. Less practiced intensivists could understand the sepsis-3 definition better than more practiced intensivists (P<0.001). Intensivists from university teaching hospitals understand the sepsis-3 definition better than the intensivists from the community hospitals (P<0.001). Intensivists from small-sized ICUs understand the sepsis-3 definition better than intensivists from big-sized ICUs (P<0.001). There were 60 (16.4%) intensivists who always diagnose sepsis according to the sepsis-3 definition since sepsis-3 published. Less practiced intensivists prefer using the sepsis-3 definition to diagnose sepsis compared with more practiced intensivists (P<0.001). Intensivists from university teaching hospitals prefer using the sepsis-3 definition to diagnose sepsis compared with the intensivists from the community hospitals (P<0.001). Intensivists from small-sized ICUs prefer adapting sepsis-3 definition to diagnosis sepsis compared with intensivists from big-sized ICUs (P<0.001). CONCLUSIONS: In current China, the sepsis-3 definition is well understood and accepted by intensivists.

Berberine promotes nerve regeneration through IGFR­mediated JNK­AKT signal pathway.

Berberine presents therapeutic ability for various central nervous system disorders, including Alzheimer's disease and cerebral ischemia. The present study investigated the role of berberine in nerve regeneration and analyzed the potential mechanism mediated by berberine in hippocampal pyramidal neurons. Reverse transcription­quantitative poylmerase chain reaction, western blot, TUNEL assay and immunofluorescence were used to analyze the therapeutic effects of berberine on nerve regeneration. Berberine treatment increased growth and viability of hippocampal pyramidal neurons. Berberine treatment inhibited apoptosis of hippocampal pyramidal neurons and increased apoptosis regulator Bcl­2 and Bcl­w expression. Neuroinflammation of tumor necrosis factor α, interleukin (IL)1ß, IL6 levels and autophagy­related proteins microtubule­associated proteins 1A/1B light chain 3B, autophagy related 16 like 1 and autophagy related 7 were downregulated by berberine treatment in hippocampal pyramidal neurons. Notably, study has found that berberine increased insulin-like growth factor receptor (IGFR) and decreased c­Jun N­terminal kinase (JNK) and protein kinase B (AKT) expression in hippocampal pyramidal neurons. IGFR antagonist abolished berberine­increased growth of hippocampal pyramidal neurons. In conclusion, these results indicate that berberine can promote nerve regeneration through IGFR­mediated JNK­AKT signal pathway.