By def inition, sepsis refers to a life threatening organ dysfunction due to a dysregulated host response to an infection[1]. More precisely, sepsis triggers a multifaceted response characterized by a simultaneous man...By def inition, sepsis refers to a life threatening organ dysfunction due to a dysregulated host response to an infection[1]. More precisely, sepsis triggers a multifaceted response characterized by a simultaneous manifestation of proinflammatory and anti-inflammatory elements that disrupt mechanisms intended to maintain homeostasis. Initially, an overwhelming hyperinflammatory reaction ensues, resulting in tissue damage and organ dysfunction.展开更多
Sepsis is currently a major problem and challenge facing the medical community.With rapid development and progress of modern medicine,researchers have put more and more attention on sepsis;meanwhile,the morbidity and ...Sepsis is currently a major problem and challenge facing the medical community.With rapid development and progress of modern medicine,researchers have put more and more attention on sepsis;meanwhile,the morbidity and mortality of sepsis remains high despite great efforts from experts in various fields.According to updated guidelines,sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection.Infection is the initial step of sepsis progression,and development from infection to sepsis is a complex pathophysiological process,including pathogen invasion,cytokine release,capillary leakage,microcirculation dysfunction,etc.which finally leads to organ metabolic disorders and functional failure.According to the latest recommended international guidelines of Sepsis 3.0,the presence of infection and SOFA score≥2 are considered as the diagnostic criteria for sepsis,and the"rescue"measures mainly focus on reversal of organ dysfunction.However,despite nearly two decades of efforts,the"Save Sepsis Campaign"has not achieved satisfactory results.Emergency medicine is the frontier subject of acute and severe illness which treats patients with acute infections at the earliest.If at this stage,physicians can predict the possibility of sepsis progression from demographic characteristics,localize the pathogen and infection,detect the inflammatory storms by tests of cytokines and evaluate the severity of the infection with more effective clinical scoring system,and then take effective measures to prevent infection from developing into sepsis in high-risk patients,the morbidity and mortality of sepsis in patients with acute infection will be greatly reduced.Based on this situation,Chinese emergency medicine experts proposed the concept of"preventing and blocking"sepsis,and launched the nationwide"Preventing Sepsis Campaign in China(PSCC)"nationwide.The main concept is summarized as"three early and two reduces"which includes early detection,early diagnosis and early intervention during t展开更多
AIM：To observe expression of CD14 protein and CD14 gene in rat liver sinsoidal endothelial cells(LSECs) during endotoxemia,and the role of CD14 protein in the activation of lipopolysaccharide(LPS)-induced LSECs.METHO...AIM：To observe expression of CD14 protein and CD14 gene in rat liver sinsoidal endothelial cells(LSECs) during endotoxemia,and the role of CD14 protein in the activation of lipopolysaccharide(LPS)-induced LSECs.METHODS:Wistar rat endotoxemia model was established first by injection of a dose of LPS(5mg/kg,Escherichia coli O111:B4)via the tail vein,then sacrificed after 0h,3h,6h,12h,and 24h,respectively,LSECs were isolated from normal and LPS-injected rats by an in situ colagenase perfusion technique.The isolated LSECs were incubated with rabbit anti-rat CD14 polyclonal antibody,then stained with goat anti rabbit IgG conjgated fluorescein isothiocyanate(FITC) and flow cytometric analysis(FCM) was performed.The percentage and mean fluorescence intensity(MFI) of CD14-positive cells were taken as the indexes.LSECs were collected to measure the expression of CD14 mRNA by in situ hybridization analysis.The isolated LSECs from normal rats were incubated firstly with anti-CD14 antibody,then stimulated with different concentrations of LPS,and the supernatants of these cells were then collected for measuring the levels of tumor necrosis factor (TNF)-a and lnterleukin(IL)-6 with ELISA.RESULTS:In rats with endotoxemia,LSECs displayed a strong MFI distinct from that of control rats .CD14 positive cells in rats with endotoxemia were 54.32%,65.83%,85.64%,and 45.65%,at 3h,6h,12h,and 24h respectively there was significant difference when compared to normal group of animals(4.45%)(P<0.01).The expression of CD14 mRNA in isolated LSECs was stronger than that in control rats,In LPS group,the levels of TNF-αand IL-6were 54±6ng.L^-1,85±9ng.L^-1,206±22ng.L^-1,350±41ng.L^-1,366±42ng.L^-1and103±11ng.L^-1,187±20ng.L^-1,244±26ng.L^-1,290±31ng.L^-1,and 299±34ng.L^-1,respectively at different concentration points,In anti-CD14 group,the levels of TNF-αand IL-6 were 56±5ng.L^-1,67±8ng.L^-1,85±10ng.L^-1,113±12ng.L^-1, ,199±22ng.L^-1and104±12ng.L^-1,125±12ng.L^-1,165±19ng.L^-1,185±21ng.L^-1,and222±23ng.L^-1，respectively 展开更多
In order to discover the risk factors for 30-day mortality in bloodstream infections（BSI） caused by Enterococcus spp.strains,we explored the clinical and therapeutic profile of patients with Enterococcus spp.BSI and...In order to discover the risk factors for 30-day mortality in bloodstream infections（BSI） caused by Enterococcus spp.strains,we explored the clinical and therapeutic profile of patients with Enterococcus spp.BSI and the characteristics of this condition.A total of 64 patients with BSI caused by Enterococcus spp.who were treated in our hospital between 2006 and 2015 were included in the study.The clinical features of patients,microbiology,and 30-day mortality were collected from the electronic medical records database and analyzed.The results showed that there were 38 patients infected by Enterococcus faecalis（E.faecalis）,24 by Enterococcus faecium（E.faecium）,1 by Enterococcus casseliflavus（E.casseliflavus）,and 1 by Enterococcus gallinarum（E.gallinarum）.A Charlson comorbidity score ≥5,corticosteroid treatment,placement of catheters or other prosthetic devices and history of antibiotic use were found more frequently in E.faecium BSI patients than in E.faecalis patients（P=0.017,P=0.027,P=0.008 and P=0.027,respectively）.Furthermore,the univariate and multivariate analysis showed that corticosteroid treatment（OR=17.385,P=0.008）,hospital acquisition（OR=16.328,P=0.038）,and vascular catheter infection（OR=14.788,P=0.025） were all independently associated with 30-day mortality.Our results indicate that E.faecalis and E.faecium are two different pathogens with unique microbiologic characteristics,which cause different clinical features in BSI,and the empiric antimicrobial treatments are paramount for patients with enterococcal BSI.展开更多
文摘By def inition, sepsis refers to a life threatening organ dysfunction due to a dysregulated host response to an infection[1]. More precisely, sepsis triggers a multifaceted response characterized by a simultaneous manifestation of proinflammatory and anti-inflammatory elements that disrupt mechanisms intended to maintain homeostasis. Initially, an overwhelming hyperinflammatory reaction ensues, resulting in tissue damage and organ dysfunction.
基金supported by CAMS Innovation Fund for Medical Sciences(2019-I2M-5-023)
文摘Sepsis is currently a major problem and challenge facing the medical community.With rapid development and progress of modern medicine,researchers have put more and more attention on sepsis;meanwhile,the morbidity and mortality of sepsis remains high despite great efforts from experts in various fields.According to updated guidelines,sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection.Infection is the initial step of sepsis progression,and development from infection to sepsis is a complex pathophysiological process,including pathogen invasion,cytokine release,capillary leakage,microcirculation dysfunction,etc.which finally leads to organ metabolic disorders and functional failure.According to the latest recommended international guidelines of Sepsis 3.0,the presence of infection and SOFA score≥2 are considered as the diagnostic criteria for sepsis,and the"rescue"measures mainly focus on reversal of organ dysfunction.However,despite nearly two decades of efforts,the"Save Sepsis Campaign"has not achieved satisfactory results.Emergency medicine is the frontier subject of acute and severe illness which treats patients with acute infections at the earliest.If at this stage,physicians can predict the possibility of sepsis progression from demographic characteristics,localize the pathogen and infection,detect the inflammatory storms by tests of cytokines and evaluate the severity of the infection with more effective clinical scoring system,and then take effective measures to prevent infection from developing into sepsis in high-risk patients,the morbidity and mortality of sepsis in patients with acute infection will be greatly reduced.Based on this situation,Chinese emergency medicine experts proposed the concept of"preventing and blocking"sepsis,and launched the nationwide"Preventing Sepsis Campaign in China(PSCC)"nationwide.The main concept is summarized as"three early and two reduces"which includes early detection,early diagnosis and early intervention during t
基金the National Natural Science Foundation of China,No.39970719,30170919
文摘AIM：To observe expression of CD14 protein and CD14 gene in rat liver sinsoidal endothelial cells(LSECs) during endotoxemia,and the role of CD14 protein in the activation of lipopolysaccharide(LPS)-induced LSECs.METHODS:Wistar rat endotoxemia model was established first by injection of a dose of LPS(5mg/kg,Escherichia coli O111:B4)via the tail vein,then sacrificed after 0h,3h,6h,12h,and 24h,respectively,LSECs were isolated from normal and LPS-injected rats by an in situ colagenase perfusion technique.The isolated LSECs were incubated with rabbit anti-rat CD14 polyclonal antibody,then stained with goat anti rabbit IgG conjgated fluorescein isothiocyanate(FITC) and flow cytometric analysis(FCM) was performed.The percentage and mean fluorescence intensity(MFI) of CD14-positive cells were taken as the indexes.LSECs were collected to measure the expression of CD14 mRNA by in situ hybridization analysis.The isolated LSECs from normal rats were incubated firstly with anti-CD14 antibody,then stimulated with different concentrations of LPS,and the supernatants of these cells were then collected for measuring the levels of tumor necrosis factor (TNF)-a and lnterleukin(IL)-6 with ELISA.RESULTS:In rats with endotoxemia,LSECs displayed a strong MFI distinct from that of control rats .CD14 positive cells in rats with endotoxemia were 54.32%,65.83%,85.64%,and 45.65%,at 3h,6h,12h,and 24h respectively there was significant difference when compared to normal group of animals(4.45%)(P<0.01).The expression of CD14 mRNA in isolated LSECs was stronger than that in control rats,In LPS group,the levels of TNF-αand IL-6were 54±6ng.L^-1,85±9ng.L^-1,206±22ng.L^-1,350±41ng.L^-1,366±42ng.L^-1and103±11ng.L^-1,187±20ng.L^-1,244±26ng.L^-1,290±31ng.L^-1,and 299±34ng.L^-1,respectively at different concentration points,In anti-CD14 group,the levels of TNF-αand IL-6 were 56±5ng.L^-1,67±8ng.L^-1,85±10ng.L^-1,113±12ng.L^-1, ,199±22ng.L^-1and104±12ng.L^-1,125±12ng.L^-1,165±19ng.L^-1,185±21ng.L^-1,and222±23ng.L^-1，respectively
基金funded by Shenzhen Scientific Research Program(No.JCYJ20150402152130173)Scientific Research Project of Shenzhen Health and Family Planning System(No.201601058)Scientific Research Program of Shenzhen Nanshan District of China(No.2015019,2015022,2016010)
文摘In order to discover the risk factors for 30-day mortality in bloodstream infections（BSI） caused by Enterococcus spp.strains,we explored the clinical and therapeutic profile of patients with Enterococcus spp.BSI and the characteristics of this condition.A total of 64 patients with BSI caused by Enterococcus spp.who were treated in our hospital between 2006 and 2015 were included in the study.The clinical features of patients,microbiology,and 30-day mortality were collected from the electronic medical records database and analyzed.The results showed that there were 38 patients infected by Enterococcus faecalis（E.faecalis）,24 by Enterococcus faecium（E.faecium）,1 by Enterococcus casseliflavus（E.casseliflavus）,and 1 by Enterococcus gallinarum（E.gallinarum）.A Charlson comorbidity score ≥5,corticosteroid treatment,placement of catheters or other prosthetic devices and history of antibiotic use were found more frequently in E.faecium BSI patients than in E.faecalis patients（P=0.017,P=0.027,P=0.008 and P=0.027,respectively）.Furthermore,the univariate and multivariate analysis showed that corticosteroid treatment（OR=17.385,P=0.008）,hospital acquisition（OR=16.328,P=0.038）,and vascular catheter infection（OR=14.788,P=0.025） were all independently associated with 30-day mortality.Our results indicate that E.faecalis and E.faecium are two different pathogens with unique microbiologic characteristics,which cause different clinical features in BSI,and the empiric antimicrobial treatments are paramount for patients with enterococcal BSI.
