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1. Clinical characteristics of Gram-negative and Gram-positive bacterial infection in acute cholangitis: a retrospective observational study

Author: Shijing Tian, Kaili Li, Hong Tang, Yan Peng, Liang Xia, Xi Wang, Xiaoying Chen, and Fachun Zhou
Subjects: Acute cholangitis, Pathogen, Clinical features, Organ dysfunction, Prognosis, Infectious and parasitic diseases, RC109-216
Abstract: Abstract Background To investigate the difference in the severity of illness, organ dysfunction, and prognosis of acute cholangitis due to different pathogenic bacterial infection types. Methods A retrospective observational study was performed. Patients who met the selection criteria according to blood culture and bile culture results of different pathogenic bacterial were divided into groups. The severity of illness, organ dysfunction, and prognosis of the groups were analyzed and compared comprehensively. Results A total of 424 patients were included, and no bacterial growth developed in 111 patients (26.2%). Among the 313 patients (73.8%) with bacterial growth, 155 patients had only Gram-negative bacteria cultured (49.5%), 48 patients had only Gram-positive bacteria cultured (15.3%), and 110 patients had both Gram-negative and Gram-positive bacteria cultured (35.1%). The proportion of Grade III patients and the APACHE II and SOFA scores of the mixed Gram-negative and positive group were the highest (p 0.05). Conclusions In acute cholangitis, mixed infection with Gram-negative and Gram-positive bacteria was more severe and was associated with a higher risk of death. There were no apparent differences between Gram-negative and Gram-positive bacterial infections.
Published: 2022
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2. Actively implementing an evidence-based feeding guideline for critically ill patients (NEED): a multicenter, cluster-randomized, controlled trial

Author: Lu Ke, Jiajia Lin, Gordon S. Doig, Arthur R. H. van Zanten, Yang Wang, Juan Xing, Zhongheng Zhang, Tao Chen, Lixin Zhou, Dongpo Jiang, Qindong Shi, Jiandong Lin, Jun Liu, Aibin Cheng, Yafeng Liang, Peiyang Gao, Junli Sun, Wenming Liu, Zhenyu Yang, Rumin Zhang, Wei Xing, An Zhang, Zhigang Zhou, Tingfa Zhou, Yang Liu, Fei Tong, Qiuhui Wang, Aijun Pan, Xiaobo Huang, Chuming Fan, Weihua Lu, Dongwu Shi, Lei Wang, Wei Li, Liming Gu, Yingguang Xie, Rongqing Sun, Feng Guo, Lin Han, Lihua Zhou, Xiangde Zheng, Feng Shan, Jianbo Liu, Yuhang Ai, Yan Qu, Liandi Li, Hailing Li, Zhiguo Pan, Donglin Xu, Zhiqiang Zou, Yan Gao, Chunli Yang, Qiuye Kou, Xijing Zhang, Jinglan Wu, Chuanyun Qian, Weixing Zhang, Minjie Zhang, Yuan Zong, Bingyu Qin, Fusen Zhang, Zhe Zhai, Yun Sun, Ping Chang, Bo Yu, Min Yu, Shiying Yuan, Yijun Deng, Liyun Zhao, Bin Zang, Yuanfei Li, Fachun Zhou, Xiaomei Chen, Min Shao, Weidong Wu, Ming Wu, Zhaohui Zhang, Yimin Li, Qiang Guo, Zhiyong Wang, Yuanqi Gong, Yunlin Song, Kejian Qian, Yongjian Feng, Baocai Fu, Xueyan Liu, Zhiping Li, Chuanyong Gong, Cheng Sun, Jian Yu, Zhongzhi Tang, Linxi Huang, Biao Ma, Zhijie He, Qingshan Zhou, Rongguo Yu, Zhihui Tong, Weiqin Li, and for the Chinese Critcal Care Nutrition Trials Group (CCCNTG)
Subjects: Intensive care unit, Cluster-randomized trial, Nutrition therapy, Evidence-based guideline, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract: Abstract Background Previous cluster-randomized controlled trials evaluating the impact of implementing evidence-based guidelines for nutrition therapy in critical illness do not consistently demonstrate patient benefits. A large-scale, sufficiently powered study is therefore warranted to ascertain the effects of guideline implementation on patient-centered outcomes. Methods We conducted a multicenter, cluster-randomized, parallel-controlled trial in intensive care units (ICUs) across China. We developed an evidence-based feeding guideline. ICUs randomly allocated to the guideline group formed a local "intervention team", which actively implemented the guideline using standardized educational materials, a graphical feeding protocol, and live online education outreach meetings conducted by members of the study management committee. ICUs assigned to the control group remained unaware of the guideline content. All ICUs enrolled patients who were expected to stay in the ICU longer than seven days. The primary outcome was all-cause mortality within 28 days of enrollment. Results Forty-eight ICUs were randomized to the guideline group and 49 to the control group. From March 2018 to July 2019, the guideline ICUs enrolled 1399 patients, and the control ICUs enrolled 1373 patients. Implementation of the guideline resulted in significantly earlier EN initiation (1.20 vs. 1.55 mean days to initiation of EN; difference − 0.40 [95% CI − 0.71 to − 0.09]; P = 0.01) and delayed PN initiation (1.29 vs. 0.80 mean days to start of PN; difference 1.06 [95% CI 0.44 to 1.67]; P = 0.001). There was no significant difference in 28-day mortality (14.2% vs. 15.2%; difference − 1.6% [95% CI − 4.3% to 1.2%]; P = 0.42) between groups. Conclusions In this large-scale, multicenter trial, active implementation of an evidence-based feeding guideline reduced the time to commencement of EN and overall PN use but did not translate to a reduction in mortality from critical illness. Trial registration: ISRCTN, ISRCTN12233792 . Registered November 20th, 2017.
Published: 2022
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3. Utilizing reclassification to explore characteristics and prognosis of KDIGOSCr AKI subgroups: a retrospective analysis of a multicenter prospective cohort study

Author: Gui-Ying Dong, Jun-Ping Qin, Youzhong An, Yan Kang, Xiangyou Yu, Mingyan Zhao, Xiaochun Ma, Yuhang Ai, Yuan Xu, Xiuming Xi, Chuanyun Qian, Dawei Wu, Renhua Sun, Shusheng Li, Zhenjie Hu, Xiangyuan Cao, Fachun Zhou, Li Jiang, Jiandong Lin, Erzhen Chen, Tiehe Qin, Zhenyang He, Jihong Zhu, and Bin Du
Subjects: acute kidney injury, kdigo, intensive care unit, mortality, length of stay, Diseases of the genitourinary system. Urology, RC870-923
Abstract: Background Acute kidney injury (AKI) is widespread in the intensive care unit (ICU) and affects patient prognosis. According to Kidney Disease: Improving Global Outcomes (KDIGO) guidelines, the absolute and relative increases of serum creatinine (Scr) are classified into the same stage. Whether the prognosis of the two types of patients is similar in the ICU remains unclear. Methods According to the absolute and relative increase of Scr, AKI stage 1 and stage 3 patients were divided into stage 1a and 1b, stage 3a and 3b groups, respectively. Their demographics, laboratory results, clinical characteristics, and outcomes were analyzed retrospectively. Results Of the 345 eligible cases, we analyzed stage 1 because stage 3a group had only one patient. Using 53 or 61.88 µmol/L as the reference Scr (Scrref), no significant differences were observed in ICU mortality (P53=0.076, P61.88=0.070) or renal replacement therapy (RRT) ratio, (P53=0.356, P61.88=0.471) between stage 1a and 1b, but stage 1b had longer ICU length of stay (LOS) than stage 1a (P53
Published: 2021
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4. Correction to: Actively implementing an evidence-based feeding guideline for critically ill patients (NEED): a multicenter, cluster-randomized, controlled trial

Author: Lu Ke, Jiajia Lin, Gordon S. Doig, Arthur R. H. van Zanten, Yang Wang, Juan Xing, Zhongheng Zhang, Tao Chen, Lixin Zhou, Dongpo Jiang, Qindong Shi, Jiandong Lin, Jun Liu, Aibin Cheng, Yafeng Liang, Peiyang Gao, Junli Sun, Wenming Liu, Zhenyu Yang, Rumin Zhang, Wei Xing, An Zhang, Zhigang Zhou, Tingfa Zhou, Yang Liu, Fei Tong, Qiuhui Wang, Aijun Pan, Xiaobo Huang, Chuming Fan, Weihua Lu, Dongwu Shi, Lei Wang, Wei Li, Liming Gu, Yingguang Xie, Rongqing Sun, Feng Guo, Lin Han, Lihua Zhou, Xiangde Zheng, Feng Shan, Jianbo Liu, Yuhang Ai, Yan Qu, Liandi Li, Hailing Li, Zhiguo Pan, Donglin Xu, Zhiqiang Zou, Yan Gao, Chunli Yang, Qiuye Kou, Xijing Zhang, Jinglan Wu, Chuanyun Qian, Weixing Zhang, Minjie Zhang, Yuan Zong, Bingyu Qin, Fusen Zhang, Zhe Zhai, Yun Sun, Ping Chang, Bo Yu, Min Yu, Shiying Yuan, Yijun Deng, Liyun Zhao, Bin Zang, Yuanfei Li, Fachun Zhou, Xiaomei Chen, Min Shao, Weidong Wu, Ming Wu, Zhaohui Zhang, Yimin Li, Qiang Guo, Zhiyong Wang, Yuanqi Gong, Yunlin Song, Kejian Qian, Yongjian Feng, Baocai Fu, Xueyan Liu, Zhiping Li, Chuanyong Gong, Cheng Sun, Jian Yu, Zhongzhi Tang, Linxi Huang, Biao Ma, Zhijie He, Qingshan Zhou, Rongguo Yu, Zhihui Tong, Weiqin Li, and for the Chinese Critical Care Nutrition Trials Group (CCCNTG)
Subjects: Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Published: 2022
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5. Enteral nutrition feeding in Chinese intensive care units: a cross-sectional study involving 116 hospitals

Author: Juan Xing, Zhongheng Zhang, Lu Ke, Jing Zhou, Bingyu Qin, Hongkai Liang, Xiaomei Chen, Wenming Liu, Zhongmin Liu, Yuhang Ai, Difeng Wang, Qiuhui Wang, Qingshan Zhou, Fusen Zhang, Kejian Qian, Dongpo Jiang, Bin Zang, Yimin Li, Xiaobo Huang, Yan Qu, Yinguang Xie, Donglin Xu, Zhiqiang Zou, Xiangde Zheng, Jianbo Liu, Feng Guo, Yafeng Liang, Qiang Sun, Hongmei Gao, Yang Liu, Ping Chang, Aibin Ceng, Rongli Yang, Gaiqi Yao, Yun Sun, Xiaorong Wang, Yi Zhang, Yichao Wen, Jian Yu, Rongqing Sun, Zhiwei Li, Shiying Yuan, Yunlin Song, Peiyang Gao, Haiyan Liu, Zhaohui Zhang, Yunfu Wu, Biao Ma, Qiang Guo, Feng Shan, Mingshi Yang, Hailing Li, Yuanfei Li, Weihua Lu, Lei Wang, Chuangyun Qian, Zhiyong Wang, Jiandong Lin, Rumin Zhang, Peng Wan, Zhiyong Peng, Yuqiang Gong, Linxi Huang, Guobao Wu, Jie Sun, Yijun Deng, Dongwu Shi, Lixin Zhou, Fachun Zhou, Qindong Shi, Xiaodong Guo, Xueyan Liu, Weidong Wu, Xiangzhong Meng, Liandi Li, Weiwei Chen, Shusheng Li, Xianyao Wan, Zhixin Chao, An Zhang, Liming Gu, Wei Chen, Jinglan Wu, Lihua Zhou, Zhenhuan Zhang, Yibing Weng, Yongshun Feng, Chunli Yang, Yongjian Feng, Sumin Zhao, Fei Tong, Dong Hao, Hui Han, Baocai Fu, Chuanyong Gong, Zhiping Li, Kunlin Hu, Qiuye Kou, Han Zhang, Jie Liu, Chuming Fan, Xin Zhou, Xiumei Chen, Junli Sun, Xuejun Zhou, Bin Song, Cheng Sun, Liyun Zhao, Xinglu Dong, Linlin Zhang, Dafei Tong, Zhiguo Pan, Chuangjie Cai, Donghao Wang, Yingjun Dong, Yuanqi Gong, Zhisong Wu, Xinke Meng, Ping Wang, and Weiqin Li
Subjects: Enteral feeding, Intensive care units, Cross-sectional study, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract: Abstract Background There is a lack of large-scale epidemiological data on the clinical practice of enteral nutrition (EN) feeding in China. This study aimed to provide such data on Chinese hospitals and to investigate factors associated with EN delivery. Methods This cross-sectional study was launched in 118 intensive care units (ICUs) of 116 mainland hospitals and conducted on April 26, 2017. At 00:00 on April 26, all patients in these ICUs were included. Demographic and clinical variables of patients on April 25 were obtained. The dates of hospitalization, ICU admission and nutrition initiation were reviewed. The outcome status 28 days after the day of investigation was obtained. Results A total of 1953 patients were included for analysis, including 1483 survivors and 312 nonsurvivors. The median study day was day 7 (IQR 2–19 days) after ICU entry. The proportions of subjects starting EN within 24, 48 and 72 h after ICU entry was 24.8% (84/352), 32.7% (150/459) and 40.0% (200/541), respectively. The proportion of subjects receiving > 80% estimated energy target within 24, 48, 72 h and 7 days after ICU entry was 10.5% (37/352), 10.9% (50/459), 11.8% (64/541) and 17.8% (162/910), respectively. Using acute gastrointestinal injury (AGI) 1 as the reference in a Cox model, patients with AGI 2–3 were associated with reduced likelihood of EN initiation (HR 0.46, 95% CI 0.353–0.599; p
Published: 2018
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6. Different Expression Characteristics of LAG3 and PD-1 in Sepsis and Their Synergistic Effect on T Cell Exhaustion: A New Strategy for Immune Checkpoint Blockade

Author: Bailin Niu, Fachun Zhou, Yanxin Su, Long Wang, Yuanyuan Xu, Ziying Yi, Yushen Wu, Huimin Du, and Guosheng Ren
Subjects: T cell exhaustion, sepsis, PD-1, LAG3, synergistic inhibition, Immunologic diseases. Allergy, RC581-607
Abstract: The impairment of immunity characterized by T cell exhaustion is the main cause of death in patients with sepsis after the acute phase. Although PD-1 blockade is highly touted as a promising treatment for improving prognosis, the role of PD-1 plays in sepsis and particularly its different roles in different periods are still very limited. A recent study revealed LAG3 can resist the therapeutic effect of PD-1 blockade in tumor, which inspired us to understand their role in sepsis. We enrolled 26 patients with acute sepsis from 422 candidates using strict inclusion criteria. Follow-up analysis revealed that the expression levels of PD-1 were rapidly increased in the early stage of sepsis but did not change significantly as infection continued (P < 0.05). However, the expression of LAG3 was contrary to that of PD-1. Compared with LAG3 or PD-1 single-positive T cells, T cells coexpressing LAG3 and PD-1 were significantly exhausted (P < 0.05). The proportion of coexpressing T cells was negatively correlated with the total number of lymphocytes (r = −0.653, P = 0.0003) and positively correlated with the SOFA score (r = 0.712, P < 0.0001). In addition, the higher the proportion of coexpressing T cells was, the longer the hospital stay and the higher the mortality. These results showed that LAG3 and PD-1 had a potential synergistic effect in regulating the gradual exhaustion of T cells in sepsis, which seriously affected the clinical prognosis of patients. Therefore, LAG3 and PD-1 double-positive T cells are an important indicator for immunity detection and prognostic evaluation. In the future, precision therapy may pay more attention to the different expression patterns of these two molecules.
Published: 2019
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7. Epidemiology and outcome of severe sepsis and septic shock in intensive care units in mainland China.

Author: Jianfang Zhou, Chuanyun Qian, Mingyan Zhao, Xiangyou Yu, Yan Kang, Xiaochun Ma, Yuhang Ai, Yuan Xu, Dexin Liu, Youzhong An, Dawei Wu, Renhua Sun, Shusheng Li, Zhenjie Hu, Xiangyuan Cao, Fachun Zhou, Li Jiang, Jiandong Lin, Enqiang Mao, Tiehe Qin, Zhenyang He, Lihua Zhou, Bin Du, and China Critical Care Clinical Trials Group
Subjects: Medicine, Science
Abstract: INTRODUCTION: Information about sepsis in mainland China remains scarce and incomplete. The purpose of this study was to describe the epidemiology and outcome of severe sepsis and septic shock in mixed ICU in mainland China, as well as the independent predictors of mortality. METHODS: We performed a 2-month prospective, observational cohort study in 22 closed multi-disciplinary intensive care units (ICUs). All admissions into those ICUs during the study period were screened and patients with severe sepsis or septic shock were included. RESULTS: A total of 484 patients, 37.3 per 100 ICU admissions were diagnosed with severe sepsis (n = 365) or septic shock (n = 119) according to clinical criteria and included into this study. The most frequent sites of infection were the lung and abdomen. The overall ICU and hospital mortality rates were 28.7% (n = 139) and 33.5% (n = 162), respectively. In multivariate analyses, APACHE II score (odds ratio[OR], 1.068; 95% confidential interval[CI], 1.027-1.109), presence of ARDS (OR, 2.676; 95%CI, 1.691-4.235), bloodstream infection (OR, 2.520; 95%CI, 1.142-5.564) and comorbidity of cancer (OR, 2.246; 95%CI, 1.141-4.420) were significantly associated with mortality. CONCLUSIONS: Our results indicated that severe sepsis and septic shock were common complications in ICU patients and with high mortality in China, and can be of help to know more about severe sepsis and septic shock in China and to improve characterization and risk stratification in these patients.
Published: 2014
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8. Expert consensus on emergency procedures for portal hypertension bleeding (2022)

Author: Huangxing, Cai, Yanfang, Chai, Feng, Chen, Wei, Cheng, Jianguo, Chu, Aijun, Shan, Ying, Deng, Bangjiang, Fang, Zhijie, Feng, Fei, Gao, Xiaotong, Han, Mingsheng, Huang, Guiyun, Jin, Jinlong, Jiaping, Li, Lei, Li, Peiwu, Li, Xiao, Li, Zhanfei, Li, Zhen, Li, Fuquan, Liu, Jueshi, Liu, Peng, Liu, Xiaoran, Liu, Ligong, Lu, Jianjun, Luo, Xuefeng, Luo, Chuanzhu, Lv, Weifu, Lv, Qingbian, Ma, Yilong, Ma, Zhiqun, Mao, Ya, Peng, Junhui, Sun, Jun, Tie, Xianzheng, Tan, Qing, Wang, Rixing, Wang, Yong, Wang, An, Wei, Zhiyu, Xia, Bin, Xiang, Bin, Xiong, Shuogui, Xu, Hui, Xue, Weizhu, Yang, Min, Yuan, Chunqing, Zhang, Guoqiang, Zhang, Jianfeng, Zhang, Jinxiang, Zhang, Zhiming, Zhang, Jianbo, Zhao, Xiaodong, Zhao, Fachun, Zhou, Shi, Zhou, Xiaoli, Zhu, Changju, Zhu, Zheng, Zhuge Yu, Yimin, Zhu, Yinghua, Zou, Sun, Lin, Long, Lin, Wang, Qing, and Xiang, Hua
Published: 2023
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9. Inhibition of STEAP1 ameliorates inflammation and ferroptosis of acute lung injury caused by sepsis in LPS-induced human pulmonary microvascular endothelial cells

Author: Xuan Zou, Chang Liu, Zuotian Huang, Song Xiang, Kaili Li, Yuan Yuan, Yingting Hao, and Fachun Zhou
Subjects: Genetics, General Medicine, Molecular Biology
Published: 2023
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10. Risk Factors and Prognosis of Carbapenem-Resistant Organism Colonization and Infection in Acute Cholangitis

Author: Kaili Li, Sanle Jiang, Hongxue Fu, Yingting Hao, Shijing Tian, and Fachun Zhou
Subjects: Pharmacology, Infectious Diseases, Infection and Drug Resistance, Pharmacology (medical)
Abstract: Kaili Li, Sanle Jiang, Hongxue Fu, Yingting Hao, Shijing Tian, Fachun Zhou Department of Critical Care Medicine, the First Affiliated Hospital of Chongqing Medical University, Chongqing, Peopleâs Republic of ChinaCorrespondence: Shijing Tian; Fachun Zhou, Emergency Department, the First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong Qu, 17th Floor, Building 1, Chongqing, Peopleâs Republic of China, Tel +86 023-89011756, Email doctortianshijing@163.com; cyzfc1966@126.com; zfc88@126.comBackground: To identify the risk factors and prognosis of carbapenem-resistant organisms (CRO) in patients with acute cholangitis.Methods: This retrospective observational study was conducted to explore the risk factors and prognosis of CRO infection in 503 acute cholangitis patients diagnosed between July 2013 and January 2022 at the First Affiliated Hospital of Chongqing Medical University, who were divided into a CRO group and non-CRO group based on the presence or absence of CRO. Univariate, multivariate analyses, and the proportional hazards model were used to compare the risk factors and prognosis of CRO suffering in patients with acute cholangitis.Results: We identified 35 patients colonized with CRO from 503 acute cholangitis patients. In the multivariate analysis, tumor (OR=7.09, 95% CI=1.11â 45.30, P=0.038) and chronic kidney disease (OR=8.70, 95% CI=2.11â 35.88, P=0.003) were ascertained as the risk factors of the occurrence on CRO infection under the background of acute cholangitis. CRO infection was identified as an independent risk factor for acute cholangitis patient death (HR=5.147, 95% CI=1.475â 17.595, P=0.01) by Cox proportional-hazards regression.Conclusion: Tumor and chronic kidney disease may be risk factors for CRO infection. Patients diagnosed with acute cholangitis further infected with CRO had a poor prognosis and a more severe mortality. Active screening for CRO is expected to facilitate early prevention, diagnosis, and treatment of high-risk patients.Keywords: CRO, acute cholangitis, risk factors, prognosis
Published: 2022

11. Utilizing reclassification to explore characteristics and prognosis of KDIGOSCr AKI subgroups: a retrospective analysis of a multicenter prospective cohort study

Author: Renhua Sun, Shusheng Li, Youzhong An, Jun-Ping Qin, Xiangyou Yu, Chuanyun Qian, Erzhen Chen, Yan Kang, Xiaochun Ma, Tiehe Qin, Zhenyang He, Gui-Ying Dong, Zhenjie Hu, Yuhang Ai, Jiandong Lin, Mingyan Zhao, Jihong Zhu, Xiuming Xi, Fachun Zhou, Bin Du, Xiangyuan Cao, Li Jiang, Dawei Wu, and Yuan Xu
Subjects: Male, medicine.medical_specialty, medicine.medical_treatment, Critical Care and Intensive Care Medicine, intensive care unit, law.invention, length of stay, law, Risk Factors, Internal medicine, medicine, Humans, Renal replacement therapy, Stage (cooking), Prospective cohort study, Survival analysis, Aged, Retrospective Studies, business.industry, Acute kidney injury, General Medicine, Middle Aged, medicine.disease, Prognosis, Intensive care unit, Survival Analysis, mortality, kdigo, Diseases of the genitourinary system. Urology, Renal Replacement Therapy, Intensive Care Units, Respiratory failure, acute kidney injury, Nephrology, Creatinine, Practice Guidelines as Topic, Clinical Study, Female, RC870-923, business, Biomarkers, Kidney disease, Research Article
Abstract: Background Acute kidney injury (AKI) is widespread in the intensive care unit (ICU) and affects patient prognosis. According to Kidney Disease: Improving Global Outcomes (KDIGO) guidelines, the absolute and relative increases of serum creatinine (Scr) are classified into the same stage. Whether the prognosis of the two types of patients is similar in the ICU remains unclear. Methods According to the absolute and relative increase of Scr, AKI stage 1 and stage 3 patients were divided into stage 1a and 1b, stage 3a and 3b groups, respectively. Their demographics, laboratory results, clinical characteristics, and outcomes were analyzed retrospectively. Results Of the 345 eligible cases, we analyzed stage 1 because stage 3a group had only one patient. Using 53 or 61.88 µmol/L as the reference Scr (Scrref), no significant differences were observed in ICU mortality (P53=0.076, P61.88=0.070) or renal replacement therapy (RRT) ratio, (P53=0.356, P61.88=0.471) between stage 1a and 1b, but stage 1b had longer ICU length of stay (LOS) than stage 1a (P53
Published: 2021

12. Coronavirus disease 2019 (COVID-19): cytokine storms, hyper-inflammatory phenotypes, and acute respiratory distress syndrome

Author: Fang Fang Xu, Yi-si Zhao, Fachun Zhou, Shi-hui Lin, and Dai-xing Zhou
Subjects: 0301 basic medicine, ARDS, lcsh:QH426-470, Coronavirus disease 2019 (COVID-19), medicine.medical_treatment, Acute respiratory distress, Biochemistry, Article, 03 medical and health sciences, 0302 clinical medicine, medicine, Genetics(clinical), 030212 general & internal medicine, Molecular Biology, Genetics (clinical), lcsh:R5-920, SARS-CoV-2, business.industry, Incidence (epidemiology), COVID-19, Cell Biology, acute respiratory distress syndrome, medicine.disease, Phenotype, lcsh:Genetics, 030104 developmental biology, Cytokine, hyper-inflammatory host response, cytokine storm, Immunology, lcsh:Medicine (General), Complication, Cytokine storm, business
Abstract: Coronavirus Disease 2019 (COVID-19) was first identified in China at the end of 2019. Acute respiratory distress syndrome (ARDS) represents the most common and serious complication of COVID-19. Cytokine storms are a pathophysiological feature of COVID-19 and play an important role in distinguishing hyper-inflammatory subphenotypes of ARDS. Accordingly, in this review, we focus on hyper-inflammatory host responses in ARDS that play a critical role in the differentiated development of COVID-19. Furthermore, we discuss inflammation-related indicators that have the potential to identify hyper-inflammatory subphenotypes of COVID-19, especially for those with a high risk of ARDS. Finally, we explore the possibility of improving the quality of monitoring and treatment of COVID-19 patients and in reducing the incidence of critical illness and mortality via better distinguishing hyper- and hypo-inflammatory subphenotypes of COVID-19.
Published: 2020
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13. The clinical and immunological features of pediatric COVID-19 patients in China

Author: Jiang-Lin Xiang, Yao-kai Chen, Guicheng Wu, Dao-Xin Wang, Ailong Huang, Ni Tang, Yuan Hu, Bei-zhong Liu, Juan Chen, Peng Hu, Pu-Liao, Zhenzhen Zhang, Haijun Deng, Quanxin Long, Jieli Hu, Wen-Guang Tian, Xian-Xiang Zhang, Xue-Fei Cai, Hong-Mei Xu, Deqiang Wang, Fachun Zhou, and Zhijie Li
Subjects: 0301 basic medicine, medicine.medical_specialty, lcsh:QH426-470, T cell, Disease, Biochemistry, Article, Incubation period, 03 medical and health sciences, 0302 clinical medicine, Immune system, Internal medicine, medicine, Genetics(clinical), 030212 general & internal medicine, Molecular Biology, Genetics (clinical), lcsh:R5-920, medicine.diagnostic_test, biology, business.industry, SARS-CoV-2, Nucleic acid test, COVID-19, Clinical features, Paediatrics, Cell Biology, Immune, Diarrhea, lcsh:Genetics, 030104 developmental biology, medicine.anatomical_structure, biology.protein, medicine.symptom, Antibody, business, lcsh:Medicine (General), CD8
Abstract: In December 2019, the corona virus disease 2019 (COVID-19) caused by novel coronavirus (SARS-CoV-2) emerged in Wuhan, China and rapidly spread worldwide. Few information on clinical features and immunological profile of COVID-19 in paediatrics. The clinical features and treatment outcomes of twelve paediatric patients confirmed as COVID-19 were analyzed. The immunological features of children patients was investigated and compared with twenty adult patients. The median age was 14.5-years (range from 0.64 to 17), and six of the patients were male. The average incubation period was 8 days. Clinically, cough (9/12, 75%) and fever (7/12, 58.3%) were the most common symptoms. Four patients (33.3%) had diarrhea during the disease. As to the immune profile, children had higher amount of total T cell, CD8+ T cell and B cell but lower CRP levels than adults (P
Published: 2020

14. Evolution Over Time of Ventilatory Management and Outcome of Patients With Neurologic Disease

Author: Tejerina E. E., Pelosi P., Robba C., Penuelas O., Muriel A., Barrios D., Frutos-Vivar F., Raymondos K., Du B., Thille A. W., Rios F., Gonzalez M., Del-Sorbo L., Marin M. D. C., Valle Pinheiro B., Soares M. A., Nin N., Maggiore S. M., Bersten A., Amin P., Cakar N., Young Suh G., Abroug F., Jibaja M., Matamis D., Ali Zeggwagh A., Sutherasan Y., Anzueto A., Esteban A, Fernando Ríos, Damian Violi, Marisol Rodríguez-Goñi, Roger Lamoglie, Fernando Villarejo, Norberto Tiribelli, Santiago Ilutovich, Matías Brizuela, Mariana Monllau, Fernando Saldarini, Silvina Borello, Alberto Marino, Mauricio Vinzio, Karina Bonasegla, Julián Hernández, María Belén Yapur, María Eugenia González, Sebastián E Mare, Judith Sagardía, Marco Bezzi, Cecilia Pereyra, Julian Strati, Daniel Vargas, Claudia Diaz, Pablo Gómez, Marcelo Palavecino, Graciela Elizabeth, Aguilera García, M Eugenia, Luis Pablo Cardonnet, Lisandro Betttini, Hernán Nuñez, Lucas Vallejo, Fernando Fernández, Jorge Arroyo, Daniel Duarte, Gerardo Filippa, Cayetano Galetti, Hernan Nunia, Fernando Lambert, Elisa Estenssoro, Marina Busico, Javier Horacio Álvarez, Alejandro Raimondi, Gustavo Badariotti, Martín Lugaro, Fernando Lipovestky, Alan Javier Zazu, Hugo Capponcelli, Patricia Vogl, Cristina Orlandi, Alejandro Gómez, Gustavo Jannello, Alejandro Risso, Leticia Rapetti, Guillermo Chiappero, Juan Domingo Fernández, Rodrigo E Gómez-Paz, Marcos Juan Zec, Pascual Valdez, Jorgelina Guyon, Ariel Chena, Sergio Lasdica, Martin Deheza, Schimdt Alejandra, Francisco Criado, Norma Beatriz Márquez, Pablo Desmery, José Luis Scapellato, Gonzalo Javier Ríos, Cristian Casabella, Jasmin Board, Andrew Davies, Andrew Bersten, Elisha Matheson, Amy Waters, John Santamaria, Jennifer Holmes, Cartan Costello, Manoj K Saxena, John Myburgh, Ellen Kinkel, Forbes McGain, Claire Cattigan, Allison Bone, Ian Seppelt, Leonie Weisbrodt, Cheryl Cuzner, Christopher MacIsaac, Deborah Barge, Tania Caf, Cameron Knott, Graeme Duke, Imogen Mitchell, Helen Rodgers, Rachel Whyte, Elisha Fulton, Alistair Nichol, Hergen Buscher, Priya Nair, Claire Reynolds, Simon J G Hockley, Ian Moore, Katherine Davidson, David Milliss, Raju Pusapati, Helen Wong, Jason Fletcher, Julie Smith, Paul Goldrick, Dianne Stephens, Jane Thomas, Anders Aneman, Sutrisno Gunawan, Tom Cowlam, George Lukas, Rick McAllister, Minka Springham, Joanne Sutton, Jeff Presneill, Tony Sutherland, Dianne Hill, Howard Connor, Jenny Dennett, Tim Coles, Freddy Sandy, Sando Chavarria, Marcelo Choque, Ronald Pairumani, Juan Guerra, Marco Antônio Soares Reis, José Carlos Versiani, Eduardo Fonseca Sad, Maria Aparecida Braga, Dinalva Aparecida Gomes, Fernando Antônio Botoni, Maurício Meireles Góes, Frederico Costa Val Barros, Rogério de Castro Pereira, Hugo Urbano, Valéria de Carvalho Magela, Aline Camile Yehia, Bruno Bonaccorsi Fernandino, Marco Antônio Ribeiro Leão, Rovílson Lara, Rubens Altair Amaral de Pádua, Janine Dias Alves, Aloísio Marques do Nascimento, Bruno do Valle Pinheiro, Carlos Alberto Studart Gomes, Marcelo Alcântara Holanda, Frederico Rodrigues Anselmo, Niall Ferguson, Neill Adhikari, Robert Fowler, Cheromi Sittambalam, Mehar-Un-Nisa Raja, Nicole Marinoff, Lauralyn McIntryre, Shawna Reddie, Laura Jones, Irene Watpool, Jeffrey Singh, Madison Dennis, Andrea Matte, Marc Lipkus, Ryan Albert, Andrew Steel, Emily Stern, Michael Miletin, Antonio Raso, Robyn Klages, Jan Friedrich, Orla Smith, Laura Wilson, Deborah Cook, Mark Bailey, Sangeeta Mehta, Stephen Lapinsky, Hannah Mathers, Cheryl Ethier, Stephanie Lubchansky, Samer Haj-Bakri, Dietrich Henzler, Lisa Julien, Luis Soto-Román, Juan Carlos Maurelia, César Antonio Maquilon, Luis Soto-Germani, Bin Du, Yan Kang, Bo Wang, Fachun Zhou, Fang Xu, Haibo Qiu, Yi Yang, Qingyuan Zhan, Bing Sun, Zhenjie Hu, Bin Yu, Xi Zhu, Yu Bai, Gang Li, Yi Li, Geng Zhang, Jianbiao Meng, Xiaobo Huang, Hong Pu, Daxing Yu, Chuanyun Qian, Wei Zhang, Yongjie Yin, Debiao Song, Yunxuan Yue, Zhengxuan Lv, Chengmin Yu, Qunmei Yao, Xue Wang, Yuan Xu, Wei He, Mian Chen, Zhihua Hu, Dongpo Jiang, Jian Huang, Wei Yu, Juanxian Gu, Yangong Chao, Zhixiang Li, Zhicheng Zhang, Wanxia Li, Zhenyang He, Jianguo Li, Chang Liu, Tiehe Qin, Shouhong Wang, Feng Li, Jun Jin, Jianhong Fu, Hongyang Xu, Hongyuan Lin, Jianying Guo, Yalin Liu, Jinghua Wang, Maoqin Li, Jiaqiong Li, Lei Chen, Qing Song, Liang Pan, Xianyao Wan, Jiuzhi Zhang, Weihai Yao, Yuhong Guo, Pang Wing Yan, Kelly Choy, Kwan Ming Chit, Patricia Leung, Chau Chin Man, Marco González, Ricardo Buitrago, Marcela Granados, Guillermo Ortiz, Cesar Enciso, Mario Gómez, Bladimir Alejandro Gil, Juan Pablo Sedano, Luis Fernando Castro Castro, Carlo Alberto Acosta, Marco Gonzalez, Francisco Molina, Camilo Pizarro, Mario Villabon, Carmelo Dueñas, Carlos Andrés Díaz, Nelson Fonseca, Rubén Camargo, Juan David Uribe, Hans-Henrik Bülow, Simona Beniczky, Jens Brushoj, Mikkel Præst, Birgitte Viebaek, Sine Wichman, Anette Mortensen, Susanne Andi Iversen, Bo Broberg, Edgard Luna, Manuel Jibaja, Leonardo Pazmiño, Katty Trelles, Fabricio Picoita, Gustavo Paredes, Vanesa Ramírez, Guillermo Falconí, Cristian Cevallos, Boris Villamagua, Marco Escobar, Freddy Sánchez, Miguel Llano, Miguel Lazcano, Ramiro Puetate, José Miguel Guerrero, Mijail Játiva, Myriam Montalvo, Franklin Villegas, Luis González Zambrano, Ronnie Mantilla, Gina Quinde, Andrea Gimenez, Luis Gonzalez Mosquera, Henry Caballero, María Fernanda García, Marcelo Ochoa, Soraya Puertas, Jackeline Coello, Mario Acosta, Medhat Soliman, Arnaud W Thille, Achille Kouatchet, Alain Mercat, Laurent Brochard, François Collet, Guillaume Marcotte, Pascal Beuret, Jean-Christophe M Richard, Gaëtan Bedunaeu, Pierre-Gildas Guitard, Fabien Soulis, Frédéric Bellec, Philippe Berger, Dorothée Carpentier, Benoit Veber, Salem Ould Zein, Géraldine Dessertaine, C Canevet, Fabien Grelon, Konstantinos Raymondos, Rolf Dembinski, Rolf Rossaint, Steffen Weber-Carstens, Christian Putensen, Maximillian Ragaller, Michael Quintel, Winfried Schubert, Thomas Bein, Heinrich Paulus, Walter Brandt, Lutz Pfeiffer, Silke Frenzel, Thoralf Kerner, P Kruska, Leila Eckholt, Joachim Hartung, Harald Fritz, Monika Holler, Johannes Busch, Andreas Viehöfer, Jens Buettner, Jörn Schlechtweg, Achim Lunkeit, Roland Schneider, Maria Wussow, Nils Marquardt, Christian Frenkel, Falk Hildebrandt, Tumbass Volker, Thomas Lipp, Cezar Mihailescu, Thomas Moellhoff, Thomas Steinke, Oliver Franke, Marcus Ruecker, Markus Schappacher, Steffen Appel, Heinz Kerger, Andreas Schwartz, Jan Dittmann, Jörg Haberkorn, Wolfgang Baier, Walter Seyde, Dimitros Matamis, Eleni Antoniadou, Pertsas Evangelos, Maria Giannakou, Zoltan Szentkereszty, Zsolt Molnar, Pravin Amin, Farhad N Kapadia, Nagarajan Ramakrishnan, Deepak Govil, Anitha Shenoy, Umesh G, Samir Sahu, Sheila Nainan Myatra, Subhash Kumar Todi, Sanjay Dhanuka, Mayur Patel, P Samaddar, Dhruva Chaudhry, Vivek Joshi, Srinivas Samavedam, Ankur Devendra Bhavsar, Prachee Sathe, Sujoy Mukherjee, Salvatore Maurizio Maggiore, Francesco Idone, Federica Antonicelli, Paolo Navalesi, Rosanna Vaschetto, Arianna Boggero, Rosalba Tufano, Michele Iannuzzi, Edoardo De Robertis, Romano Tetamo, Andrea Neville Cracchiolo, Antonio Braschi, Francesco Mojoli, Ilaria Curro', Mirko Belliato, Chiara Verga, Marta Ferrari, Erika Mannelli, Valerio Mangani, Giorgio Tulli, Francesca Frigieri, Armando Pedulla', Monica Rocco, Giorgia Citterio, Di Russo, Gaetano Perchiazzi, Loredana Pitagora, Antonio Pesenti, Michela Bombino, Davide Chiumello, Federica Tallarini, Serena Azzari, Antonina Pigna, Ivano Aprile, Marco Adversi, Antonio Corcione, Marianna Esposito, Annunziata Mattei, Vito Marco Ranieri, Rosario Urbino, Ilaria Maria Mastromauro, Antonino Giarratano, Maurizio Raineri Santi, Ambrogio Sansone, Younsuck Koh, Moo Suk Park, Je Hyeong Kim, Kyung Chan Kim, Hye Sook Choi, Yun Seong Kim, Jin Hwa Lee, Myung-Goo Lee, Won-Yeon Lee, Jin Young An, Gee Young Suh, Ki-Suck Jung, Asisclo J Villagómez Ortiz, César Cruz Lozano, Zalatiel Maycotte Luna, José Francisco López Baca, José Elizalde, Guillermo Cueto Robledo, Mario Alonso Treviño Salinas, Ricardo Martinez Zubieta, Claudia Olvera-Guzman, Marco Montes De Oca, Silvio A Ñamendys-Silva, José Salvador Martínez Cano, Jose Angel Baltazar Torres, Gustavo Morales Muñoz, Antonio Villa Delgado, Javier Ladape Martinez, Amine Ali Zeggwagh, Tarek Dendane, Abderrahim Azzouzi, Ahmed Sbihi, Wajdi Maazouzi, Mourad Amor, Charki Haimeur, Michael A Kuiper, Matty Koopmans, Uli Strauch, Dennis Bergmans, Serge Heines, Sylvia den Boer, Bas M Kors, Peter van der Voort, Paul J Dennesen, Bert Beishuizen, Ingrid van den Hul, Erna Alberts, Harry P P M Gelissen, Eduard Bootsma, Auke Reidinga, Kim Heus, Diane Mackle, Paul Young, Rachael Parke, Eileen Gilder, Jodi Brown, Lynette Newby, Catherine Simmonds, Jan Mehrtens, Seton Henderson, Tony Williams, Judi Tai, Chantal Hogan, Mary La Pine, John Durning, Sheree Gare, Troy Browne, Shirley Nelson, Jennifer Goodson, Julio Osorio, Chabu Coronado, Rollin Roldán Mori, Rosa Luz López Martínez, Adam Mikstacki, Barbara Tamowicz, Rui Moreno, Eduardo Almeida, Joana Silvestre, Heloisa Castro, Irene Aragão, Susana Alves Ferreira, Nelson Barros, Filomena Faria, Carlos André Correia Casado, Fausto Fialho Moura, Paulo Marcal, Ricardo Matos, Edward Nicolayenko, Mikhail Kirov, Andrey Yaroshetskiy, Andrei Piontek, Valery Subbotin, Yaseen Arabi, Olivia Dulfo, Chafrina Marie Olay, Edgardo E Tabhan, Nicolas Nin, Alfonso Muñoz, César Aragón, Ana Villagrá, Ainhoa Rosselló, Joan Maria Raurich, María Garitacelaya, Miguel Ángel González-Gallego, Francisco Ortuño, Miguel Fernández-Vivas, David Freire, Francisco Guerrero, Francisco Manzano, Juan Carlos, Alfredo Padrón, Pedro Rosa, Rafael Morales, Liliana Caipe, Maurizio Bottiroli, José María Nicolás, Marta Ugalde, Javier Ruiz, Lucia Capilla, Guillermo Muñiz, Jesús Sánchez-Ruiz, Javier Cebrián, Begoña Balerdi, Elena Parreño, Alvaro van Bommel, César Pérez-Calvo, Irene Dot, Javier Blanco, Raquel Manzanedo, José J Blanco, Daniel Fontaneda, Raúl González, Javier Díaz Domínguez, Alfonso Moreno, Antonio Reyes, Ian Carrasco, Itziar Mintegui, Rosa Sebastián, Javier García-Alonso, Carolina Lorencio, Josep Maria Sirvent, Patricia Jimeno, Miguel León, Pedro Galdos, Nuria Alonso, Julia López-Díaz, María Victoria de la Torre, Jorge Vidal Hernández, Nicolás Zamboschi, Francisco Lucena, Gemma Rialp, Raquel Montoiro, Victoria Goñi, María Ángeles Pena, Antonio Maestre, Marc Fabra, Jacinto Baena, Eva Benveniste, Susana Temprano, Jesús Sánchez, Carmen Campos, Sara Cabañes, María Elena Pérez-Losada, José Claudio Leo, Enrique Piacentini, María Del Carmen de la Torre, Laura Álvarez-Montero, Fernando Sánchez, Antonio Viñuales, Bernabé Álvarez, Javier Castañeda, Ángela Alonso, María Isabel Ruiz, Pedro Jesús Domínguez, Marcos Delgado, Eugenio Palazón, Antonio García-Jiménez, Rosa Álvaro, Clara Laplaza Eva Regidor, Enrique Maraví, José María Quiroga, Amalia Martínez de la Gandara, Cecilia Carbayo, María Luisa Navarrete, Manuel Valledor, Raquel Yano, José María Gutiérrez, Javier González-Robledo, Amparo Ferrandiz, Alberto Belenguer, Lidón Mateu, Laura Sayagues, María José Tolón, Nieves Franco, Elena Gallego, Félix Lacoma, Patricia Albert, 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Vasquez-Sandoval, Vincent John Scott, Craig Cernosek, Christopher Spradley, Dimple Tejwani, Sindhaghatta Venkatram, Gilda Diaz-Fuentes, Amber Monson, Anthony Saleh, Madhav Gudi, George Liziamma, Mohamed A Saad, Crissie De Spirito, Bryan Beatty, Samir Vermani, Crissie Despirito, Zaza Cohen, Amee Patrawalla, Samir Abdelhadi, Rupesh Vakil, Steven Y Chang, Brian Sherman, Rosanna Del Giudice, John Oropell, Timothy D Girard, Cayce Strength, Joyce Okahashi, Leanne Boehm, Matthew Kirchner, Erwin J Oei, Sebastian Circo, Nelson Medina, Mohammed Al-Jagbeer, V J Cardenas Jr, Smyth Smith, Shelby Sutton, Marcela Canola-Mazo, Tim Houlihan, Yogeet Kaur, Travis Parry, Craig A Piquette, Kerry Canady, Rahul Nanchal, Dana K Soetaert, Maria Del Mar Torres-Perez, Carlos Robles-Arias, William Rodriguez-Cintron, Mark Tidswell, Jennifer Germain, Lori-Ann Kozikowski, Erin Braden, Geneva Tatem, Javier Hurtado, Alberto Deicas, Daniel Weiss, Marta Beron, Román Garrido, Cristina Santos, Mario Cancela, Raúl Lombardi, Pedro Alzugaray, Jorge Gerez, Silvia Mareque, Graciela Franca, Oscar Cluzet, Edgardo Nuñez, Julio Pontet, Sergio Cáceres, Elias Caragna, Alberto Soler, Frank Torres, Gastón Pittini, Gabriel D Empaire, Stevens Salva, Fernando Pérez, Clara Pacheco, Zoraida Parra, Ingrid Von der Osten, Luis Williams, José Salinas, Do Danh Quynh, Pham Thi Van Anh, Nguyen Huu Hoang, Nghuyen Ba Tuan, RS: NUTRIM - R2 - Liver and digestive health, MUMC+: MA Arts Assistenten IC (9), Intensive Care, MUMC+: MA Medische Staf IC (9), Tejerina E.E., Pelosi P., Robba C., Penuelas O., Muriel A., Barrios D., Frutos-Vivar F., Raymondos K., Du B., Thille A.W., Rios F., Gonzalez M., Del-Sorbo L., Marin M.D.C., Valle Pinheiro B., Soares M.A., Nin N., Maggiore S.M., Bersten A., Amin P., Cakar N., Young Suh G., Abroug F., Jibaja M., Matamis D., Ali Zeggwagh A., Sutherasan Y., Anzueto A., Esteban A, and Fernando Ríos, Damian Violi, Marisol Rodríguez-Goñi, Roger Lamoglie, Fernando Villarejo, Norberto Tiribelli, Santiago Ilutovich, Matías Brizuela, Mariana Monllau, Fernando Saldarini, Silvina Borello, Alberto Marino, Norberto Tiribelli, Mauricio Vinzio, Karina Bonasegla, Julián Hernández, María Belén Yapur, María Eugenia González, Sebastián E Mare, Judith Sagardía, Marco Bezzi, Cecilia Pereyra, Julian Strati, Daniel Vargas, Claudia Diaz, Pablo Gómez, Marcelo Palavecino, Graciela Elizabeth, Aguilera García, M Eugenia, Luis Pablo Cardonnet, Lisandro Betttini, Hernán Nuñez, Lucas Vallejo, Fernando Fernández, Jorge Arroyo, Daniel Duarte, Gerardo Filippa, Cayetano Galetti, Hernan Nunia, Fernando Lambert, Elisa Estenssoro, Marina Busico, Fernando Villarejo, Javier Horacio Álvarez, Alejandro Raimondi, Gustavo Badariotti, Martín Lugaro, Fernando Lipovestky, Alan Javier Zazu, Hugo Capponcelli, Patricia Vogl, Cristina Orlandi, Alejandro Gómez, Gustavo Jannello, Alejandro Risso, Leticia Rapetti, Guillermo Chiappero, Juan Domingo Fernández, Rodrigo E Gómez-Paz, Marcos Juan Zec, Pascual Valdez, Jorgelina 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Friedrich, Orla Smith, Laura Wilson, Deborah Cook, Mark Bailey, Sangeeta Mehta, Stephen Lapinsky, Hannah Mathers, Cheryl Ethier, Stephanie Lubchansky, Samer Haj-Bakri, Dietrich Henzler, Lisa Julien, Luis Soto-Román, Juan Carlos Maurelia, César Antonio Maquilon, Luis Soto-Germani, Bin Du, Yan Kang, Bo Wang, Fachun Zhou, Fang Xu, Haibo Qiu, Yi Yang, Qingyuan Zhan, Bing Sun, Zhenjie Hu, Bin Yu, Xi Zhu, Yu Bai, Gang Li, Yi Li, Geng Zhang, Jianbiao Meng, Xiaobo Huang, Hong Pu, Bin Du, Daxing Yu, Chuanyun Qian, Wei Zhang, Yongjie Yin, Debiao Song, Yunxuan Yue, Zhengxuan Lv, Chengmin Yu, Qunmei Yao, Xue Wang, Yuan Xu, Wei He, Mian Chen, Zhihua Hu, Dongpo Jiang, Jian Huang, Wei Yu, Juanxian Gu, Yangong Chao, Zhixiang Li, Zhicheng Zhang, Wanxia Li, Zhenyang He, Jianguo Li, Chang Liu, Tiehe Qin, Shouhong Wang, Feng Li, Jun Jin, Jianhong Fu, Hongyang Xu, Hongyuan Lin, Jianying Guo, Yalin Liu, Jinghua Wang, Maoqin Li, Jiaqiong Li, Lei Chen, Qing Song, Liang Pan, Xianyao Wan, Jiuzhi Zhang, Weihai Yao, Yuhong Guo, Pang Wing Yan, Kelly Choy, Kwan Ming Chit, Patricia Leung, Chau Chin Man, Marco González, Ricardo Buitrago, Marcela Granados, Guillermo Ortiz, Cesar Enciso, Mario Gómez, Bladimir Alejandro Gil, Juan Pablo Sedano, Luis Fernando Castro Castro, Carlo Alberto Acosta, Marco Gonzalez, Francisco Molina, Camilo Pizarro, Mario Villabon, Carmelo Dueñas, Carlos Andrés Díaz, Nelson Fonseca, Rubén Camargo, Juan David Uribe, Hans-Henrik Bülow, Simona Beniczky, Jens Brushoj, Mikkel Præst, Birgitte Viebaek, Sine Wichman, Anette Mortensen, Susanne Andi Iversen, Bo Broberg, Edgard Luna, Manuel Jibaja, Leonardo Pazmiño, Katty Trelles, Fabricio Picoita, Gustavo Paredes, Vanesa Ramírez, Guillermo Falconí, Cristian Cevallos, Boris Villamagua, Marco Escobar, Freddy Sánchez, Miguel Llano, Miguel Lazcano, Ramiro Puetate, José Miguel Guerrero, Mijail Játiva, Myriam Montalvo, Franklin Villegas, Luis González Zambrano, Ronnie Mantilla, Gina Quinde, Andrea Gimenez, Luis Gonzalez Mosquera, Henry Caballero, María Fernanda García, Marcelo Ochoa, Soraya Puertas, Jackeline Coello, Mario Acosta, Medhat Soliman, Arnaud W Thille, Achille Kouatchet, Alain Mercat, Laurent Brochard, François Collet, Guillaume Marcotte, Pascal Beuret, Jean-Christophe M Richard, Gaëtan Bedunaeu, Pierre-Gildas Guitard, Fabien Soulis, Frédéric Bellec, Philippe Berger, Dorothée Carpentier, Benoit Veber, Salem Ould Zein, Géraldine Dessertaine, C Canevet, Fabien Grelon, Konstantinos Raymondos, Rolf Dembinski, Rolf Rossaint, Steffen Weber-Carstens, Christian Putensen, Maximillian Ragaller, Michael Quintel, Winfried Schubert, Thomas Bein, Heinrich Paulus, Walter Brandt, Lutz Pfeiffer, Silke Frenzel, Thoralf Kerner, P Kruska, Leila Eckholt, Joachim Hartung, Harald Fritz, Monika Holler, Johannes Busch, Andreas Viehöfer, Jens Buettner, Jörn Schlechtweg, Achim Lunkeit, Roland Schneider, Maria Wussow, Nils Marquardt, Christian Frenkel, Falk Hildebrandt, Tumbass Volker, Thomas Lipp, Cezar Mihailescu, Thomas Moellhoff, Thomas Steinke, Oliver Franke, Marcus Ruecker, Markus Schappacher, Steffen Appel, Heinz Kerger, Andreas Schwartz, Jan Dittmann, Jörg Haberkorn, Wolfgang Baier, Walter Seyde, Dimitros Matamis, Eleni Antoniadou, Pertsas Evangelos, Maria Giannakou, Zoltan Szentkereszty, Zsolt Molnar, Pravin Amin, Farhad N Kapadia, Nagarajan Ramakrishnan, Deepak Govil, Anitha Shenoy, Umesh G, Samir Sahu, Sheila Nainan Myatra, Subhash Kumar Todi, Sanjay Dhanuka, Mayur Patel, P Samaddar, Dhruva Chaudhry, Vivek Joshi, Srinivas Samavedam, Ankur Devendra Bhavsar, Prachee Sathe, Sujoy Mukherjee, Salvatore Maurizio Maggiore, Francesco Idone, Federica Antonicelli, Paolo Navalesi, Rosanna Vaschetto, Arianna Boggero, Rosalba Tufano, Michele Iannuzzi, Edoardo De Robertis, Romano Tetamo, Andrea Neville Cracchiolo, Antonio Braschi, Francesco Mojoli, Ilaria Curro', Mirko Belliato, Chiara Verga, Marta Ferrari, Erika Mannelli, Valerio Mangani, Giorgio Tulli, Francesca Frigieri, Armando Pedulla', Monica Rocco, Giorgia Citterio, Di Russo, Gaetano Perchiazzi, Loredana Pitagora, Antonio Pesenti, Michela Bombino, Davide Chiumello, Federica Tallarini, Serena Azzari, Antonina Pigna, Ivano Aprile, Marco Adversi, Antonio Corcione, Marianna Esposito, Annunziata Mattei, Vito Marco Ranieri, Rosario Urbino, Ilaria Maria Mastromauro, Antonino Giarratano, Maurizio Raineri Santi, Ambrogio Sansone, Younsuck Koh, Moo Suk Park, Je Hyeong Kim, Kyung Chan Kim, Hye Sook Choi, Yun Seong Kim, Jin Hwa Lee, Myung-Goo Lee, Won-Yeon Lee, Jin Young An, Gee Young Suh, Ki-Suck Jung, Asisclo J Villagómez Ortiz, César Cruz Lozano, Zalatiel Maycotte Luna, José Francisco López Baca, José Elizalde, Guillermo Cueto Robledo, Mario Alonso Treviño Salinas, Ricardo Martinez Zubieta, Claudia Olvera-Guzman, Marco Montes De Oca, Silvio A Ñamendys-Silva, José Salvador Martínez Cano, Jose Angel Baltazar Torres, Gustavo Morales Muñoz, Antonio Villa Delgado, Javier Ladape Martinez, Amine Ali Zeggwagh, Tarek Dendane, Abderrahim Azzouzi, Ahmed Sbihi, Wajdi Maazouzi, Mourad Amor, Charki Haimeur, Michael A Kuiper, Matty Koopmans, Uli Strauch, Dennis Bergmans, Serge Heines, Sylvia den Boer, Bas M Kors, Peter van der Voort, Paul J Dennesen, Bert Beishuizen, Ingrid van den Hul, Erna Alberts, Harry P P M Gelissen, Eduard Bootsma, Auke Reidinga, Jasmin Board, Andrew Davies, Kim Heus, Diane Mackle, Paul Young, Rachael Parke, Eileen Gilder, Jodi Brown, Lynette Newby, Catherine Simmonds, Jan Mehrtens, Seton Henderson, Tony Williams, Judi Tai, Chantal Hogan, Mary La Pine, John Durning, Sheree Gare, Troy Browne, Shirley Nelson, Jennifer Goodson, Julio Osorio, Chabu Coronado, Rollin Roldán Mori, Rosa Luz López Martínez, Adam Mikstacki, Barbara Tamowicz, Rui Moreno, Eduardo Almeida, Joana Silvestre, Heloisa Castro, Irene Aragão, Susana Alves Ferreira, Nelson Barros, Filomena Faria, Carlos André Correia Casado, Fausto Fialho Moura, Paulo Marcal, Ricardo Matos, Edward Nicolayenko, Mikhail Kirov, Andrey Yaroshetskiy, Andrei Piontek, Valery Subbotin, Yaseen Arabi, Olivia Dulfo, Chafrina Marie Olay, Edgardo E Tabhan, Nicolas Nin, Alfonso Muñoz, César Aragón, Ana Villagrá, Ainhoa Rosselló, Joan Maria Raurich, María Garitacelaya, Miguel Ángel González-Gallego, Francisco Ortuño, Miguel Fernández-Vivas, David Freire, Francisco Guerrero, Francisco Manzano, Juan Carlos, Alfredo Padrón, Pedro Rosa, Rafael Morales, Liliana Caipe, Maurizio Bottiroli, José María Nicolás, Marta Ugalde, Javier Ruiz, Lucia Capilla, Guillermo Muñiz, Jesús Sánchez-Ruiz, Javier Cebrián, Begoña Balerdi, Elena Parreño, Alvaro van Bommel, César Pérez-Calvo, Irene Dot, Javier Blanco, Raquel Manzanedo, José J Blanco, Daniel Fontaneda, Raúl González, Javier Díaz Domínguez, Alfonso Moreno, Antonio Reyes, Ian Carrasco, Itziar Mintegui, Rosa Sebastián, Javier García-Alonso, Carolina Lorencio, Josep Maria Sirvent, Patricia Jimeno, Miguel León, Pedro Galdos, Nuria Alonso, Julia López-Díaz, María Victoria de la Torre, Jorge Vidal Hernández, Nicolás Zamboschi, Francisco Lucena, Gemma Rialp, Raquel Montoiro, Victoria Goñi, María Ángeles Pena, Antonio Maestre, Marc Fabra, Jacinto Baena, Eva Benveniste, Susana Temprano, Jesús Sánchez, Carmen Campos, Sara Cabañes, María Elena Pérez-Losada, José Claudio Leo, Enrique Piacentini, María Del Carmen de la Torre, Laura Álvarez-Montero, Fernando Sánchez, Antonio Viñuales, Bernabé Álvarez, Javier Castañeda, Ángela Alonso, María Isabel Ruiz, Pedro Jesús Domínguez, Marcos Delgado, Eugenio Palazón, Antonio García-Jiménez, Rosa Álvaro, Clara Laplaza Eva Regidor, Enrique Maraví, José María Quiroga, Amalia Martínez de la Gandara, Cecilia Carbayo, María Luisa Navarrete, Manuel Valledor, Raquel Yano, José María Gutiérrez, Javier González-Robledo, Amparo Ferrandiz, Alberto Belenguer, Lidón Mateu, Laura Sayagues, María José Tolón, Nieves Franco, Elena Gallego, Félix Lacoma, Patricia Albert, Vicente Arraez, Mar Gobernado, Susana Moradillo, Carolina Gímenez-Esparza, Teresa Sánchez de Dios, Carlos Marian Crespo, Cecilia Hermosa, Federico Gordo, Genis Carrasco, María Ángeles Alonso, Alejandro Algora, Raúl de Pablo, Sofía García, Ana Carolina Caballero, José María Montón, Teresa Mut, Eva Manteiga, Alejandro de la Serna, Ana Esther Trujillo, Rafael Blancas, Inmaculada Vallverdú, José Manuel Serrano, Miquel Ferrer, Juan Diego Jiménez, Carlos Gallego, Dolores Vila, Luis Marina, Valentín Parra, Juan Ramón Cortés, Chen Chin-Ming, Ai-Chin Cheng, Fekri Abroug, Besbes Mohamed, Imed Chouchene, Mounir Bouaziz, Stambouli Neji, Islem Ouanes, Ayed Samia, Nahit Cakar, Ismail Kati, Ali Aydım Altunkan, Remzi Iscimen, Zafer Dogan, Bilge Çetin, Tayfun Adanir, Sabriye Guvenc, Unase Büyükkoçak, Antonio Anzueto, Ashley Ellis, Gary Kinasewitz, Allan Walkey, Phil Alkana, Gregory A Schmidt, Susan Gillen, Kathleen Lilli, Jennifer Twombley, Denice Wells, Larry Welder, Alejandro Arroliga, Alfredo Vasquez-Sandoval, Vincent John Scott, Craig Cernosek, Christopher Spradley, Dimple Tejwani, Sindhaghatta Venkatram, Gilda Diaz-Fuentes, Amber Monson, Anthony Saleh, Madhav Gudi, George Liziamma, Mohamed A Saad, Crissie De Spirito, Bryan Beatty, Samir Vermani, Crissie Despirito, Zaza Cohen, Amee Patrawalla, Samir Abdelhadi, Rupesh Vakil, Steven Y Chang, Brian Sherman, Rosanna Del Giudice, John Oropell, Timothy D Girard, Cayce Strength, Joyce Okahashi, Leanne Boehm, Matthew Kirchner, Ashley Ellis, Gary Kinasewitz, Erwin J Oei, Sebastian Circo, Nelson Medina, Mohammed Al-Jagbeer, V J Cardenas Jr, Smyth Smith, Shelby Sutton, Marcela Canola-Mazo, Tim Houlihan, Yogeet Kaur, Travis Parry, Craig A Piquette, Kerry Canady, Rahul Nanchal, Dana K Soetaert, Maria Del Mar Torres-Perez, Carlos Robles-Arias, William Rodriguez-Cintron, Mark Tidswell, Jennifer Germain, Lori-Ann Kozikowski, Erin Braden, Geneva Tatem, Javier Hurtado, Alberto Deicas, Daniel Weiss, Marta Beron, Román Garrido, Cristina Santos, Mario Cancela, Raúl Lombardi, Pedro Alzugaray, Jorge Gerez, Silvia Mareque, Graciela Franca, Oscar Cluzet, Edgardo Nuñez, Julio Pontet, Sergio Cáceres, Elias Caragna, Alberto Soler, Frank Torres, Gastón Pittini, Gabriel D Empaire, Stevens Salva, Fernando Pérez, Clara Pacheco, Zoraida Parra, Ingrid Von der Osten, Luis Williams, José Salinas, Do Danh Quynh, Pham Thi Van Anh, Nguyen Huu Hoang, Nghuyen Ba Tuan
Subjects: Male, medicine.medical_treatment, pulmonary complications, RESPIRATORY-DISTRESS-SYNDROME, Critical Care and Intensive Care Medicine, CASE-FATALITY, 0302 clinical medicine, Risk Factors, Brain Injuries, Traumatic, Multicenter Studies as Topic, Hospital Mortality, Prospective Studies, Simplified Acute Physiology Score, Stroke, POPULATION, Age Factors, ANEURYSMAL SUBARACHNOID HEMORRHAGE, Middle Aged, Hemorrhagic Stroke, Intensive Care Units, Observational Studies as Topic, Anesthesia, Breathing, Female, medicine.symptom, Ventilator Weaning, Cohort study, Adult, TRAUMATIC BRAIN-INJURY, Pressure support ventilation, mechanical ventilation, prognosis factors, ACUTE LUNG INJURY, 03 medical and health sciences, medicine, Humans, Aged, Ischemic Stroke, Mechanical ventilation, Noninvasive Ventilation, business.industry, MORTALITY, neurologic patients, Organ dysfunction, 030208 emergency & critical care medicine, Length of Stay, medicine.disease, TRENDS, Respiration, Artificial, 030228 respiratory system, Etiology, NEUROCRITICAL CARE, Nervous System Diseases, Tracheotomy, business
Abstract: OBJECTIVES: To describe the changes in ventilator management over time in patients with neurologic disease at ICU admission and to estimate factors associated with 28-day hospital mortality. DESIGN: Secondary analysis of three prospective, observational, multicenter studies. SETTING: Cohort studies conducted in 2004, 2010, and 2016. PATIENTS: Adult patients who received mechanical ventilation for more than 12 hours. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Among the 20,929 patients enrolled, we included 4,152 (20%) mechanically ventilated patients due to different neurologic diseases. Hemorrhagic stroke and brain trauma were the most common pathologies associated with the need for mechanical ventilation. Although volume-cycled ventilation remained the preferred ventilation mode, there was a significant (p < 0.001) increment in the use of pressure support ventilation. The proportion of patients receiving a protective lung ventilation strategy was increased over time: 47% in 2004, 63% in 2010, and 65% in 2016 (p < 0.001), as well as the duration of protective ventilation strategies: 406 days per 1,000 mechanical ventilation days in 2004, 523 days per 1,000 mechanical ventilation days in 2010, and 585 days per 1,000 mechanical ventilation days in 2016 (p < 0.001). There were no differences in the length of stay in the ICU, mortality in the ICU, and mortality in hospital from 2004 to 2016. Independent risk factors for 28-day mortality were age greater than 75 years, Simplified Acute Physiology Score II greater than 50, the occurrence of organ dysfunction within first 48 hours after brain injury, and specific neurologic diseases such as hemorrhagic stroke, ischemic stroke, and brain trauma. CONCLUSIONS: More lung-protective ventilatory strategies have been implemented over years in neurologic patients with no effect on pulmonary complications or on survival. We found several prognostic factors on mortality such as advanced age, the severity of the disease, organ dysfunctions, and the etiology of neurologic disease.
Published: 2021
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15. Practice of Extracorporeal Therapies for Septic Acute Kidney Injury Patients in Intensive Care Units in Mainland China

Author: Minmin Wang, Xue Wang, Qiang Yao, Ling Zhang, Ping Chang, Jacques Goldstein, Xinyu Liu, Yu Zhou, and Fachun Zhou
Subjects: Male, China, medicine.medical_specialty, Time Factors, medicine.medical_treatment, 030232 urology & nephrology, 030204 cardiovascular system & hematology, Disease-Free Survival, Extracorporeal, law.invention, Sepsis, 03 medical and health sciences, 0302 clinical medicine, law, Intensive care, medicine, Humans, Renal replacement therapy, Intensive care medicine, Dialysis, business.industry, Organ dysfunction, Acute kidney injury, Hematology, General Medicine, Acute Kidney Injury, medicine.disease, Intensive care unit, Renal Replacement Therapy, Survival Rate, Intensive Care Units, Nephrology, Female, medicine.symptom, business
Abstract: Background: Continuous renal replacement therapy (CRRT) and other extracorporeal therapies for acute kidney injury (AKI) and other organ dysfunction syndromes in critically ill patients are common in the intensive care unit (ICU). Many studies have focused on clinical practice for managing these conditions. However, there are few studies that describe the utilization of extracorporeal therapies, especially CRRT, in patients with sepsis-associated AKI. Summary: Two hundred ICU physicians were included in a survey from February 28, 2017, to March 20, 2017, on the current status of septic AKI and clinical practice in CRRT. According to the responses, 40% of sepsis patients in the ICU had AKI, and 25% required extracorporeal therapies. However, 29% of candidates gave up therapy for medical or nonmedical reasons. Overall survival for sepsis was 60%; among survivors, 80% were dialysis free at discharge. CRRT was the most common modality of extracorporeal therapy in the ICU, and 82% of physicians chose convection as the major clearance mode. The survey showed 30% of physicians saw the removal of inflammatory mediators as the major objective of extracorporeal therapies; however, only 18.5% of physicians considered inflammation as a measure to trigger CRRT. The median treatment duration of CRRT in China was 12 h per day for 5 days. Key Messages: There were some similarities and differences in CRRT practice for septic AKI patients in China and globally. The differences reveal some insights into improving the outcomes of these patients.
Published: 2019
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16. FAM49B, restrained by miR-22, relieved hepatic ischemia/reperfusion injury by inhibiting TRAF6/IKK signaling pathway in a Rac1-dependent manner

Author: Zuotian Huang, Junliang Pu, Yunhai Luo, Jing Fan, Kaili Li, Dadi Peng, Kezhen Zong, Baoyong Zhou, Xiangdong Guan, and Fachun Zhou
Subjects: Inflammation, Male, TNF Receptor-Associated Factor 6, rac1 GTP-Binding Protein, Immunology, Intracellular Signaling Peptides and Proteins, I-kappa B Kinase, Mice, Inbred C57BL, Mice, MicroRNAs, RAW 264.7 Cells, Gene Expression Regulation, Liver, Reperfusion Injury, Animals, Pyrazoles, Molecular Biology, Signal Transduction
Abstract: Hepatic ischemia/reperfusion (I/R) injury plays a pivotal pathogenic role in trauma, hepatectomy, and liver transplantation. However, the whole mechanism remains undescribed. The objective of this study is to investigate the internal mechanism by which microRNA-22 (miR-22) targets family with sequence similarity 49 member B (FAM49B), thus aggravating hepatic I/R injury. Here, we found that miR-22 was upregulated while FAM49B was reduced in hepatic I/R injury. Inhibition of miR-22 in vitro was able to intensify expression of FAM49B, thus reducing phosphorylation of inhibitors of nuclear factor kappa-B kinase (IKK) and downstream pro-inflammatory proteins. A dual luciferase reporter assay indicated that miR-22 directly targeted FAM49B. Remission of hepatic pathologic alterations, apoptosis, and release of cytokines derived from constraints of miR-22 were abolished in vivo by repressing FAM49B. Further interference of Ras-related C3 botulinum toxin substrate 1 (Rac1) reversed the function of FAM49B inhibition, thus achieving anti-inflammatory consequences.
Published: 2021

17. COVID-19 mortality in ICUs associated with critical care staffing

Author: Xiandi He, Jing Yan, Yuhang Ai, Shusheng Li, Jingjing Xi, Kejian Qian, Yanping Mo, Chunting Wang, Yue Peng, Peng-Lin Ma, Fachun Zhou, Yan Kang, Yimin Li, Lin Zeng, Bing-Yu Qin, and Hua Zhang
Subjects: medicine.medical_specialty, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), business.industry, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Biomedical Engineering, MEDLINE, Staffing, Dermatology, Critical Care and Intensive Care Medicine, Emergency medicine, Emergency Medicine, Immunology and Allergy, Medicine, Surgery, business, Letter to the Editor
Published: 2021

18. Active Implementation of an Evidence-Based Nutrition Guideline for Critically Ill Patients Versus Standard Care: A Cluster Randomised, Multicentre, Controlled Trial

Author: Chuming Fan, Min Shao, Chunli Yang, Biao Ma, Xueyan Liu, Qiang Guo, Qiuhui Wang, Jianbo Liu, Linxi Huang, Chuanyun Qian, Weixing Zhang, Juang Xing, Wei Xing, Liming Gu, Cheng Sun, Jinglan Wu, Yuanqi Gong, Yuan Zong, Zhihui Tong, Yun Sun, Zhiyong Wang, Ping Chang, Feng Guo, Lihua Zhou, Wenming Liu, Weiqin Li, Hailing Li, Minjie Zhang, Yan Gao, Kejian Qian, Dong-po Jiang, Baocai Fu, Zhiping Li, Rongqing Sun, Liandi Li, Yan Qu, Zhongheng Zhang, Rumin Zhang, Feng Shan, Ming Wu, Lei Wang, Weihua Lu, Junli Sun, Aibin Cheng, Xijing Zhang, Yang Wang, Tingfa Zhou, Yuanfei Li, Zhaohui Zhang, Peiyang Gao, Yang Liu, Min Yu, Wei Li, Bingyu Qin, Yongjian Feng, Jiandong Lin, Bin Zang, Donglin Xu, Yunlin Song, Zhijie He, Xiangde Zheng, Jiajia Lin, Zhongzhi Tang, Ying-guang Xie, Bo Yu, Lu Ke, Fei Tong, Yafeng Liang, Jun Liu, Zhenyu Yang, An Zhang, Qindong Shi, Qingshan Zhou, Jian Yu, Shiying Yuan, Zhiguo Pan, Zhe Zhai, Lixin Zhou, Fusen Zhang, Dongwu Shi, Arthur R.H. van Zanten, Lin Han, Gordon S. Doig, Tao Chen, Xiaomei Chen, Zhiqiang Zou, Fachun Zhou, Chuanyong Gong, Aijun Pan, Xiaobo Huang, Zhigang Zhou, Qiuye Kou, Yuhang Ai, Rongguo Yu, Yimin Li, Yi-jun Deng, Weidong Wu, and Liyun Zhao
Subjects: medicine.medical_specialty, Evidence-based practice, Next of kin, business.industry, Guideline, law.invention, Randomized controlled trial, Informed consent, law, Intensive care, Family medicine, Health care, Medicine, Medical nutrition therapy, business
Abstract: Background: Equipoise exists regarding the implementation of evidence-based guidelines for nutritional therapy in critical illness because some previous cluster-randomised controlled trials (cRCTs) demonstrate patient benefits whilst others do not. We aimed to resolve this issue by initiating an appropriately powered cRCT to assess whether active implementation of an evidence-based guideline for nutrition therapy in critical illness could reduce mortality. Methods: We did a multicentre, cluster-randomised, parallel-controlled trial in 97 intensive care units (ICUs) throughout China. We developed an up-to-date, evidence-based nutrition guideline. ICUs randomly allocated to implement the guideline formed a local "intervention team", which actively implemented the guideline using standardized educational materials. ICUs assigned to the control group remained unaware of the guideline. All ICUs enroled critically ill patients who were expected to stay longer than seven days. The primary outcome was all-cause mortality within 28 days of enrolment . Findings Between March, 2018 and July, 2019, we enrolled 1,373 patients at 48 guideline ICUs and 1,399 patients at 49 control ICUs. Implementation of the nutrition guideline resulted in significantly earlier enteral nutrition (EN) initiation (1.20 vs. 1.55 mean days to initiation of EN; difference -0.40 [95% CI, -0.71 to -0.09]; P=0.01) and delayed parenteral nutrition (PN) initiation (1.29 vs. 0.80 mean days to start of PN; difference 1.06 [95% CI, 0.44 to 1.67]; P=0.001). There was no significant difference in 28-day mortality (14.2% vs. 15.2%; difference -1.6% [95% CI -4.3% to 1.2%]; p=0.42) between study groups. Interpretation: Active implementation of an evidence-based guideline can change practice. Our active implementation strategy improved the provision of nutrition therapy to critically ill patients. However, in our cRCT, this improvement in care did not translate to a reduction in mortality. We did not identify any safety concerns associated with the active implementation of our evidence-based guideline for nutrition therapy. Trial Registration: The study was registered in the ISRCTN registry before enrolment commenced (No. ISRCTN12233792). Funding Statement: The study was funded by the Key Research and Development Program Foundation of Jiangsu Province of China (no. BE2015685) and Nutricia, Wuxi, China. Declaration of Interests: Dr. GSD reported receiving academic research grants related to nutrition in critical illness from the Australian National Health and Medical Research Council, Fresenius Kabi Deutschland GmbH and Baxter Healthcare Pty Ltd and speakers honoraria from Fresenius Kabi Deutschland GmbH, Baxter Healthcare Australia, Pty Ltd, Nestle Healthcare, Vevy, Switzerland and Nutricia Pharmaceutical (Wuxi) Co., Ltd. China. Dr. AvZ reports personal fees from Baxter, personal fees from Nestle, personal fees from Fresenius Kabi, grants and personal fees from Nutricia, grants from Cardinal Health grants from Mermaid grants from Lyric, outside the submitted work. Dr. WqL reported receiving speakers honoraria from Nutricia Pharmaceutical (Wuxi) Co., Ltd. China. No other disclosures were reported. Ethics Approval Statement: The study was approved by the local hospital ethics committees of all the participating ICUs. At each site, informed consent was obtained from the patients or their next of kin before enrolment.
Published: 2021
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19. Expert consensus on emergency procedures for portal hypertension bleeding (2022)

Author: Sun, Lin, Long, Lin, Wang, Qing, Xiang, Hua, Huangxing, Cai, Yanfang, Chai, Feng, Chen, Wei, Cheng, Jianguo, Chu, Aijun, Shan, Ying, Deng, Bangjiang, Fang, Zhijie, Feng, Fei, Gao, Xiaotong, Han, Mingsheng, Huang, Guiyun, Jin, Jinlong, Jiaping, Li, Lei, Li, Peiwu, Li, Xiao, Li, Zhanfei, Li, Zhen, Li, Fuquan, Liu, Jueshi, Liu, Peng, Liu, Xiaoran, Liu, Ligong, Lu, Jianjun, Luo, Xuefeng, Luo, Chuanzhu, Lv, Weifu, Lv, Qingbian, Ma, Yilong, Ma, Zhiqun, Mao, Ya, Peng, Junhui, Sun, Jun, Tie, Xianzheng, Tan, Qing, Wang, Rixing, Wang, Yong, Wang, An, Wei, Zhiyu, Xia, Bin, Xiang, Bin, Xiong, Shuogui, Xu, Hui, Xue, Weizhu, Yang, Min, Yuan, Chunqing, Zhang, Guoqiang, Zhang, Jianfeng, Zhang, Jinxiang, Zhang, Zhiming, Zhang, Jianbo, Zhao, Xiaodong, Zhao, Fachun, Zhou, Shi, Zhou, Xiaoli, Zhu, Changju, Zhu, Zheng, Zhuge Yu, Yimin, Zhu, and Yinghua, Zou
Abstract: Expert consensus proposes an emergency treatment protocol for portal hypertension bleeding. Herein, the emergency treatment procedures, which include first aid, medical, interventional, and surgical treatments, are described. In addition, the indications, contraindications, operating norms, precautions, and prevention of complications of portal hypertension are described to optimize the first aid process.
Published: 2023
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20. MicroRNA-877-5p alleviates ARDS via enhancing PI3K/Akt path by targeting CDKN1B both in vivo and in vitro

Author: Zuoting Huang, Fachun Zhou, Shijing Tian, Kaili Li, Xuan Zou, Jianghan Yuan, Yi Chen, and Yuan Yuan
Subjects: 0301 basic medicine, Male, ARDS, Immunology, Inflammation, 03 medical and health sciences, 0302 clinical medicine, medicine, Immunology and Allergy, Animals, Humans, Protein kinase B, PI3K/AKT/mTOR pathway, Cells, Cultured, Pharmacology, Respiratory Distress Syndrome, biology, business.industry, Cyclin-dependent kinase 2, Endothelial Cells, medicine.disease, Endothelial stem cell, Mice, Inbred C57BL, MicroRNAs, 030104 developmental biology, 030220 oncology & carcinogenesis, Cancer research, biology.protein, Cytokines, Tumor necrosis factor alpha, Female, Signal transduction, medicine.symptom, Phosphatidylinositol 3-Kinase, business, Proto-Oncogene Proteins c-akt, Cyclin-Dependent Kinase Inhibitor p27, Signal Transduction
Abstract: Acute respiratory distress syndrome (ARDS) is a public health problem with high morbidity and mortality worldwide due to lacking known characteristic biomarkers and timely intervention. Pulmonary edema caused by inflammation and pulmonary microvascular endothelial cell disfunction is the main pathophysiological change of ARDS. Circulating microRNAs (miRNAs) are differentially expressed between subjects who did and did not develop ARDS. Many miRNAs have been exemplified to be involved in ARDS and could represent the novel therapeutic targets, but the role of microRNA-877-5p (miR-877-5p) in ARDS and its regulatory mechanisms are still unknown. Herein, we explore the underlying function of miR-877-5p toward anesis of ARDS and addressed that miRNA-877 can reduce the release of tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, and IL-6 thus attenuating the damage of pulmonary microvascular endothelial cells (HPMECs). Have further evaluated the protein expression, we detected that miR-877-5p contributed to the relief of ARDS by suppressing Cyclin-dependent kinase inhibitor 1B (CDKN1B), which serves as a regulator of endothelial cell polarization and migration through phosphatidylinositol-3-kinase and AKT (PI3K/Akt) signaling pathway. Besides, we noticed that CDKN1B restrains cell differentiation by inhibiting Cdk2 (cyclin-dependent kinase 2), instead of Cdk4 (cyclin-dependent kinase 4), during which the nuclear translocation of CDKN1B may participate. Together, our works testified that miR-877-5p might suppress inflammatory responses and promote HPMECs regeneration via targeting CDKN1B by modulation of Cdk2 and PI3K/Akt path. These molecules likely modulating ARDS progression may inform biomarkers and therapeutic development.
Published: 2020

21. [Stratified outcomes of 'Kidney Disease: Improving Global Outcomes' serum creatinine criteria in critical ill patients: a secondary analysis of a multicenter prospective study]

Author: Guiying, Dong, Junping, Qin, Youzhong, An, Yan, Kang, Xiangyou, Yu, Mingyan, Zhao, Xiaochun, Ma, Yuhang, Ai, Yuan, Xu, Yushan, Wang, Chuanyun, Qian, Dawei, Wu, Renhua, Sun, Shusheng, Li, Zhenjie, Hu, Xiangyuan, Cao, Fachun, Zhou, Li, Jiang, Jiandong, Lin, Erzhen, Chen, Tiehe, Qin, Zhenyang, He, Lihua, Zhou, and Bin, Du
Subjects: Adult, Renal Replacement Therapy, China, Intensive Care Units, Young Adult, Risk Factors, Creatinine, Critical Illness, Humans, Prospective Studies, Acute Kidney Injury, Retrospective Studies
Abstract: To investigate the different outcomes of two types of acute kidney injury (AKI) according to standard of Kidney Disease: Improving Global Outcomes-AKI (KDIGO-AKI), and to analyze the risk factors that affect the prognosis of intensive care unit (ICU) patients in China.A secondary analysis was performed on the database of a previous study conducted by China Critical Care Clinical Trial Group (CCCCTG), which was a multicenter prospective study involving 3 063 patients in 22 tertiary ICUs in 19 provinces and autonomous regions of China. The demographic data, scores reflecting severity of illness, laboratory findings, intervention during ICU stay were extracted. All patients were divided into pure AKI (PAKI) and acute on chronic kidney disease (AoCKD). PAKI was defined as meeting the serum creatinine (SCr) standard of KDIGO-AKI (KDIGO-AKIOf the 3 063 patients, 1 042 were enrolled, 345 with AKI, 697 without AKI. The AKI incidence was 33.11%, while ICU mortality within 28 days of AKI patients was 13.91% (48/345). Compared with PAKI patients (n = 322), AoCKD patients (n = 23) were older [years old: 74 (59, 77) vs. 58 (41, 72)] and more critical when entering ICU [acute physiology and chronic health evaluation II (APACHE II) score: 23 (19, 27) vs. 15 (11, 22)], had worse basic renal function [eGFR (mL×minFurther detailed classification (PAKI, AoCKD) based on KDIGO-AKI
Published: 2020

22. A Peptide-Based Magnetic Chemiluminescence Enzyme Immunoassay for Serological Diagnosis of Coronavirus Disease 2019

Author: Yong Lin, Deqiang Wang, Wen-Guang Tian, Juan Chen, Yao-kai Chen, Xiao-li Zhang, Kai Fan, Kun Wang, Jing Wang, Haijun Deng, Quanxin Long, Yuan Hu, Yanmeng Chen, Ji-Hua Ren, Ni Tang, Jiang-Lin Xiang, Guicheng Wu, Jie Wei, Dao-Xin Wang, Chun-Yang Gan, Changlong He, Xue-Fei Cai, Liu Ping, Zhijie Li, Lu-Yi Huang, Ailong Huang, Pu Liao, Hong-xin Du, Bei-zhong Liu, Jie Li Hu, A-mei Chen, Qingzhu Gao, Fachun Zhou, and Peng Hu
Subjects: Male, 0301 basic medicine, Antibodies, Viral, Immunoglobulin G, Serology, law.invention, Immunoenzyme Techniques, COVID-19 Testing, 0302 clinical medicine, law, Immunology and Allergy, 030212 general & internal medicine, Polymerase chain reaction, biology, medicine.diagnostic_test, Reverse Transcriptase Polymerase Chain Reaction, Middle Aged, chemiluminescence immunoassay, AcademicSubjects/MED00290, Real-time polymerase chain reaction, Infectious Diseases, Female, Antibody, Coronavirus Infections, Adult, COVID-19 Vaccines, Pneumonia, Viral, Real-Time Polymerase Chain Reaction, Sensitivity and Specificity, Betacoronavirus, Viral Proteins, 03 medical and health sciences, Major Article, medicine, Humans, Serologic Tests, AcademicSubjects/MED00860, Pandemics, Clinical Laboratory Techniques, SARS-CoV-2, Serological Test, business.industry, COVID-19, medicine.disease, Pneumonia, 030104 developmental biology, Immunoglobulin M, Immunoassay, Luminescent Measurements, Immunology, biology.protein, Peptides, business
Abstract: Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel β-coronavirus, causes severe pneumonia and has spread throughout the globe rapidly. The disease associated with SARS-CoV-2 infection is named coronavirus disease 2019 (COVID-19). To date, real-time reverse-transcription polymerase chain reaction (RT-PCR) is the only test able to confirm this infection. However, the accuracy of RT-PCR depends on several factors; variations in these factors might significantly lower the sensitivity of detection. Methods In this study, we developed a peptide-based luminescent immunoassay that detected immunoglobulin (Ig)G and IgM. The assay cutoff value was determined by evaluating the sera from healthy and infected patients for pathogens other than SARS-CoV-2. Results To evaluate assay performance, we detected IgG and IgM in the sera from confirmed patients. The positive rate of IgG and IgM was 71.4% and 57.2%, respectively. Conclusions Therefore, combining our immunoassay with real-time RT-PCR might enhance the diagnostic accuracy of COVID-19.
Published: 2020
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23. A Peptide-based Magnetic Chemiluminescence Enzyme Immunoassay for Serological Diagnosis of Corona Virus Disease 2019 (COVID-19)

Author: Ji-Hua Ren, Jie Wei, Yao-kai Chen, Yuan Hu, Kun Wang, Xue-Fei Cai, Haijun Deng, Quanxin Long, Kai Fan, Fachun Zhou, Qingzhu Gao, Zhijie Li, Lu-Yi Huang, Jieli Hu, Changlong He, Juan Chen, Bei-zhong Liu, Jing Wang, Chun-Yang Gan, Xiao-li Zhang, Yong Lin, Dao-Xin Wang, Pu Liao, Ailong Huang, Deqiang Wang, Liu Ping, A-mei Chen, Jianglin Xiang, Yanmeng Chen, Wen-Guang Tian, Guicheng Wu, Hong-xin Du, Peng Hu, and Ni Tang
Subjects: chemistry.chemical_classification, medicine.diagnostic_test, business.industry, Outbreak, medicine.disease, medicine.disease_cause, Virology, Serology, law.invention, Pneumonia, Enzyme, chemistry, law, Immunoassay, medicine, RNA extraction, business, Chemiluminescence, Coronavirus
Abstract: A respiratory illness has been spreading rapidly in China, since its outbreak in Wuhan city, Hubei province in December 2019. The illness was caused by a novel coronavirus, named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Clinical manifestations related to SARS-CoV-2 infection ranged from no symptom to fatal pneumonia. World Health Organization (WHO) named the diseases associated with SARS-CoV-2 infection as COVID-19. Real time RT-PCR is the only laboratory test available till now to confirm the infection. However, the accuracy of real time RT-PCR depends on many factors, including sampling location and of methods, quality of RNA extraction and training of operators etc.. Variations in these factors might significantly lower the sensitivity of the detection. We developed a peptide-based luminescent immunoassay to detect IgG and IgM. Cut-off value of this assay was determined by the detection of 200 healthy sera and 167 sera from patients infected with other pathogens than SARS-CoV-2. To evaluate the performance of this assay, we detected IgG and IgM in the 276 sera from confirmed patients. The positive rate of IgG and IgM were 71.4% (197/276) and 57.2% (158/276) respectively. By combining with real time RT-PCR detection, this assay might help to enhance the accuracy of diagnosis of SARS-CoV-2 infection.
Published: 2020
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24. MicroRNA-92a serves as a risk factor in sepsis-induced ARDS and regulates apoptosis and cell migration in lipopolysaccharide-induced HPMEC and A549 cell injury

Author: Fan Xu, Jianghan Yuan, Fachun Zhou, Yi Chen, and Shijing Tian
Subjects: 0301 basic medicine, Lipopolysaccharides, ARDS, Lipopolysaccharide, Apoptosis, 030226 pharmacology & pharmacy, General Biochemistry, Genetics and Molecular Biology, Sepsis, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Downregulation and upregulation, Cell Movement, Risk Factors, Medicine, Humans, General Pharmacology, Toxicology and Pharmaceutics, Protein kinase B, Lung, Aged, A549 cell, Inflammation, Respiratory Distress Syndrome, business.industry, TOR Serine-Threonine Kinases, Endothelial Cells, Cell migration, General Medicine, Middle Aged, medicine.disease, Gene Expression Regulation, Neoplastic, Intensive Care Units, MicroRNAs, 030104 developmental biology, chemistry, A549 Cells, Microvessels, Cancer research, business, Proto-Oncogene Proteins c-akt, Signal Transduction
Abstract: Aims Sepsis-induced acute respiratory distress syndrome (ARDS) is a common, high mortality complication in intensive care unit (ICU) patients. MicroRNA-92a (miR-92a) plays a role in many diseases, but its association with sepsis-induced ARDS is unclear. Materials and methods We enrolled 53 patients, including 17 with sepsis only, and 36 with sepsis-induced ARDS. Lipopolysaccharide (LPS) was used to stimulate pulmonary microvascular endothelial cells (HPMEC) and alveolar epithelial A549 cells, which were used to investigate the miR-92a roles in ARDS. MiR-92a expression levels in patient serum and cells were quantified using quantitative reverse transcription-polymerase chain reaction (RT-PCR), and protein expression was examined using Western blotting. The effect of miR-92a on apoptosis was examined using flow cytometry. Wound healing and transwell migration assays were used to evaluate cell migration. Key findings Serum miR-92a expression was higher in patients with sepsis-induced ARDS, when compared to patients with sepsis only. After LPS treatment in cells, miR-92a expression was higher when compared with control group, cell apoptosis and inflammatory responses were increased and cell migration was inhibited. However, cell apoptosis and inflammatory responses were decreased and cell migration was enhanced after miR-92a downregulation, when compared with inhibitor negative control (NC) group. Moreover, phosphorylated-Akt and phosphorylated-mTOR expression were increased after miR-92a inhibition. Significance Our study provides evidence that circulating serum miR-92a could act as a risk factor for sepsis-induced ARDS. MiR-92a inhibition attenuated the adverse effects of LPS on ARDS through the Akt/mTOR signaling pathway.
Published: 2020

25. Enteral nutrition feeding in Chinese intensive care units: a cross-sectional study involving 116 hospitals

Author: Yunlin Song, Zhiguo Pan, Rong-li Yang, Xiangde Zheng, Zhisong Wu, Qindong Shi, Zhixin Chao, Peiyang Gao, Fusen Zhang, Jing Zhou, Qiang Sun, Feng Guo, Yinguang Xie, Weiqin Li, Jinglan Wu, Yang Liu, Xing-lu Dong, Liming Gu, Zhiwei Li, Yuanqi Gong, Qingshan Zhou, Yu-qiang Gong, Zhiyong Peng, Xiaobo Huang, Kunlin Hu, Rumin Zhang, Difeng Wang, Bin Song, Qiuye Kou, Dongwu Shi, Juan Xing, Ping Chang, Feng Shan, Yi-bing Weng, Kejian Qian, Hai-yan Liu, Wei Chen, Xiang-zhong Meng, Aibin Ceng, Weihua Lu, Jian Yu, Xiu-mei Chen, Han Zhang, Xiao-dong Guo, Xueyan Liu, Yuhang Ai, Shusheng Li, Hailing Li, Xin-ke Meng, Yong-shun Feng, Yimin Li, Xianyao Wan, Xiaomei Chen, Linxi Huang, Chuangyun Qian, Wei-wei Chen, Jianbo Liu, Bin Zang, Wenming Liu, Ming-shi Yang, Ping Wang, Shi-ying Yuan, Zhiqiang Zou, Cheng Sun, Lei Zhang, Peng Wan, Xiao-rong Wang, Chuming Fan, Hong-mei Gao, Zhen-huan Zhang, Yichao Wen, Chunli Yang, Qiuhui Wang, Fachun Zhou, Ying-jun Dong, Yuanfei Li, Zhaohui Zhang, Lixin Zhou, Yafeng Liang, Lihua Zhou, Jie Sun, An Zhang, Lu Ke, Jie Liu, Chuangjie Cai, Dong-po Jiang, Baocai Fu, Rongqing Sun, Zhongheng Zhang, Dong Hao, Chuanyong Gong, Hui Han, Bingyu Qin, Biao Ma, Xin Zhou, Gai-qi Yao, Dafei Tong, Liandi Li, Yan Qu, Fei Tong, Zhong-min Liu, Lei Wang, Qiang Guo, Jiandong Lin, Yun Sun, Zhiyong Wang, Zhiping Li, Junli Sun, Yongjian Feng, Dong-hao Wang, Guobao Wu, Hong-kai Liang, Yi-jun Deng, Weidong Wu, Liyun Zhao, Su-min Zhao, Xue-jun Zhou, Donglin Xu, Yi Zhang, and Yunfu Wu
Subjects: Male, 0301 basic medicine, China, medicine.medical_specialty, Organ Dysfunction Scores, Cross-sectional study, Enteral feeding, Gastrointestinal Injury, Critical Care and Intensive Care Medicine, 03 medical and health sciences, Enteral Nutrition, 0302 clinical medicine, Intensive care, Internal medicine, Epidemiology, medicine, Humans, Male gender, APACHE, Aged, Proportional Hazards Models, Aged, 80 and over, Chi-Square Distribution, 030109 nutrition & dietetics, Intensive care units, Proportional hazards model, business.industry, lcsh:Medical emergencies. Critical care. Intensive care. First aid, 030208 emergency & critical care medicine, lcsh:RC86-88.9, Length of Stay, Middle Aged, Icu admission, Cross-Sectional Studies, Treatment Outcome, Parenteral nutrition, Female, business
Abstract: Background There is a lack of large-scale epidemiological data on the clinical practice of enteral nutrition (EN) feeding in China. This study aimed to provide such data on Chinese hospitals and to investigate factors associated with EN delivery. Methods This cross-sectional study was launched in 118 intensive care units (ICUs) of 116 mainland hospitals and conducted on April 26, 2017. At 00:00 on April 26, all patients in these ICUs were included. Demographic and clinical variables of patients on April 25 were obtained. The dates of hospitalization, ICU admission and nutrition initiation were reviewed. The outcome status 28 days after the day of investigation was obtained. Results A total of 1953 patients were included for analysis, including 1483 survivors and 312 nonsurvivors. The median study day was day 7 (IQR 2–19 days) after ICU entry. The proportions of subjects starting EN within 24, 48 and 72 h after ICU entry was 24.8% (84/352), 32.7% (150/459) and 40.0% (200/541), respectively. The proportion of subjects receiving > 80% estimated energy target within 24, 48, 72 h and 7 days after ICU entry was 10.5% (37/352), 10.9% (50/459), 11.8% (64/541) and 17.8% (162/910), respectively. Using acute gastrointestinal injury (AGI) 1 as the reference in a Cox model, patients with AGI 2–3 were associated with reduced likelihood of EN initiation (HR 0.46, 95% CI 0.353–0.599; p
Published: 2018
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26. Inhibition of microRNA-92a ameliorates lipopolysaccharide-induced endothelial barrier dysfunction by targeting ITGA5 through the PI3K/Akt signaling pathway in human pulmonary microvascular endothelial cells

Author: Fachun Zhou and Fan Xu
Subjects: 0301 basic medicine, Lipopolysaccharides, ARDS, Integrins, Immunology, Inflammation, Lung injury, Transfection, Proinflammatory cytokine, Cell Line, 03 medical and health sciences, Phosphatidylinositol 3-Kinases, 0302 clinical medicine, medicine, Immunology and Allergy, Humans, Lung, PI3K/AKT/mTOR pathway, Pharmacology, Tube formation, Respiratory Distress Syndrome, business.industry, Akt/PKB signaling pathway, Endothelial Cells, medicine.disease, Endothelial stem cell, MicroRNAs, 030104 developmental biology, Gene Expression Regulation, 030220 oncology & carcinogenesis, Microvessels, Cancer research, Endothelium, Vascular, medicine.symptom, business, Proto-Oncogene Proteins c-akt, Biomarkers, Signal Transduction
Abstract: Overwhelming inflammation and extensive alveolar-endothelial injury are characteristic pathological features of acute respiratory distress syndrome (ARDS)). MicroRNAs are involved in the regulation of a variety of cellular processes including endothelial damage and inflammatory responses. However, little is known about their function and the molecules regulating lung microvascular endothelial injury. Here, we determined the levels of microRNA-92a (miR-92a) in lipopolysaccharide (LPS)-induced human pulmonary microvascular endothelial cells (HPMECs). We found that miR-92a expression was greater in HPMECs treated with LPS than in control cells. Inhibition of miR-92a through transfection with a miR-92a inhibitor significantly increased HPMECs migration, enhanced tube formation, and improved endothelial cell barrier dysfunction. Inhibition of miR-92a ameliorated the inflammatory response by decreasing the release of the proinflammatory factors IL-6 and TNF-α. In addition, integrin α5 (ITGA5) was found to be a target gene of miR-92a in LPS-induced endothelial barrier dysfunction. Western blot analysis showed that inhibition of miR-92a may ameliorate endothelial barrier dysfunction by activating the PI3K/Akt signaling pathway. Together, these results reveal an important role of miR-92a in LPS-induced endothelial barrier dysfunction, and suggest that miR-92a may have potential as a prognostic indicator and a future target for the treatment of acute lung injury (ALI)/ARDS.
Published: 2019

27. Does training improve diagnostic accuracy and inter-rater agreement in applying the Berlin radiographic definition of acute respiratory distress syndrome? A multicenter prospective study

Author: Tiehe Qin, Yan Kang, Zhenjie Hu, Xiaochun Ma, Zhenyang He, Li Jiang, Fachun Zhou, Xiangyou Yu, Chuanyun Qian, Yongjie Yin, Xijing Zhang, Mingyan Zhao, Xiangyuan Cao, Bin Du, Lihua Zhou, Tong Li, Rongqing Sun, Yuhang Ai, Shusheng Li, Youzhong An, Jin-Min Peng, Dawei Wu, Renhua Sun, Jiandong Lin, and Erzhen Chen
Subjects: Male, medicine.medical_specialty, ARDS, Intraclass correlation, education, Context (language use), Critical Care and Intensive Care Medicine, Diagnostic accuracy, 03 medical and health sciences, 0302 clinical medicine, Inter-rater variability, medicine, Humans, Prospective Studies, 030212 general & internal medicine, Medical diagnosis, Prospective cohort study, Observer Variation, Respiratory Distress Syndrome, Acute respiratory distress syndrome, medicine.diagnostic_test, business.industry, Research, Teaching, Reproducibility of Results, medicine.disease, Inter-rater reliability, Chest radiograph, 030228 respiratory system, Physical therapy, Female, Radiography, Thoracic, Clinical Competence, business, Kappa
Abstract: Background Poor inter-rater reliability in chest radiograph interpretation has been reported in the context of acute respiratory distress syndrome (ARDS), although not for the Berlin definition of ARDS. We sought to examine the effect of training material on the accuracy and consistency of intensivists’ chest radiograph interpretations for ARDS diagnosis. Methods We conducted a rater agreement study in which 286 intensivists (residents 41.3%, junior attending physicians 35.3%, and senior attending physician 23.4%) independently reviewed the same 12 chest radiographs developed by the ARDS Definition Task Force (“the panel”) before and after training. Radiographic diagnoses by the panel were classified into the consistent (n = 4), equivocal (n = 4), and inconsistent (n = 4) categories and were used as a reference. The 1.5-hour training course attended by all 286 intensivists included introduction of the diagnostic rationale, and a subsequent in-depth discussion to reach consensus for all 12 radiographs. Results Overall diagnostic accuracy, which was defined as the percentage of chest radiographs that were interpreted correctly, improved but remained poor after training (42.0 ± 14.8% before training vs. 55.3 ± 23.4% after training, p
Published: 2017
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28. Characteristics of Critically Ill Patients in ICUs in Mainland China*

Author: Bin, Du, Youzhong, An, Yan, Kang, Xiangyou, Yu, Mingyan, Zhao, Xiaochun, Ma, Yuhang, Ai, Yuan, Xu, Yushan, Wang, Chuanyun, Qian, Dawei, Wu, Renhua, Sun, Shusheng, Li, Zhenjie, Hu, Xiangyuan, Cao, Fachun, Zhou, Li, Jiang, Jiandong, Lin, Erzhen, Chen, Tiehe, Qin, Zhenyang, He, Lihua, Zhou, and Qian, Li
Subjects: Adult, Male, China, medicine.medical_specialty, Adolescent, Critical Illness, medicine.medical_treatment, Lung injury, Critical Care and Intensive Care Medicine, law.invention, law, Severity of illness, medicine, Humans, Hospital Mortality, Prospective Studies, Renal replacement therapy, Prospective cohort study, Diagnosis-Related Groups, Aged, Septic shock, business.industry, Acute kidney injury, Length of Stay, Middle Aged, medicine.disease, Intensive care unit, Intensive Care Units, Logistic Models, Treatment Outcome, Multivariate Analysis, Emergency medicine, Female, business, Cohort study
Abstract: Objectives We sought to describe the demographics, case mix, interventions, and clinical outcome of critically ill patients admitted to ICUs in Mainland China. Design A 2-month (July 1, 2009, to August 31, 2009) prospective, observational cohort study. Setting Twenty-two ICUs in Mainland China. Patients Adult patients admitted to participating ICUs during the study period with an ICU length of stay >24 hrs. Interventions None. Measurements and main results Patient characteristics, including demographics, underlying diseases, severity of illness, admission status, complications, intervention and treatment during ICU stay, and clinical outcome were recorded in case report form. The primary outcome measure was all-cause hospital mortality. Independent predictors for hospital mortality were determined with multivariate logistic regression analysis. One thousand two hundred ninety-seven patients met the inclusion criteria for the study, 821 (63.3%) were male, and mean age was 58.5 ± 19.2 yrs. Mean Acute Physiology and Chronic Health Evaluation II score was 18.0 ± 8.1, and mean Sequential Organ Failure Assessment score was 6.5 ± 3.8. One third of the patients were postoperative ICU admissions. Seven hundred sixty-five patients (59.0%) developed infections, followed by severe sepsis or septic shock (484, 37.3%), acute kidney injury (398, 30.7%), and acute lung injury/acute respiratory distress syndrome (351, 27.1%). Mechanical ventilation was used in almost three fourths of the patients, whereas any type of renal replacement therapy was used in 173 patients (13.3%). Hospital mortality was 20.3%. Multivariate logistic regression analysis found that Acute Physiology and Chronic Health Evaluation II score, solid tumor, severe sepsis/septic shock, acute lung injury/acute respiratory distress syndrome, and acute kidney injury were independent risk factors for hospital mortality. Conclusions Critically ill patients in ICUs in Mainland China exhibited a case mix similar to those of Western countries, although there are significant differences in intensive care unit admission rates and disease severity between Western and Chinese ICUs.
Published: 2013
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29. Knowledge and attitudes of healthcare workers in Chinese intensive care units regarding 2009 H1N1 influenza pandemic.

Author: Xiaochun Ma, Zhenyang He, Yushan Wang, Li Jiang, Yuan Xu, Chuanyun Qian, Rongqing Sun, Erzhen Chen, Zhenjie Hu, Lihua Zhou, Fachun Zhou, Tiehe Qin, Xiangyuan Cao, Youzhong An, Renhua Sun, Xijing Zhang, Jiandong Lin, Yuhang Ai, Dawei Wu, and Bin Du
Subjects: MEDICAL care, H1N1 influenza, RESPONDENTS, PHYSICIANS, PANDEMICS
Abstract: Background: To describe the knowledge and attitudes of critical care clinicians during the 2009 H1N1 influenza pandemic. Methods: A survey conducted in 21 intensive care units in 17 provinces in China. Results: Out of 733 questionnaires distributed, 695 were completed. Three hundred and fifty-six respondents (51.2%) reported their experience of caring for H1N1 patients. Despite the fact that 88.5% of all respondents ultimately finished an H1N1 training program, only 41.9% admitted that they had the knowledge of 2009 H1N1 influenza. A total of 572 respondents (82.3%) expressed willingness to care for H1N1 patients. Independent variables associated with increasing likelihood to care for patients in the logistic regression analysis were physicians or nurses rather than other professionals (odds ratio 4.056 and 3.235, p = 0.002 and 0.007, respectively), knowledge training prior to patient care (odds ratio 1.531, p = 0.044), and the confidence to know how to protect themselves and their patients (odds ratio 2.109, p = 0.001). Conclusion: Critical care clinicians reported poor knowledge of H1N1 influenza, even though most finished a relevant knowledge training program. Implementation of appropriate education program might improve compliance to infection control measures, and willingness to work in a pandemic. [ABSTRACT FROM AUTHOR]
Published: 2011
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29 results on '"Fachun Zhou"'

1. Clinical characteristics of Gram-negative and Gram-positive bacterial infection in acute cholangitis: a retrospective observational study

2. Actively implementing an evidence-based feeding guideline for critically ill patients (NEED): a multicenter, cluster-randomized, controlled trial

3. Utilizing reclassification to explore characteristics and prognosis of KDIGOSCr AKI subgroups: a retrospective analysis of a multicenter prospective cohort study

4. Correction to: Actively implementing an evidence-based feeding guideline for critically ill patients (NEED): a multicenter, cluster-randomized, controlled trial

5. Enteral nutrition feeding in Chinese intensive care units: a cross-sectional study involving 116 hospitals

6. Different Expression Characteristics of LAG3 and PD-1 in Sepsis and Their Synergistic Effect on T Cell Exhaustion: A New Strategy for Immune Checkpoint Blockade

7. Epidemiology and outcome of severe sepsis and septic shock in intensive care units in mainland China.

8. Expert consensus on emergency procedures for portal hypertension bleeding (2022)

9. Inhibition of STEAP1 ameliorates inflammation and ferroptosis of acute lung injury caused by sepsis in LPS-induced human pulmonary microvascular endothelial cells

10. Risk Factors and Prognosis of Carbapenem-Resistant Organism Colonization and Infection in Acute Cholangitis

11. Utilizing reclassification to explore characteristics and prognosis of KDIGOSCr AKI subgroups: a retrospective analysis of a multicenter prospective cohort study

12. Coronavirus disease 2019 (COVID-19): cytokine storms, hyper-inflammatory phenotypes, and acute respiratory distress syndrome

13. The clinical and immunological features of pediatric COVID-19 patients in China

14. Evolution Over Time of Ventilatory Management and Outcome of Patients With Neurologic Disease

15. Practice of Extracorporeal Therapies for Septic Acute Kidney Injury Patients in Intensive Care Units in Mainland China

16. FAM49B, restrained by miR-22, relieved hepatic ischemia/reperfusion injury by inhibiting TRAF6/IKK signaling pathway in a Rac1-dependent manner

17. COVID-19 mortality in ICUs associated with critical care staffing

18. Active Implementation of an Evidence-Based Nutrition Guideline for Critically Ill Patients Versus Standard Care: A Cluster Randomised, Multicentre, Controlled Trial

19. Expert consensus on emergency procedures for portal hypertension bleeding (2022)

20. MicroRNA-877-5p alleviates ARDS via enhancing PI3K/Akt path by targeting CDKN1B both in vivo and in vitro

21. [Stratified outcomes of 'Kidney Disease: Improving Global Outcomes' serum creatinine criteria in critical ill patients: a secondary analysis of a multicenter prospective study]

22. A Peptide-Based Magnetic Chemiluminescence Enzyme Immunoassay for Serological Diagnosis of Coronavirus Disease 2019

23. A Peptide-based Magnetic Chemiluminescence Enzyme Immunoassay for Serological Diagnosis of Corona Virus Disease 2019 (COVID-19)

24. MicroRNA-92a serves as a risk factor in sepsis-induced ARDS and regulates apoptosis and cell migration in lipopolysaccharide-induced HPMEC and A549 cell injury

25. Enteral nutrition feeding in Chinese intensive care units: a cross-sectional study involving 116 hospitals

26. Inhibition of microRNA-92a ameliorates lipopolysaccharide-induced endothelial barrier dysfunction by targeting ITGA5 through the PI3K/Akt signaling pathway in human pulmonary microvascular endothelial cells

27. Does training improve diagnostic accuracy and inter-rater agreement in applying the Berlin radiographic definition of acute respiratory distress syndrome? A multicenter prospective study

28. Characteristics of Critically Ill Patients in ICUs in Mainland China*

29. Knowledge and attitudes of healthcare workers in Chinese intensive care units regarding 2009 H1N1 influenza pandemic.

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