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[PMID]: 25906015
[Au] Autor:Burke RE; Juarez-Colunga E; Levy C; Prochazka AV; Coleman EA; Ginde AA
[Ad] Address:*Department of Veterans Affairs Medical Center, Eastern Colorado Health Care System †Department of Medicine, Division of General Internal Medicine, University of Colorado School of Medicine, Denver ‡Department of Biostatistics and Informatics, University of Colorado School of Public Health §Division of Health Care Policy and Research ∥Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO.
[Ti] Title:Patient and Hospitalization Characteristics Associated With Increased Postacute Care Facility Discharges From US Hospitals.
[So] Source:Med Care;53(6):492-500, 2015 Jun.
[Is] ISSN:1537-1948
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND/OBJECTIVES: The number of patients discharged to postacute care (PAC) facilities after hospitalization increased by 50% nationally between 1996 and 2010. We sought to describe payors and patients most affected by this trend and to identify diagnoses for which PAC facility care may be substituting for continued hospital care. DESIGN: Retrospective analysis of the National Hospital Discharge Survey from 1996 to 2010. SETTING: Adult discharges from a national sample of non-Federal hospitals. PARTICIPANTS/EXPOSURES: Adults admitted and discharged to a PAC facility between 1996 and 2010. Our analysis includes 2.99 million sampled discharges, representative of 386 million discharges nationally. MEASUREMENTS: Patient demographic and hospitalization characteristics, including length of stay (LOS) and diagnoses treated. RESULTS: More than half (50.7%) of all patients discharged to PAC facilities were 80 years old or older in 2010; 40% of hospitalizations in this age group ended with a PAC stay. Decreases in LOS and increases in PAC facility use were consistent across payors and patient demographics. PAC facilities may be substituting for continued inpatient care for patients with pneumonia, hip fracture, and sepsis as these diagnoses demonstrated the clearest trends of decreasing LOS and increasing discharges to PAC facilities. CONCLUSIONS: The rise in discharges to PAC facilities is occurring in all age groups and payors, though the predominant population is the very old Medicare patient, for whom successful rehabilitation may be most unsure. PAC facility care may be increasingly substituted for prolonged hospitalizations for patients with pneumonia, hip fracture, and sepsis.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1505
[Cu] Class update date: 150515
[Lr] Last revision date:150515
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1097/MLR.0000000000000359

  2 / 91249 MEDLINE  
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[PMID]: 25890031
[Au] Autor:Bilinsky LM; Reed MC; Nijhout HF
[Ad] Address:Department of Mathematics, Duke University, United States. Electronic address: bilinsky@math.duke.edu.
[Ti] Title:The role of skeletal muscle in liver glutathione metabolism during acetaminophen overdose.
[So] Source:J Theor Biol;376:118-33, 2015 Jul 7.
[Is] ISSN:1095-8541
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Marked alterations in systemic glutamate-glutamine metabolism characterize the catabolic state, in which there is an increased breakdown and decreased synthesis of skeletal muscle protein. Among these alterations are a greatly increased net release of glutamine (Gln) from skeletal muscle into blood plasma and a dramatic depletion of intramuscular Gln. Understanding the catabolic state is important because a number of pathological conditions with very different etiologies are characterized by its presence; these include major surgery, sepsis, trauma, and some cancers. Acetaminophen (APAP) overdose is also accompanied by dramatic changes in systemic glutamate-glutamine metabolism including large drops in liver glutathione (for which glutamate is a precursor) and plasma Gln. We have constructed a mathematical model of glutamate and glutamine metabolism in rat which includes liver, blood plasma and skeletal muscle. We show that for the normal rat, the model solutions fit experimental data including the diurnal variation in liver glutathione (GSH). We show that for the rat chronically dosed with dexamethasone (an artificial glucocorticoid which induces a catabolic state) the model can be used to explain empirically observed facts such as the linear decline in intramuscular Gln and the drop in plasma glutamine. We show that for the Wistar rat undergoing APAP overdose the model reproduces the experimentally observed rebound of liver GSH to normal levels by the 24-h mark. We show that this rebound is achieved in part by the action of the cystine-glutamate antiporter, an amino acid transporter not normally expressed in liver but induced under conditions of oxidative stress. Finally, we explain why supplementation with Gln, a Glu precursor, assists in the preservation of liver GSH during APAP overdose despite the fact that under normal conditions only Cys is rate-limiting for GSH formation.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1505
[Cu] Class update date: 150515
[Lr] Last revision date:150515
[Js] Journal subset:IM
[St] Status:In-Data-Review

  3 / 91249 MEDLINE  
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[PMID]: 25567337
[Au] Autor:Takeuchi M; Tachibana K
[Ti] Title:Mechanical ventilation for ARDS patients--for a better understanding of the 2012 Surviving Sepsis Campaign Guidelines.
[So] Source:Cardiovasc Hematol Disord Drug Targets;15(1):41-5, 2015.
[Is] ISSN:2212-4063
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:The mortality rate among patients suffering acute respiratory distress syndrome (ARDS) remains high despite implementation at clinical centers of the lung protective ventilatory strategies recommended by the International Guidelines for Management of Severe Sepsis and Septic Shock, 2012. This suggests that such strategies are still sub-optimal for some ARDS patients. For these patients, tailored use of ventilator settings should be considered, including: further reduction of tidal volumes, administration of neuromuscular blocking agents if the patient's spontaneous breathing is incompatible with mechanical ventilation, and adjusting positive end-expiratory pressure (PEEP) settings based on transpulmonary pressure levels.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1501
[Cu] Class update date: 150515
[Lr] Last revision date:150515
[Js] Journal subset:IM
[St] Status:In-Process

  4 / 91249 MEDLINE  
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[PMID]: 25632745
[Au] Autor:Yang TZ; Li LY; Han LL; Wang FY
[Ti] Title:[Effect of Tongfu Jinghua Decoction on hemodynamics and tissue oxygen metabolism in patients with post-traumatic sepsis shock].
[So] Source:Zhongguo Zhong Xi Yi Jie He Za Zhi;34(12):1453-6, 2014 Dec.
[Is] ISSN:1003-5370
[Cp] Country of publication:China
[La] Language:chi
[Ab] Abstract:OBJECTIVE: To explore the effect of Tongfu Jinghua Decoction (TJD) on hemodynamics and tissue oxygen metabolism in patients with post-traumatic sepsis shock. METHODS: Totally 60 patients were randomly assigned to the treatment group and the control group, 30 in each group. Patients in the treatment group took TJD or were administered with TJD by nasal feeding in combined with conventional Western medical treatment, while patients in the control group only received conventional Western medical treatment. Changes of each index in hemodynamics and tissue oxygen metabolism were observed before treatment, and at 6, 12, 24, and 48 h after treatment. RESULTS: Compared with before treatment in the same group, hemodynamic changes were significantly improved at each time point in the two groups. All indices of tissue oxygen metabolism at each time point of the two groups were significantly improved, except changes of O2 extraction ratio (ER) after treatment in the control group (P < 0.05, P < 0.01). Compared with the control group in the same period, heart rate (HR), systemic vascular resist- ance (SVR), and cardiac output (CO) were significantly improved with statistical difference (P < 0.05, P < 0.01). Mean arterial pressure (MAP), central venous pressure (CVP), and cardiac index (CI) were significantly improved at 6, 12, and 24 h after treatment with statistical difference (P < 0.05, P < 0.01). Each index of tissue oxygen metabolism in the treatment group were all improved at each time point with statistical difference (P < 0.05, P < 0.01). CONCLUSION: TJD combined with conventional Western medical treatment could quickly improve hemodynamics and tissue oxygen metabolism disorder in patients with septic shock, and its curative effect was superior to that of conventional Western medical treatment alone.
[Mh] MeSH terms primary: Drugs, Chinese Herbal/pharmacology
Hemodynamics/drug effects
Oxygen/metabolism
Shock, Septic/drug therapy
[Mh] MeSH terms secundary: Drugs, Chinese Herbal/therapeutic use
Heart Rate
Humans
Sepsis
Shock, Septic/metabolism
[Pt] Publication type:CLINICAL TRIAL; ENGLISH ABSTRACT; JOURNAL ARTICLE
[Nm] Name of substance:0 (Drugs, Chinese Herbal); S88TT14065 (Oxygen)
[Em] Entry month:1505
[Js] Journal subset:IM
[Da] Date of entry for processing:150130
[St] Status:MEDLINE

  5 / 91249 MEDLINE  
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[PMID]: 25529947
[Au] Autor:Zhang Z; Zhang Y; Li A; Lin M; Han Y; Zhang H; Yin L
[Ad] Address:Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China. zhangyajieryan@163.com.
[Ti] Title:[Laparoscopy assisted with transanal endoscopic microsurgery in the treatment of severe functional constipation].
[So] Source:Zhonghua Wei Chang Wai Ke Za Zhi;17(12):1179-82, 2014 Dec.
[Is] ISSN:1671-0274
[Cp] Country of publication:China
[La] Language:chi
[Ab] Abstract:OBJECTIVE: To investigate the feasibility and efficacy of laparoscopic subtotal colectomy and modified Duhamel procedure combined with transanal endoscopic microsurgery (TEM) in the treatment of severe functional constipation(SFC). METHODS: The clinical data of 10 patients with SFC treated by laparoscopic surgery combined with TEM between May 2010 and October 2012 in Ruijin Hospital of Shanghai Jiaotong University School of Medicine were retrospectively analyzed. The gastrointestinal quality of life index(GIQLI), Wexner constipation scale and daily frequency of defecation postoperatively during follow-up were collected. RESULTS: All the 10 operations were successfully accomplished laparoscopic subtotal colectomy combined with TEM without abdominal incision. There was no conversion to open procedure. One case had preventive terminal ileum stoma. The mean operative time was (256 ± 58) min. The mean blood loss was (178 ± 67) ml. The mean time to first flatus was (40 ± 11) h. There were no ureteric injury, anastomotic leak, pelvic sepsis and other complications postoperatively. There was one case of insufficient small bowel obstruction which was released by conservative treatments. The patients were discharged from the hospital in (9.0 ± 1.5) d postoperatively. The GIQLI in one year postoperatively was (112 ± 10) points, which indicated good results compared to (75 ± 12) points preoperatively (P=0.000). The Wexner constipation scale was 20.8 ± 2.2 preoperatively and decreased to 5.2 ± 1.8 at one year follow-up(P=0.000). CONCLUSION: Laparoscopic subtotal colectomy and modified Duhamel procedure combined with TEM provides SFC patients a safe and feasible minimally invasive surgery.
[Mh] MeSH terms primary: Colonic Diseases/surgery
Colorectal Surgery
Constipation/surgery
Rectal Diseases/surgery
[Mh] MeSH terms secundary: China
Defecation
Humans
Laparoscopy
Microsurgery
Minimally Invasive Surgical Procedures
Postoperative Complications
Quality of Life
Retrospective Studies
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1505
[Js] Journal subset:IM
[Da] Date of entry for processing:141222
[St] Status:MEDLINE

  6 / 91249 MEDLINE  
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[PMID]: 25429812
[Au] Autor:Wang X; Li H; Xia Z
[Ti] Title:[Advances in the study of the relationship between autophagy and sepsis-induced lung injury].
[So] Source:Zhonghua Shao Shang Za Zhi;30(4):325-8, 2014 Aug.
[Is] ISSN:1009-2587
[Cp] Country of publication:China
[La] Language:chi
[Ab] Abstract:Sepsis is one of the most common pathogenetic causes of acute lung injury (ALI), and at present there is still a lack of effective targeted techniques and methods for its prevention and treatment. Autophagy is a homeostatic mecha- nism common to all eukaryotic cells, including adaption to environment, defense against invasion of pathogens, and maintenance of cellular homeostasis. Autophagy is also involved in a variety of lung-related diseases. In septic lung injury, autophagy not only serves to dissipate dysfunctional organelles, but also inhibits the release of inflammatory cytokines. This review aims at eliciting the role of autophagy in sepsis-induced ALI and further exploring the potential targets of autophagy in inhibiting inflammation, in an effort to provide a new perspective for clinical treatment of sepsis-induced ALI.
[Mh] MeSH terms primary: Acute Lung Injury/etiology
Autophagy
Sepsis/complications
[Mh] MeSH terms secundary: Acute Lung Injury/metabolism
Cytokines/metabolism
Inflammation/metabolism
Lung/metabolism
Lung Injury
Sepsis/metabolism
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE; REVIEW
[Nm] Name of substance:0 (Cytokines)
[Em] Entry month:1505
[Js] Journal subset:IM
[Da] Date of entry for processing:141202
[St] Status:MEDLINE

  7 / 91249 MEDLINE  
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[PMID]: 25429809
[Au] Autor:Meng A; Ren Y; Yang L; He L; Zeng S; Liu Q
[Ti] Title:[Clinical study on continuous plasma filtration absorption treatment for burn sepsis].
[So] Source:Zhonghua Shao Shang Za Zhi;30(4):310-4, 2014 Aug.
[Is] ISSN:1009-2587
[Cp] Country of publication:China
[La] Language:chi
[Ab] Abstract:OBJECTIVE: To observe the therapeutic effects of continuous plasma filtration absorption (CPFA) treatment on burn sepsis. METHODS: Thirty burn patients with sepsis hospitalized in Beijing Fengtai You'anmen Hospital from July 2009 to October 2012 were treated by CPFA for twice besides routine treatment. The blood samples were collected at five sites (A, B, C, D, and E, respectively) of blood purification equipment before and after CPFA, before and after hemoabsorption, and before hemofiltration. The plasma levels of TNF-α, IL-1ß, IL-6, IL-10, interleukin-1 receptor antagonist (IL-1RA), soluble tumor necrosis factor receptor (sTNFR) I , and sTNFR-II from sites A, C, and E were determined with ELISA before CPFA was performed for the first time, and those from sites B and D were determined with ELISA after CPFA was performed for the first time. Plasma levels of the above-mentioned cytokines from sites A and B were determined with ELISA before CPFA and after CPFA was performed for the second time. The data of plasma levels of IL-1ßP3, IL-1RA, sTNFR-I, sTNFR-II, and TNF-α before CPFA and after CPFA was performed for the second time were collected for calculation of the ratios of IL-1RA to IL-1ß and sTNFR-I plus sTNFR-II to TNF-α. The expression rate of human leukocyte antigen DR (HLA-DR) on the CD14 positive monocytes, acute physiology and chronic health evaluation (APACHE) II score, body temperature, pulse, respiratory rate, and leukocyte count of patients were evaluated or recorded before CPFA and after CPFA was performed for the second time. Patients'condition was observed. Data were processed with paired t test. RESULTS: The plasma levels of TNF-α, IL-1ß, IL-6 and IL-10 from site B after CPFA was performed for the second time were significantly lower than those from site A before CPFA was performed for the first time (with t values respectively 7.05, 5.23, 4.73, 2.37, P values below 0.01). After CPFA was performed for the first time, the plasma levels of TNF-α, IL-1ß, and IL-6 from site D were significantly lower than those from site C before CPFA was performed for the first time (with t values respectively 5.48, 2. 17, 1.78, P < 0.05 or P <0.01). The plasma levels of all cytokines were close between site B after CPFA was performed for the first time and site E before CPFA was performed for the first time (with t values from 0.04 to 1.05, P values above 0.05). The plasma levels of TNF-α, IL-1ß, and IL-6 from site B after CPFA was performed for the second time were significantly lower than those from site A before CPFA was performed for the second time (with t values from 1.87 to 5.93, P <0.05 or P <0.01). The ratios of IL-1RA to IL-1ß and sTNFR-I plus sTNFR-II to TNF-α, and expression rate of HLA-DR were increased significantly after CPFA was performed for the second time as compared with those before CPFA (with t values from 3.99 to 7. 80, P values below 0.01). APACHE II score after CPFA was performed for the second time was 11 ± 6, which was lower than that before CPFA (22 ± 7, t =4.63, P <0.01). After CPFA was performed for the second time, body temperature, pulse, and respiratory rate of patients were improved (with t values from 1.95 to 3.55, P values below 0.05) , and the leukocyte count was significantly decreased (t =4.36, P <0.01) as compared with those before CPFA. All patients survived and were discharged with length of stay of (27 ± 31) d, and no adverse effects occurred during CPFA treatment. CONCLUSIONS: CPFA, which combines hemoabsorption and hemofiltration, can facilitate the treatment of burn sepsis by decreasing the level of pro-inflammatory cytokines efficiently, alleviating systemic inflammatory response, and improving the immune status.
[Mh] MeSH terms primary: Adsorption
Biological Markers/blood
Burns/blood
Cytokines/blood
Hemofiltration/methods
Sepsis/therapy
[Mh] MeSH terms secundary: Aged
Burns/complications
Burns/immunology
Fluid Therapy
Hospitalization
Humans
Inflammation Mediators/blood
Interleukin 1 Receptor Antagonist Protein/blood
Interleukin-10/blood
Interleukin-6/blood
Sepsis/blood
Sepsis/immunology
Treatment Outcome
Tumor Necrosis Factor-alpha
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Nm] Name of substance:0 (Biological Markers); 0 (Cytokines); 0 (Inflammation Mediators); 0 (Interleukin 1 Receptor Antagonist Protein); 0 (Interleukin-6); 0 (Tumor Necrosis Factor-alpha); 130068-27-8 (Interleukin-10)
[Em] Entry month:1505
[Js] Journal subset:IM
[Da] Date of entry for processing:141202
[St] Status:MEDLINE

  8 / 91249 MEDLINE  
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[PMID]: 25429806
[Au] Autor:Guo F; Liang X; Huan J
[Ti] Title:[Clinical significance of continuous thrombocytopenia in predicting sepsis after severe burn].
[So] Source:Zhonghua Shao Shang Za Zhi;30(4):295-8, 2014 Aug.
[Is] ISSN:1009-2587
[Cp] Country of publication:China
[La] Language:chi
[Ab] Abstract:OBJECTIVE: To explore the relationship between continuous thrombocytopenia and sepsis in patients with severe burns. METHODS: Clinical data of 148 severely burned patients admitted to our,two burn centers from January 2007 to December 2011 and conforming to the study criteria were retrospectively analyzed. All patients were divided into sepsis group (n =44) and non-sepsis group (n = 104) according to the presence or absence of sepsis within post burn day (PBD) 30. The data of age, gender, total burn area, full-thickness burn area, fluid infusion volume within post burn hour (PBH) 24, plasma concentration of calcium ion on PBD 1, plasma concentration of albumin on PBD 1, platelet count on PBD 1, acute physiology and chronic health evaluation (APACHE) II score on admission, the presence or absence of hypovolemic shock or inhalation injury on admission, the presence or absence of disseminated intravascular coagulation (DIC) within PBH 48, operation or no operation within PBD 3, thrombocytopenia duration within PBD 10, and mortality were statistically compared between two groups to screen the independent risk factors of sepsis. Data were processed with t test, chi-square test, single factor Logistic regression analysis, and multi-factor Logistic regression analysis. RESULTS: Between two groups, there were statistically significant differences in total burn area, full-thickness burn area, plasma concentration of calcium ion on PBD 1, plasma concentration of albumin on PBD 1, APACHE II score on admission, presence or absence of hypovolem- ic shock on admission, presence or absence of inhalation injury on admission, presence or absence of DIC within PBH 48, and mortality (with t values from 2.433 to 4.082, χ2 values from 8. 818 to 31.528, P < 0.05 or P < 0.01). Furthermore, the duration of thrombocytopenia within PBD 10 in sepsis group was (5.2 ± 2.4) d, which was significantly longer than that in non-sepsis group [(2.9 ± 1.9) d, t =6. 189, P <0.01]. There were no statistically significant differences in the other indexes between two groups (with t values from 0.971 to 1. 250, χ2 values respectively 0. 054 and 1.529, P values above 0.05). Single factor and multi-factor Logistic regression analysis indicated that APACHE II score on admission and duration of thrombocytopenia within PBD 10 were closely related to occurrence of sepsis (with odds ratio respectively 1. 140 and 1.569, P values below 0.01). CONCLUSIONS: Duration of thrombocytopenia within PBD 10 is one of the risk factors for sepsis in severely burned patients, which can reflect pathophysiological changes in the body, thus providing predictive value for the occurrence of sepsis.
[Mh] MeSH terms primary: Burns/blood
Burns/diagnosis
Sepsis/blood
Thrombocytopenia
[Mh] MeSH terms secundary: Aged
Albumins
Burn Units
Burns/complications
Humans
Predictive Value of Tests
Regression Analysis
Retrospective Studies
Sepsis/etiology
Shock/blood
Shock/etiology
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Nm] Name of substance:0 (Albumins)
[Em] Entry month:1505
[Js] Journal subset:IM
[Da] Date of entry for processing:141202
[St] Status:MEDLINE

  9 / 91249 MEDLINE  
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[PMID]: 25429805
[Au] Autor:Guo GH; Zhu F
[Ti] Title:[Functional hemodynamic monitoring should be emphasized in intensive care for burn and trauma patients].
[So] Source:Zhonghua Shao Shang Za Zhi;30(4):291-4, 2014 Aug.
[Is] ISSN:1009-2587
[Cp] Country of publication:China
[La] Language:chi
[Ab] Abstract:Hemodynamic monitoring is a very important measure for critically ill patients with burn and trauma, and it should be carried out throughout the course of treatment. Functional hemodynamic monitoring consists of the assessment of the dynamic interactions of hemodynamic variables in response to a defined volume change. Accordingly, response of fluid volume can be assessed in a quantitative fashion by measuring variation of both arterial pulse pressure and left ventricular stroke volunime during positive pressure breathing, or the change in cardiac output response to passive leg raising maneuver. Functional hemodynamic monitoring, contrary to that of static condition in order to realize dynamic and individual monitoring, is related to response to treatment, and it is a useful complement to static (routine) hemodynamic monitoring. At present, in the care of sepsis, shock, and mechanical ventilation, etc. related to burn injury and trauma, functional hemodynamic monitoring is more and more accepted and applied by medical personnel of ICU in burn and trauma departments. Therefore, further study on functional hemodynamic monitoring should be emphasized and practised.
[Mh] MeSH terms primary: Blood Pressure
Burns/therapy
Fluid Therapy
Positive-Pressure Respiration
Stroke Volume
Systole
[Mh] MeSH terms secundary: Critical Care
Critical Illness
Hemodynamics/physiology
Humans
Intensive Care
Respiration, Artificial
Sepsis/diagnosis
Sepsis/therapy
Shock/diagnosis
Shock/therapy
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1505
[Js] Journal subset:IM
[Da] Date of entry for processing:141202
[St] Status:MEDLINE

  10 / 91249 MEDLINE  
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[PMID]: 25399899
[Au] Autor:Pan A; Deng Y; Yang T; Zhang L; Shao M; Zhou S; Wang C; Liu B
[Ad] Address:Department of Critical Care Medicine, Anhui Provincial Hospital, Hefei 230001, Anhui, China, Corresponding author: Liu Bao, Email: aijunpan868@sina.com.
[Ti] Title:[Phenotype and functions of natural killer cells in septic patients and its clinical significance].
[So] Source:Zhonghua Wei Zhong Bing Ji Jiu Yi Xue;26(11):827-31, 2014 Nov.
[Is] ISSN:2095-4352
[Cp] Country of publication:China
[La] Language:chi
[Ab] Abstract:OBJECTIVE: To investigate the possible mechanism of natural killer cells (NK cells) in immune dysfunction in sepsis by monitoring the phenotype and function of periphery NK cells in patients with sepsis. METHODS: A retrospective study was conducted. The patients with systemic inflammatory response syndrome (SIRS, n=59) or sepsis (n=65) admitted to Department of Critical Care Medicine of Anhui Provincial Hospital from August 2011 to August 2013 were enrolled. Blood samples were collected within 48 hours after intensive care unit (ICU) admission, the phenotype and function of periphery NK cells were determined by flow cytometry. Twenty-eight healthy people served as controls. RESULTS: The proportion and number of peripheral blood CD3⁻ CD56⁺ NK cells in SIRS and sepsis groups were normal, and no statistical difference was found when compared with those of the healthy control group [cell proportion: 0.102 ± 0.019, 0.102 ± 0.108 vs. 0.106 ± 0.018, F = 0.018, P = 0.982; cell number (× 106/L): 182.46 ± 65.98, 172.97 ± 63.51 vs. 179.25 ± 60.44, F=0.349, P=0.706]. It was shown by NK cell degranulation detection that there was no significant difference in the expression of CD107 and interferon-γ (IFN-γ) secretion [CD107: 0.135 ± 0.050, 0.140 ± 0.058, 0.128 ± 0.070, F = 0.583, P = 0.560; IFN-γ (kU/L): 14.36 ± 4.74, 12.49 ± 4.21, 13.45 ± 5.04, F=1.616, P=0.202] among healthy control group, SIRS group, and sepsis group. It was shown by antibody dependent cytotoxic effect (ADCC) test that there was no difference in the expression of CD107 among healthy control group, SIRS group, and sepsis group (0.574 ± 0.166, 0.643 ± 0.165, 0.581 ± 0.157, F = 0.808, P = 0.448). When compared with healthy controls, the secretion of IFN-γ was increased in SIRS patients (kU/L: 40.5 ± 13.2 vs. 28.4 ± 9.6, P = 0.001), while reduced in sepsis patients (kU/L: 19.8 ± 6.7 vs. 28.4 ± 9.6, P<0.01). Compared with SIRS group, only NK cell surface inhibitory receptors CD158e (KIR 3DL1) expression in sepsis group was significantly increased (0.203 ± 0.057 vs. 0.079 ± 0.021, t = 15.762, P<0.001), and there were no significant differences in the other phenotype between the two groups. Compared with SIRS group, the IFN-γ production of the sepsis group was significantly lowered (kU/L: 0.280 ± 0.040 vs. 0.310 ± 0.038, t = 3.390, P = 0.009), and the level of IL-12 was also significantly decreased (ng/L: 0.15 ± 0.03 vs. 0.30 ± 0.08, t = 32.832, P < 0.001). CONCLUSIONS: It was showed by NK cell phenotype and function assay that the function of NK cells in patients with sepsis was impaired and led to a poor production of IFN-γ. The IFN-γ mediated immune dysfunction may be a main reason for the disorder of NK cell function, which laid the foundation of the clinical immune intervention practice to improve to NK cell function.
[Mh] MeSH terms primary: Killer Cells, Natural/immunology
Sepsis/immunology
Systemic Inflammatory Response Syndrome/immunology
[Mh] MeSH terms secundary: Case-Control Studies
Flow Cytometry
Humans
Interferon-gamma
Killer Cells, Natural/cytology
Phenotype
Retrospective Studies
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Nm] Name of substance:82115-62-6 (Interferon-gamma)
[Em] Entry month:1505
[Js] Journal subset:IM
[Da] Date of entry for processing:141117
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.2095-4352.2014.11.012


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