Publications by authors named "Er Zhen Chen"

Background: In-flight medical emergencies (IMEs) can have severe outcomes, including the deaths of passengers and aircraft diversions. Information is lacking regarding the incidence rate and characteristics of IMEs in most countries, especially in mainland China.

Objective: The objective of this study was to investigate the incidence, patterns, and associated risk factors of IMEs in mainland China and to provide medical suggestions for the evaluation and management of IMEs.

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Acute kidney injury (AKI) is a common serious complication in sepsis patients with a high mortality rate. This study aimed to develop and validate a predictive model for sepsis associated acute kidney injury (SA-AKI). In our study, we retrospectively constructed a development cohort comprising 733 septic patients admitted to eight Grade-A tertiary hospitals in Shanghai from January 2021 to October 2022.

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Purpose: Infection with carbapenem-resistant (CRKP) is a great challenge. Central nervous system (CNS) infection caused by CRKP is rarely reported, and effective treatment is limited. Thus, this study aimed to assess intrathecal (IT) or intraventricular (IVT) injection of tigecycline for clearing infection with CRKP in CNS.

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Article Synopsis
  • - A novel risk score was developed to better predict in-hospital mortality for adult sepsis patients, addressing limitations of existing scoring systems.
  • - The study analyzed data from 1,335 adult sepsis patients, separating them into modeling and validation groups, and identified key risk factors such as age, central vein catheterization, and vital signs.
  • - This new scoring system outperformed existing ones like APACHE II and MEWS, categorizing patients into four risk levels with corresponding mortality rates ranging from 9.8% to 83.5%.
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Background: Ferroptosis is a nonapoptotic form of programmed cell death, which may be related to the occurrence and development of sepsis-induced acute respiratory distress syndrome (ARDS)/acute lung injury (ALI). Mucin 1 (MUC1) is a kind of macromolecule transmembrane glycoprotein. Previous studies have shown that MUC1 could relieve ALI in sepsis and predict whether sepsis patients would develop into ARDS.

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This study aimed to investigate whether free fatty acids (FFAs) could induce the release of neutrophil extracellular traps (NETs), as well as the mechanism of FFAs-induced NETs in acute lung injury (ALI). FFAs were used to induce NETs production. The reactive oxygen species (ROS) production was detected after FFA and NADPH oxidase inhibitor treatments.

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Objective: To find the predictors for persistent inflammation-immunosuppression catabolism syndrome in ICU surgical septic patients.

Design: Single center observation study.

Participants: Inclusion: 1) patients ≥18, 2) admitted to the ICU after major surgery or transferred to the ICU within 48 hours after the diagnosis of sepsis following the definition of sepsis-3.

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Article Synopsis
  • The study examines the rising incidence of Candida bloodstream infections (BSIs) over 11 years at a large hospital in Shanghai and analyzes risk factors for mortality and the effects of antifungal treatments.
  • Out of 370 patients with 393 BSI episodes, a 28.5% mortality rate was recorded, which was notably lower for those who received antifungal therapy compared to those who did not.
  • Notable independent risk factors for 28-day mortality included age, chronic renal failure, mechanical ventilation, and severe neutropenia, highlighting the importance of timely antifungal intervention.
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Article Synopsis
  • * Survivors generally maintained a negative fluid balance starting from the second day, while non-survivors had a positive fluid balance over the entire week, indicating the importance of fluid management.
  • * The study found that both mean daily fluid balance and the Acute Physiologic and Chronic Health Evaluation II score are independent prognostic factors for patients with sepsis or septic shock, suggesting that careful fluid management is crucial for better outcomes.
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Background: Using standard vancomycin dosage in critically ill patients might lead to therapy failure and worse patient outcomes, augmented renal clearance (ARC) may be the leading risk factor. In this study, we comprehensively investigated the pharmacokinetics-pharmacodynamics (PK-PD) of vancomycin in critically ill patients with ARC, hoping to explore the precise and accurate dose adjustment method for vancomycin.

Methods: All critically ill patients tested for steady-state trough vancomycin serum concentrations during the recent 6 years in a tertiary level hospital were collected retrospectively and divided into ARC and non-ARC groups, respectively, according to creatinine clearance (CLcr).

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Background: The aim of the study was to identify the clinical features and the factors associated with burn induced mortality among young adults after exposure to indoor explosion and fire.

Methods: This is an observational study which included burn patients who were admitted to eighteen ICUs after a fire disaster. Epidemiologic and clinical characteristics, as well as therapy were recorded.

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Sepsis remains a major global concern and is associated with high mortality and morbidity despite improvements in its management. Markers currently in use have shortcomings such as a lack of specificity and failures in the early detection of sepsis. In this study, we aimed to identify key genes involved in the molecular mechanisms of sepsis and search for potential new biomarkers and treatment targets for sepsis using bioinformatics analyses.

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Background: Fluid management is crucial to acute respiratory distress syndrome (ARDS) secondary to sepsis. However, choices of fluid resuscitation strategies and fluid input volumes remain a thorny problem. Our study aimed to elucidate the relationship between fluid balance and prognosis of ARDS patients secondary to sepsis.

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  • Oxidative stress significantly contributes to the severity of acute pancreatitis, and this study investigates the effects of high-dose intravenous Vitamin C as an antioxidant treatment in rats with induced pancreatic injury.* -
  • The research showed that Vitamin C reduces cell apoptosis, lowers oxidative stress markers, and improves survival rates in rats with acute pancreatitis, primarily by activating the NRF2/NQO1/HO-1 signaling pathway.* -
  • Vitamin C treatment also decreased the levels of inflammatory markers and harmful enzymes in plasma, indicating its potential therapeutic benefits in managing severe acute pancreatitis.*
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Coronavirus disease (COVID-19) was first diagnosed in Wuhan in December 2019. The World Health Organization defined the subsequent outbreak of COVID-19 worldwide as a public health emergency of international concern. Epidemiological data indicate that at least 20% of COVID-19 patients have severe disease.

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Objective: We aimed to investigate whether inhibition of MUC1 would aggravate sepsis-induced ALI, and explore the predictive value of plasma MUC1 for sepsis patients with or without ARDS.

Materials And Methods: MUC1 siRNA pre-treatment was used to knockdown MUC1 expression in vitro. GO203 was used to inhibit the homodimerization of MUC1-C in vivo.

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Purpose: It has been reported that approximately 40% of ALI (acute lung injury) incidence resulted from sepsis. Paclitaxel, as a classic anti-cancer drug, plays an important role in the regulation of inflammation. However, we do not know whether it has a protective effect against CLP (cecal ligation and puncture)-induced septic ALI.

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Objective: The aim of the study was to investigate the role of dendritic cell-specific intercellular adhesion molecule 3-grabbing nonintegrin (DC-SIGN) in intestinal epithelial cells (IECs) in regulating sepsis-induced acute intestinal injury and systemic inflammatory response.

Methods: To induce sepsis condition, Male C57BL/6 mice were exposed to cecal ligation and puncture (CLP) in vivo, whereas a normal human IECs line (FHs74Int) was stimulated with lipopolysaccharide (LPS) in vitro. DC-SIGN siRNA pretreatment was used to knock down DC-SIGN expression both in vivo and in vitro.

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To investigate the effect of intravenous Vitamin C (VC) on hemorrhagic shock (HS)-associated rat renal injury and the involved mechanism. Thirty SD rats were randomly assigned to the sham surgery (sham), hemorrhagic shock (HS), HS+100 mg/kg VC (H + VL), HS+500 mg/kg VC (H + VH) and HS+100 mg/kg VC + EX527 (H + VL + E) groups. Tissue and blood samples were collected 6 h after surgery.

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Due to the imbalance between hyper-inflammation and hypo-inflammation, which are characterized by excessive cytokine productions and programmed death 1 (PD-1) upregulation, respectively, sepsis remains a highly lethal inflammatory syndrome with limited effective therapies. Mycophenolate mofetil (MMF), an immunosuppressant, has been reported to attenuate various inflammatory diseases. However, the role of MMF in sepsis therapy remains to be elucidated.

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Objective: To investigate the effect of biliary tract external drainage (BTED) on severe acute pancreatitis (SAP) in rats and the relationship with heme oxygenase-1 (HO-1) pathway.

Methods: Thirty SD rats weighing 250-300 g were randomly assigned into five groups (n = 6): sham surgery (SS) group, SAP group, SAP + BTED group, SAP + zinc protoporphyrin IX (ZnPP) group, SAP + BTED + ZnPP group. The SAP model was induced via retrograde injection of 4% sodium taurocholate (1 mL/kg) into biliopancreatic duct through duodenal wall.

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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.

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Background: Urine output (UO) is an essential criterion of the Kidney Disease Improving Global Outcomes (KDIGO) definition and classification system for acute kidney injury (AKI), of which the diagnostic value has not been extensively studied. We aimed to determine whether AKI based on KDIGO UO criteria (KDIGOUO) could improve the diagnostic and prognostic accuracy, compared with KDIGO serum creatinine criteria (KDIGOSCr).

Methods: We conducted a secondary analysis of the database of a previous study conducted by China Critical Care Clinical Trial Group (CCCCTG), which was a 2-month prospective cohort study (July 1, 2009 to August 31, 2009) involving 3063 patients in 22 tertiary Intensive Care Units in Mainland of China.

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