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Diagnostic value of mismatch-negativity and P3a event-related potentials for sepsis-associated encephalopathy in non-sedated patients:a pilot study 认领 引用
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作者 Zengzheng Ge Xin Lu +7 位作者 Shiyuan Yu Mubing Qin Chao Gong Qun Xu Yanxia Gao Joseph Harold Walline Huadong Zhu Yi Li 《World Journal of Emergency Medicine》 SCIE CAS CSCD 2026年第2期172-178,共7页
BACKGROUND:Although the Confusion Assessment Methods for the Intensive Care Unit(CAMICU) is a recommended tool for diagnosing sepsis-associated encephalopathy(SAE),it has several limitations.Mismatch-negativity(MMN) a... BACKGROUND:Although the Confusion Assessment Methods for the Intensive Care Unit(CAMICU) is a recommended tool for diagnosing sepsis-associated encephalopathy(SAE),it has several limitations.Mismatch-negativity(MMN) and P3a are components of event-related potentials(ERPs) used with electroencephalography(EEG) and are associated with cerebral function changes in critically ill patients.This study aimed to provide a quantitative,non-invasive method to guide SAE diagnosis in nonsedated patients.METHODS:From January 2022 to March 2023,sepsis patients without sedation were enrolled and assessed via the CAM-ICU,Glasgow Coma Scale(GCS),and ERP under standard procedures.Both MMN and P3a data were collected.The diagnostic value of MMN and P3a was assessed with processed ERP data.RESULTS:Thirty-six patients were included in this study,comprising 19 patients with SAE and 17 patients without SAE(NSAE).MMN and P3a amplitudes decreased,and only FzMMN amplitude significantly decreased in SAE patients(2.03 [1.08,2.93] mV vs.3.21 [1.92,4.34] mV,P=0.040).After median dichotomization,low F3P3a and FzP3a amplitudes were associated with higher CAM-ICU positivity rates and APACHE II scores.Both amplitude in F3P3a(AUC=0.710,95%CI:0.527–0.893,P=0.034) and FzP3a(AUC=0.700,95%CI:0.519–0.881,P=0.041) exhibited moderate diagnostic efficacy for SAE,while FzMMN amplitude lacks effective diagnostic value.CONCLUSION:In this pilot study,ERP components F3P3a and FzP3a amplitudes demonstrated moderate diagnostic value for SAE.These exploratory findings require confirmation in larger and powered cohorts. 展开更多
关键词 Sepsis-associated encephalopathy Event-related potentials Mismatch-negativity Electroencephalography Diagnostic value
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Early use of albumin may increase the risk of sepsis-associated acute kidney injury in sepsis patients:a target trial emulation 认领 引用 被引量：2
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作者 Xin-Ya Li Wei-Sheng Chen +5 位作者 Zhong-Kai Qu Jian-Guang Chen Li Li Shu-Na Li Yu Wang Jun Lyu 《Military Medical Research》 SCIE CAS CSCD 2026年第2期198-208,共11页
Background:Most sepsis patients develop sepsis-associated acute kidney injury(SA-AKI),which poses a significant threat to survival and lacks specific treatment.To date,there are no published randomized controlled tria... Background:Most sepsis patients develop sepsis-associated acute kidney injury(SA-AKI),which poses a significant threat to survival and lacks specific treatment.To date,there are no published randomized controlled trials that have established a link between albumin use and SA-AKI development in sepsis.Therefore,it is unclear whether albumin use may influence the risk of SA-AKI.Methods:The present study employed a target trial emulation using observational data to track adult sepsis patients initially admitted to the intensive care unit at Beth Israel Deaconess Medical Center,Boston,Massachusetts,for a period of 7 d from 2008 to 2022.Immortal time bias was controlled using the clone-censor-weight(CCW)method,along with a new-user design to address current user bias.The exposure variable was the early administration of albumin following the onset of sepsis.Based on albumin use,patients were classified into two groups:the albumin group(n=27,088)and the no albumin group(n=27,088).The primary outcome was the development of SA-AKI,and the secondary outcome was 7-day all-cause mortality.The primary outcome was analyzed using competing risk analyses.Furthermore,sensitivity and subgroup analyses were also performed.Results:Among the 27,088 patients analyzed,albumin administration was associated with a significantly higher SA-AKI risk(relative difference=3.47%,95%CI 1.76-5.23)compared to non-administration.There was no clinically meaningful difference in 7-day survival(relative difference=0.05%,95%CI-2.30 to 2.45).Sensitivity analyses consistently supported these results.All these analyses were conducted on data that were collected after CCW.Conclusions:Early albumin administration may increase the risk of SA-AKI in sepsis patients without conferring a short-term survival benefit.These results underscore the need for a rigorous risk-benefit assessment when incorporating albumin into sepsis resuscitation protocols and highlight the need for further clinical validation.However,it is important to exercise caution when interpreting the conclusions of this study,given its exploratory and preliminary nature. 展开更多
关键词 Target trial emulation Clone-censor-weight(CCW) Sepsis-associated acute kidney injury(SA-AKI) Albumin
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Exploring IDH2 as a therapeutic target:in silico and in vitro evidence for the potential of cobicistat and licorice glycoside E in sepsis-associated complications 认领 引用
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作者 Jing-Ni Liu Tan Qian 《Traditional Medicine Research》 2026年第6期93-104,共12页
Background:Sepsis,a life-threatening systemic inflammatory response to infection,presents significant challenges in the intensive care unit(ICU).The condition is frequently accompanied by persistent neurodegenerative ... Background:Sepsis,a life-threatening systemic inflammatory response to infection,presents significant challenges in the intensive care unit(ICU).The condition is frequently accompanied by persistent neurodegenerative changes and muscle atrophy,especially in patients with burn wounds,severely affecting recuperation and quality of life.Traditional physical therapy and advanced sedative screening represent pivotal approaches for the rehabilitation and management of these cases.Methods:A comprehensive transcriptomic study was conducted using gene expression datasets from sepsis patients and important biological models to identify potential targets.We subsequently employed virtual molecular docking and molecular dynamics simulations to screen the FDA drug library and traditional Chinese medicine databases for compounds exhibiting high binding affinity to isocitrate dehydrogenase 2(IDH2).The functional role of this target was validated in vitro using an IDH2 deficient BV-2 microglial cell model stimulated by lipopolysaccharide.Results:Key features were identified through differential expression analysis across multiple datasets.Gene set enrichment analysis(GSEA)highlighted pathways associated with chronic neurodegenerative diseases.Stable interactions between IDH2 and cobicistat or licorice glycoside E were predicted,supporting the identification of IDH2 as a promising therapeutic target.Knockdown of IDH2 in microglial cells led to markedly suppressed production of pro-inflammatory cytokines,including TNF-αand IL-6,confirming its pivotal role in neuroinflammatory response regulation.Conclusion:These findings underscore the pivotal role of IDH2 in persistent neurodegenerative changes associated with sepsis,including burn-related cases.Targeting IDH2 may reduce long-term neurovascular complications and muscle atrophy in septic ICU patients.Our findings suggest that IDH2 is a potential therapeutic target,and the combination of cobicistat and licorice glycoside E warrants further investigation as a promising therapeutic strategy.The study also emphasizes the significance of novel neuroinflammatory and neurovascular biomarkers in understanding and managing long-term sequelae in septic survivors. 展开更多
关键词 sepsis-associated encephalopathy neuroinflammation neurovascular biomarkers IDH2 cobicistat licorice glycoside E neurovascular disease burn injuries
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An approach for the emergency diagnosis and treatment of sepsis-associated encephalopathy in elderly individuals: a literature review 认领 引用 被引量：3
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作者 Wei Gu Jie Zhong +4 位作者 Chuanzhu Lyu Guoqiang Zhang Miaorong Xie Yuefeng Ma Wei Guo 《World Journal of Emergency Medicine》 SCIE CAS CSCD 2025年第5期415-422,共8页
BACKGROUND:Sepsis-associated encephalopathy(SAE)is a diff use dysfunction of the nervous system resulting from sepsis originating outside the central nervous system.Elderly individuals(≥65 years of age)constitute a p... BACKGROUND:Sepsis-associated encephalopathy(SAE)is a diff use dysfunction of the nervous system resulting from sepsis originating outside the central nervous system.Elderly individuals(≥65 years of age)constitute a particularly vulnerable population comprised by a high burden of underlying diseases and complications,which frequently leads to underdiagnosis or misdiagnosis.These patients are at increased risk of long-term or permanent central nervous system impairment,making rapid and accurate diagnosis and treatment especially critical.The review is expected to promote improvements in the diagnosis and treatment of SAE in elderly patients,ultimately achieving more standardized and effi cient SAE management.METHODS:We performed a literature search in four databases-PubMed,Embase,China National Knowledge Infrastructure(CNKI),and Wanfang-from inception to April 2025 using bilinguals(Chinese and English).RESULTS:The diagnostic criteria for SAE in elderly individuals include the following:(1)sepsis;(2)new-onset neurological dysfunction;and(3)exclusion of other causes of neurological dysfunction.Physicians should develop tailored empiric anti-infective plans for elderly SAE patients,considering comorbidities,organ function,infection site,local bacterial spectrum,and resistance.The treatment protocol can be adjusted once the pathogen is identifi ed.Stabilizing hemodynamics and ensuring cerebral perfusion are two fl uid resuscitation strategies used in elderly SAE patients.An individualized approach to fl uid resuscitation using restrictive fl uid volumes should be employed.Supportive treatment for elderly SAE patients focuses on improving tissue perfusion/oxygenation,controlling blood glucose levels,and correcting internal imbalances.Early rehabilitation,nutritional support,cognitive training,and family-based emotional support are important components of comprehensive care.CONCLUSION:The diagnosis and management of SAE in elderly patients support early recognition and timely intervention. 展开更多
关键词 Sepsis-associated encephalopathy Elderly Emergency Diagnosis Management
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Chinese emergency expert consensus on the diagnosis and treatment of sepsis-associated encephalopathy in the elderly 认领 引用
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作者 Wei Gu Jie Zhong +9 位作者 Yongli Han Yuxiang Liu Chuanzhu Lv Guoqiang Zhang Miaorong Xie Yuefeng Ma Wei Guo Society of Emergency Medicine of Chinese Medical Association Emergency Medicine Branch of Chinese Geriatrics Society Emergency Medicine Branch of Beijing Medical Association 《Journal of Acute Disease》 2025年第8期1-10,共10页
Sepsis-associated encephalopathy(SAE)is a diffuse dysfunction of the nervous system resulting from sepsis originating outside the central nervous system.The elderly(≥65 years of age)are a particularly vulnerable popu... Sepsis-associated encephalopathy(SAE)is a diffuse dysfunction of the nervous system resulting from sepsis originating outside the central nervous system.The elderly(≥65 years of age)are a particularly vulnerable population,and the emergency department is typically the first point of contact following onset of SAE.Clinical symptoms in elderly patients with SAE are often atypical,compounded by a high burden of underlying diseases and complications,which frequently leads to underdiagnosis or misdiagnosis.These patients are at increased risk of long-term or permanent central nervous system impairment,making rapid and accurate diagnosis and treatment especially critical.Currently,there are no standardized diagnostic or treatment guidelines tailored specifically to geriatric SAE.This expert consensus,grounded in evidence-based medicine and clinical experience,offers recommendations on the risk factors,clinical characteristics,diagnosis,and treatment of geriatric SAE.The goal is to standardize care,improve diagnostic accuracy,reduce mortality,and enhance patient outcomes. 展开更多
关键词 Sepsis-associated encephalopathy Elderly Emergency
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Iron metabolism and sepsis-associated liver injury:Methodological considerations and clinical perspectives 认领 引用
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作者 Gokhan Koker 《World Journal of Hepatology》 2025年第8期319-321,共3页
This letter offered commentary on the recently published article by Wang et al that investigated the relationship between iron metabolism disorders and sepsis-associated liver injury(SALI).The original study identifie... This letter offered commentary on the recently published article by Wang et al that investigated the relationship between iron metabolism disorders and sepsis-associated liver injury(SALI).The original study identified serum iron and total iron-binding capacity as potential predictive markers of SALI,contributing important insights to critical care hepatology.In this correspondence several methodological considerations that may influence the interpretation and general-izability of the findings were discussed.These include the limitations of a single-center design,the lack of serial biomarker measurements,the omission of hepcidin(a central iron regulatory hormone)as a measured variable,and the exclusive reliance on biochemical criteria for diagnosing liver injury.The potential value of incorporating imaging modalities and additional iron-related markers such as ferritin and transferrin saturation were also highlighted.The aim was to reinforce the importance of a comprehensive approach to iron metabolism in sepsis and to suggest future directions for clinical research that may enhance the diagnostic and prognostic utility of iron-related biomarkers in SALI. 展开更多
关键词 Sepsis-associated liver injury Iron metabolism Hepcidin Serum iron Total iron-binding capacity Prognostic markers Biomarkers in critical illness Liver imaging Ferritin Transferrin saturation
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OGT-Mediated O-GlcNAcylation of ATF2 Protects Against Sepsis-Associated Encephalopathy by Inhibiting Microglial Pyroptosis 认领 引用 被引量：1
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作者 Huan Yao Caixia Liang +6 位作者 Xueting Wang Chengwei Duan Xiao Song Yanxing Shang Mingyang Zhang Yiyun Peng Dongmei Zhang 《Neuroscience Bulletin》 SCIE CAS CSCD 2025年第10期1761-1778,共18页
Microglial pyroptosis and neuroinflammation have been implicated in the pathogenesis of sepsis-associated encephalopathy(SAE).OGT-mediated O-GlcNAcylation is involved in neurodevelopment and injury.However,its regulat... Microglial pyroptosis and neuroinflammation have been implicated in the pathogenesis of sepsis-associated encephalopathy(SAE).OGT-mediated O-GlcNAcylation is involved in neurodevelopment and injury.However,its regulatory function in microglial pyroptosis and involvement in SAE remains unclear.In this study,we demonstrated that OGT deficiency augmented microglial pyroptosis and exacerbated secondary neuronal injury.Furthermore,OGT inhibition impaired cognitive function in healthy mice and accelerated the progression in SAE mice.Mechanistically,OGT-mediated O-GlcNAcylation of ATF2 at Ser44 inhibited its phosphorylation and nuclear translocation,thereby amplifying NLRP3 inflammasome activation and promoting inflammatory cytokine production in microglia in response to LPS/Nigericin stimulation.In conclusion,this study uncovers the critical role of OGT-mediated O-GlcNAcylation in modulating microglial activity through the regulation of ATF2 and thus protects against SAE progression. 展开更多
关键词 O-GlcNAc transferase(OGT) Activation transcription factor 2(ATF2) Microglia Pyroptosis Sepsis-associated encephalopathy(SAE)
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Gut-liver axis in sepsis-associated liver injury:Epidemiology,challenges and clinical practice 认领 引用 被引量：1
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作者 Fabiana Andréa Moura Aryana Isabelle de Almeida Neves Siqueira 《World Journal of Gastroenterology》 SCIE CAS 2025年第1期163-166,共4页
Although the liver has a remarkable regenerative capacity,sepsis-associated liver injury(SLI)is a complication often seen in intensive care units.Due to its role in immune and inflammatory regulation,the liver is part... Although the liver has a remarkable regenerative capacity,sepsis-associated liver injury(SLI)is a complication often seen in intensive care units.Due to its role in immune and inflammatory regulation,the liver is particularly vulnerable during severe infections.Understanding the global prevalence,causes,and management of SLI is essential to improve outcomes and reduce healthcare costs.This paper aims to explore these factors,with an emphasis on identifying effective strategies for clinical management.Zhang et al’s bibliometric analysis of 787 publications(745 original articles and 42 reviews,mostly in animal models)from 2000 to 2023 highlights the growing interest in SLI,focusing on oxidative stress,gut microbiota,and inflammatory processes.Key components such as nuclear factor-kappa B and the NOD-like receptor thermal protein domain associated protein 3 inflammasome pathway,along with their links to gut microbiota imbalance and oxidative stress,are crucial for understanding SLI pathogenesis.The gut-liver axis,particularly the role of intestinal permeability and bacterial translocation in liver inflammation,is emphasized.In this context,bacterial translocation is especially relevant for critically ill patients,as it can exacerbate liver inflammation.The findings underscore the need for integrated care in intensive care units,prioritizing gut health and careful antibiotic use to prevent dysbiosis.Despite extensive research,there remains a lack of clinical trials to validate therapeutic approaches.The abundance of experimental studies highlights potential therapeutic targets,stressing the need for high-quality randomized clinical trials to translate these findings into clinical practice. 展开更多
关键词 Dysbiosis Oxidative stress Inflammation Microbiota Sepsis-associated liver injury
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Unveiling the Role of LncRNA in Sepsis-Associated Encephalopathy 认领 引用
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作者 Xin-yue Shi Hui Zhong +2 位作者 You Shang Ding-yu Zhang Shang-wen Pan 《Current Medical Science》 SCIE CAS CSCD 2025年第6期1336-1347,共12页
Sepsis-associated encephalopathy(SAE)is a critical consequence of sepsis,marked by elevated morbidity and fatality rates.An unbalanced inflammatory response is a significant pathogenic mechanism.The blood-brain barrie... Sepsis-associated encephalopathy(SAE)is a critical consequence of sepsis,marked by elevated morbidity and fatality rates.An unbalanced inflammatory response is a significant pathogenic mechanism.The blood-brain barrier(BBB)is an essential element of the central nervous system(CNS).Sepsis can impact the BBB and neural networks in multiple ways,especially via microglia,astrocytes,and neurons.Long non-coding RNAs(lncRNAs)can participate in the development of various diseases by modulating inflammatory responses,cellular metabolism,and immune cell functions.They not only impact the BBB but also directly influence neurons,affecting the development and prognosis of SAE.This review summarizes the current research status of lncRNAs in SAE,highlights the latest research advances of lncRNAs in sepsis and related diseases,and aims to explore their new application prospects in SAE,offering new targets and methodologies for its diagnosis and therapy. 展开更多
关键词 Sepsis-associated encephalopathy LncRNA Blood-brain barrier Diagnosis Treatment
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Establishment and evaluation of animal models of sepsis-associated encephalopathy 认领 引用 被引量：16
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作者 Mubing Qin Yanxia Gao +5 位作者 Shigong Guo Xin Lu Qian Zhao Zengzheng Ge Huadong Zhu Yi Li 《World Journal of Emergency Medicine》 SCIE CAS CSCD 2023年第5期349-353,共5页
BACKGROUND:Sepsis-associated encephalopathy(SAE) is a critical disease caused by sepsis.In addition to high mortality,SAE can also adversely aff ect life quality and lead to significant socioeconomic costs.This review... BACKGROUND:Sepsis-associated encephalopathy(SAE) is a critical disease caused by sepsis.In addition to high mortality,SAE can also adversely aff ect life quality and lead to significant socioeconomic costs.This review aims to explore the development of evaluation animal models of SAE,giving insight into the direction of future research in terms of its pathophysiology and therapy.METHODS:We performed a literature search from January 1,2000,to December 31,2022,in MEDLINE,PubMed,EMBASE,and Web of Science using related keywords.Two independent researchers screened all the accessible articles based on the inclusion and exclusion criteria and collected the relevant data of the studies.RESULTS:The animal models for sepsis are commonly induced through cecal ligation and puncture(CLP) or lipopolysaccharide(LPS) injection.SAE can be evaluated using nervous reflex scores and sepsis evaluation during the acute phase,or through Morris water maze(MWM),openfield test,fear condition(FC) test,inhibitory avoidance,and other tests during the late phase.CONCLUSION:CLP and LPS injection are the most common methods for establishing SAE animal models.Nervous reflexs cores,MWM,FC test,and inhibitory avoidance are widely used in SAE model analysis.Future research should focus on establishing a standardized system for SAE development and analysis. 展开更多
关键词 Sepsis Sepsis-associated encephalopathy Animal model Systematic review
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Is rosuvastatin protective against sepsis-associated encephalopathy? A secondary analysis of the SAILS trial 认领 引用 被引量：4
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作者 Shi-yuan Yu Zeng-zheng Ge +6 位作者 Jun Xiang Yan-xia Gao Xin Lu Joseph Harold Walline Mu-bing Qin Hua-dong Zhu Yi Li 《World Journal of Emergency Medicine》 SCIE CAS CSCD 2022年第5期367-372,共6页
BACKGROUND:Sepsis is a common cause of death in emergency departments and sepsis-associated encephalopathy(SAE)is a major complication.Rosuvastatin may play a neuroprotective role due to its protective effects on the ... BACKGROUND:Sepsis is a common cause of death in emergency departments and sepsis-associated encephalopathy(SAE)is a major complication.Rosuvastatin may play a neuroprotective role due to its protective effects on the vascular endothelium and its anti-inflammatory functions.Our study aimed to explore the potential protective function of rosuvastatin against SAE.METHODS:Sepsis patients without any neurological dysfunction on admission were prospectively enrolled in the“Rosuvastatin for Sepsis-Associated Acute Respiratory Distress Syndrome”study(SAILS trial,ClinicalTrials.gov number:NCT00979121).Patients were divided into rosuvastatin and placebo groups.This is a secondary analysis of the SAILS dataset.Baseline characteristics,therapy outcomes,and adverse drug events were compared between groups.RESULTS:A total of 86 patients were eligible for our study.Of these patients,51 were treated with rosuvastatin.There were significantly fewer cases of SAE in the rosuvastatin group than in the placebo group(32.1%vs.57.1%,P=0.028).However,creatine kinase levels were significantly higher in the rosuvastatin group than in the placebo group(233[22-689]U/L vs.79[12-206]U/L,P=0.034).CONCLUSION:Rosuvastatin appears to have a protective role against SAE but may result in a higher incidence of adverse events. 展开更多
关键词 Rosuvastatin calcium Sepsis-associated encephalopathy Anti-infl ammatory agents Sepsis Adverse reactions
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Comparison between sepsis-induced coagulopathy and sepsis-associated coagulopathy criteria in identifying sepsis-associated disseminated intravascular coagulation 认领 引用 被引量：5
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作者 Huixin Zhao Yiming Dong +4 位作者 Sijia Wang Jiayuan Shen Zhenju Song Mingming Xue Mian Shao 《World Journal of Emergency Medicine》 SCIE CAS CSCD 2024年第3期190-196,共7页
BACKGROUND:Disseminated intravascular coagulation(DIC)is associated with increased mortality in sepsis patients.In this study,we aimed to assess the clinical ability of sepsis-induced coagulopathy(SIC)and sepsis-assoc... BACKGROUND:Disseminated intravascular coagulation(DIC)is associated with increased mortality in sepsis patients.In this study,we aimed to assess the clinical ability of sepsis-induced coagulopathy(SIC)and sepsis-associated coagulopathy(SAC)criteria in identifying overt-DIC and preDIC status in sepsis patients.METHODS:Data from 419 sepsis patients were retrospectively collected from July 2018 to December 2022.The performances of the SIC and SAC were assessed to identify overt-DIC on days 1,3,7,or 14.The SIC status or SIC score on day 1,the SAC status or SAC score on day 1,and the sum of the SIC or SAC scores on days 1 and 3 were compared in terms of their ability to identify pre-DIC.The SIC or SAC status on day 1 was evaluated as a pre-DIC indicator for anticoagulant initiation.RESULTS:On day 1,the incidences of coagulopathy according to overt-DIC,SIC and SAC criteria were 11.7%,22.0%and 31.5%,respectively.The specificity of SIC for identifying overt-DIC was significantly higher than that of the SAC criteria from day 1 to day 14(P3 had a significantly higher sensitivity(72.00%)and area under the curve(AUC)(0.69)in identifying pre-DIC than did the SIC or SAC status(sensitivity:SIC status 44.00%,SAC status 52.00%;AUC:SIC status 0.62,SAC status 0.61).The sum of the SIC scores on days 1 and 3 had a higher AUC value for identifying the pre-DIC state than that of SAC(0.79 vs.0.69,P<0.001).Favorable effects of anticoagulant therapy were observed in SIC(adjusted hazard ratio[HR]=0.216,95%confidence interval[95%CI]:0.060–0.783,P=0.018)and SAC(adjusted HR=0.146,95%CI:0.041–0.513,P=0.003).CONCLUSION:The SIC and SAC seem to be valuable for predicting overt-DIC.The sum of SIC scores on days 1 and 3 has the potential to help identify pre-DIC. 展开更多
关键词 Sepsis Disseminated intravascular coagulation Sepsis-induced coagulopathy Sepsis-associated coagulopathy
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Risk factors for sepsis-associated encephalopathy 认领 引用 被引量：1
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作者 Jian Li Ang Li +2 位作者 Yibing Weng Shuwen Zhang Meili Duan 《Neural Regeneration Research》 SCIE CAS CSCD 2011年第4期309-312,共4页
Sepsis-associated encephalopathy （SAE） is a diffuse and acute cerebral dysfunction caused by sepsis. Many sepsis patients exhibit acute deterioration in mental status during the early stage of disease, and central n... Sepsis-associated encephalopathy （SAE） is a diffuse and acute cerebral dysfunction caused by sepsis. Many sepsis patients exhibit acute deterioration in mental status during the early stage of disease, and central nervous system dysfunction has been shown to increase patient mortality. The present study selected 284 sepsis patients who were admitted to the Intensive Care Unit of Beijing Friendship Hospital, Capital Medical University, from January to December 2009. The patients were assigned to SAE and non-SAE patient groups according to SAE occurrence. SAE incidence was 37.68%, and mortality was significantly greater in SAE patients compared with non-SAE patients （41.12% vs. 17.51%, P 〈 0.01）. Univariate analysis and multivariate logistic regression analysis indicated lower arterial partial pressure of oxygen and greater alanine aminotransferase and Acute Physiology and Chronic Health Evaluation II scores in the SAE group compared with the non-SAE group. Arterial partial pressure of oxygen, alanine aminotransferase, and Acute Physiology and Chronic Health Evaluation II scores were determined to be potential risk factors for SAE. 展开更多
关键词 sepsis-associated encephalopathy incidence mortality risk factor regression analysis
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Effects of Hydrogen Sulfide on a Rat Model of Sepsis-associated Encephalopathy 认领 引用 被引量：1
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作者 陈娣 潘昊 +3 位作者 李醇文 兰秀彩 刘蓓蓓 杨光田 《Journal of Huazhong University of Science and Technology(Medical Sciences)》 2011年第5期632-636,共5页
To investigate the interaction and involvement of sodium hydrosulfide （NaHS）, a H2S donor, on hippocampus of rats suffering from sepsis-associated encephalopathy, rats were subjected to cecal ligation and puncture ... To investigate the interaction and involvement of sodium hydrosulfide （NaHS）, a H2S donor, on hippocampus of rats suffering from sepsis-associated encephalopathy, rats were subjected to cecal ligation and puncture （CLP）-induced sepsis. Adult male Sprague-Dawley rats were randomly divided into four groups： Sham group, CLP group, CLP＋NaHS group and CLP＋aminooxyacetic acid （AOAA, an inhibitor of H2S formation） group. The four groups were observed at 3, 6, 9, 12 h after treatment. We examined hippocampal H2S synthesis and the expression of cystathionine-β-synthetase （CBS）, a major enzyme involved in the H2S synthesis in hippocampus. CBS expression was detected by reverse transcription polymerase chain reaction （RT-PCR）. The concentrations of inflammatory cytokines （TNF-α, IL-1β） were determined in hippocampus by using enzyme-linked immunosorbent assay （ELISA）. Neuronal damage was studied by histological examination of hippocampus. In CLP group, H2S synthesis was significantly increased in hippocampus compared with sham group and it peaked 3 h after CLP （P〈0.05）. Sepsis also resulted in a significantly upregulated CBS mRNA in hippocampus. The levels of TNF-α and IL-1β in the hippocampus were substantially elevated at each time point of measurement （P〈0.05）, and they also reached a peak value at about 3 h. Administration of NaHS significantly aggravated sepsis-associated hippocampus inflammation, as evidenced by TNF-α and IL-1β activity and histological changes in hippocampus. In septic rats pretreated with AOAA, sepsis-associated hippocampus inflammation was reduced. It is concluded that the rats subjected to sepsis may suffer from brain injury and elevated pro-inflammatory cytokines are responsible for the process. Furthermore, administration of H2S can increase injurious effects and treatment with AOAA can protect the brain from injury. 展开更多
关键词 hydrogen sulfide sepsis-associated encephalopathy TNF-α IL-1β
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Sepsis-associated liver injury:Mechanisms and potential therapeutic targets 认领 引用 被引量：14
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作者 Jia-Wen Chen Chen-Yi Liu +3 位作者 Shu Li Shi-Wen Wu Chao Cai Ming-Qin Lu 《World Journal of Gastroenterology》 SCIE CAS 2024年第42期4518-4522,共5页
In this editorial,we examined a recent article in the World Journal of Gastroenterology that focused on sepsis-associated liver injury(SLI)and its treatment.SLI is a serious complication of sepsis,primarily caused by ... In this editorial,we examined a recent article in the World Journal of Gastroenterology that focused on sepsis-associated liver injury(SLI)and its treatment.SLI is a serious complication of sepsis,primarily caused by microcirculatory disturbances,the gut-liver axis,and inflammatory responses.Specific treatment recommendations for SLI are lacking.The gut-liver axis represents a potential therapeutic target,with metformin showing promise in modulating the gut microbiome and enhancing intestinal barrier function.Although immunomodulatory therapies are being explored,anti-tumor necrosis factor agents and interleukin-1 receptor antagonists have not demonstrated significant clinical benefits.Statins may reduce liver inflammation and prevent injury in sepsis,but their clinical application is limited.Reduced D-related human leucocyte antigen expression on monocytes and lymphocytes suggests immune suppression in patients,indicating that corticosteroids could reverse clinical deterioration in severe infections and address adrenal cortical insufficiency.Current large-scale studies on glucocorticoid therapy for sepsis have yielded mixed results,likely due to inadequate assessment of the immune status of the host.Future research should prioritize the development of personalized immunotherapy tailored to patients’immune profiles,focusing on identifying novel indicators of immune status and advancing immunomodulatory targets and therapeutics for septic patients. 展开更多
关键词 Sepsis Sepsis-associated liver injury Gut-liver axis Immunosuppression Inflammation Immune dysregulation Glucocorticoid Adrenal cortical insufficiency
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Effects of mesencephalic astrocyte-derived neurotrophic factor on sepsis-associated acute kidney injury 认领 引用
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作者 Saifeng Chen Xuewei Hao +4 位作者 Guo Chen Guorong Liu Xiaoyan Yuan Peiling Shen Dongfeng Guo 《World Journal of Emergency Medicine》 SCIE CAS CSCD 2023年第5期386-392,共7页
BACKGROUND:To determine the protective role of mesencephalic astrocyte-derived neurotrophic factor(MANF) in regulating sepsis-associated acute kidney injury(S-AKI).METHODS:A total of 96 mice were randomly divided into... BACKGROUND:To determine the protective role of mesencephalic astrocyte-derived neurotrophic factor(MANF) in regulating sepsis-associated acute kidney injury(S-AKI).METHODS:A total of 96 mice were randomly divided into the control group,control+MANF group,S-AKI group,and S-AKI+MANF group.The S-AKI model was established by injecting lipopolysaccharide(LPS) at 10 mg/kg intraperitoneally.MANF(200 μg/kg) was administered to the control+MANF and S-AKI+MANF groups.An equal dose of normal saline was administered daily intraperitoneally in the control and S-AKI groups.Serum and kidney tissue samples were obtained for biochemical analysis.Western blotting was used to detect the protein expression of MANF in the kidney,and enzyme-linked immunosorbent assay(ELISA) was used to determine expression of MANF in the serum,pro-inflammatory cytokines(tumor necrosis factor-α [TNF-α] and interleukin-6 [IL-6]).Serum creatinine(SCr),and blood urea nitrogen(BUN)were examined using an automatic biochemical analyzer.In addition,the kidney tissue was observed for pathological changes by hematoxylin-eosin staining.The comparison between two groups was performed by unpaired Student’s t-test,and statistics among multiple groups were carried out using Tukey’s post hoc test following one-way analysis of variance(ANOVA).A P-value <0.05 was considered statistically significant.RESULTS:At the early stage of S-AKI,MANF in the kidney tissue was up-regulated,but with the development of the disease,it was down-regulated.Renal function was worsened in the S-AKI group,and TNF-α and IL-6 were elevated.The administration of MANF significantly alleviated the elevated levels of SCr and BUN and inhibited the expression of TNF-α and IL-6 in the kidney.The pathological changes were more extensive in the S-AKI group than in the S-AKI+MANF group.CONCLUSION:MANF treatment may significantly alleviate renal injury,reduce the inflammatory response,and alleviate or reverse kidney tissue damage.MANF may have a protective effect on S-AKI,suggesting a potential treatment for S-AKI. 展开更多
关键词 Sepsis-associated acute kidney injury Mesencephalic astrocyte-derived neurotrophic factor Renal function Cytokines Endoplasmic reticulum stress
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Supervised machine learning models for predicting sepsis-associated acute kidney injury in children:a real-world evaluation 认领 引用
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作者 Dan Shi Wei Gu +4 位作者 Xue-Jing Yang Yan-Qun Sun Jiang-Wen Yin Hong-Jun Miao Xu-Hua Ge 《World Journal of Pediatrics》 SCIE CSCD 2026年第5期559-573,共15页
Background Sepsis-associated acute kidney injury(S-AKI)substantially increases mortality.The recent Phoenix criteria have redefined pediatric sepsis,yet AKI risk factors under this framework remain unclear.This study ... Background Sepsis-associated acute kidney injury(S-AKI)substantially increases mortality.The recent Phoenix criteria have redefined pediatric sepsis,yet AKI risk factors under this framework remain unclear.This study aimed to develop a machine learning(ML)model to identify key predictors of AKI in pediatric patients with sepsis as defined by the Phoenix criteria.Methods This retrospective cohort study included 2424 pediatric patients with a diagnosis of sepsis,of whom 484 developed AKI according to Kidney Disease:Improving Global Outcomes criteria.Data from the first 24 hours of admission were analyzed.The cohort was randomly divided into a training set(70%)and a test set(30%).A least absolute shrinkage and selection operator-random forest hybrid approach selected features,and ten ML algorithms were developed and evaluated on the training set,with their performance subsequently validated on the test set.Model performance was assessed using area under the curve(AUC),accuracy,Brier score,and decision curve analysis.Shapley additive explanations(SHAP)analysis interpreted the optimal model.Results Feature selection identified 13 key predictors,including SpO2/FiO2 ratio,international normalized ratio,procalcitonin,absolute neutrophil count,and mean arterial pressure.The categorical boosting(CatBoost)model achieved the best performance,with an AUC of 0.843[95%confidence interval(CI)=0.818–0.867]in the training set and 0.797(95%CI=0.755–0.839)in the test set.SHAP analysis highlighted procalcitonin and absolute neutrophil count as the most influential features.A web-based tool was created for clinical application.Conclusions Based on the Phoenix criteria,we developed an interpretable CatBoost-based early prediction model and web tool for pediatric S-AKI using 13 clinical features.The model showed good predictive performance and provides a preliminary data-driven framework for S-AKI risk stratification.Future multi-center external validation is needed to confirm generalizability and explore feasibility of clinical integration. 展开更多
关键词 Machine learning Pediatric sepsis Phoenix sepsis score Risk prediction Sepsis-associated acute kidney injury
Chinese emergency expert consensus on the diagnosis and treatment of sepsis-associated encephalopathy in the elderly 认领 引用
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作者 Wei Gu Jie Zhong +9 位作者 Yongli Han Yuxiang Liu Chuanzhu Lv Guoqiang Zhang Miaorong Xie Yuefeng Ma Wei Guo Society of Emergency Medicine of Chinese Medical Association Emergency Medicine Branch of Chinese Geriatrics Society Emergency Medicine Branch of Beijing Medical Association 《Emergency and Critical Care Medicine》 2025年第3期123-130,共8页
Sepsis-associated encephalopathy(SAE)is a diffuse dysfunction of the nervous system resulting from sepsis originating outside the cen-tral nervous system.The elderly(≥65 years of age)are a particularly vulnerable pop... Sepsis-associated encephalopathy(SAE)is a diffuse dysfunction of the nervous system resulting from sepsis originating outside the cen-tral nervous system.The elderly(≥65 years of age)are a particularly vulnerable population,and the emergency department is typically the first point of contact after onset.Clinical symptoms in elderly patients with SAE are often atypical,compounded by a high burden of un-derlying diseases and complications,which frequently leads to underdiagnosis or misdiagnosis.These patients are at an increased risk of long-term or permanent central nervous system impairment,making rapid and accurate diagnosis and treatment especially critical.Cur-rently,there are no standardized diagnostic or treatment guidelines tailored specifically to geriatric SAE.This expert consensus,grounded in evidence-based medicine and clinical experience,offers recommendations on the risk factors,clinical characteristics,diagnosis,and treatment of geriatric SAE.The goal is to standardize care,improve diagnostic accuracy,reduce mortality,and enhance patient outcomes. 展开更多
关键词 Elderly Emergency Sepsis-associated encephalopathy
Diagnostic and Predictive Levels of Calcium-binding Protein A8 and Tumor Necrosis Factor Receptor-associated Factor 6 in Sepsis-associated Encephalopathy: A Prospective Observational Study 认领 引用 被引量：18
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作者 Li-Na Zhang Xiao-Hong Wang +4 位作者 Long Wu Li Huang Chun-Guang Zhao Qian-Yi Peng Yu-Hang Ai 《Chinese Medical Journal》 SCIE CAS CSCD 2016年第14期1674-1681,共8页
Background： Despite its high prevalence, morbidity, and mortality, sepsis-associated encephalopathy （SAE） is still poorly understood. The aim of this prospective and observational study was to investigate the clini... Background： Despite its high prevalence, morbidity, and mortality, sepsis-associated encephalopathy （SAE） is still poorly understood. The aim of this prospective and observational study was to investigate the clinical significance of calcium-binding protein A8 （S 100AS） in serum and tumor necrosis factor receptor-associated factor 6 （TRAF6） in peripheral blood mononuclear cells （PBMCs） in diagnosing SAE and predicting its prognosis. Methods： Data of septic patients were collected within 24 h after Intensive Care Unit admission fi-om July 2014 to March 2015. Healthy medical personnel served as the control group. SAE was defined as cerebral dysfhnction in the presence of sepsis that fulfilled the exclusion criteria. The biochemical indicators, Glasgow Coma Scale, Acute Physiology and Chronic Health Evaluation score II, TRAF6 in PBMC, serum S 100A8, S 10013, and neuron-specific enolase were evaluated in SAE patients afresh. TRAF6 and S 100A8 were also measured in the control group. Results： Of the 57 enrolled patients, 29 were diagnosed with SAE. The S 100A8 and TRAF6 concentrations in SAE patients were both significantly higher than that in no-encephalopathy （NE） patients, and higher in NE than that in controls （3.74 ± 3.13 vs. 1.08 ± 0.75 vs. 0.37 ± 0.14 ng/ml, P 〈 0.01 ; 3.18 ± 1.55 vs. 1.02 ± 0.63 vs. 0.47 ± 0.10, P 〈 0.01）. S 100A8 levels of 1.93 ng/ml were diagnostic of SAE with 92.90% specificity and 69.00% sensitivity in the receiver operating characteristic （ROC） curve, and the area under the curve was 0.86 （95% confidence interval [CI]： 0.76-0.95）. TRAF6-relative levels of 1.44 were diagnostic of SAE with 85.70% specificity and 86.20% sensitivity, and the area under the curve was 0.94 （95% CI： 0.88-0.99）. In addition, S 100A8 levels of 2.41 ng/ml predicted 28-day mortality of SAE with 90.00% specificity and 73.70% sensitivity in the ROC curve, and the area under the curve was 0.88. TRAF6 relative levels of 2.94 predicted 28-day mortality of SAE with 80.00% specificity and 68.40% sensitivity, and the area under the curve was 0.77. Compared with TRAF6, the specificity of serum S 100A8 in diagnosing SAE and predicting mortality was higher, although the sensitivity was low. In contrast, the TRAF6 had higher sensitivity for diagnosis. Conclusions： Peripheral blood levels of S 100A8 and TRAF6 in SAE patients were elevated and might be related to the severity of SAE and predict the outcome of SAE. The efficacy and specificity of S 100A8 for SAE diagnosis were superior, despite its weak sensitivity. S100A8 might be a better biomarker for diagnosis of SAE and predicting prognosis. 展开更多
关键词 Biomarker Calcium-binding Protein A8 Sepsis-associated Encephalopathy Tumor Necrosis Factor Receptor-associated Factor 6
Basic research and clinical progress of sepsis-associated encephalopathy 认领 引用 被引量：12
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作者 Ying Huang Ruman Chen +2 位作者 Lai Jiang Siyuan Li Yuchen Xue 《Journal of Intensive Medicine》 2021年第2期90-95,共6页
Sepsis-associated encephalopathy(SAE),a major cerebral complication of sepsis,occurs in 70%of patients admitted to the intensive care unit(ICU).This condition can cause serious impairment of consciousness and is assoc... Sepsis-associated encephalopathy(SAE),a major cerebral complication of sepsis,occurs in 70%of patients admitted to the intensive care unit(ICU).This condition can cause serious impairment of consciousness and is associated with a high mortality rate.Thus far,several experimental screenings and radiological techniques(e.g.,electroencephalography)have been used for the non-invasive assessment of the structure and function of the brain in patients with SAE.Nevertheless,the pathogenesis of SAE is complicated and remains unclear.In the present article,we reviewed the currently available literature on the epidemiology,clinical manifestations,pathology,diagnosis,and management of SAE.However,currently,there is no ideal pharmacological treatment for SAE.Treatment targeting mitochondrial dysfunction may be useful in the management of SAE. 展开更多
关键词 Sepsis-associated encephalopathy Long-term cognitive dysfunction Cerebral microvasculature damage
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