Application of high-flow oxygen therapy in acute pancreatitis complicated with acute respiratory dysfunction.

BACKGROUND: To reveal the potential efficiency of high-flow oxygen therapy in acute pancreatitis complicated with acute respiratory dysfunction compared with conventional oxygen therapy. METHODS: We retrospectively analyzed 69 patients treated with high-flow oxygen or conventional oxygen therapy, then compared the difference of prime and second outcomes between the two groups. RESULTS: The high-flow oxygen group had lower intubation rate (25.6% vs. 56.7%, p = 0.013) and longer median time to intubation (64.25 h vs. 7.75 h, p < 0.001) compared with the conventional oxygen group. High-flow oxygen had a stronger effect on improving dyspnea (87.2% vs. 56.7%, p = 0.006) and regression of respiratory failure (66.7% vs. 26.7%, p = 0.001). In the univariate and multivariate analyses, high-flow oxygen and APACHE II score were independent predict factors to respiratory failure regression (OR = 20.381, p = 0.038; OR = 36.827, p = 0.026). Patients treated with high-flow oxygen had shorter intensive care unit stay length (19.5 ± 13.4 vs. 7.8 ± 4.7, p = 0.009) and early mortality tended to be significantly lower (17.9% vs. 40.0%, p = 0.058). DISCUSSION: High-flow oxygen is a more effective method for acute pancreatitis complicated with acute respiratory dysfunction than conventional oxygen therapy.

C-MYC induces idiopathic pulmonary fibrosis via modulation of miR-9-5p-mediated TBPL1.

We sought to pinpoint the potential role of C-MYC in pulmonary fibroblast proliferation in idiopathic pulmonary fibrosis (IPF) and its mechanism. A mouse model of IPF was established by injection of bleomycin. C-MYC and miR-9-5p expression was determined by RT-qPCR and Western blot analysis. The interaction among C-MYC, miR-9-5p, and TBPL1 was detected by ChIP assay and dual luciferase reporter gene assay. After alteration of C-MYC, miR-9-5p, and TBPL1, their roles in pulmonary fibrosis and collagen fiber deposition in mice as well as proliferation and differentiation of pulmonary fibroblasts were assessed. Upregulated C-MYC expression was seen in the lung tissues of IPF mice and its silencing retarded IPF in mice. C-MYC could activate miR-9-5p that negatively regulated TBPL1 expression. Up-regulated C-MYC promoted proliferation and differentiation of pulmonary fibroblasts by inhibiting TBPL1 via activation of miR-9-5p, thus triggering IPF. Moreover, in the lung tissues-derived cells of IPF mice, C-MYC inhibitor, 10,058-F4, was observed to inhibit miR-9-5p expression, thereby repressing pulmonary fibrosis by up-regulating TBPL1. Our data provided evidence pinpointed the aggravative role of C-MYC in IPF by activating miR-9-5p to regulate TBPL1 expression.

Effect of prealbumin level on mortality in heatstroke patients.

This study investigated whether serum prealbumin level is associated with mortality in heatstroke patients. A retrospective study of 102 heatstroke patients admitted to the ICU in the Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University from June 2010 to November 2017 was performed they were divided into normal serum prealbumin group (n=79) and low prealbumin group (n=23) according to the difference in PA expression. The clinical data, laboratory inspection data, invasive positive pressure ventilation (IPPV), co-infection, shock and length of ICU stay during the ICU were compared between the two groups of patients. The study endpoints, deaths at admission, were recorded, and the survival curve plotted. Cox regression analysis was performed based on the clinical data of patients, and ROC curve plotted based on Cox multivariate independent prognostic indicators. There were significant differences in clinical variables PLT, ALT, AST, TBIL, ALB, TCH, LDH, TNI, BNP, creatinine, PT, APTT, FBG and D-dimer (P<0.05). The incidence of infection, shock and IPPV was significantly lower in normal serum prealbumin group of patients than those in low prealbumin group (P<0.05). There was a statistically significant difference in short-term survival rate between the groups of patients (χ2=29.101, P<0.001). Prognostic factors for heatstroke patients were IPPV, heart rate, WBC count, PLT count, ALB, PA, TBIL, LDH, CPK, Cr, PCT, PT, APTT, D-dimer, co-infection and shock at admission. Independent prognostic-related factors for heatstroke patients were IPPV, PA level, PLT level, ALB level, CPK level and PT level. When prealbumin <17.95 mg/dl was used as the death threshold for predicting at 28 days, the sensitivity was 77.8%, and the specificity was 85.7%. Significantly associated with the prognosis of heatstroke patients, prealbumin level can be used as an important predictive indicator of the disease progression and worse clinical outcomes.