Impact of heart failure on outcomes in patients with sepsis:A systematic review and meta-analysis

BACKGROUND Heart failure(HF)often affects the progress of sepsis patients,although its impact on outcomes is inconsistent and inconclusive.AIM To conduct a systematic review and meta-analysis of the impact of HF on mortality in patients with sepsis.METHODS PubMed,Embase,Web of Science,and the Cochrane Library databases were searched to compare the outcomes of sepsis patients with HF.A random effect model was used to summarize the mortality data,and the odds ratio(OR)and 95%confidence interval(CI)were calculated as effect indicators.RESULTS Among 18001 records retrieved in the literature search,35712 patients from 10 separate studies were included.The results showed that sepsis patients with HF were associated with increased total mortality(OR=1.80,95%CI:1.34-2.43;I2=92.1%),with high heterogeneity between studies.Significant subgroup differences according to age,geographical location,and HF patient sample were observed.HF did not increase the 1-year mortality of patients(OR=1.11,95%CI:0.75-1.62;I2=93.2%),and the mortality of patients with isolated right ventricular dysfunction(OR=2.32,95%CI:1.29-4.14;I2=91.5%)increased significantly.CONCLUSION In patients with sepsis,HF is often associated with adverse outcomes and mortality.Our results call for more high-quality research and strategies to improve outcomes for sepsis patients with HF.

Effects of three kinds of head acupuncture therapies on regulation of brain microenvironment and rehabilitation of nerve function in rats with cerebral palsy

OBJECTIVE:To compare and observe the effects of three kinds of cephalic acupuncture therapies commonly used in the clinic on promoting nerve function rehabilitation in the brain microenvironment of rats with cerebral palsy.METHODS:A negative control group,positive control group,and three cephalic acupuncture groups based on the administration of three cephalic acupuncture therapies were established.Ten experimental rats were selected from each group at 1,2,and 3 weeks after modeling.Neuromotor function after treatment was rated according to the Basso,Beattie,and Bresnahan method.White matter fiber bundles were evaluated by head diffusion tensor imaging.The expression levels of neuron-specific enolase,microtubule-associated protein 2,and myelin basic protein in the brain tissue extract were detected by Western blot analysis and the activities of ATPases were determined using a fixed phosphorus method.RESULTS:The pathological changes in brain tissue were restored and motor function scores were increased in the mice in each cephalic acupuncture group,and the expression of neuronal growth-related proteins in the brain tissue extract was significantly increased.Additionally,the activities of ATPases in the lesion area were significant enhanced(P<0.05).Diffusion tensor imaging revealed that the white matter fiber bundles of mice in each cephalic acupuncture group gradually increased and recovered.The nervous system structure was significantly improved.CONCLUSIONS:All three acupuncture methods promoted the rehabilitation of nerve function damaged by cerebral palsy.These effects are likely related to the improved expression of nerve growth-related proteins,enhancement of ATPase activities,and regulation of the brain microenvironment.

Efficacy of Xixiancao (Herba Siegesbeckiae Orientalis) on interactions between nuclear factor kappa-B and inflammatory cytokines in inflammatory reactions of rat synovial cells induced by sodium urate

OBJECTIVE:To investigate the interaction between nuclear factor kappa-B(NF-κB)and inflammatory cytokines in synovial cell inflammatory responses induced by sodium urate,and to evaluate the efficacy of Xixiancao(Herba Siegesbeckiae Orientalis)on these interactions.METHODS:The interactions between NF-κB and inflammatory cytokines/mediators in synovial cells in acute gouty arthritis were investigated.We observed the expressions of NF-κB,interleukin(IL)-1β,IL-8,and tumor necrosis factor alpha(TNF-α)in synovial cells at different timepoints in an in vitro model of synovial cell inflammatory responses induced by sodium urate and in an in vivo model of gouty arthritis.Changes in the expressions of NF-κB,IL-1β,IL-8,and TNF-αin synovial cells of all experimental groups were compared and observed after treatment with different doses of Xixiancao(Herba Siegesbeckiae Orientalis)and colchicine.The interactions between NF-κB and IL-1β,IL-8,and TNF-αwere analyzed.Pathological changes in synovial tissues were observed in rats with acute gouty arthritis.RESULTS:Compared with the blank group,the expression levels of NF-κB,IL-1β,IL-8,and TNF-αwere increased significantly at different timepoints in the in vitro model of synovial cell inflammatory responses induced by sodium urate,and in the in vivo model of gouty arthritis.Compared with the model group,the expressions of NF-κB,IL-1β,IL-8,and TNF-αin synovial cells induced by sodium urate were decreased in the different Xixiancao(Herba Siegesbeckiae Orientalis)dose groups and the colchicine group.The effect was more obvious in the high dose Xixiancao(Herba Siegesbeckiae Orientalis)group.The expression of NF-κB in synovial cells was positively correlated with the expressions of IL-1β,IL-8,and TNF-α.Histopathological examination of synovial tissues in the high dose Xixiancao(Herba Siegesbeckiae Orientalis)group and Colchicine group showed that the characteristics of acute gouty arthritis were reduced,and there was a trend towards a positive correlation between NF-κB and inflammatory cytokine expressions.CONCLUSION:The activation of NF-κB is associated with the activation of IL-1β,IL-8,and TNF-αduring the pathogenesis of acute gouty arthritis,leading to the continuation and enhancement of the inflammatory response.Expressions of IL-1β,IL-8,and TNF-αin synoviocytes during acute gouty arthritis effectively inhibit local inflammation.