170 results on '"Ling, Sang"'
Search Results
2. A diagnostic model for sepsis-induced acute lung injury using a consensus machine learning approach and its therapeutic implications
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Yongxin Zheng, Jinping Wang, Zhaoyi Ling, Jiamei Zhang, Yuan Zeng, Ke Wang, Yu Zhang, Lingbo Nong, Ling Sang, Yonghao Xu, Xiaoqing Liu, Yimin Li, and Yongbo Huang
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Sepsis ,Acute lung injury ,Acute respiratory distress syndrome ,Machine learning ,Transcriptome ,Medicine - Abstract
Abstract Background A significant proportion of septic patients with acute lung injury (ALI) are recognized late due to the absence of an efficient diagnostic test, leading to the postponed treatments and consequently higher mortality. Identifying diagnostic biomarkers may improve screening to identify septic patients at high risk of ALI earlier and provide the potential effective therapeutic drugs. Machine learning represents a powerful approach for making sense of complex gene expression data to find robust ALI diagnostic biomarkers. Methods The datasets were obtained from GEO and ArrayExpress databases. Following quality control and normalization, the datasets (GSE66890, GSE10474 and GSE32707) were merged as the training set, and four machine learning feature selection methods (Elastic net, SVM, random forest and XGBoost) were applied to construct the diagnostic model. The other datasets were considered as the validation sets. To further evaluate the performance and predictive value of diagnostic model, nomogram, Decision Curve Analysis (DCA) and Clinical Impact Curve (CIC) were constructed. Finally, the potential small molecular compounds interacting with selected features were explored from the CTD database. Results The results of GSEA showed that immune response and metabolism might play an important role in the pathogenesis of sepsis-induced ALI. Then, 52 genes were identified as putative biomarkers by consensus feature selection from all four methods. Among them, 5 genes (ARHGDIB, ALDH1A1, TACR3, TREM1 and PI3) were selected by all methods and used to predict ALI diagnosis with high accuracy. The external datasets (E-MTAB-5273 and E-MTAB-5274) demonstrated that the diagnostic model had great accuracy with AUC value of 0.725 and 0.833, respectively. In addition, the nomogram, DCA and CIC showed that the diagnostic model had great performance and predictive value. Finally, the small molecular compounds (Curcumin, Tretinoin, Acetaminophen, Estradiol and Dexamethasone) were screened as the potential therapeutic agents for sepsis-induced ALI. Conclusion This consensus of multiple machine learning algorithms identified 5 genes that were able to distinguish ALI from septic patients. The diagnostic model could identify septic patients at high risk of ALI, and provide potential therapeutic targets for sepsis-induced ALI.
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- 2023
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3. Ferroptosis, pyroptosis and necroptosis in acute respiratory distress syndrome
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Yongxin Zheng, Yongbo Huang, Yonghao Xu, Ling Sang, Xiaoqing Liu, and Yimin Li
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Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 ,Cytology ,QH573-671 - Abstract
Abstract Acute respiratory distress syndrome (ARDS) is an acute and uncontrolled pulmonary inflammation caused by various insults. Cell death is a critical mechanism in the pathogenesis of ARDS. Ferroptosis, a novel form of cell death defined as iron-mediated lipid peroxidation, has been shown to play a role in the pathogenesis of ARDS. Additionally, pyroptosis and necroptosis are also involved in the pathophysiological process of ARDS. The crosstalk among ferroptosis, pyroptosis, and necroptosis is getting increasing attention. Therefore, this review will mainly summarize the molecular mechanisms and central pathophysiological role of ferroptosis in ARDS. We will also discuss our understanding of pyroptosis and necroptosis as they pertain to the pathogenesis of ARDS. Furthermore, we also describe the pathological processes that engage crosstalk among ferroptosis, pyroptosis, and necroptosis. We consider that individual pathways of ferroptosis, pyroptosis, and necroptosis are highly interconnected and can compensate for one another to promote cell death.
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- 2023
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4. A feasibility study of reduced full-of-view synthetic high-b-value diffusion-weighted imaging in uterine tumors
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Qian Tang, Qiqi Zhou, Wen Chen, Ling Sang, Yu Xing, Chao Liu, Kejun Wang, Weiyin Vivian Liu, and Lin Xu
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Cervical cancer ,Reduced field-of-view diffusion-weighted imaging ,Synthetic diffusion-weighted image ,Magnetic resonance image ,Medical physics. Medical radiology. Nuclear medicine ,R895-920 - Abstract
Key points rFOV-syDWI provided better lesion clarity and image quality while shortening scan time. Scanned and synthetic ADCs have the same diagnostic value for cervical cancer. Scanned and synthetic ADCmean, minimum can distinguish cervical lesions from normal tissue
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- 2023
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5. The Current Status of the Use of Internet Hospitals for Outpatients With Pain: Retrospective Study
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Ling Sang and Li Song
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Computer applications to medicine. Medical informatics ,R858-859.7 ,Public aspects of medicine ,RA1-1270 - Abstract
BackgroundThe national “Internet +” policies and the emergence of internet hospitals have created a new direction for the management of pain outside of the hospital. Nevertheless, there are no consolidated studies conducted by pain physicians on the current state of internet hospital–based online medical services used by patients with pain outside of a hospital setting. ObjectiveIn this retrospective study, we aimed to examine the status of the use of internet hospitals by patients who experience pain. Moreover, we identified the factors that influenced patients' decisions to make an online visit through the internet hospital. MethodsDetailed information was collected online and offline from outpatients with pain at the information technology center of West China Hospital of Sichuan University from February 2020 to April 2022. Binary logistic regression analysis was conducted to identify the determinants that influenced patients' decisions to make an online visit to the internet hospital. ResultsOver a 2-year period, 85,266 pain-related clinic visits were recorded. Ultimately, 39,260 patients were enrolled for the analysis, with 12.9% (5088/39,260) having online visits. Both online and offline clinics had a greater number of visits by women than men. The average age of patients attending the online clinic was 46.85 (SD 16.56) years, whereas the average age of patients attending the offline clinic was 51.48 (SD 16.12) years. The majority of online clinic visitors (3059/5088, 60.1%) were employed, and one of the most common occupations was farming (721/5088, 14.2%). In addition, 51.8% (2635/5088) of patients who participated in the online clinics lived outside the hospital vicinity. Young (odds ratio [OR] 1.35, 95% CI 1.01-1.81; P=.045) and middle-aged (OR 1.98, 95% CI 1.81-2.16; P
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- 2023
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6. Electrical impedance tomography for titration of positive end-expiratory pressure in acute respiratory distress syndrome patients with chronic obstructive pulmonary disease
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Xuesong Liu, Xiao Liu, Jue Meng, Dongdong Liu, Yongbo Huang, Ling Sang, Yonghao Xu, Zhiheng Xu, Weiqun He, Sibei Chen, Rong Zhang, Xiaoqing Liu, and Yimin Li
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Acute respiratory distress syndrome ,Chronic obstructive pulmonary disease ,Positive end-expiratory pressure ,Electrical impedance tomography ,Oxygen delivery ,Ventilation distribution ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Abstract Background Chronic obstructive pulmonary disease (COPD) is one of most common comorbidities in acute respiratory distress syndrome (ARDS). There are few specific studies on the appropriate ventilation strategy for patients with ARDS comorbid with COPD, especially regarding on positive end-expiratory pressure (PEEP) titration. Methods To compare the respiratory mechanics in mechanical ventilated ARDS patients with or without COPD and to determine whether titration of PEEP based on electrical impedance tomography (EIT) is superior to the ARDSnet protocol. This is a single center, perspective, repeated measure study. ARDS patients requiring mechanical ventilation who were admitted to the intensive care unit between August 2017 and December 2020 were included. ARDS patients were divided according to whether they had COPD into a COPD group and a non-COPD group. Respiratory mechanics, gas exchange, and hemodynamics during ventilation were compared between the groups according to whether the PEEP level was titrated by EIT or the ARDSnet protocol. Results A total of twenty-seven ARDS patients including 14 comorbid with and 13 without COPD who met the study eligibility criteria were recruited. The PEEP levels titrated by EIT and the ARDSnet protocol were lower in the COPD group than in the non-COPD group (6.93 ± 1.69 cm H2O vs. 12.15 ± 2.40 cm H2O, P
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- 2022
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7. Patients with infectious diseases undergoing mechanical ventilation in the intensive care unit have better prognosis after receiving metagenomic next-generation sequencing assay
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Yin Xi, Jing Zhou, Zhimin Lin, Weibo Liang, Chun Yang, Dongdong Liu, Yonghao Xu, Lingbo Nong, Sibei Chen, Yuheng Yu, Weiqun He, Jie Zhang, Rong Zhang, Xuesong Liu, Xiaoqing Liu, Ling Sang, Yuanda Xu, and Yimin Li
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Metagenomic next-generation sequencing ,Intensive care unit ,Severe pneumonia ,Prognosis ,Pathogens diagnosis ,Mortality ,Infectious and parasitic diseases ,RC109-216 - Abstract
Objectives: To evaluate the relation between metagenomic next-generation sequencing (mNGS) and the prognosis of patients with infectious diseases undergoing mechanical ventilation in the intensive care unit (ICU). Methods: This is a single-center observational study, comparing nonrandomly assigned diagnostic approaches. We analyzed the medical records of 228 patients with suspected infectious diseases undergoing mechanical ventilation in the ICU from March 2018 to May 2020. The concordance of pathogen results was also assessed for the results of mNGS, culture, and polymerase chain reaction assays. Results: The 28-day mortality of the patients in the mNGS group was lower after the baseline difference correction (19.23% (20/104) vs 29.03% (36/124) , P = 0.039). Subgroup analysis showed that mNGS assay was associated with improved 28-day mortality of patients who are not immunosuppressed (14.06% vs 29.82%, P = 0.018). Not performing mNGS assay, higher acute physiology and chronic health evaluation II score, and hypertension are independent risk factors for 28-day mortality. The mNGS assay presented an advantage in pathogen positivity (69.8% double-positive and 25.0% mNGS-positive only), and the concordance between these two assays was 79.0%. Conclusion: mNGS survey may be associated with a better prognosis by reducing 28-day mortality of patients with infectious diseases on mechanical ventilation in the ICU. This technique presented an advantage in pathogen positivity over traditional methods.
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- 2022
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8. Corrigendum: Construction and validation of a robust prognostic model based on immune features in sepsis
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Yongxin Zheng, Baiyun Liu, Xiumei Deng, Yubiao Chen, Yongbo Huang, Yu Zhang, Yonghao Xu, Ling Sang, Xiaoqing Liu, and Yimin Li
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sepsis ,immune ,prognostic model ,28-day mortality ,immunosuppression ,Immunologic diseases. Allergy ,RC581-607 - Published
- 2023
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9. Identification of differentially expressed genes and signaling pathways in neutrophils during sepsis-induced immunosuppression via bioinformatics analysis
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Yongxin Zheng, Zhihui Zhang, Yongbo Huang, Jinping Wang, Ling Sang, Yonghao Xu, Xiaoqing Liu, Yimin Li, and Peifang Wei
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Medicine - Published
- 2022
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10. The influence of reference electrode in electrical impedance tomography
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Zhimin Lin, Weixiang Huang, Zhijun Gao, Lin Yang, Yimin Li, Yu Lu, Meng Dai, Feng Fu, Ling Sang, and Zhanqi Zhao
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Electrical impedance tomography ,Reference electrode ,Center of ventilation ,Regions of interest ,Respiratory rate ,Global inhomogeneity index ,Science (General) ,Q1-390 ,Social sciences (General) ,H1-99 - Abstract
Background: Some electrical impedance tomography (EIT) devices equip reference electrodes. In practice, it is not uncommon to observe high contact impedance for the reference electrode. The influence of bad contact reference electrode on data quality is unknown. The study aimed to investigate the influence of reference electrode on EIT image reconstruction. Methods: Thirty lung healthy volunteers were prospectively examined with EIT. The subjects were spontaneously breathing in supine position. Three scenarios were constructed: 1. Normal measurement; 2. Reference electrode disconnected without recalibration; 3. Reference electrode disconnected, and the measurement restarted after recalibration of the system. EIT-based parameters measuring spatial and temporal ventilation distributions were calculated and compared. A so-call deviation score was calculated to assess the differences in EIT parameters between scenarios 2 and 1, between 3 and 1. Results: The absolute differences for all parameters were significantly higher than zero (p < 0.01 for all parameters and scenarios). Deviation score for scenario 2 was 4.5 ± 3.5. Four subjects had a deviation score of 0 in scenario 2 and five subjects had a score of 1. The deviation in scenario 3 was higher (6.1 ± 3.1). No subjects had a score of 0 and only two subjects had a score of 1. Conclusions: For EIT systems that equips with reference electrode, it is important to ensure the proper contact and functionality of the reference electrode. The EIT data quality would remain unchanged in only a small portion of subjects.
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- 2022
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11. Construction and validation of a robust prognostic model based on immune features in sepsis
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Yongxin Zheng, Baiyun Liu, Xiumei Deng, Yubiao Chen, Yongbo Huang, Yu Zhang, Yonghao Xu, Ling Sang, Xiaoqing Liu, and Yimin Li
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sepsis ,immune ,prognostic model ,28-day mortality ,immunosuppression ,Immunologic diseases. Allergy ,RC581-607 - Abstract
PurposeSepsis, with life-threatening organ failure, is caused by the uncontrolled host response to infection. Immune response plays an important role in the pathophysiology of sepsis. Immune-related genes (IRGs) are promising novel biomarkers that have been used to construct the diagnostic and prognostic model. However, an IRG prognostic model used to predict the 28-day mortality in sepsis was still limited. Therefore, the study aimed to develop a prognostic model based on IRGs to identify patients with high risk and predict the 28-day mortality in sepsis. Then, we further explore the circulating immune cell and immunosuppression state in sepsis.Materials and methodsThe differentially expressed genes (DEGs), differentially expressed immune-related genes (DEIRGs), and differentially expressed transcription factors (DETFs) were obtained from the GEO, ImmPort, and Cistrome databases. Then, the TFs-DEIRGs regulatory network and prognostic prediction model were constructed by Cox regression analysis and Pearson correlation analysis. The external datasets also validated the reliability of the prognostic model. Based on the prognostic DEIRGs, we developed a nomogram and conducted an independent prognosis analysis to explore the relationship between DEIRGs in the prognostic model and clinical features in sepsis. Besides, we further evaluate the circulating immune cells state in sepsis.ResultsA total of seven datasets were included in our study. Among them, GSE65682 was identified as a discovery cohort. The results of GSEA showed that there is a significant correlation between sepsis and immune response. Then, based on a P value
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- 2022
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12. Is Spartina Alterniflora Eradication Project in Chongming Island a Nature-Based Solution?
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Xu, Dong-Fan, primary, Yuan, Qi, additional, Lu, Ling-Wen, additional, Tan, Bing, additional, Ge, Ming, additional, Chen, Jing-Yi, additional, Hao, Yingying, additional, Zhou, Si-Qi, additional, Sheng, Ling-Sang, additional, Cai, Xing-Xing, additional, and Zhao, Bin, additional
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- 2024
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13. Cytomegalovirus reactivation in immunocompetent mechanical ventilation patients: a prospective observational study
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Zhihui Zhang, Xuesong Liu, Ling Sang, Sibei Chen, Zhan Wu, Jierong Zhang, Yining Sun, Yongbo Huang, Yonghao Xu, Weiqun He, Yimin Li, and Xiaoqing Liu
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Cytomegalovirus reactivation ,Immunocompetent ,Critically ill ,Epidemiology ,Predictors ,Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background Cytomegalovirus (CMV) reactivation is associated with adverse prognoses of critically ill patients. However, the epidemiology and predictors of CMV reactivation in immunocompetent patients receiving mechanical ventilation (MV) are not clear. The aim of this study was to investigate the epidemiology and predictors of CMV reactivation in immunocompetent patients requiring MV. Methods A single-center, prospective observational study (conducted from June 30, 2017 to July 01, 2018) with a follow-up of 90 days (September 29, 2018) that included 71 CMV-seropositive immunocompetent patients with MV at a 37-bed university hospital general intensive care unit (ICU) in China. Routine detection of CMV DNAemia was performed once a week for 28 days (Days 1, 7, 14, 21, and 28). CMV serology, laboratory findings, and clinical data were obtained during hospitalization. Results Among 71 patients, 13 (18.3%) showed CMV reactivation within 28 days in the ICU. The median time to reactivation was 7 days. CMV reactivation was related to various factors, including body mass index (BMI), sepsis, N-terminal pro-b-type natriuretic peptide (NT-proBNP), blood urea nitrogen (BUN), and hemoglobin (Hb) levels (P
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- 2021
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14. Distribution of cokernels of ($n$+$u$) $\times$ $n$ matrices over $\mathbb{Z}_p$
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Tse, Ling-Sang
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Mathematics - Number Theory - Abstract
Let $n, u \geq 0$, $M$ be a ($n$+$u$) $\times$ $n$ matrices over $\mathbb{Z}_p$, and $G$ be a finite abelian p-group group. We find that the probability that the cokernel of $M$ is isomorphic to $\mathbb{Z}_p^u \oplus G$ as $n$ goes to infinity is exactly what is expected from Cohen-Lenstra heuristics for the classical case when $u$ is negative., Comment: 7 pages
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- 2016
15. COVID-19-associated coagulopathy: thromboembolism prophylaxis and poor prognosis in ICU
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Runhui Zheng, Jing Zhou, Bin Song, Xia Zheng, Ming Zhong, Li Jiang, Chun Pan, Wei Zhang, Jiaan Xia, Nanshan Chen, Wenjuan Wu, Dingyu Zhang, Yin Xi, Zhimin Lin, Ying Pan, Xiaoqing Liu, Shiyue Li, Yuanda Xu, Yimin Li, Huo Tan, Nanshan Zhong, Xiaodan Luo, and Ling Sang
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Coagulation parameters ,COVID-19 ,D-dimer ,Sepsis‐induced coagulopathy ,Disseminated intravascular coagulation ,Diseases of the blood and blood-forming organs ,RC633-647.5 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Background Coronavirus disease 2019 (COVID-19) is associated with coagulation abnormalities which are indicators of higher mortality especially in severe cases. Methods We studied patients with proven COVID-19 disease in the intensive care unit of Jinyintan Hospital, Wuhan, China from 30 to 2019 to 31 March 2020. Results Of 180 patients, 89 (49.44 %) had died, 85 (47.22 %) had been discharged alive, and 6 (3.33 %) were still hospitalised by the end of data collection. A D-dimer concentration of > 0.5 mg/L on admission was significantly associated with 30 day mortality, and a D-dimer concentration of > 5 mg/L was found in a much higher proportion of non-survivors than survivors. Sepsis-induced coagulopathy (SIC) and disseminated intravascular coagulation (DIC) scoring systems were dichotomised as 2 than 0.5 mg/L on admission is a risk factor for severe disease. A SIC score of > 4 and DIC score of > 5 may be used to predict mortality. Thromboembolic prophylaxis can reduce mortality only in patients with a D-dimer concentration of > 2 mg/L or DIC score of ≥ 5.
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- 2021
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16. The incidence, risk factors and prognosis of acute kidney injury in severe and critically ill patients with COVID-19 in mainland China: a retrospective study
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Ling Sang, Sibei Chen, Xia Zheng, Weijie Guan, Zhihui Zhang, Wenhua Liang, Ming Zhong, Li Jiang, Chun Pan, Wei Zhang, Jiaan Xia, Nanshan Chen, Wenjuan Wu, Hongkai Wu, Yonghao Xu, Xuesong Liu, Xiaoqing Liu, Jianxing He, Shiyue Li, Dingyu Zhang, Nanshan Zhong, and Yimin Li
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Coronavirus disease 2019 ,Acute respiratory distres ,Syndrome ,Acute kidney injury ,Intensive care unit ,Mechanical ventilation ,Diseases of the respiratory system ,RC705-779 - Abstract
Abstract Background The clinical correlates, prognosis and determinants of acute kidney injury (AKI) in patients with coronavirus disease 2019 (Covid-19) remain largely unclear. Methods We retrospectively reviewed medical records of all adult patients with laboratory-confirmed Covid-19 who were admitted to the intensive care unit (ICU) between January 23rd 2020 and April 6th 2020 at Wuhan JinYinTan Hospital and The First Affiliated Hospital of Guangzhou Medical University. Results Among 210 patients, 131 were males (62.4%). The median Age was 64 years (IQR: 56–71). Of 92 (43.8%) patients who developed AKI during hospitalization, 13 (14.1%), 15 (16.3%) and 64 (69.6%) were classified as being at stage 1, 2 and 3, respectively. 54 patients (58.7%) received continuous renal replacement therapy. Age, sepsis, nephrotoxic drug, invasive mechanical ventilation and elevated baseline serum creatinine levels were associated with the occurrence of AKI. Renal recovery during hospitalization was identified among 16 patients with AKI (17.4%), who had a significantly shorter time from admission to AKI diagnosis, lower incidence of right heart failure and higher ratio of partial pressure of oxygen to the fraction of inspired oxygen. Of 210 patients, 93 deceased within 28 days of ICU admission. AKI stage 3, critical disease, greater Age and the lowest ratio of partial pressure of oxygen to the fraction of inspired oxygen being
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- 2020
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17. A Randomized, Single-Blind, Group Sequential, Active-Controlled Study to Evaluate the Clinical Efficacy and Safety of α-Lipoic Acid for Critically Ill Patients With Coronavirus Disease 2019 (COVID-19)
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Ming Zhong, Aijun Sun, Ting Xiao, Ge Yao, Ling Sang, Xia Zheng, Jinyan Zhang, Xuejuan Jin, Lei Xu, Wenlong Yang, Peng Wang, Kai Hu, Dingyu Zhang, and Junbo Ge
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pneumonia ,SARS-CoV-2 ,COVID-19 ,α-Lipoic acid ,SOFA score ,Medicine (General) ,R5-920 - Abstract
ObjectTo evaluate the clinical efficacy and safety of α-Lipoic acid (ALA) for critically ill patients with coronavirus disease 2019 (COVID-19).MethodsA randomized, single-blind, group sequential, active-controlled trial was performed at JinYinTan Hospital, Wuhan, China. Between February 2020 and March 2020, 17 patients with critically ill COVID-19 were enrolled in our study. Eligible patients were randomly assigned in a 1:1 ratio to receive either ALA (1200 mg/d, intravenous infusion) once daily plus standard care or standard care plus equal volume saline infusion (placebo) for 7 days. All patients were monitored within the 7 days therapy and followed up to day 30 after therapy. The primary outcome of this study was the Sequential Organ Failure Estimate (SOFA) score, and the secondary outcome was the all-cause mortality within 30 days.ResultNine patients were randomized to placebo group and 8 patients were randomized to ALA group. SOFA score was similar at baseline, increased from 4.3 to 6.0 in the placebo group and increased from 3.8 to 4.0 in the ALA group (P = 0.36) after 7 days. The 30-day all-cause mortality tended to be lower in the ALA group (3/8, 37.5%) compared to that in the placebo group (7/9, 77.8%, P = 0.09).ConclusionIn our study, ALA use is associated with lower SOFA score increase and lower 30-day all-cause mortality as compared with the placebo group. Although the mortality rate was two-folds higher in placebo group than in ALA group, only borderline statistical difference was evidenced due to the limited patient number. Future studies with larger patient cohort are warranted to validate the role of ALA in critically ill patients with COVID-19.Clinical Trial Registrationhttp://www.chictr.org.cn/showproj.aspx?proj=49534.
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- 2022
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18. Editorial: CardioPulmonary Physiology: Novel Approaches to Pulmonary Function and Critical Care
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Zhanqi Zhao, Ling Sang, and Tong In Oh
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cardiopulmonary system ,pulmonary function ,critical care ,electrical impedance tomography ,early mobilization ,chronic obstructive pulmonary disease ,Physiology ,QP1-981 - Published
- 2022
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19. Intravenous Immunoglobulin Therapy for Critically Ill COVID-19 Patients With Different Inflammatory Phenotypes: A Multicenter, Retrospective Study
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Yan Chen, Jianfeng Xie, Wenjuan Wu, Shusheng Li, Yu Hu, Ming Hu, Jinxiu Li, Yi Yang, Tingrong Huang, Kun Zheng, Yishan Wang, Hanyujie Kang, Yingzi Huang, Li Jiang, Wei Zhang, Ming Zhong, Ling Sang, Xia Zheng, Chun Pan, Ruiqiang Zheng, Xuyan Li, Zhaohui Tong, Haibo Qiu, Li Weng, and Bin Du
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COVID-19 ,intravenous immunoglobulin therapy (IVIG) ,hyperinflammation ,hypoinflammation ,efficiency ,Immunologic diseases. Allergy ,RC581-607 - Abstract
BackgroundThe benefits of intravenous immunoglobulin administration are controversial for critically ill COVID-19 patients.MethodsWe analyzed retrospectively the effects of immunoglobulin administration for critically ill COVID-19 patients. The primary outcome was 28-day mortality. Inverse probability of treatment weighting (IPTW) with propensity score was used to account for baseline confounders. Cluster analysis was used to perform phenotype analysis.ResultsBetween January 1 and February 29, 2020, 754 patients with complete data from 19 hospitals were enrolled. Death at 28 days occurred for 408 (54.1%) patients. There were 392 (52.0%) patients who received intravenous immunoglobulin, at 11 (interquartile range (IQR) 8, 16) days after illness onset; 30% of these patients received intravenous immunoglobulin prior to intensive care unit (ICU) admission. By unadjusted analysis, no difference was observed for 28-day mortality between the immunoglobulin and non-immunoglobulin groups. Similar results were found by propensity score matching (n = 506) and by IPTW analysis (n = 731). Also, IPTW analysis did not reveal any significant difference between hyperinflammation and hypoinflammation phenotypes.ConclusionNo significant association was observed for use of intravenous immunoglobulin and decreased mortality of severe COVID-19 patients. Phenotype analysis did not show any survival benefit for patients who received immunoglobulin therapy.
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- 2022
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20. Over‐shedding of donor‐derived cell‐free DNA at immune‐related regions into plasma of lung transplant recipient
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Jiaqi Luo, Liping Liu, Lingxi Chen, Xin Xu, Yanfei Wang, Bing Wei, Chunrong Ju, Xuedong Wang, Liyan Huang, Wenchuang Zeng, Xinyao Miao, Ling Sang, Danxia Huang, Guangze Pan, Guilin Peng, Zhuxing Chen, Zicheng Zhao, Chao Yang, Weixue Cui, Wenxi Jiang, Jinjin Xu, Shuai Cheng Li, and Jianxing He
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Medicine (General) ,R5-920 - Published
- 2022
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21. Early triage of critically ill COVID-19 patients using deep learning
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Wenhua Liang, Jianhua Yao, Ailan Chen, Qingquan Lv, Mark Zanin, Jun Liu, SookSan Wong, Yimin Li, Jiatao Lu, Hengrui Liang, Guoqiang Chen, Haiyan Guo, Jun Guo, Rong Zhou, Limin Ou, Niyun Zhou, Hanbo Chen, Fan Yang, Xiao Han, Wenjing Huan, Weimin Tang, Weijie Guan, Zisheng Chen, Yi Zhao, Ling Sang, Yuanda Xu, Wei Wang, Shiyue Li, Ligong Lu, Nuofu Zhang, Nanshan Zhong, Junzhou Huang, and Jianxing He
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Science - Abstract
The sudden deterioration of patients with novel coronavirus disease 2019 (COVID-19) into critical illness is of major concern and early assessment would be vital. Here, the authors show that a deep learning-based survival model can predict the risk of COVID-19 patients developing critical illness based on clinical characteristics at admission.
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- 2020
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22. Management of critically ill patients with COVID-19 in ICU: statement from front-line intensive care experts in Wuhan, China
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You Shang, Chun Pan, Xianghong Yang, Ming Zhong, Xiuling Shang, Zhixiong Wu, Zhui Yu, Wei Zhang, Qiang Zhong, Xia Zheng, Ling Sang, Li Jiang, Jiancheng Zhang, Wei Xiong, Jiao Liu, and Dechang Chen
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COVID-19 ,Critical care ,Expert statement ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Abstract Background The ongoing coronavirus disease 2019 (COVID-2019) pandemic has swept all over the world, posing a great pressure on critical care resources due to large number of patients needing critical care. Statements from front-line experts in the field of intensive care are urgently needed. Methods Sixteen front-line experts in China fighting against the COVID-19 epidemic in Wuhan were organized to develop an expert statement after 5 rounds of expert seminars and discussions to provide trustworthy recommendation on the management of critically ill COVID-19 patients. Each expert was assigned tasks within their field of expertise to provide draft statements and rationale. Parts of the expert statement are based on epidemiological and clinical evidence, without available scientific evidences. Results A comprehensive document with 46 statements are presented, including protection of medical personnel, etiological treatment, diagnosis and treatment of tissue and organ functional impairment, psychological interventions, immunity therapy, nutritional support, and transportation of critically ill COVID-19 patients. Among them, 5 recommendations were strong (Grade 1), 21 were weak (Grade 2), and 20 were experts’ opinions. A strong agreement from voting participants was obtained for all recommendations. Conclusion There are still no targeted therapies for COVID-19 patients. Dynamic monitoring and supportive treatment for the restoration of tissue vascularization and organ function are particularly important.
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- 2020
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23. Factors associated with intraoperative extracorporeal membrane oxygenation support during lung transplantation
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Rong Zhang, Yonghao Xu, Ling Sang, Sibei Chen, Yongbo Huang, Lingbo Nong, Chun Yang, Xuesong Liu, Dongdong Liu, Yin Xi, Weiqun He, Bing Wei, Jianxing He, Yimin Li, and Xiaoqing Liu
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Extracorporeal membrane oxygenation ,Lung transplantation ,Factors ,Diseases of the respiratory system ,RC705-779 - Abstract
Abstract Background Intraoperative Extracorporeal membrane oxygenation (ECMO) is increasingly being applied as life-support for lung transplantation patients. However, factors associated with this procedure in lung transplantation patients have not yet been characterized. The aim of this study was to identify preoperative factors of intraoperative ECMO support during lung transplantation and to evaluated the outcome of lung transplantation patients supported with ECMO. Methods Patients underwent lung transplantation treated with and without ECMO in Guangzhou Institute of Respiratory Diseases between January 2015 to August 2018 were retrospectively reviewed. Patient demographics and clinical variables were collected and analyzed. Multivariate logistic regression was performed to identify factors independently associated with intraoperative extracorporeal membrane oxygenation support during lung transplantation. Results During the study period, 138 patients underwent lung transplantation at our institution, the mean LAS was (56.63 ± 18.39) (range, 32.79 to 88.70). Fourty four patients were treated with veno-venous/veno-arterial ECMO. Among the patients, 32 patients wean successfully ECMO after operation, 12 patients remain ECMO after operation, and 32 patients (62.74%) survived to hospital discharge. In multiple analysis, the following factors were associated with intraoperative ECMO support: advanced age, high PAP before operation, duration of mechanical ventilation before operation, a higher APACHE II and primary diagnosis for transplantation. The overall survival rates at 1, 3, and 12 months were 90.91, 72.73, and 56.81% in the ECMO group, and 95.40, 82.76, and 73.56% in the non-ECMO group, respectively (log-rank P = 0.081). Patients who underwent single lung transplant had a lower survival rates in ECMO group as compared with non-ECMO group at 1, 3, and 12 months (90.47% vs 98.25, 71.43% vs 84.21, and 52.38% vs 75.44%) (log-rank P = 0.048). Conclusions The preoperative factors of intraoperative ECMO support during lung transplantation included age, high PAP before operation, preoperative mechanical ventilation, a higher APACHE II and primary diagnosis for transplantation based on multivariate analysis.
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- 2020
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24. Current Status of Cell-Based Therapies for COVID-19: Evidence From Mesenchymal Stromal Cells in Sepsis and ARDS
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Zhiheng Xu, Yongbo Huang, Jianmeng Zhou, Xiumei Deng, Weiqun He, Xiaoqing Liu, Yimin Li, Nanshan Zhong, and Ling Sang
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COVID-19 ,MSCs therapies ,ARDS ,sepsis ,SARS-CoV-2 ,Immunologic diseases. Allergy ,RC581-607 - Abstract
The severe respiratory consequences of the coronavirus disease 2019 (COVID-19) pandemic have prompted the urgent need for novel therapies. Cell-based therapies, primarily using mesenchymal stromal cells (MSCs), have demonstrated safety and potential efficacy in the treatment of critical illness, particularly sepsis and acute respiratory distress syndrome (ARDS). However, there are limited preclinical data for MSCs in COVID-19. Recent studies have shown that MSCs could decrease inflammation, improve lung permeability, enhance microbe and alveolar fluid clearance, and promote lung epithelial and endothelial repair. In addition, MSC-based therapy has shown promising effects in preclinical studies and phase 1 clinical trials in sepsis and ARDS. Here, we review recent advances related to MSC-based therapy in the context of sepsis and ARDS and evaluate the potential value of MSCs as a therapeutic strategy for COVID-19.
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- 2021
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25. Optimal Positive End Expiratory Pressure Levels in Ventilated Patients Without Acute Respiratory Distress Syndrome: A Bayesian Network Meta-Analysis and Systematic Review of Randomized Controlled Trials
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Jing Zhou, Zhimin Lin, Xiumei Deng, Baiyun Liu, Yu Zhang, Yongxin Zheng, Haichong Zheng, Yingzhi Wang, Yan Lai, Weixiang Huang, Xiaoqing Liu, Weiqun He, Yuanda Xu, Yimin Li, Yongbo Huang, and Ling Sang
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Acute respiratory distress syndrome ,Mechanical ventilation ,Positive end expiratory pressure ,Pneumothorax ,Mortality ,Medicine (General) ,R5-920 - Abstract
Background: To find the optimal positive end expiratory pressure (PEEP) in mechanical ventilated patients without Acute Respiratory Distress Syndrome (ARDS), we conducted a Bayesian network meta-analysis and systematic review of randomized controlled trials (RCTs) comparing different level of PEEP based on a novel classification of PEEP level: ZEEP group (PEEP = 0 cm H2O); lower PEEP group (PEEP = 1–6 cm H2O); intermediate PEEP group (PEEP = 7–10 cm H2O); higher PEEP group (PEEP > 10 cm H2O).Result: Twenty eight eligible studies with 2,712 patients were included. There were no significant differences in the duration of mechanical ventilation between higher and intermediate PEEP (MD: 0.020, 95% CI: −0.14, 0.28), higher and lower PEEP (MD: −0.010, 95% CI: −0.23, 0.22), higher PEEP and ZEEP (MD: 0.010, 95% CI: −0.40, 0.22), intermediate and lower PEEP (MD: −0.040, 95% CI: −0.18, 0.040), intermediate PEEP and ZEEP (MD: −0.010, 95% CI: −0.42, 0.10), lower PEEP and ZEEP (MD: 0.020, 95% CI: −0.32, 0.13), respectively. Higher PEEP was associated with significantly higher PaO2/FiO2 ratio(PFR) when compared to ZEEP (MD: 73.24, 95% CI: 11.03, 130.7), and higher incidence of pneumothorax when compared to intermediate PEEP, lower PEEP and ZEEP (OR: 2.91e + 12, 95% CI: 40.3, 1.76e + 39; OR: 1.85e + 12, 95% CI: 29.2, 1.18e + 39; and OR: 1.44e + 12, 95% CI: 16.9, 8.70e + 38, respectively). There was no association between PEEP levels and other secondary outcomes.Conclusion: We identified higher PEEP was associated with significantly higher PFR and higher incidence of pneumothorax. Nonetheless, in terms of other outcomes, no significant differences were detected among four levels of PEEP.Systematic Review Registration: The study had registered on an international prospective register of systematic reviews, PROSPERO, on 09 April 2021, identifier: [CRD42021241745].
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- 2021
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26. Delayed Initiation of ECMO Is Associated With Poor Outcomes in Patients With Severe COVID-19: A Multicenter Retrospective Cohort Study
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Xuyan Li, Ming Hu, Ruiqiang Zheng, Yishan Wang, Hanyujie Kang, Li Jiang, Ming Zhong, Ling Sang, Xia Zheng, Chun Pan, Wei Zhang, Haibo Qiu, Bin Du, and Zhaohui Tong
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coronavirus disease 2019 ,respiratory failure ,acute respiratory distress syndrome ,extracorporeal membrane oxygenation ,outcome ,Medicine (General) ,R5-920 - Abstract
Background: Extracorporeal membrane oxygenation (ECMO) is a rapidly evolving therapy for acute lung and/or heart failure. However, the information on the application of ECMO in severe coronavirus disease 2019 (COVID-19) is limited, such as the initiation time. Especially in the period and regions of ECMO instrument shortage, not all the listed patients could be treated with ECMO in time. This study aimed to investigate and clarify the timing of ECMO initiation related to the outcomes of severe patients with COVID-19. The results show that ECMO should be initiated within 24 h after the criteria are met.Methods: In this retrospective, multicenter cohort study, we enrolled all ECMO patients with confirmed COVID-19 at the three hospitals between December 29, 2019 and April 5, 2020. Data on the demographics, clinical presentation, laboratory profile, clinical course, treatments, complications, and outcomes were collected. The primary outcomes were successful ECMO weaning rate and 60-day mortality after ECMO. Successful weaning from ECMO means that the condition of patients improved with adequate oxygenation and gas exchange, as shown by the vital signs, blood gases, and chest X-ray, and the patient was weaned from ECMO for at least 48 h.Results: A total of 31 patients were included in the analysis. The 60-day mortality rate after ECMO was 71%, and the ECMO weaning rate was 26%. Patients were divided into a delayed ECMO group [3 (interquartile range (IQR), 2–5) days] and an early ECMO group [0.5 (IQR, 0–1) days] based on the time between meeting the ECMO criteria and ECMO initiation. In this study, 14 and 17 patients were included in the early and delayed treatment groups, respectively. Early initiation of ECMO was associated with decreased 60-day mortality after ECMO (50 vs. 88%, P = 0.044) and an increased ECMO weaning rate (50 vs. 6%, P = 0.011).Conclusions: In ECMO-supported patients with COVID-19, delayed initiation of ECMO is a risk factor associated with a poorer outcome.Trial Registration: Clinical trial submission: March 19, 2020. Registry name: A medical records-based study for the clinical application of extracorporeal membrane oxygenation in the treatment of severe respiratory failure patients with novel coronavirus pneumonia (COVID-19). Chinese Clinical Trial Registry: https://www.chictr.org.cn/showproj.aspx?proj=51267,identifier:~ChiCTR2000030947.
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- 2021
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27. Reverse Trigger in Ventilated Non-ARDS Patients: A Phenomenon Can Not Be Ignored!
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Zhimin Lin, Jing Zhou, Xiaoling Lin, Yingzhi Wang, Haichong Zheng, Weixiang Huang, Xiaoqing Liu, Yimin Li, Nanshan Zhong, Yongbo Huang, Yuanda Xu, and Ling Sang
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reverse triggering ,mechanical ventilation ,sedation ,acute respiratory distress syndrome ,respiratory mechanics ,Physiology ,QP1-981 - Abstract
IntroductionThe role of reverse trigger (RT) was unknown in ventilated non-acute respiratory distress syndrome (ARDS) patients. So we conducted a retrospective study to evaluate the incidence, characteristics and physiologic consequence of RT in such population.MethodSix ventilated non-ARDS patients were included, the esophageal balloon catheter were placed for measurements of respiratory mechanics in all patients. And the data were analyzed to identified the occurrence of RT, duration of the entrainment, the entrainment pattern or ratio, the phase difference (dP) and the phase angle (θ), phenotypes, Effects and clinical correlations of RT.ResultRT was detected in four patients of our series (66.7%), and the occurrence of RT varying from 19 to 88.6% of their recording time in these 4 patients. One patient (No.2) showed a stable 1:1 ratio and Mid-cycle RT was the most common phenotype. However, the remained patients showed a mixed ratios, and Late RT was the most common phenotype, followed by RT with breath stacking. The average values of mean phase delay and phase angles were 0.39s (0.32, 0.98) and 60.52° (49.66, 102.24). Mean phase delay and phase angles were shorter in early reverse triggering with early and delayed relaxation, and longer in mid, late RT and RT with breath stacking. Pmus was variable between patients and phenotypes, and larger Pmus was generated in Early RT, Delayed Relaxation and mid cycle RT. When the RT occurred, the Peso increased 17.27 (4.91, 19.71) cmH2O compared to the controlled breathing, and the average value of incremental ΔPeso varied widely inter and intra patients (Table 3B and Figure 1). Larger ΔPeso was always generated in Early RT, Delayed Relaxation and mid cycle RT, accompanied by an significant increase of PL with 19.12 (0.75) cmH2O and 16.10 (6.23) cmH2O.ConclusionRT could also be observed in ventilated non-ARDS patients. The characteristics of pattern and phenotype was similar to RT in ARDS patients to a large extent. And RT appeared to alter lung stress and delivered volumes.
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- 2021
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28. Traitement des patients atteints d'une forme moderee ou grave de maladie a coronavirus 2019 : Ligne directrice fondee sur des donnees probantes
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Ye, Zhikang, Rochwerg, Bram, Wang, Ying, Adhikari, Neill K., Murthy, Srinivas, Lamontagne, Francois, Fowler, Robert A., Qiu, Haibo, Wei, Li, Loeb, Ling Sang Mark, Shen, Ning, Huang, Minhua, Jiang, Zhaonan, Arabi, Yaseen M., Colunga-Lozano, Luis Enrique, Jiang, Li, Koh, Younsuck, Liu, Dong, Liu, Fang, Phua, Jason, Shen, Aizong, Huo, Tianyi, Du, Bin, Zhai, Suodi, and Guyatt, Gordon H.
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Coronaviruses ,COVID-19 ,Health - Abstract
C'est le 11 mars 2020 que l'Organisation mondiale de la sante (OMS) a officiellement declare l'etat de pandemie relativement a la flambee de maladie a coronavirus 2019 (COVID-19). La propagation [...]
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- 2020
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29. Lung Recruitment, Individualized PEEP, and Prone Position Ventilation for COVID-19-Associated Severe ARDS: A Single Center Observational Study
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Ling Sang, Xia Zheng, Zhanqi Zhao, Min Zhong, Li Jiang, Yongbo Huang, Xiaoqing Liu, Yimin Li, and Dingyu Zhang
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coronavirus disease 2019 ,acute respiratory distress syndrome ,lung recruitability ,PEEP titration ,prone position ventilation ,Medicine (General) ,R5-920 - Abstract
Background: Patients with coronavirus disease 2019 (COVID-19) may develop severe acute respiratory distress syndrome (ARDS). The aim of the study was to explore the lung recruitability, individualized positive end-expiratory pressure (PEEP), and prone position in COVID-19-associated severe ARDS.Methods: Twenty patients who met the inclusion criteria were studied retrospectively (PaO2/FiO2 68.0 ± 10.3 mmHg). The patients were ventilated under volume-controlled mode with tidal volume of 6 mL/kg predicted body weight. The lung recruitability was assessed via the improvement of PaO2, PaCO2, and static respiratory system compliance (Cstat) from low to high PEEP (5–15 cmH2O). Patients were considered recruitable if two out of three parameters improved. Subsequently, PEEP was titrated according to the best Cstat. The patients were turned to prone position for further 18–20 h.Results: For recruitability assessment, average value of PaO2 was slightly improved at PEEP 15 cmH2O (68.0 ± 10.3 vs. 69.7 ± 7.9 mmHg, baseline vs. PEEP 15 cmH2O; p = 0.31). However, both PaCO2 and Cstat worsened (PaCO2: 72.5 ± 7.1 vs. 75.1 ± 9.0 mmHg; p < 0.01. Cstat: 17.5 ± 3.5 vs. 16.6 ± 3.9 ml/cmH2O; p = 0.05). Only four patients (20%) were considered lung recruitable. Individually titrated PEEP was higher than the baseline PEEP (8.0 ± 2.1 cmH2O vs. 5 cmH2O, p < 0.001). After 18–20 h of prone positioning, investigated parameters were significantly improved compared to the baseline (PaO2: 82.4 ± 15.5 mmHg. PaCO2: 67.2 ± 6.4 mmHg. Cstat: 20.6 ± 4.4 ml/cmH2O. All p < 0.001 vs. baseline).Conclusions: Lung recruitability was very low in COVID-19-associated severe ARDS. Individually titrated PEEP and prone positioning might improve lung mechanics and blood gasses.
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- 2021
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30. Changes in erythrocyte polyunsaturated fatty acids and plasma eicosanoids level in patients with asthma
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Jing Zhou, Lifang Chen, Zhenjie Liu, Ling Sang, Yimin Li, and Dongjuan Yuan
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Asthma ,Polyunsaturated fatty acids ,Eicosanoids ,Inflammation ,Nutritional diseases. Deficiency diseases ,RC620-627 - Abstract
Abstract Background To investigate the changes of polyunsaturated fatty acids (PUFAs) and their downstream eicosanoids in patients with asthma, the levels of erythrocyte membrane lipids and plasma lipid metabolites were examined. Methods Erythrocyte membrane lipids were extracted and esterificated, and then fatty acid compositions were determined by gas chromatography. The concentrations of six eicosanoids of PGE2, TXA2, LTB4, PGE1, 6-k-PGF1α and PGF2α in plasma were measured by ELISA. Results The results showed that the contents of erythrocyte membrane fatty acids in patients with asthma were mainly composed of C16:0, C18:0, C18:1, C18:2(n-6), and C20:4(n-6). The ratio n-6/n-3 PUFAs in patients and health persons were (4.42 ± 1.33):1 and (3.21 ± 0.79):1 (p
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- 2018
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31. Addendum: Early triage of critically ill COVID-19 patients using deep learning
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Wenhua Liang, Jianhua Yao, Ailan Chen, Qingquan Lv, Mark Zanin, Jun Liu, SookSan Wong, Yimin Li, Jiatao Lu, Hengrui Liang, Guoqiang Chen, Haiyan Guo, Jun Guo, Rong Zhou, Limin Ou, Niyun Zhou, Hanbo Chen, Fan Yang, Xiao Han, Wenjing Huan, Weimin Tang, Weijie Guan, Zisheng Chen, Yi Zhao, Ling Sang, Yuanda Xu, Wei Wang, Shiyue Li, Ligong Lu, Nuofu Zhang, Nanshan Zhong, Junzhou Huang, and Jianxing He
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Science - Published
- 2021
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32. The efficacy and safety of IBI314 on delta and omicron variant of SARS-CoV-2: First-in-human evidence
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Ling Sang, Bo Cheng, Yuheng Yu, Yin Xi, Yun Wang, Bingdong Fan, Jijie Li, Jingtao Dai, Guifen Gan, Shijun Tong, Bin Sun, Xiaojing Qi, Wenhua Liang, Jianxing He, and Nanshan Zhong
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Microbiology (medical) ,Infectious Diseases ,SARS-CoV-2 ,Spike Glycoprotein, Coronavirus ,COVID-19 ,Humans ,Enzyme-Linked Immunosorbent Assay - Published
- 2022
33. The effect of Huayu Lifei formula on the expression of miR-27a and α-SMA in lung tissue of bleomycin-induced rat lung fibrosis model.
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LIN Ling-sang, CHEN Jie, LI Si-guang, ZHANG Lei, and DING Yi-peng
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GENE expression ,PULMONARY fibrosis ,REPORTER genes ,BINDING sites ,LABORATORY rats - Abstract
Objective: Investigating the inhibitory effect of Huayu Lifyei Formula on bleomycininduced rat pulmonary fibrosis and its impact on the expression of miR-27a and a-SMA. Methods: Wistar rats were arbitrarily classified into a normal group, a model group, and a group treated with Huayu Lifyei Formula, each consisting of ten rats. Pulmonary fibrosis rat model was established by injecting bleomycin. Subsequent to the modeling, the Huayu Lifyei Formula treatment group was administered Huayu Lifyei Formula via gavage for a period of 7 days. Rats were sacrificed on the 14th day after modeling. The right lung was taken for HE staining, Masson staining, and immunohistochemical observation of alpha-smooth muscle actin (a-SMA) expression. The expression of miR-27a was measured by qRT-PCR, with the miR-27a binding site on ACTA2 (the gene encoding a-SMA protein) confirmed using dualluciferase reporter gene technology. Results: When compared to the model group, the Huayu Lifyei Formula treatment group showed considerable alleviation of pathological morphological changes in lung tissue, with significant reductions in alveolitis, fibrosis, collagen deposition in lung tissue, and the expression of a-SMA protein. Meanwhile, the expression of miR-27a in the Huayu Lifyei Formula treatment group significantly increased, and the dual-luciferase reporter gene confirmed the binding site of miR-27a with the ACTA2 gene. Conclusion: Huayu Lifyei Formula can inhibit bleomycin-induced pulmonary fibrosis in rats, and its mechanism may be related to the promotion of miR-27a expression. [ABSTRACT FROM AUTHOR]
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- 2023
34. End-Expiratory Lung Impedance Measured With Electrical Impedance Tomography at Different Days Are Not Comparable
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Ling, Sang, primary and Zhao, Zhanqi, additional
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- 2023
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35. Cigarette induced release of exo-miR-34a from 16HBE vesicles targeting CASP2 promoted the proliferation of COPD MRC-5 cell.
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LI Si-guang, LIN Ling-sang, CHEN Jie, ZHAO Jie, and DING Yi-peng
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GENE expression ,CIGARETTES ,TRANSMISSION electron microscopes ,CHRONIC obstructive pulmonary disease ,CIGARETTE smoke - Abstract
Objective: To explore how cigarette smoke extract (CES) regulates the expression of exosomal miR-34a in 16 HBE bronchial epithelial cells, thus affecting the proliferation of MRC-5 lung fibroblasts. Methods: CES was prepared from commercially available cigarettes, and 16HBE cells were treated with CES. The exosomal miR-34a collected from Yipeng Ding, Chief Physician, M.D., the supernatant was used for MRC-5 cell culture. The expression level of exosomal miR-34a was detected by RT-PCR. The proliferation ability of MRC-5 cells was determined by CCK-8 cell counting kit. The expression of CASP2 was detected by Western blot, and the target binding of miR-34a and CASP2 gene was verified by dual luciferase. Results: Under the transmission electron microscope, the exosomes in the supernatant of 16 HBE were spherical, with a particle size of about 100 nm; after CES treatment, the expression of exosomal miR-34a significantly increased. Further research showed that the exosomal miR-34a induced by CES can promote the proliferation of MRC-5 cells; miR-34a and CASP2 have a target binding relationship; miR-34a mimic significantly inhibited the expression of CASP2. Conclusion: In CES-induced 16HBE cells, exosomal miR-34a plays a key role in fibroblast proliferation through target binding with the CASP2 gene. [ABSTRACT FROM AUTHOR]
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- 2023
36. The Current Usage Status of Internet Hospital for Pain Outpatients in a Tertiary Hospital: Retrospective Study (Preprint)
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Ling Sang and Li Song
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BACKGROUND The national "Internet +" policies and the emergency of internet hospitals have created a new direction for the management of pain outside of the hospital. Nevertheless, there are no consolidated studies conducted by pain physicians on the current state of internet hospital-based online medical services used by patients with pain outside of a hospital setting. OBJECTIVE This retrospective study aims to examine the usage status of internet hospital by patients with pain. Moreover, we will identify the factors that influence patients' decisions to make an online visit through the internet hospital. METHODS Detailed information was collected online and offline about pain outpatients at West China Hospital (information technology center) of Sichuan University from February 2020 to April 2022. Binary logistic regression analysis was conducted to identify the determinants that influence patients' decisions to make an online visit based on the internet hospital. RESULTS Over a two-year period, 85,266 pain clinic visits were recorded. Ultimately, 39,260 patients were enrolled for the analysis, with 12.96% (5088/39260) of online visits. Both online and offline clinics had a greater number of women than men. The average age of patients attending the online clinic was 46.85±16.56 (Mean ± standard deviation) whereas the average age of patients attending the offline clinic was 51.48±16.12. The majority of online clinic visitors (3059/5088, 60.12%) were employed. And (2635/5088, 51.79%) of patients who participated in online clinics lived outside the hospital vicinity. Age, working status, and place of residence were associated with patients’ intention to choose online visits through the internet hospital. CONCLUSIONS Internet hospitals are flourishing as a more efficient and promising way of pain management and follow-up for patients with pain out-of-hospital. People with pain who are young, working, and non-local are more likely to visit internet hospitals.
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- 2022
37. Secondary infection in severe and critical COVID-19 patients in China: a multicenter retrospective study
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Chun Pan, Nuofu Zhang, Zhimin Lin, Shiyue Li, Wenjuan Wu, Ying Pan, Yonghao Xu, Dingyu Zhang, Dongdong Liu, Ming Zhong, Chang'an Li, Xiaoqing Liu, Zheng Lv, Nanshan Zhong, Wei Zhang, Ling Sang, Yuanda Xu, Bin Song, Dan Ye, Nanshan Chen, Weibo Liang, Xuesong Liu, Jiaan Xia, Sibei Chen, Yin Xi, Li Jiang, Xia Zheng, and Yimin Li
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Adult ,medicine.medical_specialty ,Secondary infection ,Carbapenem-resistant enterobacteriaceae ,Internal medicine ,Epidemiology ,medicine ,Humans ,Pandemics ,Survival rate ,Retrospective Studies ,Advanced and Specialized Nursing ,Cross Infection ,biology ,Coinfection ,SARS-CoV-2 ,business.industry ,COVID-19 ,Retrospective cohort study ,Middle Aged ,medicine.disease ,biology.organism_classification ,Anti-Bacterial Agents ,Acinetobacter baumannii ,Stenotrophomonas maltophilia ,Anesthesiology and Pain Medicine ,business - Abstract
Background. Since 2020 COVID-19 pandemic became an emergent public sanitary incident. The epidemiology data and the impact on prognosis of secondary infection in severe and critical COVID-19 patients in China remained largely unclear.Methods. We retrospectively reviewed medical records of all adult patients with laboratory-confirmed COVID-19 who were admitted to ICUs from January 18th 2020 to April 26th 2020 at two hospitals in Wuhan, China and one hospital in Guangzhou, China. We measured the frequency of bacteria and fungi cultured from respiratory tract, blood and other body fluid specimens. The risk factors for and impact of secondary infection on clinical outcomes were also assessed. Results. Secondary infections were very common (86.6%) when patients were admitted to ICU for >72 hours. The majority of infections were respiratory, with the most common organisms being Klebsiella pneumoniae (24.5%), Acinetobacter baumannii (21.8%), Stenotrophomonas maltophilia (9.9%), Candida albicans (6.8%), and Pseudomonas spp. (4.8%). Furthermore, the proportions of multidrug resistant (MDR) bacteria and carbapenem resistant Enterobacteriaceae (CRE) were high. We also found that age ≥60 years and mechanical ventilation ≥13days independently increased the likelihood of secondary infection. Finally, patients with positive cultures had reduced ventilator free days in 28 days and patients with CRE and/or MDR bacteria positivity showed lower 28 day survival rate.Conclusions. In a retrospective cohort of severe and critical COVID-19 patients admitted to ICUs in China, the prevalence of secondary infection was high, especially with CRE and MDR bacteria, resulting in poor clinical outcomes.
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- 2021
38. Independent risk factors of hypoxemia in patients after surgery with acute type A aortic dissection
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Jieyi Pan, Weixiang Huang, Yimin Li, Weibo Liang, Weiqun He, Lingbo Nong, Yuheng Yu, Sibei Chen, Xuesong Liu, Ling Sang, Yan Lai, Xiaoqing Liu, Yonghao Xu, Yongbo Huang, Yuanda Xu, and Jing Zhou
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medicine.medical_specialty ,medicine.medical_treatment ,Hypoxemia ,law.invention ,Risk Factors ,law ,medicine ,Humans ,Renal replacement therapy ,Hypoxia ,Retrospective Studies ,Advanced and Specialized Nursing ,Aortic dissection ,APACHE II ,business.industry ,Acute kidney injury ,Retrospective cohort study ,Perioperative ,medicine.disease ,Intensive care unit ,respiratory tract diseases ,Surgery ,Aortic Dissection ,Intensive Care Units ,Anesthesiology and Pain Medicine ,medicine.symptom ,business ,circulatory and respiratory physiology - Abstract
This study aimed to investigate independent risk factors of postoperative hypoxemia in patients with acute type A aortic dissection (ATAAD).A single-center retrospective study was conducted with enrolled 75 ATAAD patients following surgery, which were stratified into three groups on the basis of the postoperative PaO2/FiO2 ratio: severe hypoxemia group (PaO2/FiO2 ratio ≤100 mmHg); moderate hypoxemia group (100 mmHgPaO2/FiO2 ratio ≤200 mmHg); and non-hypoxemia group (PaO2/FiO2 ratio200 mmHg). The patient's demography, perioperative laboratory results, operative details, clinical outcomes were collected and analyzed. Univariable and multivariable analyses were performed and logistic regression model was established.The incidence of postoperative severe hypoxemia and hypoxemia was 32% and 52%, respectively. Among the three groups, severe hypoxemia group exhibited a high significance of body mass index (BMI) and preoperative white blood cell (WBC) and main distribution of hypertension; meanwhile, Marfan syndrome was mainly distributed in non-hypoxemia group. On intensive care unit (ICU) admission, severe hypoxemia group exhibited a high significance of Acute Physiology and Chronic Health Evaluation (APACHE II) score of postoperative patients, and more patients would present shock. Moreover, severe hypoxemia group patients had a higher incidence of postoperative acute kidney injury (AKI) and usage of renal replacement therapy, longer length of stay (LOS) of ICU, and shorter 28 days ventilator-free days (VFDs).The incidence of postoperative hypoxemia was high in ATAAD patients owing to comprehensive high-risk factors. Besides, postoperative complications negatively impacted their clinical outcomes.
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- 2021
39. Effect of Schottky annealing temperature on reverse leakage current of 6500 V 4H-SiC JBS diodes
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Xiping Niu, Xiaoguang Wei, Yunlai An, Ling Sang, Peifei Wu, Yang Zhou, Botao Sun, Wenting Zhang, Rui Liu, Zechen Du, Chenmeng Li, Zhanwei Shen, Tongtong Yang, Weixia Luo, Yan Tian, and Fei Yang
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Inorganic Chemistry ,Materials Chemistry ,Condensed Matter Physics - Published
- 2023
40. Predictors of fatal outcomes among hospitalized COVID‐19 patients with pre‐existing hypertension in China
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Chunli Liu, Honglian Ruan, Ling Sang, Hong Shan, Tao Wang, Shiyue Li, Lei Liu, Ruchong Chen, Ruidi Tang, Zhengyi Ni, Nuofu Zhang, Yu Hu, Shuting Yi, Su Xi, Zili Zhang, Jing Li, Yixiang Peng, Nanshan Zhong, Cheng Hong, and Chunliang Lei
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Pulmonary and Respiratory Medicine ,China ,cardiac injury ,medicine.medical_specialty ,hypertension ,renin‐angiotensin‐aldosterone system suppressors ,medicine.medical_treatment ,Diastole ,Angiotensin-Converting Enzyme Inhibitors ,Angiotensin Receptor Antagonists ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,COVID‐19 ,Internal medicine ,Humans ,Immunology and Allergy ,Medicine ,Hospital Mortality ,030212 general & internal medicine ,Risk factor ,Stage (cooking) ,Genetics (clinical) ,Retrospective Studies ,Mechanical ventilation ,SARS-CoV-2 ,business.industry ,Hazard ratio ,COVID-19 ,Original Articles ,blood pressure control ,Confidence interval ,Blood pressure ,030228 respiratory system ,chemistry ,Spironolactone ,Original Article ,business - Abstract
Background Coronavirus disease 2019 (COVID‐19) is an emerging, rapidly evolving pandemic, hypertension is one of the most common co‐existing chronic conditions and a risk factor for mortality. Nearly one‐third of the adult population is hypertensive worldwide, it is urgent to identify the factors that determine the clinical course and outcomes of COVID‐19 patients with hypertension. Methods and results 148 COVID‐19 patients with pre‐existing hypertension with clarified outcomes (discharge or deceased) from a national cohort in China were included in this study, of whom 103 were discharged and 45 died in hospital. Multivariate regression showed higher odds of in‐hospital death associated with high‐sensitivity cardiac troponin (hs‐cTn) > 28 pg/ml (hazard ratio [HR]: 3.27, 95% confidence interval [CI]: 1.55–6.91) and interleukin‐6 (IL‐6) > 7 pg/ml (HR: 3.63, 95% CI:1.54–8.55) at admission. Patients with uncontrolled blood pressure (BP) (n = 52) which were defined as systolic BP ≥140 mm Hg or diastolic BP ≥90 mm Hg for more than once (≥2 times) during hospitalization, were more likely to have ICU admission (p = 0.037), invasive mechanical ventilation (p = 0.028), and renal injury (p = 0.005). A stricter BP control with the threshold of 130/80 mm Hg was associated with lower mortality. Treatment with renin‐angiotensin‐aldosterone system (RAAS) suppressors, including angiotensin‐converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARB), and spironolactone, was associated with a lower rate of ICU admission compared to other types of anti‐hypertensive medications (8 (22.9%) vs. 25 (43.1%), p = 0.048). Conclusion Among COVID‐19 patients with pre‐existing hypertension, elevated hs‐cTn and IL‐6 could help clinicians to identify patients with fatal outcomes at an early stage, blood pressure control is associated with better clinical outcomes, and RAAS suppressors do not increase mortality and may decrease the need for ICU admission.
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- 2021
41. Prognostic Genes of Sepsis-induced ARDS identified by Gene Co- expression Network Analysis
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Yongxin Zheng, Chuyun Qian, Yongbo Huang, Yonghao Xu, Ling Sang, Xiaoqing Liu, and Yimin Li
- Abstract
Background and objectives: Acute respiratory distress syndrome (ARDS) is a common and fatal complication of sepsis. The molecular mechanisms of early recognition are still limited. The aim of the study was to identify the potential different genes between sepsis alone and sepsis-induced ARDS. Methods: The gene expression profiles of GSE66890 were selected from the Gene Expression Omnibus (GEO) database for bioinformatic analysis. Weight gene co-expression network analysis (WGCNA) was used to construct a co-expression network to explore the associations between gene sets and clinical traits, and to identify the candidate hub genes. Then, GSE10474 and GSE32707 were used to validate our results. Results: A total of 11 modules were obtained via the average linkage hierarchical clustering. In the significant module, based on the |MM|>0.9 and |GS|>0.2, 4 genes TOP2A, CENPF, DLGAP5 and BIRC5 which had the highest connectivity were identified as the hub genes. Logistic regression model and receiver operating characteristic (ROC) curve validated that the expression levels of 4 hub genes exhibited a moderate diagnostic efficiency for sepsis alone and sepsis-induced ARDS. Among them, the 4 genes were significantly upregulated in sepsis-induced ARDS patients. Additionally, nomogram showed that 4 hub genes may have a good ability to predicting the probability of sepsis-induced ARDS patients. Conclusions: Our research provides a more effective understanding of the importance of biological pathways and the relationships between major genes in sepsis-induced ARDS in the perspective of searching for new molecular targets. TOP2A, CENPF, DLGAP5 and BIRC5 might be potential diagnostic biomarkers for sepsis-induced ARDS.
- Published
- 2022
42. Association of D-dimer elevation with inflammation and organ dysfunction in ICU patients with COVID-19 in Wuhan, China: a retrospective observational study
- Author
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Bin Song, Ling Sang, Jiaran Shi, Xia Zheng, Ming Zhong, Dingyu Zhang, Wang Zhang, Yunsong Yu, Yun Zhang, Li Jiang, and Liang Kang
- Subjects
Male ,China ,Aging ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,retrospective study ,Multiple Organ Failure ,Inflammation ,law.invention ,Fibrin Fibrinogen Degradation Products ,coronavirus disease 2019 ,Risk Factors ,law ,Internal medicine ,D-dimer ,medicine ,Humans ,Aged ,Retrospective Studies ,SARS-CoV-2 ,business.industry ,Organ dysfunction ,Disease progression ,COVID-19 ,organ dysfunction ,Lipid metabolism ,Retrospective cohort study ,Cell Biology ,Middle Aged ,Lipid Metabolism ,Intensive care unit ,critical care ,Intensive Care Units ,Disease Progression ,Female ,medicine.symptom ,business ,Biomarkers ,Research Paper - Abstract
Coronavirus disease 2019 (COVID-19)-associated coagulation dysfunction is gaining attention. In particular, dynamic changes in the D-dimer level may be related to disease progression. Here, we explored whether elevated D-dimer level was related to multiple organ failure and a higher risk of death. This study included 158 patients with COVID-19 who were admitted to the intensive care unit (ICU) at Jinyintan Hospital in Wuhan, China between January 20, 2020 and February 26, 2020. Clinical and laboratory data were collected. The relationship between D-dimer elevation and organ dysfunction was analyzed, as were dynamic changes in inflammation and lipid metabolism. Approximately 63.9% of patients with COVID-19 had an elevated D-dimer level on ICU admission. The 14 day ICU mortality rate was significantly higher in patients with a high D-dimer level than in those with a normal D-dimer level. Patients with a D-dimer level of 10-40μg/mL had similar organ function on ICU admission to those with a D-dimer level of 1.5-10μg/mL. However, patients with higher levels of D-dimer developed organ injuries within 7 days. Furthermore, significant differences in inflammation and lipid metabolism markers were observed between the two groups. In conclusion, the D-dimer level is closely related to COVID-19 severity and might influence the likelihood of rapid onset of organ injury after admission.
- Published
- 2021
43. Characterization of 1.2 kV 4H-SiC planar power MOSFETs
- Author
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Ling Sang, Xiping Niu, Yunlai An, Tao Zhu, Wenting Zhang, Rui Liu, Zechen Du, Huan Ge, Jialin Li, Ling Li, Xiaoguang Wei, and Fei Yang
- Subjects
Inorganic Chemistry ,Materials Chemistry ,Condensed Matter Physics - Published
- 2023
44. Effects of constant voltage stress on bipolar degradation in 4H-SiC IGBT
- Author
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Yunlai An, Wenting Zhang, Xinling Tang, Xiping Niu, Liang Wang, Xiaolei Yang, Zhanwei Shen, Junmin Sun, Ling Sang, Rui Liu, Zechen Du, Weixia Luo, Ling Li, Zhongyuan Chen, Xiaoguang Wei, and Fei Yang
- Subjects
Inorganic Chemistry ,Materials Chemistry ,Condensed Matter Physics - Published
- 2023
45. Effect of overlap region for schottky metal and field oxide on the electrical characteristics of 6500 V/50A 4H-SiC JBS diodes
- Author
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Xiping Niu, Ling Sang, Yunlai An, Peifei Wu, Wenting Zhang, Rui Liu, Zechen Du, Chenmeng Li, Xiaoguang Wei, and Fei Yang
- Subjects
Inorganic Chemistry ,Materials Chemistry ,Condensed Matter Physics - Published
- 2023
46. Demonstrations of high voltage SiC materials, devices and applications in the solid state transformer
- Author
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Fei Yang, Xinling Tang, Xiaoguang Wei, Ling Sang, Rui Liu, Song Bai, Tonghua Peng, Guoliang Zhao, Peng Yang, Tongtong Yang, and Guangfu Tang
- Subjects
Inorganic Chemistry ,Materials Chemistry ,Condensed Matter Physics - Published
- 2023
47. Changes of blood gas analysis in moderate-to-severe acute respiratory distress syndrome patients during long-term prone position ventilation: a retrospective cohort study
- Author
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Qiuxue Deng, Baozhu Zhang, Wenjing Li, Hanwen Liang, Zhenjie Jiang, Jiesen Zhang, Yonghao Xu, Weiqun He, Xiaoqing Liu, Ling Sang, Huiqing Zeng, and Yuanda Xu
- Subjects
General Medicine - Published
- 2023
48. Coagulation dysfunction in ICU patients with coronavirus disease 2019 in Wuhan, China: a retrospective observational study of 75 fatal cases
- Author
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Ling Sang, Liang Kang, Yun Zhang, Xingxiang Wang, Bin Song, Ming Zhong, Li Jiang, Xia Zheng, Zhaohui Qu, Dingyu Zhang, Jiaran Shi, and Wang Zhang
- Subjects
Male ,China ,cardiac injury ,Aging ,medicine.medical_specialty ,medicine.drug_class ,Fibrinogen ,Gastroenterology ,law.invention ,coronavirus disease 2019 ,chemistry.chemical_compound ,law ,death ,Lactate dehydrogenase ,Internal medicine ,medicine ,Humans ,Coagulation Disorder ,Aged ,Retrospective Studies ,biology ,SARS-CoV-2 ,business.industry ,Anticoagulant ,Anticoagulants ,COVID-19 ,Retrospective cohort study ,Cell Biology ,Blood Coagulation Disorders ,Middle Aged ,Troponin ,Intensive care unit ,Intensive Care Units ,Coagulation ,chemistry ,inflammation ,biology.protein ,Female ,coagulation dysfunction ,business ,Research Paper ,medicine.drug - Abstract
Coagulation dysfunction in critically ill patients with coronavirus disease 2019 (COVID-19) has not been well described, and the efficacy of anticoagulant therapy is unclear. In this study, we retrospectively reviewed 75 fatal COVID-19 cases who were admitted to the intensive care unit at Jinyintan Hospital (Wuhan, China). The median age of the cases was 67 (62–74) years, and 47 (62.7%) were male. Fifty patients (66.7%) were diagnosed with disseminated intra-vascular coagulation. Approximately 90% of patients had elevated D-dimer and fibrinogen degradation products, which decreased continuously after anticoagulant treatment and was accompanied by elevated albumin (all P
- Published
- 2020
49. Enhancement of Minority Carrier Lifetime in Ultra-High Voltage 4H-SiC PiN Diodes by Carbon-Film Annealing
- Author
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Jing Hua Xia, Ling Sang, Yi Ying Zha, Fei Yang, Wen Ting Zhang, and Yun Lai An
- Subjects
010302 applied physics ,Materials science ,business.industry ,Annealing (metallurgy) ,Mechanical Engineering ,PIN diode ,02 engineering and technology ,Carrier lifetime ,021001 nanoscience & nanotechnology ,Condensed Matter Physics ,01 natural sciences ,law.invention ,Carbon film ,Ultra high voltage ,Mechanics of Materials ,law ,0103 physical sciences ,Optoelectronics ,General Materials Science ,0210 nano-technology ,business - Abstract
A novel process is developed for minority carrier lifetime enhancement in ultra-high 4H-SiC PiN diodes. It comprises two separate processes. Firstly, the ultra-thick epitaxial grown drift layer (200μm) covered with a protective thin carbon film is subject to a 1500°C high-temperature anneal process in Ar atmosphere for 2 hours. Secondly, a surface passivation process is adopted to reduce the surface recombination rate. μ-PCD tests show that after high-temperature anneal, the thick drift layer shows a minority carrier lifetime increase to about 1.6 μs. PiN diodes based on the novel process are fabricated and their electric characteristics are measured. Results show a low specific on-resistance of 16.3 mΩ·cm2 at 25°C and 14 mΩ·cm2 at 125 °C. Compared with simulation results, it is shown that its effective minority carrier lifetime increase to about 5μs .Our study demonstrates that the developed novel process is effective in minority carrier lifetime enhancement in ultra-voltage 4H-SiC PiN diodes.
- Published
- 2020
50. Design and Fabrication of Non-Uniform Spacing Multiple Floating Field Limiting Rings for 6500V 4H-SiC JBS Diodes
- Author
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Li Xin Tian, Fei Yang, Ling Sang, Yi Ying Zha, Xi Ping Niu, Jing Hua Xia, Liang Tian, Jun Min Wu, and Rui Jin
- Subjects
010302 applied physics ,Fabrication ,Materials science ,Field (physics) ,business.industry ,Mechanical Engineering ,02 engineering and technology ,Limiting ,021001 nanoscience & nanotechnology ,Condensed Matter Physics ,01 natural sciences ,Mechanics of Materials ,0103 physical sciences ,Optoelectronics ,General Materials Science ,0210 nano-technology ,business ,Diode - Abstract
Designed for 6500V 4H-SiC JBS diodes, a highly-efficient termination structure of a non-uniform multiple floating field limiting rings (MFFLR) featuring with a non-uniform ring spacing and a multiple region division is studied and purposed. For each region, ring spacing is modulated independently by a multiplication factor and a linear increment factor. The non-uniform MFFLR structure is simulated and optimized for a better electric field distribution and a higher breakdown voltage. Based on the simulation results, 4H-SiC JBS diodes with the optimized non-uniform termination designs are fabricated. Experimental results show that the SiC JBS diode with optimized non-uniform MFFLR termination structure can achieve a breakdown voltage of up to 7800 V, and its termination efficiency is about 94% of an ideal parallel-plane junction’s. Our results demonstrate that the optimized non-uniform MFFLR termination structure is capable for SiC JBS diodes with breakdown voltage of 6500V and above. Our results can provide a valuable design methodology of edge termination structures for other high-voltage SiC devices.
- Published
- 2020
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