1.Clinical implications of circulating mucosal associated invariant T (MALT) cells in septic patients
Yulin MAO ; Zhufeng LU ; Junfeng HUANG ; Hailei MAO ; Ying ZHANG ; Xiaoming ZHANG ; Duming ZHU
Chinese Journal of Infection and Chemotherapy 2017;17(4):376-381
Objective To investigate the number and activation status of circulating mucosal associated invariant T (MAIT) cells in patients with sepsis.Methods Flow cytometric method was used to determine the number and percentage of MAIT cells and their expression of activation molecule CD69.Results The circulating MAIT cells dropped significantly at early stage of sepsis in septic patients.The MAIT cells in the sepsis group continued to express high levels of CD69 on day 1 and day 3 after admission to ICU.Conclusions Remarkable decrease of circulating MAIT cells may portend the possibility of sepsis in patients with severe infection.
2.Network analysis of depression,anxiety,insomnia under long-term high-altitude exposure
Haojie FAN ; Keer CAI ; Haowei DENG ; Yuejiao HOU ; Xiang CHENG ; Lingling ZHU ; Ming FAN ; Duming WANG ; Yongqi ZHAO
Military Medical Sciences 2024;48(6):401-406
Objective To explore the network structure of anxiety,depression and sleep among individuals under long-term high-altitude exposure.Methods A total of 303 subjects who had resided at high altitudes for more than 6 months on end were selected.The insomnia severity index(ISI),patient health questionnaire(PHQ-9),and generalized anxiety disorder scale(GAD-7)were employed to assess insomnia,depression and anxiety before network analysis was conducted to identify the central and bridge nodes in the symptom network.Results The incidence of moderate or severe depression,anxiety and insomnia were 38.9%[95%confidence interval(CI):33.4%-44.5%],23.1%(95%CI:18.3%-27.9%),and 18.5%(95%CI:14.1%-22.9%),respectively."Noticeability of sleep problems by others"had the highest expected influence centrality,followed by"sleep maintenance""uncontrollable worry""restlessness"and"sleep problems".Five bridge symptoms were identified:"sad mood""sleep problems""restlessness""feeling afraid"and"trouble relaxing".Conclusion Sleep-related symptoms play a crucial role in the overall network structure,serving as both central and bridge nodes.Additionally,the"feeling down or depressed"acts as a bridge node and holds importance in the comorbidity network of anxiety and depression.Targeting these key symptoms through intervention and prevention strategies may improve the psychological well-being of individuals with long-term residence in high-altitude regions.
3.Safety and efficacy of ciprofol vs. propofol for sedation in intensive care unit patients with mechanical ventilation: a multi-center, open label, randomized, phase 2 trial
Yongjun LIU ; Xiangyou YU ; Duming ZHU ; Jun ZENG ; Qinhan LIN ; Bin ZANG ; Chuanxi CHEN ; Ning LIU ; Xiao LIU ; Wei GAO ; Xiangdong GUAN
Chinese Medical Journal 2022;135(9):1043-1051
Background::Ciprofol (HSK3486; Haisco Pharmaceutical Group Co., Ltd., Chengdu, China), developed as a novel 2,6-disubstituted phenol derivative showed similar tolerability and efficacy characteristics as propofol when applicated as continuous intravenous infusion for 12 h maintenance sedation in a previous phase 1 trial. The phase 2 trial was designed to investigate the safety, efficacy, and pharmacokinetic characteristics of ciprofol for sedation of patients undergoing mechanical ventilation.Methods::In this multicenter, open label, randomized, propofol positive-controlled, phase 2 trial, 39 Chinese intensive care unit patients receiving mechanical ventilation were enrolled and randomly assigned to a ciprofol or propofol group in a 2:1 ratio. The ciprofol infusion was started with a loading infusion of 0.1-0.2 mg/kg for 0.5-5.0 min, followed by an initial maintenance infusion rate of 0.30 mg·kg -1·h -1, which could be adjusted to an infusion rate of 0.06 to 0.80 mg·kg -1·h -1, whereas for propofol the loading infusion dose was 0.5-1.0 mg/kg for 0.5-5.0 min, followed by an initial maintenance infusion rate of 1.50 mg·kg -1·h -1, which could be adjusted to 0.30-4.00 mg·kg -1·h -1 to achieve -2 to +1 Richmond Agitation-Sedation Scale sedation within 6-24 h of drug administration. Results::Of the 39 enrolled patients, 36 completed the trial. The median (min, max) of the average time to sedation compliance values for ciprofol and propofol were 60.0 (52.6, 60.0) min and 60.0 (55.2, 60.0) min, with median difference of 0.00 (95% confidence interval: 0.00, 0.00). In total, 29 (74.4%) patients comprising 18 (69.2%) in the ciprofol and 11 (84.6%) in the propofol group experienced 86 treatment emergent adverse events (TEAEs), the majority being of severity grade 1 or 2. Drug- and sedation-related TEAEs were hypotension (7.7% vs. 23.1%, P = 0.310) and sinus bradycardia (3.8% vs. 7.7%, P = 1.000) in the ciprofol and propofol groups, respectively. The plasma concentration-time curves for ciprofol and propofol were similar. Conclusions::ciprofol is comparable to propofol with good tolerance and efficacy for sedation of Chinese intensive care unit patients undergoing mechanical ventilation in the present study setting.Trial registration::ClinicalTrials.gov, NCT04147416.