Onco-critical care has emerged as an important subspecialty at the intersection of critical care medicine and oncology, attracting increasing attention in recent years. With continuous innovations in cancer therapies, patient survival has improved significantly; however, the incidence of associated critical complications has also increased. The reasons for cancer patients requiring intensive care unit admission are diverse and can be broadly categorized into three groups: progression of the underlying malignancy, treatment-related complications, and coexisting classical critical illnesses. Traditional critical care concepts and practices face limitations in addressing the multidimensional and heterogeneous challenges of onco-critical care. Based on the core mechanism of critical illness development—host/organ unregulated response (HOUR)—this article systematically elaborates on how this framework advances understanding and clinical practice into onco-critical care, with emphasis on its manifestations in neuroendocrine, immune-inflammatory, and coagulation-metabolic pathways. The review summarizes recent advances in clinical assessment and phenotyping systems for onco-critical illness and discusses a multidisciplinary, integrated management strategy centered on the "Disease Control, Host Response Modulation, Organ Support" triad. Finally, major challenges and future directions in this field are outlined. By integrating existing evidence and theoretical insights, this review aims to provide new perspectives and a theoretical foundation for the clinical management of onco-critical illness, thereby promoting its evolution toward precision and standardization.

This study aimed to explore the therapeutic mechanisms of Colquhounia Root Tablets(CRT) in treating diabetic kidney disease(DKD) by integrating biomolecular network mining with animal model verification. By analyzing clinical transcriptomics data, an interaction network was constructed between candidate targets of CRT and DKD-related genes. Based on the topological eigenvalues of network nodes, 101 core network targets of CRT against DKD were identified. These targets were found to be closely related to multiple pathways associated with type 2 diabetes, immune response, and metabolic reprogramming. Given that immune-inflammatory imbalance driven by metabolic reprogramming is one of the key pathogenic mechanisms of DKD, and that many core network targets of CRT are involved in this pathological process, receptor for advanced glycation end products(RAGE)-reactive oxygen species(ROS)-phosphatidylinositol 3-kinase(PI3K)-protein kinase B(AKT)-nuclear factor-κB(NF-κB)-NOD-like receptor family pyrin domain containing 3(NLRP3) signaling axis was selected as a candidate target for in-depth research. Further, a rat model of DKD induced by a high-sugar, high-fat diet and streptozotocin was established to evaluate the pharmacological effects of CRT and verify the expression of related targets. The experimental results showed that CRT could effectively correct metabolic disturbances in DKD, restore immune-inflammatory balance, and improve renal function and its pathological changes by inhibiting the activation of the RAGE-ROS-PI3K-AKT-NF-κB-NLRP3 signaling axis. In conclusion, this study reveals that CRT alleviates the progression of DKD through dual regulation of metabolic reprogramming and immune-inflammatory responses, providing strong experimental evidence for its clinical application in DKD.
Animals ; Diabetic Nephropathies/metabolism* ; Receptor for Advanced Glycation End Products/genetics* ; NF-kappa B/genetics* ; Signal Transduction/drug effects* ; Rats ; NLR Family, Pyrin Domain-Containing 3 Protein/genetics* ; Proto-Oncogene Proteins c-akt/genetics* ; Drugs, Chinese Herbal/administration & dosage* ; Male ; Phosphatidylinositol 3-Kinases/genetics* ; Reactive Oxygen Species/metabolism* ; Humans ; Plant Roots/chemistry* ; Rats, Sprague-Dawley ; Tablets/administration & dosage*

Background: and Purpose: Plasma biomarkers, including phosphorylated tau (ptau217), glial fibrillary acidic protein (GFAP), and neurofilament light chain (NfL), are promising tools for detecting Alzheimer’s disease (AD) pathology. However, cross-laboratory reproducibility remains a challenge, even when using identical analytical platforms such as single-molecule array (Simoa). This study aimed to compare plasma biomarker measurements (ptau217, GFAP, and NfL) between 2 laboratories, the University of Gothenburg (UGOT) and DNAlink, and evaluate their associations with amyloid positron emission tomography (PET) imaging. Methods: Plasma biomarkers were measured using Simoa platforms at both laboratories:the UGOT and DNAlink Incorporation. Diagnostic performance for predicting amyloid PET positivity, cross-laboratory agreement, and the impact of normalization techniques were assessed. Bland-Altman plots and correlation analyses were employed to evaluate agreement and variability. Results: Plasma ptau217 concentrations exhibited strong correlations with amyloid PET global centiloid values, with comparable diagnostic performance between laboratories (area under the curve=0.94 for UGOT and 0.95 for DNAlink). Cross-laboratory agreement for ptau217 was excellent (r=0.96), improving further after natural log transformation. GFAP and NfL also demonstrated moderate to strong correlations (r=0.86 for GFAP and r=0.99 for NfL), with normalization reducing variability. Conclusions Plasma biomarker measurements were consistent across laboratories using identical Simoa platforms, with strong diagnostic performance and improved agreement after normalization. These findings support the scalability of plasma biomarkers for multicenter studies and underscore their potential for standardized applications in AD research and clinical practice.

Objective:To explore the application value of diaphragmatic thickening fraction (DTF) and lung ultrasound score (LUS) in predicting the weaning outcome of elderly patients with acute respiratory distress syndrome (ARDS) under mechanical ventilation, and to analyze their correlation, thereby providing evidence for clinical decision-making.Methods:A retrospective analysis was conducted on elderly ARDS patients admitted to the ICU of the First Affiliated Hospital of Jinzhou Medical University from January 2020 to December 2023. The inclusion criteria included age > 60 years, endotracheal intubation, mechanical ventilation time >24 h, and a diagnosis of ARDS based on the Berlin definition. Exclusion criteria included neuromuscular diseases, spinal cord injury, post-thoracoabdominal surgery, thoracic or tracheal deformity, and mid-course tracheostomy conversion. Patients were divided into a success group and a failure group based on weaning outcomes. Demographic data, Acute Physiology and Chronic Health EvaluationⅡ (APACHEⅡ) scores, Sequential Organ Failure Assessment (SOFA) scores, oxygenation index at ICU admission, and pre-extubation DTF, LUS, and oxygenation index were recorded. Binary logistic regression analysis was used to identify independent risk factors affecting weaning outcomes. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of DTF and LUS for weaning outcomes. Pearson correlation analysis was conducted to examine the relationship between DTF and LUS.Results:A total of 317 patients were included, including 212 in the success group and 105 in the failure group. There were no statistically significant differences in gender, age, APACHEⅡ score, SOFA score, etc., between the two groups (all P>0.05). Pre-weaning LUS was higher in the failure group than in the success group [(17.26±3.04) vs. (13.69±4.06), P<0.001], and the DTF was significantly lower than that of the successful group [(27.83%±6.37%) vs. (40.15%±6.49%), P<0.001]. Binary logistic regression identified LUS and DTF as independent influencing factors for weaning outcomes (both P<0.05). ROC analysis revealed that LUS predicted weaning failure with an AUC of 0.748 (95% CI: 0.695-0.801, P<0.001), sensitivity of 83.81% and specificity of 56.60%. DTF predicted weaning success with an AUC of 0.935 (95% CI: 0.909-0.961, P<0.001), sensitivity of 83.02% and specificity of 89.52%. A negative correlation was observed between LUS and DTF before weaning ( r=-0.385, P<0.001). Conclusions:Both DTF and LUS are effective indicators for assessing weaning outcomes in elderly ARDS patients, offering complementary clinical insights. Higher LUS reflects more severe pulmonary pathology and increased weaning risk, while lower DTF indicates impaired diaphragmatic function and reduced likelihood of successful extubation. Integration of these parameters provides a comprehensive foundation for clinical decision-making.

Objective: This study employs metabolomics to analyze the characteristic biomarkers and metabolic pathways in the serum of pregnant women with positive thyroid peroxidase antibodies(TPOAb) during early pregnancy. The objective is to explore the relationship between thyroid dysfunction and maternal-fetal health. Methods : Early-pregnancy women undergoing antenatal check-ups for thyroid function and antibody testing at our hospital were selected. According to the TPOAb results, participants were categorized into a TPOAb-positive group and a TPOAb-negative group. The serum metabolic profiles were analyzed using liquid chromatography-tandem mass spectrometry(LC-MS/MS) technology to identify differences between the two groups. The Kyoto Encyclopedia of Genes and Genomes(KEGG) database was utilized for metabolic pathway enrichment analysis of differential metabolites. Results : A total of 79 significantly different metabolites were identified in the serum of TPOAb-positive pregnant women compared to the control group, including 20 upregulated and 59 downregulated metabolites. KEGG enrichment analysis indicated that these differential metabolites were mainly involved in 21 key metabolic pathways. Among the metabolites associated with TPOAb, 31 were identified, with 6 showing positive correlation and 25 showing negative correlation. Metabolic pathway enrichment analysis revealed that these differential metabolites were closely related to Glycerophospholipid metabolism, Valine, leucine and isoleucine biosynthesis, Glycosylphosphatidylinositol(GPI)-anchor biosynthesis, and Glycerolipid metabolism pathways. Conclusion Significant differences in metabolites and their associated metabolic pathways are identified in the serum of TPOAb-positive pregnant women during early gestation, indicating that these metabolite alterations are closely linked to thyroid dysfunction and maternal-fetal health.

Objective To investigate the effects of laparoscopic sleeve gastrectomy(LSG)on the cardiac structure and function in obese patients with heart failure(HF)and compare the efficacy of LSG across obese patients with different HF types.Methods This study included 33 obese patients with HF who underwent LSG.The clinical indicators were compared between before operation and 12 months after operation.Repeated measures analysis of variance was employed to evaluate the changes in echocardiographic parameters before operation and 3,6,and 12 months after operation.Patients were allocated into a HF with preserved ejection fraction group(n=17),a HF with mildly reduced ejection fraction group(n=5)and a HF with reduced ejection fraction(HFrEF)group(n=11)based on left ventricular ejection fraction(LVEF)before operation for subgroup analyses of the effects of LSG on the cardiac structure and function of obese patients with HF.The paired samples t-test was conducted to assess the degree of cardiac structural and functional alterations after LSG.Results The 33 patients included 69.7% males,with an average age of(35.3±9.9)years,and a body mass index(BMI)of(51.2±9.8)kg/m².The median follow-up was 9.0(5.0,13.3)months.Compared with the preoperative values,the postoperative BMI(P=0.002),body surface area(BSA)(P=0.009),waist circumference(P=0.010),hip circumference(P=0.031),body fat content(P=0.007),and percentage of patients with cardiac function grades Ⅲ-IV(P<0.001)decreased.At the 12-month follow-up left atrial diameter(P=0.006),right atrial long-axis inner diameter(RAD1)(P<0.001),right atrial short-axis inner diameter(RAD2)(P<0.001),right ventricular inner diameter(P=0.002),interventricular septal thickness at end-diastolic(P=0.002),and left ventricular end-diastolic volumes(P=0.004)and left ventricular end-systolic volumes(P=0.003) all significantly reduced compared with preoperative values.Additionally,left ventricular fractional shortening and LVEF improved(both P<0.001).Subgroup analyses revealed that cardiac structural parameters significantly decreased in the HF with preserved ejection fraction,HF with mildly reduced ejection fraction,and HFrEF subgroups compared with preoperative values.Notably,the HFrEF group demonstrated the best performance in terms of left atrial diameter(P=0.003),left ventricular inner diameter at end-diastole(P=0.008),RAD1(P<0.001),RAD2(P=0.004),right ventricular inner diameter(P=0.019),left ventricular end-diastolic volume(P=0.004)and left ventricular end-systolic volume(P=0.001),cardiac output(P=0.006),tricuspid regurgitation velocity(P=0.002),and pulmonary artery systolic pressure(P=0.001) compared to preoperatively.Postoperative left ventricular fractional shortening(P<0.001,P=0.003,P<0.001)and LVEF(P<0.001,P=0.011,P=0.001)became higher in all the three subgroups than the preoperative values.Conclusions LSG decreased the body weight,BMI,and BSA,improved the cardiac function grade,reversed the enlargement of the left atrium and left ventricle,reduced the right atrium and right ventricle,and enhanced the left ventricular systolic function.It was effective across obese patients with different HF types.Particularly,LSG demonstrates the best performance in improving the structures of both atria and ventricles in obese patients with HFrEF.
Humans ; Male ; Female ; Gastrectomy/methods* ; Heart Failure/complications* ; Adult ; Obesity/physiopathology* ; Laparoscopy ; Middle Aged ; Heart/physiopathology* ; Stroke Volume

Objective:To investigate the clinical management,complications,and prognostic prediction model of bronchopulmonary dysplasia(BPD)in preterm infants.Methods:A total of 854 very preterm infants(gestational age ≤ 32 weeks)admitted to the Neonatal Intensive Care Unit(NICU)of Shanghai Children's Hospital from January 2018 to December 2022 were retrospectively enrolled.After applying inclusion and exclusion criteria,713 infants were included.Based on the 2018 National Institute of Child Health and Human Development(NICHD)diagnostic criteria for BPD,the cohort was divided into a BPD group(n=164)and a non-BPD group(n=549).Clinical data of infants and maternal characteristics were compared between groups.Univariate and stepwise multivariate logistic regression analyses were performed to identify independent risk factors for BPD and evaluate clinical management.A nomogram model was subsequently developed to predict BPD prognosis.Results:Gestational age,duration of non-invasive ventilation,total oxygen therapy time,total hospital stay,hemodynamically significant patent ductus arteriosus(hsPDA),maximum diameter of patent ductus arteriosus(PDA),fetal growth restriction(FGR),use of vasoactive agents,and proportion of pulmonary surfactant administration were identified as independent risk factors for BPD(all P＜0.05,OR＞0).The nomogram model demonstrated excellent predictive performance,with an area under the receiver operating characteristic curve(AUC)of 0.93 and a calibration curve slope approaching 1.The Hosmer-Lemeshow goodness-of-fit test indicated satisfactory model calibration(x2=8.2865,P=0.406).Conclusion:Gestational age,non-invasive ventilation duration,total oxygen therapy time,total hospital stay,hsPDA,PDA maximum diameter,FGR,vasoactive agents,and pulmonary surfactant use are critical predictors of BPD in preterm infants.The prognostic models for BPD incidence and severity,constructed based on these factors,exhibit strong predictive accuracy and may serve as a valuable clinical tool for risk stratification and early intervention.

Objective To explore the expression and clinical significance of serum C1qA and C1qB in children with idiopathic short stature (ISS). Methods 108 children with ISS (ISS group) and 108 healthy children (control group) who were admitted to the pediatric department of the 910th Hospital of the Joint Logistics Support Force of the People's Liberation Army of China from May 2020 to May 2023 were selected. An enzyme-linked immunosorbent assay was used to detect serum levels of C1qA and C1qB. Pearson correlation analysis was used to investigate the correlation between serum C1qA and C1qB levels,growth and development indicators,and inflammatory markers in children with ISS. Multivariate logistic regression analysis was used to identify the risk factors for the onset of ISS and the value of C1qA and C1qB in diagnosing ISS was analyzed based on the working characteristics of the subjects. Results The levels of C1qA (1206.35±275.15 ng/ml) and C1qB (1084.65±220.48 ng/ml) in ISS group were higher than those in control group (612.35±135.06 ng/ml,501.32±108.77 ng/ml),the differences were statistically significant (t=20.140,24.658,all P<0.05).The height,weight,body mass index(BMI ) and bone age index of the ISS group were lower than those of the control group(t/x2=2.092～10.661),and the ISS family history,tumor necrosis factor-α(TNF-α) and interleukin-6(IL-6) levels were higher than those of the control group(t/x2=4.338,10.550,15.865),the differences were statistically significant (all P<0.05),respectively .The serum levels of C1qA and C1qB in children with ISS were negatively correlated with height,weight,BMI,and bone age index(r=-0.502～-0.352,all P<0.05),and positively correlated with TNF-α and IL-6 levels(r=0.326～0.411,all P<0.05).Low bone age index,high level of TNF-α,high level of IL-6,high level of C1qA and high level of C1qB were risk factors for ISS (waldx2=4.979～7.328,all P<0.05).ROC curve showed that the area under the curve of serum C1qA and C1qB in the diagnosis of ISS was 0.838 and 0.816,respectively. The area under the curve of combined detection of serum C1qA and C1qB in the diagnosis of ISS was 0.931,which was higher than that of two indicators alone (Z=3.812,3.896,all P<0.05).Conclusion The serum levels of C1qA and C1qB are increased in children with ISS,which is related to short stature. Combined detection of serum C1qA and C1qB is helpful to diagnose the risk of ISS.

Objective To compare the efficacy of testicular repositioning and fixation combined with decompression of the testicular fascial compartment (testicular leucotomy+sheath flap repair) versus conventional testicular repositioning and fixation in surgery for testicular torsion in children. Methods Fifty-six patients with testicular torsion admitted to Hebei Provincial Children's Hospital from January 2019 to October 2023 were selected and divided into the observation group (26 cases) and the control group (30 cases),and the observation group was treated with testicular reorientation and fixation+testicular fascial compartment decompression,while the control group was treated with conventional testicular reorientation and fixation. There was no statistically significant difference in the age and left and right sides of the patients in the two groups (P>0.05). The intraop-erative bleeding,postoperative testicular atrophy,the presence of postoperative scrotal infection and postoperative hospitalization time of the two groups were compared. Results All patients successfully completed the operation without intraoperative complications. There was no statistically significant difference between the observation group and the control group in terms of intraoperative bleeding,postoperative scrotal infection rate and postoperative hospitalization time (P>0.05);the postoperative testicular atrophy rate of the observation group was significantly lower than that of the control group (P<0.05). Conclusions Testicular restoration and fixation+testicular fascial compartment decompression can effectively reduce the pressure of testicular fascial compartment,reduce the ischemia-reperfusion injury of testis,and reduce the occurrence of testicular atrophy,which is safe and effective in the treatment of testicular torsion in children.

Background: and Purpose: Plasma biomarkers, including phosphorylated tau (ptau217), glial fibrillary acidic protein (GFAP), and neurofilament light chain (NfL), are promising tools for detecting Alzheimer’s disease (AD) pathology. However, cross-laboratory reproducibility remains a challenge, even when using identical analytical platforms such as single-molecule array (Simoa). This study aimed to compare plasma biomarker measurements (ptau217, GFAP, and NfL) between 2 laboratories, the University of Gothenburg (UGOT) and DNAlink, and evaluate their associations with amyloid positron emission tomography (PET) imaging. Methods: Plasma biomarkers were measured using Simoa platforms at both laboratories:the UGOT and DNAlink Incorporation. Diagnostic performance for predicting amyloid PET positivity, cross-laboratory agreement, and the impact of normalization techniques were assessed. Bland-Altman plots and correlation analyses were employed to evaluate agreement and variability. Results: Plasma ptau217 concentrations exhibited strong correlations with amyloid PET global centiloid values, with comparable diagnostic performance between laboratories (area under the curve=0.94 for UGOT and 0.95 for DNAlink). Cross-laboratory agreement for ptau217 was excellent (r=0.96), improving further after natural log transformation. GFAP and NfL also demonstrated moderate to strong correlations (r=0.86 for GFAP and r=0.99 for NfL), with normalization reducing variability. Conclusions Plasma biomarker measurements were consistent across laboratories using identical Simoa platforms, with strong diagnostic performance and improved agreement after normalization. These findings support the scalability of plasma biomarkers for multicenter studies and underscore their potential for standardized applications in AD research and clinical practice.