Qinjing Zeng

Sepsis-induced myocardial dysfunction is a common complication in septic patients. To date, a limited number of biomarkers that could predict cardiomyocyte apoptosis have been explored. In this study, we successfully established a cecal ligation and puncture (CLP)-induced septic model, and it was found that miR-501-5p expression was down-regulated in peripheral blood samples of septic patients with cardiac dysfunction, lipopolysaccharide (LPS)-induced cardiomyocytes, and the myocardium and peripheral blood in the septic model. Moreover, it was revealed that miR-501-5p overexpression could increase left ventricular diastolic pressure (LVDP), fractional shortening (FS), ejection fraction (EF), and maximum rate of the rise of left ventricular pressure (+dp/dt) in vivo, while it decreased the levels of myocardial injury-related indicators. In addition, LPS induction accelerated apoptosis and elevated the inflammation in HL-1 and HCM cells, which could be reversed by miR-501-5p overexpression. Mechanistically, we considered nuclear receptor subfamily 4 group A member 3 (NR4A3) as the target of miR-501-5p, and it was found that miR-501-5p prevented the binding between NR4A3 and Bcl-2. It was found that miR-501-5p exerted an inhibitory effect on cardiomyocyte apoptosis and inflammation in a NR4A3-dependent manner. Overall, our results may provide evidence for consideration of miR-501-5p in the therapy of sepsis.

INTRODUCTION: This study aimed to analyze the factors affecting continuous renal replacement therapy (CRRT) duration in critically ill patients and provide a reference for clinical treatment. MATERIAL AND METHODS: We divided patients into regional citrate anti-coagulation (RCA) and low-molecular-weight-heparin (LMWH) groups according to the anti-coagulation method and collected the relevant data, to analyze the factors associated with CRRT time. RESULTS: Compared with the LMWH group, the RCA group had a longer mean treatment time (55.36 ± 22.57 vs. 37.65 ± 27.09 h, p < 0.001), lower transmembrane pressure, and lower filter pressure, regardless of vascular access site. Multivariable linear regression analysis showed a significant correlation between anti-coagulation patterns, filter pressure at CRRT discontinuation, nurses' level of intensive care unit experience, pre-machine fibrinogen level, and CRRT time. CONCLUSION: Anti-coagulation is the most important factor affecting CRRT duration. Filter pressure, nurses' level of intensive care unit experience, and fibrinogen level also affecting CRRT duration.

<title>Abstract</title> Anemia is a common occurrence during sepsis. However, the relationship between anemia duration and short-term effects on mortality in patients with sepsis remains unclear. This study examined the association between number of days with severe anemia in the first week and 28-day mortality rate among patients with sepsis. This retrospective cohort study used the clinical data extracted from Medical Information Mart for Intensive Care IV 2.2. A total of 1335 patients with sepsis were included in the study. After adjusting for confounders, the 28-day mortality of patients with sepsis increased with each additional day of severe anemia (hemoglobin level &lt; 8 g/dl) in the first week of intensive care unit admission with an odds ratio (OR) of 1.12 (95% confidence interval (CI) [1.05; 1.2], P &lt; 0.001). Furthermore, patients who experienced severe anemia for at least three days had a higher 28-day mortality rate than those with less severe anemia below three days (OR: 1.59, 95% CI [1.19; 2.11], P = 0.002). After employing various propensity score matching methods, we consistently observed a similar association. The adjusted ORs in propensity score matching, inverse probability of treatment weighting, standardized mortality ratio weighting, pairwise algorithmic, and overlap weight were 1.49 (95% CI, 1.08 ~ 2.07, P = 0.016), 1.65 (95% CI, 1.28 ~ 2.12, P &lt; 0.001), 1.49 (95% CI, 1.16 ~ 1.93, P = 0.002), 1.48 (95% CI, 1.07 ~ 2.04, P = 0.018), and 1.48 (95% CI, 1.01 ~ 2.17, P = 0.044) respectively. Thus, this study suggests that a longer duration of severe anemia in the first week may be linked to increased 28-day mortality in patients with sepsis.