Berberine (BBR) is an isoquinoline alkaloid that is widely distributed in the plant kingdom and is commonly found in Coptis chinensis Franch. It has low bioavailability, but it can interact with gut microbiota and affect a variety of diseases. The effects of BBR in diabetes, hyperlipidemia, atherosclerosis, liver diseases, intestinal diseases, mental disorders, autoimmune diseases, and other diseases are all thought to be related to gut microbiota. This review systematically and comprehensively summarize these interactions and their effects, and describes the changes of gut microbiota after the intervention of different doses of berberine and its potential clinical consequences, in order to provide a basis for the rational application of BBR in the future clinical treatment.

Fibrosis can occur in various organs, leading to structural destruction, dysfunction, and even organ failure. Hence, organ fibrosis is being actively researched worldwide. Glucagon-like peptide-1 (GLP-1), a naturally occurring hormone, binds to a G-protein-coupled receptor widely distributed in the pancreas, kidney, lung, heart, gastrointestinal tract, and other organs. Synthetic GLP-1 analogs can be used as GLP-1 receptor agonists (GLP-1RAs) for treating diabetes mellitus. In recent years, GLP-1RAs have also been found to exert anti-inflammatory, antioxidant, and cardiovascular protective effects. GLP-1RAs have also been shown to inhibit fibrosis of solid organs, such as the lung, heart, liver, and kidney. In this review, we discuss the advancements in research on the role of GLP-1RAs in the fibrosis of the heart, lung, liver, kidney, and other organs to obtain new clues for treating organ fibrosis.

Sepsis and septic shock affect millions of people worldwide each year with high clinical mortality rates. At present, basic research on sepsis has emerged in an endless stream, but there are few effective clinical translation results. Ginseng, a medicinal and edible representative of Araliaceae plants, contains a variety of biologically active compounds including ginsenosides, alkaloids, glycosides, polysaccharides, and polypeptides. Neuromodulation, anticancer activity, blood lipid regulation, and antithrombotic activity have been linked to ginseng treatment. At present, basic and clinical research have suggested various applications of ginseng in sepsis. In view of the different effects of various ginseng components on the pathogenesis of sepsis, and in order to further understand and develop the possible value of ginseng in sepsis, this manuscript reviews the application of various components of ginseng in the treatment of sepsis in recent years.

This study aimed to evaluate the health-related quality of life of adult survivors of extracorporeal membrane oxygenation and identify the factors influencing their long-term outcomes. The findings are intended to provide a reference for optimizing post-extracorporeal membrane oxygenation care. A cross-sectional survey was conducted with 106 adult extracorporeal membrane oxygenation survivors. Data were collected using the General Information Questionnaire, the 36-item Short Form Health Survey, the Barthel Index, the Post-Traumatic Stress Disorder Rating Scale, and the Nottingham Health Profile Part II. Statistical analyses included the two-sample rank sum test, multi-sample Kruskal-Wallis test, Spearman correlation analysis, and multiple linear regression to assess relationships between health-related quality of life and various factors. Long-term health-related quality of life scores for extracorporeal membrane oxygenation survivors were 63.72 ± 20.87 for Physical Component Summary(PCS) and 72.69 ± 23.67 for Mental Component Summary (MCS). PCS was positively correlated with the Barthel Index score (r = 0.560, P < 0.01) and negatively correlated with the Post-Traumatic Stress Disorder Rating Scale (r = -0.58, P < 0.01) and Nottingham Health Profile Part II scores (r = -0.757, P < 0.01). MCS showed similar trends, with a positive correlation with the Barthel Index score (r = 0.589, P < 0.01) and negative correlations with the Post-Traumatic Stress Disorder Rating Scale (r = -0.741, P < 0.01) and Nottingham Health Profile Part II (r = -0.647, P < 0.01). Independent factors affecting health-related quality of life included physical health, caregiver type, employment status, Barthel Index score, Post-Traumatic Stress Disorder Rating Scale, and Nottingham Health Profile Part II score, accounting for 82.6% of variability in PCS. MCS was influenced by employment status, place of residence, and the same clinical scales, explaining 73.9% of the variation. Adult extracorporeal membrane oxygenation survivors have poor health-related quality of life, particularly in social functioning. Key factors affecting their quality of life include caregiver type, employment status, physical and psychological health scores, and place of residence. Establishing specialized extracorporeal membrane oxygenation clinics is crucial for providing comprehensive care and improving long-term outcomes for survivors.

Objective: From the perspective of intensive care physicians, this paper reviews the diagnosis and treatment of CIP patients, analyzes and refines relevant literature on CIP. To summarize the characteristics of diagnosis and treatment of severe CIP provides the basis and reference for early identification, diagnosis and treatment.Methods: A case of severe CIP caused by piamprilizumab and ICI was reviewed and the literature was reviewed.Results: This was a patient with lung squamous cell carcinoma with lymphoma who had been treated with multiple chemoradiotherapy and immunotherapy with piamprizumab. The patient was admitted to the ICU with respiratory failure. The intensive care physician performs anti-infective, fluid management, hormonal anti-inflammatory, respiratory and nutritional support treatment, and relies on mNGS to exclude severe infection and CIP treatment, thus successfully saving the patient's life and improving discharge.Conclusions: The incidence of CIP is very low, and its diagnosis should be combined with clinical manifestations and previous drug use. mNGS can provide certain value in the exclusion of severe infections, so as to provide basis and reference for the early identification, diagnosis and treatment of severe CIP.

Background: Perioperative airway management and oxygenation maintenance during central airway obstruction (CAO) treatment pose great challenges. While veno-venous extracorporeal membrane oxygenation (V-V ECMO) shows promise as a bridge therapy, optimal implementation and management strategies remain lacking. We present our experience with V-V ECMO in CAO management from a high-volume center. Methods: We retrospectively analyzed 29 consecutive patients who received V-V ECMO support for CAO between 2015 and 2023. Patient demographics, clinical characteristics, ECMO cannulation and operation parameters, interventional procedures, complications, and outcomes were reviewed. Results: Among patients with median airway diameter of 4.5 mm (IQR 2–5 mm), etiologies included primary tumors (n = 17), metastases (n = 7), and post-intubation/tracheostomy stenosis (n = 5). Treatment comprised bronchoscopic interventions (n = 9) and surgical procedures (thoracic = 15, head/neck = 5). Using predominantly femoral-jugular cannulation (n = 27), we implemented a minimal anticoagulation protocol (catheter flush with 5U/mL heparin only). All patients survived through 6-month follow-up with minimal ECMO-related complications. Conclusion: The application of V-V ECMO with minimal anticoagulation demonstrates safety and efficacy as a bridging support in the therapeutic approach to CAO.