Among a number of clinical factors, bacterial infection is one of the most common causes of acute lung injury (ALI), a serious complication that carries a high risk of mortality (~40%). During the process of ALI, intense local and systemic inflammation is elicited, which exacerbates the injury. Neutrophil infiltration into airspace is observed in early stage of ALI, and is required for the full development of ALI through an array of mechanisms, including the release of granule contents and the production of pro‑inflammatory cytokines, due to the overactivation of complement and cytokines. The present study noted that ethyl pyruvate alleviated ALI in lipopolysaccharide (LPS)‑induced ALI mice. Increased autophagy in neutrophils from ALI mice was observed, while ethyl pyruvate diminished autophagy in neutrophils and constrained granule release, and therefore myeloperoxidase (MPO) in bronchoalveolar lavage fluid and the production of proinflammatory cytokines. Using neutrophil cells, it was identified that autophagy was required for neutrophil activation and granule release, and that ethyl pyruvate caused neutrophil autophagy, leading to the restriction of granule release, and thus contributing to the mitigation of ALI. If autophagy was obviated through knockdown of key regulator of autophagy Atg5, the effects of ethyl pyruvate on granule release by neutrophils disappeared. Taken together, the results demonstrated that ethyl pyruvate alleviates ALI through inhibition of autophagy‑induced granule release by neutrophils, and this mechanism suggested a novel potential therapeutic target in autophagy regulation for ALI.

Article Expression profiling and ontology analysis of circulating long non-coding RNAs in septic acute kidney injury patients was published on December 1, 2016 in the journal Clinical Chemistry and Laboratory Medicine (CCLM) (volume 54, issue 12).

We conducted a prospective, observational study to assess the prognostic value of hemostasis-related parameters in unselected ICU patients. We collected baseline characteristics from 497 consecutive unselected medical and trauma patients during their ICU stay. Each hemostasis-related parameter was analyzed alone or combined with APACHE II scores for any association with ICU mortality by calculating the under the curve (AUC) of the ROC curve, the net reclassification improvement (NRI) and integrated discrimination improvement (IDI) indices. Of all hemostasis-related indicators examined, the AUC for fibrin degradation products (FDPs) was less than that for APACHE II scores, but larger than that for disseminated intravascular coagulation (DIC) scores. The prediction power of FDPs is relatively low. Multiple regression analysis revealed that FDPs and APACHE II scores significantly predicted primary outcome. The combined use of FDPs level and APACHE II scores generated an NRI of 9.94% and an IDI of 3.54%. In conclusion, FDP is the best independent indicator of ICU mortality among all hemostasis-related indicators examined. The use of FDP level and APACHE II scores in parallel significantly improves the ability to predict ICU mortality, suggesting the application of these parameters could be used to improve patient care and management in the ICU.

Aortic intramural hemorrhage (IMH) is one of the disease processes that comprise the spectrum of acute aortic syndrome (AAS) with clinical manifestations and a mortality rate similar to those of classic aortic dissection (AD). However, IMH should be considered as a distinct disease entity rather than a precursor to classic dissection because of differences in their pathology, etiology, natural history, and imaging findings. Multidetector computed tomography (CT) is recommended as the first-line diagnostic imaging modality for IMH, but transesophageal echocardiography (TEE) and magnetic resonance imaging (MRI) are also helpful. There is still debate over the appropriate treatment of IMH. Medical treatment of type B IMH appears effective and safe, while surgical treatment is recommended for type A IMH. Thoracic endovascular aortic repair (TEVAR) is a promising treatment for selected patients, and more clinical evidence needs to be assembled.