1
|
Wang Y, Huang X, Li F, Jia X, Jia N, Fu J, Liu S, Zhang J, Ge H, Huang S, Hui Y, Sun C, Xiao F, Cui X, Luu LDW, Qu D, Li J, Tai J. Serum-integrated omics reveal the host response landscape for severe pediatric community-acquired pneumonia. Crit Care 2023; 27:79. [PMID: 36859478 PMCID: PMC9976684 DOI: 10.1186/s13054-023-04378-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 02/21/2023] [Indexed: 03/03/2023] Open
Abstract
OBJECTIVE Community-acquired pneumonia (CAP) is the primary cause of death for children under five years of age globally. Hence, it is essential to investigate new early biomarkers and potential mechanisms involved in disease severity. METHODS Proteomics combined with metabolomics was performed to identify biomarkers suitable for early diagnosis of severe CAP. In the training cohort, proteomics and metabolomics were performed on serum samples obtained from 20 severe CAPs (S-CAPs), 15 non-severe CAPs (NS-CAPs) and 15 healthy controls (CONs). In the verification cohort, selected biomarkers and their combinations were validated using ELISA and metabolomics in an independent cohort of 129 subjects. Finally, a combined proteomics and metabolomics analysis was performed to understand the major pathological features and reasons for severity of CAP. RESULTS The proteomic and metabolic signature was markedly different between S-CAPs, NS-CAPs and CONs. A new serum biomarker panel including 2 proteins [C-reactive protein (CRP), lipopolysaccharide (LBP)] and 3 metabolites [Fasciculol C, PE (14:0/16:1(19Z)), PS (20:0/22:6(4Z, 7Z, 10Z, 13Z, 16Z, 19Z))] was developed to identify CAP and to distinguish severe pneumonia. Pathway analysis of changes revealed activation of the cell death pathway, a dysregulated complement system, coagulation cascade and platelet function, and the inflammatory responses as contributors to tissue damage in children with CAP. Additionally, activation of glycolysis and higher levels of nucleotides led to imbalanced deoxyribonucleotide pools contributing to the development of severe CAP. Finally, dysregulated lipid metabolism was also identified as a potential pathological mechanism for severe progression of CAP. CONCLUSION The integrated analysis of the proteome and metabolome might open up new ways in diagnosing and uncovering the complexity of severity of CAP.
Collapse
Affiliation(s)
- Yi Wang
- Experimental Research Center, Capital Institute of Pediatrics, Beijing, 100020, People's Republic of China.
| | - Xiaolan Huang
- Experimental Research Center, Capital Institute of Pediatrics, Beijing, 100020, People's Republic of China
| | - Fang Li
- Department of Critical Medicine, Children's Hospital Affiliated Capital Institute of Pediatrics, Beijing, 100020, People's Republic of China
| | - Xinbei Jia
- Department of Otorhinolaryngology Head and Neck Surgery, Children's Hospital Capital Institute of Pediatrics, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Nan Jia
- Experimental Research Center, Capital Institute of Pediatrics, Beijing, 100020, People's Republic of China
| | - Jin Fu
- Experimental Research Center, Capital Institute of Pediatrics, Beijing, 100020, People's Republic of China
| | - Shuang Liu
- Department of Critical Medicine, Children's Hospital Affiliated Capital Institute of Pediatrics, Beijing, 100020, People's Republic of China
| | - Jin Zhang
- Department of Critical Medicine, Children's Hospital Affiliated Capital Institute of Pediatrics, Beijing, 100020, People's Republic of China
| | - Haiyan Ge
- Department of Critical Medicine, Children's Hospital Affiliated Capital Institute of Pediatrics, Beijing, 100020, People's Republic of China
| | - Siyuan Huang
- Department of Critical Medicine, Children's Hospital Affiliated Capital Institute of Pediatrics, Beijing, 100020, People's Republic of China
| | - Yi Hui
- Department of Critical Medicine, Children's Hospital Affiliated Capital Institute of Pediatrics, Beijing, 100020, People's Republic of China
| | - Chunrong Sun
- Experimental Research Center, Capital Institute of Pediatrics, Beijing, 100020, People's Republic of China
| | - Fei Xiao
- Experimental Research Center, Capital Institute of Pediatrics, Beijing, 100020, People's Republic of China
| | - Xiaodai Cui
- Experimental Research Center, Capital Institute of Pediatrics, Beijing, 100020, People's Republic of China
| | | | - Dong Qu
- Department of Critical Medicine, Children's Hospital Affiliated Capital Institute of Pediatrics, Beijing, 100020, People's Republic of China.
| | - Jieqiong Li
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100027, People's Republic of China.
| | - Jun Tai
- Department of Otorhinolaryngology Head and Neck Surgery, Children's Hospital Capital Institute of Pediatrics, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
| |
Collapse
|
2
|
Wang Y, Qi S. Study on the Application of the Concept of Childlike Interest with Refined Nursing Intervention in the Treatment of Children with Severe Pneumonia. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:5360733. [PMID: 35966238 PMCID: PMC9365535 DOI: 10.1155/2022/5360733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/01/2022] [Accepted: 07/06/2022] [Indexed: 11/17/2022]
Abstract
Objectives To analyze the application of childlike concept with refined nursing intervention in the treatment of children with severe pneumonia. Methods 100 cases of children with severe pneumonia admitted to our hospital from June 2019 to June 2021 were selected and divided into the control group and the observation group, in which the control group was given refined nursing care and the observation group was given the childlike concept with refined nursing intervention to compare the treatment effects of patients in both groups. The clinical indexes such as recovery time of body temperature, disappearance time of pulmonary rales, recovery time of heart rate, disappearance time of cough, and hospitalization time, were compared between the two groups. Results Compared with the control group, the time to recovery of body temperature, time to disappearance of pulmonary rales, time to recovery of heart rate, time to disappearance of cough, and hospitalization time were significantly lower in the observation group, and the difference was statistically significant (P < 0.05). Compared with the control group, the compliance rate of patients in the observation group was significantly lower, and the difference was statistically significant (P < 0.05). Compared with the control group, the total effective rate of patients in the observation group was significantly higher, and the difference was statistically significant (P < 0.05). Compared with the control group, the overall satisfaction rate of patients in the observation group was significantly higher, and the difference was statistically significant (P < 0.05). The results of univariate analysis showed that the differences between the two groups were statistically significant (P < 0.05) in terms of economic conditions, payment method, child's condition, child's age, comorbid underlying diseases, and nursing care method, and the results of logistic multifactor regression analysis showed that the payment method of self-payment, child's critical condition, and comorbid underlying diseases were the most important factors affecting the anxiety of the family members of children with severe pneumonia. risk factors for the occurrence of anxiety in the families of children with severe pneumonia, and the method of care was a protective factor (P < 0.05). Conclusion The concept of childlike fun and refined nursing interventions can effectively improve the treatment effect of children with severe pneumonia, improve patients' condition, increase patients' compliance and satisfaction, and reduce the risk of anxiety and other negative emotions of the child's family members.
Collapse
Affiliation(s)
- Yuwei Wang
- Department of Pediatrics, Affiliated Zhejiang Hospital, Zhejiang University School of Medicine, China
| | - Shuping Qi
- Department of Pediatrics, Affiliated Zhejiang Hospital, Zhejiang University School of Medicine, China
| |
Collapse
|