本综述聚焦循证护理在呼吸与危重症医学科的应用,全面阐述其基础理论、流行病学、病理机制、诊断治疗、临床实践等多方面内容。循证护理通过整合临床专业知识、最佳研究证据和患者价值观,为呼吸重症患者提供优质护理。文中分析了呼吸与危重症医学科常见疾病的流行病学特征与病理机制,探讨循证护理在评估、诊断、治疗及康复过程中的应用及效果,并讨论了其临床操作规范、多学科协作模式以及面临的伦理法律挑战、争议与解决方案,展望未来发展方向与研究热点,旨在为呼吸与危重症医学科的护理实践提供全面的理论支持与实践指导,推动循证护理在该领域的进一步发展与应用。This review focuses on the application of evidence-based nursing (EBN) in respiratory and critical care medicine, providing a comprehensive discussion on its foundational theories, epidemiology, pathological mechanisms, diagnosis, treatment, and clinical practice. By integrating clinical expertise, the best available research evidence, and patient values, EBN delivers high-quality care for critically ill respiratory patients. The article analyzes the epidemiological characteristics and pathological mechanisms of common diseases in respiratory and critical care medicine, explores the application and efficacy of EBN in assessment, diagnosis, treatment, and rehabilitation, and discusses its clinical protocols, multidisciplinary collaboration models, as well as ethical, legal challenges, controversies, and potential solutions. Furthermore, it outlines future research directions and emerging trends, aiming to provide robust theoretical support and practical guidance for nursing practice in respiratory and critical care medicine, thereby advancing the further development and application of EBN in this field.
本综述聚焦细胞因子谱与重症肺炎的多方面研究。首先阐述细胞因子在重症肺炎中的病理机制、重症肺炎流行病学特征及细胞因子谱的历史演变与研究进展。接着探讨常规检验指标在重症肺炎中的诊断价值、现状及未来发展方向,以及细胞因子谱与常规检验指标的联合应用,包括联合诊断策略、在预后评估中的作用及临床实践与技术进展。同时介绍重症肺炎诊断技术的最新进展,治疗策略的演变,并分析细胞因子谱与常规检验指标在应用中的争议点。旨在全面梳理该领域研究,为重症肺炎的诊治提供理论依据与研究方向。This review focuses on multifaceted research regarding cytokine profiles and severe pneumonia. First, it elaborates on the pathological mechanisms of cytokines in severe pneumonia, the epidemiological characteristics of severe pneumonia, and the historical evolution and research progress of cytokine profiling. Subsequently, it explores the diagnostic value, current status, and future directions of conventional laboratory markers in severe pneumonia, as well as the combined application of cytokine profiles and conventional biomarkers—including integrated diagnostic strategies, their role in prognostic evaluation, and clinical practice alongside technological advancements. Additionally, it highlights the latest progress in diagnostic techniques for severe pneumonia and the evolution of treatment strategies, while analyzing controversies in the application of cytokine profiles and conventional biomarkers. The review aims to comprehensively synthesize research in this field, providing a theoretical foundation and future directions for the diagnosis and treatment of severe pneumonia.
炎症性疾病(inflammation disease, ID)是泛指一类伴有炎症反应的一系列疾病,其发病机制复杂。环状RNA (circular RNA, circRNA)是一类经过反向剪接形成的具有闭合环状结构的、大量存在于真核转录组中的非编码RNA,是目前生命科学和医学领域研究的热点分子,其在不同疾病中呈差异性表达,参与机体各类生理和病理过程。本文将对环状RNA在肿瘤、心血管疾病、神经系统疾病、糖尿病、自身免疫性疾病及感染性疾病等ID中的最新研究进展进行综述,以期为环状RNA在基础和临床的研究提供参考。Inflammatory Disease refers to a series of diseases accompanied by inflammatory reactions, and its pathogenesis is complex. Circle RNA is a kind of non-coding RNA with closed ring structure formed by reverse splicing, which exists in a large number of eukaryotic transcriptome. It is a hot molecule in the field of life science and medicine. Studies have found that it is differentially expressed in different diseases and participates in various physiological and pathological processes. In this review, we will review the recent research progress of circRNAs in inflammatory diseases of cancer, cardiovascular disease, neurological disease, diabetes, autoimmune diseases and infectious diseases. In order to provide theoretical basis for circrnas in clinical and basic research.
目的:探讨降钙素原与白蛋白比值(PAR)在脓毒症并发急性呼吸窘迫综合征(ARDS)预后中的评估价值。方法:回顾性分析2019年9月~2022年9月入住益阳市中心医院呼吸内科重症监护室(Respiratory Intensive Care Unit, RICU)的131例脓毒症并发ARDS患者的临床资料,根据患者28天预后,进一步将脓毒症并发ARDS患者分成生存组(n = 71)和死亡组(n = 60),比较两组降钙素原与白蛋白比值的差异,采用受试者工作曲线(ROC)评估PAR对脓毒症并发ARDS的预后价值;Spearman相关分析分析PAR与SOFA评分的相关性;Cox回归筛选脓毒症并发ARDS预后的独立危险因素;进一步比较不同亚组的PAR水平;最后采用Kaplan-Meier生存分析法比较不同PAR水平患者的生存率。结果:死亡组PAR水平显著高于生存组[0.85 (0.11, 2.84) vs. 0.19 (0.03, 1.01), P = 0.001]。ROC曲线分析表明,PAR判断脓毒症并发ARDS的预后性能最佳,曲线下面积(AUC)为0.725 (95% CI: 0.6141~0.800, P 1.74的脓毒症并发ARDS患者28-d预后更差(P 1.74时,脓毒症并发ARDS患者28 d死亡率更高。
