Background. Left ventricular (LV) systolic dysfunction is common in septic shock. Global longitudinal strain (GLS) measured by speckle tracking echocardiography (STE) is a useful marker of intrinsic left ventricular systolic function. However, the association between left ventricular GLS and outcome in septic patients is not well understood. We performed this prospective study to investigate the prognostic value of LV systolic function utilizing speckle tracking echocardiography in patients with septic shock. Methods. All the patients with septic shock based on sepsis-3 definition admitted to the intensive care unit were prospectively studied with STE within 24 hours after the onset of septic shock. Baseline clinical and echocardiographic variables were collected. The primary outcome was in-hospital mortality. Results. During a 19-month period, 90 consecutive patients were enrolled in the study. The in-hospital mortality rate was 43.3%. Compared with survivors, nonsurvivors exhibited significantly less negative GLS ( − 13.1 ± 3.3 % versus − 15.8 ± 2.9 % ; p < 0.001 ), which reflected worse LV systolic function. The area under the ROC curves of GLS for the prediction of mortality was 0.76 (95% CI 0.67 to 0.87). Patients with GLS > − 14.1 % showed a significantly higher mortality rate (67.7% versus 15.6%; p < 0.0001 ; log ‐ rank = 23.3 ; p < 0.0001 ). In the multivariate analysis, GLS (HR, 1.27; 95% CI 1.07 to 1.50, p = 0.005 ) and SOFA scores (HR, 1.27; 95% CI 1.08 to 1.50, p = 0.004 ) were independent predictors of in-hospital mortality. Conclusions. Our study indicated that LV systolic function measured by STE might be associated with mortality in patients with septic shock.

Background. Left ventricular systolic dysfunction (LVSD) is common in sepsis. Speckle-tracking echocardiography (STE) is a useful emerging tool for evaluating the intrinsic left ventricular systolic function. High-sensitivity cardiac troponin T (hs-cTnT) is the most sensitive biomarker of myocardial injury. However, there are limited data regarding the association between hs-cTnT level and left ventricular systolic dysfunction based on STE in septic patients. We performed this prospective study to evaluate the diagnostic value of hs-cTnT level for subclinical left ventricular systolic dysfunction measured by STE in septic patients according to the sepsis-3 definition. Methods. Patients with sepsis based on sepsis-3 definition admitted to the intensive care unit were prospectively performed STE and hs-cTnT level within 24 hours after the onset of sepsis. Baseline clinical and echocardiographic variables were collected. Left ventricular systolic dysfunction was defined as a global longitudinal strain of   ≥−15%. Results. During a 19-month period, 116 patients were enrolled in the study. The elevated hs-cTnT level was seen in 86.2% of septic patients, and 43.1% of patients had LVSD on STE. The median hs-cTnT level and the proportion of elevated hs-cTnT level (>14 ng/L) were significantly higher in patients with LVSD than in patients without LVSD. The area under the ROC curves of hs-cTnT to detect LVSD was 0.73 ( P  < 0.001). In the multivariate analysis, hs-cTnT (HR, 1.002; 95% CI, 1.000 to 1.004; P  = 0.025) and septic shock (HR, 7.6; 95% CI, 2.25 to 25.76; P  = 0.001) were independent predictors of LVSD. Conclusion. Our study indicated that the serum hs-cTnT level might be a useful biomarker for detecting LVSD in septic patients.

Traumatic brain injury (TBI) is a complicated topic.TBI has expensive treatment, sequelae, high mortality and efficient therapeutic strategies for TBI are urgently needed. Patients with severe TBI account for 10% of all traumatic brain injury patients, but more than 80% of patients who die from traumatic brain injury are in this group of patients. That proves the danger of severe TBI. Mesenchymal stem cells (MSCs) are multipotent cells with high proliferative and self-renewal capacities, as well as immunomodulatory and neuroregenerative effects. MSCshave been shown to treat TBI and significantly reduce inflammation of injured tissue. In the present study, we evaluated the quality and effectiveness of mesenchymal stem cell transplantation with the graft dose of 9x106cells/kg. Clinical indexes (Pulse, temperature, SBP, HATTr, HATTB, GCS) and subclinical (Hepatic index, kidney, cortisol, lactate, glucose, hematological index, respiratory index) were monitored on 60 patients within 6 months. The results showed that the recovery journey is different for every person with the graft dose of 6-9x106 cells/kg, but there were no adverse complications for the patients, the clinical and paraclinical indicators were stable. No significant side effects were observed during the trial as well as after 6 months of treatment. The MSC transfusions significantly increased the life quality patients; reduced brain damage  and increased HSC counts. Inflammatory cytokines (IL-6) levels decreased and GCS increased in the MSC transfusion group, indicating that the patient's health improved.