Background Sepsis is defined as a systemic inflammatory response to microbial infections with multiple organ dysfunction. This study analysed untargeted metabolomics combined with proteomics of serum from patients with sepsis to reveal the underlying pathological mechanisms involved in sepsis. Methods A total of 63 patients with sepsis and 43 normal controls were enrolled from a prospective multicentre cohort. The biological functions of the metabolome were assessed by coexpression network analysis. A molecular network based on metabolomics and proteomics data was constructed to investigate the key molecules. Results Untargeted metabolomics analysis revealed widespread dysregulation of amino acid metabolism, which regulates inflammation and immunity, in patients with sepsis. Seventy-three differentially expressed metabolites (|log2 fold change| > 1.5, adjusted P value < 0.05 and variable importance in the projection (VIP) > 1.5) that could predict sepsis were identified. External validation of the hub metabolites was consistent with the derivation results (area under the receiver operating characteristic curve (AUROC): 0.81–0.96/0.62–1.00). The pentose phosphate pathway was found to be related to sepsis-associated encephalopathy. Phenylalanine metabolism was associated with sepsis-associated acute kidney injury. The key molecular alterations of the multiomics network in sepsis compared to normal controls implicate acute inflammatory response, platelet degranulation, myeloid cell activation involved in immune response and phenylalanine, tyrosine and tryptophan biosynthesis, and arginine biosynthesis. Conclusions Integrated analysis of untargeted metabolomics and proteomics revealed characteristic metabolite and protein alterations in sepsis, which were mainly involved in inflammation-related pathways and amino acid metabolism. This study depicted the pathological characteristics and pathways involved in sepsis and potential therapeutic targets.

Background: Pulmonary fibrosis is a common complication in patients with viral pneumonia, which causes restricted ventilation disorders and affects the prognosis of patients. However, the pulmonary function of patients with 2019 novel coronavirus (COVID-19)-induced pneumonia has not yet been reported.Methods: A retrospective analysis of 137 patients with COVID-19-induced pneumonia who were discharged from the Enze Hospital, Taizhou Enze Medical Center (Group), from January 31, 2020, to March 11, 2020. Follow-up occurred two weeks after hospital discharge, whereupon patients received a pulmonary function test. Results: Of the 137 patients who received a pulmonary function test two weeks after discharge, 51.8% were male, and the mean age was 47 years. Only 19.7% of the patients were identified as having severe novel coronavirus pneumonia. The pulmonary function test showed that for a small number of patients ((FEV1/FVC)/% <70%,) the mean ICV and FVC was 2.4±0.7 L, 3.2±0.8 L, respectively. In severe cases, 88.9% of patients had an IVC <80% of the predicted value and 55.6% of patients had an FVC <80% of the predicted value. The MEF25, MEF50, and MEF75 <70% values were 55.6%, 40.7%, and 25.9%, respectively. In the non-severe group, 79.1% of patients has an IVC <80% of the predicted value, and 16.4% of patients had an FVC <80% of the predicted value. The mean MEF25, MEF50, and MEF75 <70% values were 57.3%, 30%, and 13.6%, respectively.Conclusions: In this study, the results suggest that the pulmonary function of patients with 2019 novel coronavirus (COVID-19)-induced pneumonia manifested as restrictive ventilation disorder and small airway obstruction. The incidence was increased among critically ill patients.Trial registration number: ChiCTR2000029866.

Background: The time of enteral nutrition (EN) administration on patients with sepsis is controversial.The study was to explore the effect of early enteral nutrition (EEN) on the prognosis of patients with sepsis.Methods: We performed a secondary analysis of the acute gastrointestinal injury grade study. The patients were divided into two groups from the time of EN administration: EEN group (n=85): EN within 24 hours; Control group (N=78): EN after 24 hours. The key observation was the length of ICU stay, and length of hospital stay, and 28-and 60-day mortality.Results: Of 676 patients, 163 were included. There are no significant between-group differences in the characteristics at baseline. The overall mortality rate at 28 days in the EEN group was 28.2% vs. 43.6% in the control group (P=0.041). The mortality rate at 60 days in the EEN group was 36.5% vs. 52.6% in the control group (P=0.039). In a subgroup analysis of patients who whether used vasoactive drugs: the EEN group was found to be significantly associated with 60-day mortality (P=0.039). The ICU stay length in the EEN group was longer than in the control group {11 [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] vs. 10 [6-16]; P=0.022}. Also, the length of the hospital stay was longer than in the Control group {23 [14-53] vs. 18 [10-39]; P=0.023}. Univariate Cox regression analysis showed that EEN, using vasoactive drugs, Acute kidney injury (AKI), Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and the global acute gastrointestinal injury (AGI) grade were significantly (P<0.05) associated with 60-day mortality. In a multivariate analysis including these