DISCUSSION
deaths, ischemia‐reperfusion injury, SIRS, shock, ischemia, hypoperfusion, hypoxia, infections, hyperlactatemia, liver injury, infection, UTI, septic shock, sepsis, septic
INFECTIOUS DISEASES, PCT, INFLAMMATORY RESPONSES, SHOCK, LIVER FAILURE, ISCHEMIA, HYPOPERFUSION, HYPOXIA, INFECTIONS, DISEASE, INFECTION, UTI, SEPTIC SHOCK, SEPSIS, INFECTIOUS DISEASES
Infectious diseases affect the entire course of human development, of which there were nearly 50 million new septic patients worldwide in 2017 and 11 million deaths due to sepsis, accounting for 19.7% of global deaths.UTI is a glycoprotein purified from healthy human urineUTI suppresses neutrophil superoxide generation caused by stimuli, such as formylmethionyl‐leucyl‐phenylalanine in a dose‐dependent manner. The reduction of neutrophil superoxide production generated by stimuli, such as formylmethionyl‐leucyl‐phenylalanine, may reflect the fact that UTI reduces the expression of pro‐synuclein‐activated protein kinase, which successfully scavenges endotoxin and protects cellular mitochondria. Patients with sepsis or septic shock who receive UTI have a reduction in all‐cause mortality and other associated outcomes.This finding indicates that UTI has a dual synergistic effect of anti‐inflammation and protection of organ function because UTI inhibits ischemia and reperfusion and enhances the antioxidant defense, thus leading to restoration of the structure and function of hepatocytes. The WBC count, and CRP, PCT, TNF‐α, and IL‐6 levels are the most common clinical indicators to assess infectious diseases.In this study the trend of improvement in inflammatory monitoring indices, such as the WBC count, and the PCT, CRP, TNF‐α, and IL‐6 levels in the study group were significantly faster than the control group, and the difference between the two groups was statistically significant. After anti‐infection and shock correction, all patients showed a significant reduction in inflammatory markers compared to pretreatment. This finding confirms the effectiveness of UTI in controlling infections and suppressing inflammatory responses with good efficacy, including endotoxin, which is consistent with previous studies on UTI efficacy in treating pulmonary, urinary, and post‐traumatic infections.The liver of patients with an unliquefied bacterial LA, combined with infectious shock, is one of the more heavily involved target organs in these patients, and the production of large amounts of inflammatory mediators in the body during SIRS easily induces apoptosis of hepatocytes, which together with tissue ischemia‐reperfusion injury and microthrombus formation, can easily lead to acute liver injury and even liver failure.When a severe infection occurs, tissue hypoperfusion and cellular hypoxia often already exist before the change in routine hemodynamic monitoring indices, and blood Lac levels are already elevated, thus resulting in hyperlactatemia. The elevated blood Lac levels are an early and sensitive biochemical indicator of inadequate tissue perfusion and oxygen delivery, and therefore blood Lac can be one of the important indicators for assessing disease severity and prognosis.The limitations of the current study were as follows: 1. The specific effect of UTI on antioxidant profiles was not observed. Therefore, further research is expected to address this issue. 2. Studies need to have rigorous study designs, such as double‐blind, randomized, controlled trials to eliminate the effects of other interfering factors on the results. 3. This study was limited to a single center due to resource and time constraints. Further confirmation of our findings with a large multicenter sample is necessary to strengthen the generalizability and external validity.