Recent studies have proposed three lymphatic drainage systems in the brain,that is,the glymphatic system,the intramural periarterial drainage pathway,and meningeal lymphatic vessels,whose roles in various neurological...Recent studies have proposed three lymphatic drainage systems in the brain,that is,the glymphatic system,the intramural periarterial drainage pathway,and meningeal lymphatic vessels,whose roles in various neurological diseases have been widely explored.The glymphatic system is a fluid drainage and waste clearance pathway that utilizes perivascular space and aquaporin-4 protein located in the astrocyte endfeet to provide a space for exchange of cerebrospinal fluid and interstitial fluid.The intramural periarterial drainage pathway drives the flow of interstitial fluid through the capillary basement membrane and the arterial tunica media.Meningeal lymphatic vessels within the dura mater are involved in the removal of cerebral macromolecules and immune responses.After ischemic stroke,impairment of these systems could lead to cerebral edema,accumulation of toxic factors,and activation of neuroinflammation,while restoration of their normal functions can improve neurological outcomes.In this review,we summarize the basic concepts of these drainage systems,including drainage routes,physiological functions,regulatory mechanisms,and detection technologies.We also focus on the roles of lymphatic drainage systems in brain injury after ischemic stroke,as well as recent advances in therapeutic strategies targeting these drainage systems.These findings provide information for potential novel strategies for treatment of stroke.展开更多
BACKGROUND: Currently, no documentation is available regarding Chinese children with acute liver failure(ALF). This study was undertaken to investigate etiologies and outcomes of Chinese children with ALF.METHODS: We ...BACKGROUND: Currently, no documentation is available regarding Chinese children with acute liver failure(ALF). This study was undertaken to investigate etiologies and outcomes of Chinese children with ALF.METHODS: We retrospectively enrolled 32 pediatric patients with ALF admitted in five hospitals in different areas of China from January 2007 to December 2012. The coagulation indices, serum creatinine, serum lactate dehydrogenase,blood ammonia and prothrombin activity were analyzed; the relationship between these indices and mortality was evaluated by multivariate analysis.RESULTS: The most common causes of Chinese children with ALF were indeterminate etiology(15/32), drug toxicity(8/32),and acute cytomegalovirus hepatitis(6/32). Only 1 patient(3.13%)received liver transplantation and the spontaneous mortality of Chinese children with ALF was 58.06%(18/31). Patients who eventually died had higher baseline levels of international normalized ratio(P=0.01), serum creatinine(P=0.04), serum lactate dehydrogenase(P=0.01), blood ammonia(P<0.01) and lower prothrombin activity(P=0.01) than those who survived.Multivariate analysis showed that the entry blood ammonia was the only independent factor significantly associated with mortality(odds ratio=1.069, 95% confidence interval 1.023-1.117,P<0.01) and it had a sensitivity of 94.74%, a specificity of 84.62%and an accuracy of 90.63% for predicting the death. Based on the established model, with an increase of blood ammonia level,the risk of mortality would increase by 6.9%.CONCLUSIONS: The indeterminate causes predominated in the etiologies of ALF in Chinese children. The spontaneous mortality of pediatric patients with ALF was high, whereas the proportion of patients undergoing liver transplantation was significantly low. Entry blood ammonia was a reliable predictor for the death of pediatric patients with ALF.展开更多
Objective:To explore the application of feedforward control in the nursing emergency management of COVID-19.Methods:The feedforward control theory was applied to the emergency management of COVID-19 nursing,including ...Objective:To explore the application of feedforward control in the nursing emergency management of COVID-19.Methods:The feedforward control theory was applied to the emergency management of COVID-19 nursing,including grasping the latest epidemic information,preparing for the early stage,formulating nursing workflow,implementing flexible management,standardizing isolation and protection measures,unifying nursing document record format,and implementing humanistic care.Results:During the period of support to Wuhan,the nursing work in the isolated area was orderly,the nursing staff's job satisfaction was high,no nursing errors and hospital infections occurred.Conclusion:Efficient feedforward control in the nursing emergency management that could avoid work blindness to a certain extent and play a guiding role in maintaining the normal operation of treatment and nursing work and protecting the safety of patients and medical staff in the ward during the epidemic period of COVID-19.展开更多
基金supported by the Natural Science Foundation of Beijing(Key Program)No.Z200025(to JHY)+1 种基金the National Natural Science Foundation of China,No.81873818(to LHQ)Supporting Platform Construction Project of Peking University Health Science Center,No.BMU2021ZC011(to JHY).
文摘Recent studies have proposed three lymphatic drainage systems in the brain,that is,the glymphatic system,the intramural periarterial drainage pathway,and meningeal lymphatic vessels,whose roles in various neurological diseases have been widely explored.The glymphatic system is a fluid drainage and waste clearance pathway that utilizes perivascular space and aquaporin-4 protein located in the astrocyte endfeet to provide a space for exchange of cerebrospinal fluid and interstitial fluid.The intramural periarterial drainage pathway drives the flow of interstitial fluid through the capillary basement membrane and the arterial tunica media.Meningeal lymphatic vessels within the dura mater are involved in the removal of cerebral macromolecules and immune responses.After ischemic stroke,impairment of these systems could lead to cerebral edema,accumulation of toxic factors,and activation of neuroinflammation,while restoration of their normal functions can improve neurological outcomes.In this review,we summarize the basic concepts of these drainage systems,including drainage routes,physiological functions,regulatory mechanisms,and detection technologies.We also focus on the roles of lymphatic drainage systems in brain injury after ischemic stroke,as well as recent advances in therapeutic strategies targeting these drainage systems.These findings provide information for potential novel strategies for treatment of stroke.
文摘BACKGROUND: Currently, no documentation is available regarding Chinese children with acute liver failure(ALF). This study was undertaken to investigate etiologies and outcomes of Chinese children with ALF.METHODS: We retrospectively enrolled 32 pediatric patients with ALF admitted in five hospitals in different areas of China from January 2007 to December 2012. The coagulation indices, serum creatinine, serum lactate dehydrogenase,blood ammonia and prothrombin activity were analyzed; the relationship between these indices and mortality was evaluated by multivariate analysis.RESULTS: The most common causes of Chinese children with ALF were indeterminate etiology(15/32), drug toxicity(8/32),and acute cytomegalovirus hepatitis(6/32). Only 1 patient(3.13%)received liver transplantation and the spontaneous mortality of Chinese children with ALF was 58.06%(18/31). Patients who eventually died had higher baseline levels of international normalized ratio(P=0.01), serum creatinine(P=0.04), serum lactate dehydrogenase(P=0.01), blood ammonia(P<0.01) and lower prothrombin activity(P=0.01) than those who survived.Multivariate analysis showed that the entry blood ammonia was the only independent factor significantly associated with mortality(odds ratio=1.069, 95% confidence interval 1.023-1.117,P<0.01) and it had a sensitivity of 94.74%, a specificity of 84.62%and an accuracy of 90.63% for predicting the death. Based on the established model, with an increase of blood ammonia level,the risk of mortality would increase by 6.9%.CONCLUSIONS: The indeterminate causes predominated in the etiologies of ALF in Chinese children. The spontaneous mortality of pediatric patients with ALF was high, whereas the proportion of patients undergoing liver transplantation was significantly low. Entry blood ammonia was a reliable predictor for the death of pediatric patients with ALF.
基金We would like to thank Peng‑Zhi ZHANG and Xue‑Song WANG for their assistance in nursing workflow sorting.
文摘Objective:To explore the application of feedforward control in the nursing emergency management of COVID-19.Methods:The feedforward control theory was applied to the emergency management of COVID-19 nursing,including grasping the latest epidemic information,preparing for the early stage,formulating nursing workflow,implementing flexible management,standardizing isolation and protection measures,unifying nursing document record format,and implementing humanistic care.Results:During the period of support to Wuhan,the nursing work in the isolated area was orderly,the nursing staff's job satisfaction was high,no nursing errors and hospital infections occurred.Conclusion:Efficient feedforward control in the nursing emergency management that could avoid work blindness to a certain extent and play a guiding role in maintaining the normal operation of treatment and nursing work and protecting the safety of patients and medical staff in the ward during the epidemic period of COVID-19.
