Sepsis is a secondary condition resulting from severe systemic infections.It is a significant contributor to mortality in critically ill patients with rapid onset and severe symptoms.Acupuncture is a traditional Chine...Sepsis is a secondary condition resulting from severe systemic infections.It is a significant contributor to mortality in critically ill patients with rapid onset and severe symptoms.Acupuncture is a traditional Chinese medical treatment.Recent clinical studies have demonstrated that acupuncture,as an important synergistic therapy,has promising therapeutic effects in the treatment of sepsis.This paper reviews the mechanisms of immunomodulation and target organ protection associated with acupuncture and synergistic drug acupuncture in the treatment of sepsis.It also integrates existing studies to elucidate the modulation of the immune system and the protective effect of acupuncture on target organs.展开更多
Spinal cord injury is a serious disease of the central nervous system involving irreversible nerve injury and various organ system injuries.At present,no effective clinical treatment exists.As one of the artificial hi...Spinal cord injury is a serious disease of the central nervous system involving irreversible nerve injury and various organ system injuries.At present,no effective clinical treatment exists.As one of the artificial hibernation techniques,mild hypothermia has preliminarily confirmed its clinical effect on spinal cord injury.However,its technical defects and barriers,along with serious clinical side effects,restrict its clinical application for spinal cord injury.Artificial hibernation is a futureoriented disruptive technology for human life support.It involves endogenous hibernation inducers and hibernation-related central neuromodulation that activate particular neurons,reduce the central constant temperature setting point,disrupt the normal constant body temperature,make the body adapt"to the external cold environment,and reduce the physiological resistance to cold stimulation.Thus,studying the artificial hibernation mechanism may help develop new treatment strategies more suitable for clinical use than the cooling method of mild hypothermia technology.This review introduces artificial hibernation technologies,including mild hypothermia technology,hibernation inducers,and hibernation-related central neuromodulation technology.It summarizes the relevant research on hypothermia and hibernation for organ and nerve protection.These studies show that artificial hibernation technologies have therapeutic significance on nerve injury after spinal co rd injury through inflammatory inhibition,immunosuppression,oxidative defense,and possible central protection.It also promotes the repair and protection of res pirato ry and digestive,cardiovascular,locomoto r,urinary,and endocrine systems.This review provides new insights for the clinical treatment of nerve and multiple organ protection after spinal cord injury thanks to artificial hibernation.At present,artificial hibernation technology is not mature,and research fa ces various challenges.Neve rtheless,the effort is wo rthwhile for the future development of medicine.展开更多
Chinese trade unions have always been keen on devel- oping and protecting worker rights. Today, they have the task of helping build up harmonious labor relations. By working to properly handle letters and visits, unio...Chinese trade unions have always been keen on devel- oping and protecting worker rights. Today, they have the task of helping build up harmonious labor relations. By working to properly handle letters and visits, union orga- nizations aim at resolving problems workers are most concerned with, problems that are most practical and affect the immediate interests of work- ers. The job is of great significance to the country＇s endeavor to ensure decent labor and social stability.展开更多
BACKGROUND:Liver transplantation is the therapy of choice for patients with end-stage liver diseases.However,the gap between the low availability of organs and high demand is continuously increasing.Innovative strateg...BACKGROUND:Liver transplantation is the therapy of choice for patients with end-stage liver diseases.However,the gap between the low availability of organs and high demand is continuously increasing.Innovative strategies for organ protection are necessary to expand donor pool and to achieve better outcomes for liver transplantation.The present review analyzed and compared various strategies of liver protection.DATA SOURCES:Databases such as PubM ed,Embase and Ovid were searched for the literature related to donor liver protection strategies using following key words:"ischemia reperfusion injury","graft preservation","liver transplantation","machine perfusion"and"conditioning".Of the 146 studies identified,only those with cutting edge strategies were analyzed.RESULTS:A variety of therapeutic approaches were proposed to alleviate graft ischemia/reperfusion injury,which included static cold storage,machine perfusion(hypothermic,normothermic and subnormothermic),manual conditioning(pre,post and remote),and pharmacological conditioning.Evidences from animal experiments and clinical trials suggested that all these strategies could potentially protect liver graft;however,their clinical applications are limited partially due to their own disadvantages.CONCLUSIONS:There are a plenty of methods suggested to decrease the degree of donor liver transplantation-related injury.However,none of these approaches is perfect in clinical practice.More translational researches(molecular and clinical studies)are needed to improve the techniques in liver graft protection.展开更多
EDITOR＇S NOTE： Following is a transcript of an interview by the Human Rights magazine with Jing Dali, chief procurator of the Hubei Provincial People＇s Procuratorate. Jing talked about how China＇s procuratorial wo...EDITOR＇S NOTE： Following is a transcript of an interview by the Human Rights magazine with Jing Dali, chief procurator of the Hubei Provincial People＇s Procuratorate. Jing talked about how China＇s procuratorial work protects human rights in his province and what will be done to improve it.展开更多
Glucagon-like peptide-1(GLP-1)is a multifunctional hormone with broad pharmacological potential to control inflammation,protect cardiovascular,kidney,and liver functions.Moreover,GLP-1 can also cross the blood-brain b...Glucagon-like peptide-1(GLP-1)is a multifunctional hormone with broad pharmacological potential to control inflammation,protect cardiovascular,kidney,and liver functions.Moreover,GLP-1 can also cross the blood-brain barrier and bind with GLP-1R distributed in various parts of the brain,thereby reducing apoptosis caused by neuroinflammation and oxygen stress,and promoting learning,memory,cognitive function,neuroprotection,and nerve cell remodeling.However,the exact molecular pathway by which GLP-1 receptor agonists(GLP-1RAs)exerts protective effects on many organs is not fully understood,so it is a hot topic of research.In this article,the recent research on the multi-organ protection of GLP-1 is reviewed,with emphasis on the research progress in the field of nervous system and perioperative anesthesia.展开更多
Surgical site infections remain a significant challenge in gastrointestinal surgery,despite advances in surgical techniques and antimicrobial therapy.Wang et al’s retrospective analysis highlights the transformative ...Surgical site infections remain a significant challenge in gastrointestinal surgery,despite advances in surgical techniques and antimicrobial therapy.Wang et al’s retrospective analysis highlights the transformative potential of comprehensive perioperative disinfection and isolation protocols in gastrointestinal surgery,demonstrating a 55%reduction in postoperative infection rates and attenuation of systemic inflammation.Their findings underscore the critical role of multidisciplinary strategies—such as preoperative povidone-iodine decolonization,intraoperative laminar airflow systems,and strict postoperative wound care—in mitigating infection risk and preserving organ function.However,the study revealed persistent gaps in protocol standardization and compliance monitoring,particularly in resource-limited settings.Although these measures reduce reliance on antibiotics and align with global antimicrobial resistance containment efforts,challenges such as the high cost of technology and issues with contextual adaptability warrant urgent attention.This study conclusively demonstrated that structured perioperative disinfection protocols significantly transform surgical outcomes by creating comprehensive infection barriers that extend beyond traditional antibiotic prophylaxis.Future priorities include prospective multicenter trials to validate efficacy,cost-benefit analyses for equitable implementation,and integration of artificial intelligence-driven innovations to optimize infection prevention.This study redefines infection control as a cornerstone of surgical quality,urging collaborative action to bridge the gap between clinical evidence and real-world practice.展开更多
Acupuncture, as a healing art in traditional Chinese medicine, has been widely used to treat various diseases. In the history of acupuncture anesthesia, in the past decades, mechanisms of acupuncture analgesia has bee...Acupuncture, as a healing art in traditional Chinese medicine, has been widely used to treat various diseases. In the history of acupuncture anesthesia, in the past decades, mechanisms of acupuncture analgesia has been widely investigated, and in recent years, acupuncture protection on organ functions has attracted great interest. This review summarized the research progress on mechanisms of acupuncture for analgesia and its protection against organ function injury in anesthesia, and its perspective of analgesia, immunomodulation, neuroendocrine regulation and multiple organ protection. The current evidence supports that acupuncture analgesia and its organ protection in anesthesia is associated with the integration of neuroendocrine-immune networks in the level of neurotransmitters, cytokines, hormones, neuronal ensembles,lymphocytes, and endocrine cells. Although the mechanisms of acupuncture analgesia and its organ protection are still not completely understood, basic as well as clinic researches on the mechanisms and applications of acupuncture and related techniques are being carried out.展开更多
A novel polymer-bound 1,2-diol, 3-polystyrylsulfonyl-1,2-propanediol (6) had been prepared by the reaction of sodium polystyrylsulfinate with allyl bromide, followed by oxidation and. hydrolysis or directly with 3-chl...A novel polymer-bound 1,2-diol, 3-polystyrylsulfonyl-1,2-propanediol (6) had been prepared by the reaction of sodium polystyrylsulfinate with allyl bromide, followed by oxidation and. hydrolysis or directly with 3-chloro-1,2-propanediol in the presence of a phase transfer catalyst, n-tetrabutylammonium iodide. The capacity of resin 6 for terephthaidehyde reached 1.43 mmol/g. The aldehydic groups attached to polymer 6 reacted with hydroxylamine hydrochloride or reduced by sodium borohydride giving p-formylbenzaldoxime (yield: 89%)and p-formyl-benzalcohol (yield: 734%), respectively. The high yields of these polymer-supported reactions showed that the polymer 6 possessed the effective isolation of its reactive sites.展开更多
The large‐scale industrialization of lithium metal(Li),as a potential anode for a high energy density energy storage system,has been hindered by dendrite growth.The construction of an artificial solid electrolyte int...The large‐scale industrialization of lithium metal(Li),as a potential anode for a high energy density energy storage system,has been hindered by dendrite growth.The construction of an artificial solid electrolyte interphase layer featuring high ionic and low electronic conductivity has been verified to be a high‐performance strategy to confine the dendrite growth and promote the Li anode stability.Therefore,a functional organic protective layer is homogeneously deposited on the Li anode surface via an in situ chemical reaction between tetracyanoquinodi-methane(TCNQ)and Li.The as‐synthesized Li_(n)‐TCNQ organic film could efficiently trap non‐uniform Li deposition and restrain dendrite propa-gation.Particularly,an asymmetric M‐TCNQ‐Li|Cu cell with the Li_(n)‐TCNQ layer breezed through a high Coulombic efficiency of 91.15%after 100 cycles at 1.0 mA cm^(-2).The M‐TCNQ‐Li|NCM622 cell delivered a high capacity of 143.40 mAh g^(-1) at 0.2 C and maintained a good cyclic stability of 110.44 mAh g^(-1) after 160 cycles.The analysis results of spectroscopic tests further demonstrate that the Li_(n)‐TCNQ with the enhanced absorp-tion energy is conducive to lithiophilicity and decreases the overpotential of Li deposition.展开更多
Acute-on-chronic liver failure(ACLF)is a syndrome in which acute liver failure with extrahepatic organ failure occurs on chronic liver disease.Recently,liver transplantation is the only effective treatment for ACLF.Th...Acute-on-chronic liver failure(ACLF)is a syndrome in which acute liver failure with extrahepatic organ failure occurs on chronic liver disease.Recently,liver transplantation is the only effective treatment for ACLF.There is still room for discussion on the optimal surgery timing for ACLF,perioperative infection prevention and control,and maintenance of nutrition and organ function.The Transplantation Immu-nology Committee of Branch of Organ Transplantation Physician of Chinese Medical Doctor Association and Enhanced Recovery of Liver Transplantation Group of Enhanced Recovery after Surgery Committee of Chinese Research Hospital Association invited relevant experts to discuss the perioperative management of ACLF liver transplantation in areas including surgery timing,organ protection,nutritional support,infection prevention and control,rehabilitation exercises,regulation of the internal environment,etc.An expert consensus was developed as reference for clinicians.展开更多
Mechanical ventilation(MV)is an essential life support method for patients with acute respiratory distress syn-drome(ARDS),which is one of the most common critical illnesses with high mortality in the intensive care u...Mechanical ventilation(MV)is an essential life support method for patients with acute respiratory distress syn-drome(ARDS),which is one of the most common critical illnesses with high mortality in the intensive care unit(ICU).A lung-protective ventilation strategy based on low tidal volume(LTV)has been recommended since a few years;however,as this did not result in a significant decrease of ARDS-related mortality,a more optimal venti-lation mode was required.Airway pressure release ventilation(APRV)is an old method defined as a continuous positive airway pressure(CPAP)with a brief intermittent release phase based on the open lung concept;it also perfectly fits the ARDS treatment principle.Despite this,APRV has not been widely used in the past,rather only as a rescue measure for ARDS patients who are difficult to oxygenate.Over recent years,with an increased under-standing of the pathophysiology of ARDS,APRV has been reproposed to improve patient prognosis.Nevertheless,this mode is still not routinely used in ARDS patients given its vague definition and complexity.Consequently,in this paper,we summarize the studies that used APRV in ARDS,including adults,children,and animals,to illustrate the settings of parameters,effectiveness in the population,safety(especially in children),incidence,and mechanism of ventilator-induced lung injury(VILI)and effects on extrapulmonary organs.Finally,we found that APRV is likely associated with improvement in ARDS outcomes,and does not increase injury to the lungs and other organs,thereby indicating that personalized APRV settings may be the new hope for ARDS treatment.展开更多
Application of volatile anesthetics greatly alters modern medicine.There are obvious advantages of volatile anesthetics such as strong anesthetic potency,rapid onset and elimination through respiration system.Isoflura...Application of volatile anesthetics greatly alters modern medicine.There are obvious advantages of volatile anesthetics such as strong anesthetic potency,rapid onset and elimination through respiration system.Isoflurane is one of the most widely used volatile anesthetics in clinic.Emulsified isoflurane,the emulsion of isoflurane,is a novel intravenous general anesthetic.With the development of emulsified isoflurane in the past fifteen years,its utility has spread from intravenous general anesthesia to various fields including regional anesthesia,organ protection,as well as anesthetic pharmacological study.In this review,we will summarize literatures of emulsified isoflurane about its history,clinical application and future potential utility in the above mentioned fields.展开更多
基金the National Key Research and Development Program(No.2022YFC3500704).
文摘Sepsis is a secondary condition resulting from severe systemic infections.It is a significant contributor to mortality in critically ill patients with rapid onset and severe symptoms.Acupuncture is a traditional Chinese medical treatment.Recent clinical studies have demonstrated that acupuncture,as an important synergistic therapy,has promising therapeutic effects in the treatment of sepsis.This paper reviews the mechanisms of immunomodulation and target organ protection associated with acupuncture and synergistic drug acupuncture in the treatment of sepsis.It also integrates existing studies to elucidate the modulation of the immune system and the protective effect of acupuncture on target organs.
基金supported by the Key Projects of the National Natural Science Foundation of China,No.11932013(to XC)Key Military Logistics Research Projects,No.B WJ21J002(to XC)+4 种基金the Key projects of the Special Zone for National Defence Innovation,No.21-163-12-ZT006002-13(to XC)the National Nature Science Foundation of China No.82272255(to XC)the National Defense Science and Technology Outstanding Youth Science Fund Program,No.2021-JCIQ-ZQ-035(to XC)the Scientific Research Innovation Team Project of Armed Police Characteristic Medical Center,No.KYCXTD0104(to ZL)the National Natural Science Foundation of China Youth Fund,No.82004467(to BC)。
文摘Spinal cord injury is a serious disease of the central nervous system involving irreversible nerve injury and various organ system injuries.At present,no effective clinical treatment exists.As one of the artificial hibernation techniques,mild hypothermia has preliminarily confirmed its clinical effect on spinal cord injury.However,its technical defects and barriers,along with serious clinical side effects,restrict its clinical application for spinal cord injury.Artificial hibernation is a futureoriented disruptive technology for human life support.It involves endogenous hibernation inducers and hibernation-related central neuromodulation that activate particular neurons,reduce the central constant temperature setting point,disrupt the normal constant body temperature,make the body adapt"to the external cold environment,and reduce the physiological resistance to cold stimulation.Thus,studying the artificial hibernation mechanism may help develop new treatment strategies more suitable for clinical use than the cooling method of mild hypothermia technology.This review introduces artificial hibernation technologies,including mild hypothermia technology,hibernation inducers,and hibernation-related central neuromodulation technology.It summarizes the relevant research on hypothermia and hibernation for organ and nerve protection.These studies show that artificial hibernation technologies have therapeutic significance on nerve injury after spinal co rd injury through inflammatory inhibition,immunosuppression,oxidative defense,and possible central protection.It also promotes the repair and protection of res pirato ry and digestive,cardiovascular,locomoto r,urinary,and endocrine systems.This review provides new insights for the clinical treatment of nerve and multiple organ protection after spinal cord injury thanks to artificial hibernation.At present,artificial hibernation technology is not mature,and research fa ces various challenges.Neve rtheless,the effort is wo rthwhile for the future development of medicine.
文摘Chinese trade unions have always been keen on devel- oping and protecting worker rights. Today, they have the task of helping build up harmonious labor relations. By working to properly handle letters and visits, union orga- nizations aim at resolving problems workers are most concerned with, problems that are most practical and affect the immediate interests of work- ers. The job is of great significance to the country＇s endeavor to ensure decent labor and social stability.
基金supported in part by grants from the National Science and Technology Major Project(2012ZX10002-017)Natural Science Foundation of China for Innovative Research Group(81121002)+3 种基金the National Natural Science Foundation of China(81470891)the Qianjiang Talent Program of Zhejiang Province,China(2012R10045)the 863 National High-Technology Research and Development Program of China for young scientists(2015AA020923)the Scientific Research Program for the Returned Overseas Chinese Scholars,Ministry of Health,China(491010-G51104)
文摘BACKGROUND:Liver transplantation is the therapy of choice for patients with end-stage liver diseases.However,the gap between the low availability of organs and high demand is continuously increasing.Innovative strategies for organ protection are necessary to expand donor pool and to achieve better outcomes for liver transplantation.The present review analyzed and compared various strategies of liver protection.DATA SOURCES:Databases such as PubM ed,Embase and Ovid were searched for the literature related to donor liver protection strategies using following key words:"ischemia reperfusion injury","graft preservation","liver transplantation","machine perfusion"and"conditioning".Of the 146 studies identified,only those with cutting edge strategies were analyzed.RESULTS:A variety of therapeutic approaches were proposed to alleviate graft ischemia/reperfusion injury,which included static cold storage,machine perfusion(hypothermic,normothermic and subnormothermic),manual conditioning(pre,post and remote),and pharmacological conditioning.Evidences from animal experiments and clinical trials suggested that all these strategies could potentially protect liver graft;however,their clinical applications are limited partially due to their own disadvantages.CONCLUSIONS:There are a plenty of methods suggested to decrease the degree of donor liver transplantation-related injury.However,none of these approaches is perfect in clinical practice.More translational researches(molecular and clinical studies)are needed to improve the techniques in liver graft protection.
文摘EDITOR＇S NOTE： Following is a transcript of an interview by the Human Rights magazine with Jing Dali, chief procurator of the Hubei Provincial People＇s Procuratorate. Jing talked about how China＇s procuratorial work protects human rights in his province and what will be done to improve it.
基金Shanxi Youth Science and Technology Research Foundation(2019041035-3).
文摘Glucagon-like peptide-1(GLP-1)is a multifunctional hormone with broad pharmacological potential to control inflammation,protect cardiovascular,kidney,and liver functions.Moreover,GLP-1 can also cross the blood-brain barrier and bind with GLP-1R distributed in various parts of the brain,thereby reducing apoptosis caused by neuroinflammation and oxygen stress,and promoting learning,memory,cognitive function,neuroprotection,and nerve cell remodeling.However,the exact molecular pathway by which GLP-1 receptor agonists(GLP-1RAs)exerts protective effects on many organs is not fully understood,so it is a hot topic of research.In this article,the recent research on the multi-organ protection of GLP-1 is reviewed,with emphasis on the research progress in the field of nervous system and perioperative anesthesia.
文摘Surgical site infections remain a significant challenge in gastrointestinal surgery,despite advances in surgical techniques and antimicrobial therapy.Wang et al’s retrospective analysis highlights the transformative potential of comprehensive perioperative disinfection and isolation protocols in gastrointestinal surgery,demonstrating a 55%reduction in postoperative infection rates and attenuation of systemic inflammation.Their findings underscore the critical role of multidisciplinary strategies—such as preoperative povidone-iodine decolonization,intraoperative laminar airflow systems,and strict postoperative wound care—in mitigating infection risk and preserving organ function.However,the study revealed persistent gaps in protocol standardization and compliance monitoring,particularly in resource-limited settings.Although these measures reduce reliance on antibiotics and align with global antimicrobial resistance containment efforts,challenges such as the high cost of technology and issues with contextual adaptability warrant urgent attention.This study conclusively demonstrated that structured perioperative disinfection protocols significantly transform surgical outcomes by creating comprehensive infection barriers that extend beyond traditional antibiotic prophylaxis.Future priorities include prospective multicenter trials to validate efficacy,cost-benefit analyses for equitable implementation,and integration of artificial intelligence-driven innovations to optimize infection prevention.This study redefines infection control as a cornerstone of surgical quality,urging collaborative action to bridge the gap between clinical evidence and real-world practice.
基金supported by grants from The National Basic Research Program of China,Ministry of Science and Technology of China(2013CB531900)The National Natural Science Foundation of China(81230023,81221002 and 81171042)The‘‘111’’Project of The Ministry of Education of China(B07001)
文摘Acupuncture, as a healing art in traditional Chinese medicine, has been widely used to treat various diseases. In the history of acupuncture anesthesia, in the past decades, mechanisms of acupuncture analgesia has been widely investigated, and in recent years, acupuncture protection on organ functions has attracted great interest. This review summarized the research progress on mechanisms of acupuncture for analgesia and its protection against organ function injury in anesthesia, and its perspective of analgesia, immunomodulation, neuroendocrine regulation and multiple organ protection. The current evidence supports that acupuncture analgesia and its organ protection in anesthesia is associated with the integration of neuroendocrine-immune networks in the level of neurotransmitters, cytokines, hormones, neuronal ensembles,lymphocytes, and endocrine cells. Although the mechanisms of acupuncture analgesia and its organ protection are still not completely understood, basic as well as clinic researches on the mechanisms and applications of acupuncture and related techniques are being carried out.
基金The project is supported by the National Natural Science Foundation of China.
文摘A novel polymer-bound 1,2-diol, 3-polystyrylsulfonyl-1,2-propanediol (6) had been prepared by the reaction of sodium polystyrylsulfinate with allyl bromide, followed by oxidation and. hydrolysis or directly with 3-chloro-1,2-propanediol in the presence of a phase transfer catalyst, n-tetrabutylammonium iodide. The capacity of resin 6 for terephthaidehyde reached 1.43 mmol/g. The aldehydic groups attached to polymer 6 reacted with hydroxylamine hydrochloride or reduced by sodium borohydride giving p-formylbenzaldoxime (yield: 89%)and p-formyl-benzalcohol (yield: 734%), respectively. The high yields of these polymer-supported reactions showed that the polymer 6 possessed the effective isolation of its reactive sites.
基金National Research Foundation of Korea,Grant/Award Number:RS‐2024‐00453815SKKU Global Research Platform Research Fund。
文摘The large‐scale industrialization of lithium metal(Li),as a potential anode for a high energy density energy storage system,has been hindered by dendrite growth.The construction of an artificial solid electrolyte interphase layer featuring high ionic and low electronic conductivity has been verified to be a high‐performance strategy to confine the dendrite growth and promote the Li anode stability.Therefore,a functional organic protective layer is homogeneously deposited on the Li anode surface via an in situ chemical reaction between tetracyanoquinodi-methane(TCNQ)and Li.The as‐synthesized Li_(n)‐TCNQ organic film could efficiently trap non‐uniform Li deposition and restrain dendrite propa-gation.Particularly,an asymmetric M‐TCNQ‐Li|Cu cell with the Li_(n)‐TCNQ layer breezed through a high Coulombic efficiency of 91.15%after 100 cycles at 1.0 mA cm^(-2).The M‐TCNQ‐Li|NCM622 cell delivered a high capacity of 143.40 mAh g^(-1) at 0.2 C and maintained a good cyclic stability of 110.44 mAh g^(-1) after 160 cycles.The analysis results of spectroscopic tests further demonstrate that the Li_(n)‐TCNQ with the enhanced absorp-tion energy is conducive to lithiophilicity and decreases the overpotential of Li deposition.
基金This work was supported by National 13th Five-Year Science and Technology Plan Major Projects of China(2017ZX10203205-006-001)National Key Research and Development Program of China(2017YFA0104304)+3 种基金National Natural Science Foundation of China(81770648,81972286)Natural Science Foundation of Guangdong Province,China(2015A030312013,2018A0303130305)Science and Technology Program of Guangdong Province,China(2017B020209004,20169013,2020B1212060019)Guangzhou Science and Technology Project,China(201400000001-3).
文摘Acute-on-chronic liver failure(ACLF)is a syndrome in which acute liver failure with extrahepatic organ failure occurs on chronic liver disease.Recently,liver transplantation is the only effective treatment for ACLF.There is still room for discussion on the optimal surgery timing for ACLF,perioperative infection prevention and control,and maintenance of nutrition and organ function.The Transplantation Immu-nology Committee of Branch of Organ Transplantation Physician of Chinese Medical Doctor Association and Enhanced Recovery of Liver Transplantation Group of Enhanced Recovery after Surgery Committee of Chinese Research Hospital Association invited relevant experts to discuss the perioperative management of ACLF liver transplantation in areas including surgery timing,organ protection,nutritional support,infection prevention and control,rehabilitation exercises,regulation of the internal environment,etc.An expert consensus was developed as reference for clinicians.
基金supported by the National Natural Science Foundation of China(gereral program,Grant No.81,873,929)。
文摘Mechanical ventilation(MV)is an essential life support method for patients with acute respiratory distress syn-drome(ARDS),which is one of the most common critical illnesses with high mortality in the intensive care unit(ICU).A lung-protective ventilation strategy based on low tidal volume(LTV)has been recommended since a few years;however,as this did not result in a significant decrease of ARDS-related mortality,a more optimal venti-lation mode was required.Airway pressure release ventilation(APRV)is an old method defined as a continuous positive airway pressure(CPAP)with a brief intermittent release phase based on the open lung concept;it also perfectly fits the ARDS treatment principle.Despite this,APRV has not been widely used in the past,rather only as a rescue measure for ARDS patients who are difficult to oxygenate.Over recent years,with an increased under-standing of the pathophysiology of ARDS,APRV has been reproposed to improve patient prognosis.Nevertheless,this mode is still not routinely used in ARDS patients given its vague definition and complexity.Consequently,in this paper,we summarize the studies that used APRV in ARDS,including adults,children,and animals,to illustrate the settings of parameters,effectiveness in the population,safety(especially in children),incidence,and mechanism of ventilator-induced lung injury(VILI)and effects on extrapulmonary organs.Finally,we found that APRV is likely associated with improvement in ARDS outcomes,and does not increase injury to the lungs and other organs,thereby indicating that personalized APRV settings may be the new hope for ARDS treatment.
文摘Application of volatile anesthetics greatly alters modern medicine.There are obvious advantages of volatile anesthetics such as strong anesthetic potency,rapid onset and elimination through respiration system.Isoflurane is one of the most widely used volatile anesthetics in clinic.Emulsified isoflurane,the emulsion of isoflurane,is a novel intravenous general anesthetic.With the development of emulsified isoflurane in the past fifteen years,its utility has spread from intravenous general anesthesia to various fields including regional anesthesia,organ protection,as well as anesthetic pharmacological study.In this review,we will summarize literatures of emulsified isoflurane about its history,clinical application and future potential utility in the above mentioned fields.
