The author obtains an algebraic version of the main result from his previous paper 'A characterization of Riesz spaces which are Riesz isomorphic to C(X) for some completely regular space X', and also studies...The author obtains an algebraic version of the main result from his previous paper 'A characterization of Riesz spaces which are Riesz isomorphic to C(X) for some completely regular space X', and also studies the relations among some conditions used therein.展开更多
Intensive care unit(ICU)acquired sarcopenia and myosteatosis are increasingly recognized complications of critical illness,characterized by a rapid loss of ske-letal muscle mass,quality,and function.These conditions r...Intensive care unit(ICU)acquired sarcopenia and myosteatosis are increasingly recognized complications of critical illness,characterized by a rapid loss of ske-letal muscle mass,quality,and function.These conditions result from a complex interplay of systemic inflammation,immobilization,catabolic stress,mitochon-drial dysfunction,and immune dysregulation,often culminating in impaired recovery,prolonged hospitalization,and increased long-term mortality.First identified in survivors of sepsis and prolonged mechanical ventilation,these muscle abnormalities were initially described using computed tomography-based assessments of muscle area and density.Subsequent advances in imaging,biomarker discovery,and functional testing have enabled earlier detection and risk stratification across diverse ICU populations.While nutritional optimization and early mobilization form the cornerstone of current prevention and treatment strategies,the emergence of novel approaches,including automated artificial intelligence-based screening,neuromuscular electrical stimulation,and targeted pharmacologic therapies,has broadened the clinical scope of interventions.Despite their significant prognostic implications,ICU-acquired sarcopenia and myosteatosis remain under-recognized in routine critical care practice.This mini-review aims to synthesize current knowledge regarding their pathophysiology,available diagnostic modalities,prognostic relevance,and the evolving landscape of therapeutic strategies for long-term functional recovery in critically ill patients.展开更多
In this editorial we comment on the detrimental consequences that post-intensive care syndrome(PICS)has in the quality of life of intensive care unit(ICU)survivors,highlighting the importance of early onset of multidi...In this editorial we comment on the detrimental consequences that post-intensive care syndrome(PICS)has in the quality of life of intensive care unit(ICU)survivors,highlighting the importance of early onset of multidisciplinary rehabilitation from within the ICU.Although,the syndrome was identified and well described early in 2012,more awareness has been raised on the long-term PICS related health problems by the increased number of coronavirus disease 2019 ICU survivors.It is well outlined that the syndrome affects both the patient and the family and is described as the appearance or worsening of impairment in physical,cognitive,or mental health as consequence of critical illness.PICS was described in order:(1)To raise awareness among clinicians,researchers,even the society;(2)to highlight the need for a multilevel screening of these patients that starts from within the ICU and continues after discharge;(3)to present preventive strategies;and(4)to offer guidelines in terms of rehabilitation.An early multidisci-plinary approach is the key element form minimizing the incidence of PICS and its consequences in health related quality of life of both survivors and their families.展开更多
目的 探究前瞻性护理在预防机械通气患者发生ICU获得性衰弱(intensive care unit-acquired weakness,ICU-AW)中的作用。方法 选取2022年8月—2023年12月于南京医科大学附属南京医院呼吸与危重症医学科收治的67例机械通气患者。按照随机...目的 探究前瞻性护理在预防机械通气患者发生ICU获得性衰弱(intensive care unit-acquired weakness,ICU-AW)中的作用。方法 选取2022年8月—2023年12月于南京医科大学附属南京医院呼吸与危重症医学科收治的67例机械通气患者。按照随机数字表法分为对照组(n=33)和研究组(n=34),对照组接受常规护理,研究组在常规护理的基础上接受前瞻性护理。采用医学研究委员会肌力评分(Medical Research Council Muscle Strength,MRC)比较2组肌力,采用日常生活活动量表(Activity of Daily Living,ADL)及巴氏指数(Barthel Index,BI)量表评估2组日常生活能力。采用焦虑自评量表(Self-Rating Anxiety Scale,SAS)及抑郁自评量表(Self-Rating Depression Scale,SDS)评估患者的焦虑、抑郁状态,统计2组患者的机械通气时间及住院时间。结果 护理前2组患者的MRC评分差异无统计学意义(P>0.05),研究组患者护理前后的MRC得分差值高于对照组,差异具有统计学意义(t=4.082,P<0.001);护理前2组患者的ADL得分差异无统计学意义(P>0.05),研究组患者护理前后ADL评分差值高于对照组,差异具有统计学意义(t=8.906,P<0.001);护理前2组患者的BI评分无统计学意义(P>0.05),研究组患者护理前后BI评分差值高于对照组,差异具有统计学意义(t=2.386,P=0.036);护理前2组患者SAS评分及SDS评分差异均无统计学意义(P>0.05),研究组患者护理前后SAS评分及SDS评分差值均高于对照组,差异具有统计学意义(t=5.064、5.238,P均<0.001);研究组患者机械通气时间低于对照组(t=11.063,P<0.001),研究组患者平均住院时间低于对照组(t=10.169,P<0.001)。结论 前瞻性护理可以有效预防ICU-AW,提高患者自理能力,同时缓解患者焦虑、抑郁心理状态,减少其机械通气时间及住院时间,值得在临床中进一步研究与推广。展开更多
目的研究补阳还五汤联合针刺治疗重症监护病房(intensive care unit,ICU)获得性肌无力对患者免疫功能及肌力恢复的影响。方法选取ICU获得性肌无力患者72例,随机数表法均分为两组,每组36例,两组患者均接受常规康复干预,同时对照组采用针...目的研究补阳还五汤联合针刺治疗重症监护病房(intensive care unit,ICU)获得性肌无力对患者免疫功能及肌力恢复的影响。方法选取ICU获得性肌无力患者72例,随机数表法均分为两组,每组36例,两组患者均接受常规康复干预,同时对照组采用针灸治疗,观察组采用补阳还五汤联合针刺治疗。比较两组患者的恢复时间、肌力、日常活动能力、免疫功能指标、不良反应情况。结果观察组机械通气时间、ICU住院时间、总住院时间均短于对照组[(5.97±2.10)d、(16.32±3.77)d、(32.67±3.18)d vs(7.45±1.84)d、(18.90±4.06)d、(35.29±4.06)d],差异有统计学意义(P<0.05);治疗前两组肌力、日常活动能力、免疫功能指标差异无统计学意义(P>0.05),治疗后2、4周,观察组肌力评定量表(medical research council scale,MRC)评分低于对照组[(76.85±6.92)分、(86.90±5.83)分vs(72.03±5.11)分、(82.76±6.47)分],差异有统计学意义(P<0.05);观察组Barthel指数(modified Barthel index,MBI)评分低于对照组[(74.34±5.68)分、(90.25±5.36)分vs(68.21±6.10)分、(86.03±6.33)分],差异有统计学意义(P<0.05);治疗后观察组白细胞介素(interleukin,IL)-6、IL-8、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)及胰岛素样生长因子-1(insulin-like growth factor 1,IGF-1)水平优于对照组[(22.51±2.64)pg/mL、(43.74±5.60)pg/mL、(29.49±2.85)pg/mL、(117.50±10.49)ng/mL vs(26.08±3.05)pg/mL、(47.09±6.11)pg/mL、(33.01±2.48)pg/mL、(105.63±11.20)ng/mL],差异有统计学意义(P<0.05);观察组不良反应发生率8.33%(3/36)、对照组13.89%(5/36),差异无统计学意义(P>0.05)。结论补阳还五汤联合针刺治疗ICU获得性肌无力效果满意,能增强肌力,改善日常生活能力,调节免疫平衡,促进患者更快康复,是安全可靠的治疗方案。展开更多
目的 系统评价患者重症监护室获得性衰弱(intensive care unit-acquired weakness,ICU-AW)风险预测模型。方法 计算机系统检索Cocharane Library、Embase、PubMed、Web of Science、中国知网、万方数据及维普数据库发表的与主题相关的研...目的 系统评价患者重症监护室获得性衰弱(intensive care unit-acquired weakness,ICU-AW)风险预测模型。方法 计算机系统检索Cocharane Library、Embase、PubMed、Web of Science、中国知网、万方数据及维普数据库发表的与主题相关的研究,检索时间为建库至2024年7月15日。根据纳入、排除标准筛选文献,2名研究者依据预测模型研究数据提取表和偏倚风险评估工具独立提取资料和评价质量,采用RStudio软件对各模型的曲线下面积和预测因子进行meta分析。结果 共纳入19篇文献,包括19个风险预测模型,12个模型仅进行了内部验证,1个模型仅进行了外部验证,4个模型进行了内外部验证。meta分析结果显示,受试者特征曲线下面积合并值为0.82(95%CI=0.78~0.86)。最常见的预测因子包括多器官功能障碍(OR=3.51,95%CI=2.21~5.83)、脓毒血症(OR=3.40,95%CI=1.82~6.36)、使用糖皮质激素(OR=3.27,95%CI=1.65~6.49)、使用神经肌肉阻滞剂(OR=2.45,95%CI=1.94~3.10)、女性(OR=2.20,95%CI=1.68~2.88)、血乳酸值(OR=1.64,95%CI=1.44~1.87)、血糖(OR=1.61,95%CI=1.02~2.55)、机械通气(OR=1.42,95%CI=1.24~1.62)、APACHE评分(OR=1.13,95%CI=1.07~1.19)、ICU住院时间(OR=1.10,95%CI=1.04~1.16)、年龄(OR=1.04,95%CI=1.02~1.06)。结论 当前重症监护室患者ICU-AW风险预测模型尚处于发展阶段,建议未来对现有模型进一步优化和进行外部验证。展开更多
目的对ICU获得性口腔衰弱的相关研究进行范围综述,总结ICU获得性口腔衰弱的概念性定义及相关要素。方法以澳大利亚乔安娜布里格斯研究所(Joanna Briggs Institute,JBI)循证卫生保健中心范围综述报告规范清单(PRISMA extension for scopi...目的对ICU获得性口腔衰弱的相关研究进行范围综述,总结ICU获得性口腔衰弱的概念性定义及相关要素。方法以澳大利亚乔安娜布里格斯研究所(Joanna Briggs Institute,JBI)循证卫生保健中心范围综述报告规范清单(PRISMA extension for scoping reviews,PRISMA-ScR)为方法学框架。计算机检索PubMed、Em-base、CINAHL、Web of Science、Scopus、中国知网、万方数据库及中国生物医学文献数据库,检索时限为建库至2024年11月12日。筛选ICU获得性衰弱与口腔衰弱交叉的文献,对文献进行信息提取,运用概念性评估工具分析评估并整合要素。结果共纳入14篇文献,提取14个相关概念,94个相关要素。在提取出的相关概念中,没有一项符合"良好"概念性定义要求。归纳出3个要素分类,14个要素主题。结论基于范围综述的概念分析研究证实ICU患者因侵入性操作等特殊医疗环境易发口腔衰弱,但其定义尚未统一;现有评估工具缺乏针对ICU患者特殊需求的系统性标准;有待进一步完善和优化ICU获得性口腔衰弱相关理念,以提高ICU护理质量,提高患者后续生活质量。展开更多
目的研究多学科协作支持的护理干预在重症监护室(intensive care unit,ICU)获得性衰弱(acquired weakness,ICU-AW)患者中的应用效果。方法选取2022年9月-2023年9月于威海市中医院诊治的ICU-AW患者70例,随机分为研究组和对照组各35例。...目的研究多学科协作支持的护理干预在重症监护室(intensive care unit,ICU)获得性衰弱(acquired weakness,ICU-AW)患者中的应用效果。方法选取2022年9月-2023年9月于威海市中医院诊治的ICU-AW患者70例,随机分为研究组和对照组各35例。对照组接受常规护理措施,研究组接受多学科协作支持的护理干预。比较两组干预7 d、14 d的英国医学研究委员会(Medical Research Council,MRC)评分,并进一步比较两组的康复效果、心理压力及护理满意度。结果干预7 d、14 d后,研究组MRC评分高于对照组,差异有统计学意义(P<0.05);研究组下床时间、机械通气时间以及住ICU时间均短于对照组,差异有统计学意义(P<0.05);研究组心理压力各项评分高于对照组,差异有统计学意义(P<0.05);研究组护理工作满意度高于对照组,差异有统计学意义(P<0.05)。结论多学科协作支持干预模式能进一步促进ICU-AW患者的恢复速度,改善心理状态和提高护理满意度。展开更多
文摘The author obtains an algebraic version of the main result from his previous paper 'A characterization of Riesz spaces which are Riesz isomorphic to C(X) for some completely regular space X', and also studies the relations among some conditions used therein.
文摘Intensive care unit(ICU)acquired sarcopenia and myosteatosis are increasingly recognized complications of critical illness,characterized by a rapid loss of ske-letal muscle mass,quality,and function.These conditions result from a complex interplay of systemic inflammation,immobilization,catabolic stress,mitochon-drial dysfunction,and immune dysregulation,often culminating in impaired recovery,prolonged hospitalization,and increased long-term mortality.First identified in survivors of sepsis and prolonged mechanical ventilation,these muscle abnormalities were initially described using computed tomography-based assessments of muscle area and density.Subsequent advances in imaging,biomarker discovery,and functional testing have enabled earlier detection and risk stratification across diverse ICU populations.While nutritional optimization and early mobilization form the cornerstone of current prevention and treatment strategies,the emergence of novel approaches,including automated artificial intelligence-based screening,neuromuscular electrical stimulation,and targeted pharmacologic therapies,has broadened the clinical scope of interventions.Despite their significant prognostic implications,ICU-acquired sarcopenia and myosteatosis remain under-recognized in routine critical care practice.This mini-review aims to synthesize current knowledge regarding their pathophysiology,available diagnostic modalities,prognostic relevance,and the evolving landscape of therapeutic strategies for long-term functional recovery in critically ill patients.
文摘In this editorial we comment on the detrimental consequences that post-intensive care syndrome(PICS)has in the quality of life of intensive care unit(ICU)survivors,highlighting the importance of early onset of multidisciplinary rehabilitation from within the ICU.Although,the syndrome was identified and well described early in 2012,more awareness has been raised on the long-term PICS related health problems by the increased number of coronavirus disease 2019 ICU survivors.It is well outlined that the syndrome affects both the patient and the family and is described as the appearance or worsening of impairment in physical,cognitive,or mental health as consequence of critical illness.PICS was described in order:(1)To raise awareness among clinicians,researchers,even the society;(2)to highlight the need for a multilevel screening of these patients that starts from within the ICU and continues after discharge;(3)to present preventive strategies;and(4)to offer guidelines in terms of rehabilitation.An early multidisci-plinary approach is the key element form minimizing the incidence of PICS and its consequences in health related quality of life of both survivors and their families.
文摘目的 探究前瞻性护理在预防机械通气患者发生ICU获得性衰弱(intensive care unit-acquired weakness,ICU-AW)中的作用。方法 选取2022年8月—2023年12月于南京医科大学附属南京医院呼吸与危重症医学科收治的67例机械通气患者。按照随机数字表法分为对照组(n=33)和研究组(n=34),对照组接受常规护理,研究组在常规护理的基础上接受前瞻性护理。采用医学研究委员会肌力评分(Medical Research Council Muscle Strength,MRC)比较2组肌力,采用日常生活活动量表(Activity of Daily Living,ADL)及巴氏指数(Barthel Index,BI)量表评估2组日常生活能力。采用焦虑自评量表(Self-Rating Anxiety Scale,SAS)及抑郁自评量表(Self-Rating Depression Scale,SDS)评估患者的焦虑、抑郁状态,统计2组患者的机械通气时间及住院时间。结果 护理前2组患者的MRC评分差异无统计学意义(P>0.05),研究组患者护理前后的MRC得分差值高于对照组,差异具有统计学意义(t=4.082,P<0.001);护理前2组患者的ADL得分差异无统计学意义(P>0.05),研究组患者护理前后ADL评分差值高于对照组,差异具有统计学意义(t=8.906,P<0.001);护理前2组患者的BI评分无统计学意义(P>0.05),研究组患者护理前后BI评分差值高于对照组,差异具有统计学意义(t=2.386,P=0.036);护理前2组患者SAS评分及SDS评分差异均无统计学意义(P>0.05),研究组患者护理前后SAS评分及SDS评分差值均高于对照组,差异具有统计学意义(t=5.064、5.238,P均<0.001);研究组患者机械通气时间低于对照组(t=11.063,P<0.001),研究组患者平均住院时间低于对照组(t=10.169,P<0.001)。结论 前瞻性护理可以有效预防ICU-AW,提高患者自理能力,同时缓解患者焦虑、抑郁心理状态,减少其机械通气时间及住院时间,值得在临床中进一步研究与推广。
文摘目的研究补阳还五汤联合针刺治疗重症监护病房(intensive care unit,ICU)获得性肌无力对患者免疫功能及肌力恢复的影响。方法选取ICU获得性肌无力患者72例,随机数表法均分为两组,每组36例,两组患者均接受常规康复干预,同时对照组采用针灸治疗,观察组采用补阳还五汤联合针刺治疗。比较两组患者的恢复时间、肌力、日常活动能力、免疫功能指标、不良反应情况。结果观察组机械通气时间、ICU住院时间、总住院时间均短于对照组[(5.97±2.10)d、(16.32±3.77)d、(32.67±3.18)d vs(7.45±1.84)d、(18.90±4.06)d、(35.29±4.06)d],差异有统计学意义(P<0.05);治疗前两组肌力、日常活动能力、免疫功能指标差异无统计学意义(P>0.05),治疗后2、4周,观察组肌力评定量表(medical research council scale,MRC)评分低于对照组[(76.85±6.92)分、(86.90±5.83)分vs(72.03±5.11)分、(82.76±6.47)分],差异有统计学意义(P<0.05);观察组Barthel指数(modified Barthel index,MBI)评分低于对照组[(74.34±5.68)分、(90.25±5.36)分vs(68.21±6.10)分、(86.03±6.33)分],差异有统计学意义(P<0.05);治疗后观察组白细胞介素(interleukin,IL)-6、IL-8、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)及胰岛素样生长因子-1(insulin-like growth factor 1,IGF-1)水平优于对照组[(22.51±2.64)pg/mL、(43.74±5.60)pg/mL、(29.49±2.85)pg/mL、(117.50±10.49)ng/mL vs(26.08±3.05)pg/mL、(47.09±6.11)pg/mL、(33.01±2.48)pg/mL、(105.63±11.20)ng/mL],差异有统计学意义(P<0.05);观察组不良反应发生率8.33%(3/36)、对照组13.89%(5/36),差异无统计学意义(P>0.05)。结论补阳还五汤联合针刺治疗ICU获得性肌无力效果满意,能增强肌力,改善日常生活能力,调节免疫平衡,促进患者更快康复,是安全可靠的治疗方案。
文摘目的对ICU获得性口腔衰弱的相关研究进行范围综述,总结ICU获得性口腔衰弱的概念性定义及相关要素。方法以澳大利亚乔安娜布里格斯研究所(Joanna Briggs Institute,JBI)循证卫生保健中心范围综述报告规范清单(PRISMA extension for scoping reviews,PRISMA-ScR)为方法学框架。计算机检索PubMed、Em-base、CINAHL、Web of Science、Scopus、中国知网、万方数据库及中国生物医学文献数据库,检索时限为建库至2024年11月12日。筛选ICU获得性衰弱与口腔衰弱交叉的文献,对文献进行信息提取,运用概念性评估工具分析评估并整合要素。结果共纳入14篇文献,提取14个相关概念,94个相关要素。在提取出的相关概念中,没有一项符合"良好"概念性定义要求。归纳出3个要素分类,14个要素主题。结论基于范围综述的概念分析研究证实ICU患者因侵入性操作等特殊医疗环境易发口腔衰弱,但其定义尚未统一;现有评估工具缺乏针对ICU患者特殊需求的系统性标准;有待进一步完善和优化ICU获得性口腔衰弱相关理念,以提高ICU护理质量,提高患者后续生活质量。
文摘目的研究多学科协作支持的护理干预在重症监护室(intensive care unit,ICU)获得性衰弱(acquired weakness,ICU-AW)患者中的应用效果。方法选取2022年9月-2023年9月于威海市中医院诊治的ICU-AW患者70例,随机分为研究组和对照组各35例。对照组接受常规护理措施,研究组接受多学科协作支持的护理干预。比较两组干预7 d、14 d的英国医学研究委员会(Medical Research Council,MRC)评分,并进一步比较两组的康复效果、心理压力及护理满意度。结果干预7 d、14 d后,研究组MRC评分高于对照组,差异有统计学意义(P<0.05);研究组下床时间、机械通气时间以及住ICU时间均短于对照组,差异有统计学意义(P<0.05);研究组心理压力各项评分高于对照组,差异有统计学意义(P<0.05);研究组护理工作满意度高于对照组,差异有统计学意义(P<0.05)。结论多学科协作支持干预模式能进一步促进ICU-AW患者的恢复速度,改善心理状态和提高护理满意度。
