2024年7月,加速康复外科(enhanced recovery after surgery,ERAS)协会在JAMA Surgery上发布了首部针对新生儿重症监护病房(neonatal intensive care unit,NICU)外科患儿的《新生儿围手术期管理指南》[1]。然而多数接受手术的新生儿病情...2024年7月,加速康复外科(enhanced recovery after surgery,ERAS)协会在JAMA Surgery上发布了首部针对新生儿重症监护病房(neonatal intensive care unit,NICU)外科患儿的《新生儿围手术期管理指南》[1]。然而多数接受手术的新生儿病情相对稳定,并不入住NICU。因此,有必要制定一部针对普通新生儿围手术期的ERAS指导意见来规范临床实践,减轻患儿围手术期创伤应激,减少并发症发生,促进患儿康复。中华医学会小儿外科学分会新生儿外科学组成立共识制定委员会,成员包括新生儿外科、麻醉、营养、护理、感染管理和循证医学等多学科专家。患儿人群定义为接受非心脏手术的新生儿(生后28 d内)。经多轮讨论,共确定10个主题,形成21条推荐意见。本共识循证医学证据的质量分为4个等级(表1)[2]。展开更多
随着微创技术在妇科领域的广泛应用,腔镜手术已成为妇科良性肿瘤治疗的重要方式之一。然而,传统护理模式在术前准备、术中管理及术后恢复方面仍存在一定局限,难以满足患者快速康复的需求。快速康复护理路径(Enhanced Recovery After Sur...随着微创技术在妇科领域的广泛应用,腔镜手术已成为妇科良性肿瘤治疗的重要方式之一。然而,传统护理模式在术前准备、术中管理及术后恢复方面仍存在一定局限,难以满足患者快速康复的需求。快速康复护理路径(Enhanced Recovery After Surgery,ERAS)以循证医学为基础,通过对手术全过程进行科学化优化,减少机体应激反应,促进术后早期活动和功能恢复。本文以妇科良性肿瘤腔镜手术患者为研究对象,从快速康复护理路径的具体措施入手,探讨其在舒缓术后疼痛、改善肠道功能、减少并发症、缩短住院时间及提升患者身心康复方面的实际效果。研究发现,该护理路径能显著提高患者术后恢复质量,促进生活自理能力和总体满意度的提升,为妇科微创手术患者护理方案的优化提供了重要参考依据。展开更多
We found the qualitative study by Xu et al.on how patients feel about laparoscopic incisions under enhanced recovery after surgery(ERAS)protocols to be very interesting.1 Xu et al.carried out a qualitative study on pa...We found the qualitative study by Xu et al.on how patients feel about laparoscopic incisions under enhanced recovery after surgery(ERAS)protocols to be very interesting.1 Xu et al.carried out a qualitative study on patient experience with laparoscopic incisions under an ERAS protocol to highlight the problem of psychosocial and aesthetic concerns,which are often overlooked when planning surgical operations.This study,which involved semistructured interviews with sixteen people,aimed to narrow perioperative education and the decision-making process for incision site selection,thus making the processes more focused on patient priorities.The study is based on a timely but under-researched subject area;however,it is possible to outline four possible areas of improvement that would allow the study to be more transparent and,at the same time,more applicable to clinical practice.展开更多
Lysine lipoylation plays vital roles in cell metabolism and redox processes.For example,removal of lipoylation will decrease pyruvate dehydrogenase activity and affect the citric acid cycle.Despite the important funct...Lysine lipoylation plays vital roles in cell metabolism and redox processes.For example,removal of lipoylation will decrease pyruvate dehydrogenase activity and affect the citric acid cycle.Despite the important functions of lysine lipoylation,the mechanisms for the addition and removal of this modification remain largely unexplored.Very few useful chemical tools are available to study the interactions of lysine lipoylation with its regulatory delipoylation proteins.For example,immunoaffinity purification-mass spectrometry is one of such tools,which highly relies on antibody efficiency and purification techniques.Single-step activity based fluorogenic probes developed by our groups and others is also an efficient method to study the deacylation activity.Affinitybased labeling probe using photo-cross-linker is a powerful platform to study the transient and dynamic interactions of peptide ligands with the interacting proteins.Herein,we have designed and synthesized a dual-function probe KTLlip for studying enzymatic delipoylation(eraser)activity and interaction of lysine lipoylation with the eraser at the same time.We show that KTLlip can be used as a useful tool to detect delipoylation as demonstrated by its ability to fluorescently label the eraser activity of recombinant Sirt2.We envision that the probe will help delineate the roles of delipoylation enzyme in biology.展开更多
地氟醚(desflurane)自1990年初应用于临床后,凭借其独特的药代动力学特性与临床应用优势,成为现代吸入麻醉的重要组成部分。经过10多年的临床应用与实践,人们对地氟醚理化特性的认识也越来越清晰[1-2]。特别是近年来,随着加速术后康复(e...地氟醚(desflurane)自1990年初应用于临床后,凭借其独特的药代动力学特性与临床应用优势,成为现代吸入麻醉的重要组成部分。经过10多年的临床应用与实践,人们对地氟醚理化特性的认识也越来越清晰[1-2]。特别是近年来,随着加速术后康复(enhanced recovery after surgery,ERAS)理念的普及和日间手术的发展,地氟醚的临床价值愈发凸显。展开更多
文摘2024年7月,加速康复外科(enhanced recovery after surgery,ERAS)协会在JAMA Surgery上发布了首部针对新生儿重症监护病房(neonatal intensive care unit,NICU)外科患儿的《新生儿围手术期管理指南》[1]。然而多数接受手术的新生儿病情相对稳定,并不入住NICU。因此,有必要制定一部针对普通新生儿围手术期的ERAS指导意见来规范临床实践,减轻患儿围手术期创伤应激,减少并发症发生,促进患儿康复。中华医学会小儿外科学分会新生儿外科学组成立共识制定委员会,成员包括新生儿外科、麻醉、营养、护理、感染管理和循证医学等多学科专家。患儿人群定义为接受非心脏手术的新生儿(生后28 d内)。经多轮讨论,共确定10个主题,形成21条推荐意见。本共识循证医学证据的质量分为4个等级(表1)[2]。
文摘随着微创技术在妇科领域的广泛应用,腔镜手术已成为妇科良性肿瘤治疗的重要方式之一。然而,传统护理模式在术前准备、术中管理及术后恢复方面仍存在一定局限,难以满足患者快速康复的需求。快速康复护理路径(Enhanced Recovery After Surgery,ERAS)以循证医学为基础,通过对手术全过程进行科学化优化,减少机体应激反应,促进术后早期活动和功能恢复。本文以妇科良性肿瘤腔镜手术患者为研究对象,从快速康复护理路径的具体措施入手,探讨其在舒缓术后疼痛、改善肠道功能、减少并发症、缩短住院时间及提升患者身心康复方面的实际效果。研究发现,该护理路径能显著提高患者术后恢复质量,促进生活自理能力和总体满意度的提升,为妇科微创手术患者护理方案的优化提供了重要参考依据。
文摘We found the qualitative study by Xu et al.on how patients feel about laparoscopic incisions under enhanced recovery after surgery(ERAS)protocols to be very interesting.1 Xu et al.carried out a qualitative study on patient experience with laparoscopic incisions under an ERAS protocol to highlight the problem of psychosocial and aesthetic concerns,which are often overlooked when planning surgical operations.This study,which involved semistructured interviews with sixteen people,aimed to narrow perioperative education and the decision-making process for incision site selection,thus making the processes more focused on patient priorities.The study is based on a timely but under-researched subject area;however,it is possible to outline four possible areas of improvement that would allow the study to be more transparent and,at the same time,more applicable to clinical practice.
基金supported by the Science Technology and Innovation Committee of Shenzhen Municipality(Grant Nos.JCYJ20180507181654823 and JCYJ20170413141047772)the National Natural Science Foundation of China(Grant No.21778044).
文摘Lysine lipoylation plays vital roles in cell metabolism and redox processes.For example,removal of lipoylation will decrease pyruvate dehydrogenase activity and affect the citric acid cycle.Despite the important functions of lysine lipoylation,the mechanisms for the addition and removal of this modification remain largely unexplored.Very few useful chemical tools are available to study the interactions of lysine lipoylation with its regulatory delipoylation proteins.For example,immunoaffinity purification-mass spectrometry is one of such tools,which highly relies on antibody efficiency and purification techniques.Single-step activity based fluorogenic probes developed by our groups and others is also an efficient method to study the deacylation activity.Affinitybased labeling probe using photo-cross-linker is a powerful platform to study the transient and dynamic interactions of peptide ligands with the interacting proteins.Herein,we have designed and synthesized a dual-function probe KTLlip for studying enzymatic delipoylation(eraser)activity and interaction of lysine lipoylation with the eraser at the same time.We show that KTLlip can be used as a useful tool to detect delipoylation as demonstrated by its ability to fluorescently label the eraser activity of recombinant Sirt2.We envision that the probe will help delineate the roles of delipoylation enzyme in biology.
文摘地氟醚(desflurane)自1990年初应用于临床后,凭借其独特的药代动力学特性与临床应用优势,成为现代吸入麻醉的重要组成部分。经过10多年的临床应用与实践,人们对地氟醚理化特性的认识也越来越清晰[1-2]。特别是近年来,随着加速术后康复(enhanced recovery after surgery,ERAS)理念的普及和日间手术的发展,地氟醚的临床价值愈发凸显。
