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Journal of intensive medicine 2024年第2期4卷 137-159页

作者： Xiangdong Guan Dechang Chen Yuan Xu Chinese Society of Critical care medicine Department of Critical care medicine The First Affiliated Hospital of Sun Yat-sen UniversityGuangzhouChina Department of Critical care medicine Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina Department of Critical care medicine Beijing Tsinghua Changgung HospitalBeijingChina 不详

The Chinese Society of Critical care medicine(CSCCM)has developed clinical practice guidelines for nutrition assessment and monitoring for patients in adult intensive care units(ICUs)in *** guideline focuses on nutrition evaluation and metabolic monitoring to achieve optimal and personalized nutrition therapy for critically ill *** guideline was developed by experts in critical care medicine and evidence-based medicine methodology and was developed after a thorough review of the system and a summary of relevant trials or studies published from 2000 to July 2023.A total of 18 recommendations were formed and consensus was reached through discussions and reviews by expert groups in critical care medicine,parenteral and enteral nutrition,and *** recommendations are based on currently available evidence and cover several key fields,including screening and assessment,evaluation and assessment of enteral feeding intolerance,metabolic and nutritional measurement and monitoring during nutrition therapy,and organ function evaluation related to nutrition *** question was analyzed according to the Population,Intervention,Comparison,and Outcome(PICO)*** addition,interpretations were provided for four questions that did not reach a consensus but may have potential clinical and research *** plan is to update this nutrition assessment and monitoring guideline using the international guideline update method within 3–5 years.

关键词： Adults Critical illness intensive care unit Nutriti on Nutriti on assessment and monitoring Guideline Recommendations Chinese Society of Critical care medicine-Chinese Medical Association(CSCCM-CMA)

Nitric oxide inhalation inhibits inducible nitric oxide synthase but not nitrotyrosine formation and cell apoptosis in rat lungs with meconiuminduced injury

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Acta Pharmacologica Sinica 2005年第9期26卷 1123-1129页

作者： Mei-ping LU Li-zhong DU~2 Wei-zhong GU Xiang-xiang CHEN Neonatal intensive care unit,Department of Pediatrics,Children’s hospital,Zhejiang university school of medicine,Hangzhou 310003,china Department of Pediatrics Neonatal Intensive Care Unit Children's Hospital Zhejiang University School of Medicine Hangzhou China

Aim:To investigate the effects of inhaled nitric oxide(NO)on pulmonaryinflammation,apoptosis,peroxidation and protein nitration in a rat model of acutelung injury(ALI)induced by ***:Twenty-four healthy maleSprague-Dawley rats were randomly devided into 3 groups(n=8):meconium-induced ALl with intratracheal instillation of 1 mL/kg saline(Mec/saline group),continuous inhalation of NO at 20 μL/L.(Mec/iNO),and the control group(control).Electromicroscopic examination was used to determine the extent of *** was used to detect DNA fragmentation in pulmonary apoptoticcells,expressed as the apoptosis index(AI).Western blotting was used to detectpulmonary inducible NO synthase(iNOS)***-PCR was used to detectinterleukin(IL)-1β mRNA *** count in bronchoalveolar lavage(BAL),myeloperoxidase(MPO)activity,as well as malondialdehyde(MDA)andnitrotyrosine formation,the markers of toxic NO-superoxide pathway in rat lungparenchyma specimens,were also ***:Expression of iNOS pro-tein and IL- 113 mRNA were increased significantly in the Mec/saline group(bothP<0.01)compared with the control *** cell count,MPO activity,lunginjury score,pulmonary AI,MDA level and nitrotyrosine formation were alsoincreased significantly(all P<0.01).The meconium-induced iNOS protein andIL-1β mRNA expression were inhibited significantly by NO inhalation when com-pared with the Mec/saline group(both P<0.01 ).BAL cell count,MPO activity andlung injury score were also decreased significantly(P<0.01 or P<0,05).However,there were no statistical differences in MDA level,nitrotyrosine formation or pul-monary AI between the Mec/saline and Mec/iNO *** revealed a significant degree of epithelial apoptosis in both the Mec/saline and Mec/iNO ***:Early continuous inhalation of NO20 μL/L may protect the lungs from inflammatory injury,but does not decreaseepithelial apoptosis or lung nitrotyrosine formati

关键词： inhaled nitric oxide meconium acute lung injury nitrotyrosine apoptosis

Effective use of corticosteroids in treatment of plastic bronchitis with hemoptysis in Chinese adults

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Acta Pharmacologica Sinica 2006年第9期27卷 1206-1212页

作者： Gang WANG~1 You-juan WANG~2 Feng-ming LUO~2 Lei WANG~1 Li-li JIANG~3 Lin WANG~4 Bing MAO~(1,5)1 Department of Integrated Traditional Chinese and Western medicine,2 Department of Pulmonary and Critical care medicine,3 Department of Pathology 4 Department of Anesthesiology and intensive care medicine,West china hospital,Sichuan university,Chengdu 610041,china Department of Integrated Traditional Chinese and Western medicine West China Hospital Sichuan University Chengdu China Department of Pulmonary and Critical care medicine West China Hospital Sichuan University Chengdu China Department of Pathology West China Hospital Sichuan University Chengdu China Department of Anesthesiology and intensive care medicine West China Hospital Sichuan University Chengdu China

Aim:To investigate whether corticosteroids are effective in the treatment of plas-tic bronchitis with ***:A retrospective,clinical study *** two patients with only first episodes of plastic bronchitis withhemoptysis were divided into a steroid group(n=18)treated with glucocorticoids,and a non-steroid group(n=14).The supportive therapy was uniformly applied toboth groups,except for *** such as temperature and whiteblood cell counts were ***,the volume of hemoptysis andbronchial casts were evaluated in detail ***:There was no difference inthe demographic data and variables at baseline between both groups(all P>0.05).On days 5,6,7 and 8,the volume of hemoptysis was significantly decreased in thesteroid group compared with the non-steroid group(43±15 mL vs 117±33 mL ond 5,29±12 mL vs 97±23 mL on d 6,18±10mL vs 80±20 mL on d 7,and 13±8 mLvs 66±14 mL on d 8;all P<0.05),and on d 10 after fibreoptic bronchoscopy,thecases with bronchial casts was reduced evidently in the steroid group in compari-son with the non-steroid group(OR=5.69,95% CI=1.76-43.6;P=0.005).There wasno significance in mechanical ventilation and mortality between both ***:Despite some limitations of this study,it has been demonstratedthat,on the basis of common supportive therapy,corticosteroids would be effec-tive and safe for the treatment of plastic bronchitis with hemoptysis.

关键词： plastic bronchitis clinical features hemoptysis corticosteroids efficacy safety

Cardiovascular Risk Factors in china

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Journal of Geriatric Cardiology 2024年第2期21卷 153-199页

作者： Sheng-Shou HU the Writing Committee of the Report on Cardiovascular Health and Diseases in china Fuwai hospital National Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina 不详

The Annual Report on Cardiovascular Health and Diseases in china(2022) intricate landscape of cardiovascular health in china. This section dissects cardiovascular risk factors in china which including hypertension, dyslipidemia, diabetes mellitus, chronic kidney disease, metabolic syndrome and air pollution. Hypertension prevalence has steadily increased in china,with efforts to control it facing challenges in achieving optimal rates, especially in rural areas. Interventions like salt substitutes and intensive blood pressure control show promise but need improvement. Abnormal lipid levels, indicative of dyslipidemia,have risen significantly, posing a risk for cardiovascular diseases. Despite efforts, many patients struggle to achieve target lipid levels, necessitating improved treatment strategies. Both type 1 and type 2 diabetes mellitus affect millions of adults in china,with long-term complications adding to the disease burden. Early intervention and effective management are crucial to mitigate its impact. Prevalent among older adults, chronic kidney disease is associated with diabetes mellitus, hypertension, and cardiovascular diseases, necessitating comprehensive management approaches. The prevalence of metabolic syndrome, characterized by a cluster of risk factors, has increased in both adults and adolescents, calling for lifestyle modifications and public health interventions. Ambient and household air pollution remain significant environmental risk factors, despite some improvements in air quality. Continued efforts to reduce emissions are essential for mitigating associated health risks. Addressing these risk factors requires a multifaceted approach, including public health initiatives, policy interventions, and individual-level strategies to promote healthy lifestyles and reduce environmental exposures. Surveillance and research efforts are crucial for monitoring trends and developing effective strategies to lessen the burden of cardiovascular diseases in

关键词： landscape adding spite

Sedation and safety of propofol for therapeutic endoscopic retrograde cholangiopancreatography

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Hepatobiliary & Pancreatic Diseases International 2005年第3期4卷 437-440页

作者： Digestive Department (Chen WX, Lin HJ, Gu Q, Zhong XQ, Yu CH, Li YM and Gu ZY) and Department of intensive care unit (Zhang WF), First Affiliated hospital, Zhejiang university school of medicine, Hangzhou 310003 , china Digestive Department First Affiliated Hospital Zhejiang University School of Medicine Hangzhou 310003 China. chenwiexing@***

Endoscopic retrograde cholangiopancrea tography(ERCP) is the most complex gastrointestinal procedure,which needs patients' cooperation. The aim of this study was to observe the quality and safey of sedation with propofol in patients undergoing therapeutic ERCP. METHODS:Seventy patients who had undergone therapeutic ERCP were randomly divided into two *** group, given intravenously propofol, and the other sedated with routine method, served as the control. Blood pressure, heart rate,oxygen saturation were monitored and cardiorespiratory event was observed. Patient cooperation,performance, recovery time and amnesia served as variables postoperation. RESULTS:Blood pressure elevated in four patients in the propofol group, less than in the control group(P<0.01). Seven patients showed decreased blood pressure after administration of propofol,but none in the control group (P<0.01). Twelve patients in the control group showed mild or significant resistance, but none in the propofol group (P<0.01). The time for performance in the propofol group(P<0.05) was shorter than in the control group. Patient recovery was quicker in the propofol group than in the control group (P<0.01). The degree of amnesia better in the propofol group than in the control group ( P<0.01). The degree of amnesia was also better in the propofol group than in the control group (P<0.01). CONCLUSIONS:Propofol proves to be an excellent sedative for therapeutic ERCP. Being effective and safe, it shows a shorter ERCP duration but quick recovery and better amnesia. It is better than other routine sedatives.

关键词： propofol diazepam endoscopic retrograde cholangiopancreatography sedation

Clinical manifestations of patients with chronic pancreatitis

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Hepatobiliary & Pancreatic Diseases International 2006年第1期5卷 133-137页

作者： Wei-Xing Chen, Wei-Fang Zhang, Bo Li, Hui-Jia Lin, Xian Zhang, Hong-Tan Chen, Zhu-Ying Gu and You-Ming Li Department of Gastroenterology, First Afliliated hospital. Zhejiang university school of medicine. Hangzhou 310003, china Department of intensive care unit, First Affiliated hospital, Zhejiang university school of medicine, Hangzhou 310003, china Department of Gastroenterology First Affiliated Hospital Zhejiang University School of Medicine Hangzhou 310003 China. chenweixing@***

BACKGROUND: Recent advances in molecular and genomic technologies and pancreatic imaging techniques provided some insights into genetic, environmental, immunologic, and pathobiological factors for chronic pancreatitis (CP). This study was undertaken to investigate the clinical manifestations of patients with chronic pancreatitis at our hospital. METHODS: The data of the patients with CP who had been treated at our hospital between 1997 and 2004 were analyzed. RESULTS: The major symptoms of the patients with CP were abdominal pain, dyspepsia, loss of weight, diabetes mellitus, pancreatic pseudocyst, steatorrhea, and calcification. Biliary diseases were found to be the first cause of CP in this study; but alcohol abuse was the major cause of CP in men and biliary diseases were the first etiological factors for CP in women. The etiological difference of constituent ratio between men and women was related to alcohol comsumption (P<0.01). CONCLUSIONS: During the past 8 years, biliary diseases have been the major etiological factors for CP, but their constituent ratio is decreasing, and the constituent ratio of alcohol abuse is increasing gradually. Alcohol tends to replace biliary diseases as the primary etiological factor for CP.

关键词： chronic pancreatitis clinical manifestation etiology

神经重症患者中枢神经系统感染多黏菌素局部应用的中国专家共识(2024年版)

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中华神经医学杂志 2024年第2期23卷 109-118页

作者：中国医师协会神经外科分会神经重症专家委员会中国神经外科重症管理协作组石广志冯光不详首都医科大学附属北京天坛医院重症医学科北京100070 河南省人民医院(郑州大学人民医院)神经外科郑州450003

神经重症患者中枢神经系统感染治疗难度大、病死率高,多重耐药革兰阴性杆菌感染占比逐年升高。多黏菌素是治疗多重耐药革兰阴性杆菌的有效药物,但其血脑屏障通过率低,静脉给药难以达到有效的药物浓度,脑室内或鞘内给药等局部应用的方式... 详细信息

神经重症患者中枢神经系统感染治疗难度大、病死率高,多重耐药革兰阴性杆菌感染占比逐年升高。多黏菌素是治疗多重耐药革兰阴性杆菌的有效药物,但其血脑屏障通过率低,静脉给药难以达到有效的药物浓度,脑室内或鞘内给药等局部应用的方式近年来越来越多地被临床采用,但缺乏相关的规范化操作指引,故本共识专家委员会围绕多黏菌素局部应用治疗中枢神经系统感染的适应证、用法用量、治疗途径等问题进行反复讨论,形成14条共识推荐意见,以期为多黏菌素中枢神经系统局部应用提供科学和切实可行的临床指导。

关键词：神经重症中枢神经系统感染多黏菌素鞘内给药脑室内给药

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第132例——新生儿呼吸困难伴胸腔积液

中华儿科杂志 2011年第5期49卷 386-388页

作者：陈正浙江大学医学院附属儿童医院新生儿监护室

病历摘要患儿男,22 d,因＂呼吸困难伴左侧胸腔积液22 d＂入院.患儿系G4P2孕30周胎膜早破28 h自然分娩,出生体重1600 g.孕24周B超提示＂左侧胸腔积液,心脏受压右移＂.生后1 min Apgar评分2分,经气管插管及心肺复苏抢救,并行左侧胸腔穿... 详细信息

病历摘要患儿男,22 d,因＂呼吸困难伴左侧胸腔积液22 d＂入院.患儿系G4P2孕30周胎膜早破28 h自然分娩,出生体重1600 g.孕24周B超提示＂左侧胸腔积液,心脏受压右移＂.生后1 min Apgar评分2分,经气管插管及心肺复苏抢救,并行左侧胸腔穿刺,抽出约25 ml淡黄色液体,5 min Apgar评分8分,立即转入当地医院NICU.

关键词：新生儿呼吸困难左侧胸腔积液 Apgar评分胎膜早破自然分娩出生体重孕24周复苏抢救

Early lactate clearance as a reliable predictor of initial poor graft function after orthotopic liver transplantation

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Hepatobiliary & Pancreatic Diseases International 2011年第6期10卷 587-592页

作者： Jian-Feng Wu,Rong-Yao Wu,Juan Chen,Bin Ou-Yang,Min-Ying Chen and Xiang-Dong Guan Department of Surgical intensive care unit,First Affiliated hospital,Sun Yat-Sen university,Guangzhou 510080,china Department of Surgical intensive care unit First Affliated Hospital Sun Yat-Sen University Guangzhou 510080 China

BACKGROUND:Initial poor graft function (IPGF) following orthotopic liver transplantation is a major determinant of postoperative survival and *** clearance is a good marker of liver *** this study,we investigated the clinical utility of early lactate clearance as an early and accurate predictor for IPGF following liver ***:This was a prospective observational study of 222 patients referred to the surgical intensive care unit (SICU) after orthotopic liver *** IPGF group consisted of patients with alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) >1500 IU/L within 72 hours after orthotopic liver *** lactate clearance was defined as lactate at SICU presentation (hour 0) minus lactate at hour 6,divided by lactate at SICU *** model for end-stage liver disease (MELD) score,Child-Pugh score and laboratory data including AST,ALT,total bilirubin (TB) and prothrombin time (PT) were recorded at SICU presentation and compared between the non-IPGF and IPGF groups Receiver operating characteristic (ROC) curves were plotted to measure the performance of early lactate clearance,MELD score,Child-Pugh score,TB and ***:IPGF occurred in 45 of the 222 patients (20.3%).The early lactate clearance in the non-IPGF group was markedly higher than that in the IPGF group (43.2±13.8% vs 13.4±13.7% Phospital mortality (OR=3.625).CONCLUSIONS:Early lactate clearance can serve as a prompt and accurate bedside predictor of *** with early lactate clearance less than 24.8% are associated with a higher incidence of IPGF.

关键词： early lactate clearance initial poor graft function liver transplantation