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Complex regional pain syndrome: a recent update

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Burns & Trauma 2017年第1期5卷 24-34页

作者： En Lin Goh Swathikan Chidambaram daqing ma Anaesthetics Pain Medicine and Intensive CareDepartment of Surgery and CancerFaculty of MedicineImperial College LondonChelsea and Westminster Hospital369 Fulham RoadLondon SW10 9NHUK

Complex regional pain syndrome (CRPS) is a debilitating condition affecting the limbs that can be induced by surgery or trauma. This condition can complicate recovery and impair one’s functional and psychological well-being. The wide variety of terminology loosely used to describe CRPS in the past has led to misdiagnosis of this condition, resulting in poor evidence-base regarding the treatment modalities available and their impact. The aim of this review is to report on the recent progress in the understanding of the epidemiology, pathophysiology and treatment of CRPS and to discuss novel approaches in treating this condition.

关键词： CRPS Epidemiology Pathophysiology Treatment Future therapy

Perioperative"remote"acute lung injury:recent update

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The Journal of Biomedical Research 2017年第3期31卷 197-212页

作者： Zhaosheng Jin Ka Chun Suen daqing ma Anaesthetics Pain Medicine and intensive CareDepartment of Surgery and CancerFaculty of MedicineImperial College LondonChelsea&Westminster HospitalLondon SW10 9NHUK

Perioperative acute lung injury（ALI） is a syndrome characterised by hypoxia and chest radiograph changes.It is a serious post-operative complication,associated with considerable mortality and morbidity.In addition to mechanical ventilation,remote organ insult could also trigger systemic responses which induce ALI.Currently,there are limited treatment options available beyond conservative respiratory support.However,increasing understanding of the pathophysiology of ALI and the biochemical pathways involved will aid the development of novel treatments and help to improve patient outcome as well as to reduce cost to the health service.In this review we will discuss the epidemiology of peri-operative ALI;the cellular and molecular mechanisms involved on the pathological process;the clinical considerations in preventing and managing perioperative ALI and the potential future treatment options.

关键词： acute lung injury intraoperative care/adverse effects postoperative complications inflammation,anesthetics general fluid therapy

Acute-on-chronic liver failure：recent update

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The Journal of Biomedical Research 2017年第4期31卷 283-300页

作者： Azeem Alam Ka Chun Suen daqing ma Anaesthetics Pain Medicine and Intensive Care Department of Surgery and Cancer Faculty of Medicine Imperial College London Chelsea & Westminster Hospital London SW7 2AZ UK

Acute on chronic liver failure（ACLF） was first described in 1995 as a clinical syndrome distinct to classic acute decompensation.Characterized by complications of decompensation,ACLF occurs on a background of chronic liver dysfunction and is associated with high rates of organ failure and significant short-term mortality estimated between45%and 90%.Despite the clinical relevance of the condition,it still remains largely undefined with continued disagreement regarding its precise etiological factors,clinical course,prognostic criteria and management pathways.It is concerning that,despite our relative lack of understanding of the condition,the burden of ACLF among cirrhotic patients remains significant with an estimated prevalence of 30.9%.This paper highlights our current understanding of ACLF,including its etiology,diagnostic and prognostic criteria and pathophysiology.It is evident that further refinement of the ACLF classification system is required in order to detect high-risk patients and improve short-term mortality rates.The field of metabolomics certainly warrants investigation to enhance diagnostic and prognostic parameters,while the use of granulocyte-colony stimulating factor is a promising future therapeutic intervention for patients with ACLF.

关键词： acute liver failure acute decompensation of cirrhosis hepatorenal syndrome chronic hepatic encephalopathy systemic inflammation

Postoperative sleep disorders and their potential impacts on surgical outcomes

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The Journal of Biomedical Research 2020年第4期34卷 271-280页

作者： Sanketh Rampes Katie ma Yasmin Amy Divecha Azeem Alam daqing ma Facuity of Life Sciences&Medicine King's College LondonLondon SEI 1ULUK Anaesthetics Pain Medicine and Intensive CareDepartment of Surgery and CancerFaculty of MedicineImperial College LondonChelsea and Westminster HospitalLondon SW109NHUK.

Postoperative sleep disturbance is a common occurrence with significant adverse effects on patients including delayed recovery,impairment of cognitive function,pain sensitivity and cardiovascular events.The development of postoperative sleep disturbance is multifactorial and involves the surgical inflammatory response,the severity of surgical trauma,pain,anxiety,the use of anesthetics and environmental factors such as nocturnal noise and light levels.many of these factors can be managed perioperatively to minimize the deleterious impact on sleep.Pharmacological and non-pharmacological treatment strategies for postoperative sleep disturbance include dexmedetomidine,zolpidem,melatonin,enhanced recovery after surgery(ERAS) protocol and controlling of environmental noise and light levels.It is likely that a combination of pharmacological and non-pharmacological therapies will have the greatest impact;however,further research is required before their use can be routinely recommended.

关键词： postoperative sleep disturbance surgical outcomes

Epithelial-mesenchymal transition in organ fibrosis development:current understanding and treatment strategies

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Burns & Trauma 2022年第1期10卷 598-617页

作者： Lexin Liu Qizhe Sun Frank Davis Jianhua mao Hailin Zhao daqing ma Division of Anaesthetics Pain Medicine and Intensive CareDepartment of Surgery and CancerFaculty of MedicineImperial College LondonChelsea andWestminster HospitalLondonSW109NHUK Department of Nephrology and Urology Pediatric Urolith CenterThe Children’s Hospital of Zhejiang University School of MedicineNational Clinical Research Center for Child HealthHangzhouZhejiang Province310003China Department of Nephrology The Children Hospital of Zhejiang UniversitySchool of MedicineHangzhouZhejiang Province310003China

Organ fibrosis is a process in which cellular homeostasis is disrupted and extracellular matrix is excessively deposited.Fibrosis can lead to vital organ failure and there are no effective treatments yet.Although epithelial-mesenchymal transition(EMT)may be one of the key cellular mechanisms,the underlying mechanisms of fibrosis remain largely unknown.EMT is a cell phenotypic process in which epithelial cells lose their cell-to-cell adhesion and polarization,after which they acquire mesenchymal features such as infiltration and migration ability.Upon injurious stimulation in different organs,EMT can be triggered by multiple signaling pathways and is also regulated by epigenetic mechanisms.This narrative review summarizes the current understanding of the underlying mechanisms of EMT in fibrogenesis and discusses potential strategies for attenuating EMT to prevent and/or inhibit fibrosis.Despite better understanding the role of EMT in fibrosis development,targeting EMT and beyond in developing therapeutics to tackle fibrosis is challenging but likely feasible.

关键词： EMT Fibrosis TGF-β Smad HDAC inhibitors TGF-βantibody Organ fibrosis Senescence Extracellular matrix

Expert consensus on difficult airway assessment

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Hepatobiliary Surgery and Nutrition 2023年第4期12卷 545-566页

作者： Ming Xia Wuhua ma Mingzhang Zuo Xiaoming Deng Fushan Xue Denise Battaglini Vivek Aggarwal Giustino Varrassi Vladimir Cerny Ida Di Giacinto Rita Cataldo daqing ma Toru Yamamoto martina Rekatsina Alessandro De Cassai Andrea Carsetti marvin G.Chang Edwin Seet Daniel P.Davis Michael G.Irwin Yuguang Huang Hong Jiang Department of Anesthesiology Shanghai Ninth People’s HospitalShanghai Jiao Tong University School of MedicineShanghaiChina Department of Anesthesiology The First Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouChina Department of Anaesthesiology Beijing HospitalNational Center of GerontologyInstitute of Geriatric MedicineChinese Academy of Medical ScienceBeijingChina Department of Anesthesiology Plastic Surgery HospitalCAMS and PUMCBeijingChina Department of Anesthesiology Beijing Friendship HospitalCapital Medical UniversityBeijingChina Anesthesia and Intensive Care San Martino Policlinico HospitalIRCCS for Oncology and NeuroscienceGenoaItaly Department of Conservative Dentistry&Endodontics Jamia Millia IslamiaNew DelhiIndia Paolo Procacci Foundation RomaItaly Department of Anaesthesiology and Intensive Care Medicine University Hospital Hradec KraloveHradec KraloveCzech Republic Unit of Anesthesia and Intensive Care Mazzoni HospitalAscoli PicenoItaly Unit of Anaesthesia Intensive Care and Pain ManagementDepartment of MedicineUniversitàCampus Bio-Medico of RomeRomaItaly Division of Anaesthetics Pain Medicine&Intensive CareDepartment of Surgery&CancerFaculty of MedicineImperial College Londonand Chelsea and Westminster HospitalLondonUK Division of Dental Anesthesiology Graduate School of Medicine and Dental SciencesNiigata UniversityNiigataJapan Department of Anaesthesiology National and Kapodistrian University of AthensAthensGreece Institute of Anesthesia and Intensive Care Unit University Hospital of PaduaPaduaItaly Department of Biomedical Sciences and Public Health UniversitàPolitecnica delle MarcheAnconaItaly Anesthesia and Intensive Care Unit Azienda Ospedaliero Universitaria delle MarcheAnconaItaly Department of Anesthesia Critical Careand Pain MedicineMassachusetts General HospitalBostonMAUSA Lee Kong Chian School of Medicine Nanyang Technological UniversitySingaporeSingapore Department of Anaesthesia Yong Loo Lin School of Medic

Background:Identifying a potentially difficult airway is crucial both in anaesthesia in the operating room(OR)and non-operation room sites.There are no guidelines or expert consensus focused on the assessment of the difficult airway before,so this expert consensus is developed to provide guidance for airway assessment,making this process more standardized and accurate to reduce airway-related complications and improve safety.Methods:Seven members from the Airway management Group of the Chinese Society of Anaesthesiology(CSA)met to discuss the first draft and then this was sent to 15 international experts for review,comment,and approval.The Grading of Recommendations,Assessment,Development and Evaluation(GRADE)is used to determine the level of evidence and grade the strength of recommendations.The recommendations were revised through a three-round Delphi survey from experts.Results:This expert consensus provides a comprehensive approach to airway assessment based on the medical history,physical examination,comprehensive scores,imaging,and new developments including transnasal endoscopy,virtual laryngoscopy,and 3D printing.In addition,this consensus also reviews some new technologies currently under development such as prediction from facial images and voice information with the aim of proposing new research directions for the assessment of difficult airway.Conclusions:This consensus applies to anesthesiologists,critical care,and emergency physicians refining the preoperative airway assessment and preparing an appropriate intubation strategy for patients with a potentially difficult airway.

关键词： Expert consensus difficult airway airway management

Perioperative lung injury after major surgery

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Perioperative lung injury after major surgery

Perioperative acute lung injury and its protection afforded by dexmedetomidine

中国中西医结合麻醉学会[CSIA]年会暨第二届全国中西...

作者： daqing ma Anaesthetics Pain Medicine & Intensive Care Department of Surgery and Cancer Imperial College London Chelsea & Westminster Hospital

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Perioperative acute lung injury and its protection afforded ...

Microstructures,corrosion behavior and mechanical properties of as-cast Mg-6Zn-2X(Fe/Cu/Ni)alloys for plugging tool applications

2017中国中西医结合麻醉学会[CSIA]年会暨第四届...

作者： daqing ma Imperial College London Chelsea &Westminster Hospital

Perioperative acute lung injury(ALI)is a syndrome characterised by hypoxia and chest radiograph changes.In the general surgical population,the incidence of ARDS is reported to be 0.2%.Indeed,it is thought that patients who undergo elective superficial,orthopaedic and pelvic surgeries are at minimal risk of developing perioperative acute lung injury(ALI).For thoracic and abdominal surgeries are associated with higher risks.

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International Journal of Minerals,Metallurgy and materials 2024年第4期31卷 697-711页

作者： Baosheng Liu Jiali Wei Shaohua Zhang Yuezhong Zhang Pengpeng Wu daqing Fang Guorui ma School of materials Science and Engineering Taiyuan University of Science and TechnologyTaiyuan 030024China State Key Laboratory for Mechanical Behavior of materials Xi’an Jiaotong UniversityXi’an 710049China Intelligent Equipment Research and Development Center Zhuhai Institute of Advanced Technology Chinese Academy of SciencesZhuhai 519080China Advanced materials Research Institute Zhuhai Dingmei Medical Technology Co.Ltd.Zhuhai 519000China

Mg-6Zn-2X(Fe/Cu/Ni)alloys were prepared through semi-continuous casting,with the aim of identifying a degradable magnesium(Mg)alloy suitable for use in fracturing balls.A comparative analysis was conducted to assess the impacts of adding Cu and Ni,which result in finer grains and the formation of galvanic corrosion sites.Scanner electronic microscopy examination revealed that precipitated phases concentrated at grain boundaries,forming a semi-continuous network structure that facilitated corrosion penetration in Mg-6Zn-2Cu and Mg-6Zn-2Ni alloys.Pitting corrosion was observed in Mg-6Zn-2Fe,while galvanic corrosion was identified as the primary mechanism in Mg-6Zn-2Cu and Mg-6Zn-2Ni alloys.Among the tests,the Mg-6Zn-2Ni alloy exhibited the highest corrosion rate(approximately 932.9 mm/a)due to its significant potential difference.Mechanical testing showed that Mg-6Zn-2Ni alloy possessed suitable ultimate compressive strength,making it a potential candidate material for degradable fracturing balls,effectively addressing the challenges of balancing strength and degradation rate in fracturing applications.

关键词： magnesium alloys microstructure micro-galvanic corrosion mechanical properties