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Clinical practice guidelines for nutritional assessment and monitoring of adult ICU patients in China

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 China.This guideline focuses on nutrition evaluation and metabolic monitoring to achieve optimal and personalized nutrition therapy for critically ill patients.This 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 surgery.The 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 supply.Each question was analyzed according to the Population,Intervention,Comparison,and Outcome(PICO)principle.In addition,interpretations were provided for four questions that did not reach a consensus but may have potential clinical and research value.The 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)

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Effect of Mn^(2+)on the phosphorus removal and bioflocculation under anoxic condition

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Journal of Environmental Sciences 2022年第5期34卷 37-46页

作者： Xiaohui Xu Lanhe Zhang xiangdong Zhang Xiaohui guan Dezhou Wei School of Resources&Civil Engineering Northeastern UniversityShenyang 110819China School of Chemical Engineering Northeast Electric Power UniversityJilin 132012China

Manganese ion(Mn^(2+))generated from metallurgical,steel making and chemical industries enters sewage treatment plants and affects the sludge activity and flocculation.The effect of Mn^(2+)on the removal of chemical oxygen demand(COD)and total phosphorus(TP)and sludge activity were investigated in anoxic zone of an anaerobic/anoxic/oxic(A2O)process.The compositions and structures of extracellular polymeric substances(EPS)were charac-terized using three-dimensional excitation emission matrix fluorescence spectroscopy(3D-EEM),X-ray photoelectron spectroscopy(XPS)and Fourier transform infrared spectroscopy(FTIR)to reveal the relationship among Mn^(2+),EPS and sludge flocculation.The results showed thatlow concentration of Mn^(2+)(10 mg/L)hindered microbial flocculation and reduced removal efficiencies of the pollutants.When Mn^(2+)was 5 mg/L,removal efficiencies of COD and TP reached 65%and 90%,respectively.Sludge flocculation was the best and SVI was 70.56 mL//g.The changes of Mn^(2+)concentration caused deviation of groups'compositions in LB-EPS and TB-EPS,where the main components were always protein(PN)and polysaccharide(PS).The addition of Mn^(2+)resulted in the degradation of humic acids.However,it did not give rise to significant morphology changes of EPS.

关键词： Mn^(2+) Wastewater Anoxic sludge Extracellular polymeric substances (EPS) Flocculation

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Lung ultrasound:a valuable tool for assessing COVID-19 patients with different severity

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Chinese Medical Journal 2022年第9期135卷 1114-1116页

作者： Xiang Si Hui Yi Dayue Liu Ruizhi Wang Yumei Liu Jianfeng Wu Xiangdong Guan Department of Critical Care Medicine The First Affiliated HospitalSun Yat-sen UniversityGuangzhouGuangdong 510080China Department of Respiratory and Critical Care Medicine The First Affiliated HospitalSun Yat-sen UniversityGuangzhouGuangdong 510080China Institute of Pulmonary Diseases Sun Yat-sen UniversityGuangzhouGuangdong 528406China Department of Healthcare-Associated Infection Management The First Affiliated HospitalSun Yat-sen UniversityGuangzhouGuangdong 510080China Department of Laboratory Medicine The First Affiliated HospitalSun Yat-sen UniversityGuangzhouGuangdong 510080China Department of Respiratory Medicine Hankou Hospital of WuhanWuhanHubei 430012China.

To the Editor:Lung ultrasound(LUS)may be a promising technique to assess lung injury from coronavirus disease 2019(COVID-19).However,the LUS characteristics and their assessment value have not been well described.We aimed to explore the LUS characteristics and their assessment value in COVID-19 patients with different levels of disease severity.

关键词： Lung severity patients

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Determination of Elastoplastic Mechanical Properties of the Weld and Heat Affected Zone Metals in Tailor-Welded Blanks by Nanoindentation Test

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Chinese Journal of Mechanical Engineering 2015年第5期28卷 911-918页

作者： MA xiangdong guan Yingping YANG Liu Key Laboratory of Advanced Forming & Stamping Technology and Science of Ministry of Education Yanshan University

The elastoplastic mechanical properties of the weld and heat affected zone metals have comparatively major impact on the forming process of tailor-welded blanks. A few scholars investigated the elastoplastic mechanical properties of the weld and heat affected zone, but they only simply assumed that it was a uniform distribution elastoplastic material different from the base materials. Four types of tailor-welded blanks which consist of ST12 and 304 stainless steel plates are selected as the research objects, the elastoplastic mechanical properties of the tailor-welded blanks weld and heat affected zone metals are obtained based on the nanoindentation tests, and the Erichsen cupping tests are conducted by combining numerical simulation with physical experiment. The nanoindentation tests results demonstrate that the elastoplastic mechanical properties of the weld and heat affected zone metals are not only different from the base materials, but also varying between the weld metals and the heat affected zone metals. Comparing the Erichsen cupping test resulted from numerical with that from experimental method, it is found that the numerical value of Erichsen cupping test which consider the elastoplastic mechanical properties of the weld and heat affected zone metals have a good agreement with the experimental result, and the relative error is only 4.8%. The proposed research provides good solutions for the inhomogeneous elastoplastic mechanical properties of the tailor-welded blanks weld and heat affected zone metals, and improves the control performance of tailor-welded blanks forming accuracy.

关键词： tailor-welded blanks elastoplastic mechanical properties nanoindentation test Erichsen cupping test

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Safety and efficacy of ciprofol vs.propofol for sedation in intensive care unit patients with mechanical ventilation:a multi-center,open label,randomized,phase 2 trial

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Chinese Medical Journal 2022年第9期135卷 1043-1051页

作者： Yongjun Liu Xiangyou Yu Duming Zhu Jun Zeng Qinhan Lin Bin Zang Chuanxi Chen Ning Liu Xiao Liu Wei Gao Xiangdong Guan Department of Critical Care Medicine The First Affiliated HospitalSun Yat-sen UniversityGuangzhou 510080China Department of Critical Care Medicine The First Affiliated Hospital of Xinjiang Medical UniversityUrumqi 830011China Department of Critical Care Medicine Zhongshan HospitalFudan UniversityShanghai 200032China Department of Critical Care Medicine Guangzhou First People's HospitalGuangzhou 510180China Department of Critical Care Medicine Qingyuan People's HospitalThe Sixth Affiliated Hospital of Guangzhou Medical UniversityQingyuan 511518China Department of Critical Care Medicine Shengjing Hospital of China Medical UniversityShenyang 110022China Department of Research and Development Haisco Pharmaceutical Group Co.LtdShanghai 201203China.

Background:Ciprofol(HSK3486;Haisco Pharmaceutical Group Co.,Ltd.,Chengdu,China),developed as a novel 2,6-disubstituted phenol derivative showed similar tolerability and efficacy characteristics as propofol when applicated as continuous intravenous infusion for 12 h maintenance sedation in a previous phase 1 trial.The phase 2 trial was designed to investigate the safety,efficacy,and pharmacokinetic characteristics of ciprofol for sedation of patients undergoing mechanical ventilation.Methods:In this multicenter,open label,randomized,propofol positive-controlled,phase 2 trial,39 Chinese intensive care unit patients receiving mechanical ventilation were enrolled and randomly assigned to a ciprofol or propofol group in a 2:1 ratio.The ciprofol infusion was started with a loading infusion of 0.1-0.2 mg/kg for 0.5-5.0 min,followed by an initial maintenance infusion rate of 0.30 mg·kg^(-1)·h^(-1),which could be adjusted to an infusion rate of 0.06 to 0.80 mg·kg^(-1)·h^(-1),whereas for propofol the loading infusion dose was 0.5-1.0 mg/kg for 0.5-5.0 min,followed by an initial maintenance infusion rate of 1.50 mg·kg^(-1)·h^(-1),which could be adjusted to 0.30-4.00 mg·kg^(-1)·h^(-1)to achieve-2 to+1 Richmond Agitation-Sedation Scale sedation within 6-24 h of drug administration.Results:Of the 39 enrolled patients,36 completed the trial.The median(min,max)of the average time to sedation compliance values for ciprofol and propofol were 60.0(52.6,60.0)min and 60.0(55.2,60.0)min,with median difference of 0.00(95%confidence interval:0.00,0.00).In total,29(74.4%)patients comprising 18(69.2%)in the ciprofol and 11(84.6%)in the propofol group experienced 86 treatment emergent adverse events(TEAEs),the majority being of severity grade 1 or 2.Drug-and sedation-related TEAEs were hypotension(7.7%vs.23.1%,P=0.310)and sinus bradycardia(3.8%vs.7.7%,P=1.000)in the ciprofol and propofol groups,respectively.The plasma concentration-time curves for ciprofol and propofol were similar.Conclusions:ciprofol is comparable to propofol with good t

关键词： HSK3486 Ciprofol Propofol Sedation Mechanical ventilation

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体外膜肺氧合抗凝管理现状和挑战

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中华医学杂志 2022年第25期102卷 1864-1869页

作者：司向管向东中山大学附属第一医院重症医学科广东省急危重症临床医学研究中心广州510080

体外膜肺氧合(ECMO)的抗凝管理面临着巨大挑战,出血或栓塞等凝血系统相关并发症是影响患者死亡率的主要因素之一,如何把控血栓形成与出血并发症之间的动态平衡成为ECMO管理的重中之重。本文对ECMO支持期间的凝血改变,如何选用合适的抗... 详细信息

体外膜肺氧合(ECMO)的抗凝管理面临着巨大挑战,出血或栓塞等凝血系统相关并发症是影响患者死亡率的主要因素之一,如何把控血栓形成与出血并发症之间的动态平衡成为ECMO管理的重中之重。本文对ECMO支持期间的凝血改变,如何选用合适的抗凝药物和抗凝监测手段进行论述,旨在对ECMO患者最佳的抗凝策略进行探讨,更好地服务于ECMO患者。

关键词：体外膜氧合作用重症监护凝血抗凝

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后疫情时代重症医学的发展前瞻漫谈

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中华重症医学电子杂志 2022年第2期8卷 97-100页

作者：管向东中山大学附属第一医院重症医学科广州510080

一、重症医学的临床研究现状与思考过去的20多年时间,全球重症医学临床研究逐渐加快了步伐,出现了大量高质量、值得借鉴的研究,其中,涵盖了很多国际化、大型、多中心随机对照试验(randomized controlled trial,RCT)。这些研究,原始科学... 详细信息

一、重症医学的临床研究现状与思考过去的20多年时间,全球重症医学临床研究逐渐加快了步伐,出现了大量高质量、值得借鉴的研究,其中,涵盖了很多国际化、大型、多中心随机对照试验(randomized controlled trial,RCT)。这些研究,原始科学问题均出自临床,成为临床循证指南和专家共识的主要基础。以脓毒症方面为例,2017年,一项研究脓毒症治疗时机的大型临床试验的结果发表,该研究纳入了来自美国149家医院的49000多例患者的数据,人们对其给予高度的关注。该研究表明,从发现脓毒症的最初时间开始,治疗脓毒症的时机每延迟1 h,病死率就会增加4%(相对风险)。脓毒症早期液体治疗的效果,仅在需要血管加压药的脓毒症休克患者中得到证实。

关键词：重症医学相对风险脓毒症休克循证指南临床研究现状大型临床试验医学临床研究发展前瞻

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Preparation and Thermal Properties of Shape-stabilized Paraffin/NPGDMA/BN Composite for Phase Change Energy Storage

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Chinese Journal of Chemistry 2020年第12期38卷 1737-1742页

作者： Xuefeng Li Lingying Chen Weifang Han Chunhua Ge Hongyu guan Rui Zhang xiangdong Zhang College of Chemistry Liaoning UniversityShenyangLiooling 110036China School of Materials Science and Engineering Liaocheng UniversityLiaochengShandong 252000China

of main observation and conclusion Paraffin,as an excellent phase change material(PCM),is limited by the leakage problem and low thermal conductivity.In this research,a novel paraffin/neopentyl glycol dimethacrylate/boron nitride(paraffin/NPGDMA/BN)composite PCM was successfully prepared via a physical mixing process.NPGDMA in paraffin/NPGDMA/BN composite PCM was cured by UV light under the action of photo initiator,which can improve the shape stability to avoid the leakage of paraffin in the process of phase change.By comparing the leakage rate,latent heat,and thermal conductivity,the optimal mass ratio of paraffin and NPGDMA was selected to be 7:3.It was showed that the presence of 5 wt%BN led to increasing in thermal conductivity by up to 59%.The microstructure of the composite PCMs was characterized by SEM,FTIR,and XRD.The composite PCMs can be processed into a variety of shapes by using molds.The paraffin/NPGDMA/BN composite PCM exhibited a significantly improved shape stability and large phase change enthalpy of 123.0 J/g.The leakage rate of paraffin/NPGDMA/BN was much improved after being soaked with petroleum ether.

关键词： composite conductivity stability

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Critical Care Medicine Branch of Chinese Medical Association Providing International Assistance During the Pandemic

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International Understanding 2020年第1期 25-26页

作者： guan xiangdong Li Junling 不详

It has been several months since COVID-19 hit the world,and the number of confirmed cases has been on the rise.China has resolutely shouldered the responsibility of a major country.Under the scourge of the epidemic th... 详细信息

关键词： Medicine Medical Care

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无本回译:困境、思考与展望——兼与黎昌抱教授及同行商榷

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大连大学学报 2023年第2期44卷 35-40页

作者：关相东陕西师范大学外国语学院陕西西安710062

近15年来,无本回译理论取得了重大突破,但仍然存在盲区及瓶颈。基于现有研究成果,本文尝试性提出四点思考:(1)无本回译的原文本如何界定;(2)对于原文本“作者类型”划分的必要性问题;(3)廓清无本回译与其他类似概念在所指方面的复杂关系... 详细信息

近15年来,无本回译理论取得了重大突破,但仍然存在盲区及瓶颈。基于现有研究成果,本文尝试性提出四点思考:(1)无本回译的原文本如何界定;(2)对于原文本“作者类型”划分的必要性问题;(3)廓清无本回译与其他类似概念在所指方面的复杂关系;(4)传统“回译”内涵是否可以做一扩充,囊括无本回译。在此基础上,对该理论的发展态势进行展望,以期为翻译学的核心概念及译论完善提供参考和借鉴。

关键词：无本回译异语写作文本作者类型回译

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