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Intraoperative thromboelastography-guided transfusion in a patient with factor XI deficiency: A case report

World Journal of Clinical Cases 2022年第1期10卷 242-248页

作者： Wen-Juan Guo Wei-yun Chen xue-rong yu Le Shen yu-Guang Huang Department of Anesthesiology Peking Union Medical College HospitalPeking Union Medical College and Chinese Academy of Medical SciencesBeijing 100730China Department of Anesthesiology State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalPeking Union Medical College and Chinese Academy of Medical SciencesBeijing 100730China

BACKGROUND Factor XI(FXI)deficiency,also known as hemophilia C,is a rare bleeding disorder of unpredictable severity that correlates poorly with FXI coagulation *** often poses great challenges in perioperative hemostatic ***(TEG)is a method for testing blood coagulation using a viscoelastic hemostatic assay of whole blood to assess the overall coagulation ***,we present the successful application of intraoperative TEG monitoring in an FXI-deficient patient as an individualized blood transfusion *** SUMMARY A 21-year-old male patient with FXI deficiency was scheduled to undergo reconstructive surgery for macrodactyly of the left foot under general *** minimize his bleeding risk,he was scheduled to receive fresh frozen plasma(FFP)as an empirical prophylactic FXI replacement at a dose of 15-20 mL/kg body weight(900-1200 mL)before *** FFP transfusion was to be adjusted according to surgical ***,TEG assessment was used at the beginning and toward the end of his *** to intraoperative TEG results,the normalization of coagulation function was achieved with an infusion of only 800 mL FFP,and blood loss was *** patient showed an uneventful postoperative course and was discharged on postoperative day *** TEG can be readily applied in the intraoperative period to individualize transfusion needs in patients with rare inherited coagulopathy.

关键词： Factor XI deficiency Thromboelastography Transfusion Intraoperative Coagulopathy Case report

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Effect of Point-of-care Hemoglobin/Hematocrit Devices and Autologous Blood Salvage on Reduction of Perioperative Allogeneic Blood Transfusion

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Chinese Medical Sciences Journal 2016年第2期31卷 83-88页

作者： Wei-yun Chen xue-rong yu Jiao Zhang Qing yuan yu-guang Huang Department of Anesthesiology Peking Union Medical College HospitalChinese Academy of Medical Sciences & Peking Union Medical College

Objective To evaluate the effect of point-of-care hemoglobin/hematocrit(POC HGB/HCT) devices and intraoperative blood salvage on the amount of perioperative allogeneic blood transfusion and blood conservation in clinical practice. Methods A total of 46 378 medical records of 22 selected hospitals were reviewed. The volume of allogeneic red blood cell and plasma, number of patients transfused, number of intraoperative autologous blood salvage, total volume of autologous blood transfusion, and amount of surgery in the year of 2011 and 2013 were tracked. Paired t-test was used in intra-group comparison, while t-test of two isolated samples carried out in inter-group comparison. P<0.05 was defined as statistically significant difference. Results In the hospitals where POC HGB/HCT device was used(n=9), the average allogeneic blood transfusion volume per 100 surgical cases in 2013 was significantly lower than that in 2011(39.86±20.20 vs. 30.49±17.50 Units, t=3.522, P=0.008). In the hospitals without POC HGB/HCT meter, the index was not significantly different between 2013 and 2011. The average allogeneic blood transfusion volume was significantly reduced in 2013 than in 2011 in the hospitals where intraoperative autologous blood salvage ratio [autologous transfusion volume/(autologous transfusion volume+allogeneic transfusion volume)] was increased(n=12, t=2.290, P=0.042). No significant difference of the above index was found in the hospitals whose autologous transfusion ratio did not grow. Conclusion Intraoperative usage of POC HGB/HCT devices and increasing autologous transfusion ratio could reduce perioperative allogeneic blood transfusion.

关键词： point-of-care hemoglobin/hematocrit devices autologous blood transfusion blood management red blood cell transfusion transfusion practices

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Evaluation of Risk Factors for Arytenoid Dislocation after Endotracheal Intubation: a Retrospective Case-control Study

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Chinese Medical Sciences Journal 2014年第4期29卷 221-224页

作者： Le Shen Wu-tao Wang xue-rong yu Xiu-hua Zhang yu-guang Huang Department of Anesthesiology Peking Union Medical College Hospital Chinese Academy of Medical Sciences & Peking Union Medical College Department of Anesthesiology Affiliated Hospital of Xi'an Medical University

Objective To investigate the risk factors for postoperative arytenoid dislocation. Methods From September 2003 to August 2013, the records of 16 patients with a history of postoperative arytenoid dislocation were reviewed. Patients matched in terms of date and type of procedures were chosen as the controls(n=16). Recorded data for all patients were demographics, smoking status, alcoholic status, preoperative physical status, airway evaluation, intubation procedures, preoperative laboratory test results, anesthetic consumption and intensive care unit stay. For arytenoid dislocation cases, we further analyzed the incidences of the left and right arytenoid dislocation, and the outcomes of surgical repair and conservative treatment. Categorical variables were presented as frequencies and percentages, and were compared using the chi-squared test. Continuous variables were expressed as means±SD and compared using the Student's unpaired t-test. To determine the predictors of arytenoid dislocation, a logistic regression model was used for multivariate analysis. Results Sixteen patients with postoperative arytenoid dislocation were enrolled, with a median age of 52 years. Most postoperative arytenoid dislocation patients(15/16, 93.75%) received surgical repair, except one patient who recovered after conservative treatment. None of the postoperative arytenoid dislocation patients were smokers. Red blood cell(P=0.044) and hemoglobin(P=0.031) levels were significantly lower among arytenoid dislocation cases compared with the controls. Conclusions Non-smoking and anemic patients may be susceptible to postoperative arytenoid dislocation. However, neither of them was independent risk factor for postoperative arytenoid dislocation.

关键词： arytenoid dislocation complication endotracheal intubation

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PSD95 Gene Specific siRNAs Attenuate Neuropathic Pain through Modulating Neuron Sensibility and Postsynaptic CaMKIIα Phosphorylation

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Chinese Medical Sciences Journal 2011年第4期26卷 201-207页

作者： Le Shen Xu Li Wen Chen Li Xu Wei Liu xue-rong yu yu-guang Huang Department of Anesthesiology Peking Union Medical College Hospital Chinese Academy of Medical Sciences ＆ Peking Union Medical College Beijing 100730 China

Objective To observe the effects of PSD95 gene specific siRNAs on neuropathic pain relief, neuron viability, and postsynaptic calcium/calmodulin-dependent protein kinase IIα (CaMKIIα) phosphorylation in vitro and in vivo. Methods Gene-specific siRNAs of rat PSD95 were synthesized chemically for transfection. Adult male Sprague-Dawley (SD) rats were randomly divided into 3 groups: nave group (n=6), sham group (n=6), and sciatic nerve chronic constriction injury (CCI) group (n=24). The CCI group was further divided into 4 groups (n=6 in each group), which were pretreated with normal saline, transfection vehicle, negative control siRNAs, and PSD95 gene specific siRNAs respectively. All the subgroups received corresponding agents intrathecally for 3 days, started one day before the CCI of sciatic nerve. Both mechanical allodynia and thermal hyperalgesia were measured on post-operative day 3 and 7. PSD95 gene silenced NG108-15 cells were further stimulated by glutamate, with the cell viability and the expression/phosphorylation of CaMKIIα measured by MTT cell proliferation assay and Western blot, respectively. Results The siRNAs decreased PSD95 mRNA level significantly both in vivo and in vitro. Neuropathic pain rats pretreated with PSD95 gene specific siRNAs exhibited significant elevation in the mechanical withdrawal threshold and paw withdrawal thermal latency, without affecting the baseline nociception. PSD95 gene silencing enhanced neuronal tolerance against the glutamate excitotoxicity, meanwhile the phosphorylation of CaMKIIα Thr286 was attenuated. Conclusion Pre-emptive administration of PSD95 gene specific siRNAs may attenuate the central sensitization CaMKIIα-related signaling cascades, leading to the relief of neuropathic pain.

关键词： PSD95 siRNAs neuropathic pain glutamate excitotoxicity calcium/calmodulin- dependent protein kinase IItt

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Severe Acute Respiratory Distress Syndrome after Bilateral Total Knee Replacement

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Chinese Medical Journal 2015年第21期128卷 2977-2978页

作者： Lu-Lu Ma xue-rong yu Department of Anesthesiology Peking Union Medical College Hospital Beijing 100730 China

To the Editor： Total knee arthroplasty （TKA） is one of the most common orthopedic surgeries to reduce pain and improve function for patients with osteoarthritis. However, TKA is associated with high-risk of perioperative morbidity and mortality. We presented a patient who developed severe acute respiratory distress syndrome （ARDS） postoperatively after bilateral TKA procedure. A 68-year-old female patient was scheduled for bilateral total knee replacement because ofosteoarthritis. Her past medical history was unremarkable, unless pacemaker implantation for Mobitz type II second-degree atrioventricular block. There was no significant finding in her preoperative examination. She had the operation under general anesthesia and was extubated uneventfully after the surgery.

关键词： Severe Acute Respiratory Distress Syndrome Bilateral Total Knee Replacement

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Clinical improvement in the therapy of aural keloids

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Chinese Medical Journal 2009年第23期122卷 2865-2868页

作者： ZHANG Yan-ge CEN Ying LIU Xiao-xue yu rong XU xue-wen Department of Burns and Plastic Surgery West China HospitalSichuan University Chengdu Sichuan 610041 China

Background Keloids have a predilection for the aural region because of the special shape of the pinna. It is difficult to resect keloids entirely and maintain a satisfactory pinnal shape. Surgical excision in combination with radiotherapy is considered to be the most efficacious treatment available for severe keloids. This study was conducted to evaluate the treatment of aural keloids with intralesional excision and immediate postoperative adjuvant radiotherapy. Methods Forty-six patients with a combined total of 74 aural keloids were treated by intralesional excision and immediate postoperative adjuvant radiotherapy. All patients received a total dose of 20 Gy in 10 consecutive days. The time interval between keloid excision and delivery of the first radiotherapy fraction was 〈24 hours in all cases. The median follow-up was 2.2 years. Results Twenty-nine patients with 48 keloids （64.9%） were highly satisfied with their outcome, and were rated as good by the surgeon. Six patients with 12 keloids （16.2%） showed general satisfaction but wanted aesthetic refinement, and these patients were rated as fair by the surgeon. Three patients with four keloids （5.4%） showed no evidence of recurrence after surgery, but disliked the result because of the discoloration and irregularity of the scar surface. These patients were rated as poor by the surgeon. Partial recurrence occurred in 8 patients with 10 keloids （13.5%）. No major complications were observed. Conclusion Intralesional excision and immediate postoperative adjuvant radiotherapy is well tolerated and very effective in Dreventing recurrence of aural region keloids.

关键词： keloid surgery radiotherapy, adjuvant ear

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Difficult Airway for Patients Undergoing Spine Surgeries

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Chinese Medical Journal 2016年第6期129卷 749-750页

作者： Lu-Lu Ma xue-rong yu Bo Zhu yu-Guang Huang Jian-Xiong Shen Jian-Guo Zhang Department of Anesthesiology Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100730 China Department of Orthopedics Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100730 China

INTRODUCTION The “cannot intubate, cannot ventilate” situation although rare is a nightmare for anesthesiologists. Difficult airway is defined as difficult facemask or supraglottic airway （SGA） ventilation, difficult SGA placement, laryngoscopy, tracheal intubation, or failed intubation. We presented three cases of difficult airway and their airway management.

关键词： Ankylosing Spondylitis Difficult Airway Klippel-Feil Syndrome

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Author＇s Reply to the Letter to Editor “Difficult Airway Management： Correct Concepts and Algorithm are Important for Patient Safety”

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Chinese Medical Journal 2016年第15期129卷 1887-1888页

作者： Lu-Lu Ma xue-rong yu Bo Zhu yu-Guang Huang Jian-Xiong Shen Jian-Guo Zhang Oepartment of Anesthesiology Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100730 China Department of Orthopedics Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100730 China

For the three cases listed in this article, difficult airway was anticipated preoperatively. We described how we intubated, but it did not mean what we did was the best choice.

关键词： Correct Concepts Algorithm

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PD-YOLO:Colon Polyp Detection Model Based on Enhanced Small-Target Feature Extraction

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Computers, Materials & Continua 2025年第1期82卷 913-928页

作者： Yicong yu Kaixin Lin Jiajun Hong rong-Guei Tsai yuanzhi Huang New Engineering Industry College Putian UniversityPutian351100China Engineering Research Center of Big Data Application in Private Health Medicine(Putian University) Fujian Province UniversityPutian351100China Computer College Guangdong University of Science&TechnologyDongguan523668China

In recent years,the number of patientswith colon disease has increased *** polyps are the precursor lesions of colon *** not diagnosed in time,they can easily develop into colon cancer,posing a serious threat to patients’lives and health.A colonoscopy is an important means of detecting colon ***,in polyp imaging,due to the large differences and diverse types of polyps in size,shape,color,etc.,traditional detection methods face the problem of high false positive rates,which creates problems for doctors during the diagnosis *** order to improve the accuracy and efficiency of colon polyp detection,this question proposes a network model suitable for colon polyp detection(PD-YOLO).This method introduces the self-attention mechanism CBAM(Convolutional Block Attention Module)in the backbone layer based on YOLOv7,allowing themodel to adaptively focus on key information and ignore the unimportant *** help themodel do a better job of polyp localization and bounding box regression,add the SPD-Conv(Symmetric Positive Definite Convolution)module to the neck layer and use deconvolution instead of *** results indicate that the PD-YOLO algorithm demonstrates strong robustness in colon polyp *** to the original YOLOv7,on the Kvasir-SEG dataset,PD-YOLO has shown an increase of 5.44 percentage points in AP@0.5,showcasing significant advantages over other mainstream methods.

关键词： Polyp detection YOLOv7 SPD-Conv CBAM deconvolution

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Recent Advances in Artificial Sensory Neurons:Biological Fundamentals,Devices,Applications,and Challenges

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Nano-Micro Letters 2025年第3期17卷 168-216页

作者： Shuai Zhong Lirou Su Mingkun Xu Desmond Loke Bin yu Yishu Zhang rong Zhao Guangdong Institute of Intelligence Science and Technology HengqinZhuhai 519031People’s Republic of China College of Integrated Circuits Zhejiang UniversityHangzhou 3112000People’s Republic of China ZJU-Hangzhou Global Scientific and Technological Innovation Center Hangzhou 310027People’s Republic of China Department of Science Mathematics and TechnologySingapore University of Technology and DesignSingapore 487372Singapore Department of Precision Instruments Tsinghua UniversityBeijing 100084People’s Republic of China Center for Brain‑Inspired Computing Research Tsinghua UniversityBeijing 100084People’s Republic of China IDG/McGovern Institute for Brain Research Tsinghua UniversityBeijing 100084People’s Republic of China

Spike-based neural networks,which use spikes or action potentialsto represent information,have gained a lot of attention because of their high energyefficiency and low power *** fully leverage its advantages,convertingthe external analog signals to spikes is an essential *** including analog-to-digital converters or ring oscillators,and sensorssuffer from high power and area *** efforts are devoted to constructingartificial sensory neurons based on emerging devices inspired by the biologicalsensory *** can simultaneously perform sensing and spike conversion,overcoming the deficiencies of traditional sensory *** review summarizesand benchmarks the recent progress of artificial sensory *** starts with thepresentation of various mechanisms of biological signal transduction,followed bythe systematic introduction of the emerging devices employed for artificial ***,the implementations with different perceptual capabilitiesare briefly outlined and the key metrics and potential applications are also ***,we highlight the challenges and perspectives for the future development of artificial sensory neurons.

关键词： Artificial intelligence Emerging devices Artificial sensory neurons Spiking neural networks Neuromorphic sensing

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