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Immune mechanisms and immuno -therapy in sepsis:where do we stand ?

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中国病理生理杂志 2001年第11期 61-62页

作者： Mohammed M.Sayeed AM PhD FCCM professor of Surgery and Physiology Director of Trauma/critical care R esearch Loyola University Stritch School of Medicine Maywood IllinoisUSA

Sepsis and septic shock have continued to produce significant morbidity and mortality, in recent times, in acutely injured patients as well as patients in the intensive care units despite advances in antibiotic therapy and in the cardi ovascular and pulmonary support for these patients. This emphasizes the need to gain a better understanding of the fundamental mechanisms of the pathogenesis of sepsis syndrome in the critically ill or injured patients. The present knowled ge of the mechanisms of septic pathogenesis clearly indicates involvement of mod ulations in the functions of the cells of body's immune defense system, namely, monocytes/macrophages, polymorphonuclear leukocytes, and lymphocytes. Most of su ch knowledge has been derived from laboratory experiments in animal models of se ptic injury, or from studies of immune-system cells, in vitro. Clinical stud ies have also supported the role of immune perturbations. Yet, to date, very few the rapeutic approaches are available to effectively counter the sepsis-related immu ne disturbances. Functional modulations in the immune system cells, in the injured/septic hos ts, can exert not only adaptive/beneficial effects but also profoundly adverse effects on the non-immune-system cells such as endothelial, epithelial, neurona l, endocrine, neuro-endocrine, smooth muscle, skeletal muscle, and cardiac muscl e cells. The primary functional modulation in the immune-system cells after inju ry or with critical illness is activation of such cells via molecules from pat hogens, for example, lipopolysaccharide from gram negative organisms, lipoteic hoic acid/peptidoglycan from gram positive organisms, or zymosan from fungi. Suc h pathogenic molecules activate monocytes and tissue macrophages to result in th e expression and release of cytokine mediators (TNFα, IL-1, IL-6, IL-8, and IL- 10), as well as certain lipid mediators (PGE2, LTB4, PAF). While these media tors could play a host-defense role in support of the host via con

关键词： Immune mechanisms and immuno therapy in sepsis

Immune mechanisms and immuno -therapy in sepsis:where do we stand ?

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中国病理生理杂志 2001年第11期17卷 1100-1101页

作者： Mohammed M.Sayeed AM PhD FCCM professor of Surgery and Physiology Director of Trauma/critical care R esearch Loyola University Stritch School of Medicine Maywood IllinoisUSA

关键词：脓毒症免疫机制免疫治疗

Data,digital worlds,and the avatarization of health care

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Global Health Journal 2024年第1期8卷 1-3页

作者： Jane Thomason Industry associate Centre for Blockchain TechnologiesUniversity College LondonLondon WC1E 6BTUnited Kingdom

Significant technological trends are impacting health care,from consumerisation,datafication,circular economy,and platformization of *** 3.0,or the Internet of Value,enables direct peer-to-peer value exchange,opening up new business models that will impact health *** the many technologies that will also be part of the healthcare transformation is artificial intelligence,which shocked the world with the debut of ChatGPT in *** opinion piece will explore how AI underpins the health transformation and,far from being an enemy of health,is the critical friend health care has been waiting for.

关键词： Avatarization Artificial intelligence Big Tech ChatGPT Consumerization 5G Healthcare

Acute Pain Management

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Acute Pain Management

China＇s Internet Finance： A critical Review

北医—哈佛麻醉与疼痛治疗论坛大会

作者： Carol Warfield Lowenstein professor of anesthesia Harvard Medical School Chairman Department of anesthesia Critical Care and Pain Medicine Beth Israel Deaconess Medical Center MD

＜正＞Prevalence of Postop Pain ＞23 million Americans have surgery annually ＞ 50% of patients experience inadequate pain relief after surgery Most patients underreport pain because they expect pain after surgery US Census Bureau. Statistical Abstract of the United States:2000 （120th ed）:131, Warfleld CA,Kahn ***.1995;63:1090-4. Fllos ks Lehmann KA. Eur Surg Res.1999:31:97-107.

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China & World Economy 2017年第4期25卷 78-92页

作者： Jianguo Xu associate professor National School of Development and Institute of Digital Finance Peking University China

China＇s Internet finance industry developed explosively from 2012 to 2015. Undersupply of finaneial services, progress of information technology and accommodative regulations for Internet finance jointly explain the explosive development. Regulation tightened after the small-scale P2P lending crisis in 2015. The present paper discusses the role of information technology and mega data analysis in financial services, with particular attention paid to some popular misconceptions. The paper predicts that large financial institutions and information technology companies will play a dominant role in the future development of lnternet finance.

关键词： financial regulation financial repression information technology mega data analysis

Confidential machine learning on untrusted platforms:a survey

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Cybersecurity 2021年第1期4卷 461-479页

作者： Sharma Sagar Chen Keke Northwestern Mutual Data Science associate professor Director of Trustworthy and Intelligent Computing Lab Department of Computer Science Marquette University Milwaukee WisconsinUSA HP Inc. USA

With the ever-growing data and the need for developing powerful machine learning models,data owners increasingly depend on various untrusted platforms(e.g.,public clouds,edges,and machine learning service providers)for scalable processing or collaborative ***,sensitive data and models are in danger of unauthorized access,misuse,and privacy compromises.A relatively new body of research confidentially trains machine learning models on protected data to address these *** this survey,we summarize notable studies in this emerging area of *** a unified framework,we highlight the critical challenges and innovations in outsourcing machine learning *** focus on the cryptographic approaches for confidential machine learning(CML),primarily on model training,while also covering other directions such as perturbation-based approaches and CML in the hardware-assisted computing *** discussion will take a holistic way to consider a rich context of the related threat models,security assumptions,design principles,and associated trade-offs amongst data utility,cost,and confidentiality.

关键词： Confidential computing Cryptographic protocols Machine learning

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临床证据(14) 急性肾衰竭

英国医学杂志中文版 2003年第3期6卷 174-183页

作者： John Kellum Martine Leblanc Ramesh Venkataraman 陈旻 associate professor Department of critical care Medicine University of Pittsburgh Pittsburgh USA Assistant professor of Nephrology and critical care Maisonneuve-Rosemont Hospital University of MontrealMontreal Canada Visiting Instructor Department of critical care Medicine University of Pittsburgh Pittsburgh USA

背景知识定义急性肾衰竭(ARF)是指肾小球滤过率突然和持续性下降,导致尿素和其他化学物质在血液中堆积。目前还没有清晰一致的生化学定义,但多数研究的定义为血清肌酐(Scr)2～3mg/dL(200-250 μmol/L),在Scr基础值小于2 mg/dL(170μmo... 详细信息

背景知识定义急性肾衰竭(ARF)是指肾小球滤过率突然和持续性下降,导致尿素和其他化学物质在血液中堆积。目前还没有清晰一致的生化学定义,但多数研究的定义为血清肌酐(Scr)2～3mg/dL(200-250 μmol/L),在Scr基础值小于2 mg/dL(170μmol/L)时,升高0.5 mg/dL(45μmol/L)

关键词：急性肾衰竭临床证据发病率病因预防液体治疗

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Subcutaneous Dissociative Conscious Sedation (sDCS) a New Approach to Compromised Airway in Mediastinal Masses

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Open Journal of Anesthesiology 2012年第4期2卷 166-169页

作者： Mihan J. Javid Mohammad B. Rahim Shahab Rafiian associate professor of Anesthesiology Department of Anesthesiology and Critical Care Imam Khomeinee Medical Center Tehran University of Medical Sciences Iran Department of Thoracic Surgery Imam Khomeinee Medical Center Tehran University of Medical Sciences Iran

Purpose: anesthesia and airway management for mediastinal masses are challenging and are accompanied by mortality and morbidity. Avoiding the loss of airway muscular tone in mediastinal masses has been confirmed necessary to avoid airway collapse. Sufficient spontaneous ventilation is of paramount importance in order to reduce the rate of mortality and morbidity. Various anesthetics and anesthesia techniques have been used for maintaining spontaneous ventilation and patent airway. In this report, a successful double lumen endobronchial intubation using “subcutaneous dissociative conscious sedation” as a novel method in the management of compromised airway (a case of a mediastinal mass) is presented. Clinical features: A 42 year- old, 62 Kg man was presented for an open biopsy of a middle mediastinal mass. The patient had a history of chest pain, dyspnea, cough, fever and sweats for 2 months. Regarding to the life threatening nature of mediastinal masses resulting from unpredictable events of airway obstruction and the reported cases of deaths after induction of anesthesia in patients with mediastinal masses and regarding to the importance of not losing muscular tone and keeping airway tone intact in patients with mediastinal masses” subcutaneous Dissociative Conscious Sedation (a novel method of anesthesia)”was selected in order to guarantee the safety of the patient and keep the airway secure. Conclusion: Owing to the characteristics of the “subcutaneous dissociative conscious sedation” this method is suggested as an appropriate substitute to general anesthesia for Endobronchial Double Lumen Intubation in mediastinal masses and compromised airway.

关键词： Airway Management Difficult Airway Low Dose Ketamine Mediastinal Masses Subcutaneous Ketamine Subcutaneous Dissociative Conscious Sedation

Most patients with non-hypertensive diseases at a critical care resuscitation unit require arterial pressure monitoring: a prospective observational study

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World Journal of Emergency Medicine 2023年第3期14卷 173-178页

作者： Emily Engelbrecht-Wiggans Jamie Palmer Grace Hollis Fernando Albelo Afrah Ali Emily Hart Dominique Gelmann Iana Sahadzic James Gerding Quincy K.Tran Daniel J.Haase University of Maryland School of Medicine Baltimore 21201USA The Research associate Program in Emergency Medicine and critical care Department of Emergency MedicineUniversity of Maryland School of MedicineBaltimore 21201USA Department of Emergency Medicine University of Maryland School of MedicineBaltimore 21201USA Program in Trauma the R Adams Cowley Shock Trauma CenterUniversity of Maryland School of MedicineBaltimore 21201USA

BACKGROUND:Blood pressure(BP)monitoring is essential for patient *** arterial BP(IABP)is more accurate than non-invasive BP(NIBP),although the clinical signifi cance of this diff erence is *** hypothesized that IABP would result in a change of management(COM)among patients with non-hypertensive diseases in the acute phase of ***:This prospective study included adults admitted to the critical care Resuscitation Unit(CCRU)with non-hypertensive disease from February 1,2019,to May 31,*** plans to maintain a mean arterial pressure>65 mmHg(1 mmHg=0.133 kPa)were recorded in real time for both NIBP and IABP measurements.A COM was defined as a discrepancy between IABP and NIBP that resulted in an increase/decrease or addition/discontinuation of a medication/*** and regression tree analysis identified significant variables associated with a COM and assigned relative variable importance(RVI)***:Among the 206 patients analyzed,a COM occurred in 94(45.6%[94/206])*** most common COM was an increase in current infusion dosages(40 patients,19.4%).Patients receiving norepinephrine at arterial cannulation were more likely to have a COM compared with those without(45[47.9%]vs.32[28.6%],P=0.004).Receiving norepinephrine(relative variable importance[RVI]100%)was the most signifi cant factor associated with a *** complications were identifi ed with IABP ***:A COM occurred in 94(45.6%)non-hypertensive patients in the *** vasopressors was the greatest factor associated with *** should consider IABP monitoring more often in non-hypertensive patients requiring norepinephrine in the acute resuscitation *** studies are necessary to confi rm the risk-to-benefi t ratios of IABP among these high-risk patients.

关键词： Non-hypertensive diseases Invasive arterial blood pressure Non-invasive blood pressure

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