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Optimizing artificial intelligence in sepsis management: Opportunities in the present and looking closely to the future

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Journal of intensive Medicine 2024年第1期4卷 34-45页

作者： Darragh O’Reilly Jennifer McGrath Ignacio Martin-Loeches Department of intensive care Medicine Multidisciplinary Intensive Care Research Organization(MICRO)St James’HospitalDublinIreland Department of Respiratory intensive care Hospital ClinicUniversitat de BarcelonaIDIBAPSCIBERESBarcelonaSpain

Sepsis remains a major challenge internationally for healthcare *** incidence is rising due to poor public awareness and delays in its recognition and subsequent *** sepsis,mortality increases with every hour left *** intelligence(AI)is transforming worldwide healthcare delivery at *** review has outlined how AI can augment strategies to address this global disease *** and machine learning(ML)algorithms can analyze vast quantities of increasingly complex clinical datasets from electronic medical records to assist clinicians in diagnosing and treating sepsis earlier than traditional *** review highlights how these models can predict the risk of sepsis and organ failure even before it *** gives providers additional time to plan and execute treatment plans,thereby avoiding increasing complications associated with delayed diagnosis of *** potential for cost savings with AI implementation is also discussed,including improving workflow efficiencies,reducing administrative costs,and improving healthcare *** these advantages,clinicians have been slow to adopt AI into clinical *** of the limitations posed by AI solutions include the lack of diverse data sets for model building so that they are widely applicable for routine clinical ***,the subsequent algorithms are often based on complex mathematics leading to clinician hesitancy to embrace such ***,we highlight the need for robust political and regulatory frameworks in this area to achieve the trust and approval of clinicians and patients to implement this transformational technology。

关键词： Artificial intelligence Data science Machine learning intensive care unit(ICU) Critical care Sepsis

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Extracorporeal membrane oxygenation versus cardiopulmonary bypass during transcatheter aortic valve implantation: a meta-analysis of survival benefits

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World Journal of Emergency Medicine 2024年第4期15卷 306-310页

作者： Huiruo Liu Liangshan Wang Xing Hao Zhongtao Du Chenglong Li Hong Wang Xiaotong Hou centre for Cardiac intensive care Beijing Institute of HeartLung and Blood Vessel DiseasesBeijing Anzhen HospitalCapital Medical UniversityBeijing 100029China

Since its approval by the Food and Drug Administration in 2011,transcatheter aortic valve implantation(TAVI)has rapidly evolved to become the preferred ultimate intervention for high-and intermediate-risk patients with severe symptomatic aortic stenosis.[1]This is due to its non-open-heart,minimally invasive and off-pump advantages.[1]Nevertheless,as a result of the frequent frailty and comorbidity profiles of patients undergoing TAVI,such as advanced cardiac dysfunction and extensive coronary artery disease,or technically difficult anatomy for the procedure itself,[2-4]it is common for these patients to experience critical circulatory collapse *** factors are linked to elevated mortality rates,necessitating suitable mechanical circulatory support(MCS)to reverse the disastrous situations.[5]

关键词： anatomy bypass elevated

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Current situation and prospect for the diagnosis and treatment of pediatric critical rare diseases in China

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Pediatric Investigation 2024年第1期8卷 66-71页

作者： Yingchao Liu Suyun Qian Pediatric intensive care Unit Beijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina

The onset of critical rare diseases(RDs)in children is rapid and dangerous,accompanied by a high mortality rate,which brings a heavy burden to both families and *** malformations,neuromuscular diseases,metabolic diseases,and heart diseases are the most common types of RDs in children of China,often manifesting with multiple organ *** present,the diagnosis and treatment of critical RDs in children face challenges such as prolonged diagnosis time,a high misdiagnosis rate,limited treatment modalities,and a significant disease ***,with the progress in genetic testing technology,the establishment of multidisciplinary diagnosis and treatment platforms,and the implementation of relevant RD policies in China,children with critical RDs will received enhanced medical services,experience improved prognoses,and reintegrate into social life.

关键词： Children Critical Current situation Prospect Rare diseases

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Prediction of mechanical ventilation outcome by early abdominal-visceral-blood-flow-and-function score in critically ill patients after cardiopulmonary bypass in the ICU: A prospective observational study

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Journal of intensive Medicine 2024年第1期4卷 101-107页

作者： Chaofu Yue Longxiang Su Jun Wang Na Cui Yuankai Zhou Wei Cheng Bo Tang Xi Rui Huaiwu He Yun Long Department of intensive care Unit Peking Union Medical College HospitalBeijingChina Department of intensive care Unit Qujing First People’s HospitalQujingYunnanChina Department of intensive care Unit Shiyan People’s Hospital of Bao’an DistrictShenzhenGuangdongChina

Background:Abdominal organs are important organs that sense and respond to ischemia and hypoxia,but there are few evaluation *** use ultrasonography to evaluate abdominal organ function and blood flow in patients with mechanical ventilation(MV)after cardiopulmonary bypass and to obtain a semiquantitative score for abdominal organ function and blood ***:Patients with cardiopulmonary bypass in the Critical care Department of Peking Union Medical College Hospital in China from March to July 2021 were enrolled in this prospective observational *** correlation of the abdominal-visceral-blood-flow-and-function score(AVBFS)with the duration of MV,number of days spent in the intensive care unit(ICU),acute physiology and chronic health evaluation II(APACHE-II),sequential organ failure assessment(SOFA),lactate,epinephrine,and norepinephrine use was analyzed,and the results were used to assess the predictive value of the receiver operating characteristic curve(ROC)regression analysis score for the duration of ***:Of the 92 patients who underwent cardiopulmonary bypass,41 were finally *** AVBFS were significantly correlated with the duration of MV,number of days spent in the ICU,APACHE-II score,SOFA score,and norepinephrine use *** AVBFS in a group of patients using ventilators≥36 h were significantly higher than those obtained for a group of patients using ventilators<36 h(P<0.05).The evaluation results for the AVBFS at 0-12 h after ICU admission were as follows:area under the ROC curve(AUC)=0.876(95%confidence interval[CI]:0.767 to 0.984),cut-off value=2.5,specificity=0.842,and sensitivity=***:Abdominal visceral organ function and blood perfusion can be used to evaluate gastrointestinal *** is related to early and late extubation after cardiac surgery.

关键词： Ultrasonic evaluation Abdominal-visceral-blood-flow-and-function score(AVBFS) Gastrointestinal dysfunction Mechanical ventilation Cardiopulmonary bypass

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Enhancing Diagnosis and Treatment Adjustments for Travelers Infected with Burkholderia pseudomallei:A Case Report-Beijing Municipality,China,June 2023

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China CDC weekly 2024年第25期6卷 614-616页

作者： Shijie Li Yushan He Yiyang Mao Jun Liu Wenmiao Xu Suyun Qian Quan Wang Pediatric intensive care Unit Beijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina Capital Medical University BeijingChina

Summary What is already known about this topic?Burkholderia pseudomallei(BP)infection leads to melioidosis,a tropical disease endemic to coastal provinces of southern *** in nonendemic areas,do not commonly consider this disease as a primary differential diagnosis for febrile *** is added by this report?This article discusses a case of melioidosis in Northern *** patient,who had recently visited a Southeast Asian region with high melioidosis prevalence,fell ill after exposure to contaminated *** disease progressed quickly and with *** are the implications for public health practice?Healthcare workers need to remain vigilant regarding travel-related diseases for accurate differential diagnosis and to provide timely and effective treatment,especially for patients with recent travel history or symptoms during travel.

关键词： diagnosis China. travel

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Early diagnosis and management of neonatal sepsis:a perspective

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World Journal of Pediatrics 2024年第4期20卷 303-306页

作者： Li‑Zhong Du Neonatal intensive care Unit Children’s Hospital Zhejiang University School of MedicineNational Clinical Research Center for Child Health3333 Binsheng RoadHangzhou 310052China

Neonatal sepsis is an illness caused by bloodstream bacteria or fungal infections that affect newborn infants under 28 days of *** stands as a significant contributor to morbidity and mortality in neonatal intensive care units(NICUs).With the improved survival rates of very low-birth-weight or extremely premature infants,a growing number of these vulnerable infants are receiving intensive care and undergoing invasive procedures,making nosocomial infections a persistent challenge in *** mortality rate associated with neonatal sepsis varies depending on factors such as birth weight,gestational age,and other *** can also lead to a range of long-term health consequences,including neurodevelopmental disabilities like cerebral palsy,visual or hearing impairments,and cognitive ***,neonatal sepsis is linked to various adverse outcomes,including respiratory complications,bronchopulmonary dysplasia,nutritional and growth issues,and immunological dysfunction[1].Due to its atypical clinical presentation and the low rate of specific diagnostic indicators,such as a positive blood culture,accurately diagnosing neonatal sepsis is ***,the appropriateness of antibiotic treatment is often a matter of controversy.

关键词： neonatal mortality diagnosis

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Lysinuric protein intolerance with novel mutations in solute carrier family 7A member 7 in a Chinese family

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Pediatric Investigation 2024年第2期8卷 149-153页

作者： Yilin Pang Feng Huo Xiao Liu Yimu Fan Zhezhe Zhang Jie Wu Quan Wang Emergency Department Emergency Intensive Care UnitBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina

Introduction:Lysinuric protein intolerance(LPI)is a rare genetic disorder caused by mutations in the solute carrier family 7A member 7(SLC7A7)*** presentation:We presented two siblings with LPI,carrying novel mutations of c.776delT(p.L259Rfs*18)and c.155G>T(p.G52V)in *** younger sibling,preferring protein-rich foods,showed severe symptoms,including alveolar proteinosis,macrophage activation syndrome,severe diarrhea,and disturbance of consciousness with involuntary *** contrast,the elder sibling only had mild symptoms,likely due to aversion to protein-rich food since toddler ***:LPI is a congenital genetic metabolic disease with multisystem *** appropriate protein-restricted diet therapy as soon as possible could help prevent the progression of LPI.

关键词： Diet Lysinuric protein intolerance Pulmonary alveolar proteinosis SLC7A7

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Advancing cell-based therapy in sepsis:An anesthesia outlook

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Chinese Medical Journal 2024年第13期137卷 1522-1534页

作者： Hui Ye Xiaoyu Zou Xiangming Fang Department of Anesthesiology and intensive care The First Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhouZhejiang 310003China The Children’s Hospital National Clinical Research Center for Child HealthSchool of MedicineZhejiang UniversityHangzhouZhejiang 312000China

Sepsis poses a health challenge globally owing to markedly high rates of morbidity and *** employing bundle therapy over two decades,approaches including transient organ supportive therapy and clinical trials focusing on signaling pathways have failed in effectively reversing multiple organ failure in patients with *** and appropriate perioperative management for surgical patients with concurrent sepsis is ***,innovative therapies focusing on remedying organ injuries are *** therapy has emerged as a promising therapeutic avenue for repairing local damage to vital organs and restoring homeostasis during perioperative treatment for *** the pivotal role of immune cell responses in the pathogenesis of sepsis,stem cell-based interventions that primarily modulate immune responses by interacting with multiple immune cells have progressed into clinical *** strides made in single-cell sequencing and gene-editing technologies have advanced the understanding of disease-specific immune responses in *** antigen receptor(CAR)-immune cell therapy offers an intriguing option for the treatment of *** review provides a concise overview of immune cell therapy,its current status,and the strides made in the context of sepsis research,discussing potential strategies for the management of patients with sepsis during perioperative stages.

关键词： Sepsis Perioperative Receptors,chimeric antigen Immunotherapy,adoptive Perfusion Tissue repair Multiple organ failure Shock,septic

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Role of mitochondrial dysfunction in kidney disease:Insights from the cGAS-STING signaling pathway

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Chinese Medical Journal 2024年第9期137卷 1044-1053页

作者： Lu Li Fei Liu Chunyue Feng Zhenjie Chen Nan Zhang Jianhua Mao Department of Nephrology Children’s HospitalZhejiang University School of MedicineNational Clinical Research Center for Child HealthHangzhouZhejiang 310052China Department of Pediatric intensive care Unit Children’s HospitalZhejiang University School of MedicineNational Clinical Research Center for Child HealthHangzhouZhejiang 310052China

Over the past decade,mitochondrial dysfunction has been investigated as a key contributor to acute and chronic kidney ***,the precise molecular mechanisms linking mitochondrial damage to kidney disease remain *** recent insights into the cyclic guanosine monophosphate-adenosine monophosphate(GMP-AMP)synthetase(cGAS)-stimulator of interferon gene(STING)signaling pathway have revealed its involvement in many renal *** of these findings is that mitochondrial DNA(mtDNA)induces inflammatory responses via the cGAS-STING ***,we provide an overview of the mechanisms underlying mtDNA release following mitochondrial damage,focusing specifically on the association between mtDNA release-activated cGAS-STING signaling and the development of kidney ***,we summarize the latest findings of cGAS-STING signaling pathway in cell,with a particular emphasis on its downstream signaling related to kidney *** review intends to enhance our understanding of the intricate relationship among the cGAS-STING pathway,kidney diseases,and mitochondrial dysfunction.

关键词： Mitochondrial dysfunction Mitochondrial DNA cGAS-STING pathway Kidney diseases Chronic kidney disease

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intensive care unit-acquired weakness: Recent insights

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Journal of intensive Medicine 2024年第1期4卷 73-80页

作者： Juan Chen Man Huang Department of General intensive care Unit The Second Affiliated Hospital of Zhejiang University School of MedicineHangzhou 310009ZhejiangChina

intensive care unit-acquired weakness(ICU-AW)is a common complication in critically ill patients and is associated with a variety of adverse *** include the need for prolonged mechanical ventilation and ICU stay;higher ICU,in-hospital,and 1-year mortality;and increased in-hospital ***-AW is associated with multiple risk factors including age,underlying disease,severity of illness,organ failure,sepsis,immobilization,receipt of mechanical ventilation,and other factors related to critical *** pathological mechanism of ICUAW remains unclear and may be considerably *** review aimed to evaluate recent insights into ICU-AW from several aspects including risk factors,pathophysiology,diagnosis,and treatment strategies;this provides new perspectives for future research.

关键词： intensive care unit-acquired weakness Muscle weakness Muscle atrophy Risk factor Mechanism Treatment

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