As high-voltage direct current(HVDC)lines with large capacity are being commissioned with higher frequency,the characteristics of“strong”DC and“weak”AC transmission in the power grid are topics of interest.In part...As high-voltage direct current(HVDC)lines with large capacity are being commissioned with higher frequency,the characteristics of“strong”DC and“weak”AC transmission in the power grid are topics of interest.In particular,the coupling and interaction between the sending-side and receivingside AC systems interconnected by large-scale DC links is gaining importance.In this paper,the impact of the multiple HVDC commutation failure on the stability of the sending system under different power flow directions is analyzed based on the threearea AC/DC equivalent model.The main influencing factors and the counter-measures are discussed,and the single HVDC line blocking is taken as a comparison.Finally,the results are verified using the North China-Central China-East China power grid case system.The study provides a basis and reference to ensure security and stability of the ultra-high-voltage(UHV)AC/DC hybrid power grid.展开更多
The kidneys have a close functional relationship with other organs especially the lungs. This connection makes the kidney and the lungs as the most organs involved in the multi-organ failure syndrome. The combination ...The kidneys have a close functional relationship with other organs especially the lungs. This connection makes the kidney and the lungs as the most organs involved in the multi-organ failure syndrome. The combination of acute lung injury （ALl） and renal failure results a great clinical significance of 80% mortality rate. Acute kidney injury （AKI） leads to an increase in circulating cytokines, chemokines, activated innate immune cells and diffuse of these agents to other organs such as the lungs. These factors initiate pathological cascade that ultimately leads to ALl and acute respiratory distress syndrome （ARDS）. We comprehensively searched the English medical literature focusing on AKI, ALl, organs cross talk, renal failure, multi organ failure and ARDS using the databases of PubMed, Embase, Scopus and directory of open access journals. In this narrative review, we summarized the pathophysiology and treatment of respiratory distress syndrome following AKI. This review promotes knowledge of the link between kidney and lung with mechanisms, diagnostic biomarkers, and treatment involved ARDS induced by AKI.展开更多
To review the challenges and countermeasures in the hospital care for Wenchuan earthquake casualties and draw lessons for the protective response in the future. Medical records and laboratory findings of the victims a...To review the challenges and countermeasures in the hospital care for Wenchuan earthquake casualties and draw lessons for the protective response in the future. Medical records and laboratory findings of the victims admitted in West China Hospital （WCH） were retro- spectively analyzed. Related data were compared between beforemath and aftermath of the earthquake and between WCH and frontier county hospitals. One thousand and thirty-one earthquake survivors were hospitalized, 1 358 victims underwent surgery and 142 victims were transferred to intensive care unit. The incidence of infection, crush syndrome and multiple organ dysfunction syndrome （MODS） was 39.6%, 20,7% and 2.3% respectively. Wound classification showed that the incidence of extremity damage was 72%, while the incidence of chest trauma, abdominal trauma and brain trauma was less than 10% respectively. Isolating rates of environmental pathogens were increased in the aftermath of earthquake, and the spectrum of the pathogens and related antibiotic sensitivities were quite different from those in the beforemath of earthquake. The social economic and population conditions in the earthquake-stricken areas affected the composition of the victims and the geographic features restricted the efficiency of rescue. Trauma-induced MODS, crush syndrome and severe infections all constituted the dilemma for the hospital care, to resolve whether the multidiscipline team work was proved to be an optimizing choice. For a more effective disaster protective response in the future, the study on rescue plan and the ladder therapies for massive casualties should be potentiated.展开更多
Abdominal compartment syndrome(ACS)develops when organ failure arises secondary to an increase in intraabdominal pressure.The abdominal pressure is determined by multiple factors such as blood pressure,abdominal compl...Abdominal compartment syndrome(ACS)develops when organ failure arises secondary to an increase in intraabdominal pressure.The abdominal pressure is determined by multiple factors such as blood pressure,abdominal compliance,and other factors that exert a constant pressure within the abdominal cavity.Several conditions in the critically ill may increase abdominal pressure compromising organ perfusion that may lead to renal and respiratory dysfunction.Among surgical and trauma patients,aggressive fluid resuscitation is the most commonly reported risk factor to develop ACS.Other conditions that have also been identified as risk factors are ascites,hemoperitoneum,bowel distention,and large tumors.All patients with abdominal trauma possess a higher risk of developing intra-abdominal hypertension(IAH).Certain surgical interventions are reported to have a higher risk to develop IAH such as damage control surgery,abdominal aortic aneurysm repair,and liver transplantation among others.Close monitoring of organ function and intra-abdominal pressure(IAP)allows clinicians to diagnose ACS rapidly and intervene with target-specific management to reduce IAP.Surgical decompression followed by temporary abdominal closure should be considered in all patients with signs of organ dysfunction.There is still a great need for more studies to determine the adequate timing for interventions to improve patient outcomes.展开更多
INTRODUCTIONAcute narcotizing pancreatitis usually takes a severe clinical course and is associated with multiple organ dysfunction .With the further understanding of pathophysiological events of acute pancreatisis an...INTRODUCTIONAcute narcotizing pancreatitis usually takes a severe clinical course and is associated with multiple organ dysfunction .With the further understanding of pathophysiological events of acute pancreatisis and the therapeutic measuses taken by the clinicians ,the patients can pass through the critical carry stages ,and then the septic complication caused by rtanslocated bacteria, mostly gram-negative microbes from the intestines ensues[1].展开更多
Elevated intra-abdominal pressure(IAP)is a known cause of increased morbidity and mortality among critically ill patients.Intra-abdominal hypertension(IAH)and abdominal compartment syndrome can lead to rapid deteriora...Elevated intra-abdominal pressure(IAP)is a known cause of increased morbidity and mortality among critically ill patients.Intra-abdominal hypertension(IAH)and abdominal compartment syndrome can lead to rapid deterioration of organ function and the development of multiple organ failure.Raised IAP affects every system and main organ in the human body.Even marginally sustained IAH results in malperfusion and may disrupt the process of recovery.Yet,despite being so common,this potentially lethal condition often goes unnoticed.In 2004,the World Society of the Abdominal Compartment Syndrome,an international multidisciplinary consensus group,was formed to provide unified definitions,improve understanding and promote research in this field.Simple,reliable and nearly costless standardized methods of non-invasive measurement and monitoring of bladder pressure allow early recognition of IAH and timely optimized management.The correct,structured approach to treatment can have a striking effect and fully restore homeostasis.In recent years,significant progress has been made in this area with the contribution of surgeons,internal medicine specialists and anesthesiologists.Our review focuses on recent advances in order to present the complex underlying pathophysiology and guidelines concerning diagnosis,monitoring and treatment of this life-threatening condition.展开更多
BACKGROUND Multiple acyl-CoA dehydrogenase deficiency(MADD)is a disease of rare autosomal recessive disorder.There are three types of MADD.Type I is a neonatalonset form with congenital anomalies.Type II is a neonatal...BACKGROUND Multiple acyl-CoA dehydrogenase deficiency(MADD)is a disease of rare autosomal recessive disorder.There are three types of MADD.Type I is a neonatalonset form with congenital anomalies.Type II is a neonatal-onset form without congenital anomalies.Type III is considered to a milder form and usually responds to riboflavin.However,late-onset form could also be fatal and not responsive to treatments.CASE SUMMARY We report a severe case of a young man with onset type III MADD induced by drugs and strenuous exercise characterized by rhabdomyolysis and liver dysfunction.Urine analysis indicated 12 out of 70 kinds of organic acids like glutaric acid-2 were detected.Serum analysis in genetic metabolic diseases revealed 24 out of 43 tested items were abnormal,revealing the elevation of several acylcarnitines and the reduction of carnitine in the patient.By next generation sequencing technology for gene sequencing related to fatty acid oxidation and carnitine cycle defects,a rare ETFDH gene variant was identified:NM_004453:4:C.1448C>T(p.Pro483 Leu).The patient was diagnosed with lateonset GAII.He was not responsive to riboflavin and progressively worsened into multiple organ failure that finally led to death.CONCLUSION Type III MADD can also be fatal and not responsive to treatments.展开更多
Sepsis poses a health challenge globally owing to markedly high rates of morbidity and mortality.Despite employing bundle therapy over two decades,approaches including transient organ supportive therapy and clinical t...Sepsis poses a health challenge globally owing to markedly high rates of morbidity and mortality.Despite 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 sepsis.Prompt and appropriate perioperative management for surgical patients with concurrent sepsis is urgent.Consequently,innovative therapies focusing on remedying organ injuries are necessitated.Cell therapy has emerged as a promising therapeutic avenue for repairing local damage to vital organs and restoring homeostasis during perioperative treatment for sepsis.Given 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 trials.The strides made in single-cell sequencing and gene-editing technologies have advanced the understanding of disease-specific immune responses in sepsis.Chimeric antigen receptor(CAR)-immune cell therapy offers an intriguing option for the treatment of sepsis.This 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.展开更多
基金This work was supported by Technology Projects of State Grid Corporation of China(No.XT71-15-050).
文摘As high-voltage direct current(HVDC)lines with large capacity are being commissioned with higher frequency,the characteristics of“strong”DC and“weak”AC transmission in the power grid are topics of interest.In particular,the coupling and interaction between the sending-side and receivingside AC systems interconnected by large-scale DC links is gaining importance.In this paper,the impact of the multiple HVDC commutation failure on the stability of the sending system under different power flow directions is analyzed based on the threearea AC/DC equivalent model.The main influencing factors and the counter-measures are discussed,and the single HVDC line blocking is taken as a comparison.Finally,the results are verified using the North China-Central China-East China power grid case system.The study provides a basis and reference to ensure security and stability of the ultra-high-voltage(UHV)AC/DC hybrid power grid.
文摘The kidneys have a close functional relationship with other organs especially the lungs. This connection makes the kidney and the lungs as the most organs involved in the multi-organ failure syndrome. The combination of acute lung injury （ALl） and renal failure results a great clinical significance of 80% mortality rate. Acute kidney injury （AKI） leads to an increase in circulating cytokines, chemokines, activated innate immune cells and diffuse of these agents to other organs such as the lungs. These factors initiate pathological cascade that ultimately leads to ALl and acute respiratory distress syndrome （ARDS）. We comprehensively searched the English medical literature focusing on AKI, ALl, organs cross talk, renal failure, multi organ failure and ARDS using the databases of PubMed, Embase, Scopus and directory of open access journals. In this narrative review, we summarized the pathophysiology and treatment of respiratory distress syndrome following AKI. This review promotes knowledge of the link between kidney and lung with mechanisms, diagnostic biomarkers, and treatment involved ARDS induced by AKI.
文摘To review the challenges and countermeasures in the hospital care for Wenchuan earthquake casualties and draw lessons for the protective response in the future. Medical records and laboratory findings of the victims admitted in West China Hospital （WCH） were retro- spectively analyzed. Related data were compared between beforemath and aftermath of the earthquake and between WCH and frontier county hospitals. One thousand and thirty-one earthquake survivors were hospitalized, 1 358 victims underwent surgery and 142 victims were transferred to intensive care unit. The incidence of infection, crush syndrome and multiple organ dysfunction syndrome （MODS） was 39.6%, 20,7% and 2.3% respectively. Wound classification showed that the incidence of extremity damage was 72%, while the incidence of chest trauma, abdominal trauma and brain trauma was less than 10% respectively. Isolating rates of environmental pathogens were increased in the aftermath of earthquake, and the spectrum of the pathogens and related antibiotic sensitivities were quite different from those in the beforemath of earthquake. The social economic and population conditions in the earthquake-stricken areas affected the composition of the victims and the geographic features restricted the efficiency of rescue. Trauma-induced MODS, crush syndrome and severe infections all constituted the dilemma for the hospital care, to resolve whether the multidiscipline team work was proved to be an optimizing choice. For a more effective disaster protective response in the future, the study on rescue plan and the ladder therapies for massive casualties should be potentiated.
文摘Abdominal compartment syndrome(ACS)develops when organ failure arises secondary to an increase in intraabdominal pressure.The abdominal pressure is determined by multiple factors such as blood pressure,abdominal compliance,and other factors that exert a constant pressure within the abdominal cavity.Several conditions in the critically ill may increase abdominal pressure compromising organ perfusion that may lead to renal and respiratory dysfunction.Among surgical and trauma patients,aggressive fluid resuscitation is the most commonly reported risk factor to develop ACS.Other conditions that have also been identified as risk factors are ascites,hemoperitoneum,bowel distention,and large tumors.All patients with abdominal trauma possess a higher risk of developing intra-abdominal hypertension(IAH).Certain surgical interventions are reported to have a higher risk to develop IAH such as damage control surgery,abdominal aortic aneurysm repair,and liver transplantation among others.Close monitoring of organ function and intra-abdominal pressure(IAP)allows clinicians to diagnose ACS rapidly and intervene with target-specific management to reduce IAP.Surgical decompression followed by temporary abdominal closure should be considered in all patients with signs of organ dysfunction.There is still a great need for more studies to determine the adequate timing for interventions to improve patient outcomes.
文摘INTRODUCTIONAcute narcotizing pancreatitis usually takes a severe clinical course and is associated with multiple organ dysfunction .With the further understanding of pathophysiological events of acute pancreatisis and the therapeutic measuses taken by the clinicians ,the patients can pass through the critical carry stages ,and then the septic complication caused by rtanslocated bacteria, mostly gram-negative microbes from the intestines ensues[1].
文摘Elevated intra-abdominal pressure(IAP)is a known cause of increased morbidity and mortality among critically ill patients.Intra-abdominal hypertension(IAH)and abdominal compartment syndrome can lead to rapid deterioration of organ function and the development of multiple organ failure.Raised IAP affects every system and main organ in the human body.Even marginally sustained IAH results in malperfusion and may disrupt the process of recovery.Yet,despite being so common,this potentially lethal condition often goes unnoticed.In 2004,the World Society of the Abdominal Compartment Syndrome,an international multidisciplinary consensus group,was formed to provide unified definitions,improve understanding and promote research in this field.Simple,reliable and nearly costless standardized methods of non-invasive measurement and monitoring of bladder pressure allow early recognition of IAH and timely optimized management.The correct,structured approach to treatment can have a striking effect and fully restore homeostasis.In recent years,significant progress has been made in this area with the contribution of surgeons,internal medicine specialists and anesthesiologists.Our review focuses on recent advances in order to present the complex underlying pathophysiology and guidelines concerning diagnosis,monitoring and treatment of this life-threatening condition.
文摘BACKGROUND Multiple acyl-CoA dehydrogenase deficiency(MADD)is a disease of rare autosomal recessive disorder.There are three types of MADD.Type I is a neonatalonset form with congenital anomalies.Type II is a neonatal-onset form without congenital anomalies.Type III is considered to a milder form and usually responds to riboflavin.However,late-onset form could also be fatal and not responsive to treatments.CASE SUMMARY We report a severe case of a young man with onset type III MADD induced by drugs and strenuous exercise characterized by rhabdomyolysis and liver dysfunction.Urine analysis indicated 12 out of 70 kinds of organic acids like glutaric acid-2 were detected.Serum analysis in genetic metabolic diseases revealed 24 out of 43 tested items were abnormal,revealing the elevation of several acylcarnitines and the reduction of carnitine in the patient.By next generation sequencing technology for gene sequencing related to fatty acid oxidation and carnitine cycle defects,a rare ETFDH gene variant was identified:NM_004453:4:C.1448C>T(p.Pro483 Leu).The patient was diagnosed with lateonset GAII.He was not responsive to riboflavin and progressively worsened into multiple organ failure that finally led to death.CONCLUSION Type III MADD can also be fatal and not responsive to treatments.
基金National Natural Science Foundation of China(No.82230074)
文摘Sepsis poses a health challenge globally owing to markedly high rates of morbidity and mortality.Despite 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 sepsis.Prompt and appropriate perioperative management for surgical patients with concurrent sepsis is urgent.Consequently,innovative therapies focusing on remedying organ injuries are necessitated.Cell therapy has emerged as a promising therapeutic avenue for repairing local damage to vital organs and restoring homeostasis during perioperative treatment for sepsis.Given 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 trials.The strides made in single-cell sequencing and gene-editing technologies have advanced the understanding of disease-specific immune responses in sepsis.Chimeric antigen receptor(CAR)-immune cell therapy offers an intriguing option for the treatment of sepsis.This 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.
