我们要感谢所有在新生儿监护病房工作的同事。

本议定书经上海交通大学医学院济医院机构审查委员会批准. 
 1. 病人的准备 注意: ICP 传感器由手术操作 ( 图 1 ) 放置在患者中。该传感器被放置在硬膜外间隙, 硬膜下间隙, 薄壁, 或心室系统. 
<ol> <li> 通过特定的通信电缆将 ICP 监视设备与床边显示器连接. </li>
	<li> 调整病人和 #39 的床边监控器的参考, 使床边监测器的数据与 ICP 监测机相符. </li>
	<li> 在患者和 #39 的左侧或右侧桡动脉上执行动脉行位置 20 . </li>
	<li> 将动脉线与感受连接. </li>
	<li> 通过通信电缆将压力传感器与患者和 #39 的床头显示器连接起来. </li>
	<li> 零调整床边显示器, 使测量血压与实际值重合. </li>
</ol> 2。生理参数的记录 <ol> <li> 通过网线将患者和 #39 的床边显示器与数据收集和存储设备连接起来. </li>
	<li> 按电源按钮打开数据收集设备. </li>
	<li> 等待几秒钟, 直到多模态监控软件自动运行. </li>
	<li> 输入患者的信息, 包括名称、ID、诊断和初始格拉斯哥昏迷量表 (GCS). </li>
	<li> 单击 #34; 保存并启动监视和 #34; 按钮以启动数据收集和存储. </li>
	<li> 单击 #34; 在数据获取结束时在屏幕上关闭和 #34; 按钮 ( 图 2 ). </li>
	<li> 输入最终的 gc. </li>
</ol> 3。参数分析 <ol> <li> 通过主机上的通用串行总线 (USB) 接口将存储的数据转储到 U 磁盘. </li>
	<li> 输入用户名和密码以登录到分析服务器. </li>
	<li> 单击并 #34; 创建新的记录和 #34; 按钮, 然后在 u盘中选择数据文件以开始上载. </li>
	<li> 在分析数据之前等待大约10到20分钟 (取决于数据大小). </li>
	<li> 单击 #34;D etail 和 #34; 每个记录的按钮以查看结果. </li>
	<li> 单击 #34; 图表查看和 #34; 查看最终的图表. </li>
	<li> 拖动时间线以查看更多详细信息. </li>
	<li> 单击 #34; scattergram 和 #34; 按钮可查看参数的分布. </li>
</ol>

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没有收到任何财政支助。

本文的目的是介绍一种新型的神经外科危重患者综合监测分析系统, 用于监测生理参数, 分析当前临床状况, 希望预测预后神经外科危重患者。目前, icp 监测的重点主要是平均 icp 值, 而忽略其他参数, 这可能会带来不准确或延迟的风险4,5,21。另一方面, icp 波形、放大器、RAP、PRx 和审咨委等衍生参数在预测预后和指导正确治疗方面有重要意义5,16,17, 18,19。然而, 所有这些参数都需要多模态监测和大数据的采集和分析, 这会占用大量的时间和精力。此外, 目前在临床工作中, 很少有专门的设备适合医生。
为了解决这个问题, 我们最近开发了一个多模监控系统。在将数据发送到在线服务器进行分析工作之前, 利用自动数据收集和存储设备对患者的生理信息进行连续采集, 以研究这些参数的含义。如前所述, 多模态监测系统具有以下优点。首先, 它可以以高频的频率收集 real-time 的数据。数据采集频率可达120赫兹. 其次, 它可以记录多个参数,即、ICP 波形、PRx、RAP 和审咨委。所有这些都是分析当前临床状况和预测预后的关键。此外, 还可实现长期连续监测。它可以记录所有的细节在病人的治疗。最后但并非最不重要的是, 它是便携的, 易于学习。临床医生可以轻松地将数据上传到特定的分析服务器, 这将自动执行计算和图形构造。协议中只有两个关键步骤。一是 ICP 传感器的位置。另一种是动脉线放置和动脉血压监测。在正确的连接和操作后, 多模态监控系统可以自动采集和存储 real-time 数据, 并对其进行分析和绘图, 适合临床医生。
然而, 它也有一些限制。该系统仅包括 ICP 和侵袭性血压, 缺乏心电图、脑电图、TCD 等其它参数。另一个缺陷是自动分析模式不丰富, 只能进行一定的计算和图形构造。
我们一直在不断地修改这个系统, 并修复了在长期使用中出现的几个问题。我们相信, 所有的限制将在未来得到解决, 它将更加适用。
希望将多学科监护系统作为监测生理参数的关键措施, 分析当前临床现状, 预测神经外科危重患者的预后。

ICP 监测被广泛用于评价神经外科的颅内状态, 尤其是神经外科危重患者1,2,3。除了平均 icp 值外, icp 波形、放大器、RAP、PRx、审咨委等等参数均可反映脑循环状态、脑脊液代偿性储备和大脑顺应4、5、6,7,8,9,10,11,12,13. 他们可以预示着即将到来的神经恶化, 甚至病人的结果14,15,16,17,18。它们也可以作为正确处理19的指导。然而, 大多数临床医生只关注的平均 ICP 值, 而忽略这些参数。这部分是因为在日常临床工作中, 很少有适合临床医生使用的特定设备。
为了解决这些弊端, 我们最近开发了一个多模监控系统。我们使用自动数据收集和存储设备, 以不断获取病人的生理信息, 如血压, ICP, 和氧饱和度, 并分析这些生理参数, 以揭示目前的临床状况,希望能预测神经外科危重患者的预后。该多模态监测系统具有以下几个优点: (1) 能在高频采集 real-time 数据, (2) 可记录多个参数,即、ICP 波形、PRx、RAP 和审咨委, (3) 可实现长期连续监测, (4)它是便携的, 易于学习。
因此, 本文的目的是显示一个详细的方法如何使用多学科监测系统记录各种生理参数的神经外科危重患者。

<table style="border-collapse:collapse;width:639pt" width="852">
	<colgroup>
		<col style="width:136pt" width="181" />
		<col style="width:171pt" width="228" />
		<col style="width:134pt" width="179" />
		<col style="width:198pt" width="264" />
	</colgroup>
	<tbody>
		<tr height="21" style="height:15.75pt">
			<td height="21" style="width:136pt;height:15.75pt" width="181">Bedside monitor</td>
			<td style="width:171pt" width="228">Philips</td>
			<td style="width:134pt" width="179">IntelliVue MP40 M8003A</td>
			<td style="width:198pt" width="264">With interfacing module</td>
		</tr>
		<tr height="21" style="height:15.75pt">
			<td height="21" style="height:15.75pt">ICP monitoring machine</td>
			<td>&#160;Johnson &#38; Johnson or Sophysa</td>
			<td></td>
			<td></td>
		</tr>
		<tr height="21" style="height:15.75pt">
			<td height="21" style="height:15.75pt">Arterial cannula</td>
			<td>BD</td>
			<td>REF682245</td>
			<td></td>
		</tr>
		<tr height="21" style="height:15.75pt">
			<td height="21" style="height:15.75pt">Pressure transducer</td>
			<td>Haisheng Medical</td>
			<td>DBPT-0103</td>
			<td></td>
		</tr>
		<tr height="21" style="height:15.75pt">
			<td height="21" style="height:15.75pt">Data collection device</td>
			<td>Shanghai Haoju</td>
			<td>Neumatic</td>
			<td></td>
		</tr>
		<tr height="21" style="height:15.75pt">
			<td height="21" style="height:15.75pt">Computer</td>
			<td></td>
			<td></td>
			<td>Requires Windows operating system</td>
		</tr>
	</tbody>
</table>

a detailed protocol for physiological parameters acquisition and analysis in neurosurgical critical patients

颅内压力 (ICP) 监测是目前广泛应用于神经外科危重患者。除了平均 icp 值外, icp 波形、脉冲振幅、icp 振幅与 icp 平均值 (RAP)、压力反应性指数 (PRx)、icp 和动脉血压 (基地) 波幅相关 (审咨委) 等相关参数上, 可以反映颅内状态, 预测预后, 也可作为正确治疗的指导。然而, 大多数临床医生只关注的平均 ICP 值, 而忽略这些参数, 因为目前的设备的局限性。我们最近开发了一个综合的监控系统来解决这些弊端。这种便携式的 user-friendly 系统将使用数据采集和存储装置, 以持续地获取患者的生理参数,即: 即、基地、ICP 和氧饱和度, 然后分析这些生理参数。希望将多学科监护系统作为监测生理参数的关键措施, 分析当前临床状况, 预测神经外科危重患者的预后。

这一新的多学科监测系统应用于22神经外科危重患者 (15 男性)。其中12人 (54.55%) 患有外伤性脑损伤, 其中 9 (40.91%) 有颅内出血, 1 (4.55%) 有严重脑梗塞。总监测时间超过1900小时 (约88小时每名患者)。手术成功后, 我们不断监测和分析他们的 ICP、BP、CPP、PRx、说唱和审咨委。图 3显示了来自该监视系统的代表性数据。我们可以调整时间线以查看更详细的信息 (图 4)。此外, 我们还可以分析任何两个参数之间的关系, 这在图 5中演示。
<img alt="Figure 1" class="xfigimg" src="/files/ftp_upload/56388/56388fig1.jpg"> 
图 1: ICP 传感器位置.患者在监测前进行 ICP 传感器放置手术。该传感器可放置在硬膜外间隙、硬膜下间隙、软组织或心室系统。这个数字显示心室穿刺和传感器放置。ICP 传感器位于导管尖端。<a href="//ecsource-jove-com.remotexs.ntu.edu.sg/files/ftp_upload/56388/56388fig1large.jpg" target="_blank">请单击此处查看此图的较大版本.</a>
<img alt="Figure 2" class="xfigimg" src="/files/ftp_upload/56388/56388fig2.jpg"> 
图 2: 监视系统的屏幕.左上区域显示当前 ICP 波形和血压。左下区域显示当前 RAP、PRx、审咨委、CPP 和 AMP。屏幕的右部分显示历史记录。底部显示的是一些功能按钮, 如输出、屏幕截图和添加标记。<a href="//ecsource-jove-com.remotexs.ntu.edu.sg/files/ftp_upload/56388/56388fig2large.jpg" target="_blank">请单击此处查看此图的较大版本.</a>
<img alt="Figure 3" class="xfigimg" src="/files/ftp_upload/56388/56388fig3.jpg"> 
图 3: 脑出血患者的代表性数据.对 ICP、BP、CPP、PRx、RAP、审咨委等参数进行了记录和绘制。X 轴是时间轴, Y 轴是单独的参数。<a href="//ecsource-jove-com.remotexs.ntu.edu.sg/files/ftp_upload/56388/56388fig3large.jpg" target="_blank">请单击此处查看此图的较大版本.</a>
<img alt="Figure 4" class="xfigimg" src="/files/ftp_upload/56388/56388fig4.jpg"> 
图 4: 代表性数据的详细信息.当我们调整时间线时, 我们可以看到更多的细节。X 轴是时间轴, Y 轴是单独的参数。<a href="//ecsource-jove-com.remotexs.ntu.edu.sg/files/ftp_upload/56388/56388fig4large.jpg" target="_blank">请单击此处查看此图的较大版本.</a>
<img alt="Figure 5" class="xfigimg" src="/files/ftp_upload/56388/56388fig5.jpg"> 
图 5: ICP 与 PRx 的关系我们可以更改 X 轴和 Y 轴上的参数, 以分析任意两个参数之间的关系。在这个图中, X 轴是 ICP, Y 轴是 PRx。每个红点代表一个 real-time 记录。我们可以看到, 在这个病人, 他的 PRx 有一个从-0.7 到1的变化和最低的 PRx 是达到时, 他的 ICP 是10柱。<a href="//ecsource-jove-com.remotexs.ntu.edu.sg/files/ftp_upload/56388/56388fig5large.jpg" style="font-size: 14px;" target="_blank">请单击此处查看此图的较大版本.</a>

Watch this Scientific Journal Video about A Detailed Protocol for Physiological Parameters Acquisition and Analysis in Neurosurgical Critical Patients at JoVE.com

A Detailed Protocol for Physiological Parameters Acquisition and Analysis in Neurosurgical Critical Patients

最近, 我们开发了一个便携式多学科监测系统, 监测各种生理参数的神经外科危重患者。介绍了如何使用这种多模态监控系统的详细协议。

神经外科危重患者生理参数采集与分析的详细方案

Intracranial pressure (ICP) monitoring is now widely used in neurosurgical critical patients. Besides mean ICP value, the ICP derived parameters such as ...

a-detailed-protocol-for-physiological-parameters-acquisition-analysis

Nanyang Technological University

Research

JoVE Journal

Medicine

6.8K 次观看.  Shanghai Jiaotong University School of Medicine. 最近, 我们开发了一个便携式多学科监测系统, 监测各种生理参数的神经外科危重患者。介绍了如何使用这种多模态监控系统的详细协议。

视频: A Detailed Protocol for Physiological Parameters Acquisition and Analysis in Neurosurgical Critical Patients

Intra-Operative Behavioral Tasks in Awake Humans Undergoing Deep Brain Stimulation Surgery

Deep brain stimulation (DBS) is a surgical procedure that directs chronic, high frequency electrical stimulation to specific targets in the brain through implanted electrodes. Deep brain stimulation was first implemented as a therapeutic modality by Benabid et al. in the late 1980s, when he used this technique to stimulate the ventral intermediate nucleus of the thalamus for the treatment of tremor 1. Currently, the procedure is used to treat patients who fail to respond adequately to medical management for diseases such as Parkinson's, dystonia, and essential tremor. The efficacy of this procedure for the treatment of Parkinson's disease has been demonstrated in well-powered, randomized controlled trials 2. Presently, the U.S. Food and Drug Administration has approved DBS as a treatment for patients with medically refractory essential tremor, Parkinson's disease, and dystonia. Additionally, DBS is currently being evaluated for the treatment of other psychiatric and neurological disorders, such as obsessive compulsive disorder, major depressive disorder, and epilepsy. 
DBS has not only been shown to help people by improving their quality of life, it also provides researchers with the unique opportunity to study and understand the human brain. Microelectrode recordings are routinely performed during DBS surgery in order to enhance the precision of anatomical targeting. Firing patterns of individual neurons can therefore be recorded while the subject performs a behavioral task. Early studies using these data focused on descriptive aspects, including firing and burst rates, and frequency modulation 3. More recent studies have focused on cognitive aspects of behavior in relation to neuronal activity 4,5. This article will provide a description of the intra-operative methods used to perform behavioral tasks and record neuronal data with awake patients during DBS cases. Our exposition of the process of acquiring electrophysiological data will illuminate the current scope and limitations of intra-operative human experiments.

Deep brain stimulation surgery offers a unique opportunity to examine information encoding in the awake human brain. This article will describe intra-operative methods used to perform cognitive and behavioral tasks while simultaneously acquiring physiological data such as EMG, single-unit neuronal activity and/or local field potentials.

在接受深部脑刺激手术术中唤醒人类行为任务

Deep brain stimulation (DBS) is a surgical procedure that directs chronic, high frequency electrical stimulation to specific targets in the brain through ...

科研

医学

Manual Muscle Testing:  A Method of Measuring Extremity Muscle Strength Applied to Critically Ill Patients

Survivors of acute respiratory distress syndrome (ARDS) and other causes of critical illness often have generalized weakness, reduced exercise tolerance, and persistent nerve and muscle impairments after hospital discharge.1-6 Using an explicit protocol with a structured approach to training and quality assurance of research staff, manual muscle testing (MMT) is a highly reliable method for assessing strength, using a standardized clinical examination, for patients following ARDS, and can be completed with mechanically ventilated patients who can tolerate sitting upright in bed and are able to follow two-step commands. 7, 8 
This video demonstrates a protocol for MMT, which has been taught to &ge;43 research staff who have performed &gt;800 assessments on &gt;280 ARDS survivors. Modifications for the bedridden patient are included. Each muscle is tested with specific techniques for positioning, stabilization, resistance, and palpation for each score of the 6-point ordinal Medical Research Council scale.7,9-11 Three upper and three lower extremity muscles are graded in this protocol: shoulder abduction, elbow flexion, wrist extension, hip flexion, knee extension, and ankle dorsiflexion. These muscles were chosen based on the standard approach for evaluating patients for ICU-acquired weakness used in prior publications. 1,2.

Survivors of acute respiratory distress syndrome (ARDS) and critical illness frequently develop long-lasting muscle weakness. Manual muscle testing (MMT) is a standardized clinical examination commonly used to measure strength of peripheral skeletal muscle groups. This video demonstrates MMT using the 6-point Medical Research Council scale.

危重病人中的应用手册肌力测试:下肢肌力测量方法

Survivors of acute respiratory distress syndrome (ARDS) and other causes of critical illness often have generalized weakness, reduced exercise tolerance, ...

Parabiosis in Mice: A Detailed Protocol

Parabiosis is a surgical union of two organisms allowing sharing of the blood circulation. Attaching the skin of two animals promotes formation of microvasculature at the site of inflammation. Parabiotic partners share their circulating antigens and thus are free of adverse immune reaction. First described by Paul Bert in 18641, the parabiosis surgery was refined by Bunster and Meyer in 1933 to improve animal survival2. In the current protocol, two mice are surgically joined following a modification of the Bunster and Meyer technique. Animals are connected through the elbow and knee joints followed by attachment of the skin allowing firm support that prevents strain on the sutured skin. Herein, we describe in detail the parabiotic joining of a ubiquitous GFP expressing mouse to a wild type (WT) mouse. Two weeks after the procedure, the pair is separated and GFP positive cells can be detected by flow cytometric analysis in the blood circulation of the WT mouse. The blood chimerism allows one to examine the contribution of the circulating cells from one animal in the other.

Parabiotic joining of two organisms leads to the development of a shared circulatory system. In this protocol, we describe the surgical steps to form a parabiotic connection between a wild-type mouse and a constitutive GFP-expressing mouse.

联体小鼠:一个详细的协议

Parabiosis is a surgical union of two organisms allowing sharing of the blood circulation. Attaching the skin of two animals promotes formation of ...

Clinical Assessment of Spatiotemporal Gait Parameters in Patients and Older Adults

Spatial and temporal characteristics of human walking are frequently evaluated to identify possible gait impairments, mainly in orthopedic and neurological patients1-4, but also in healthy older adults5,6. The quantitative gait analysis described in this protocol is performed with a recently-introduced photoelectric system (see&#160;Materials table) which has the potential to be used in the clinic because it is portable, easy to set up (no subject preparation is required before a test), and does not require maintenance and sensor calibration. The photoelectric system consists of series of high-density floor-based photoelectric cells with light-emitting and light-receiving diodes that are placed parallel to each other to create a corridor, and are oriented perpendicular to the line of progression7. The system simply detects interruptions in light signal, for instance due to the presence of feet within the recording area. Temporal gait parameters and 1D spatial coordinates of consecutive steps are subsequently calculated to provide common gait parameters such as step length, single limb support and walking velocity8, whose validity against a criterion instrument has recently been demonstrated7,9. The measurement procedures are very straightforward; a single patient can be tested in less than 5 min&#160;and a comprehensive report can be generated in less than 1&#160;min.

This protocol is used to evaluate spatial and temporal gait variables of neurological/orthopedic patients and older persons by means of a recently-introduced floor-based photocell system.

时空步态参数的患者和老年人的临床评估

Spatial and temporal characteristics of human walking are frequently evaluated to identify possible gait impairments, mainly in orthopedic and ...

A Simple Critical-sized Femoral Defect Model in Mice

While bone has a remarkable capacity for regeneration, serious bone trauma often results in damage that does not properly heal. In fact, one tenth of all limb bone fractures fail to heal completely due to the extent of the trauma, disease, or age of the patient. Our ability to improve bone regenerative strategies is critically dependent on the ability to mimic serious bone trauma in test animals, but the generation and stabilization of large bone lesions is technically challenging. In most cases, serious long bone trauma is mimicked experimentally by establishing a defect that will not naturally heal. This is achieved by complete removal of a bone segment that is larger than 1.5 times the diameter of the bone cross-section. The bone is then stabilized with a metal implant to maintain proper orientation of the fracture edges and allow for mobility. 
Due to their small size and the fragility of their long bones, establishment of such lesions in mice are beyond the capabilities of most research groups. As such, long bone defect models are confined to rats and larger animals. Nevertheless, mice afford significant research advantages in that they can be genetically modified and bred as immune-compromised strains that do not reject human cells and tissue.
Herein, we demonstrate a technique that facilitates the generation of a segmental defect in mouse femora using standard laboratory and veterinary equipment. With practice, fabrication of the fixation device and surgical implantation is feasible for the majority of trained veterinarians and animal research personnel. Using example data, we also provide methodologies for the quantitative analysis of bone healing for the model.

Animal models are frequently employed to mimic serious bone injury in biomedical research. Due to their small size, establishment of stabilized bone lesions in mice are beyond the capabilities of most research groups. Herein, we describe a simple method for establishing and analyzing experimental femoral defects in mice.

一个简单的临界尺寸股骨缺损模型小鼠

While bone has a remarkable capacity for regeneration, serious bone trauma often results in damage that does not properly heal. In fact, one tenth of all ...

A Detailed Protocol for Perspiration Monitoring Using a Novel, Small, Wireless Device

Perspiration monitoring can be utilized for the detection of certain diseases, such as thermoregulation and mental disorders, particularly when the patients are unaware of such disorders or are having difficulty expressing their symptoms. Until now, several devices for perspiration monitoring have been developed; however, such devices tend to have a relatively large exterior, considerable power consumption, and/or less sensitivity.
Recently, we developed a small, wireless device for perspiration monitoring. The device consists of a temperature/relative humidity (T/RH) sensor, battery-driven small data logger, and silica gel as a desiccant in a small cylindrical exterior. The T/RH sensor is placed between the detection windows (through which the water vapor from the skin enters) and the silica gel. The underlying principle of the perspiration monitoring device is based on Fick&#39;s law of diffusion, which means that water vapor flux from the skin to the silica gel (i.e.&#160;transepidermal water loss and perspiration) can be captured by change in humidity at the T/RH sensor. In addition, a baseline subtraction method was adopted to distinguish perspiration and transepidermal water loss.
As shown in the previous report, the developed device can monitor the perspiration at any sites of the body in an easy, wireless manner. However, detailed methods of how to use the device have not been disclosed yet. In this article, therefore, we would like to show the point-by-point tutorials of how to use the device for perspiration monitoring, by showing the sympathetic activity test with the sympathetic skin response monitoring as an example.

Recently, we developed a small wireless device for perspiration monitoring. In this article, we present detailed protocols on how to use the device for perspiration monitoring with an example of the sympathetic activity test.

详细的汗渍监控协议使用一种新的，小的，无线设备

Perspiration monitoring can be utilized for the detection of certain diseases, such as thermoregulation and mental disorders, particularly when the ...

Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex

The concept of objective nociceptive assessment and optimal pain management have gained increasing attention. Despite the known negative short- and long-term consequences of unresolved pain or excessive analgosedation, adequate nociceptive monitoring remains challenging in non-communicative, critically ill adults. In the intensive care unit (ICU), routine nociceptive evaluation is carried out by the attending nurse using the Behavior Pain Scale (BPS) in mechanically ventilated patients. This assessment is limited by medication use (e.g., neuromuscular blocking agents) and the inherent subjective character of nociceptive evaluation by third parties.
Here, we describe the use of two nociceptive reflex testing devices as tools for objective pain evaluation: the pupillary dilation reflex (PDR) and nociception flexion reflex (NFR). These measurement tools are non-invasive and well tolerated, providing clinicians and researchers with objective information regarding two different nociceptive processing pathways: (1)&#160;the pain-related autonomic reactivity&#160;and (2) the ascending component of the somatosensory system. The use of PDR and NFR measurements are currently limited to specialized pain clinics and research institutions because of impressions that these are technically demanding or time-consuming procedures, or even because of a lack of knowledge regarding their existence.
By focusing on the two abovementioned nociceptive reflex assessments, this study evaluated their feasibility as a physiological pain measurement method in daily practice. Pursuing novel technologies for evaluating the analgesia level in unconscious patients may further improve individual pharmacological treatment and patient related outcome measures. Therefore, future research must include large well-designed clinical trials in a real-life environment.

Pain assessment in anesthetized patients who cannot communicate with the outside world in any way remains challenging despite the development of innovative objective pain evaluation tools. In this project, the pupillary dilation reflex and the nociception flexion reflex are assessed in critically ill, mechanically ventilated adult patients.

应用 Pupillometry 和伤害性屈曲反射的可行性研究--通气 ICU 患者的客观伤害评估

The concept of objective nociceptive assessment and optimal pain management have gained increasing attention. Despite the known negative short- and ...

Endotoxin Activity Assay for the Detection of Whole Blood Endotoxemia in Critically Ill Patients

Lipopolysaccharide, also known as endotoxin, is a fundamental component of gram-negative bacteria and plays a crucial role in the development of sepsis and septic shock. The early identification of an infectious process that is rapidly evolving to a critical illness might prompt a quicker and more intensive treatment, thereby potentially leading to better patient outcomes. The Endotoxin Activity (EA) assay can be used at the bedside as a reliable biomarker of systemic endotoxemia. The detection of elevated endotoxin activity levels has been repeatedly shown to be associated with an increased disease severity in patients with sepsis and septic shock. The assay is quick and easy to perform. Briefly, after sampling, an aliquot of whole blood is mixed with an anti-endotoxin antibody and with added LPS. Endotoxin activity is measured as the relative oxidative burst of primed neutrophils as detected by chemioluminescence. The assay&#39;s output is expressed on a scale from 0 (absent) to 1 (maximal) and categorized as &#8220;low&#8221; (&#60;0.4 units), &#8220;intermediate&#8221; (0.4&#8211;0.59 units), or &#8220;high&#8221; (&#8805;0.6 units). The detailed methodology and rationale for the implementation of the EA assay are reported in this manuscript.

We hereby present a protocol to measure at the bedside the endotoxin activity of human whole blood samples. The Endotoxin Activity assay is a simple test to perform and may be a useful biomarker in critically ill patients with sepsis.

危重病人全血内毒素血症检测的内毒素活性测定

Lipopolysaccharide, also known as endotoxin, is a fundamental component of gram-negative bacteria and plays a crucial role in the development of sepsis ...

A Real-World High-Intensity Interval Training Protocol for Cardiorespiratory Fitness Improvement

High-Intensity Interval Training (HIIT) has emerged as an interesting time-efficient approach to increase exercise adherence and improve health. However, few studies have tested the efficiency of HIIT protocols in a &#34;real world&#34; setting, e.g., HIIT protocols designed for outdoor spaces without specialized equipment. This study presents a &#34;real world&#34; training protocol, named &#34;beep training&#34;, and compares the efficiency of a HIIT regiment versus a traditional long-duration Moderate-Intensity Continuous Training (MICT) regiment using this beep training protocol on VO2 max of overweight untrained men. Twenty-two subjects performed outdoor running with MICT (n = 11) or HIIT (n = 11). Cardiorespiratory fitness was assessed before and after training protocols using a metabolic analyzer. Both training protocols were performed 3 days a week for 8 weeks using the Beep Test results. The MICT group performed the exercise program at 60%-75% of the maximum speed of the 20 m shuttle test (Vmax) and with a progression of the distance of 3,500-5,000 m. The HIIT group performed the interval exercise with 7-10 bouts of 200 m at 85%-100% of the maximum speed of the 20 m shuttle test (Vmax), interspersed with 1 min of passive recovery. Although the HIIT group presented a significantly lower training volume than the MICT group (p &#60; 0.05) after 8 weeks of beep training, HIIT was superior to MICT in improving VO2 max (MICT: ~4.1%; HIIT: ~7.3%; p &#60; 0.05). The &#34;real world&#34; HIIT regiment based on beep training protocol is a time-efficient, low-cost, and easy-to-implement protocol for overweight untrained men.

This study presents a low-cost and easy-to-implement "real world" high-intensity interval training (HIIT) protocol for scientific research and discusses its efficiency for cardiorespiratory fitness.

一种用于改善心肺健康的真实世界高强度间歇训练方案

High-Intensity Interval Training (HIIT) has emerged as an interesting time-efficient approach to increase exercise adherence and improve health. However, ...

Protocol for Developing a Femur Osteotomy Model in Wistar Albino Rats

Fracture healing is a physiological process resulting in the regeneration of bone defects by the coordinated action of osteoblasts and osteoclasts. Osteoanabolic drugs have the potential to augment the repair of fractures but have constraints like high costs or undesirable side effects. The bone healing potential of a drug can initially be determined by in vitro studies, but in vivo studies are needed for the final proof of concept. Our objective was to develop a femur osteotomy rodent model that could help researchers understand the development of callus formation following fracture of the shaft of the femur and that could help establish whether a potential drug has bone healing properties. Adult male Wistar albino rats were used after Institutional Animal Ethics Committee clearance. The rodents were anesthetized, and under aseptic conditions, complete transverse fractures at the middle one-third of the shafts of the femurs were created using open osteotomy. The fractures were reduced and internally fixed using intramedullary K-wires, and secondary fracture healing was allowed to take place. After surgery, intraperitoneal analgesics and antibiotics were given for 5 days. Sequential weekly x-rays assessed callus formation. The rats were sacrificed based on radiologically pre-determined time points, and the development of the fracture callus was analyzed radiologically and using immunohistochemistry.

Here, we present a protocol to iatrogenically fracture the shaft of the femur of Wistar albino rats and follow up on the development of the callus. This femur osteotomy model can help researchers evaluate the process of fracture healing and to study how a drug could influence fracture healing.

开发Wistar白化大鼠股骨截骨模型的协议

Fracture healing is a physiological process resulting in the regeneration of bone defects by the coordinated action of osteoblasts and osteoclasts. ...