Objective:To explore the effect of continuous non-invasive blood pressure monitoring on intraoperative hemodynamics and postoperative myocardial injury in craniotomy.Methods:120 cases of elective craniotomy were divid...Objective:To explore the effect of continuous non-invasive blood pressure monitoring on intraoperative hemodynamics and postoperative myocardial injury in craniotomy.Methods:120 cases of elective craniotomy were divided into the self-control group(continuous non-invasive blood pressure monitoring and intermittent cuff non-invasive blood pressure monitoring,CNAP group)and propensity score matching group(only intermittent cuff non-invasive blood pressure measurement in previous craniotomy,PSM group);Goal-directed hemodynamic management in CNAP group included heart rate(HR),blood pressure(BP),stroke volume(SV),stroke variability(SVV),and systemic vascular resistance index(SVRI).The main index is to compare the troponin level within 72 hours after operation between the CNAP group and the PSM group;The secondary indicators are the comparison of the hemodynamic conditions between the CNAP group and the PSM at 10 specific time points.Results:The incidence of postoperative myocardial injury in the CNAP group was significantly lower than that in the PSM group(12%vs.30%,P=0.01);in the CNAP group hypotensive episodes(6 vs.3,P=0.01),positive balance of fluid therapy(700 vs.500 mL,P<0.001),more use of vasoactive drugs(29 vs.18,P=0.04),more stable hemodynamics medical status(P=0.03)were recorded.Conclusion:The hemodynamic management strategy based on continuous non-invasive blood pressure monitoring can reduce the incidence of myocardial injury after elective craniotomy and maintain a more stable hemodynamic state.展开更多
As part of the enhanced recovery after surgery （ERAS） protocol, the goal-directed fluid management with hemodynamic monitoring can effectively guide perioperative fluid use and significantly improve the outcomes in ...As part of the enhanced recovery after surgery （ERAS） protocol, the goal-directed fluid management with hemodynamic monitoring can effectively guide perioperative fluid use and significantly improve the outcomes in highrisk patients undergoing major surgeries. Several minimally invasive and non-invasive monitoring devices are commercially available for clinical use. As part of an internal evaluation, we reported the results from three different hemodynamic monitoring devices used in a patient undergoing a major abdominal surgery.展开更多
Human metabolite moisture detection is important in health monitoring and non-invasive diagnosis.However,ultra-sensitive quantitative extraction of respiration information in real-time remains a great challenge.Herein...Human metabolite moisture detection is important in health monitoring and non-invasive diagnosis.However,ultra-sensitive quantitative extraction of respiration information in real-time remains a great challenge.Herein,chemiresistors based on imine-linked covalent organic framework(COF)films with dual-active sites are fabricated to address this issue,which demonstrates an amplified humidity-sensing signal performance.By regulation of monomers and functional groups,these COF films can be pre-engineered to achieve high response,wide detection range,fast response,and recovery time.Under the condition of relative humidity ranging from 13 to 98%,the COFTAPB-DHTA film-based humidity sensor exhibits outstanding humidity sensing perfor-mance with an expanded response value of 390 times.Furthermore,the response values of the COF film-based sensor are highly linear to the relative humidity in the range below 60%,reflecting a quantitative sensing mechanism at the molecular level.Based on the dual-site adsorption of the(-C=N-)and(C-N)stretching vibrations,the revers-ible tautomerism induced by hydrogen bonding with water molecules is demonstrated to be the main intrinsic mechanism for this effective humidity detection.In addition,the synthesized COF films can be further exploited to effectively detect human nasal and oral breathing as well as fabric permeability,which will inspire novel designs for effective humidity-detection devices.展开更多
Convenient non-invasive flow monitoring would facilitate the operation and control in microfluidic chips,but is challenging due to the small space of microchannels and complex operation required in traditional optical...Convenient non-invasive flow monitoring would facilitate the operation and control in microfluidic chips,but is challenging due to the small space of microchannels and complex operation required in traditional optical methods.In this work,we propose a novel non-invasive strategy to probe microfluidic flows via streaming potential phenomenon.By sealing one side of the microchannel with a piece of hydrogel film,streaming potential inside the channel can be clearly detected by electrodes at outer surface of the hydrogel due to ion diffusion in the hydrogel.Flow is detected without sensors contacting with the internal liquid.Moreover,the electrodes shape like a tiny probe,which can move around mapping the flow distribution in a chip with the spatial resolution of 1 mm and flow rate detection limit of 3μL·min–1.Bubbles inside the channels can also be detected,due to the fluctuation of streaming voltage when gas-liquid interface flows through the electrode,showing an easy and potential way for multi-functional flow monitoring in microfluidic chips.展开更多
Introduction: Propofol use during endoscopic procedures has become increasingly popular and assessing and maintaining airway patency is a significant challenge. Anesthesiologists often use airway maneuvers to maintain...Introduction: Propofol use during endoscopic procedures has become increasingly popular and assessing and maintaining airway patency is a significant challenge. Anesthesiologists often use airway maneuvers to maintain airway patency and ventilation during procedural sedation. A novel, non-invasive, Respiratory Volume Monitor (RVM) that provided continuous, real-time measurements of minute ventilation (MV), tidal volume (TV) and respiratory rate (RR) was used to monitor respiratory performance before, during, and after endoscopic procedures, quantify MV changes before and after airway maneuvers, and to quantify propofol-induced respiratory depression. Methods: RVM traces were obtained from 25 patients undergoing sedation for endoscopic procedures. Airway maneuvers were performed in 19/25 patients. All 25 patients received propofol as the primary sedative. Results: Forty-five airway maneuvers were performed. During these maneuvers, all respiratory parameters increased relative to pre-maneuver levels. On average, MV increased by 24% ± 5% (mean ± SEM), TV 14% ± 5% and RR: 17% ± 6%. The cohort average MVBASELINE was 9.5 ± 0.7 L/min (TV = 670 ± 60 ml, RR = 15 ± 0.7). Following propofol MV decreased transiently, reaching nadir five minutes after the last dose of propofol at 82% ± 10% of baseline (MV = 7.5 ± 1.0 L/min). The reduction in MV was driven by reduction in TV, not RR. Conclusions: Data demonstrated that RVM was able to track changes in ventilation and was able to quantify respiratory changes following airway maneuvers. All patients had a significant reduction in ventilatory volumes after propofol. Five minutes after the last dose of propofol, MV and TV were significantly reduced while RR was not, suggesting that monitoring respiratory rate alone was not a sufficient indicator of respiratory status.展开更多
In the present study, a fast chemical shift imaging （CSI） method has been used to dynamically monitor the formation of oil-water emulsions and the phase separation process of the emulsion phase from the excessive wa...In the present study, a fast chemical shift imaging （CSI） method has been used to dynamically monitor the formation of oil-water emulsions and the phase separation process of the emulsion phase from the excessive water or oil phase on the molecular level. With signals sampled from series of small voxels simultaneously within a few seconds, high-resolution one-dimensional （1D） 1H nuclear magnetic resonance （NMR） spectra from different spatial positions for inhomogeneous emulsion systems induced by susceptibility differences among components can be obtained independently. On the basis of integrals from these ~H NMR spectra, profiles obtained explicitly demonstrate the spatial and temporal variations of oil concentrations. Furthermore, the phase separation time and the length of the oil-water emulsion phase are determined. In addition, effects of oil types and proportions of the emulsifier on the emulsification states are also inspected. Experimental results indicate that 1D PHASICS （Partial Homogeneity Assisted Inhomogeneity Correction Spectroscopy） provides a helpful and promising alternative to research on dynamic processes or chemical reactions.展开更多
Failure of an automated blood pressure cuff to deflate when a patient is under general anesthesia can lead to catastrophic consequences if unnoticed for more than three hours [1]. We present this as a hearsay case in ...Failure of an automated blood pressure cuff to deflate when a patient is under general anesthesia can lead to catastrophic consequences if unnoticed for more than three hours [1]. We present this as a hearsay case in which an automated blood pressure cuff of the Spacelabs Ultraview Clinical Workstation monitor (model No. 90385) applied pressure for about five hours resulting in limb thrombosis. In order to analyze this catastrophe, simulation scenarios were tested to elucidate the possible errors and malfunctions that may have led to this injury. We present the analysis of the advantages and validity of the hearsay case report. We also include our proposed criteria that should be required when a hearsay case is considered for publication.展开更多
With the rise in prevalence of Type II diabetes throughout the world, an increasing need for a portable monitoring system for both blood glucose and lipoprotein concentrations is in demand. Recent work has led to non-...With the rise in prevalence of Type II diabetes throughout the world, an increasing need for a portable monitoring system for both blood glucose and lipoprotein concentrations is in demand. Recent work has led to non-invasive wearable devices for monitoring changes in blood glucose concentrations using electromagnetic (EM) waves. However, this still fall short as a means of monitoring cholesterol levels in diabetic patients. The EM study on human tissues emphasized here may also relate to the safety guidelines applied to cellular communications, power lines, and other EM applications. The specific absorption rate (SAR) for the power of the non-ionizing frequency must not exceed a threshold as it impacts DNA and can lead to cancerous tissues. In this study, we used COMSOL software for the investigation of the viability of using EM within the frequency range of 64 MHz-1 GHz as a means of monitoring the transmission properties of human blood and lipoprotein. In this approach, wave equations were solved within blood and lipoprotein boundaries. Research parameters, including frequency range, Power input (SAR), and lipoprotein densities, were investigated. The transmission properties, produced by the electrical and thermal characteristics of these physiological parameters, have led to proper diagnosis of lipoprotein density. Within the frequency range of 64 MHz to 1 GHz, and for a power range of 0.1 to 0.6 SAR, lipoprotein density from 1.00 g/mL to 1.20 g/mL was considered. A 2D model, with an antenna source that supplied the electromagnetic waves to human tissues, was created for the simulations. These were used for the study of the transmission properties of the EM energy into the blood and lipoprotein tissues. While the range of magnetic flux values between simulations varies only slightly or not at all, the distribution of these values is impacted by given parameters. As such, a device capable of comparing magnetic flux values and penetration depths could easily distinguish between samples of different lipoprotein densities. The results obtained in this study can be accommodated non-invasively by human tissues, and can be produced in a practical model using wearable devices. A practical model is proposed for future consideration.展开更多
文摘Objective:To explore the effect of continuous non-invasive blood pressure monitoring on intraoperative hemodynamics and postoperative myocardial injury in craniotomy.Methods:120 cases of elective craniotomy were divided into the self-control group(continuous non-invasive blood pressure monitoring and intermittent cuff non-invasive blood pressure monitoring,CNAP group)and propensity score matching group(only intermittent cuff non-invasive blood pressure measurement in previous craniotomy,PSM group);Goal-directed hemodynamic management in CNAP group included heart rate(HR),blood pressure(BP),stroke volume(SV),stroke variability(SVV),and systemic vascular resistance index(SVRI).The main index is to compare the troponin level within 72 hours after operation between the CNAP group and the PSM group;The secondary indicators are the comparison of the hemodynamic conditions between the CNAP group and the PSM at 10 specific time points.Results:The incidence of postoperative myocardial injury in the CNAP group was significantly lower than that in the PSM group(12%vs.30%,P=0.01);in the CNAP group hypotensive episodes(6 vs.3,P=0.01),positive balance of fluid therapy(700 vs.500 mL,P<0.001),more use of vasoactive drugs(29 vs.18,P=0.04),more stable hemodynamics medical status(P=0.03)were recorded.Conclusion:The hemodynamic management strategy based on continuous non-invasive blood pressure monitoring can reduce the incidence of myocardial injury after elective craniotomy and maintain a more stable hemodynamic state.
文摘As part of the enhanced recovery after surgery （ERAS） protocol, the goal-directed fluid management with hemodynamic monitoring can effectively guide perioperative fluid use and significantly improve the outcomes in highrisk patients undergoing major surgeries. Several minimally invasive and non-invasive monitoring devices are commercially available for clinical use. As part of an internal evaluation, we reported the results from three different hemodynamic monitoring devices used in a patient undergoing a major abdominal surgery.
基金supported by the National Key Research and Development Program of China(2022YFB3205500,and 2022YFC3104700)the National Natural Science Foundation of China(62101329 and 61971284)+4 种基金the Shanghai Sailing Program(21YF1421400)the Natural Science Foundation of Shanghai(23ZR1430100)the Oceanic Interdisciplinary Program of Shanghai Jiao Tong University(SL2020ZD203,SL2021MS006 and SL2020MS031)Scientific Research Fund of Second Institute of Oceanography,Ministry of Natural Resources of P.R.China(SL2003)Startup Fund for Youngman Research at Shanghai Jiao Tong University.
文摘Human metabolite moisture detection is important in health monitoring and non-invasive diagnosis.However,ultra-sensitive quantitative extraction of respiration information in real-time remains a great challenge.Herein,chemiresistors based on imine-linked covalent organic framework(COF)films with dual-active sites are fabricated to address this issue,which demonstrates an amplified humidity-sensing signal performance.By regulation of monomers and functional groups,these COF films can be pre-engineered to achieve high response,wide detection range,fast response,and recovery time.Under the condition of relative humidity ranging from 13 to 98%,the COFTAPB-DHTA film-based humidity sensor exhibits outstanding humidity sensing perfor-mance with an expanded response value of 390 times.Furthermore,the response values of the COF film-based sensor are highly linear to the relative humidity in the range below 60%,reflecting a quantitative sensing mechanism at the molecular level.Based on the dual-site adsorption of the(-C=N-)and(C-N)stretching vibrations,the revers-ible tautomerism induced by hydrogen bonding with water molecules is demonstrated to be the main intrinsic mechanism for this effective humidity detection.In addition,the synthesized COF films can be further exploited to effectively detect human nasal and oral breathing as well as fabric permeability,which will inspire novel designs for effective humidity-detection devices.
基金supported by the National Natural Science Foundation of China(Grant Nos.51976141,52006123,62161160311).
文摘Convenient non-invasive flow monitoring would facilitate the operation and control in microfluidic chips,but is challenging due to the small space of microchannels and complex operation required in traditional optical methods.In this work,we propose a novel non-invasive strategy to probe microfluidic flows via streaming potential phenomenon.By sealing one side of the microchannel with a piece of hydrogel film,streaming potential inside the channel can be clearly detected by electrodes at outer surface of the hydrogel due to ion diffusion in the hydrogel.Flow is detected without sensors contacting with the internal liquid.Moreover,the electrodes shape like a tiny probe,which can move around mapping the flow distribution in a chip with the spatial resolution of 1 mm and flow rate detection limit of 3μL·min–1.Bubbles inside the channels can also be detected,due to the fluctuation of streaming voltage when gas-liquid interface flows through the electrode,showing an easy and potential way for multi-functional flow monitoring in microfluidic chips.
文摘Introduction: Propofol use during endoscopic procedures has become increasingly popular and assessing and maintaining airway patency is a significant challenge. Anesthesiologists often use airway maneuvers to maintain airway patency and ventilation during procedural sedation. A novel, non-invasive, Respiratory Volume Monitor (RVM) that provided continuous, real-time measurements of minute ventilation (MV), tidal volume (TV) and respiratory rate (RR) was used to monitor respiratory performance before, during, and after endoscopic procedures, quantify MV changes before and after airway maneuvers, and to quantify propofol-induced respiratory depression. Methods: RVM traces were obtained from 25 patients undergoing sedation for endoscopic procedures. Airway maneuvers were performed in 19/25 patients. All 25 patients received propofol as the primary sedative. Results: Forty-five airway maneuvers were performed. During these maneuvers, all respiratory parameters increased relative to pre-maneuver levels. On average, MV increased by 24% ± 5% (mean ± SEM), TV 14% ± 5% and RR: 17% ± 6%. The cohort average MVBASELINE was 9.5 ± 0.7 L/min (TV = 670 ± 60 ml, RR = 15 ± 0.7). Following propofol MV decreased transiently, reaching nadir five minutes after the last dose of propofol at 82% ± 10% of baseline (MV = 7.5 ± 1.0 L/min). The reduction in MV was driven by reduction in TV, not RR. Conclusions: Data demonstrated that RVM was able to track changes in ventilation and was able to quantify respiratory changes following airway maneuvers. All patients had a significant reduction in ventilatory volumes after propofol. Five minutes after the last dose of propofol, MV and TV were significantly reduced while RR was not, suggesting that monitoring respiratory rate alone was not a sufficient indicator of respiratory status.
基金Project supported by the Natural Science Foundation of Fujian Province,China(Grant Nos.2016J01078 and 2017J05011)the Fundamental Research Funds for the Central Universities of China(Grant Nos.20720160125 and 20720150018)the National Natural Science Foundation of China(Grant No.11705068)
文摘In the present study, a fast chemical shift imaging （CSI） method has been used to dynamically monitor the formation of oil-water emulsions and the phase separation process of the emulsion phase from the excessive water or oil phase on the molecular level. With signals sampled from series of small voxels simultaneously within a few seconds, high-resolution one-dimensional （1D） 1H nuclear magnetic resonance （NMR） spectra from different spatial positions for inhomogeneous emulsion systems induced by susceptibility differences among components can be obtained independently. On the basis of integrals from these ~H NMR spectra, profiles obtained explicitly demonstrate the spatial and temporal variations of oil concentrations. Furthermore, the phase separation time and the length of the oil-water emulsion phase are determined. In addition, effects of oil types and proportions of the emulsifier on the emulsification states are also inspected. Experimental results indicate that 1D PHASICS （Partial Homogeneity Assisted Inhomogeneity Correction Spectroscopy） provides a helpful and promising alternative to research on dynamic processes or chemical reactions.
文摘Failure of an automated blood pressure cuff to deflate when a patient is under general anesthesia can lead to catastrophic consequences if unnoticed for more than three hours [1]. We present this as a hearsay case in which an automated blood pressure cuff of the Spacelabs Ultraview Clinical Workstation monitor (model No. 90385) applied pressure for about five hours resulting in limb thrombosis. In order to analyze this catastrophe, simulation scenarios were tested to elucidate the possible errors and malfunctions that may have led to this injury. We present the analysis of the advantages and validity of the hearsay case report. We also include our proposed criteria that should be required when a hearsay case is considered for publication.
文摘With the rise in prevalence of Type II diabetes throughout the world, an increasing need for a portable monitoring system for both blood glucose and lipoprotein concentrations is in demand. Recent work has led to non-invasive wearable devices for monitoring changes in blood glucose concentrations using electromagnetic (EM) waves. However, this still fall short as a means of monitoring cholesterol levels in diabetic patients. The EM study on human tissues emphasized here may also relate to the safety guidelines applied to cellular communications, power lines, and other EM applications. The specific absorption rate (SAR) for the power of the non-ionizing frequency must not exceed a threshold as it impacts DNA and can lead to cancerous tissues. In this study, we used COMSOL software for the investigation of the viability of using EM within the frequency range of 64 MHz-1 GHz as a means of monitoring the transmission properties of human blood and lipoprotein. In this approach, wave equations were solved within blood and lipoprotein boundaries. Research parameters, including frequency range, Power input (SAR), and lipoprotein densities, were investigated. The transmission properties, produced by the electrical and thermal characteristics of these physiological parameters, have led to proper diagnosis of lipoprotein density. Within the frequency range of 64 MHz to 1 GHz, and for a power range of 0.1 to 0.6 SAR, lipoprotein density from 1.00 g/mL to 1.20 g/mL was considered. A 2D model, with an antenna source that supplied the electromagnetic waves to human tissues, was created for the simulations. These were used for the study of the transmission properties of the EM energy into the blood and lipoprotein tissues. While the range of magnetic flux values between simulations varies only slightly or not at all, the distribution of these values is impacted by given parameters. As such, a device capable of comparing magnetic flux values and penetration depths could easily distinguish between samples of different lipoprotein densities. The results obtained in this study can be accommodated non-invasively by human tissues, and can be produced in a practical model using wearable devices. A practical model is proposed for future consideration.
