1.Technique and Application of Deep Learning-based EEG Denoising
Bao-Lian SHAN ; Hai-Qing YU ; Yong-Zhi HUANG ; Jia-Yuan MENG ; Min-Peng XU ; Tzyy-Ping JUNG ; Dong MING
Progress in Biochemistry and Biophysics 2026;53(8):2147-2160
Electroencephalography (EEG) is a non-invasive neurophysiological monitoring technique. It records the electrical activity of the cerebral cortex using electrodes placed on the scalp surface. Owing to its high safety, portability, and millisecond-level temporal resolution, EEG has been widely utilized in a variety of fields, including clinical diagnosis, brain-computer interfaces (BCIs), and cognitive neuroscience research. However, due to its microvolt-level amplitude, EEG is highly susceptible to various artifacts, including electrooculographic (EOG), electrocardiographic (ECG), electromyographic (EMG), and power line interference (PLI). These artifacts can obscure genuine neural activity and introduce spurious electrophysiological features. Consequently, they may compromise EEG signal quality, thereby reducing the reliability of downstream analyses. To address this issue, numerous EEG artifact removal methods have been developed, including both traditional denoising techniques and deep learning-based approaches. Traditional EEG denoising methods have long served as the primary solutions for artifact removal. Representative approaches include filtering, regression, and blind source separation. Although these methods have demonstrated effectiveness in specific scenarios, they suffer from several inherent limitations. Filtering assumes that artifacts and EEG signals can be separated in the frequency domain, but many artifacts, such as EOG and EMG, overlap with EEG spectra, which may lead to the loss of valuable neural information. Regression methods require high-quality artifact references to estimate and subtract contaminations, limiting their effectiveness in reference-free scenarios. Blind source separation can remove artifacts without external references, but it typically requires the number of EEG channels to exceed the number of sources, restricting its application in single- or low-channel EEG recordings. Deep learning-based EEG denoising methods address these limitations effectively. First, they learn the nonlinear mapping between contaminated and clean EEG directly from data in an end-to-end manner. This approach does not rely on assumptions about spectral separability, thereby preserving neural activity more completely. Second, the reference information is incorporated during the training phase, allowing the trained model to perform artifact removal independently without external references. Third, deep learning models can be flexibly designed to accommodate various recording setups, achieving robust denoising for both high-density and single-channel EEG. Collectively, these advantages enable deep learning-based methods to overcome the main challenges of traditional approaches, providing more accurate and reliable EEG signal recovery. The superior denoising performance of deep learning-based EEG denoising methods has attracted increasing attention in EEG artifact removal research. As a result, many deep learning-based denoising methods have been developed and successfully applied in neural engineering areas. However, a systematic review of the techniques and applications in this field is still lacking. To address this gap, this paper reviews recent advances in deep learning-based EEG denoising from four perspectives: technical principle, benchmark dataset, denoising model, and evaluation method. Representative applications in neural signal analysis and BCI decoding are also summarized. Furthermore, the advantage, existing challenge, and future research direction of deep learning-based EEG denoising are discussed. This review aims to provide valuable theoretical insights and technical guidance for researchers. It is also expected to promote further advances and broader applications of deep learning-based EEG denoising techniques.
2.Comparative Study on the Efficacy of Traditional Mongolian Medicine Bone Setting and Surgical Treatment for Humeral Surgical Neck Fractures
Jin Ai Hua ; ; Ba Hu Shan ; Ta Na ; Wu Da Mu ; Bao Tu Ya ; Si Qin ; Tsend-Ayush D ; Bolortulga Z
Mongolian Journal of Health Sciences 2026;91(1):38-42
Background:
The surgical neck of the humerus is located approximately 2–3 cm distal to the anatomical neck (collum anatomicum) at the junction of the greater and lesser tubercles and the humeral shaft. Owing to the transition between cortical and cancellous bones, this region is biomechanically vulnerable and prone to fractures, particularly in older adults. Fractures of the surgical neck of the humerus are classified under the International Classification of Diseases, 10th Revision (ICD-10), with diagnostic codes S42.21.3, S42.22, and S42.23. National statistics indicate that 210,763 new trauma cases were reported in Mongolia in 2023, representing an 11.6% increase compared to the previous year, of which 11,452 cases (5.4%) involved shoulder and humeral injuries.
Aim:
This study aimed to compare the clinical effects of traditional Mongolian bone-setting therapy and surgical treatment on pain intensity, shoulder function, range of motion, and activities of daily living in patients with surgical neck of the humerus fractures.
Materials and Methods:
Based on the Department of Traditional Therapies of the Mongolian National University of Medical Sciences (MNUMS) and the Department of Orthopedic Trauma of the Inner Mongolia International Hospital, Inner Mongolia Autonomous Region, China, a total of 60 patients diagnosed with surgical neck fractures of the humerus were enrolled in this study between January 2024 and December 2025. The patients were randomly assigned into two groups: a Mongolian traditional bone-setting therapy group (n=30) and a surgical treatment group (n=30). Assessments were conducted before treatment and at 1 month and 3 months after treatment. Shoulder joint range of motion, activities of daily living, and muscle strength were evaluated using the Constant–Murley score, while pain intensity was assessed using the Visual Analog Scale (VAS). The collected data were systematically analyzed, and the therapeutic outcomes of the two treatment modalities were comprehensively compared and summarized.
Result:
The baseline demographic and clinical characteristics were comparable between the groups. In the traditional bone-setting group, VAS scores decreased significantly, whereas Constant–Murley scores improved markedly at both follow-up points. The overall outcomes in the traditional bone-setting group were significantly better than those in the surgical group (P<0.05).
Conclusion
Traditional Mongolian bone-setting therapy offers rapid pain relief, superior long-term functional recovery, and fewer complications, making it a valuable treatment option, particularly for elderly patients and those unsuitable for surgery.
3.Research on traditional bone-setting treatment for surgical neck fractures of the humerus
Bolortulga Z ; Jin Ai Hua ; ; Ba Hu Shan ; Ta Na ; Wu Da Mu ; Bao Tu Ya ; Oyuntsetseg N ; Zandi N ; Si Qin ; Tsend-Ayush D
Mongolian Journal of Health Sciences 2026;93(3):178-184
Background:
Mongolian traditional bone-setting is a non-surgical treatment method for fractures; however, there is a lack of evidencebased research evaluating its effectiveness, which forms the basis of our study.
Aim:
To study the therapeutic efficacy of traditional bonesetting treatment for surgical neck fractures of the humerus.
Materials and Methods:
From June 2023 to June 2025, 120 patients diagnosed with surgical neck fractures of the humerus and treated at the Inner Mongolia International Mongolian Hospital were randomly divided into a traditional bone-setting group (n=64) and a surgical treatment group (n=56). Shoulder and upper limb function were evaluated at 1, 3, and 6 months after treatment using the Constant–Murley score, Oxford Shoulder Score (OSS), and Visual Analog Scale (VAS) for pain.
Result:
A total of 120 patients with surgical neck fractures of the humerus were divided into two groups, with no significant differences in the baseline characteristics (p>0.05).In the traditional bone-setting group, pain (VAS) decreased more rapidly at 1–3 months (p<0.01), while activities of daily living and functional outcomes improved significantly at 3–6 months (p<0.01). At 6 months, shoulder function (Constant–Murley score) was significantly improved (p=0.049).In contrast, the surgical group showed faster recovery in joint range of motion and muscle strength in the early stage; however, by 6 months, the outcomes between the two groups were comparable.
Conclusion
In the treatment of surgical neck fractures of the humerus, no significant difference was observed between traditional bone-setting and surgical treatment in terms of shoulder range of motion and muscle strength recovery. However, the advantages of traditional bone-setting lie in its ability to relieve pain more rapidly, promote faster functional recovery, improve activities of daily living, and achieve better long-term outcomes than modern bone-setting. Therefore, traditional bone setting is a safe and effective treatment method that aligns with modern theories of bone healing and rehabilitation principles and holds significant value for wider clinical application and further research in the management of surgical neck fractures of the humerus.
4.Construction and Application of An Animal Model of Respiratory Syncytial Virus Infection Based on Humanized IGF1R Mice
Xiaowei YANG ; Dan XIE ; Shuran LI ; Lei BAO ; Zihan GENG ; Xian LIU ; Mengyao CUI ; Yaxin WANG ; Shan CAO ; Xiaolan CUI ; Jing SUN ; Shanshan GUO
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(21):48-53
ObjectiveTo construct an animal model of respiratory syncytial virus(RSV)-infected pneumonia suitable for preclinical studies. MethodsThe virulence of RSV to the four cell lines was observed by cytopathic effect (CPE), and 50% tissue culture infective dose(TCID50) was calculated. Twenty BALB/c mice were randomly divided into a normal group and a model group. Six BALB/c-hIGF1R mice served as the humanized IGF1R model group. Except for the normal group, the other groups received intranasal RSV infection on days 1 and 3 to establish a viral pneumonia model. The efficacy of establishing an RSV-induced pneumonia animal model based on humanized insulin-like growth factor 1 receptor (IGF1R) mice was evaluated by measuring organ indices, peripheral blood lymphocyte percentages, pulmonary pathology and imaging, and pulmonary viral load. Additionally, ten BALB/c mice served as normal group, and thirty-two BALB/c-hIGF1R mice were randomly assigned to humanized IGF1R model group, ribavirin group (82.5 mg·kg-¹·d-¹), and high and low dose groups of Lianhua Qingwen (3.3 mg·kg-¹·d-¹ , 1.65 mg·kg-¹·d-¹), with 8 mice per group. The viral load in lung tissue was measured after ribavirin and Lianhua Qingwen intervention, and the model was applied to the evaluation of anti-RSV drugs. ResultsIn the lungs of the humanized IGF1R model group, large solid and diffuse ground-glass shadows were seen, and the lung volume was significantly increased (P<0.01). The lung index was significantly increased (P<0.01), and both the spleen index and thymus index were significantly decreased (P<0.01). The percentages of CD3+ and CD4+T cells were significantly decreased (P<0.05), and there was a large amount of inflammation and stasis in the perivascular area of the lung tissue, which was predominantly characterized by lymphocytes. The endothelium of blood vessels was partially detached, with a small number of eosinophils. After infecting BALB/c-hIGF1R mice with RSV, the expression of viral nucleic acids in the lung tissue of the mice was significantly increased, with significant differences compared with the normal group (P<0.01). The expression of viral nucleic acids in the ribavirin group and the high and low dose groups of Lianhua Qingwen was significantly reduced, with significant differences compared with the normal group (P<0.01). ConclusionHumanized IGF1R mice are more susceptible to respiratory SVC, and the animal model of RSV-infected pneumonia based on humanized IGF1R mice was successfully constructed, which is suitable for the evaluation of anti-RSV drugs.
5.Construction and Application of An Animal Model of Respiratory Syncytial Virus Infection Based on Humanized IGF1R Mice
Xiaowei YANG ; Dan XIE ; Shuran LI ; Lei BAO ; Zihan GENG ; Xian LIU ; Mengyao CUI ; Yaxin WANG ; Shan CAO ; Xiaolan CUI ; Jing SUN ; Shanshan GUO
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(21):48-53
ObjectiveTo construct an animal model of respiratory syncytial virus(RSV)-infected pneumonia suitable for preclinical studies. MethodsThe virulence of RSV to the four cell lines was observed by cytopathic effect (CPE), and 50% tissue culture infective dose(TCID50) was calculated. Twenty BALB/c mice were randomly divided into a normal group and a model group. Six BALB/c-hIGF1R mice served as the humanized IGF1R model group. Except for the normal group, the other groups received intranasal RSV infection on days 1 and 3 to establish a viral pneumonia model. The efficacy of establishing an RSV-induced pneumonia animal model based on humanized insulin-like growth factor 1 receptor (IGF1R) mice was evaluated by measuring organ indices, peripheral blood lymphocyte percentages, pulmonary pathology and imaging, and pulmonary viral load. Additionally, ten BALB/c mice served as normal group, and thirty-two BALB/c-hIGF1R mice were randomly assigned to humanized IGF1R model group, ribavirin group (82.5 mg·kg-¹·d-¹), and high and low dose groups of Lianhua Qingwen (3.3 mg·kg-¹·d-¹ , 1.65 mg·kg-¹·d-¹), with 8 mice per group. The viral load in lung tissue was measured after ribavirin and Lianhua Qingwen intervention, and the model was applied to the evaluation of anti-RSV drugs. ResultsIn the lungs of the humanized IGF1R model group, large solid and diffuse ground-glass shadows were seen, and the lung volume was significantly increased (P<0.01). The lung index was significantly increased (P<0.01), and both the spleen index and thymus index were significantly decreased (P<0.01). The percentages of CD3+ and CD4+T cells were significantly decreased (P<0.05), and there was a large amount of inflammation and stasis in the perivascular area of the lung tissue, which was predominantly characterized by lymphocytes. The endothelium of blood vessels was partially detached, with a small number of eosinophils. After infecting BALB/c-hIGF1R mice with RSV, the expression of viral nucleic acids in the lung tissue of the mice was significantly increased, with significant differences compared with the normal group (P<0.01). The expression of viral nucleic acids in the ribavirin group and the high and low dose groups of Lianhua Qingwen was significantly reduced, with significant differences compared with the normal group (P<0.01). ConclusionHumanized IGF1R mice are more susceptible to respiratory SVC, and the animal model of RSV-infected pneumonia based on humanized IGF1R mice was successfully constructed, which is suitable for the evaluation of anti-RSV drugs.
6.Effect of Shufeng Jiedu Capsules on Relieving Influenza Virus Pneumonia by Suppressing TLR/NF-κB Pathway in Respiratory Epithelial Cells
Zihan GENG ; Lei BAO ; Shan CAO ; Qiang ZHU ; Jun PAN ; Shuran LI ; Ronghua ZHAO ; Jing SUN ; Yanyan BAO ; Shaoqiu MU ; Xiaolan CUI ; Shanshan GUO
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(24):61-68
ObjectiveTo investigate the possible mechanism of Shufeng Jiedu capsules (SFJD) in alleviating influenza A (H1N1) virus pneumonia and focus on its effect on Toll-like receptor (TLR) signaling pathway in respiratory epithelial cells. MethodsA mouse model of viral pneumonia was established via the A/PR/8/34 (PR8) strain of influenza A virus. Mice were randomly divided into a normal group, a PR8 infection (PR8) group, and an SFJD group (8.4 g·kg-1), with 10 mice in each group. The day of infection was designated as day 1. The SFJD group was administered intragastrically at a volume of 20 mL·kg-1 daily, while the normal and PR8 groups were given an equal volume of deionized water. Micro-computed tomography (Micro-CT) was performed on day 5, and the mice were dissected to collect their lungs, after which the lung index was calculated to verify the therapeutic effect of SFJD. Single-cell sequencing was used to analyze the differentially expressed genes in respiratory epithelial cells. Multiplex fluorescence immunohistochemistry was employed to detect the expression of TLR, tumor necrosis factor receptor-associated factor 6 (TRAF6), and myeloid differentiation factor 88 (MyD88) proteins in epithelial cell adhesion molecule (EpCAM)-positive cells, and the proportion of respiratory epithelial cells expressing TLR pathway proteins was calculated. Respiratory epithelial cells were then sorted by flow cytometry, and Western blot was used to detect the expression of TLR, MyD88, TRAF6, Toll-interleukin receptor domain-containing adaptor inducing interferon-β (TRIF), inhibitor of κB kinase α (IKKα), and nuclear factor-κB (NF-κB) in the sorted epithelial cells. Enzyme-linked immunosorbent assay (ELISA) was used to measure the levels of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) in lung tissue. ResultsAt the transcriptional level, SFJD reversed the expression of TLR signaling pathway genes in respiratory epithelial cells, downregulating multiple TLR signaling pathway-related genes (P<0.01). At the protein level, SFJD significantly reduced the proportion of respiratory epithelial cells expressing TLR3 (P<0.05), the expression levels of TLR2, TLR3, TLR4, TRIF, TRAF6, IKKα, and NF-κB in epithelial cells(P<0.05, P<0.01), as well as the levels of pro-inflammatory cytokines IL-1β and TNF-α in lung tissue (P<0.01). ConclusionSFJD may alleviate viral pneumonia by suppressing the expression of TLR in respiratory epithelial cells and their subsequent signaling cascades.
7.SIRT3 protects endometrial receptivity in patients with polycystic ovary syndrome.
Zhonghong ZENG ; Hongying SHAN ; Mingmei LIN ; Siyu BAO ; Dan MO ; Feng DENG ; Yang YU ; Yihua YANG ; Ping ZHOU ; Rong LI
Chinese Medical Journal 2025;138(10):1225-1235
BACKGROUND:
The sirtuin family is well recognized for its crucial involvement in various cellular processes. Nevertheless, studies on its role in the human endometrium are limited. This study aimed to explore the expression and localization of the sirtuin family in the human endometrium, focusing on sirtuin 3 (SIRT3) and its potential role in the oxidative imbalance of the endometrium in polycystic ovary syndrome (PCOS).
METHODS:
Endometrial specimens were collected from both patients with PCOS and controls undergoing hysteroscopy at the Center for Reproductive Medicine, Peking University Third Hospital, from July to August 2015 and used for cell culture. The protective effects of SIRT3 were investigated, and the mechanism of SIRT3 in improving endometrial receptivity of patients with PCOS was determined using various techniques, including cellular bioenergetic analysis, small interfering ribonucleic acid (siRNA) silencing, real-time quantitative polymerase chain reaction, Western blot, immunofluorescence, immunohistochemistry, and flow cytometry analysis.
RESULTS:
The sirtuin family was widely expressed in the human endometrium, with SIRT3 showing a significant increase in expression in patients with PCOS compared with controls ( P <0.05), as confirmed by protein and gene assays. Concurrently, endometrial antioxidant levels were elevated, while mitochondrial respiratory capacity was reduced, in patients with PCOS ( P <0.05). An endometrial oxidative stress (OS) model revealed that the downregulation of SIRT3 impaired the growth and proliferation status of endometrial cells and reduced their receptivity to day 4 mouse embryos. The results suggested that SIRT3 might be crucial in maintaining normal cellular state by regulating antioxidants, cell proliferation, and apoptosis, thereby contributing to enhanced endometrial receptivity.
CONCLUSIONS
Our findings proposed a significant role of SIRT3 in improving endometrial receptivity in patients with PCOS by alleviating OS and regulating the balance between cell proliferation and apoptosis. Therefore, SIRT3 could be a promising target for predicting and improving endometrial receptivity in this patient population.
Humans
;
Female
;
Polycystic Ovary Syndrome/metabolism*
;
Endometrium/metabolism*
;
Sirtuin 3/genetics*
;
Oxidative Stress/genetics*
;
Adult
;
Animals
;
Mice
;
Apoptosis/physiology*
;
Immunohistochemistry
;
Cell Proliferation/physiology*
8.Saltwater stir-fried Plantaginis Semen alleviates renal fibrosis by regulating epithelial-mesenchymal transition in renal tubular cells.
Xin-Lei SHEN ; Qing-Ru ZHU ; Wen-Kai YU ; Li ZHOU ; Qi-Yuan SHAN ; Yi-Hang ZHANG ; Yi-Ni BAO ; Gang CAO
China Journal of Chinese Materia Medica 2025;50(5):1195-1208
This study aimed to investigate the effect of saltwater stir-fried Plantaginis Semen(SPS) on renal fibrosis in rats and decipher the underlying mechanism. Thirty-six Sprague-Dawley rats were randomly assigned into control, model, losartan potassium, and low-, medium-, and high-dose(15, 30, and 60 g·kg~(-1), respectively) SPS groups. Rats in other groups except the control group were subjected to unilateral ureteral obstruction(UUO) to induce renal fibrosis, and the modeling and gavage lasted for 14 days. After 14 consecutive days of treatment, the levels of serum creatinine(Scr) and blood urea nitrogen(BUN) in rats of each group were determined by an automatic biochemical analyzer. Hematoxylin-eosin(HE) and Masson staining were used to evaluate pathological changes in the renal tissue. Western blot and immunofluorescence assay were conducted to determine the protein levels of fibronectin(FN), collagen Ⅰ, vimentin, and α-smooth muscle actin(α-SMA) in the renal tissue. The mRNA levels of epithelial-mesenchymal transition(EMT)-associated transcription factors including twist family bHLH transcription factor 1(TWIST1), snail family transcriptional repressor 1(SNAI1), and zinc finger E-box binding homeobox 1(ZEB1), as well as inflammatory cytokines such as interleukin-1β(IL-1β), interleukin-6(IL-6), and tumor necrosis factor-α(TNF-α), were determined by RT-qPCR. Human renal proximal tubular epithelial(HK2) cells exposed to transforming growth factor-β(TGF-β) for the modeling of renal fibrosis were used to investigate the inhibitory effect of SPS on EMT. Network pharmacology and Western blot were employed to explore the molecular mechanism of SPS in alleviating renal fibrosis. The results showed that SPS significantly reduced Scr and BUN levels and alleviated renal injury and collagen deposition in UUO rats. Moreover, SPS notably down-regulated the protein levels of FN, collagen Ⅰ, vimentin, and α-SMA as well as the mRNA levels of SNAI1, ZEB1, TWIST1, IL-1β, IL-6, and TNF-α in the kidneys of UUO rats and TGF-β-treated HK-2 cells. In addition, compared with Plantaginis Semen without stir-frying with saltwater, SPS showed increased content of specific compounds, which were mainly enriched in the mitogen-activated protein kinase(MAPK) signaling pathway. SPS significantly inhibited the phosphorylation of extracellular signal-regulated kinase(ERK) and p38 MAPK in the kidneys of UUO rats and TGF-β-treated HK2 cells. In conclusion, SPS can alleviate renal fibrosis by attenuating EMT through inhibition of the MAPK signaling pathway.
Animals
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Epithelial-Mesenchymal Transition/drug effects*
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Rats, Sprague-Dawley
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Male
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Rats
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Fibrosis/genetics*
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Drugs, Chinese Herbal/administration & dosage*
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Kidney Diseases/pathology*
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Kidney Tubules/pathology*
;
Humans
9.Expert consensus on evaluation index system construction for new traditional Chinese medicine(TCM) from TCM clinical practice in medical institutions.
Li LIU ; Lei ZHANG ; Wei-An YUAN ; Zhong-Qi YANG ; Jun-Hua ZHANG ; Bao-He WANG ; Si-Yuan HU ; Zu-Guang YE ; Ling HAN ; Yue-Hua ZHOU ; Zi-Feng YANG ; Rui GAO ; Ming YANG ; Ting WANG ; Jie-Lai XIA ; Shi-Shan YU ; Xiao-Hui FAN ; Hua HUA ; Jia HE ; Yin LU ; Zhong WANG ; Jin-Hui DOU ; Geng LI ; Yu DONG ; Hao YU ; Li-Ping QU ; Jian-Yuan TANG
China Journal of Chinese Materia Medica 2025;50(12):3474-3482
Medical institutions, with their clinical practice foundation and abundant human use experience data, have become important carriers for the inheritance and innovation of traditional Chinese medicine(TCM) and the "cradles" of the preparation of new TCM. To effectively promote the transformation of new TCM originating from the TCM clinical practice in medical institutions and establish an effective evaluation index system for the transformation of new TCM conforming to the characteristics of TCM, consensus experts adopted the literature research, questionnaire survey, Delphi method, etc. By focusing on the policy and technical evaluation of new TCM originating from the TCM clinical practice in medical institutions, a comprehensive evaluation from the dimensions of drug safety, efficacy, feasibility, and characteristic advantages was conducted, thus forming a comprehensive evaluation system with four primary indicators and 37 secondary indicators. The expert consensus reached aims to encourage medical institutions at all levels to continuously improve the high-quality research and development and transformation of new TCM originating from the TCM clinical practice in medical institutions and targeted at clinical needs, so as to provide a decision-making basis for the preparation, selection, cultivation, and transformation of new TCM for medical institutions, improve the development efficiency of new TCM, and precisely respond to the public medication needs.
Medicine, Chinese Traditional/standards*
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Humans
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Consensus
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Drugs, Chinese Herbal/therapeutic use*
;
Surveys and Questionnaires
10.Exploring critical thinking in the management of diagnosis and treatment of fulminant pregnancy-associated atypical haemolytic uraemic syndrome.
Fei GAO ; Lunsheng JIANG ; Shan MA ; Yuantuan YAO ; Wanping AO ; Bao FU
Chinese Critical Care Medicine 2025;37(7):680-683
Critical care emphasizes critical thinking, focuses on the triggers that lead to disease progression, and attaches great importance to early diagnosis of diseases and assessment of the compensatory capacity of vital organs. Pregnancy-associated atypical hemolytic uremic syndrome (P-aHUS) is relatively rare in the intensive care unit (ICU). Most cases occur within 10 weeks after delivery. Severe cases can be life-threatening. It characterized by microangiopathic hemolytic anemia, decreased platelet count (PLT), and acute kidney injury (AKI). Early clinical diagnosis is difficult due to its similarity to various disease manifestations. On January 28, 2024, a 26-year-old pregnant woman at 26+3 weeks gestation was transferred to the ICU 19 hours post-vaginal delivery due to abdominal pain, reduced urine output, decreased PLT, elevated D-dimer, tachycardia, increased respiratory rate and declined oxygenation. On the day of ICU admission, the critical care physician identified the causes that triggered the acute respiratory and circulatory events based on the "holistic and local" critical care thinking. The condition was stabilized rapidly by improving the capacity overload. In terms of etiological diagnosis, under the guidance of the "point and face" critical care thinking, starting from abnormality indicators including a decrease in hemoglobin (Hb) and PLT and elevated D-dimer and fibrin degradation product (FDP) without other abnormal coagulation indicators, the critical care physician ultimately determined the diagnosis direction of thrombotic microangiopathy (TMA) by delving deeply into the essence of the disease and formulating a laboratory examination plan in a reasonable and orderly manner. In terms of in-depth diagnosis, combining the disease development process, family history, and past history, applying the two-way falsification thinking of "forward and reverse" as well as "questioning and hypothesis", the diagnosis possibilities of preeclampsia, HELLP syndrome [including hemolysis (H), elevated liver function (EL) and low platelet count (LP)], thrombotic thrombocytopenic purpura (TTP), typical hemolytic uremic syndrome (HUS), and autoimmune inflammatory diseases inducing the condition was ruled out. The diagnosis of complement activation-induced P-aHUS was finally established for the patient, according to the positive result of the complement factor H (CFH). Active decision was made in the initial treatment. The plasma exchange was initiated early. "Small goals" were formulated in stages. The "small endpoints" were dynamically controlled in a goal-oriented manner to achieve continuous realization of the overall treatment effect through phased "small goals". On the 5th day of ICU treatment, the trend of microthrombosis in the patient was controlled, organ function damage was improved, and the patient was transferred out of the ICU. It is possible to reach a favorable clinical outcome for critically ill patients by applying a critical care mindset to quickly integrate diagnostic and therapeutic strategies, accurately identifying the triggers and causes that led to the progression of the disease, and using critical care medical techniques for early and effective intervention.
Humans
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Female
;
Pregnancy
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Adult
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Atypical Hemolytic Uremic Syndrome/therapy*
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Intensive Care Units
;
Pregnancy Complications, Hematologic/therapy*
;
Critical Care

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