96 research outputs found

    Plasma exchange treatment of a diabetic ketoacidosis child with hyperlipidemia to avoid pancreatitis: a case report

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    Type 1 diabetes mellitus (T1DM) is a metabolic disorder characterized by an absolute deficiency of insulin due to pancreatic failure. Diabetes ketoacidosis (DKA) has emerged as one of the most common complications of T1DM. Although exceedingly rare, the onset of T1DM with DKA may result in lipemia secondary to severe hypertriglyceridemia (HTG), accounting for several cases in the pediatric population. Along this line, plasma exchange treatment in children with DKA and severe hyperlipidemia has only been reported in some cases. In this case report, the diagnosis of an 11-year-old girl with diabetes ketoacidosis accompanied by severe HTG, along with subsequent plasma exchange treatment, is presented. Initially, the patient received initial management with crystalloid fluid bolus and intravenous insulin therapy. Despite rapid correction of acidosis, persistent HTG subsequently prompted the plasma exchange treatment. A total of three sessions were administered over 2 days, leading to a significant reduction in the triglyceride levels and corneal opacity resolution, indicating a successful therapeutic intervention

    Latissimus dorsi flap – the main force in breast reconstruction for breast tumor in Chinese population

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    BackgroundThe latissimus dorsi flap (LDF) is the most commonly used autologous flap for breast reconstruction (BR) in China. We conducted this study to explore the current status of BR using LDF with/without implants.MethodsThis study was a single-center retrospective study that included breast tumor patients who underwent LDF breast reconstruction at Fudan University Shanghai Cancer Center (FUSCC) between 2000 and 2021.ResultsWe analyzed 4918 patients who underwent postmastectomy BR, including 1730 patients (35.2%) with autologous flaps. LDF was used for BR in 1093 (22.2%) patients, and an abdominal flap was used in 637 (13.0%) patients. The proportion of LDFs used in autologous BR patients decreased each year and dropped to approximately 65.0% after 2013 due to the increased use of abdominal flaps. Among these patients, 609 underwent extended LDF (ELDF) BR, 455 underwent LDF BR with implants, and 30 received a LDF as a salvage flap due to previous flap or implant failure. Patients who underwent ELDF reconstruction were older and had a higher BMI than those who received a LDF with implants. There was no significant difference in the mean postoperative hospital stay, neoadjuvant chemotherapy rates, or adjuvant radiotherapy rates between the two groups. Major complications requiring surgical intervention occurred in 25 patients (2.29%). There was no significant difference in the incidence of major complications between the two groups (P=0.542).ConclusionsLDF breast reconstruction is a well-developed and safe procedure. The duration of postoperative hospitalization nor the incidence of major complications was affected by implant use

    Opportunistic Intermittent Control with Safety Guarantees for Autonomous Systems

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    Control schemes for autonomous systems are often designed in a way that anticipates the worst case in any situation. At runtime, however, there could exist opportunities to leverage the characteristics of specific environment and operation context for more efficient control. In this work, we develop an online intermittent-control framework that combines formal verification with model-based optimization and deep reinforcement learning to opportunistically skip certain control computation and actuation to save actuation energy and computational resources without compromising system safety. Experiments on an adaptive cruise control system demonstrate that our approach can achieve significant energy and computation savings

    Kun: Answer Polishment for Chinese Self-Alignment with Instruction Back-Translation

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    In this paper, we introduce Kun, a novel approach for creating high-quality instruction-tuning datasets for large language models (LLMs) without relying on manual annotations. Adapting a self-training algorithm based on instruction back-translation and answer polishment, Kun leverages unlabelled data from diverse sources such as Wudao, Wanjuan, and SkyPile to generate a substantial dataset of over a million Chinese instructional data points. This approach significantly deviates from traditional methods by using a self-curation process to refine and select the most effective instruction-output pairs. Our experiments with the 6B-parameter Yi model across various benchmarks demonstrate Kun's robustness and scalability. Our method's core contributions lie in its algorithmic advancement, which enhances data retention and clarity, and its innovative data generation approach that substantially reduces the reliance on costly and time-consuming manual annotations. This methodology presents a scalable and efficient solution for improving the instruction-following capabilities of LLMs, with significant implications for their application across diverse fields. The code and dataset can be found at https://github.com/Zheng0428/COIG-KunComment: 12 pages, 12 figure
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