A rapidly growing field is piezoresistive sensor for accurate respiration rate monitoring to suppress the worldwide respiratory illness.However,a large neglected issue is the sensing durability and accuracy without in...A rapidly growing field is piezoresistive sensor for accurate respiration rate monitoring to suppress the worldwide respiratory illness.However,a large neglected issue is the sensing durability and accuracy without interference since the expiratory pressure always coupled with external humidity and temperature variations,as well as mechanical motion artifacts.Herein,a robust and biodegradable piezoresistive sensor is reported that consists of heterogeneous MXene/cellulose-gelation sensing layer and Ag-based interdigital electrode,featuring customizable cylindrical interface arrangement and compact hierarchical laminated architecture for collectively regulating the piezoresistive response and mechanical robustness,thereby realizing the long-term breath-induced pressure detection.Notably,molecular dynamics simulations reveal the frequent angle inversion and reorientation of MXene/cellulose in vacuum filtration,driven by shear forces and interfacial interactions,which facilitate the establishment of hydrogen bonds and optimize the architecture design in sensing layer.The resultant sensor delivers unprecedented collection features of superior stability for off-axis deformation(0-120°,~2.8×10^(-3) A)and sensing accuracy without crosstalk(humidity 50%-100%and temperature 30-80).Besides,the sensor-embedded mask together with machine learning models is achieved to train and classify the respiration status for volunteers with different ages(average prediction accuracy~90%).It is envisioned that the customizable architecture design and sensor paradigm will shed light on the advanced stability of sustainable electronics and pave the way for the commercial application in respiratory monitory.展开更多
Objective:To explore the clinical effect of a non-invasive ventilator combined with conventional therapy in the treatment of patients with chronic obstructive pulmonary disease(COPD)combined with respiratory failure.M...Objective:To explore the clinical effect of a non-invasive ventilator combined with conventional therapy in the treatment of patients with chronic obstructive pulmonary disease(COPD)combined with respiratory failure.Methods:68 patients with COPD combined with respiratory failure treated in our hospital from September 2021 to October 2023 were selected as the research subjects.Using the random number table method,they were divided into a control group and an experimental group of 34 cases each.The control group received conventional symptomatic treatment,and the experimental group received non-invasive ventilator treatment based on the control group.The clinical effects,blood gas indicators(partial pressure of carbon dioxide(PaCO_(2)),partial pressure of oxygen(PaO_(2)),arterial oxygen saturation(SaO_(2))),lung function(forced expiratory volume in 1 second(FEV1),forced vital capacity(FVC),6 min walking distance),complications,and inflammatory factor levels(c-reactive protein(CRP),interleukin-6(IL-6),neutrophil-to-lymphocyte ratio(NLR))of the two groups of patients were observed.Results:(1)The clinical efficacy of the patients in the experimental group(33/97.06%)was more significant as compared with the control group(25/73.53%)(P<0.05);(2)After treatment,the clinical efficacy of the two groups of patients in terms of FEV1,FEV1/FVC,6-minute walking distance,PaO_(2)and SaO_(2)all increased in the experimental group as compared to that of the control group(P<0.05);(3)After treatment,the PaCO_(2),CRP,IL-6,and NLR of the two groups of patients decreased,and the decrease in the experimental group was higher than that of the control group(P<0.05);(4)The patients’complication rate in the experimental group(2/5.88%)was lower as compared to that of the control group(9/26.46%)(P<0.05).Conclusion:Non-invasive ventilators combined with conventional therapy achieved good clinical results in treating patients with COPD and respiratory failure.展开更多
Objective:This study aims to evaluate the clinical efficacy of non-invasive positive pressure ventilation(NIPPV)in patients with severe bronchial asthma combined with respiratory failure.Methods:90 patients with sever...Objective:This study aims to evaluate the clinical efficacy of non-invasive positive pressure ventilation(NIPPV)in patients with severe bronchial asthma combined with respiratory failure.Methods:90 patients with severe bronchial asthma combined with respiratory failure between September 2022 and December 2023 were selected for the study and randomly divided into the experimental group(NIPPV-assisted treatment)and the control group.The differences between the two groups were compared in terms of total effective rate of treatment,days of clinical symptom disappearance,days of hospitalization,lung function indexes,incidence of adverse reactions,and quality of life.Results:Patients in the experimental group had a significantly higher total effective rate of treatment(97.78%)than the control group(75.56%).In terms of pulmonary function indexes,patients in the experimental group showed significant improvement after treatment,especially the increase in forced expiratory volume and forced vital capacity,while these improvements were not as obvious in the control group.In addition,the incidence of adverse reactions was significantly lower in the experimental group than in the control group,suggesting that the application of NIPPV is relatively safe.Quality of life assessment also showed that patients in the experimental group had significantly better quality of life than the control group after treatment.Conclusion:This study demonstrated the effectiveness of NIPPV as an adjunctive treatment for severe bronchial asthma combined with respiratory failure.NIPPV can improve lung function,reduce the incidence of adverse effects,increase the overall effectiveness of the treatment,and contribute to the improvement of patients'quality of life.Therefore,NIPPV should be regarded as an effective and safe treatment in clinical management,especially in patients with severe bronchial asthma combined with respiratory failure,where its application has potential clinical significance.展开更多
Objective:To analyze key factors associated with the failure of non-invasive ventilation(NIV)in patients with acute exacerbations of chronic obstructive pulmonary disease(AECOPD)complicated by type II respiratory fail...Objective:To analyze key factors associated with the failure of non-invasive ventilation(NIV)in patients with acute exacerbations of chronic obstructive pulmonary disease(AECOPD)complicated by type II respiratory failure.Methods:A total of 122 patients with AECOPD and type II respiratory failure admitted to Gaoyou People’s Hospital between January 2020 and June 2023 were selected for the study.Upon admission,all patients received ECG monitoring and NIV,along with comprehensive therapies such as anti-infective treatment,antispasmodics,bronchodilators,and expectorants.NIV was provided using the S/T mode,with ventilator parameters adjusted based on the patient’s respiratory status and blood gas analysis results.Clinical data were retrospectively analyzed from electronic medical records.Results:Out of the 122 patients,30 experienced NIV failure,accounting for 24.59%.Significant differences were observed in C-reactive protein(CRP),pH,and partial pressure of arterial carbon dioxide(PaCO_(2))between patients with successful and failed NIV outcomes(P<0.05).There were no statistically significant differences in gender,age,arterial oxygen partial pressure(PaO_(2)),neutrophil count(NEUT),procalcitonin(PCT),albumin(ALB),or tidal volume between the two groups(P>0.05).Logistic regression analysis confirmed that CRP,pH,and PaCO_(2)were significant risk factors for NIV failure(P<0.05).Conclusion:CRP,pH,and PaCO_(2)are independent risk factors influencing NIV failure.展开更多
The clinical course ofchronic liver diseases is significantly dependent on the progression rate and the extent offibrosis, i.e. the non-structured replacement of necrotic parenchyma by extracellular matrix. Fibrogenes...The clinical course ofchronic liver diseases is significantly dependent on the progression rate and the extent offibrosis, i.e. the non-structured replacement of necrotic parenchyma by extracellular matrix. Fibrogenesis, i.e. the development offibrosis can be regarded as an unlimited wound healing process, which is based on matrix (connective tissue) synthesis in activated hepatic stellate cells, fibroblasts (fibrocytes), hepatocytes and biliary epithelial cells, which are converted to matrix-producing (myo-)fibroblasts by a process defined as epithelial-mesenchymal transition. Blood (noninvasive) biomarkers offibrogenesis and fibrosis can be divided into class and class analytes. Class biomarkers are those single tests, which are based on the pathophysiology offibrosis, whereas class biomarkers aremostly multiparametric algorithms, which have been statistically evaluated with regard to the detection and activity ofongoing fibrosis. Currently available markers fulfil the criteria ofideal clinical-chemical tests only partially, but increased understanding ofthe complex pathogenesis offibrosis offers additional ways for pathophysiologically well based serum (plasma) biomarkers. They include TGF-β-driven marker proteins, bone marrow-derived cells (fibrocytes), and cytokines, which govern proand anti-fibrotic activities. Proteomic and glycomic approaches ofserum are under investigation to set up specific protein or carbohydrate profiles in patients with liver fibrosis. These and other novel parameters will supplement or eventually replaceliver biopsy/histology, high resolution imaging analysis, and elastography for the detection and monitoring of patients at risk ofdeveloping liver fibrosis.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
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
To study monitoring hemodynamics and oxygen dynamics of adult respiratory distress syndrome (ARDS) secondary to high altitude pulmonary edema (HAPE),we performed clinic and laboratory studies in 8 patients who prelimi...To study monitoring hemodynamics and oxygen dynamics of adult respiratory distress syndrome (ARDS) secondary to high altitude pulmonary edema (HAPE),we performed clinic and laboratory studies in 8 patients who preliminarily developed high altitude cerebral edema (HACE) and then ARDS occurred at an altitude of 4 500 m. After an initial emergency treatment on high mountains,all the patients were rapidly transported to a hospital at a lower altitude of 2 808 m. The right cardiac catheterizations were carried out within 5 h after hospitalized. The monitoring hemodynamics and oxygen dynamics were studied via a thermodilution Swan-Gaze catheter. The results showed that before treatments at the beginning of monitoring,there presented a significant pulmonary artery hypertension with a decreased cardiac function,and a lower oxygen metabolism in all the 8 patients. However,after some effective treatments,including mechanical ventilation and using dexamethasone,furosemide,etc,four days later the result of a repeated monitoring showed that their pulmonary artery pressure had been decreased with an improved cardiac function with all the oxygen metabolic indexes increased significantly. Our studies suggested that performing monitoring hemodynamics in patients with ARDS secondary to HAPE will define the clinical therapeutic measures which will benefit the outcome.展开更多
Continuous and dynamic measurements of human respiratory parameters are very important for vital diseases of respiratory system during mechanical ventilation. This paper analyzed the structure and mechanical propertie...Continuous and dynamic measurements of human respiratory parameters are very important for vital diseases of respiratory system during mechanical ventilation. This paper analyzed the structure and mechanical properties of the human respiratory system, and designed an active intervening monitoring micro system for it. The mobile mechanism of the micro system is soft and earthworm-like movement actuated by pneumatic rubber actuator, the measurement and therapy unit of the system is an extensible mechanism with sensors in the front. The micro monitoring system can move in respiratory tract and measure the respiratory parameters in bronchium continuously. Experiments had been done in swine＇s respiratory tract, the results proved that the micro robot system could measure the respiratory parameters in real-time successfully and its movement was smith in swine＇s respiratory tract.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
Real-time physiological information monitoring can predict and prevent disease, or improve treatment by early diagnosis. A comprehensive and continuous monitoring of human health requires highly integrated wearable an...Real-time physiological information monitoring can predict and prevent disease, or improve treatment by early diagnosis. A comprehensive and continuous monitoring of human health requires highly integrated wearable and comfortable sensing devices. To address this need, we propose a low-cost electronic fabric-enabled multifunctional flexible sensing integration platform that includes a flexible pressure sensor for monitoring postural pressure, a humidity sensor for monitoring the humidity of the skin surface, and a flexible temperature sensor for visualizing the ambient temperature around the human body. Thanks to the unique rough surface texture, hierarchical structure, and robust electromechanical features of the MXene-modified nonwoven fabrics, the flexible pressure sensor can achieve a monitoring sensitivity of 1529.1 kPa~(-1) and a pressure range of 150 kPa, which meets the demand for human pressure detection. In addition, the unique porous structure of the fabric and the stacked multilayer structure of MXene enable the humidity sensor to exhibit extremely high monitoring sensitivity, even through clothing, and still be able to detect the humidity on the skin surface.Temperature sensors based on screen-printed thermochromic liquid crystals enable visual monitoring in the range of 0℃–65℃. Through further integration with flexible printed circuit board circuits, we demonstrate a proof-of-concept device that enables real-time monitoring of human physiological information such as physical pressure, humidity, and ambient temperature environment, suggesting that the device provides an excellent platform for the development of commercially viable wearable healthcare monitors.展开更多
Objective:To observe the application effect of non-invasive ventilator in the treatment of acute heart failure merged with respiratory failure in ICU.Methods:A total of 80 patients with acute heart failure merged with...Objective:To observe the application effect of non-invasive ventilator in the treatment of acute heart failure merged with respiratory failure in ICU.Methods:A total of 80 patients with acute heart failure merged with respiratory failure who were admitted in ICU from January, 2015 to January, 2016 were included in the study and randomized into the observation group and the control group with 40 cases in each group. The patients in the two groups were given routine treatments after admission. On this basis, the patients in the observation group were given non-invasive ventilator. The patients in the control group were given continuous low flow oxygen inhalation. PaO2, pH, PaCO2, SaO2, and PaO2/FiO2 before and after treatment between the two groups were compared. The serum NT-pro BNP and cTnI levels before treatment, 24 h and 48 h after treatment in the two groups were compared.Results:The comparison of PaO2, pH, PaCO2, SaO2, and PaO2/FiO2 before treatment between the two groups was not statistically significant. PaO2, pH, SaO2, and PaO2/FiO2 after treatment in the two groups were significantly elevated, while PaCO2 was significantly reduced when compared with before treatment. PaO2, pH, SaO2, and PaO2/FiO2 after treatment in the observation group were significantly higher than those in the control group, while PaCO2 was significantly lower than that in the control group. The comparison of NT-pro BNP and cTnI levels before treatment between the two groups was not statistically significant. NT-pro BNP and cTnI levels 12 h and 24 h after treatment in the two groups were significantly elevated when compared with before treatment. NT-pro BNP and cTnI levels 12 h and 24 h after treatment in the observation group were significantly lower than those in the control group.Conclusions:Non-invasive ventilator in the treatment of acute heart failure merged with respiratory failure can effectively improve the ventilation function, reduce NT-pro BNP and cTnI levels, and is of great significance in enhancing the rescued effect.展开更多
Effect of multiple respiratory gas monitoring (MRGM ) on inspiredconcentration of oxygen in circult system during closed anesthesia was studied in 5l adult patients scheduled for abdominal surgery. Required flow rate ...Effect of multiple respiratory gas monitoring (MRGM ) on inspiredconcentration of oxygen in circult system during closed anesthesia was studied in 5l adult patients scheduled for abdominal surgery. Required flow rate of fresh oxygen (OFR), inspired oxygen concentration (FiO2 ) and oxygen saturation of pulse oximeter (SpO2) were measured continu0usly. Patients were equally divided into three groups at randorn, group C (no MRGN used ), group M, (using MRGM with its tail gas returned to circuit system), group M2 (using MRGM without tail gas returned ). The results revealed that during 180 min of closed anesthesia, OFR required in group C and M, were about 200-230 ml/min, and in group M, it was ab0ut 400 ml/min. In group C FiO2 decreased by about 10 % after 60 min of closed anesthesia (P<0. 01, 60 min vs 0 min ) and then stayed stable at this level. In group M,, FiO2 decreased by 16% at 60 min and 34 % at 180 min and the decrease was significantly greater than that in gr0up C (P<0. 01). In group Me, FiO2 remained c0nstant during closed anesthesia, which was much high(Jr than those in group C and M,. The tail gas of Capnomac Ultima MRGM contained less oxygen than its sample gas drawn fr0m circuit system simuItaneously.展开更多
Wearable electronics integrated with stretchable sensors are considered a promising and non-invasive strategy to monitor respiratory status for health assessment.However,long-term and stable monitoring of respiratory ...Wearable electronics integrated with stretchable sensors are considered a promising and non-invasive strategy to monitor respiratory status for health assessment.However,long-term and stable monitoring of respiratory abnormality is still a grand challenge.Here,we report a facile one-step thermal stretching strategy to fabricate an anti-fatigue ionic gel(AIG)sensor with high fatigue threshold(0=1130 J m^(–2)),high stability(>20,000 cycles),high linear sensitivity,and recyclability.A multimodal wearable respiratory monitoring system(WRMS)developed with AIG sensors can continuously measure respiratory abnormality(single-sensor mode)and compliance(multi-sensor mode)by monitoring the movement of the ribcage and abdomen in a long-term manner.For single-sensor mode,the respiratory frequency(Fr),respiratory energy(Er),and inspire/expire time(I/E ratio)can be extracted to evaluate the respiratory status during sitting,sporting,and sleeping.Further,the multi-sensors mode is developed to evaluate patientventilator asynchrony through validated clinical criteria by monitoring the incongruous movement of the chest and abdomen,which shows great potential for both daily home care and clinical applications.展开更多
Objective: to observe the effect and efficiency of noninvasive ventilator in the treatment of COPD with respiratory failure. Method: to our patients with COPD with respiratory failure, choose the main stage for Februa...Objective: to observe the effect and efficiency of noninvasive ventilator in the treatment of COPD with respiratory failure. Method: to our patients with COPD with respiratory failure, choose the main stage for February 2020 to December 2021, randomly divided into two groups, a group of 37 cases mainly in routine treatment, the remaining main non-invasive ventilator treatment, observation group treatment efficiency, blood gas analysis, lung function, symptom relief, and complication rate. Results: the relevant data results obtained with treatment efficiency were higher than the observation group, P 0.05;the analysis of the observation group was P 0.05 better than the observation group and P 0.05 was better than the symptom relief data results, and the observation group was P 0.05, and the heart rate was lower than the control group, with P 0.05. Conclusion: non-invasive ventilator treatment in patients with COPD and respiratory failure can improve the treatment efficiency, improve the blood gas analysis and lung function, promote the relief of clinical symptoms, and improve the heart rate and respiratory rate.展开更多
Objective: the treatment of neonatal respiratory distress syndrome, there are two schemes that can treat the disease and the curative effect is better than that of the two schemes. Methods: the patients who participat...Objective: the treatment of neonatal respiratory distress syndrome, there are two schemes that can treat the disease and the curative effect is better than that of the two schemes. Methods: the patients who participated in this experiment were all from our hospital from January 2019 to December 2021. Forty children with hyaline membrane disease were selected for experimental analysis. The analysis method adopted in this experiment is a comparative model. Therefore, the general data grouping method should be applied to the group, the control group and the observation group, with 20 children in each group. The children in the control group received nasal continuous positive pressure ventilation, while the children in the observation group received nasal intermittent positive pressure ventilation. After taking the treatment, the evaluation index is mainly based on the patient's blood gas index, ventilation treatment effect and complications. Results: after some treatment, we concluded that the blood gas indexes of the observation group had obvious improvement effect after 2 hours of treatment, and because of the control group. Before this, there was no difference in blood gas indexes between the two groups. The two groups found that the observation group was superior to the control group in all aspects after comparing the operation time, total oxygen absorption time and relevant time indicators of the children. At the same time, the incidence of complications in the observation group is also higher than that in the control group. Conclusion: through analysis and research, it is concluded that in the treatment of neonatal respiratory distress syndrome, nasal intermittent positive pressure ventilation is significantly better than nasal continuous positive pressure ventilation for the recovery of children. It can effectively improve the ventilation function and blood gas index of children, which is a very important promotion.展开更多
Chronic kidney disease(CKD)is a degenerative disorder that affects millions of people throughout the world,causing considerable morbidity and healthcare burden.Frequent blood sampling is the current gold standard for ...Chronic kidney disease(CKD)is a degenerative disorder that affects millions of people throughout the world,causing considerable morbidity and healthcare burden.Frequent blood sampling is the current gold standard for monitoring CKD to evaluate biochemical and mineral indicators.However,there are draw-backs to frequent blood draws,such as pain for patients,the possibility of infe-ction,and higher medical expenses.Saliva-based diagnostics offer advantages such as ease of collection,reduced invasiveness,and improved patient compli-ance.A comprehensive literature review was conducted to analyze studies eva-luating the diagnostic utility of salivary creatinine,urea,calcium,and parathyroid hormone(PTH)in patients with CKD.Various saliva collection methods,inc-luding stimulated and unstimulated approaches,were investigated for efficiency and reliability,and a correlation was shown between serum and salivary crea-tinine,urea,PTH,and calcium levels,indicating their potential as CKD biomar-kers.Despite these promising findings,challenges such as standardization of collection methods,variability in salivary flow rates,and predictive value in association with blood parameters are addressed to ensure clinical applicability.This review explores the potential and challenges of saliva as a non-invasive alternative for CKD diagnostics.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
Objective:To evaluate the in-hospital outcome of moderate to severe COVID-19 patients admitted in High Dependency Unit(HDU)in relation to invasive vs.non-invasive mode of ventilation.Methods:In this study,the patients...Objective:To evaluate the in-hospital outcome of moderate to severe COVID-19 patients admitted in High Dependency Unit(HDU)in relation to invasive vs.non-invasive mode of ventilation.Methods:In this study,the patients required either non-invasive[oxygen≤10 L/min or>10 L/min through mask or nasal prongs,rebreather masks and bilevel positive airway pressure(BiPAP)]or invasive ventilation.For analysis of 30-day in hospital mortality in relation to use of different modes of oxygen,Kaplan Meier and log rank analyses were used.In the end,independent predictors of survival were determined by Cox regression analysis.Results:Invasive ventilation was required by 15.1%patients while 84.9%patients needed non-invasive ventilation.Patients with evidence of thromboembolism,high inflammatory markers and hypoxemia mainly required invasive ventilation.The 30-day in hospital mortality was 72.7%for the invasive group and 12.9%for the non-invasive group(1.8%oxygen<10 L/min,0.9%oxygen>10 L/min,3.6%rebreather mask and 4.5%BiPAP).The median time from hospital admission to outcome was 7 days for the invasive group and 18 days for the non-invasive group(P<0.05).Age,presence of co-morbidities,number of days requiring oxygen,rebreather,BiPAP and invasive ventilation were independent predictors of outcome.Conclusions:Invasive mechanical ventilation is associated with adverse outcomes possibly due to ventilator associated lung injury.Thus,protective non-invasive ventilation remains the necessary and safe treatment for severely hypoxic COVID-19 patients.展开更多
AIM: To determine whether a newly developed respiratory rate monitor can practically and accurately monitor ventilation under propofol sedation in combination with standard monitoring. METHODS: Patients [American Soci...AIM: To determine whether a newly developed respiratory rate monitor can practically and accurately monitor ventilation under propofol sedation in combination with standard monitoring. METHODS: Patients [American Society of Anesthesiologists(ASA) Classification Ⅰ-Ⅲ] scheduled for elective colonoscopy under propofol sedation were monitored with a new device that measures the respiratory rate based on humidity in expired air. Patients with clinically significant cardiac disorders or pulmonary disease and patients requiring emergency procedures were excluded from study participation. All of the patients also received standard monitoring with pulse oximetry. This was a single-center study conducted in a community hospital in Switzerland. After obtaining written informed consent from all subjects, 76 patients(51 females and 25 males) were monitored during colonoscopy under propofol sedation. The primary endpoint was the occurrence of any respiratory event(apnea or hypopnea). Apnea was defined as the cessation of breathing for a minimum of 10 s. Significant apnea was defined as the cessation of breathing for more than 30 s. Hypopnea was defined as a reduction in the respiratory rate below 6/min for a minimum of 10 s. Any cases of significant apnea triggered interventions by the endoscopy team. The interventions included withholding propofol, verbal stimulation of the patients, and increased oxygen supplementation or the chin lift maneuver. A secondary endpoint was the correlation of apnea or hypopnea with hypoxemia(measured as a decrease in SaO2 of at least 5% from baseline or less than 90%). RESULTS: At least one respiratory event was detected in thirty-seven patients(48.7%). In total, there were 73 respiratory events, ranging from one to six events in a single patient. Significant apnea(> 30 s) occurred in five patients(6%). Only one episode of apnea led to a relative SaO2 reduction(from 98% to 93%) after a 50 s lag time. No event requiring assisted ventilation was recorded. Our analysis revealed that the total propofol dose was an independent risk factor for respiratory events(P = 0.01). Artifacts developed with the same frequency with the new device as with conventional pulse oximetry. Compared with pulse oximetry alone, this new monitoring device detected more respiratory events and may provide earlier warning of impending respiratory abnormalities. CONCLUSION: Apnea commonly occurs during endoscopy under sedation and may precede hypoxemia. We recommend this respiration rate monitor as an alternative to capnography to aid in detecting ventilatory problems.展开更多
基金supported by the National Natural Science Foundation of China(22074072,22274083,52376199)the Shandong Provincial Natural Science Foundation(ZR2023LZY005)+1 种基金the Exploration Project of the State Key Laboratory of BioFibers and EcoTextiles of Qingdao University(TSKT202101)the Fundamental Research Funds for the Central Universities(2022BLRD13,2023BLRD01).
文摘A rapidly growing field is piezoresistive sensor for accurate respiration rate monitoring to suppress the worldwide respiratory illness.However,a large neglected issue is the sensing durability and accuracy without interference since the expiratory pressure always coupled with external humidity and temperature variations,as well as mechanical motion artifacts.Herein,a robust and biodegradable piezoresistive sensor is reported that consists of heterogeneous MXene/cellulose-gelation sensing layer and Ag-based interdigital electrode,featuring customizable cylindrical interface arrangement and compact hierarchical laminated architecture for collectively regulating the piezoresistive response and mechanical robustness,thereby realizing the long-term breath-induced pressure detection.Notably,molecular dynamics simulations reveal the frequent angle inversion and reorientation of MXene/cellulose in vacuum filtration,driven by shear forces and interfacial interactions,which facilitate the establishment of hydrogen bonds and optimize the architecture design in sensing layer.The resultant sensor delivers unprecedented collection features of superior stability for off-axis deformation(0-120°,~2.8×10^(-3) A)and sensing accuracy without crosstalk(humidity 50%-100%and temperature 30-80).Besides,the sensor-embedded mask together with machine learning models is achieved to train and classify the respiration status for volunteers with different ages(average prediction accuracy~90%).It is envisioned that the customizable architecture design and sensor paradigm will shed light on the advanced stability of sustainable electronics and pave the way for the commercial application in respiratory monitory.
文摘Objective:To explore the clinical effect of a non-invasive ventilator combined with conventional therapy in the treatment of patients with chronic obstructive pulmonary disease(COPD)combined with respiratory failure.Methods:68 patients with COPD combined with respiratory failure treated in our hospital from September 2021 to October 2023 were selected as the research subjects.Using the random number table method,they were divided into a control group and an experimental group of 34 cases each.The control group received conventional symptomatic treatment,and the experimental group received non-invasive ventilator treatment based on the control group.The clinical effects,blood gas indicators(partial pressure of carbon dioxide(PaCO_(2)),partial pressure of oxygen(PaO_(2)),arterial oxygen saturation(SaO_(2))),lung function(forced expiratory volume in 1 second(FEV1),forced vital capacity(FVC),6 min walking distance),complications,and inflammatory factor levels(c-reactive protein(CRP),interleukin-6(IL-6),neutrophil-to-lymphocyte ratio(NLR))of the two groups of patients were observed.Results:(1)The clinical efficacy of the patients in the experimental group(33/97.06%)was more significant as compared with the control group(25/73.53%)(P<0.05);(2)After treatment,the clinical efficacy of the two groups of patients in terms of FEV1,FEV1/FVC,6-minute walking distance,PaO_(2)and SaO_(2)all increased in the experimental group as compared to that of the control group(P<0.05);(3)After treatment,the PaCO_(2),CRP,IL-6,and NLR of the two groups of patients decreased,and the decrease in the experimental group was higher than that of the control group(P<0.05);(4)The patients’complication rate in the experimental group(2/5.88%)was lower as compared to that of the control group(9/26.46%)(P<0.05).Conclusion:Non-invasive ventilators combined with conventional therapy achieved good clinical results in treating patients with COPD and respiratory failure.
文摘Objective:This study aims to evaluate the clinical efficacy of non-invasive positive pressure ventilation(NIPPV)in patients with severe bronchial asthma combined with respiratory failure.Methods:90 patients with severe bronchial asthma combined with respiratory failure between September 2022 and December 2023 were selected for the study and randomly divided into the experimental group(NIPPV-assisted treatment)and the control group.The differences between the two groups were compared in terms of total effective rate of treatment,days of clinical symptom disappearance,days of hospitalization,lung function indexes,incidence of adverse reactions,and quality of life.Results:Patients in the experimental group had a significantly higher total effective rate of treatment(97.78%)than the control group(75.56%).In terms of pulmonary function indexes,patients in the experimental group showed significant improvement after treatment,especially the increase in forced expiratory volume and forced vital capacity,while these improvements were not as obvious in the control group.In addition,the incidence of adverse reactions was significantly lower in the experimental group than in the control group,suggesting that the application of NIPPV is relatively safe.Quality of life assessment also showed that patients in the experimental group had significantly better quality of life than the control group after treatment.Conclusion:This study demonstrated the effectiveness of NIPPV as an adjunctive treatment for severe bronchial asthma combined with respiratory failure.NIPPV can improve lung function,reduce the incidence of adverse effects,increase the overall effectiveness of the treatment,and contribute to the improvement of patients'quality of life.Therefore,NIPPV should be regarded as an effective and safe treatment in clinical management,especially in patients with severe bronchial asthma combined with respiratory failure,where its application has potential clinical significance.
文摘Objective:To analyze key factors associated with the failure of non-invasive ventilation(NIV)in patients with acute exacerbations of chronic obstructive pulmonary disease(AECOPD)complicated by type II respiratory failure.Methods:A total of 122 patients with AECOPD and type II respiratory failure admitted to Gaoyou People’s Hospital between January 2020 and June 2023 were selected for the study.Upon admission,all patients received ECG monitoring and NIV,along with comprehensive therapies such as anti-infective treatment,antispasmodics,bronchodilators,and expectorants.NIV was provided using the S/T mode,with ventilator parameters adjusted based on the patient’s respiratory status and blood gas analysis results.Clinical data were retrospectively analyzed from electronic medical records.Results:Out of the 122 patients,30 experienced NIV failure,accounting for 24.59%.Significant differences were observed in C-reactive protein(CRP),pH,and partial pressure of arterial carbon dioxide(PaCO_(2))between patients with successful and failed NIV outcomes(P<0.05).There were no statistically significant differences in gender,age,arterial oxygen partial pressure(PaO_(2)),neutrophil count(NEUT),procalcitonin(PCT),albumin(ALB),or tidal volume between the two groups(P>0.05).Logistic regression analysis confirmed that CRP,pH,and PaCO_(2)were significant risk factors for NIV failure(P<0.05).Conclusion:CRP,pH,and PaCO_(2)are independent risk factors influencing NIV failure.
文摘The clinical course ofchronic liver diseases is significantly dependent on the progression rate and the extent offibrosis, i.e. the non-structured replacement of necrotic parenchyma by extracellular matrix. Fibrogenesis, i.e. the development offibrosis can be regarded as an unlimited wound healing process, which is based on matrix (connective tissue) synthesis in activated hepatic stellate cells, fibroblasts (fibrocytes), hepatocytes and biliary epithelial cells, which are converted to matrix-producing (myo-)fibroblasts by a process defined as epithelial-mesenchymal transition. Blood (noninvasive) biomarkers offibrogenesis and fibrosis can be divided into class and class analytes. Class biomarkers are those single tests, which are based on the pathophysiology offibrosis, whereas class biomarkers aremostly multiparametric algorithms, which have been statistically evaluated with regard to the detection and activity ofongoing fibrosis. Currently available markers fulfil the criteria ofideal clinical-chemical tests only partially, but increased understanding ofthe complex pathogenesis offibrosis offers additional ways for pathophysiologically well based serum (plasma) biomarkers. They include TGF-β-driven marker proteins, bone marrow-derived cells (fibrocytes), and cytokines, which govern proand anti-fibrotic activities. Proteomic and glycomic approaches ofserum are under investigation to set up specific protein or carbohydrate profiles in patients with liver fibrosis. These and other novel parameters will supplement or eventually replaceliver biopsy/histology, high resolution imaging analysis, and elastography for the detection and monitoring of patients at risk ofdeveloping liver fibrosis.
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.
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.
基金"973"National Key Basic Research and Development Program(No.2012CB518202)Project of Qinghai Development of Science and Technology(No.2011-N-150)
文摘To study monitoring hemodynamics and oxygen dynamics of adult respiratory distress syndrome (ARDS) secondary to high altitude pulmonary edema (HAPE),we performed clinic and laboratory studies in 8 patients who preliminarily developed high altitude cerebral edema (HACE) and then ARDS occurred at an altitude of 4 500 m. After an initial emergency treatment on high mountains,all the patients were rapidly transported to a hospital at a lower altitude of 2 808 m. The right cardiac catheterizations were carried out within 5 h after hospitalized. The monitoring hemodynamics and oxygen dynamics were studied via a thermodilution Swan-Gaze catheter. The results showed that before treatments at the beginning of monitoring,there presented a significant pulmonary artery hypertension with a decreased cardiac function,and a lower oxygen metabolism in all the 8 patients. However,after some effective treatments,including mechanical ventilation and using dexamethasone,furosemide,etc,four days later the result of a repeated monitoring showed that their pulmonary artery pressure had been decreased with an improved cardiac function with all the oxygen metabolic indexes increased significantly. Our studies suggested that performing monitoring hemodynamics in patients with ARDS secondary to HAPE will define the clinical therapeutic measures which will benefit the outcome.
文摘Continuous and dynamic measurements of human respiratory parameters are very important for vital diseases of respiratory system during mechanical ventilation. This paper analyzed the structure and mechanical properties of the human respiratory system, and designed an active intervening monitoring micro system for it. The mobile mechanism of the micro system is soft and earthworm-like movement actuated by pneumatic rubber actuator, the measurement and therapy unit of the system is an extensible mechanism with sensors in the front. The micro monitoring system can move in respiratory tract and measure the respiratory parameters in bronchium continuously. Experiments had been done in swine＇s respiratory tract, the results proved that the micro robot system could measure the respiratory parameters in real-time successfully and its movement was smith in swine＇s respiratory tract.
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financially National Natural Science Foundation of China (No. 62274140)Fundamental Research Funds for the Central Universities (No. 20720230030)+3 种基金Xiaomi Young Talents Program/Xiaomi Foundation, Shenzhen Science and Technology Program (No. JCYJ20230807091401003)National Key Research and Development Program of China (No. 2023YFB3208600)National Key Laboratory of Materials Behaviors and Evaluation Technology in Space Environments (No. WDZC-HGD-2022-08)Science and Technology on Vacuum Technology and Physics Laboratory Fund (No. HTKJ2023KL510008)。
文摘Real-time physiological information monitoring can predict and prevent disease, or improve treatment by early diagnosis. A comprehensive and continuous monitoring of human health requires highly integrated wearable and comfortable sensing devices. To address this need, we propose a low-cost electronic fabric-enabled multifunctional flexible sensing integration platform that includes a flexible pressure sensor for monitoring postural pressure, a humidity sensor for monitoring the humidity of the skin surface, and a flexible temperature sensor for visualizing the ambient temperature around the human body. Thanks to the unique rough surface texture, hierarchical structure, and robust electromechanical features of the MXene-modified nonwoven fabrics, the flexible pressure sensor can achieve a monitoring sensitivity of 1529.1 kPa~(-1) and a pressure range of 150 kPa, which meets the demand for human pressure detection. In addition, the unique porous structure of the fabric and the stacked multilayer structure of MXene enable the humidity sensor to exhibit extremely high monitoring sensitivity, even through clothing, and still be able to detect the humidity on the skin surface.Temperature sensors based on screen-printed thermochromic liquid crystals enable visual monitoring in the range of 0℃–65℃. Through further integration with flexible printed circuit board circuits, we demonstrate a proof-of-concept device that enables real-time monitoring of human physiological information such as physical pressure, humidity, and ambient temperature environment, suggesting that the device provides an excellent platform for the development of commercially viable wearable healthcare monitors.
文摘Objective:To observe the application effect of non-invasive ventilator in the treatment of acute heart failure merged with respiratory failure in ICU.Methods:A total of 80 patients with acute heart failure merged with respiratory failure who were admitted in ICU from January, 2015 to January, 2016 were included in the study and randomized into the observation group and the control group with 40 cases in each group. The patients in the two groups were given routine treatments after admission. On this basis, the patients in the observation group were given non-invasive ventilator. The patients in the control group were given continuous low flow oxygen inhalation. PaO2, pH, PaCO2, SaO2, and PaO2/FiO2 before and after treatment between the two groups were compared. The serum NT-pro BNP and cTnI levels before treatment, 24 h and 48 h after treatment in the two groups were compared.Results:The comparison of PaO2, pH, PaCO2, SaO2, and PaO2/FiO2 before treatment between the two groups was not statistically significant. PaO2, pH, SaO2, and PaO2/FiO2 after treatment in the two groups were significantly elevated, while PaCO2 was significantly reduced when compared with before treatment. PaO2, pH, SaO2, and PaO2/FiO2 after treatment in the observation group were significantly higher than those in the control group, while PaCO2 was significantly lower than that in the control group. The comparison of NT-pro BNP and cTnI levels before treatment between the two groups was not statistically significant. NT-pro BNP and cTnI levels 12 h and 24 h after treatment in the two groups were significantly elevated when compared with before treatment. NT-pro BNP and cTnI levels 12 h and 24 h after treatment in the observation group were significantly lower than those in the control group.Conclusions:Non-invasive ventilator in the treatment of acute heart failure merged with respiratory failure can effectively improve the ventilation function, reduce NT-pro BNP and cTnI levels, and is of great significance in enhancing the rescued effect.
文摘Effect of multiple respiratory gas monitoring (MRGM ) on inspiredconcentration of oxygen in circult system during closed anesthesia was studied in 5l adult patients scheduled for abdominal surgery. Required flow rate of fresh oxygen (OFR), inspired oxygen concentration (FiO2 ) and oxygen saturation of pulse oximeter (SpO2) were measured continu0usly. Patients were equally divided into three groups at randorn, group C (no MRGN used ), group M, (using MRGM with its tail gas returned to circuit system), group M2 (using MRGM without tail gas returned ). The results revealed that during 180 min of closed anesthesia, OFR required in group C and M, were about 200-230 ml/min, and in group M, it was ab0ut 400 ml/min. In group C FiO2 decreased by about 10 % after 60 min of closed anesthesia (P<0. 01, 60 min vs 0 min ) and then stayed stable at this level. In group M,, FiO2 decreased by 16% at 60 min and 34 % at 180 min and the decrease was significantly greater than that in gr0up C (P<0. 01). In group Me, FiO2 remained c0nstant during closed anesthesia, which was much high(Jr than those in group C and M,. The tail gas of Capnomac Ultima MRGM contained less oxygen than its sample gas drawn fr0m circuit system simuItaneously.
基金supported by the National Natural Science Foundation of China(NNSFC grant No.52125301)the Sichuan Province Science and Technology Department Project(grant No.2021YJ0448)+1 种基金the Post Doctoral Research Fund,West China Hospital,Sichuan University(grant No.2020HXBH181)We thank Shanghai Synchrotron Radiation Facility(SSRF)BL16B1 for providing technological support for SAXS and WAXD characterization。
文摘Wearable electronics integrated with stretchable sensors are considered a promising and non-invasive strategy to monitor respiratory status for health assessment.However,long-term and stable monitoring of respiratory abnormality is still a grand challenge.Here,we report a facile one-step thermal stretching strategy to fabricate an anti-fatigue ionic gel(AIG)sensor with high fatigue threshold(0=1130 J m^(–2)),high stability(>20,000 cycles),high linear sensitivity,and recyclability.A multimodal wearable respiratory monitoring system(WRMS)developed with AIG sensors can continuously measure respiratory abnormality(single-sensor mode)and compliance(multi-sensor mode)by monitoring the movement of the ribcage and abdomen in a long-term manner.For single-sensor mode,the respiratory frequency(Fr),respiratory energy(Er),and inspire/expire time(I/E ratio)can be extracted to evaluate the respiratory status during sitting,sporting,and sleeping.Further,the multi-sensors mode is developed to evaluate patientventilator asynchrony through validated clinical criteria by monitoring the incongruous movement of the chest and abdomen,which shows great potential for both daily home care and clinical applications.
文摘Objective: to observe the effect and efficiency of noninvasive ventilator in the treatment of COPD with respiratory failure. Method: to our patients with COPD with respiratory failure, choose the main stage for February 2020 to December 2021, randomly divided into two groups, a group of 37 cases mainly in routine treatment, the remaining main non-invasive ventilator treatment, observation group treatment efficiency, blood gas analysis, lung function, symptom relief, and complication rate. Results: the relevant data results obtained with treatment efficiency were higher than the observation group, P 0.05;the analysis of the observation group was P 0.05 better than the observation group and P 0.05 was better than the symptom relief data results, and the observation group was P 0.05, and the heart rate was lower than the control group, with P 0.05. Conclusion: non-invasive ventilator treatment in patients with COPD and respiratory failure can improve the treatment efficiency, improve the blood gas analysis and lung function, promote the relief of clinical symptoms, and improve the heart rate and respiratory rate.
文摘Objective: the treatment of neonatal respiratory distress syndrome, there are two schemes that can treat the disease and the curative effect is better than that of the two schemes. Methods: the patients who participated in this experiment were all from our hospital from January 2019 to December 2021. Forty children with hyaline membrane disease were selected for experimental analysis. The analysis method adopted in this experiment is a comparative model. Therefore, the general data grouping method should be applied to the group, the control group and the observation group, with 20 children in each group. The children in the control group received nasal continuous positive pressure ventilation, while the children in the observation group received nasal intermittent positive pressure ventilation. After taking the treatment, the evaluation index is mainly based on the patient's blood gas index, ventilation treatment effect and complications. Results: after some treatment, we concluded that the blood gas indexes of the observation group had obvious improvement effect after 2 hours of treatment, and because of the control group. Before this, there was no difference in blood gas indexes between the two groups. The two groups found that the observation group was superior to the control group in all aspects after comparing the operation time, total oxygen absorption time and relevant time indicators of the children. At the same time, the incidence of complications in the observation group is also higher than that in the control group. Conclusion: through analysis and research, it is concluded that in the treatment of neonatal respiratory distress syndrome, nasal intermittent positive pressure ventilation is significantly better than nasal continuous positive pressure ventilation for the recovery of children. It can effectively improve the ventilation function and blood gas index of children, which is a very important promotion.
文摘Chronic kidney disease(CKD)is a degenerative disorder that affects millions of people throughout the world,causing considerable morbidity and healthcare burden.Frequent blood sampling is the current gold standard for monitoring CKD to evaluate biochemical and mineral indicators.However,there are draw-backs to frequent blood draws,such as pain for patients,the possibility of infe-ction,and higher medical expenses.Saliva-based diagnostics offer advantages such as ease of collection,reduced invasiveness,and improved patient compli-ance.A comprehensive literature review was conducted to analyze studies eva-luating the diagnostic utility of salivary creatinine,urea,calcium,and parathyroid hormone(PTH)in patients with CKD.Various saliva collection methods,inc-luding stimulated and unstimulated approaches,were investigated for efficiency and reliability,and a correlation was shown between serum and salivary crea-tinine,urea,PTH,and calcium levels,indicating their potential as CKD biomar-kers.Despite these promising findings,challenges such as standardization of collection methods,variability in salivary flow rates,and predictive value in association with blood parameters are addressed to ensure clinical applicability.This review explores the potential and challenges of saliva as a non-invasive alternative for CKD diagnostics.
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.
文摘Objective:To evaluate the in-hospital outcome of moderate to severe COVID-19 patients admitted in High Dependency Unit(HDU)in relation to invasive vs.non-invasive mode of ventilation.Methods:In this study,the patients required either non-invasive[oxygen≤10 L/min or>10 L/min through mask or nasal prongs,rebreather masks and bilevel positive airway pressure(BiPAP)]or invasive ventilation.For analysis of 30-day in hospital mortality in relation to use of different modes of oxygen,Kaplan Meier and log rank analyses were used.In the end,independent predictors of survival were determined by Cox regression analysis.Results:Invasive ventilation was required by 15.1%patients while 84.9%patients needed non-invasive ventilation.Patients with evidence of thromboembolism,high inflammatory markers and hypoxemia mainly required invasive ventilation.The 30-day in hospital mortality was 72.7%for the invasive group and 12.9%for the non-invasive group(1.8%oxygen<10 L/min,0.9%oxygen>10 L/min,3.6%rebreather mask and 4.5%BiPAP).The median time from hospital admission to outcome was 7 days for the invasive group and 18 days for the non-invasive group(P<0.05).Age,presence of co-morbidities,number of days requiring oxygen,rebreather,BiPAP and invasive ventilation were independent predictors of outcome.Conclusions:Invasive mechanical ventilation is associated with adverse outcomes possibly due to ventilator associated lung injury.Thus,protective non-invasive ventilation remains the necessary and safe treatment for severely hypoxic COVID-19 patients.
文摘AIM: To determine whether a newly developed respiratory rate monitor can practically and accurately monitor ventilation under propofol sedation in combination with standard monitoring. METHODS: Patients [American Society of Anesthesiologists(ASA) Classification Ⅰ-Ⅲ] scheduled for elective colonoscopy under propofol sedation were monitored with a new device that measures the respiratory rate based on humidity in expired air. Patients with clinically significant cardiac disorders or pulmonary disease and patients requiring emergency procedures were excluded from study participation. All of the patients also received standard monitoring with pulse oximetry. This was a single-center study conducted in a community hospital in Switzerland. After obtaining written informed consent from all subjects, 76 patients(51 females and 25 males) were monitored during colonoscopy under propofol sedation. The primary endpoint was the occurrence of any respiratory event(apnea or hypopnea). Apnea was defined as the cessation of breathing for a minimum of 10 s. Significant apnea was defined as the cessation of breathing for more than 30 s. Hypopnea was defined as a reduction in the respiratory rate below 6/min for a minimum of 10 s. Any cases of significant apnea triggered interventions by the endoscopy team. The interventions included withholding propofol, verbal stimulation of the patients, and increased oxygen supplementation or the chin lift maneuver. A secondary endpoint was the correlation of apnea or hypopnea with hypoxemia(measured as a decrease in SaO2 of at least 5% from baseline or less than 90%). RESULTS: At least one respiratory event was detected in thirty-seven patients(48.7%). In total, there were 73 respiratory events, ranging from one to six events in a single patient. Significant apnea(> 30 s) occurred in five patients(6%). Only one episode of apnea led to a relative SaO2 reduction(from 98% to 93%) after a 50 s lag time. No event requiring assisted ventilation was recorded. Our analysis revealed that the total propofol dose was an independent risk factor for respiratory events(P = 0.01). Artifacts developed with the same frequency with the new device as with conventional pulse oximetry. Compared with pulse oximetry alone, this new monitoring device detected more respiratory events and may provide earlier warning of impending respiratory abnormalities. CONCLUSION: Apnea commonly occurs during endoscopy under sedation and may precede hypoxemia. We recommend this respiration rate monitor as an alternative to capnography to aid in detecting ventilatory problems.
