Pulmonary rehabilitation(PR)aims to improve lung function in patients with chronic respiratory disease(CRD).In recent years,significant advancements have been made in pulmonary rehabilitation technologies,demonstratin...Pulmonary rehabilitation(PR)aims to improve lung function in patients with chronic respiratory disease(CRD).In recent years,significant advancements have been made in pulmonary rehabilitation technologies,demonstrating their potential for enhancing lung function in patients with respiratory diseases.The purpose of this study is to outline recent developments in the field of pulmonary rehabilitation guided by pulmonary rehabilitation robots,which has not been previously addressed in earlier reviews.To fill this gap,this paper first provides a systematic summary of the monitoring and actuation technologies of pulmonary rehabilitation robot systems and evaluates these technologies from multiple dimensions,including portability,wearability potential,invasiveness,and clinical applications,analyzing the potential for integrating various technologies into pulmonary rehabilitation robot systems.Furthermore,three technical directions are proposed:real-time precise monitoring,suitable structure and actuation strategies,and the intelligence of pulmonary rehabilitation robot systems.On the basis of these directions,this paper presents a comprehensive technical outlook for a soft wearable pulmonary rehabilitation robot system,providing reference and guidance for future research.To our knowledge,this is the first review of pulmonary rehabilitation robot systems and their key technologies.Additionally,the review section on respiratory assistive technologies simultaneously covers key technologies such as mechanical ventilation(MV),exoskeleton robots,and functional electrical stimulation(FES)for the first time.It also summarizes the respiratory assistive technology paradigm from the innovative perspectives of respiratory assistive modalities,targeted body sites,and types of ventilation for the first time.This study offers a broader perspective and a deeper understanding of pulmonary re-habilitation robots,with a technical outlook encompassing multimodal data fusion perception,respiratory event detection and intention recognition,full-phase assistance strategies,modeling,decoupling,and quantification of multipleinput multiple-output(MIMO)systems,as well as model-based interactive control strategies.展开更多
Severe acute pancreatitis(SAP)can induce acute respiratory distress syndrome(ARDS)and abdominal compartment syndrome(ACS).Although prone position ventilation(PPV)can improve outcomes in patients with ARDS,there is sig...Severe acute pancreatitis(SAP)can induce acute respiratory distress syndrome(ARDS)and abdominal compartment syndrome(ACS).Although prone position ventilation(PPV)can improve outcomes in patients with ARDS,there is significant controversy regarding its concurrent use with ACS owing to concerns of increased risk of intra-abdominal pressure(IAP).[1]We present a case of successful PPV application without adverse eff ects.展开更多
Respiratory infections are associated with high morbidity and mortality and are a major global health problem[1].Acute respiratory infections are caused by multiple respiratory pathogens,including viruses and bacteria...Respiratory infections are associated with high morbidity and mortality and are a major global health problem[1].Acute respiratory infections are caused by multiple respiratory pathogens,including viruses and bacteria.Viral-bacterial co-infections,which have become increasingly common and a global concern,can lead to substantial complications,causing higher morbidity and adverse prognosis[2].Previous studies have reported low positive detection rates of targeted pathogens related to acute respiratory infections,owing to the limited number of detected pathogens and variations in the sensitivity of diagnostic methods[3-4].Low positive detection rates may impede our understanding of respiratory pathogen characteristics and hamper the development of precise treatment and prevention strategies.展开更多
Neutrophil extracellular trap(NET)formation or NETosis is a specialized innate immune process in which neutrophils release chromatin fibers decorated with histones and antimicrobial proteins.Although pivotal for patho...Neutrophil extracellular trap(NET)formation or NETosis is a specialized innate immune process in which neutrophils release chromatin fibers decorated with histones and antimicrobial proteins.Although pivotal for pathogen clearance,aberrant NETosis has emerged as a critical modulator of acute and chronic respiratory pathologies,including acute respiratory distress syndrome,asthma,and chronic obstructive pulmonary disease.Dysregulated NET release exacerbates airway inflammation by inducing epithelial injury,mucus hypersecretion,and the recruitment of inflammatory leukocytes,thereby accelerating tissue remodeling and functional decline.Mechanistically,NETosis is governed by peptidyl arginine deiminase 4(PADI4)-mediated histone citrullination,NADPH oxidase-dependent reactive oxygen species production,mitochondrial metabolic reprogramming,and activation of toll-like receptors and inflammasomes.These molecular events perpetuate inflammation and prevent its resolution.Emerging evidence indicates that natural bioactive compounds,such as flavonoids,terpenoids,and polyphenols,attenuate NETosis by modulating oxidative stress,inhibiting PADI4 activation,or suppressing downstream pro-inflammatory cascades.Collectively,these findings highlight the therapeutic potential of targetingNETosis tomitigate neutrophil-driven airway pathology.This review aims to comprehensively synthesize recent mechanistic insights into NETosis and to delineate how modulation of NET formation contributes to the prevention and treatment of inflammatory respiratory diseases.展开更多
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
BACKGROUND Due to the dry and cold climate,the obvious temperature difference between day and night,and the low oxygen content of the air in the plateau area,people are prone to upper respiratory tract diseases,and of...BACKGROUND Due to the dry and cold climate,the obvious temperature difference between day and night,and the low oxygen content of the air in the plateau area,people are prone to upper respiratory tract diseases,and often the condition is prolonged,and the patients are prone to anxiety and uneasiness,which may be related to the harshness of the plateau environment,somatic discomfort due to the lack of oxygen,anxiety about the disease,and other factors.AIM To investigate the effects of cognitive behavioral therapy(CBT)on anxiety,sleep disorders,and hypoxia tolerance in patients with high-altitude respiratory diseases.METHODS A total of 2337 patients with high-altitude-related respiratory diseases treated at our hospital between November 2023 and January 2024 were selected as the study subjects.The subjects’pre-high-altitude residential altitude was approximately 1700 meters.They were divided into two groups.Both groups were given symptomatic treatment,and the control group implemented conventional nursing intervention,while the research group simultaneously conducted CBT intervention;assessed the degree of health knowledge of the two groups,and applied the Hamilton Anxiety Scale and the Pittsburgh Sleep Quality Index to assess the anxiety and sleep quality of the patients before and after the intervention,respectively.It also observed the length and efficiency of sleep,and detected the level of serum hypoxia inducible factor-1α,erythropoietin(EPO)and clinical intervention before and after intervention.EPO levels,and investigated satisfaction with the clinical intervention.RESULTS The rate of excellent health knowledge in the intervention group was 93.64%,which was higher than that in the control group(74.23%;P<0.05).Before the intervention,there was no significant difference in Hamilton Anxiety Scale and Pittsburgh Sleep Quality Index scores between the two groups(P>0.05),and after the intervention,the scores of the study group were significantly lower than those of the control group(P<0.05).There was no significant difference in sleep duration and sleep efficiency between the groups before the intervention(P>0.05),and after the intervention,the scores of the study group were significantly larger than those of the control group(P<0.05).There was no significant difference in serum hypoxia inducible factor-1αand EPO between the two groups before intervention(P>0.05),and both research groups were significantly lower than the control group after intervention(P<0.05).According to the questionnaire survey,the intervention satisfaction of the study group was 95.53%,which was higher than that of the control group(80.14%;P<0.05).CONCLUSION The CBT intervention in the treatment of patients with high-altitude-related respiratory diseases helps improve patients'health knowledge,relieve anxiety,improve sleep quality and hypoxia tolerance,and improve nursing satisfaction.展开更多
Although diet and gut microbial composition have been linked to chronic respiratory diseases,these associations remain difficult to interpret because of confounding and reverse causation.The gut-lung axis provides a p...Although diet and gut microbial composition have been linked to chronic respiratory diseases,these associations remain difficult to interpret because of confounding and reverse causation.The gut-lung axis provides a plausible framework for this interaction,yet direct genetic evidence is limited.Using a two-step,two-sample Mendelian randomization(MR)framework,supplemented by multivariable MR(MVMR)to adjust for pleiotropic effects and Benjamini-Hochberg false discovery rate(FDR)correction for multiple testing,we assessed the causal contributions of dietary habits and gut microbial taxa to major chronic respiratory diseases.We identified 22 dietary factors with causal effects on disease risk and 225 microbial taxa that acted as independent risk or protective contributors.Mediation analyses further showed that the effects of 12 dietary habits were transmitted through 32 specific microbial taxa.Notably,genetically predicted pork intake increased the risk of chronic obstructive pulmonary disease(COPD)(OR=10.53,95%CI[8.54,13.00]),an effect partly mediated by elevated abundance of CAG-485 sp002404675.In contrast,bread consumption conferred protection against asthma(OR=0.68,95%CI[0.64,0.72]),whereas this benefit was offset by approximately 45%through a pathway involving reduced Veillonella abundance.Collectively,these findings provide genetic support for the gut-lung axis and demonstrate that the gut microbiome functions as a causal mediator linking diet to chronic respiratory disease risk.However,since this study was based on individuals of European ancestry,caution is warranted when generalizing these causal estimates to non-European populations,such as East Asian groups.This work suggests new opportunities for microbiota-targeted prevention and therapeutic strategies.展开更多
Interferon-related genes are involved in antiviral responses,inflammation,and immunity,which are closely related to sepsis-associated acute respiratory distress syndrome(ARDS).We analyzed 1972 participants with genoty...Interferon-related genes are involved in antiviral responses,inflammation,and immunity,which are closely related to sepsis-associated acute respiratory distress syndrome(ARDS).We analyzed 1972 participants with genotype data and 681 participants with gene expression data from the Molecular Epidemiology of ARDS(MEARDS),the Molecular Epidemiology of Sepsis in the ICU(MESSI),and the Molecular Diagnosis and Risk Stratification of Sepsis(MARS)cohorts in a three-step study focusing on sepsis-associated ARDS and sepsis-only controls.First,we identified and validated interferon-related genes associated with sepsis-associated ARDS risk using genetically regulated gene expression(GReX).Second,we examined the association of the confirmed gene(interferon regulatory factor 1,IRF1)with ARDS risk and survival and conducted a mediation analysis.Through discovery and validation,we found that the GReX of IRF1 was associated with ARDS risk(odds ratio[OR_(MEARDS)]=0.84,P=0.008;OR_(MESSI)=0.83,P=0.034).Furthermore,individual-level measured IRF1 expression was associated with reduced ARDS risk(OR=0.58,P=8.67×10^(-4)),and improved overall survival in ARDS patients(hazard ratio[HR_(28-day)]=0.49,P=0.009)and sepsis patients(HR_(28-day)=0.76,P=0.008).Mediation analysis revealed that IRF1 may enhance immune function by regulating the major histocompatibility complex,including HLA-F,which mediated more than 70%of protective effects of IRF1 on ARDS.The findings were validated by in vitro biological experiments including time-series infection dynamics,overexpression,knockout,and chromatin immunoprecipitation sequencing.Early prophylactic interventions to activate IRF1 in sepsis patients,thereby regulating HLA-F,may reduce the risk of ARDS and mortality,especially in severely ill patients.展开更多
Genome-wide association study(GWAS)data are used to explore the associations between blood metabolites and 5 respiratory diseases:asthma,tuberculosis(TB),chronic obstructive pulmonary disease(COPD),cor pulmonale,and b...Genome-wide association study(GWAS)data are used to explore the associations between blood metabolites and 5 respiratory diseases:asthma,tuberculosis(TB),chronic obstructive pulmonary disease(COPD),cor pulmonale,and bronchitis.The main method of analysis used is the inverse-variance weighted(IVW)approach,complemented by several sensitivity analyses,including MR-Egger regression,the weighted median,the weighted mode,Cochran’s Q test,and the pleiotropy test.Additional directional tests,Meta-analysis and metabolic pathway analyses are conducted for deeper insights.3 metabolites showing significant causal relationships are identified.Catechol glucuronide levels as a protective factor have a positive causal relationship with asthma;the creatine to carnitine ratio has a negative causal relationship with COPD as a risk factor;and the adenosine 5’-diphosphate(ADP)to N-acetylglucosamine to N-acetylgalactosamine ratio as a protective factor has a positive causal relationship with bronchitis.Additionally,13 metabolites demonstrate strong causal relationships.Furthermore,we delineate 14 metabolic pathways related to the outcomes,including 6 associated with asthma,2 with TB,1 with COPD,4 with cor pulmonale,and 1 with bronchitis.A causal relationship between blood metabolites and 5 respiratory diseases has been established.The identified metabolites and pathways offer new insights into the underlying mechanisms of these diseases,necessitating further experimental validation.展开更多
Objective:To evaluate the global,regional,and national burden and determinants of Acute Respiratory Infections(ARIs)among children and adolescents from 1990 to 2021.Methods:We analysed ARI mortality and disability-adj...Objective:To evaluate the global,regional,and national burden and determinants of Acute Respiratory Infections(ARIs)among children and adolescents from 1990 to 2021.Methods:We analysed ARI mortality and disability-adjusted life years(DALYs),stratified by age,sex,and economic development level based on data retrieved from the Global Burden of Disease study 2021.Decomposition and frontier analyses were employed to identify key drivers of burden variation and visualize potential reductions based on development levels.Results:Between 1990 and 2021,the global burden of ARIs showed a significant decline in both achievable age-standardized DALYs rate and age-standardized mortality rates(EAPC=-3.87 and-3.81,respectively).Different age groups and sex witnessed different levels of ARI burden,males experienced heavier burden than females and the 0-4 years-old group experienced heavier burden than other study age groups.Most of the 204 countries and territories experienced a downward trend of ARI burden,with slight increases observed only in Lesotho and Dominica.A negative correlation was found between the Socio-demographic Index and ARI burden.Decomposition analysis indicated that the significant decreases in deaths and DALYs were primarily driven by epidemiological changes.Conclusions:The global burden of ARIs among children and adolescents has declined over the past three decades,but substantial regional disparities persist.Targeted public health strategies are needed to address the continued ARI burden in high-risk regions and vulnerable age groups.展开更多
Advanced healthcare monitors for air pollution applications pose a significant challenge in achieving a balance between high-performance filtration and multifunctional smart integration.Electrospinning triboelectric n...Advanced healthcare monitors for air pollution applications pose a significant challenge in achieving a balance between high-performance filtration and multifunctional smart integration.Electrospinning triboelectric nanogenerators(TENG)provide a significant potential for use under such difficult circumstances.We have successfully constructed a high-performance TENG utilizing a novel multi-scale nanofiber architecture.Nylon 66(PA66)and chitosan quaternary ammonium salt(HACC)composites were prepared by electrospinning,and PA66/H multiscale nanofiber membranes composed of nanofibers(≈73 nm)and submicron-fibers(≈123 nm)were formed.PA66/H multi-scale nanofiber membrane as the positive electrode and negative electrode-spun PVDF-HFP nanofiber membrane composed of respiration-driven PVDF-HFP@PA66/H TENG.The resulting PVDF-HFP@PA66/H TENG based air filter utilizes electrostatic adsorption and physical interception mechanisms,achieving PM_(0.3)filtration efficiency over 99%with a pressure drop of only 48 Pa.Besides,PVDF-HFP@PA66/H TENG exhibits excellent stability in high-humidity environments,with filtration efficiency reduced by less than 1%.At the same time,the TENG achieves periodic contact separation through breathing drive to achieve self-power,which can ensure the long-term stability of the filtration efficiency.In addition to the air filtration function,TENG can also monitor health in real time by capturing human breathing signals without external power supply.This integrated system combines high-efficiency air filtration,self-powered operation,and health monitoring,presenting an innovative solution for air purification,smart protective equipment,and portable health monitoring.These findings highlight the potential of this technology for diverse applications,offering a promising direction for advancing multifunctional air filtration systems.展开更多
Objective:To investigate the effect of“72-hour proactive follow-up”led by respiratory specialist nurses on reducing the 30-day readmission rate in patients with acute exacerbation of chronic obstructive pulmonary di...Objective:To investigate the effect of“72-hour proactive follow-up”led by respiratory specialist nurses on reducing the 30-day readmission rate in patients with acute exacerbation of chronic obstructive pulmonary disease(COPD)after hospital discharge.Methods:A randomized controlled trial was conducted involving 60 patients with acute exacerbation of COPD admitted from September 2024 to September 2025.The participants were divided into a control group and an observation group,with 30 individuals in each group.The control group received routine discharge guidance nursing measures,including instructions on medication use,key points for condition monitoring,and scheduling of follow-up appointments.The observation group implemented“72-hour proactive follow-up”nursing measures,which included telephone follow-up within 72 hours after discharge,quantitative assessment of respiratory symptoms,dynamic adjustment of medication regimens,and personalized health education.The 30-day readmission rate,mMRC dyspnea index,CAT quality of life score,and other parameters were compared between the two groups.Results:The 30-day readmission rate in the observation group was significantly lower than that in the control group(p<0.05).The mMRC dyspnea index(1.8±0.5)in the observation group was significantly lower than that in the control group(2.5±0.7)(p<0.05).The CAT quality of life score(18.2±3.1)in the observation group was significantly higher than that in the control group(22.4±4.2)(p<0.05).The patient satisfaction score(92.5±4.3)in the observation group was higher than that in the control group(85.6±5.8)(p<0.05).Conclusion:The“72-hour proactive follow-up”nursing intervention demonstrates a favorable effect in reducing readmission rates,exhibiting significant clinical practical value.It can optimize the allocation of medical resources,effectively enhance patients’self-management efficacy,and holds prominent value for clinical promotion and application.展开更多
Objective: To evaluate the efficacy of noninvasive positive pressure ventilation (NIPPV) in respiratory support for severe pneumonia. Methods: Data were analyzed from 74 patients with severe pneumonia undergoing respi...Objective: To evaluate the efficacy of noninvasive positive pressure ventilation (NIPPV) in respiratory support for severe pneumonia. Methods: Data were analyzed from 74 patients with severe pneumonia undergoing respiratory support at our hospital between May 2024 and April 2025. Patients were randomly assigned using a random number table to two groups (n = 37 each): the experimental group received NIPPV, while the control group underwent conventional invasive mechanical ventilation. Intergroup differences were compared. Results: Compared with the control group, the experimental group demonstrated significantly higher PaO2 and oxygenation index, significantly lower PaCO2, significantly reduced levels of WBC, CRP, and PCT, significantly higher overall efficacy rate, and significantly lower incidence of adverse reactions after treatment (p < 0.05). Pre-treatment PaO2, oxygenation index, PaCO2, WBC, CRP, and PCT levels showed no significant differences between groups (p > 0.05). Conclusion: Non-invasive positive pressure ventilation demonstrates favorable outcomes in respiratory support for severe pneumonia.展开更多
BACKGROUND:Individualized positive end-expiratory pressure(PEEP)titration is a crucial technique in mechanical ventilation therapy for acute respiratory distress syndrome(ARDS)patients with intra-abdominal hypertensio...BACKGROUND:Individualized positive end-expiratory pressure(PEEP)titration is a crucial technique in mechanical ventilation therapy for acute respiratory distress syndrome(ARDS)patients with intra-abdominal hypertension(IAH).This study aimed to evaluate the eff ectiveness of electrical impedance tomography(EIT)-guided PEEP titration in this population.METHODS:This prospective study enrolled 36 ARDS patients,including 22 patients with IAH and 14 without IAH.All the patients underwent EIT-guided PEEP titration at the intersection point between alveolar overdistension and collapse during a decremental PEEP trial.The changes in pulmonary ventilation distribution,respiratory mechanics and hemodynamics during the titration process were observed.RESULTS:After EIT-guided PEEP titration was performed,the PEEP,peak inspiratory pressure and plateau pressure increased significantly(P<0.05).Furthermore,no significant differences were observed in respiratory system compliance,tidal volume,driving pressure,or the 4*DP+RR index between the two groups(P>0.05).The mechanical power increased in the non-IAH(NIAH)group after PEEP titration(P<0.05).Ventilation in gravity-dependent lung regions significantly increased(P<0.05),and the oxygenation index(PaO2/FiO2)improved signifi cantly(P<0.05)in both groups.However,blood pressure,heart rate,respiratory rate,central venous pressure,and lactate levels did not signifi cantly change.In the IAH group,the PaO2/FiO2 ratio improved less than that in the NIAH group did(P<0.05).CONCLUSION:In our study,individualized PEEP titration guided by EIT improved oxygenation in ARDS patients with concomitant IAH without signifi cantly aff ecting hemodynamics.The presence of IAH may limit the improvement of oxygenation during EIT-guided PEEP titration.展开更多
Acute respiratory distress syndrome(ARDS)is a life-threatening condition that is characterized by high mortality rates and limited therapeutic options.Notably,Zhang et al demonstrated that CD146+mesenchymal stromal ce...Acute respiratory distress syndrome(ARDS)is a life-threatening condition that is characterized by high mortality rates and limited therapeutic options.Notably,Zhang et al demonstrated that CD146+mesenchymal stromal cells(MSCs)exhibited greater therapeutic efficacy than CD146-MSCs.These cells enhance epithelial repair through nuclear factor kappa B/cyclooxygenase-2-associated paracrine signaling and secretion of pro-angiogenic factors.We concur that MSCs hold significant promise for ARDS treatment;however,the heterogeneity of cell products is a translational barrier.Phenotype-aware strategies,such as CD146 enrichment,standardized potency assays,and extracellular vesicle profiling,are essential for improving the consistency of these studies.Further-more,advanced preclinical models,such as lung-on-a-chip systems,may provide more predictive insights into the therapeutic mechanisms.This article underscores the importance of CD146+MSCs in ARDS,emphasizes the need for precision in defining cell products,and discusses how integrating subset selection into translational pipelines could enhance the clinical impact of MSC-based therapies.展开更多
Acute respiratory distress syndrome(ARDS)is a severe clinical condition characterized by acute respiratory failure due to widespread pulmonary inflammation and edema.The incidence of ARDS among intensive care unit(ICU...Acute respiratory distress syndrome(ARDS)is a severe clinical condition characterized by acute respiratory failure due to widespread pulmonary inflammation and edema.The incidence of ARDS among intensive care unit(ICU)patients is approximately 10%,with mortality rates ranging from 35%to 45%and exceeding 50%in severe cases.[1]Identifying and controlling risk factors for ARDS is critical for early prevention.Smoking remains a significant global public health issue,affecting one-third of adults and 40%of children through exposure to secondhand smoke.[2]In an animal study,cigarette smoke impaired lung endothelial barrier function through oxidative stress and exacerbated lipopolysaccharide-induced increases in vascular permeability in vivo.This finding is consistent with the pathological changes observed in ARDS.[3]Although many observational studies have suggested a potential link between smoking and ARDS,the causal relationship remains unclear.This study uses Mendelian randomization(MR)to explore whether smoking behavior causally influences ARDS and investigates the mechanisms by which smoking may contribute to ARDS development through transcriptomic analysis of the Gene Expression Omnibus(GEO)database.展开更多
BACKGROUND Acute respiratory distress syndrome(ARDS)is a critical condition characterized by acute hypoxemia,non-cardiogenic pulmonary edema,and decreased lung compliance.The Berlin definition,updated in 2012,classifi...BACKGROUND Acute respiratory distress syndrome(ARDS)is a critical condition characterized by acute hypoxemia,non-cardiogenic pulmonary edema,and decreased lung compliance.The Berlin definition,updated in 2012,classifies ARDS severity based on the partial pressure of arterial oxygen/fractional inspired oxygen fraction ratio.Despite various treatment strategies,ARDS remains a significant public health concern with high mortality rates.AIM To evaluate the implications of driving pressure(DP)in ARDS management and its potential as a protective lung strategy.METHODS We conducted a systematic review using databases including EbscoHost,MEDLINE,CINAHL,PubMed,and Google Scholar.The search was limited to articles published between January 2015 and September 2024.Twenty-three peer-reviewed articles were selected based on inclusion criteria focusing on adult ARDS patients undergoing mechanical ventilation and DP strategies.The literature review was conducted and reported according to PRISMA 2020 guidelines.RESULTS DP,the difference between plateau pressure and positive end-expiratory pressure,is crucial in ARDS management.Studies indicate that lower DP levels are significantly associated with improved survival rates in ARDS patients.DP is a better predictor of mortality than tidal volume or positive end-expiratory pressure alone.Adjusting DP by optimizing lung compliance and minimizing overdistension and collapse can reduce ventilator-induced lung injury.CONCLUSION DP is a valuable parameter in ARDS management,offering a more precise measure of lung stress and strain than traditional metrics.Implementing DP as a threshold for safety can enhance protective ventilation strategies,po-tentially reducing mortality in ARDS patients.Further research is needed to refine DP measurement techniques and validate its clinical application in diverse patient populations.展开更多
BACKGROUND Respiratory syncytial virus(RSV)is a leading cause of lower respiratory tract infections in neonates.While typically associated with bronchiolitis and pneumonia,RSV can rarely cause extrapulmonary complicat...BACKGROUND Respiratory syncytial virus(RSV)is a leading cause of lower respiratory tract infections in neonates.While typically associated with bronchiolitis and pneumonia,RSV can rarely cause extrapulmonary complications such as myocarditis,which may present with life-threatening symptoms if not promptly recognized.CASE SUMMARY We describe the case of a 26-day-old male neonate who presented with respiratory distress,poor feeding,and irritability.Initial evaluation revealed an RSV infection confirmed via nasopharyngeal swab.As the clinical course progressed,the infant developed cardiac arrhythmias,elevated cardiac enzymes,and echocardiographic findings consistent with myocarditis.Management included mechanical ventilation,corticosteroid therapy,L-carnitine,and vitamin D supplementation.The patient responded well to treatment and was successfully extubated and discharged in stable condition after nine days of hospitalization.CONCLUSION This case highlights the importance of early recognition and multidisciplinary management of RSV-associated myocarditis in neonates.展开更多
BACKGROUND Critically ill patients often present on admission or develop acute respiratory failure requiring intubation and application of positive pressure ventilation during their hospital stay.AIM To investigate an...BACKGROUND Critically ill patients often present on admission or develop acute respiratory failure requiring intubation and application of positive pressure ventilation during their hospital stay.AIM To investigate and identify the epidemiological data,parameters associated with respiratory settings or the mechanics,and values related to arterial blood gases(ABGs)that are associated with outcomes in critically ill patients.METHODS A retrospective analysis of 131 patients[mean age,67.3 years;mean acute physiology and chronic health evaluation(APACHE)score,21.4]with acute respiratory failure requiring invasive mechanical ventilation was performed.The parameters that were statistically analyzed included demographic data,the presence of comorbidities,the presence of coronavirus disease 19(COVID-19),the respiratory rate(RR),peak airway pressure(Ppeak),minute ventilation(MV),positive endexpiratory pressure,and the values related to ABGs.In order to facilitate the statistical analysis,patients were evaluated and compared in groups:Survivors(n=41)vs non-survivors(n=90)and patients without acute kidney injury(AKI)(n=60)vs patients with AKI(n=71).Four endpoints were studied:Mortality,length of stay,duration of mechanical ventilation,and AKI.Group comparisons were performed using the following statistical tests:Theχ^(2) test with Yates’correction,Fisher’s exact test,the Mann-Whitney U test,and Spearman’s rank correlation analysis.Binary logistic regression analysis conducted after the univariate statistical tests facilitated the investigation of the independent predictors of mortality and AKI.A two-sided P value of less than 0.05 was considered the threshold of statistical significance.RESULTS Non-survivors presented statistically significant differences in terms of being older in age,the presence of comorbidities,elevated APACHE score,medical(vs surgical)reasons for admission,presence of COVID-19,lower pH at ABGs,lower values of the oxygenation ratio(arterial oxygen partial pressure to the fraction of inspired oxygen)and arterial oxygen partial pressure,and elevated values of Ppeak,positive end-expiratory pressure,RR,arterial carbon dioxide partial pressure,and MV.The factors identified as independent predictors of mortality were the presence of comorbidities,APACHE score,COVID-19 status,arterial carbon dioxide partial pressure,Ppeak,RR,and MV.COVID-19 presence and elevated values of RR and Ppeak were positively correlated with the other three endpoints(length of stay,the duration of mechanical ventilation in survivors,and the occurrence of AKI in the entire study population)that were studied.The other parameters exhibited a variable(either positive/negative,or no)correlation to the four endpoints under investigation.CONCLUSION Among all investigated outcome measures,COVID-19,Ppeak,and RR were strongly associated with all the endpoints studied,suggesting that proper interventions involving the modifiable respiratory parameters Ppeak and RR could improve the overall outcome in these patients.A novel finding of this study was the relationship between RR and AKI,which is worthy of further investigation.Future studies may explore the clinical interpretation of these findings to improve outcomes in critically ill patients with acute respiratory failure.展开更多
Acute respiratory infections(ARIs)are the main cause of morbidity and mortality worldwide,especially among children.The human bocavirus(HBoV)is a nonenveloped DNA virus that was recently identified as a respiratory pa...Acute respiratory infections(ARIs)are the main cause of morbidity and mortality worldwide,especially among children.The human bocavirus(HBoV)is a nonenveloped DNA virus that was recently identified as a respiratory pathogen associated with respiratory tract infections(RTIs),predominantly in infants and young children.It is also detected from the gastrointestinal tract in children.The prevalence of HBoV1 acute respiratory tract infection varies across age groups,ranging from 10.3%to 12.51%in individuals under 3 years of age.The spectrum of clinical presentation includes mild upper RTIs,acute exacerbation of asthma,bronchitis,bronchiolitis,pneumonia,and multi-organ failure.Although HBoV is often detected in patients with ARIs who have other respiratory viruses(17%-85%),recent studies have identified it as the sole aetiology for mild to severe ARIs.Children with pre-existing medical conditions infected with HBoV often have a risk of severe illness.HBoV infection is diagnosed primarily by detecting viral DNA in respiratory samples using molecular methods.Currently,there is no specific antiviral treatment for HBoV infections and the cases are managed symptomatically.General preventive measures used for the prevention of viral RTIs are applicable,as there is no effective vaccine against this virus.The HBoV has been implicated in RTIs,particularly in children,and has also been detected in cases of gastroenteritis.Despite its global prevalence,the exact pathogenic role of HBoV remains unclear due to frequent co-infections with other viruses.This minireview discusses the virology,epidemiology,clinical manifestations,diagnosis,and potential treatment approaches related to HBoV infections.展开更多
基金supported by the National Key Research and Development Project(2022YFB4703200)。
文摘Pulmonary rehabilitation(PR)aims to improve lung function in patients with chronic respiratory disease(CRD).In recent years,significant advancements have been made in pulmonary rehabilitation technologies,demonstrating their potential for enhancing lung function in patients with respiratory diseases.The purpose of this study is to outline recent developments in the field of pulmonary rehabilitation guided by pulmonary rehabilitation robots,which has not been previously addressed in earlier reviews.To fill this gap,this paper first provides a systematic summary of the monitoring and actuation technologies of pulmonary rehabilitation robot systems and evaluates these technologies from multiple dimensions,including portability,wearability potential,invasiveness,and clinical applications,analyzing the potential for integrating various technologies into pulmonary rehabilitation robot systems.Furthermore,three technical directions are proposed:real-time precise monitoring,suitable structure and actuation strategies,and the intelligence of pulmonary rehabilitation robot systems.On the basis of these directions,this paper presents a comprehensive technical outlook for a soft wearable pulmonary rehabilitation robot system,providing reference and guidance for future research.To our knowledge,this is the first review of pulmonary rehabilitation robot systems and their key technologies.Additionally,the review section on respiratory assistive technologies simultaneously covers key technologies such as mechanical ventilation(MV),exoskeleton robots,and functional electrical stimulation(FES)for the first time.It also summarizes the respiratory assistive technology paradigm from the innovative perspectives of respiratory assistive modalities,targeted body sites,and types of ventilation for the first time.This study offers a broader perspective and a deeper understanding of pulmonary re-habilitation robots,with a technical outlook encompassing multimodal data fusion perception,respiratory event detection and intention recognition,full-phase assistance strategies,modeling,decoupling,and quantification of multipleinput multiple-output(MIMO)systems,as well as model-based interactive control strategies.
文摘Severe acute pancreatitis(SAP)can induce acute respiratory distress syndrome(ARDS)and abdominal compartment syndrome(ACS).Although prone position ventilation(PPV)can improve outcomes in patients with ARDS,there is significant controversy regarding its concurrent use with ACS owing to concerns of increased risk of intra-abdominal pressure(IAP).[1]We present a case of successful PPV application without adverse eff ects.
基金supported by the Beijing Science and Technology Planning Project of the Beijing Science and Technology Commission(Z241100009024047)the High-Level Public Health Technical Talent Training Plan(lingjunrencai-01-02).
文摘Respiratory infections are associated with high morbidity and mortality and are a major global health problem[1].Acute respiratory infections are caused by multiple respiratory pathogens,including viruses and bacteria.Viral-bacterial co-infections,which have become increasingly common and a global concern,can lead to substantial complications,causing higher morbidity and adverse prognosis[2].Previous studies have reported low positive detection rates of targeted pathogens related to acute respiratory infections,owing to the limited number of detected pathogens and variations in the sensitivity of diagnostic methods[3-4].Low positive detection rates may impede our understanding of respiratory pathogen characteristics and hamper the development of precise treatment and prevention strategies.
基金supported by the Main Research Program(E0210202-05)of the Korea Food Research Institute(KFRI),funded by the Korean Ministry of Science and ICT.
文摘Neutrophil extracellular trap(NET)formation or NETosis is a specialized innate immune process in which neutrophils release chromatin fibers decorated with histones and antimicrobial proteins.Although pivotal for pathogen clearance,aberrant NETosis has emerged as a critical modulator of acute and chronic respiratory pathologies,including acute respiratory distress syndrome,asthma,and chronic obstructive pulmonary disease.Dysregulated NET release exacerbates airway inflammation by inducing epithelial injury,mucus hypersecretion,and the recruitment of inflammatory leukocytes,thereby accelerating tissue remodeling and functional decline.Mechanistically,NETosis is governed by peptidyl arginine deiminase 4(PADI4)-mediated histone citrullination,NADPH oxidase-dependent reactive oxygen species production,mitochondrial metabolic reprogramming,and activation of toll-like receptors and inflammasomes.These molecular events perpetuate inflammation and prevent its resolution.Emerging evidence indicates that natural bioactive compounds,such as flavonoids,terpenoids,and polyphenols,attenuate NETosis by modulating oxidative stress,inhibiting PADI4 activation,or suppressing downstream pro-inflammatory cascades.Collectively,these findings highlight the therapeutic potential of targetingNETosis tomitigate neutrophil-driven airway pathology.This review aims to comprehensively synthesize recent mechanistic insights into NETosis and to delineate how modulation of NET formation contributes to the prevention and treatment of inflammatory respiratory diseases.
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.
基金Supported by Army Logistics Department Health Bureau Project,No.QJGYXYJZX-012.
文摘BACKGROUND Due to the dry and cold climate,the obvious temperature difference between day and night,and the low oxygen content of the air in the plateau area,people are prone to upper respiratory tract diseases,and often the condition is prolonged,and the patients are prone to anxiety and uneasiness,which may be related to the harshness of the plateau environment,somatic discomfort due to the lack of oxygen,anxiety about the disease,and other factors.AIM To investigate the effects of cognitive behavioral therapy(CBT)on anxiety,sleep disorders,and hypoxia tolerance in patients with high-altitude respiratory diseases.METHODS A total of 2337 patients with high-altitude-related respiratory diseases treated at our hospital between November 2023 and January 2024 were selected as the study subjects.The subjects’pre-high-altitude residential altitude was approximately 1700 meters.They were divided into two groups.Both groups were given symptomatic treatment,and the control group implemented conventional nursing intervention,while the research group simultaneously conducted CBT intervention;assessed the degree of health knowledge of the two groups,and applied the Hamilton Anxiety Scale and the Pittsburgh Sleep Quality Index to assess the anxiety and sleep quality of the patients before and after the intervention,respectively.It also observed the length and efficiency of sleep,and detected the level of serum hypoxia inducible factor-1α,erythropoietin(EPO)and clinical intervention before and after intervention.EPO levels,and investigated satisfaction with the clinical intervention.RESULTS The rate of excellent health knowledge in the intervention group was 93.64%,which was higher than that in the control group(74.23%;P<0.05).Before the intervention,there was no significant difference in Hamilton Anxiety Scale and Pittsburgh Sleep Quality Index scores between the two groups(P>0.05),and after the intervention,the scores of the study group were significantly lower than those of the control group(P<0.05).There was no significant difference in sleep duration and sleep efficiency between the groups before the intervention(P>0.05),and after the intervention,the scores of the study group were significantly larger than those of the control group(P<0.05).There was no significant difference in serum hypoxia inducible factor-1αand EPO between the two groups before intervention(P>0.05),and both research groups were significantly lower than the control group after intervention(P<0.05).According to the questionnaire survey,the intervention satisfaction of the study group was 95.53%,which was higher than that of the control group(80.14%;P<0.05).CONCLUSION The CBT intervention in the treatment of patients with high-altitude-related respiratory diseases helps improve patients'health knowledge,relieve anxiety,improve sleep quality and hypoxia tolerance,and improve nursing satisfaction.
文摘Although diet and gut microbial composition have been linked to chronic respiratory diseases,these associations remain difficult to interpret because of confounding and reverse causation.The gut-lung axis provides a plausible framework for this interaction,yet direct genetic evidence is limited.Using a two-step,two-sample Mendelian randomization(MR)framework,supplemented by multivariable MR(MVMR)to adjust for pleiotropic effects and Benjamini-Hochberg false discovery rate(FDR)correction for multiple testing,we assessed the causal contributions of dietary habits and gut microbial taxa to major chronic respiratory diseases.We identified 22 dietary factors with causal effects on disease risk and 225 microbial taxa that acted as independent risk or protective contributors.Mediation analyses further showed that the effects of 12 dietary habits were transmitted through 32 specific microbial taxa.Notably,genetically predicted pork intake increased the risk of chronic obstructive pulmonary disease(COPD)(OR=10.53,95%CI[8.54,13.00]),an effect partly mediated by elevated abundance of CAG-485 sp002404675.In contrast,bread consumption conferred protection against asthma(OR=0.68,95%CI[0.64,0.72]),whereas this benefit was offset by approximately 45%through a pathway involving reduced Veillonella abundance.Collectively,these findings provide genetic support for the gut-lung axis and demonstrate that the gut microbiome functions as a causal mediator linking diet to chronic respiratory disease risk.However,since this study was based on individuals of European ancestry,caution is warranted when generalizing these causal estimates to non-European populations,such as East Asian groups.This work suggests new opportunities for microbiota-targeted prevention and therapeutic strategies.
基金supported by the National Natural Science Foundation of China(Grant No.82220108002 to F.C.and Grant No.82273737 to R.Z.)the U.S.National Institutes of Health(Grant Nos.CA209414,HL060710,and ES000002 to D.C.C.,Grant Nos.CA209414 and CA249096 to Y.L.)+1 种基金the Priority Academic Program Development of Jiangsu Higher Education Institutions(PAPD)supported by the Qing Lan Project of the Higher Education Institutions of Jiangsu Province and the Outstanding Young Level Academic Leadership Training Program of Nanjing Medical University.
文摘Interferon-related genes are involved in antiviral responses,inflammation,and immunity,which are closely related to sepsis-associated acute respiratory distress syndrome(ARDS).We analyzed 1972 participants with genotype data and 681 participants with gene expression data from the Molecular Epidemiology of ARDS(MEARDS),the Molecular Epidemiology of Sepsis in the ICU(MESSI),and the Molecular Diagnosis and Risk Stratification of Sepsis(MARS)cohorts in a three-step study focusing on sepsis-associated ARDS and sepsis-only controls.First,we identified and validated interferon-related genes associated with sepsis-associated ARDS risk using genetically regulated gene expression(GReX).Second,we examined the association of the confirmed gene(interferon regulatory factor 1,IRF1)with ARDS risk and survival and conducted a mediation analysis.Through discovery and validation,we found that the GReX of IRF1 was associated with ARDS risk(odds ratio[OR_(MEARDS)]=0.84,P=0.008;OR_(MESSI)=0.83,P=0.034).Furthermore,individual-level measured IRF1 expression was associated with reduced ARDS risk(OR=0.58,P=8.67×10^(-4)),and improved overall survival in ARDS patients(hazard ratio[HR_(28-day)]=0.49,P=0.009)and sepsis patients(HR_(28-day)=0.76,P=0.008).Mediation analysis revealed that IRF1 may enhance immune function by regulating the major histocompatibility complex,including HLA-F,which mediated more than 70%of protective effects of IRF1 on ARDS.The findings were validated by in vitro biological experiments including time-series infection dynamics,overexpression,knockout,and chromatin immunoprecipitation sequencing.Early prophylactic interventions to activate IRF1 in sepsis patients,thereby regulating HLA-F,may reduce the risk of ARDS and mortality,especially in severely ill patients.
基金The National Natural Science Foundation of China-Regional Science Foundation Project“Research on constructing cell communication networks based on single-cell and spatial transcriptomics data”(62362062)The Multimodal Major Chronic Disease Prevention and Control Science and Engineering Key Laboratory Project of MIIT“Identification of novel drug targets for lung cancer via Mendelian randomization analysis based on blood proteomics”(MCD-2023-1-15).
文摘Genome-wide association study(GWAS)data are used to explore the associations between blood metabolites and 5 respiratory diseases:asthma,tuberculosis(TB),chronic obstructive pulmonary disease(COPD),cor pulmonale,and bronchitis.The main method of analysis used is the inverse-variance weighted(IVW)approach,complemented by several sensitivity analyses,including MR-Egger regression,the weighted median,the weighted mode,Cochran’s Q test,and the pleiotropy test.Additional directional tests,Meta-analysis and metabolic pathway analyses are conducted for deeper insights.3 metabolites showing significant causal relationships are identified.Catechol glucuronide levels as a protective factor have a positive causal relationship with asthma;the creatine to carnitine ratio has a negative causal relationship with COPD as a risk factor;and the adenosine 5’-diphosphate(ADP)to N-acetylglucosamine to N-acetylgalactosamine ratio as a protective factor has a positive causal relationship with bronchitis.Additionally,13 metabolites demonstrate strong causal relationships.Furthermore,we delineate 14 metabolic pathways related to the outcomes,including 6 associated with asthma,2 with TB,1 with COPD,4 with cor pulmonale,and 1 with bronchitis.A causal relationship between blood metabolites and 5 respiratory diseases has been established.The identified metabolites and pathways offer new insights into the underlying mechanisms of these diseases,necessitating further experimental validation.
文摘Objective:To evaluate the global,regional,and national burden and determinants of Acute Respiratory Infections(ARIs)among children and adolescents from 1990 to 2021.Methods:We analysed ARI mortality and disability-adjusted life years(DALYs),stratified by age,sex,and economic development level based on data retrieved from the Global Burden of Disease study 2021.Decomposition and frontier analyses were employed to identify key drivers of burden variation and visualize potential reductions based on development levels.Results:Between 1990 and 2021,the global burden of ARIs showed a significant decline in both achievable age-standardized DALYs rate and age-standardized mortality rates(EAPC=-3.87 and-3.81,respectively).Different age groups and sex witnessed different levels of ARI burden,males experienced heavier burden than females and the 0-4 years-old group experienced heavier burden than other study age groups.Most of the 204 countries and territories experienced a downward trend of ARI burden,with slight increases observed only in Lesotho and Dominica.A negative correlation was found between the Socio-demographic Index and ARI burden.Decomposition analysis indicated that the significant decreases in deaths and DALYs were primarily driven by epidemiological changes.Conclusions:The global burden of ARIs among children and adolescents has declined over the past three decades,but substantial regional disparities persist.Targeted public health strategies are needed to address the continued ARI burden in high-risk regions and vulnerable age groups.
基金financial support from the National Key Research and Development Program of China(2022YFB3804905)National Natural Science Foundation of China(22375047,22378068,and 22378071)+1 种基金Natural Science Foundation of Fujian Province(2022J01568)111 Project(No.D17005).
文摘Advanced healthcare monitors for air pollution applications pose a significant challenge in achieving a balance between high-performance filtration and multifunctional smart integration.Electrospinning triboelectric nanogenerators(TENG)provide a significant potential for use under such difficult circumstances.We have successfully constructed a high-performance TENG utilizing a novel multi-scale nanofiber architecture.Nylon 66(PA66)and chitosan quaternary ammonium salt(HACC)composites were prepared by electrospinning,and PA66/H multiscale nanofiber membranes composed of nanofibers(≈73 nm)and submicron-fibers(≈123 nm)were formed.PA66/H multi-scale nanofiber membrane as the positive electrode and negative electrode-spun PVDF-HFP nanofiber membrane composed of respiration-driven PVDF-HFP@PA66/H TENG.The resulting PVDF-HFP@PA66/H TENG based air filter utilizes electrostatic adsorption and physical interception mechanisms,achieving PM_(0.3)filtration efficiency over 99%with a pressure drop of only 48 Pa.Besides,PVDF-HFP@PA66/H TENG exhibits excellent stability in high-humidity environments,with filtration efficiency reduced by less than 1%.At the same time,the TENG achieves periodic contact separation through breathing drive to achieve self-power,which can ensure the long-term stability of the filtration efficiency.In addition to the air filtration function,TENG can also monitor health in real time by capturing human breathing signals without external power supply.This integrated system combines high-efficiency air filtration,self-powered operation,and health monitoring,presenting an innovative solution for air purification,smart protective equipment,and portable health monitoring.These findings highlight the potential of this technology for diverse applications,offering a promising direction for advancing multifunctional air filtration systems.
文摘Objective:To investigate the effect of“72-hour proactive follow-up”led by respiratory specialist nurses on reducing the 30-day readmission rate in patients with acute exacerbation of chronic obstructive pulmonary disease(COPD)after hospital discharge.Methods:A randomized controlled trial was conducted involving 60 patients with acute exacerbation of COPD admitted from September 2024 to September 2025.The participants were divided into a control group and an observation group,with 30 individuals in each group.The control group received routine discharge guidance nursing measures,including instructions on medication use,key points for condition monitoring,and scheduling of follow-up appointments.The observation group implemented“72-hour proactive follow-up”nursing measures,which included telephone follow-up within 72 hours after discharge,quantitative assessment of respiratory symptoms,dynamic adjustment of medication regimens,and personalized health education.The 30-day readmission rate,mMRC dyspnea index,CAT quality of life score,and other parameters were compared between the two groups.Results:The 30-day readmission rate in the observation group was significantly lower than that in the control group(p<0.05).The mMRC dyspnea index(1.8±0.5)in the observation group was significantly lower than that in the control group(2.5±0.7)(p<0.05).The CAT quality of life score(18.2±3.1)in the observation group was significantly higher than that in the control group(22.4±4.2)(p<0.05).The patient satisfaction score(92.5±4.3)in the observation group was higher than that in the control group(85.6±5.8)(p<0.05).Conclusion:The“72-hour proactive follow-up”nursing intervention demonstrates a favorable effect in reducing readmission rates,exhibiting significant clinical practical value.It can optimize the allocation of medical resources,effectively enhance patients’self-management efficacy,and holds prominent value for clinical promotion and application.
文摘Objective: To evaluate the efficacy of noninvasive positive pressure ventilation (NIPPV) in respiratory support for severe pneumonia. Methods: Data were analyzed from 74 patients with severe pneumonia undergoing respiratory support at our hospital between May 2024 and April 2025. Patients were randomly assigned using a random number table to two groups (n = 37 each): the experimental group received NIPPV, while the control group underwent conventional invasive mechanical ventilation. Intergroup differences were compared. Results: Compared with the control group, the experimental group demonstrated significantly higher PaO2 and oxygenation index, significantly lower PaCO2, significantly reduced levels of WBC, CRP, and PCT, significantly higher overall efficacy rate, and significantly lower incidence of adverse reactions after treatment (p < 0.05). Pre-treatment PaO2, oxygenation index, PaCO2, WBC, CRP, and PCT levels showed no significant differences between groups (p > 0.05). Conclusion: Non-invasive positive pressure ventilation demonstrates favorable outcomes in respiratory support for severe pneumonia.
基金PEEP titration in ARDS patients using EIT combined with lung ultrasound,Key Laboratory of Emergency Trauma Research,Ministry of Education (KLET-202201)airway clearance protocol in ICU mechanically ventilated patients based on electrical impedance imaging technology,Natural Science Foundation of Hunan Province (2024JJ9148)effects of end expiratory positive pressure on lung re-expansion in patients with ARDS and intra-abdominal hypertension monitored using lung ultrasound,Natural Science Foundation of Hunan Province (2023JJ60308)
文摘BACKGROUND:Individualized positive end-expiratory pressure(PEEP)titration is a crucial technique in mechanical ventilation therapy for acute respiratory distress syndrome(ARDS)patients with intra-abdominal hypertension(IAH).This study aimed to evaluate the eff ectiveness of electrical impedance tomography(EIT)-guided PEEP titration in this population.METHODS:This prospective study enrolled 36 ARDS patients,including 22 patients with IAH and 14 without IAH.All the patients underwent EIT-guided PEEP titration at the intersection point between alveolar overdistension and collapse during a decremental PEEP trial.The changes in pulmonary ventilation distribution,respiratory mechanics and hemodynamics during the titration process were observed.RESULTS:After EIT-guided PEEP titration was performed,the PEEP,peak inspiratory pressure and plateau pressure increased significantly(P<0.05).Furthermore,no significant differences were observed in respiratory system compliance,tidal volume,driving pressure,or the 4*DP+RR index between the two groups(P>0.05).The mechanical power increased in the non-IAH(NIAH)group after PEEP titration(P<0.05).Ventilation in gravity-dependent lung regions significantly increased(P<0.05),and the oxygenation index(PaO2/FiO2)improved signifi cantly(P<0.05)in both groups.However,blood pressure,heart rate,respiratory rate,central venous pressure,and lactate levels did not signifi cantly change.In the IAH group,the PaO2/FiO2 ratio improved less than that in the NIAH group did(P<0.05).CONCLUSION:In our study,individualized PEEP titration guided by EIT improved oxygenation in ARDS patients with concomitant IAH without signifi cantly aff ecting hemodynamics.The presence of IAH may limit the improvement of oxygenation during EIT-guided PEEP titration.
基金the Scientific and Technological Research Council of Türkiye(TÜBİTAK)Under the International Postdoctoral Research Fellowship Program(2219),No.1059B192400980the National Postdoctoral Research Fellowship Program(2218),No.122C158.
文摘Acute respiratory distress syndrome(ARDS)is a life-threatening condition that is characterized by high mortality rates and limited therapeutic options.Notably,Zhang et al demonstrated that CD146+mesenchymal stromal cells(MSCs)exhibited greater therapeutic efficacy than CD146-MSCs.These cells enhance epithelial repair through nuclear factor kappa B/cyclooxygenase-2-associated paracrine signaling and secretion of pro-angiogenic factors.We concur that MSCs hold significant promise for ARDS treatment;however,the heterogeneity of cell products is a translational barrier.Phenotype-aware strategies,such as CD146 enrichment,standardized potency assays,and extracellular vesicle profiling,are essential for improving the consistency of these studies.Further-more,advanced preclinical models,such as lung-on-a-chip systems,may provide more predictive insights into the therapeutic mechanisms.This article underscores the importance of CD146+MSCs in ARDS,emphasizes the need for precision in defining cell products,and discusses how integrating subset selection into translational pipelines could enhance the clinical impact of MSC-based therapies.
基金funded by the Hunan Provincial Natural Science Foundation of China(2024JJ2038,2024JJ9161)the Central Government Guides Local Science and Technology Development Fund Projects(2024ZYC031)+4 种基金the Hunan Health High-Level Talent Project(R2023073)the National Key Clinical Specialty Scientific Research Project(Z2023114)the Young Doctor Foundation of Hunan Provincial People’s Hospital(BSJJ202209)the Key Cultivation Project of Hunan Provincial People’s Hospital(RS2022A06)the Clinical Research Center for Emergency and Critical Care in Hunan Province(2021SK4011).
文摘Acute respiratory distress syndrome(ARDS)is a severe clinical condition characterized by acute respiratory failure due to widespread pulmonary inflammation and edema.The incidence of ARDS among intensive care unit(ICU)patients is approximately 10%,with mortality rates ranging from 35%to 45%and exceeding 50%in severe cases.[1]Identifying and controlling risk factors for ARDS is critical for early prevention.Smoking remains a significant global public health issue,affecting one-third of adults and 40%of children through exposure to secondhand smoke.[2]In an animal study,cigarette smoke impaired lung endothelial barrier function through oxidative stress and exacerbated lipopolysaccharide-induced increases in vascular permeability in vivo.This finding is consistent with the pathological changes observed in ARDS.[3]Although many observational studies have suggested a potential link between smoking and ARDS,the causal relationship remains unclear.This study uses Mendelian randomization(MR)to explore whether smoking behavior causally influences ARDS and investigates the mechanisms by which smoking may contribute to ARDS development through transcriptomic analysis of the Gene Expression Omnibus(GEO)database.
文摘BACKGROUND Acute respiratory distress syndrome(ARDS)is a critical condition characterized by acute hypoxemia,non-cardiogenic pulmonary edema,and decreased lung compliance.The Berlin definition,updated in 2012,classifies ARDS severity based on the partial pressure of arterial oxygen/fractional inspired oxygen fraction ratio.Despite various treatment strategies,ARDS remains a significant public health concern with high mortality rates.AIM To evaluate the implications of driving pressure(DP)in ARDS management and its potential as a protective lung strategy.METHODS We conducted a systematic review using databases including EbscoHost,MEDLINE,CINAHL,PubMed,and Google Scholar.The search was limited to articles published between January 2015 and September 2024.Twenty-three peer-reviewed articles were selected based on inclusion criteria focusing on adult ARDS patients undergoing mechanical ventilation and DP strategies.The literature review was conducted and reported according to PRISMA 2020 guidelines.RESULTS DP,the difference between plateau pressure and positive end-expiratory pressure,is crucial in ARDS management.Studies indicate that lower DP levels are significantly associated with improved survival rates in ARDS patients.DP is a better predictor of mortality than tidal volume or positive end-expiratory pressure alone.Adjusting DP by optimizing lung compliance and minimizing overdistension and collapse can reduce ventilator-induced lung injury.CONCLUSION DP is a valuable parameter in ARDS management,offering a more precise measure of lung stress and strain than traditional metrics.Implementing DP as a threshold for safety can enhance protective ventilation strategies,po-tentially reducing mortality in ARDS patients.Further research is needed to refine DP measurement techniques and validate its clinical application in diverse patient populations.
文摘BACKGROUND Respiratory syncytial virus(RSV)is a leading cause of lower respiratory tract infections in neonates.While typically associated with bronchiolitis and pneumonia,RSV can rarely cause extrapulmonary complications such as myocarditis,which may present with life-threatening symptoms if not promptly recognized.CASE SUMMARY We describe the case of a 26-day-old male neonate who presented with respiratory distress,poor feeding,and irritability.Initial evaluation revealed an RSV infection confirmed via nasopharyngeal swab.As the clinical course progressed,the infant developed cardiac arrhythmias,elevated cardiac enzymes,and echocardiographic findings consistent with myocarditis.Management included mechanical ventilation,corticosteroid therapy,L-carnitine,and vitamin D supplementation.The patient responded well to treatment and was successfully extubated and discharged in stable condition after nine days of hospitalization.CONCLUSION This case highlights the importance of early recognition and multidisciplinary management of RSV-associated myocarditis in neonates.
文摘BACKGROUND Critically ill patients often present on admission or develop acute respiratory failure requiring intubation and application of positive pressure ventilation during their hospital stay.AIM To investigate and identify the epidemiological data,parameters associated with respiratory settings or the mechanics,and values related to arterial blood gases(ABGs)that are associated with outcomes in critically ill patients.METHODS A retrospective analysis of 131 patients[mean age,67.3 years;mean acute physiology and chronic health evaluation(APACHE)score,21.4]with acute respiratory failure requiring invasive mechanical ventilation was performed.The parameters that were statistically analyzed included demographic data,the presence of comorbidities,the presence of coronavirus disease 19(COVID-19),the respiratory rate(RR),peak airway pressure(Ppeak),minute ventilation(MV),positive endexpiratory pressure,and the values related to ABGs.In order to facilitate the statistical analysis,patients were evaluated and compared in groups:Survivors(n=41)vs non-survivors(n=90)and patients without acute kidney injury(AKI)(n=60)vs patients with AKI(n=71).Four endpoints were studied:Mortality,length of stay,duration of mechanical ventilation,and AKI.Group comparisons were performed using the following statistical tests:Theχ^(2) test with Yates’correction,Fisher’s exact test,the Mann-Whitney U test,and Spearman’s rank correlation analysis.Binary logistic regression analysis conducted after the univariate statistical tests facilitated the investigation of the independent predictors of mortality and AKI.A two-sided P value of less than 0.05 was considered the threshold of statistical significance.RESULTS Non-survivors presented statistically significant differences in terms of being older in age,the presence of comorbidities,elevated APACHE score,medical(vs surgical)reasons for admission,presence of COVID-19,lower pH at ABGs,lower values of the oxygenation ratio(arterial oxygen partial pressure to the fraction of inspired oxygen)and arterial oxygen partial pressure,and elevated values of Ppeak,positive end-expiratory pressure,RR,arterial carbon dioxide partial pressure,and MV.The factors identified as independent predictors of mortality were the presence of comorbidities,APACHE score,COVID-19 status,arterial carbon dioxide partial pressure,Ppeak,RR,and MV.COVID-19 presence and elevated values of RR and Ppeak were positively correlated with the other three endpoints(length of stay,the duration of mechanical ventilation in survivors,and the occurrence of AKI in the entire study population)that were studied.The other parameters exhibited a variable(either positive/negative,or no)correlation to the four endpoints under investigation.CONCLUSION Among all investigated outcome measures,COVID-19,Ppeak,and RR were strongly associated with all the endpoints studied,suggesting that proper interventions involving the modifiable respiratory parameters Ppeak and RR could improve the overall outcome in these patients.A novel finding of this study was the relationship between RR and AKI,which is worthy of further investigation.Future studies may explore the clinical interpretation of these findings to improve outcomes in critically ill patients with acute respiratory failure.
文摘Acute respiratory infections(ARIs)are the main cause of morbidity and mortality worldwide,especially among children.The human bocavirus(HBoV)is a nonenveloped DNA virus that was recently identified as a respiratory pathogen associated with respiratory tract infections(RTIs),predominantly in infants and young children.It is also detected from the gastrointestinal tract in children.The prevalence of HBoV1 acute respiratory tract infection varies across age groups,ranging from 10.3%to 12.51%in individuals under 3 years of age.The spectrum of clinical presentation includes mild upper RTIs,acute exacerbation of asthma,bronchitis,bronchiolitis,pneumonia,and multi-organ failure.Although HBoV is often detected in patients with ARIs who have other respiratory viruses(17%-85%),recent studies have identified it as the sole aetiology for mild to severe ARIs.Children with pre-existing medical conditions infected with HBoV often have a risk of severe illness.HBoV infection is diagnosed primarily by detecting viral DNA in respiratory samples using molecular methods.Currently,there is no specific antiviral treatment for HBoV infections and the cases are managed symptomatically.General preventive measures used for the prevention of viral RTIs are applicable,as there is no effective vaccine against this virus.The HBoV has been implicated in RTIs,particularly in children,and has also been detected in cases of gastroenteritis.Despite its global prevalence,the exact pathogenic role of HBoV remains unclear due to frequent co-infections with other viruses.This minireview discusses the virology,epidemiology,clinical manifestations,diagnosis,and potential treatment approaches related to HBoV infections.
