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
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 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 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
Personalized health services are of paramount importance for the treatment and prevention of cardiorespiratory diseases,such as hypertension.The assessment of cardiorespiratory function and biometric identification(ID...Personalized health services are of paramount importance for the treatment and prevention of cardiorespiratory diseases,such as hypertension.The assessment of cardiorespiratory function and biometric identification(ID)is crucial for the effectiveness of such personalized health services.To effectively and accurately monitor pulse wave signals,thus achieving the assessment of cardiorespiratory function,a wearable photonic smart wristband based on an all-polymer sensing unit(All-PSU)is proposed.The smart wristband enables the assessment of cardiorespiratory function by continuously monitoring respiratory rate(RR),heart rate(HR),and blood pressure(BP).Furthermore,it can be utilized for biometric ID purposes.Through the analysis of pulse wave signals using power spectral density(PSD),accurate monitoring of RR and HR is achieved.Additionally,utilizing peak detection algorithms for feature extraction from pulse signals and subsequently employing a variety of machine learning methods,accurate BP monitoring and biometric ID have been realized.For biometric ID,the accuracy rate is 98.55%.Aiming to monitor RR,HR,BP,and ID,our solution demonstrates advantages in integration,functionality,and monitoring precision.These enhancements may contribute to the development of personalized health services aimed at the treatment and prevention of cardiorespiratory diseases.展开更多
Objective This study aims to analyze the burden of lower respiratory infections in Chinese elderly people aged 70 and above.Methods This study utilized Global Burden of Disease(GBD)1990-2050 prediction data to analyze...Objective This study aims to analyze the burden of lower respiratory infections in Chinese elderly people aged 70 and above.Methods This study utilized Global Burden of Disease(GBD)1990-2050 prediction data to analyze changes in mortality rates and disability-adjusted life year(DALY)rates for lower respiratory infections in the elderly population(aged 70 and above)in China from 1990 to 2050.It also discusses future trends in the burden of lower respiratory infections(LRI)in China under different scenarios.Results According to GBD predictions,the burden of lower respiratory infections in the elderly aged 70 years and above in China is lower than the global average.The burden has been decreasing from 1990 to 2020,but is projected to increase from 2020 to 2050.Scenario-based predictions suggest that,under scenarios involving improvements in nutrition and vaccination,the burden of lower respiratory infections in the elderly in China is expected to be the lowest in 2050.Conclusion This study indicates that the burden of lower respiratory infections in elderly people aged 70 years and above in China remains a significant public health issue and may worsen.The government should consider strengthening the preventive measures and management strategies for respiratory infections in the elderly population.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 Mitochondrial myopathies are characterized by primary dysfunction of the mitochondrial respiratory chain;they typically present as chronic muscle weak-ness.Clinically visible acute respiratory dysfunctions ...BACKGROUND Mitochondrial myopathies are characterized by primary dysfunction of the mitochondrial respiratory chain;they typically present as chronic muscle weak-ness.Clinically visible acute respiratory dysfunctions associated with mito-chondrial myopathies occur rarely.CASE SUMMARY In this report,we present the case of a patient who developed postoperative hypoventilation after undergoing an uneventful administration of general anesthesia.A 34-year-old woman with no family history of myopathy underwent laparoscopic removal of a right-sided ureteric stone.Two days postoperatively,her oxygen saturation decreased rapidly,and blood gas analysis revealed hypercapnia.We promptly intubated and initiated the patient and initiated her on mechanical ventilation as she remained awake.Clinical examination findings were unremarkable;the results of laboratory investigations,including those for thyroid,hepatic,renal,and neuromuscular functions,were within normal limits.Muscle biopsy revealed muscle fibers of varying sizes as well as several dege-nerating and regenerating myofibers.Modified Gomori trichrome staining of the cross-sections revealed ragged red fibers.Based on these findings,we diagnosed the patient with mitochondrial myopathy.The patient’s condition gradually improved,and she was discharged on a home ventilator 73 days postoperatively.CONCLUSION Our case highlights that mitochondrial myopathy should be considered in the differential diagnosis of patients with postoperative respiratory failure.展开更多
Objective:To explore the obstructive factors in the behavior of medical staff during the implementation of respiratory rehabilitation process,and to provide a basis for the rehabilitation management intervention of CO...Objective:To explore the obstructive factors in the behavior of medical staff during the implementation of respiratory rehabilitation process,and to provide a basis for the rehabilitation management intervention of COPD.Methods:A descriptive nature research method was adopted.An interview outline was formulated based on the theoretical domain framework.From October to December 2024,15 medical staff from the respiratory department of a tertiary hospital in Shaanxi Province were selected for semi-structured interviews.The interview data were analyzed using the Colaizzi 7-step analysis method.Result:The analysis of this study found that the obstructive factors for medical staff to implement respiratory rehabilitation include five theoretical domains.The problems are respectively the lack of knowledge about respiratory rehabilitation and insufficient training intensity,the insufficient self-recognition of implementing respiratory rehabilitation,the low awareness rate of patients and the low cooperation degree,the insufficient provision of instruments and facilities,the lack of rehabilitation training venues and respiratory rehabilitation clinics,and the lack of scientific and standardized respiratory rehabilitation management processes.Conclusion:There are many obstructive factors affecting the implementation of respiratory rehabilitation by medical staff.Clinical managers should take corresponding measures,continuously improve the rehabilitation management strategies for COPD,and promote the clinical application of the best evidence for respiratory rehabilitation.展开更多
Acute respiratory tract infections(ARTIs)are among the leading causes of morbidity and mortality in children worldwide.Human adenovirus(HAdV)infections are estimated to account for at least 5%of pediatric ARTIs.The ci...Acute respiratory tract infections(ARTIs)are among the leading causes of morbidity and mortality in children worldwide.Human adenovirus(HAdV)infections are estimated to account for at least 5%of pediatric ARTIs.The circulated genotypes of HAdV and the correlation between genotype and clinical manifestations in Wuhan,China,before and after the complete relaxation of nonpharmaceutical interventions against severe acute respiratory syndrome coronavirus 2,remain unknown.Here,101 HAdV strains were isolated from throat swab samples collected from hospitalized children with ARTIs who tested positive for HAdV nucleic acid.Of these,sixty-six strains from 2022 to twenty-three strains from 2023 were successfully genotyped and subjected to phylogenetic analysis based on the hexon,penton base,and fiber genes.Six genotypes,B3,C1,C2,C5,C104,and C108 were identified.HAdV-B3(84.85%)was the most prevalent type in 2022,while HAdV-C(86.96%),including C1,C2,C108,and C104,was the most prevalent in 2023.These strains were phylogenetically related to strains from Japan,China,and the United States in recent years.When comparing clinical characteristics,pediatric patients infected with B3,C1,C2,C5,C104,or C108 exhibited similar clinical manifestations,primarily fever and cough,but varying interleukin(IL)-10 levels.In conclusion,from June 2022 to September 2023,the circulated genotypes of HAdV in Wuhan included B3,C1,C2,C108,C5,and C104.The endemic pattern of HAdV in Wuhan,China,shifted from species B as the dominant type in 2022 to species C in 2023.展开更多
Ferroptosis is a form of cell death that occurs when there is an excess of reactive oxygen species(ROS),lipid peroxidation,and iron accumulation.The precise regulation of metabolic pathways,including iron,lipid,and am...Ferroptosis is a form of cell death that occurs when there is an excess of reactive oxygen species(ROS),lipid peroxidation,and iron accumulation.The precise regulation of metabolic pathways,including iron,lipid,and amino acid metabolism,is crucial for cell survival.This type of cell death,which is associated with oxidative stress,is controlled by a complex network of signaling molecules and pathways.It is also implicated in various respiratory diseases such as asthma,chronic obstructive pulmonary disease(COPD),acute lung injury(ALI),lung cancer,pulmonary fibrosis(PF),and the coronavirus disease 2019(COVID-19).To combat drug resistance,it is important to identify appropriate biological markers and treatment targets,as well as intervene in respiratory disorders to either induce or prevent ferroptosis.The focus is on the role of ferroptosis in the development of respiratory diseases and the potential of targeting ferroptosis for prevention and treatment.The review also explores the interaction between immune cell ferroptosis and inflammatory mediators in respiratory diseases,aiming to provide more effective strategies for managing cellular ferroptosis and respiratory disorders.展开更多
Background:Acute respiratory distress syndrome(ARDS)is the major therapeutic dilemma associated with significant inflammation and severe pulmonary dysfunction.Liriodendrin is a bioactive compound extract from traditio...Background:Acute respiratory distress syndrome(ARDS)is the major therapeutic dilemma associated with significant inflammation and severe pulmonary dysfunction.Liriodendrin is a bioactive compound extract from traditional Chinesemedicine,historically utilized formodulating inflammatory responses and alleviating symptoms in multiple diseasemodels.Methods:At present,BALB/c mice to explore the effects of liriodendrin on lipopolysaccharide(LPS)-induced ARDS.Before LPS was administered,the mice were treated with either liriodendrin or dexamethasone.Leukocyte infiltration,lung edema,and alveolar-capillary barrier integrity were evaluated in the bronchoalveolar lavage fluid(BALF)and pulmonary parenchyma.The expression of adhesion molecules and proinflammatory cytokines in BALF was evaluated by enzyme-linked immunosorbent assay.Western blotting assay facilitated the analysis of the expression or phosphorylation of inducible nitric oxide synthase(iNOS),cyclooxygenase-2(COX-2),NOD-like receptor family pyrin domain-containing 3(NLRP3),apoptosis-associated speck-like protein containing a CARD(ASC),cleaved caspase-1(CL-csapase-1),nuclear factor kappa-light-chain-enhancer of activated B cells(NF-κB),inhibitor of kappa B(IκB),mitogen-activated protein kinase(MAPK),and protein kinase B(Akt)in the lungs.In addition,the anti-inflammatory effects of liriodendrin were evaluated in LPS-stimulated RAW264.7 macrophages.Before LPS was administered,the RAW264.7 macrophages were treated with either liriodendrin or dexamethasone.Nitric Oxide(NO)production was measured using the Griess reaction assay,while ELISA assessed IL-1β,IL-6,and TNF-αlevels.Western blot analysis evaluated NF-κB phosphorylation and the expression of NLRP3,ASC,and CLcaspase-1.Results:These outcomes revealed that liriodendrin intervention markedly ameliorated the pathological features of LPS-induced ARDS,including leukocyte infiltration,lung edema,and alveolar-capillary barrier disruption.Liriodendrin also reduced the LPS-induced secretion of intercellular adhesion molecule-1(ICAM-1)and vascular cell adhesionmolecule-1(VCAM-1),expression of iNOS and COX2,and production of proinflammatory cytokines.Finally,we further discovered that the concentration trend of liriodendron amelioration ofARDSwas similar to those ofNLRP3 formation,NF-κB pathway activation,and p38 MAPK,c-Jun N-terminal kinase(JNK),and Akt phosphorylation but not to that of extracellular signal-regulated kinase(ERK)phosphorylation.Liriodendrin inhibited LPS-induced inflammatory responses in RAW264.7 macrophages.It markedly reduced NO production,propro-inflammatorytokines,NF-κB phosphorylation,and NLRP3 formation.Conclusions:In summary,liriodendrin effectively ameliorated the pathological features of LPS-induced ARDS inmice,demonstrating significant anti-inflammatory properties attributed to NLRP3 formation through NF-κB pathway activation by p38MAPK,JNK,and Akt phosphorylation.In LPS-treated RAW264.7 macrophages,liriodendrin reduced NO production,pro-inflammatory cytokines,and NLRP3 formation,suggesting its potential as an agent for ARDS and relative inflammation.展开更多
BACKGROUND Acute respiratory infections(ARI)and diarrhoea are among the leading causes of infant and under-five mortality worldwide.Zinc,the second most abundant trace element in the human body,is widely used in the t...BACKGROUND Acute respiratory infections(ARI)and diarrhoea are among the leading causes of infant and under-five mortality worldwide.Zinc,the second most abundant trace element in the human body,is widely used in the treatment of both conditions.It mitigates diarrhoea by restoring mucosal integrity and enhancing enterocyte brush border enzyme activity.In ARI,zinc boosts immune function,promotes epithelial regeneration,and inhibits the replication of respiratory viruses.AIM To assess the effectiveness of prophylactic intermittent zinc supplementation in preventing acute diarrhoea and ARI in infants.METHODS This open-label,randomized controlled trial with a 1:1 allocation ratio was conducted over 15 months(October 2022 to December 2023)at a tertiary care hospital in Eastern India.A total of 320 infants attending the outpatient department for routine vaccinations were enrolled and randomly assigned to intervention and control groups.The intervention group received zinc drops for two weeks,with the regimen repeated one month later and again at six months during subsequent vaccination visits.The control group received no placebo or alternative treatment.Outcomes were assessed after the final follow-up at nine months.RESULTS The mean annual incidence of ARI and diarrhoea was significantly lower in the zinc group than in the control group[ARI:0.25±0.61 vs 0.92±1.22;mean difference=-0.67(95%CI:-0.88 to-0.45),P<0.001,Cohen’s d=-0.69]and[diarrhoea:1.04±1.30 vs 2.07±2.09;mean difference=-1.03(95%CI:-1.42 to-0.65),P<0.001,Cohen's d=-0.59],respectively.Additionally,the zinc group showed significantly greater gains in length[10±0.6 cm vs 8.6±0.4 cm;mean difference=1.4(95%CI:1.3-1.5),P<0.001,Cohen’s d=2.74]and weight[3150±108 g vs 2818±76 g;mean difference=332(95%CI:310-352),P<0.001,Cohen's d=3.56].CONCLUSION Prophylactic intermittent zinc supplementation administered alongside routine immunization substantially reduces the incidence of ARI and diarrhoea in infants and promotes improved growth.This affordable strategy holds promise for reducing infant morbidity and mortality without increasing healthcare burdens.展开更多
The classification of respiratory sounds is crucial in diagnosing and monitoring respiratory diseases.However,auscultation is highly subjective,making it challenging to analyze respiratory sounds accurately.Although d...The classification of respiratory sounds is crucial in diagnosing and monitoring respiratory diseases.However,auscultation is highly subjective,making it challenging to analyze respiratory sounds accurately.Although deep learning has been increasingly applied to this task,most existing approaches have primarily relied on supervised learning.Since supervised learning requires large amounts of labeled data,recent studies have explored self-supervised and semi-supervised methods to overcome this limitation.However,these approaches have largely assumed a closedset setting,where the classes present in the unlabeled data are considered identical to those in the labeled data.In contrast,this study explores an open-set semi-supervised learning setting,where the unlabeled data may contain additional,unknown classes.To address this challenge,a distance-based prototype network is employed to classify respiratory sounds in an open-set setting.In the first stage,the prototype network is trained using labeled and unlabeled data to derive prototype representations of known classes.In the second stage,distances between unlabeled data and known class prototypes are computed,and samples exceeding an adaptive threshold are identified as unknown.A new prototype is then calculated for this unknown class.In the final stage,semi-supervised learning is employed to classify labeled and unlabeled data into known and unknown classes.Compared to conventional closed-set semisupervised learning approaches,the proposed method achieved an average classification accuracy improvement of 2%–5%.Additionally,in cases of data scarcity,utilizing unlabeled data further improved classification performance by 6%–8%.The findings of this study are expected to significantly enhance respiratory sound classification performance in practical clinical settings.展开更多
The aim of this study is to investigate how clinical pharmacists can optimize drug use for pediatric patients with respiratory diseases.We extracted etiological,symptomatic,and medication-related information from pati...The aim of this study is to investigate how clinical pharmacists can optimize drug use for pediatric patients with respiratory diseases.We extracted etiological,symptomatic,and medication-related information from patient medical records.The rationality of each patient’s medication regimen was evaluated using relevant tools,including DXY,Medication Assistant Software(mobile version),MCDEX Software(mobile version),and literature from databases such as VIP and CNKI.By considering the patients’age,prescribed medication regimens,and disease characteristics,we identified key aspects and precautions for pharmaceutical care.Pharmacists provided tailored pharmaceutical care and medication education based on each patient’s specific age,treatment plan,and illness profile.Through active involvement in personalized medication management,pharmacists can offer individualized drug services,enhancing both the safety and effectiveness of treatments for pediatric patients.展开更多
BACKGROUND Depression is a common psychological disorder often associated with genetic,neurobiological,and psychosocial factors.This condition is characterized by low mood and decreased conscious activity and can lead...BACKGROUND Depression is a common psychological disorder often associated with genetic,neurobiological,and psychosocial factors.This condition is characterized by low mood and decreased conscious activity and can lead to severe consequences such as suicidal thoughts.Respiratory failure,a disorder of pulmonary ventilation and gas exchange,is frequently complicated by depression,aggravating the condition and creating complications in treatment.Patients with both conditions tend to exhibit poor compliance with medical advice,resulting in adverse outcomes such as sleep disorders,arrhythmias,and electrolyte imbalances.Therefore,effective nursing interventions are crucial for improving patient outcomes.While routine nursing care can provide basic support,dedicated nursing,which involves specialized and personalized care by highly trained professionals,may offer additional benefits.AIM To examine the effect of dedicated nursing intervention on medical advice compliance and adverse event incidence in patients with depression complicated by respiratory failure.METHODS A total of 160 patients with depression complicated by respiratory failure admitted to the Second Affiliated Hospital of Soochow University from January to December 2024 were randomly categorized into a control group(n=80)receiving routine nursing care and observation group(n=80)receiving routine nursing combined with dedicated nursing care.The establishment of a specialized nursing team;the development of a personalized nursing plan;and the implementation of comprehensive care strategies targeting emotional support,sleep improvement,pulmonary function enhancement,and adherence to medical advice were included in the dedicated nursing intervention.Emotional state[evaluated using the Self-Rating Depression Scale(SDS)],sleep quality[assessed using the Pittsburgh Sleep Quality Index(PSQI)],hope level[measured using the Herth Hope Scale(HHS)],pulmonary function[comprising forced vital capacity(FVC)and forced expiratory volume in the first second(FEV1)],exercise endurance[6-minute walk distance test(6MWD)],compliance with medical advice,and incidence of adverse events were compared between the two groups.RESULTS No significant differences were observed in SDS,PSQI,HHS,FVC,FEV1,6MWD,or compliance with medical advice between the two groups(P>0.05)before the intervention.However,after the intervention,the control group exhibited significantly lower SDS and PSQI scores;higher HHS scores;greater improvements in FVC,FEV1,and 6MWD;and higher compliance with medical advice compared with the control group(P<0.05).In addition,the incidence of adverse events was significantly lower in the control group(P<0.05).CONCLUSION Dedicated nursing intervention significantly improves emotional state,sleep quality,hope level,pulmonary function,exercise endurance,and compliance with medical advice while reducing adverse events in patients with depression complicated by respiratory failure.Therefore,dedicated nursing appears to be an effective approach to enhance patient outcomes in this population.展开更多
Phencyclidine(PCP,known as angel dust) is a nonbarbiturate,non-narcotic intravenous(IV) anesthetic with potent analgesic effects.However,its medical use was discontinued because of postoperative agitation,disorientati...Phencyclidine(PCP,known as angel dust) is a nonbarbiturate,non-narcotic intravenous(IV) anesthetic with potent analgesic effects.However,its medical use was discontinued because of postoperative agitation,disorientation,psychosis,cardiotoxicity,and hallucinogenic effects.Consequently,the PCP began to be illicitly distributed.The use methods include snorting,inhalation,IV,and subcutaneous(SC) injection.[1-5] The characteristic toxidrome of PCP includes altered mental status,tachycardia,and nystagmus.At higher doses,patients may become comatose and develop sympathomimetic effects such as tachycardia,hypertension,hypersalivation,urinary retention,and bronchospasm.In cases of intoxication,the pupillary light reflex remains intact,although the pupil size may vary.[1,3-6] PCP has a direct cardiotoxic effect and may induce arrhythmias.[2] Hyperreflexia,muscle rigidity,choreiform movements and muscle fasciculations may occur.[2,4,6] PCP-induced acute respiratory distress syndrome(ARDS) and alveolar hemorrhage(AH) are rare but potentially life-threatening complications.The main causes of non-traumatic death in patients with PCP intoxication include cardiopulmonary arrest,intracranial hemorrhage and rhabdomyolysis.[2,3,5] This case report aims to emphasize the management and potential benefits of inhaled N-acetylcysteine(NAC) and tranexamic acid(TXA)for PCP-induced ARDS and AH.展开更多
Objective Recombination events are common and serve as the primary driving force of diverse human adenovirus(HAdV),particularly in children with acute respiratory tract infections(ARIs).Therefore,continual monitoring ...Objective Recombination events are common and serve as the primary driving force of diverse human adenovirus(HAdV),particularly in children with acute respiratory tract infections(ARIs).Therefore,continual monitoring of these events is essential for effective viral surveillance and control.Methods Respiratory specimens were collected from children with ARIs between January 2022 and December 2023.The penton base,hexon,and fiber genes were amplified from HAdV-positive specimens and sequenced to determine the virus type.In cases with inconsistent typing results,genes were cloned into the pGEM-T vector to detect recombination events.Metagenomic next-generation sequencing(mNGS)was performed to characterize the recombinant HAdV genomes.Results Among 6,771 specimens,277(4.09%,277/6,771)were positvie for HAdV,of which 157(56.68%,157/277)were successfully typed,with HAdV-B3 being the dominant type(91.08%,143/157),and 14(5.05%,14/277)exhibited inconsistent typing results,six of which belonged to species B.The penton base genes of these six specimens were classified as HAdV-B7,whereas their hexon and fiber genes were classified as HAdV-B3,resulting in a recombinant genotype designated P7H3F3,which closely resembled HAdV-B114.Additionally,a partial gene encoding L152/55 kD was identified,which originated from HAdV-B16.Conclusion A novel recombinant,P7H3F3,was identified,containing sequences derived from HAdV-B3 and HAdV-B7,which is similar to HAdV-B114,along with additional sequences from HAdV-B16.展开更多
Introduction: Respiratory distress is a clinical condition accompanied by an increase in work of breathing, with the respiratory accessory muscles brought into play to ensure normal arterial oxygenation. It is a major...Introduction: Respiratory distress is a clinical condition accompanied by an increase in work of breathing, with the respiratory accessory muscles brought into play to ensure normal arterial oxygenation. It is a major cause of morbidity and mortality in pediatrics. The aim of our study was to investigate the epidemiological, clinical and therapeutic aspects of respiratory distress in children aged between 1 month and 15 years seen in the emergency department of the Bangui paediatric university hospital. Methodology: This was a 3-month descriptive cross-sectional study, from January 1 to March 31, 2023. All children aged 1 month to less than 15 years presenting with respiratory distress were included. Results: A total of 3021 children were admitted to the emergency medical services of Bangui’s pediatric university hospital. Of these, 164 were included in the study. The predominance was male, with a sex ratio of 1.09. The 0 - 2 age group was the most represented, with 67 patients (42.85%). The majority of patients came from Bangui, accounting for 146 (89.02%) of cases. Respiratory difficulty (59.15%), characterized by dyspnea and cough, associated with fever, vomiting, physical asthenia and diarrhea, were the main reasons for consultation. The main pathologies noted were respiratory 92 (56.10%), followed by cardiac pathologies 21 (12.8%). Antibiotic administration (76.82%) was the most common therapeutic procedure used in the management of respiratory distress. Conclusion: Respiratory distress remains an important cause of infant mortality in our context, with major management problems.展开更多
In this paper,we study the epidemic model of respiratory syncytial virus SIRS with age structure.Firstly,the basic reproduction number R_(0) of the model is calculated and the positivity and ultimate boundedness of th...In this paper,we study the epidemic model of respiratory syncytial virus SIRS with age structure.Firstly,the basic reproduction number R_(0) of the model is calculated and the positivity and ultimate boundedness of the solution to the model under initial conditions are proven.Secondly,it is proven that when R_(0)<1,the disease-free equilibrium is locally and globally asymptotically stable;and when R_(0)>1,the disease is uniformly persistent and there is at least a positive equilibrium.Finally,the effectiveness of the theoretical results is demonstrated by numerical simulation,and the impact of vaccination on disease transmission is predicted.展开更多
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 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 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.
基金funded by the National Key R&D Program of China(2022YFE0140400)the National Natural Science Foundation of China(62405027, 62111530238, 62003046)+3 种基金Supporting project of major scientific research projects of Beijing Normal University at Zhuhai (ZHPT2023007)supported by the Tang Scholar of Beijing Normal Universityco-funded by the financial support of the European Union under the REFRESH-Research Excellence For REgion Sustainability and High-tech Industries project number CZ.10.03.01/00/22003/0000048 via the Operational Programme Just Transitionthe scope of the projects CICECO-Aveiro Institute of Materials, UIDB/50011/2020 (DOI 10.54499/UIDB/50011/2020), UIDP/50011/2020 (DOI 10.54499/UIDP/50011/2020) & LA/P/0006/2020 (DOI 10.54499/LA/P/0006/2020) financed by national funds through the FCT/MCTES (PIDDAC)
文摘Personalized health services are of paramount importance for the treatment and prevention of cardiorespiratory diseases,such as hypertension.The assessment of cardiorespiratory function and biometric identification(ID)is crucial for the effectiveness of such personalized health services.To effectively and accurately monitor pulse wave signals,thus achieving the assessment of cardiorespiratory function,a wearable photonic smart wristband based on an all-polymer sensing unit(All-PSU)is proposed.The smart wristband enables the assessment of cardiorespiratory function by continuously monitoring respiratory rate(RR),heart rate(HR),and blood pressure(BP).Furthermore,it can be utilized for biometric ID purposes.Through the analysis of pulse wave signals using power spectral density(PSD),accurate monitoring of RR and HR is achieved.Additionally,utilizing peak detection algorithms for feature extraction from pulse signals and subsequently employing a variety of machine learning methods,accurate BP monitoring and biometric ID have been realized.For biometric ID,the accuracy rate is 98.55%.Aiming to monitor RR,HR,BP,and ID,our solution demonstrates advantages in integration,functionality,and monitoring precision.These enhancements may contribute to the development of personalized health services aimed at the treatment and prevention of cardiorespiratory diseases.
基金supported by the National High Level Hospital Clinical Research Funding(No.BJ-2023-066).
文摘Objective This study aims to analyze the burden of lower respiratory infections in Chinese elderly people aged 70 and above.Methods This study utilized Global Burden of Disease(GBD)1990-2050 prediction data to analyze changes in mortality rates and disability-adjusted life year(DALY)rates for lower respiratory infections in the elderly population(aged 70 and above)in China from 1990 to 2050.It also discusses future trends in the burden of lower respiratory infections(LRI)in China under different scenarios.Results According to GBD predictions,the burden of lower respiratory infections in the elderly aged 70 years and above in China is lower than the global average.The burden has been decreasing from 1990 to 2020,but is projected to increase from 2020 to 2050.Scenario-based predictions suggest that,under scenarios involving improvements in nutrition and vaccination,the burden of lower respiratory infections in the elderly in China is expected to be the lowest in 2050.Conclusion This study indicates that the burden of lower respiratory infections in elderly people aged 70 years and above in China remains a significant public health issue and may worsen.The government should consider strengthening the preventive measures and management strategies for respiratory infections in the elderly population.
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BACKGROUND Mitochondrial myopathies are characterized by primary dysfunction of the mitochondrial respiratory chain;they typically present as chronic muscle weak-ness.Clinically visible acute respiratory dysfunctions associated with mito-chondrial myopathies occur rarely.CASE SUMMARY In this report,we present the case of a patient who developed postoperative hypoventilation after undergoing an uneventful administration of general anesthesia.A 34-year-old woman with no family history of myopathy underwent laparoscopic removal of a right-sided ureteric stone.Two days postoperatively,her oxygen saturation decreased rapidly,and blood gas analysis revealed hypercapnia.We promptly intubated and initiated the patient and initiated her on mechanical ventilation as she remained awake.Clinical examination findings were unremarkable;the results of laboratory investigations,including those for thyroid,hepatic,renal,and neuromuscular functions,were within normal limits.Muscle biopsy revealed muscle fibers of varying sizes as well as several dege-nerating and regenerating myofibers.Modified Gomori trichrome staining of the cross-sections revealed ragged red fibers.Based on these findings,we diagnosed the patient with mitochondrial myopathy.The patient’s condition gradually improved,and she was discharged on a home ventilator 73 days postoperatively.CONCLUSION Our case highlights that mitochondrial myopathy should be considered in the differential diagnosis of patients with postoperative respiratory failure.
基金Shaanxi Provincial People’s Hospital Science and Technology Development Incubation Fund Program 2023(Project No.:2023HL-12)。
文摘Objective:To explore the obstructive factors in the behavior of medical staff during the implementation of respiratory rehabilitation process,and to provide a basis for the rehabilitation management intervention of COPD.Methods:A descriptive nature research method was adopted.An interview outline was formulated based on the theoretical domain framework.From October to December 2024,15 medical staff from the respiratory department of a tertiary hospital in Shaanxi Province were selected for semi-structured interviews.The interview data were analyzed using the Colaizzi 7-step analysis method.Result:The analysis of this study found that the obstructive factors for medical staff to implement respiratory rehabilitation include five theoretical domains.The problems are respectively the lack of knowledge about respiratory rehabilitation and insufficient training intensity,the insufficient self-recognition of implementing respiratory rehabilitation,the low awareness rate of patients and the low cooperation degree,the insufficient provision of instruments and facilities,the lack of rehabilitation training venues and respiratory rehabilitation clinics,and the lack of scientific and standardized respiratory rehabilitation management processes.Conclusion:There are many obstructive factors affecting the implementation of respiratory rehabilitation by medical staff.Clinical managers should take corresponding measures,continuously improve the rehabilitation management strategies for COPD,and promote the clinical application of the best evidence for respiratory rehabilitation.
基金supported by the projects of National Virus Resource Center(NVRC-PY-03,E1YZ020501)Natural Science Foundation of Hubei Province(2022CFB564)+4 种基金Foundation of Hubei Provincial Health Commission(WJ2023M108)National Basic Science Data Sharing Platform(no.2018ZX10101004)National Basic Science Data Sharing Service Platform(no.NBSDC-DB-13)the International Cooperation Base of Hubei Province for Infection and Immunitysupported by Outstanding Medical Young Scholars of Hubei Province and Wuhan Young and Middle-aged Medical Backbone Talent Program.
文摘Acute respiratory tract infections(ARTIs)are among the leading causes of morbidity and mortality in children worldwide.Human adenovirus(HAdV)infections are estimated to account for at least 5%of pediatric ARTIs.The circulated genotypes of HAdV and the correlation between genotype and clinical manifestations in Wuhan,China,before and after the complete relaxation of nonpharmaceutical interventions against severe acute respiratory syndrome coronavirus 2,remain unknown.Here,101 HAdV strains were isolated from throat swab samples collected from hospitalized children with ARTIs who tested positive for HAdV nucleic acid.Of these,sixty-six strains from 2022 to twenty-three strains from 2023 were successfully genotyped and subjected to phylogenetic analysis based on the hexon,penton base,and fiber genes.Six genotypes,B3,C1,C2,C5,C104,and C108 were identified.HAdV-B3(84.85%)was the most prevalent type in 2022,while HAdV-C(86.96%),including C1,C2,C108,and C104,was the most prevalent in 2023.These strains were phylogenetically related to strains from Japan,China,and the United States in recent years.When comparing clinical characteristics,pediatric patients infected with B3,C1,C2,C5,C104,or C108 exhibited similar clinical manifestations,primarily fever and cough,but varying interleukin(IL)-10 levels.In conclusion,from June 2022 to September 2023,the circulated genotypes of HAdV in Wuhan included B3,C1,C2,C108,C5,and C104.The endemic pattern of HAdV in Wuhan,China,shifted from species B as the dominant type in 2022 to species C in 2023.
基金funded by the Science and Technology Special Project of Zhanjiang,China(Grant No.:2022A01034)the Guangdong Provincial Department of Education Research Project,China(Grant No.:2022KTSCX)+2 种基金the Science and Technology Program of Guangdong Province,China(Grant No.:2023A1515010850)the Special Fund for Science and Technology Innovation Strategy of Guangdong Province,China(Grant No.:pdjh2023a0227)the National Undergraduate Training Program for Innovation and Entrepreneurship,China(Grant No.:202310571003).
文摘Ferroptosis is a form of cell death that occurs when there is an excess of reactive oxygen species(ROS),lipid peroxidation,and iron accumulation.The precise regulation of metabolic pathways,including iron,lipid,and amino acid metabolism,is crucial for cell survival.This type of cell death,which is associated with oxidative stress,is controlled by a complex network of signaling molecules and pathways.It is also implicated in various respiratory diseases such as asthma,chronic obstructive pulmonary disease(COPD),acute lung injury(ALI),lung cancer,pulmonary fibrosis(PF),and the coronavirus disease 2019(COVID-19).To combat drug resistance,it is important to identify appropriate biological markers and treatment targets,as well as intervene in respiratory disorders to either induce or prevent ferroptosis.The focus is on the role of ferroptosis in the development of respiratory diseases and the potential of targeting ferroptosis for prevention and treatment.The review also explores the interaction between immune cell ferroptosis and inflammatory mediators in respiratory diseases,aiming to provide more effective strategies for managing cellular ferroptosis and respiratory disorders.
基金supported by Chung Shan Medical University and Changhua Christian Hospital(CSMU-CCH-111-08)supported by research grants from the Chung Shan Medical University Hospital,Taichung,Taiwan(CSH-2023-C-023)the National Science and Technology Council,Taiwan,for financially supporting this research under Contract Nos.NSTC 112-2320-B-040-017,NSTC112-2314-B-040-009,and NSTC 112-2320-B-040-011.
文摘Background:Acute respiratory distress syndrome(ARDS)is the major therapeutic dilemma associated with significant inflammation and severe pulmonary dysfunction.Liriodendrin is a bioactive compound extract from traditional Chinesemedicine,historically utilized formodulating inflammatory responses and alleviating symptoms in multiple diseasemodels.Methods:At present,BALB/c mice to explore the effects of liriodendrin on lipopolysaccharide(LPS)-induced ARDS.Before LPS was administered,the mice were treated with either liriodendrin or dexamethasone.Leukocyte infiltration,lung edema,and alveolar-capillary barrier integrity were evaluated in the bronchoalveolar lavage fluid(BALF)and pulmonary parenchyma.The expression of adhesion molecules and proinflammatory cytokines in BALF was evaluated by enzyme-linked immunosorbent assay.Western blotting assay facilitated the analysis of the expression or phosphorylation of inducible nitric oxide synthase(iNOS),cyclooxygenase-2(COX-2),NOD-like receptor family pyrin domain-containing 3(NLRP3),apoptosis-associated speck-like protein containing a CARD(ASC),cleaved caspase-1(CL-csapase-1),nuclear factor kappa-light-chain-enhancer of activated B cells(NF-κB),inhibitor of kappa B(IκB),mitogen-activated protein kinase(MAPK),and protein kinase B(Akt)in the lungs.In addition,the anti-inflammatory effects of liriodendrin were evaluated in LPS-stimulated RAW264.7 macrophages.Before LPS was administered,the RAW264.7 macrophages were treated with either liriodendrin or dexamethasone.Nitric Oxide(NO)production was measured using the Griess reaction assay,while ELISA assessed IL-1β,IL-6,and TNF-αlevels.Western blot analysis evaluated NF-κB phosphorylation and the expression of NLRP3,ASC,and CLcaspase-1.Results:These outcomes revealed that liriodendrin intervention markedly ameliorated the pathological features of LPS-induced ARDS,including leukocyte infiltration,lung edema,and alveolar-capillary barrier disruption.Liriodendrin also reduced the LPS-induced secretion of intercellular adhesion molecule-1(ICAM-1)and vascular cell adhesionmolecule-1(VCAM-1),expression of iNOS and COX2,and production of proinflammatory cytokines.Finally,we further discovered that the concentration trend of liriodendron amelioration ofARDSwas similar to those ofNLRP3 formation,NF-κB pathway activation,and p38 MAPK,c-Jun N-terminal kinase(JNK),and Akt phosphorylation but not to that of extracellular signal-regulated kinase(ERK)phosphorylation.Liriodendrin inhibited LPS-induced inflammatory responses in RAW264.7 macrophages.It markedly reduced NO production,propro-inflammatorytokines,NF-κB phosphorylation,and NLRP3 formation.Conclusions:In summary,liriodendrin effectively ameliorated the pathological features of LPS-induced ARDS inmice,demonstrating significant anti-inflammatory properties attributed to NLRP3 formation through NF-κB pathway activation by p38MAPK,JNK,and Akt phosphorylation.In LPS-treated RAW264.7 macrophages,liriodendrin reduced NO production,pro-inflammatory cytokines,and NLRP3 formation,suggesting its potential as an agent for ARDS and relative inflammation.
文摘BACKGROUND Acute respiratory infections(ARI)and diarrhoea are among the leading causes of infant and under-five mortality worldwide.Zinc,the second most abundant trace element in the human body,is widely used in the treatment of both conditions.It mitigates diarrhoea by restoring mucosal integrity and enhancing enterocyte brush border enzyme activity.In ARI,zinc boosts immune function,promotes epithelial regeneration,and inhibits the replication of respiratory viruses.AIM To assess the effectiveness of prophylactic intermittent zinc supplementation in preventing acute diarrhoea and ARI in infants.METHODS This open-label,randomized controlled trial with a 1:1 allocation ratio was conducted over 15 months(October 2022 to December 2023)at a tertiary care hospital in Eastern India.A total of 320 infants attending the outpatient department for routine vaccinations were enrolled and randomly assigned to intervention and control groups.The intervention group received zinc drops for two weeks,with the regimen repeated one month later and again at six months during subsequent vaccination visits.The control group received no placebo or alternative treatment.Outcomes were assessed after the final follow-up at nine months.RESULTS The mean annual incidence of ARI and diarrhoea was significantly lower in the zinc group than in the control group[ARI:0.25±0.61 vs 0.92±1.22;mean difference=-0.67(95%CI:-0.88 to-0.45),P<0.001,Cohen’s d=-0.69]and[diarrhoea:1.04±1.30 vs 2.07±2.09;mean difference=-1.03(95%CI:-1.42 to-0.65),P<0.001,Cohen's d=-0.59],respectively.Additionally,the zinc group showed significantly greater gains in length[10±0.6 cm vs 8.6±0.4 cm;mean difference=1.4(95%CI:1.3-1.5),P<0.001,Cohen’s d=2.74]and weight[3150±108 g vs 2818±76 g;mean difference=332(95%CI:310-352),P<0.001,Cohen's d=3.56].CONCLUSION Prophylactic intermittent zinc supplementation administered alongside routine immunization substantially reduces the incidence of ARI and diarrhoea in infants and promotes improved growth.This affordable strategy holds promise for reducing infant morbidity and mortality without increasing healthcare burdens.
基金supported by Innovative Human Resource Development for Local Intellectualization Programthrough the Institute of Information&Communications Technology Planning&Evaluation(IITP)grant funded by the Korea government(MSIT)(IITP-2025-RS-2022-00156360).
文摘The classification of respiratory sounds is crucial in diagnosing and monitoring respiratory diseases.However,auscultation is highly subjective,making it challenging to analyze respiratory sounds accurately.Although deep learning has been increasingly applied to this task,most existing approaches have primarily relied on supervised learning.Since supervised learning requires large amounts of labeled data,recent studies have explored self-supervised and semi-supervised methods to overcome this limitation.However,these approaches have largely assumed a closedset setting,where the classes present in the unlabeled data are considered identical to those in the labeled data.In contrast,this study explores an open-set semi-supervised learning setting,where the unlabeled data may contain additional,unknown classes.To address this challenge,a distance-based prototype network is employed to classify respiratory sounds in an open-set setting.In the first stage,the prototype network is trained using labeled and unlabeled data to derive prototype representations of known classes.In the second stage,distances between unlabeled data and known class prototypes are computed,and samples exceeding an adaptive threshold are identified as unknown.A new prototype is then calculated for this unknown class.In the final stage,semi-supervised learning is employed to classify labeled and unlabeled data into known and unknown classes.Compared to conventional closed-set semisupervised learning approaches,the proposed method achieved an average classification accuracy improvement of 2%–5%.Additionally,in cases of data scarcity,utilizing unlabeled data further improved classification performance by 6%–8%.The findings of this study are expected to significantly enhance respiratory sound classification performance in practical clinical settings.
基金National Natural Science Foundation of China(Grant No.21302131).
文摘The aim of this study is to investigate how clinical pharmacists can optimize drug use for pediatric patients with respiratory diseases.We extracted etiological,symptomatic,and medication-related information from patient medical records.The rationality of each patient’s medication regimen was evaluated using relevant tools,including DXY,Medication Assistant Software(mobile version),MCDEX Software(mobile version),and literature from databases such as VIP and CNKI.By considering the patients’age,prescribed medication regimens,and disease characteristics,we identified key aspects and precautions for pharmaceutical care.Pharmacists provided tailored pharmaceutical care and medication education based on each patient’s specific age,treatment plan,and illness profile.Through active involvement in personalized medication management,pharmacists can offer individualized drug services,enhancing both the safety and effectiveness of treatments for pediatric patients.
基金Supported by the Second Nursing Research Project of the Humanities Nursing Professional Committee,No.RW2024PY03the Open Project of Suzhou Key Laboratory of Elderly Smart Nursing and Health Care in 2024.
文摘BACKGROUND Depression is a common psychological disorder often associated with genetic,neurobiological,and psychosocial factors.This condition is characterized by low mood and decreased conscious activity and can lead to severe consequences such as suicidal thoughts.Respiratory failure,a disorder of pulmonary ventilation and gas exchange,is frequently complicated by depression,aggravating the condition and creating complications in treatment.Patients with both conditions tend to exhibit poor compliance with medical advice,resulting in adverse outcomes such as sleep disorders,arrhythmias,and electrolyte imbalances.Therefore,effective nursing interventions are crucial for improving patient outcomes.While routine nursing care can provide basic support,dedicated nursing,which involves specialized and personalized care by highly trained professionals,may offer additional benefits.AIM To examine the effect of dedicated nursing intervention on medical advice compliance and adverse event incidence in patients with depression complicated by respiratory failure.METHODS A total of 160 patients with depression complicated by respiratory failure admitted to the Second Affiliated Hospital of Soochow University from January to December 2024 were randomly categorized into a control group(n=80)receiving routine nursing care and observation group(n=80)receiving routine nursing combined with dedicated nursing care.The establishment of a specialized nursing team;the development of a personalized nursing plan;and the implementation of comprehensive care strategies targeting emotional support,sleep improvement,pulmonary function enhancement,and adherence to medical advice were included in the dedicated nursing intervention.Emotional state[evaluated using the Self-Rating Depression Scale(SDS)],sleep quality[assessed using the Pittsburgh Sleep Quality Index(PSQI)],hope level[measured using the Herth Hope Scale(HHS)],pulmonary function[comprising forced vital capacity(FVC)and forced expiratory volume in the first second(FEV1)],exercise endurance[6-minute walk distance test(6MWD)],compliance with medical advice,and incidence of adverse events were compared between the two groups.RESULTS No significant differences were observed in SDS,PSQI,HHS,FVC,FEV1,6MWD,or compliance with medical advice between the two groups(P>0.05)before the intervention.However,after the intervention,the control group exhibited significantly lower SDS and PSQI scores;higher HHS scores;greater improvements in FVC,FEV1,and 6MWD;and higher compliance with medical advice compared with the control group(P<0.05).In addition,the incidence of adverse events was significantly lower in the control group(P<0.05).CONCLUSION Dedicated nursing intervention significantly improves emotional state,sleep quality,hope level,pulmonary function,exercise endurance,and compliance with medical advice while reducing adverse events in patients with depression complicated by respiratory failure.Therefore,dedicated nursing appears to be an effective approach to enhance patient outcomes in this population.
文摘Phencyclidine(PCP,known as angel dust) is a nonbarbiturate,non-narcotic intravenous(IV) anesthetic with potent analgesic effects.However,its medical use was discontinued because of postoperative agitation,disorientation,psychosis,cardiotoxicity,and hallucinogenic effects.Consequently,the PCP began to be illicitly distributed.The use methods include snorting,inhalation,IV,and subcutaneous(SC) injection.[1-5] The characteristic toxidrome of PCP includes altered mental status,tachycardia,and nystagmus.At higher doses,patients may become comatose and develop sympathomimetic effects such as tachycardia,hypertension,hypersalivation,urinary retention,and bronchospasm.In cases of intoxication,the pupillary light reflex remains intact,although the pupil size may vary.[1,3-6] PCP has a direct cardiotoxic effect and may induce arrhythmias.[2] Hyperreflexia,muscle rigidity,choreiform movements and muscle fasciculations may occur.[2,4,6] PCP-induced acute respiratory distress syndrome(ARDS) and alveolar hemorrhage(AH) are rare but potentially life-threatening complications.The main causes of non-traumatic death in patients with PCP intoxication include cardiopulmonary arrest,intracranial hemorrhage and rhabdomyolysis.[2,3,5] This case report aims to emphasize the management and potential benefits of inhaled N-acetylcysteine(NAC) and tranexamic acid(TXA)for PCP-induced ARDS and AH.
基金supported by the Capital’s Funds for Health Improvement and Research(CFH,shoufa-2022-1G-1131 and shoufa 2022-4G-1133)the High Level Technical Talent Construction Project of Beijing Municipal Health Commission(Discipline Leader-02-20)+1 种基金Beijing Municipal Public Welfare Development and Reform Pilot Project for Medical Research Institutes(JYY2023-10)the Pathogen Spectrum and Host Marker Analysis in Children with Respiratory Tract Infections of Children(Grant 2024-0040).
文摘Objective Recombination events are common and serve as the primary driving force of diverse human adenovirus(HAdV),particularly in children with acute respiratory tract infections(ARIs).Therefore,continual monitoring of these events is essential for effective viral surveillance and control.Methods Respiratory specimens were collected from children with ARIs between January 2022 and December 2023.The penton base,hexon,and fiber genes were amplified from HAdV-positive specimens and sequenced to determine the virus type.In cases with inconsistent typing results,genes were cloned into the pGEM-T vector to detect recombination events.Metagenomic next-generation sequencing(mNGS)was performed to characterize the recombinant HAdV genomes.Results Among 6,771 specimens,277(4.09%,277/6,771)were positvie for HAdV,of which 157(56.68%,157/277)were successfully typed,with HAdV-B3 being the dominant type(91.08%,143/157),and 14(5.05%,14/277)exhibited inconsistent typing results,six of which belonged to species B.The penton base genes of these six specimens were classified as HAdV-B7,whereas their hexon and fiber genes were classified as HAdV-B3,resulting in a recombinant genotype designated P7H3F3,which closely resembled HAdV-B114.Additionally,a partial gene encoding L152/55 kD was identified,which originated from HAdV-B16.Conclusion A novel recombinant,P7H3F3,was identified,containing sequences derived from HAdV-B3 and HAdV-B7,which is similar to HAdV-B114,along with additional sequences from HAdV-B16.
文摘Introduction: Respiratory distress is a clinical condition accompanied by an increase in work of breathing, with the respiratory accessory muscles brought into play to ensure normal arterial oxygenation. It is a major cause of morbidity and mortality in pediatrics. The aim of our study was to investigate the epidemiological, clinical and therapeutic aspects of respiratory distress in children aged between 1 month and 15 years seen in the emergency department of the Bangui paediatric university hospital. Methodology: This was a 3-month descriptive cross-sectional study, from January 1 to March 31, 2023. All children aged 1 month to less than 15 years presenting with respiratory distress were included. Results: A total of 3021 children were admitted to the emergency medical services of Bangui’s pediatric university hospital. Of these, 164 were included in the study. The predominance was male, with a sex ratio of 1.09. The 0 - 2 age group was the most represented, with 67 patients (42.85%). The majority of patients came from Bangui, accounting for 146 (89.02%) of cases. Respiratory difficulty (59.15%), characterized by dyspnea and cough, associated with fever, vomiting, physical asthenia and diarrhea, were the main reasons for consultation. The main pathologies noted were respiratory 92 (56.10%), followed by cardiac pathologies 21 (12.8%). Antibiotic administration (76.82%) was the most common therapeutic procedure used in the management of respiratory distress. Conclusion: Respiratory distress remains an important cause of infant mortality in our context, with major management problems.
基金supported by the Natural Science Foundation of Xinjiang(No.2022D01E41)the National Natural Science Foundation of China(No.12261087)the Open Project of Key Laboratory of Applied Mathematics of Xinjiang Autonomous Region(No.2021D04014)。
文摘In this paper,we study the epidemic model of respiratory syncytial virus SIRS with age structure.Firstly,the basic reproduction number R_(0) of the model is calculated and the positivity and ultimate boundedness of the solution to the model under initial conditions are proven.Secondly,it is proven that when R_(0)<1,the disease-free equilibrium is locally and globally asymptotically stable;and when R_(0)>1,the disease is uniformly persistent and there is at least a positive equilibrium.Finally,the effectiveness of the theoretical results is demonstrated by numerical simulation,and the impact of vaccination on disease transmission is predicted.
