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
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
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
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
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
BACKGROUND The frequent occurrence of respiratory diseases in the island reef environment of the navy severely affects the health of personnel and the combat effectiveness of the troops.Current common screening method...BACKGROUND The frequent occurrence of respiratory diseases in the island reef environment of the navy severely affects the health of personnel and the combat effectiveness of the troops.Current common screening methods can only indicate whether there is an infection with pathogenic microorganisms but not the degree of disease progression.Therefore,it is necessary to identify simple-to-operate and cost-effective methods that indicate the degree of disease progression,based on traditional screening methods.AIM To explores correlation between serum concentrations of nicotinamide phosphoribosyltransferase(NAMPT),nicotinamide nucleotide adenylyltransferase 1(NMNAT1),and the risk of upper respiratory infections in the island reef envirsonment.METHODS A total of 600 cases of upper respiratory infections among naval officers and soldiers were included.Types of infection were confirmed through sputum culture combined with multiplex polymerase chain reaction.The serum concentrations of NAMPT and NMNAT1 were measured using ELISA,and infection severity was assessed using the pneumonia severity index(PSI).Statistical analysis was performed using nonparametric tests and Spearman correlation analysis.RESULTS The serum concentrations of NAMPT and NMNAT1 in high-risk group patients with PSI were significantly lower than those in the medium and low-risk groups(P<0.05),and the concentrations increased in a stepwise manner with disease progression.However,within the same risk group,the differences in concentrations of NAMPT and NMNAT1among patients infected with different pathogens were not significant(P>0.05).CONCLUSIONConcentrations of NAMPT and NMNAT1 are closely related to severity of upper respiratory infections,and theircommon regulatory mechanisms provide new directions for development of broad-spectrum anti-infectionstrategies.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
Respiratory infectious diseases frequently erupt on a global scale,with RNA viruses,such as SARS-CoV-2,RSV,and influenza viruses,posing challenges to vaccine development due to their high mutation rates.Traditional va...Respiratory infectious diseases frequently erupt on a global scale,with RNA viruses,such as SARS-CoV-2,RSV,and influenza viruses,posing challenges to vaccine development due to their high mutation rates.Traditional vaccine development cycles are lengthy and struggle to keep pace with rapidly evolving viruses,whereas messenger RNA(mRNA)vaccines have demonstrated significant advantages due to their short development periods,straightforward production,and low costs.After the outbreak of the COVID-19 pandemic,multiple mRNA vaccines,including Pfizer-BioNTech and Moderna,rapidly received emergency use authorization,validating their feasibility.The Nobel Prize in Physiology or Medicine in 2023 was awarded to Katalin Karikóand Drew Weissman,underscoring the efficacy of mRNA vaccine technology.In 2024,the U.S.Food and Drug Administration(FDA)approval of Moderna's respiratory syncytial virus(RSV)mRNA vaccine marked the immense potential of mRNA technology in vaccine innovation.This review article summarizes the design,clinical research,and future challenges of mRNA vaccines for respiratory viruses,delving into antigen design,mRNA delivery systems,and advancements in vaccines for multiple respiratory viruses,including innovations in self-amplifying mRNA and circular mRNA vaccines.Additionally,the development of combination vaccines is underway,aiming to provide protection against multiple viruses through a single administration.Despite the significant progress in mRNA vaccine development,challenges remain regarding raw material costs,stability,and delivery efficiency.In the future,with technological advancements and the accumulation of clinical experience,the design strategies and delivery systems of mRNA vaccines are expected to be continuously optimized,thereby enhancing their safety and efficacy.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
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
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
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 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.
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.
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.
文摘BACKGROUND The frequent occurrence of respiratory diseases in the island reef environment of the navy severely affects the health of personnel and the combat effectiveness of the troops.Current common screening methods can only indicate whether there is an infection with pathogenic microorganisms but not the degree of disease progression.Therefore,it is necessary to identify simple-to-operate and cost-effective methods that indicate the degree of disease progression,based on traditional screening methods.AIM To explores correlation between serum concentrations of nicotinamide phosphoribosyltransferase(NAMPT),nicotinamide nucleotide adenylyltransferase 1(NMNAT1),and the risk of upper respiratory infections in the island reef envirsonment.METHODS A total of 600 cases of upper respiratory infections among naval officers and soldiers were included.Types of infection were confirmed through sputum culture combined with multiplex polymerase chain reaction.The serum concentrations of NAMPT and NMNAT1 were measured using ELISA,and infection severity was assessed using the pneumonia severity index(PSI).Statistical analysis was performed using nonparametric tests and Spearman correlation analysis.RESULTS The serum concentrations of NAMPT and NMNAT1 in high-risk group patients with PSI were significantly lower than those in the medium and low-risk groups(P<0.05),and the concentrations increased in a stepwise manner with disease progression.However,within the same risk group,the differences in concentrations of NAMPT and NMNAT1among patients infected with different pathogens were not significant(P>0.05).CONCLUSIONConcentrations of NAMPT and NMNAT1 are closely related to severity of upper respiratory infections,and theircommon regulatory mechanisms provide new directions for development of broad-spectrum anti-infectionstrategies.
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Grants from the Ministry of Science and Technology of the People's Republic of China,Grant/Award Number:2021YFA1300301 and 2018YFA0507101National Natural Science Foundation of China,Grant/Award Number:31730054 and 31770900Beijing Natural Science Foundation,Grant/Award Number:5212016。
文摘Respiratory infectious diseases frequently erupt on a global scale,with RNA viruses,such as SARS-CoV-2,RSV,and influenza viruses,posing challenges to vaccine development due to their high mutation rates.Traditional vaccine development cycles are lengthy and struggle to keep pace with rapidly evolving viruses,whereas messenger RNA(mRNA)vaccines have demonstrated significant advantages due to their short development periods,straightforward production,and low costs.After the outbreak of the COVID-19 pandemic,multiple mRNA vaccines,including Pfizer-BioNTech and Moderna,rapidly received emergency use authorization,validating their feasibility.The Nobel Prize in Physiology or Medicine in 2023 was awarded to Katalin Karikóand Drew Weissman,underscoring the efficacy of mRNA vaccine technology.In 2024,the U.S.Food and Drug Administration(FDA)approval of Moderna's respiratory syncytial virus(RSV)mRNA vaccine marked the immense potential of mRNA technology in vaccine innovation.This review article summarizes the design,clinical research,and future challenges of mRNA vaccines for respiratory viruses,delving into antigen design,mRNA delivery systems,and advancements in vaccines for multiple respiratory viruses,including innovations in self-amplifying mRNA and circular mRNA vaccines.Additionally,the development of combination vaccines is underway,aiming to provide protection against multiple viruses through a single administration.Despite the significant progress in mRNA vaccine development,challenges remain regarding raw material costs,stability,and delivery efficiency.In the future,with technological advancements and the accumulation of clinical experience,the design strategies and delivery systems of mRNA vaccines are expected to be continuously optimized,thereby enhancing their safety and efficacy.
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.
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.
