Effectiveness of oxygen nebulization at preventing radiotherapy-induced mucositis in patients with nasopharyngeal cancer

Purpose:To evaluate the effectiveness of oxygen nebulization at preventing radiotherapyinduced mucositis in patients with nasopharyngeal cancer.Methods:Sixty patients with nasopharyngeal cancer treated with simultaneous integrated boost intensity-modulated radiotherapy were randomly assigned to oxygen nebulization or ultrasonic nebulization groups;treatment was once daily for 20 minutes.All patients received routine oral care.We compared saliva pH and volume,food intake,and change in oral mucosa during radiotherapy,and dry mouth and sore throat after radiotherapy between the two groups.Results:There were significant differences in the incidence of grade III or IV mucositis,saliva volume and pH,and dry mouth and sore throat between the two groups when the total dose was 33 Gy(p<0.05 or p<0.01).Conclusion:Oxygen nebulization reduces radiotherapy-induced mucositis and relieves symptoms such as dry mouth and sore throat in patients with nasopharyngeal cancer.

Cardiac arrhythmias and cardiac arrest related to mushroom poisoning: A case report

BACKGROUND Mushroom exposure is a global health issue.The manifestations of mushroom poisoning (MP) may vary.Some species have been reported as rhabdomyolytic,hallucinogenic,or gastrointestinal poisons.Critical or even fatal MPs are mostly attributable to Amanita phalloides,with the development of severe liver or renal failure.Myocardial injury and even cases mimicking ST-segment elevation myocardial infarction (STEMI) have been previously reported,while cardiac arrhythmia or cardiac arrest is not commonly seen.CASE SUMMARY We report a 68-year-old woman with MP who suffered from delirium,seizure,long QT syndrome on electrocardiogram (ECG),severe cardiac arrhythmias of multiple origins,and cardiac arrest.She was intubated and put on blood perfusion.Her kidney and liver functions were intact;creatine kinase-MB was mildly elevated,and then fell within normal range during her hospital stay.We sent the mushrooms she left for translation elongation factor subunit 1α,ribosomal RNA gene sequence,and internal transcribed spacer sequence analyses.There were four kinds of mushrooms identified,two of which were found to be toxic.CONCLUSION This is the first time that we found cardiac toxicity caused by Panaeolus subbalteatus and Conocybe lactea,which were believed to be toxic to the liver,kidney,and brain.We suggest that intensive monitoring and ECG follow-up are essential to diagnose prolonged QT interval and different forms of tachycardia in MP patients,even without the development of severe liver or renal failure.The mechanisms need to be further investigated and clarified based on animal experiments and molecular signal pathways.

Traffic flow prediction based on BILSTM model and data denoising scheme

Accurate prediction of road traffic flow is a significant part in the intelligent transportation systems.Accurate prediction can alleviate traffic congestion,and reduce environmental pollution.For the management department,it can make effective use of road resources.For individuals,it can help people plan their own travel paths,avoid congestion,and save time.Owing to complex factors on the road,such as damage to the detector and disturbances from environment,the measured traffic volume can contain noise.Reducing the influence of noise on traffic flow prediction is a piece of very important work.Therefore,in this paper we propose a combination algorithm of denoising and BILSTM to effectively improve the performance of traffic flow prediction.At the same time,three denoising algorithms are compared to find the best combination mode.In this paper,the wavelet(WL) denoising scheme,the empirical mode decomposition(EMD) denoising scheme,and the ensemble empirical mode decomposition(EEMD) denoising scheme are all introduced to suppress outliers in traffic flow data.In addition,we combine the denoising schemes with bidirectional long short-term memory(BILSTM)network to predict the traffic flow.The data in this paper are cited from performance measurement system(PeMS).We choose three kinds of road data(mainline,off ramp,on ramp) to predict traffic flow.The results for mainline show that data denoising can improve prediction accuracy.Moreover,prediction accuracy of BILSTM+EEMD scheme is the highest in the three methods(BILSTM+WL,BILSTM+EMD,BILSTM+EEMD).The results for off ramp and on ramp show the same performance as the results for mainline.It is indicated that this model is suitable for different road sections and long-term prediction.

Correlation between the warning symptoms and prognosis of cardiac arrest

BACKGROUND A low survival rate in patients with cardiac arrest is associated with failure to recognize the condition in its initial stage.Therefore,recognizing the warning symptoms of cardiac arrest in the early stage may play an important role in survival.AIM To investigate the warning symptoms of cardiac arrest and to determine the correlation between the symptoms and outcomes.METHODS We included all adult patients with all-cause cardiac arrest who visited Peking University Third Hospital or Beijing Friendship Hospital between January 2012 and December 2014.Data on population,symptoms,resuscitation parameters,and outcomes were analysed.RESULTS Of the 1021 patients in the study,65.9%had symptoms that presented before cardiac arrest,25.2%achieved restoration of spontaneous circulation(ROSC),and 7.2%survived to discharge.The patients with symptoms had higher rates of an initial shockable rhythm(12.2%vs 7.5%,P=0.020),ROSC(29.1%vs 17.5%,P=0.001)and survival(9.2%vs 2.6%,P=0.001)than patients without symptoms.Compared with the out-of-hospital cardiac arrest(OHCA)without symptoms subgroup,the OHCA with symptoms subgroup had a higher rate of calls before arrest(81.6%vs 0.0%,P<0.001),health care provider-witnessed arrest(13.0%vs 1.4%,P=0.001)and bystander cardiopulmonary resuscitation(15.5%vs 4.9%,P=0.002);a shorter no flow time(11.7%vs 2.8%,P=0.002);and a higher ROSC rate(23.8%vs 13.2%,P=0.011).Compared to the in-hospital cardiac arrest(IHCA)without symptoms subgroup,the IHCA with symptoms subgroup had a higher mean age(66.2±15.2 vs 62.5±16.3 years,P=0.005),ROSC(32.0%vs 20.6%,P=0.003),and survival rates(10.6%vs 2.5%,P<0.001).The top five warning symptoms were dyspnea(48.7%),chest pain(18.3%),unconsciousness(15.2%),paralysis(4.3%),and vomiting(4.0%).Chest pain(20.9%vs 12.7%,P=0.011),cardiac etiology(44.3%vs 1.5%,P<0.001)and survival(33.9%vs 16.7%,P=0.001)were more common in males,whereas dyspnea(54.9%vs 45.9%,P=0.029)and a non-cardiac etiology(53.3%vs 41.7%,P=0.003)were more common in females.CONCLUSION Most patients had warning symptoms before cardiac arrest.Dyspnea,chest pain,and unconsciousness were the most common symptoms.Immediately recognizing these symptoms and activating the emergency medical system prevents resuscitation delay and improves the survival rate of OHCA patients in China.

Analysis of the Impact Factor of Emergency Medicine Journals in the Past 10 Years

To the Editor：The journal ＂impact factor （IF）＂ was conceived by Garfield in 1955 to help librarians identify the most influential journals based on the number of citations,and the first ranking of journals by IF was published in 1972.[1] We systematically analyzed the IFs of emergency medicine journals published in Journal Citation Report （JCR） for the past 10 years （2005-2014）.