Sequential invasive-noninvasive mechanical ventilation weaning strategy for patients after tracheostomy

BACKGROUND: Because the continuity and integrity of the trachea are likely damaged to some extent after tracheostomy, the implementation of sequential ventilation has certain difficulties, and sequential invasive-noninvasive ventilation on patients after tracheostomy is less common in practice. The present study aimed to investigate the feasibility of invasive-noninvasive sequential weaning strategy in patients after tracheostomy.METHODS: Fifty patients including 24 patients with withdrawal of mechanical ventilation(conventional group) and 26 patients with sequential invasive-noninvasive weaning by directly plugging of tracheostomy(sequential group) were analyzed retrospectively after appearance of pulmonary infection control(PIC) window. The analysis of arterial blood gases, ventilator-associated pneumonia(VAP) incidence, the total duration of mechanical ventilation, the success rate of weaning and total cost of hospitalization were compared between the two groups.RESULTS: Arterial blood gas analysis showed that the sequential weaning group was better than the conventional weaning group 1 and 24 hours after invasive ventilation. The VAP incidence was lowered, the duration of mechanical ventilation shortened, the success rate of weaning increased, and the total cost of hospitalization decreased.CONCLUSION: Sequential invasive-noninvasive ventilator weaning is feasible in patients after tracheostomy.

Cryptococcal pneumonia in a human immunodeficiency virusnegative patient: A case report

BACKGROUND Cases of cryptococcal pneumonia are frequently observed in patients with various innate or acquired immunodeficiencies,including organ transplant patients,cancer patients undergoing chemotherapy,patients with acquired immune deficiency syndrome,or patients on dialysis.Fluconazole is most often used to treat this condition when it is detected.CASE SUMMARY In the present report,we describe the case of a 42-year-old human immunodeficiency virus-negative man with normal immune function who had cryptococcal pneumonia that was diagnosed after undergoing computed tomography-guided percutaneous lung puncture.We successfully treated this patient via administration of 200 mg voriconazole twice per day for 9 mo.CONCLUSION This report provides evidence of the successful treatment of pulmonary cryptococcosis using voriconazole.

NOMA-Aided Generalized Pre-Coded Quadrature Spatial Modulation for Downlink Communication Systems

Generalised pre-coding quadrature spatial modulation(GPQSM)is recently proposed to increase the spectral efficiency(SE)of GPSM,which extends the transmitted symbols into in-phase/quadrature domains.In this paper,a novel scheme named non-orthogonal multiple access(NOMA)-aided GPQSM(NOMA-GPQSM),which incorporates the GPQSM scheme into the multi-user communication networks with assist of NOMA,is proposed to further improve the SE and system performance.In NOMA-GPQSM,one base station(BS)is set to serve K users,where user 1 is closest to the BS,and user K is farthest from the BS.In addition,a low-complexity detection method is proposed to reduce the high detection complexity of the maximum-likelihood(ML)detection in successive interference cancellation(SIC)method for all users by NOMA-GPQSM.The theoretical analysis of the BER performance for all users is also derived.Simulation results show that near users achieve relatively good performance,and far users achieve acceptable performance by adjusting power factors for all users in NOMA-GPQSM.