Effects of pulmonary surfactant combined with noninvasive positive pressure ventilation in neonates with respiratory distress syndrome

BACKGROUND Neonatal respiratory distress syndrome(NRDS)is one of the most common diseases in neonatal intensive care units,with an incidence rate of about 7%among infants.Additionally,it is a leading cause of neonatal death in hospitals in China.The main mechanism of the disease is hypoxemia and hypercapnia caused by lack of surfactant AIM To explore the effect of pulmonary surfactant(PS)combined with noninvasive positive pressure ventilation on keratin-14(KRT-14)and endothelin-1(ET-1)levels in peripheral blood and the effectiveness in treating NRDS.METHODS Altogether 137 neonates with respiratory distress syndrome treated in our hospital from April 2019 to July 2021 were included.Of these,64 control cases were treated with noninvasive positive pressure ventilation and 73 observation cases were treated with PS combined with noninvasive positive pressure ventilation.The expression of KRT-14 and ET-1 in the two groups was compared.The deaths,complications,and PaO_(2),PaCO_(2),and PaO_(2)/FiO_(2)blood gas indexes in the two groups were compared.Receiver operating characteristic curve(ROC)analysis was used to determine the diagnostic value of KRT-14 and ET-1 in the treatment of NRDS.RESULTS The observation group had a significantly higher effectiveness rate than the control group.There was no significant difference between the two groups in terms of neonatal mortality and adverse reactions,such as bronchial dysplasia,cyanosis,and shortness of breath.After treatment,the levels of PaO_(2)and PaO_(2)/FiO_(2)in both groups were significantly higher than before treatment,while the level of PaCO_(2)was significantly lower.After treatment,the observation group had significantly higher levels of PaO_(2)and PaO_(2)/FiO_(2)than the control group,while PaCO_(2)was notably lower in the observation group.After treatment,the KRT-14 and ET-1 levels in both groups were significantly decreased compared with the pre-treatment levels.The observation group had a reduction of KRT-14 and ET-1 levels than the control group.ROC curve analysis showed that the area under the curve(AUC)of KRT-14 was 0.791,and the AUC of ET-1 was 0.816.CONCLUSION Combining PS with noninvasive positive pressure ventilation significantly improved the effectiveness of NRDS therapy.KRT-14 and ET-1 levels may have potential as therapeutic and diagnostic indicators.

Effects of positive psychological control intervention on sleep and psychology of officers and soldiers working at sea

BACKGROUND The working environment of submarine crews is also very special.They are in a closed,high-temperature,high-noise,high-vibration and narrow working and living space for a long time,and they suffer from physical discomfort caused by seasickness,which will affect the mental health of officers and soldiers.American psychologists have achieved positive results in psychological resilience training for officers and soldiers from the perspective of positive psychology.At present,there are few reports on the correlation between psychological resilience in the field of domestic research on submarine crew psychology,and it is necessary to conduct further research.METHODS A total of 121 soldiers working in a confined space of a large ship were randomly divided into an experimental group and a control group.The 50 soldiers in the experimental group were given a training course intervention,while the 71 soldiers in the control group did not receive any intervention measures.The Pittsburgh Sleep Quality Index,Psychological Resilience Scale,military Psycho-logical Stress Self-Assessment Questionnaire,and General Self-Efficacy Scale scores were compared before and 6 months after the intervention.RESULTS Under the positive psychological control intervention,except for sleep efficiency(P=0.05),the difference between the remaining dimensions of the Pittsburgh Sleep Quality Index scores and the total scores of the experimental group compared with the control group was statistically significant(P<0.05);the assessment of the psychological condition showed that,in addition to the Psychological Stress Self-assessment Questionnaire for Military Personnel scores(P=0.05),the scores of the Mental Toughness Scale(Dispositional Resilience Scale Resilience II)in the experimental group,General Self-Efficacy Scale scores were statistically significant(P<0.05)compared to pre-intervention.CONCLUSION Positive psychological intervention and control can improve the sleep state and psychological state of officers and soldiers working in confined space at sea.

Analysis of the Effect of Non-Invasive Positive Pressure Ventilation in Emergency Treatment of Severe Bronchial Asthma with Respiratory Failure

Objective:This study aims to evaluate the clinical efficacy of non-invasive positive pressure ventilation(NIPPV)in patients with severe bronchial asthma combined with respiratory failure.Methods:90 patients with severe bronchial asthma combined with respiratory failure between September 2022 and December 2023 were selected for the study and randomly divided into the experimental group(NIPPV-assisted treatment)and the control group.The differences between the two groups were compared in terms of total effective rate of treatment,days of clinical symptom disappearance,days of hospitalization,lung function indexes,incidence of adverse reactions,and quality of life.Results:Patients in the experimental group had a significantly higher total effective rate of treatment(97.78%)than the control group(75.56%).In terms of pulmonary function indexes,patients in the experimental group showed significant improvement after treatment,especially the increase in forced expiratory volume and forced vital capacity,while these improvements were not as obvious in the control group.In addition,the incidence of adverse reactions was significantly lower in the experimental group than in the control group,suggesting that the application of NIPPV is relatively safe.Quality of life assessment also showed that patients in the experimental group had significantly better quality of life than the control group after treatment.Conclusion:This study demonstrated the effectiveness of NIPPV as an adjunctive treatment for severe bronchial asthma combined with respiratory failure.NIPPV can improve lung function,reduce the incidence of adverse effects,increase the overall effectiveness of the treatment,and contribute to the improvement of patients'quality of life.Therefore,NIPPV should be regarded as an effective and safe treatment in clinical management,especially in patients with severe bronchial asthma combined with respiratory failure,where its application has potential clinical significance.

Combined application of organic fertilizer and chemical fertilizer alleviates the kernel position effect in summer maize by promoting post-silking nitrogen uptake and dry matter accumulation

Adjusting agronomic measures to alleviate the kernel position effect in maize is important for ensuring high yields.In order to clarify whether the combined application of organic fertilizer and chemical fertilizer(CAOFCF)can alleviate the kernel position effect of summer maize,field experiments were conducted during the 2019 and 2020 growing seasons,and five treatments were assessed:CF,100%chemical fertilizer;OFCF1,15%organic fertilizer+85%chemical fertilizer;OFCF2,30%organic fertilizer+70%chemical fertilizer;OFCF3,45%organic fertilizer+55%chemical fertilizer;and OFCF4,60%organic fertilizer+40%chemical fertilizer.Compared with the CF treatment,the OFCF1 and OFCF2 treatments significantly alleviated the kernel position effect by increasing the weight ratio of inferior kernels to superior kernels and reducing the weight gap between the superior and inferior kernels.These effects were largely due to the improved filling and starch accumulation of inferior kernels.However,there were no obvious differences in the kernel position effect among plants treated with CF,OFCF3,or OFCF4 in most cases.Leaf area indexes,post-silking photosynthetic rates,and net assimilation rates were higher in plants treated with OFCF1 or OFCF2 than in those treated with CF,reflecting an enhanced photosynthetic capacity and improved postsilking dry matter accumulation(DMA)in the plants treated with OFCF1 or OFCF2.Compared with the CF treatment,the OFCF1 and OFCF2 treatments increased post-silking N uptake by 66.3 and 75.5%,respectively,which was the major factor driving post-silking photosynthetic capacity and DMA.Moreover,the increases in root DMA and zeatin riboside content observed following the OFCF1 and OFCF2 treatments resulted in reduced root senescence,which is associated with an increased post-silking N uptake.Analyses showed that post-silking N uptake,DMA,and grain yield in summer maize were negatively correlated with the kernel position effect.In conclusion,the combined application of 15-30%organic fertilizer and 70-85%chemical fertilizer alleviated the kernel position effect in summer maize by improving post-silking N uptake and DMA.These results provide new insights into how CAOFCF can be used to improve maize productivity.

The Positive Effects of Physical Exercise on Mental Health Among Chinese Students Under Great Competitive Pressure

Under an environment full of competitive stress,students tend to form negative emotions,and the time for them to engage in physical exercise is greatly limited due to overwhelming academic tasks.Therefore,in this paper,we focus on acknowledging the purpose of physical exercise,and how physical exercise affects the mental health of students under stressful circumstances but not in the context of leisure.Questionnaire was distributed to participants with an average age of 20,to investigate their preference,frequency,and reason for exercising,and their attitude towards it.Our results showed that participants think that exercise can strengthen the body,relieve stress,improve fitness and interpersonal relationship regardless of their purpose such as interests,emotional necessity and even out of non-subjective ideas.In conclusion,physical exercise helped to improve students’mental health especially under great pressure and ultimately,it will enhance their academics and bring about the unity of mind and body.

240 nm AlGaN-based deep ultraviolet micro-LEDs:size effect versus edge effect

240 nm AlGaN-based micro-LEDs with different sizes are designed and fabricated.Then,the external quantum efficiency(EQE)and light extraction efficiency(LEE)are systematically investigated by comparing size and edge effects.Here,it is revealed that the peak optical output power increases by 81.83%with the size shrinking from 50.0 to 25.0μm.Thereinto,the LEE increases by 26.21%and the LEE enhancement mainly comes from the sidewall light extraction.Most notably,transversemagnetic(TM)mode light intensifies faster as the size shrinks due to the tilted mesa side-wall and Al reflector design.However,when it turns to 12.5μm sized micro-LEDs,the output power is lower than 25.0μm sized ones.The underlying mechanism is that even though protected by SiO2 passivation,the edge effect which leads to current leakage and Shockley-Read-Hall(SRH)recombination deteriorates rapidly with the size further shrinking.Moreover,the ratio of the p-contact area to mesa area is much lower,which deteriorates the p-type current spreading at the mesa edge.These findings show a role of thumb for the design of high efficiency micro-LEDs with wavelength below 250 nm,which will pave the way for wide applications of deep ultraviolet(DUV)micro-LEDs.

Evaluation of the intracellular lipid-lowering effect of polyphenols extract from highland barley in HepG2 cells

Active ingredients from highland barley have received considerable attention as natural products for developing treatments and dietary supplements against obesity.In practical application,the research of food combinations is more significant than a specific food component.This study investigated the lipid-lowering effect of highland barley polyphenols via lipase assay in vitro and HepG2 cells induced by oleic acid(OA).Five indexes,triglyceride(TG),total cholesterol(T-CHO),low density lipoprotein-cholesterol(LDL-C),aspartate aminotransferase(AST),and alanine aminotransferase(ALT),were used to evaluate the lipidlowering effect of highland barley extract.We also preliminary studied the lipid-lowering mechanism by Realtime fluorescent quantitative polymerase chain reaction(q PCR).The results indicated that highland barley extract contains many components with lipid-lowering effects,such as hyperoside and scoparone.In vitro,the lipase assay showed an 18.4%lipase inhibition rate when the additive contents of highland barley extract were 100μg/m L.The intracellular lipid-lowering effect of highland barley extract was examined using 0.25 mmol/L OA-induced HepG2 cells.The results showed that intracellular TG,LDL-C,and T-CHO content decreased by 34.4%,51.2%,and 18.4%,respectively.ALT and AST decreased by 51.6%and 20.7%compared with the untreated hyperlipidemic HepG2 cells.q PCR results showed that highland barley polyphenols could up-regulation the expression of lipid metabolism-related genes such as PPARγand Fabp4.

Engineering Strategies for Suppressing the Shuttle Effect in Lithium–Sulfur Batteries

Lithium–sulfur(Li–S)batteries are supposed to be one of the most potential next-generation batteries owing to their high theoretical capacity and low cost.Nevertheless,the shuttle effect of firm multi-step two-electron reaction between sulfur and lithium in liquid electrolyte makes the capacity much smaller than the theoretical value.Many methods were proposed for inhibiting the shuttle effect of polysulfide,improving corresponding redox kinetics and enhancing the integral performance of Li–S batteries.Here,we will comprehensively and systematically summarize the strategies for inhibiting the shuttle effect from all components of Li–S batteries.First,the electrochemical principles/mechanism and origin of the shuttle effect are described in detail.Moreover,the efficient strategies,including boosting the sulfur conversion rate of sulfur,confining sulfur or lithium polysulfides(LPS)within cathode host,confining LPS in the shield layer,and preventing LPS from contacting the anode,will be discussed to suppress the shuttle effect.Then,recent advances in inhibition of shuttle effect in cathode,electrolyte,separator,and anode with the aforementioned strategies have been summarized to direct the further design of efficient materials for Li–S batteries.Finally,we present prospects for inhibition of the LPS shuttle and potential development directions in Li–S batteries.

Experimental study on the effect of water absorption level on rockburst occurrence of sandstone

To investigate the mechanism of rockburst prevention by spraying water onto the surrounding rocks,15 experiments are performed considering different water absorption levels on a single face.High-speed photography and acoustic emission(AE)system are used to monitor the rockburst process.The effect of water on sandstone rockburst and the prevention mechanism of water on sandstone rockburst are analyzed from the perspective of energy and failure mode.The results show that the higher the ab-sorption degree,the lower the intensity of the rockburst after absorbing water on single side of sand-stone.This is reflected in the fact that with the increase in the water absorption level,the ejection velocity of rockburst fragments is smaller,the depth of the rockburst pit is shallower,and the AE energy is smaller.Under the water absorption level of 100%,the magnitude of rockburst intensity changes from medium to slight.The prevention mechanism of water on sandstone rockburst is that water reduces the capacity of sandstone to store strain energy and accelerates the expansion of shear cracks,which is not conducive to the occurrence of plate cracking before rockburst,and destroys the conditions for rockburst incubation.

High responsivity photodetectors based on graphene/WSe_(2) heterostructure by photogating effect

Graphene, with its zero-bandgap electronic structure, is a highly promising ultra-broadband light absorbing material.However, the performance of graphene-based photodetectors is limited by weak absorption efficiency and rapid recombination of photoexcited carriers, leading to poor photodetection performance. Here, inspired by the photogating effect, we demonstrated a highly sensitive photodetector based on graphene/WSe_(2) vertical heterostructure where the WSe_(2) layer acts as both the light absorption layer and the localized grating layer. The graphene conductive channel is induced to produce more carriers by capacitive coupling. Due to the strong light absorption and high external quantum efficiency of multilayer WSe_(2), as well as the high carrier mobility of graphene, a high photocurrent is generated in the vertical heterostructure. As a result, the photodetector exhibits ultra-high responsivity of 3.85×10~4A/W and external quantum efficiency of 1.3 × 10~7%.This finding demonstrates that photogating structures can effectively enhance the sensitivity of graphene-based photodetectors and may have great potential applications in future optoelectronic devices.

Cumulative effects of excess high-normal alanine aminotransferase levels in relation to new-onset metabolic dysfunction-associated fatty liver disease in China

BACKGROUND Within the normal range,elevated alanine aminotransferase(ALT)levels are associated with an increased risk of metabolic dysfunction-associated fatty liver disease(MAFLD).AIM To investigate the associations between repeated high-normal ALT measurements and the risk of new-onset MAFLD prospectively.METHODS A cohort of 3553 participants followed for four consecutive health examinations over 4 years was selected.The incidence rate,cumulative times,and equally and unequally weighted cumulative effects of excess high-normal ALT levels(ehALT)were measured.Cox proportional hazards regression was used to analyse the association between the cumulative effects of ehALT and the risk of new-onset MAFLD.RESULTS A total of 83.13%of participants with MAFLD had normal ALT levels.The incidence rate of MAFLD showed a linear increasing trend in the cumulative ehALT group.Compared with those in the low-normal ALT group,the multivariate adjusted hazard ratios of the equally and unequally weighted cumulative effects of ehALT were 1.651[95%confidence interval(CI):1.199-2.273]and 1.535(95%CI:1.119-2.106)in the third quartile and 1.616(95%CI:1.162-2.246)and 1.580(95%CI:1.155-2.162)in the fourth quartile,respectively.CONCLUSION Most participants with MAFLD had normal ALT levels.Long-term high-normal ALT levels were associated with a cumulative increased risk of new-onset MAFLD.

Impact of effective stress on permeability for carbonate fractured-vuggy rocks

To gain insight into the flow mechanisms and stress sensitivity for fractured-vuggy reservoirs,several core models with different structural characteristics were designed and fabricated to investigate the impact of effective stress on permeability for carbonate fractured-vuggy rocks(CFVR).It shows that the permeability performance curves under different pore and confining pressures(i.e.altered stress conditions)for the fractured core models and the vuggy core models have similar change patterns.The ranges of permeability variation are significantly wider at high pore pressures,indicating that permeability reduction is the most significant during the early stage of development for fractured-vuggy reservoirs.Since each obtained effective stress coefficient for permeability(ESCP)varies with the changes in confining pressure and pore pressure,the effective stresses for permeability of four representative CFVR show obvious nonlinear characteristics,and the variation ranges of ESCP are all between 0 and 1.Meanwhile,a comprehensive ESCP mathematical model considering triple media,including matrix pores,fractures,and dissolved vugs,was proposed.It is proved theoretically that the ESCP of CFVR generally varies between 0 and 1.Additionally,the regression results showed that the power model ranked highest among the four empirical models mainly applied in stress sensitivity characterization,followed by the logarithmic model,exponential model,and binomial model.The concept of“permeability decline rate”was introduced to better evaluate the stress sensitivity performance for CFVR,in which the one-fracture rock is the strongest,followed by the fracture-vug rock and two-horizontalfracture rock;the through-hole rock is the weakest.In general,this study provides a theoretical basis to guide the design of development and adjustment programs for carbonate fractured-vuggy reservoirs.

Carbon Emission Effects Driven by Evolution of Chinese Dietary Structure from 1987 to 2020

Exploring carbon emission effects based on the evolution of residents’ dietary structure to achieve the carbon neutrality goal and mitigate climate change is an important task.This study took China as the research object(data excluding Hong Kong,Macao and Taiwan) and used the carbon emission coefficient method to quantitatively measure the food carbon emissions from 1987–2020,then analyzed the carbon emission effects under the evolution of dietary structure.The results showed that during the study period,the Chinese dietary structure gradually changed to a high-carbon consumption pattern.The dietary structure of urban residents developed to a balanced one,while that of rural residents developed to a high-quality one.During the study period,the per capita food carbon emissions and total food consumption of Chinese showed an increasing trend.The per capita food carbon emissions of residents in urban and rural showed an overall upward trend.The total food carbon emissions in urban increased significantly,while that in rural increased first and then decreased.The influence of beef and mutton on carbon emissions is the highest in dietary structure.Compared with the balanced dietary pattern,the food carbon emissions of Chinese residents had not yet reached the peak,but were evolving to a high-carbon consumption pattern.

Review on synergistic damage effect of irradiation and corrosion on reactor structural alloys

The synergistic damage effect of irradiation and corrosion of reactor structural materials has been a prominent research focus.This paper provides a comprehensive review of the synergistic effects on the third-and fourth-generation fission nuclear energy structural materials used in pressurized water reactors and molten salt reactors.The competitive mechanisms of multiple influencing factors,such as the irradiation dose,corrosion type,and environmental temperature,are summarized in this paper.Conceptual approaches are proposed to alleviate the synergistic damage caused by irradiation and corrosion,thereby promoting in-depth research in the future and solving this key challenge for the structural materials used in reactors.

“Buckets effect”in the kinetics of electrocatalytic reactions

In this study,we systematically investigated the effect of proton concentration on the kinetics of the oxygen reduction reaction(ORR)on Pt(111)in acidic solutions.Experimental results demonstrate a rectangular hyperbolic relationship,i.e.,the ORR current excluding the effect of other variables increases with proton concentration and then tends to a constant value.We consider that this is caused by the limitation of ORR kinetics by the trace oxygen concentration in the solution,which determines the upper limit of ORR kinetics.A model of effective concentration is further proposed for rectangular hyperbolic relationships:when the reactant concentration is high enough to reach a critical saturation concentration,the effective reactant concentration will become a constant value.This could be due to the limited concentration of a certain reactant for reactions involving more than one reactant or the limited number of active sites available on the catalyst.Our study provides new insights into the kinetics of electrocatalytic reactions,and it is important for the proper evaluation of catalyst activity and the study of structureperformance relationships.

Research progress on the effects of positive stress reduction on positive awareness and psychosocial functioning in patients with depressive disorders

To review the current research status of positive thought stress reduction therapy(PTSRT),psychosocial functioning of patients with depressive disorders,the shortcomings and outlook of the influence of PTSRT on positive thought awareness,and psychosocial functioning of patients with depressive disorders.This review has the objective to provide clinical healthcare personnel with essential information about the use of PTSRT to improve the level of positive thought and psychosocial functioning of patients with depressive disorders.

Simulation of the Ecosystem Productivity Responses to Aerosol Diffuse Radiation Fertilization Effects over the Pan-Arctic during 2001–19

The pan-Arctic is confronted with air pollution transported from lower latitudes.Observations have shown that aerosols help increase plant photosynthesis through the diffuse radiation fertilization effects(DRFEs).While such DRFEs have been explored at low to middle latitudes,the aerosol impacts on pan-Arctic ecosystems and the contributions by anthropogenic and natural emission sources remain less quantified.Here,we perform regional simulations at 0.2o×0.2ousing a well-validated vegetation model(Yale Interactive terrestrial Biosphere,YIBs)in combination with multi-source of observations to quantify the impacts of aerosol DRFEs on the net primary productivity(NPP)in the pan-Arctic during 2001-19.Results show that aerosol DRFEs increase pan-Arctic NPP by 2.19 Pg C(12.8%)yr^(-1)under clear-sky conditions,in which natural and anthropogenic sources contribute to 8.9% and 3.9%,respectively.Under all-sky conditions,such DRFEs are largely dampened by cloud to only 0.26 Pg C(1.24%)yr^(-1),with contributions of 0.65% by natural and 0.59% by anthropogenic species.Natural aerosols cause a positive NPP trend of 0.022% yr^(-1)following the increased fire activities in the pan-Arctic.In contrast,anthropogenic aerosols induce a negative trend of-0.01% yr^(-1)due to reduced emissions from the middle latitudes.Such trends in aerosol DRFEs show a turning point in the year of 2007 with more positive NPP trends by natural aerosols but negative NPP trends by anthropogenic aerosols thereafter.Though affected by modeling uncertainties,this study suggests a likely increasing impact of aerosols on terrestrial ecosystems in the pan-Arctic under global warming.

Understanding the Relationship Between Shrinking Cities and Land Prices:Spatial Pattern,Effectiveness,and Policy Implications

Urban shrinkage has emerged as a widespread phenomenon globally and has a significant impact on land,particularly in terms of land use and price.This study focuses on 2851 county-level cities in China in 2005–2018(excluding Hong Kong,Macao,Taiwan,and‘no data’areas in Qinhai-Tibet Plateau)as the fundamental units of analysis.By employing nighttime light(NTL)data to identify shrinking cities,the propensity score matching(PSM)model was used to quantitatively examine the impact of shrinking cities on land prices,and evaluate the magnitude of this influence.The findings demonstrate the following:1)there were 613 shrinking cities in China,with moderate shrinkage being the most prevalent and severe shrinkage being the least.2)Regional disparities are evident in the spatial distribution of shrinking cities,especially in areas with diverse terrain.3)The spatial pattern of land price exhibits a significant correlated to the economic and administrative levels.4)Shrinking cities significantly negatively impact on the overall land price(ATT=–0.1241,P<0.05).However,the extent of the effect varies significantly among different spatial regions.This study contributes novel insights into the investigation of land prices and shrinking cities,ultimately serving as a foundation for government efforts to promote the sustainable development of urban areas.

Effect of nursing intervention on rehabilitation of patients with chronic sinusitis and nasal polyps after nasal endoscopy

BACKGROUND Chronic sinusitis is a kind of chronic suppurative inflammation of the sinus mucosa.Nasal endoscopy is a good method to treat nasal polyps.However postoperative rehabilitation and care should not be neglected.AIM To investigate the Effect of nursing intervention on the rehabilitation of patients with chronic sinusitis and nasal polyps(CSNPS)after nasal endoscopy.METHODS A total of 129 patients with CSNPS hospitalized from February 2017 to February 2019 were studied.Using the digital parity method,we investigated nursing cooperation strategies for endoscopic surgery.The comparison group(64 cases):Surgical nursing was carried out with traditional nursing measures;experimental group(65 cases):Surgical nursing was carried out by traditional nursing countermeasures+comprehensive nursing measures.We compared postoperative recovery rates,nursing satisfaction rates,and nasal cavity ratings between the two groups.RESULTS Experimental group patients with CSNPS had a significantly higher recovery rate(98.46%)compared to the control group(79.69%).This difference was statistically significant(χ2=11.748,P<0.05).Additionally,the satisfaction rate with treatment was also significantly higher in the experimental group(98.46%)compared to the control group(79.69%),with a statistically significant difference(χ2=11.748,P<0.05).Before nursing,there was no significant difference in sinus nasal cavity scores between the experimental group(20.29±7.25 points)and the control group(20.30±7.27 points)(t=0.008,P>0.05).However,after nursing,the sinus nasal cavity score in the experimental group(8.85±3.22 points)was significantly lower than that in the control group(14.99±5.02 points)(t=8.282,P<0.05).CONCLUSION Comprehensive nursing intervention in patients with CSNPS can significantly improve the total recovery rate after endoscopic surgery.

Effect of Prone Position in Severe Covid-19 Patients in a Referral Center: A Cohort Retrospective Study

Introduction: Covid-19 is defined as a pandemic disease by WHO, in November 2023, WHO recorded 772.1 million confirmed cases and 6.9 million deaths, including 68,382 confirmed cases and 1426 deaths in Madagascar. The management of severe cases of Covid-19 remains a challenge for the healthcare system in a resource-limited country, due to the consumption of human resources, the shortage of medical resources and the lack of capacity in resource-limited countries. Prone position (PP) improves survival in acute respiratory distress, and numerous studies have shown that during Covid-19, it reduces mortality rates at 28 and 90 days, and increases the number of days without mechanical ventilation. However, data on the beneficial effects of PP remain limited in low-income countries. In this context, our study aims to evaluate the benefits of the prone position for severe Covid-19 patients in a referral center in Madagascar. Method: This is a retrospective cohort study, during the 2nd and 3rd waves of COVID-19, over a period of 11 months in two wards managing COVID-19 cases. We included all patients aged 15 and over with severe forms of COVID-19 who required 6 l/min of oxygen therapy. Results: We enrolled 123 patients, including 40 in the prone position and 83 in the supine position, with a mean age of 60.5 ± 12 years. The prone position (DV) reduced the risk of probable complications of COVID-19 with a strong association in terms of use of respiratory assistance (OR = 0.15;95% CI = 0.05 - 0.47), respiratory deterioration (OR = 0.22;95% CI = 0.09 - 0.58), shock (OR = 0.30;95% CI = 0.11 - 0.79) and hemodynamic instability (OR = 0.33;95% CI = 0.12 - 0.95). Univariate analysis of the effect of prone position on SpO2 showed improvement with significant associations with SpO2 at Day 1- Day 3, D4 - D7, D8 - D14, and persisting even at D15 - D21, D3 and D2 before discharge, and at discharge. In the overall population, the mean length of hospital stay was 22.8 ± 22.1 days, with extremes of 1 and 67 days. Univariate analysis of the effect of the prone position showed a reduction in length of hospital stay with a strong association (p = 0.001) and a mean difference of 14 days. The prone position reduced mortality with a significant association (OR = 0.44;95% CI = 0.20 - 0.98). Conclusion: Awake prone position prevents complications of COVID, improves SPO2 even up to hospital discharge and reduces hospital stay. This practice is simple, less costly and suitable in low income countries.