Relationship between neonatal respiratory distress syndrome pulmonary ultrasonography and respiratory distress score,oxygenation index,and chest radiography grading

BACKGROUND Accurate condition assessment is critical for improving the prognosis of neonatal respiratory distress syndrome(RDS),but current assessment methods for RDS pose a cumulative risk of harm to neonates.Thus,a less harmful method for assessing the health of neonates with RDS is needed.AIM To analyze the relationships between pulmonary ultrasonography and respiratory distress scores,oxygenation index,and chest X-ray grade of neonatal RDS to identify predictors of neonatal RDS severity.METHODS This retrospective study analyzed the medical information of 73 neonates with RDS admitted to the neonatal intensive care unit of Liupanshui Maternal and Child Care Service Center between April and December 2022.The pulmonary ultrasonography score,respiratory distress score,oxygenation index,and chest Xray grade of each newborn before and after treatment were collected.Spearman correlation analysis was performed to determine the relationships among these values and neonatal RDS severity.RESULTS The pulmonary ultrasonography score,respiratory distress score,oxygenation index,and chest X-ray RDS grade of the neonates were significantly lower after treatment than before treatment(P<0.05).Spearman correlation analysis showed that before and after treatment,the pulmonary ultrasonography score of neonates with RDS was positively correlated with the respiratory distress score,oxygenation index,and chest X-ray grade(ρ=0.429–0.859,P<0.05).Receiver operating characteristic curve analysis indicated that pulmonary ultrasonography screening effectively predicted the severity of neonatal RDS(area under the curve=0.805–1.000,P<0.05).CONCLUSION The pulmonary ultrasonography score was significantly associated with the neonatal RDS score,oxygenation index,and chest X-ray grade.The pulmonary ultrasonography score was an effective predictor of neonatal RDS severity.

Lymphocytopenia and Neutrophilia Deteriorate at the Lowest Oxygenation Index Timepoint in COVID-19 Patient

Objective: Coronavirus disease 2019 (COVID-19) spread throughout the world and caused hundreds of thousands of infected people to death. However, the pathogenesis of severe acute respiratory syndrome coronavirus-2 (SARS COV-2) is poorly understood. The objective of this study is to retrospectively explore the pathogenesis of COVID-19 from clinical laboratory findings, taking disease progression into account. Methods: A single-centered, retrospective study was carried out, which included moderate (n = 76) and severe COVID-19 cases (n = 22). The difference of laboratory findings from blood routine examination and hepatorenal function test were retrospectively evaluated between the state of moderate and severe. The disease progression was indicated by oxygenation index. Results: Age is a risk factor for disease progression from moderate to severe. Lymphocytopenia, neutrophilia, liver and kidney function decreasement occurred in severe patients on admission, compared with moderate patients. Lymphocytopenia and neutrophilia deteriorated at the lowest oxygenation index timepoint in the severe patients. And the oxygenation index was associated with ratio of lymphocyte and neutrophil in COVID-19 patients. Conclusions: Lymphocytopenia and neutrophilia, which deteriorate in the progression of severe patients, are the main pathogenesis of COVID-19. More measures need to be taken to control lymphocytopenia and neutrophilia in severe COVID-19. Oxygenation index presented potentiality as predictor on the progression of COVID-19.

Hypotension prediction index together with cerebral oxygenation in guiding intraoperative hemodynamic management: a case report

Intraoperative hypotension happens in everyday clinical practice. It was suggested to have a strong association with adverse postoperative outcomes. Hypotension prediction index(HPI) was developed to predict intraoperative hypotension(mean arterial pressure <65 mmHg) in real time. However, pressure autoregulation also plays an important role in maintaining adequate organ perfusion/oxygenation during hypotension. A cerebral oxygenation monitor provides clinicians with the values of organ oxygenation. We reported a case that the cerebral oxygenation monitor was used together with HPI to guide intraoperative blood pressure management. We found that cerebral oxygenation was maintained in the event of hypotension during surgery. The patient had no intraoperative or postoperative adverse outcomes despite the hypotension. We believe this can provide an individualized intraoperative blood pressure management to avoid over-or under-treating hypotension.

Application value of dexmedetomidine in anesthesia for elderly patients undergoing radical colon cancer surgery

BACKGROUND Colon cancer presents a substantial risk to the well-being of elderly people worldwide.With advancements in medical technology,surgical treatment has become the primary approach for managing colon cancer patients.However,due to age-related physiological changes,especially a decline in cognitive function,older patients are more susceptible to the effects of surgery and anesthesia,increasing the relative risk of postoperative cognitive dysfunction(POCD).There-fore,in the surgical treatment of elderly patients with colon cancer,it is of pa-ramount importance to select an appropriate anesthetic approach to reduce the occurrence of POCD,protect brain function,and improve surgical success rates.METHODS One hundred and seventeen patients with colon cancer who underwent elective surgery under general anesthesia were selected and divided into two groups:A and B.Group A received Dex before anesthesia induction,and B group received an equivalent amount of normal saline.Changes in the mini-mental state exami-nation,regional cerebral oxygen saturation(rSO2),bispectral index,glucose uptake rate(GluER),lactate production rate(LacPR),serum S100βand neuron-specific enolase(NSE),POCD,and adverse anesthesia reactions were compared between the two groups.RESULTS Surgical duration,duration of anesthesia,and intraoperative blood loss were comparable between the two groups(P>0.05).The overall dosage of anesthetic drugs used in group A,including propofol and remifentanil,was significantly lower than that used in group B(P<0.05).Group A exhibited higher rSO2 values at the time of endotracheal intubation,30 min after the start of surgery,and immediately after extubation,higher GluER values and lower LacPR values at the time of endotra-cheal intubation,30 min after the start of surgery,immediately after extubation,and 5 min after extubation(P<0.05).Group A exhibited lower levels of serum S100βand NSE 24 h postoperatively and a lower incidence of cognitive dysfunction on the 1st and 5th postoperative days(P<0.05).CONCLUSION The use of Dex in elderly patients undergoing radical colon cancer surgery helps maintain rSO2 Levels and reduce cerebral metabolic levels and the incidence of anesthesia-and surgery-induced cognitive dysfunction.

基于机器学习的硅胶泡沫复合材料LOI预测研究

为了探究机器学习(ML)预测硅橡胶泡沫(SiFs)阻燃材料极限氧指数(LOI)的可行性,通过建立改性蒙脱土(MMT)/硅橡胶阻燃泡沫材料LOI数据库,分析了影响LOI的工艺参数的重要性,采用线性回归(LR)、支持向量回归(SVR)、决策树(DT)、随机森林(RF)、极致梯度提升(XGBoost)5种机器学习算法搭建预测模型,并通过网格搜索和交叉验证对精度较高的模型超参数进一步优化训练。结果表明:工艺参数对SiFs的LOI预测模型贡献程度由大到小顺序为阻燃剂、抑制剂、20~30 mPa·s羟基硅油、反应温度、催化剂、含氢硅油。阻燃剂含量与LOI预测模型的皮尔逊相关系数最大绝对值为0.58。XGBoost模型最适合用于预测LOI,判定系数(R2)最高到0.811。研究结果为缩短SiFs阻燃材料的研发周期提供新思路。

体外膜肺氧合护理课程培训指标体系的构建

目的:构建体外膜肺氧合(ECMO)护理课程培训指标体系。方法:以文献回顾确定指标体系初稿,采用德尔菲法进行专家函询,通过层次分析法确定最终ECMO护理培训指标体系的内容及各指标的权重。结果:专家函询积极系数为100%,权威系数为0.85,肯德尔协调系数为0.249。最终形成包括6个一级指标、23个二级指标及66个三级指标的ECMO护理培训指标体系。结论:ECMO护理课程培训指标体系具有良好的科学性和可靠性,进一步验证后可用于ECMO护理课程培训后的效果评价。

基于Optiwave的脊形SiGe-OI光波导结构设计

利用有效折射率的数值解法,计算出了SiGe-OI脊形光波导的有效折射率.通过对SiGe-OI光波导结构参量的理论分析和计算,得到了SiGe-OI脊形光波导传输单模光波时内外脊高H,h及脊宽W的尺寸.通过Optiwave软件对SiGe-OI脊形光波导进行建模仿真,验证了理论分析和计算的正确性.

不同预氧化温度破碎煤在轴压下的自燃特性

目的为了探究采空区破碎煤在应力状态下的氧化自燃特性,方法采用荷载加压煤自燃特性参数测定装置,研究不同预氧化温度破碎煤在不同轴压状态下的自燃特性,分析破碎煤在氧化过程的耗氧速率、特征温度点、气体生成和表观活化能等特征参数变化规律。结果结果表明:轴压会增强煤的自燃特性,具体表现为耗氧速率增加,CO和C_(2)H_(4)气体体积分数增大,氧化特征温度点前移,表观活化能减小;轴压为0,4 MPa时,预氧化温度70℃煤样的氧化特性最强,轴压为8 MPa时,预氧化温度升高导致煤样的氧化特性降低;结合耗氧速率、指标气体和表观活化能的变化,表明预氧化温度70℃的煤自燃倾向性更高,更易复燃。结论(1)不同预氧化温度煤样的自燃特性在轴压的影响下表现一致:轴压会增强煤的氧化特性,更容易到达快速氧化阶段。(2)不同轴压下预氧化温度对煤样的自燃特性影响存在差异:预氧化温度升高反而会降低煤样的氧化特性,表明在高轴压影响下煤体预氧化温度越高,其氧化特性越弱。

阻燃联合染色改性杨木单板工艺

以酸性大红3R为染料、磷酸二氢铵为阻燃剂对杨木单板进行联合处理,探究阻燃染色同步处理单板的可行性,选择阻燃剂质量分数、染料质量分数、温度和时间为考察因素,以上染率、色差和氧指数为性能评价指标,通过直观和方差分析得出了影响单板上染率、色差及氧指数的显著因素及最佳工艺方案。此外,利用扫描电镜⁃能谱仪(SEM⁃EDS)对阻燃剂及染料分子在单板内部的分布状态进行了观察,并对它们的特征元素质量分数进行测定。在此基础上,采用模糊数学综合评判法对这3个评价指标进行了综合评判。结果表明:单板进行阻燃染色同步处理具有一定的可行性,提升了木材的染色效果,单板表面颜色偏暗偏黄,在实际生产过程中可以对染色配方进行调整以达到目标染色效果。上染率最佳工艺方案为:阻燃剂质量分数15%,染料质量分数1.5%,温度80℃,时间3 h。色差最佳工艺方案为:阻燃剂质量分数20%,染料质量分数2.0%,温度80℃,时间3 h。氧指数最佳工艺方案为:阻燃剂质量分数30%,染料质量分数0.5%,温度80℃,时间4 h。SEM⁃EDS分析表明,阻燃剂质量分数太高(30%)容易使分子间发生团聚,导致导管孔隙发生堵塞,P、S特征元素的增加表明阻燃剂与染料分子成功进入单板内部。通过模糊数学综合评判法得出阻燃染色单板综合性能的最佳工艺参数为:阻燃剂质量分数30%,染料质量分数0.5%,温度80℃,时间3 h。

温拌阻燃沥青混合料阻燃性能分析

为了探索常用的阻燃剂对温拌阻燃沥青混合料阻燃性能的影响,采用IFR、EG和Sb2O3三种不同阻燃剂制备了温拌阻燃改性沥青,开展了氧指数试验和直接燃烧试验后沥青质量损失率试验,并对直接燃烧后温拌阻燃沥青混合料的路用性能损失率进行测试。结果表明,IFR、EG和Sb2O3三种不同阻燃剂均能够发挥一定的阻燃作用;在掺量相同的前提下,EG阻燃剂的阻燃效果最佳,其次是IFR阻燃剂,最后是Sb2O3阻燃剂。

Lung recruitment maneuver effects on respiratory mechanics and extravascular lung water index in patients with acute respiratory distress syndrome

BACKGROUND：Animal experiments showed that recruitment maneuver （RM） and protective ventilation strategy of the lung could improve oxygenation and reduce extravascular lung water. This study was to investigate the effects of RM on respiratory mechanics and extravascular lung water index （EVLWI） in patients with acute respiratory distress syndrome （ARDS）. METHODS：Thirty patients with ARDS were randomized into a RM group and a non-RM group. In the RM group, after basic mechanical ventilation stabilized for 30 minutes, RM was performed and repeated once every 12 hours for 3 days. In the non-RM group, lung protective strategy was conducted without RM. Oxygenation index （PaO2/FiO2）, peak inspiratory pressure （PIP）, Plateau pressure （Pplat）, static pulmonary compliance （Cst） and EVLWI of patients before treatment and at 12, 24, 48, 72 hours after the treatment were measured and compared between the groups. Hemodynamic changes were observed before and after RM. One-way ANOVA, Student＇s t test and Fisher＇s exact test were used to process the data. RESULTS：The levels of PaO2/FiO2 and Cst increased after treatment in the two groups, but they were higher in the RM group than in the non-RM group （P〈0.05）. The PIP and Pplat decreased after treatment in the two groups, but they were lower in the RM group than in the non-RM group （P〈0.05）. The EVLWI in the two groups showed downward trend after treatment （P〈0.05）, and the differences were signifcant at all time points （P〈0.01）; the EVLWI in the RM group was lower than that in the non-RM group at 12, 24, 48 and 72 hours （P〈0.05 or P〈0.01）. Compared with pre-RM, hemodynamics changes during RM were significantly different （P〈0.01）; compared with pre-RM, the changes were not significantly different at 120 seconds after the end of RM （P〉0.05）. CONCLUSIONS： RM could reduce EVLWI, increase oxygenation and lung compliance. The effect of RM on hemodynamics was transient.

High index surface‐exposed and composition‐graded PtCu_(3)@Pt_(3)Cu@Pt nanodendrites for high‐performance oxygen reduction

Alloying and nanostructuring are two strategies used to facilitate the efficient electrocatalysis of the oxygen reduction reaction(ORR)by Pt,where the high index surfaces(HISs)of Pt exhibit superior activity for ORR.Here,we report the fabrication of PtCu3 nanodendrites possessing rich spiny branches exposing n(111)×(110)HISs.The dendrites were formed through an etching‐modulated seeding and growing strategy.Specifically,an oxidative atmosphere was initially applied to form the concaved nanocubes of the Pt‐Cu seeds,which was then switched to an inert atmosphere to promote an explosive growth of dendrites.Separately,the oxidative or inert atmosphere failed to produce this hyperbranched structure.Electrochemical dealloying of the PtCu3 nanodendrites produced Pt3Cu shells with Pt‐rich surfaces where HIS‐exposed dendrite structures were maintained.The resulting PtCu_(3)@Pt_(3)Cu@Pt nanodendrites in 0.1 M HClO4 exhibited excellent mass and area specific activities for ORR,which were 14 and 24 times higher than that of commercial Pt/C,respectively.DFT calculations revealed that Cu alloying and HISs both contributed to the significantly enhanced activity of Pt,and that the oxygen binding energy on the step sites of HISs on the PtCu_(3)@Pt_(3)Cu@Pt nanodendrites approached the optimal value to achieve a near peak‐top ORR activity.

A Method of Inversing the Peak Density of Atomic Oxygen Vertical Distribution in the MLT Region From the OI (557.7 nm)Night Airglow Intensity

In this paper, using the MSISE-90 model as the reference atmosphere, we discuss the feasibility and method of deducing the peak densities of the undisturbed atomic oxygen profiles in the MLT region (the mesosphere and lower thermosphere region) from OI (557.7 nm) night airglow intersities. The peak densities for different seasons, latitudes and longitudes are deduced from OI (557.7nm) airglow intensities through this expression. We analyze the features of inversion relative errors and discuss the influence of the variations in temperature on inversion errors. The results indicate that all inversion errors are less than 5% except for those at high altitudes in the summer hemisphere. And the impact of the variations in temperature on errors is not significant.

Oxygen Radical Generation as an Index of Neurotoxic Damage

Biochemical, anatomical, and physiological characteristics of the brain make it especially vulnerable to insult. Specifically, some of these characteristics such as myelin and a high energy requirement provide for the introduction of free radical-induced insult. Recently, the biochemistry of free radicals has received considerable attention. It also has become increasingly suggestive that many drug and chemical-induced toxicities may be evoked via free radicals and oxidative stress. Major points addressed in this work are the regulation of neural-free radical generation by antioxidants and protective enzymes, xenobiotic-induced disruption of cerebral redox status, and specific examples of neurotoxic agent-induced alterations in free radicals as measured by the fluorescent probe dichlorofluorescein. This article considers that free radical mechanisms may contribute significantly to the properties of several diverse neurotoxic agents and proposes that free radicals may be common phenomena of neurotoxicity.

重症肺炎患者血小板参数、OI值与患者治疗结局关系的多因素分析

目的观察老年重症肺炎患者血小板参数、氧合指数(OI)与其预后间的联系。方法回顾性选取2016年4月至2019年8月重庆市中医院救治后28 d内死亡的35例老年重症肺炎患者(死亡组),及同时期未死亡的70例重症肺炎患者(存活组),记录2组患者的基线资料、急性生理功能与慢性健康评分(APACHEⅡ)、外周血白细胞(WBC)、中性粒细胞(N)、pH值、动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、白蛋白(ALB)等指标情况,同时观察患者血小板参数、OI水平并对比患者合并疾病情况;采用多因素分析探究血小板参数、OI等指标与患者预后间的联系。结果死亡组和存活组患者基础资料、合并症情况、肾功能不全以及外周血WBC水平比较,差异无统计学意义(P>0.05);死亡组患者多器官功能障碍综合征(MODS)发生率、合并心功能不全发生率、APACHEⅡ评分、N、PaCO_(2)测定值高于存活组,住院时间、pH值、PaO_(2)、ALB测定值低于存活组,差异均有统计学意义(P<0.05)。死亡组PLT、OI测定值较存活组更低,而MPV、PDW高于存活组,差异均有统计学意义(P<0.05)。多因素分析显示:APACHEⅡ评分增高、发生MODS、pH值降低、发生心功能不全、PLT值降低、OI值降低是老年重症肺炎患者治疗不良结局的独立危险因素(P<0.05)。结论老年重症肺炎患者治疗不良结局的影响因素很多,PLT值降低、OI值降低可能会加大患者不良预后的风险。

Effect of hyperbaric oxygen therapy on BI index, GCS, SAS and SDS in patients with craniocerebral injury

Objective: To research and analyze the effect of psychological nursing intervention on self-rating depression (SDS), self-rating anxiety scale (SAS), Glasgow Score (GCS), Barthel index (Barthel, index, BI) of patients. Methods: From September 2015 to September 2016, 84 patients with craniocerebral injury admitted to our hospital were divided into observation group (n = 42) and control group (n = 42) according to randomized single blindness method. All patients were treated with hyperbaric oxygen therapy. The control group was given routine nursing care, while the observation group was treated by psychological nursing intervention. Results: The scores of GCS in the observation group after 2 weeks and 8 weeks of treatment were respectively (7.79±1.42), (11.86±2.56) which were higher than those in the control group (6.23±1.01), (8.21±1.65) the data show significant difference. After treatment, the scores of SDS and SAS in the observation group were respectively (39.14±1.21), (41.67±1.12) which were lower than those in the control group (45.56±2.50), (56.89±2.47) the data show significant difference. The BI index of the observation group was (43.29±4.63), which was higher than that of the control group (36.83±3.10), the scores of NFD was (23.12±1.01) in the observation group, which was lower than that in the control group (28.45±1.67), the data were statistically significant. Conclusion: Psychological care intervention in patients with craniocerebral injury treated by hyperbaric oxygen therapy is helpful to improve the adverse psychological state and consciousness state, improve the ability of daily living activities and promote the recovery of neurological function. It can be actively promoted and applied in clinical practice.

Multi-index analysis of the melting process of laterite metallized pellet

Herein, a multi-index analysis of the nickel content of an alloy, output rate of the alloy, nickel recovery rate, and iron recovery rate during the melting of laterite metallized pellets was performed. The thermodynamic reduction behavior of oxides such as NiO, FeO, Fe_3 O_4, and Cr_2 O_3 was studied using the FactSage software, which revealed that SiO_2 is not conducive to the reduction of iron oxides, whereas the addition of basic oxides such as CaO and MgO is beneficial for the reduction of iron oxides. On the basis of a comprehensive analysis to achieve greater nickel recovery and lower iron recovery rates, the optimum experimental parameters in the orthogonal experiment were A3 B1 C3(t = 30 min, C/O = 0.4, R = 1.2); the indicators wNi, φalloy, ηNi, and ηFe had values of 15.0 wt%, 12.1%, 44.9%, and 96.4%, respectively. In single-factor experiments, increasing basicity(R) substantially improved the separation effect in the low-basicity range 0.5 ≤ R ≤ 0.8 but not in the high-basicity range 0.8 ≤ R ≤ 1.2. Similar results were obtained for the effect of the C/O ratio. Moreover, the recovery rate of nickel increased with increasing recovery rate of iron.

Analysis of the Correlation among Three Oxygen Demand Indexes in Surface Water

Based on the monitoring data of chemical oxygen demand(COD),permanganate index(I Mn)and five-day biochemical oxygen demand(BOD 5)of surface water in Tongling section of Yangtze River,the linear relationship among the three indexes in the annual data analysis and the internal reasons,as well as the linear relationship and changes among the three indexes in different seasons were analyzed.The results reveal that in terms of the whole year,COD,I Mn and BOD 5 had a significant correlation and good linear relationship.The fitting slopes of the three indexes were 3.89 of COD/I Mn,4.39 of COD/BOD 5 and 1.16 of I Mn/BOD 5,respectively,which corresponded to the proportional relationship among the three indexes.From the perspective of seasonal changes,there was a very significant correlation between the three indexes in spring and summer.In autumn and winter,only COD and I Mn had a good correlation,but they had a poor correlation with BOD 5.

经鼻加温湿化高流量氧疗对重症肺炎患儿血气指标、MMP-9及TNF-α的影响

目的 探讨经鼻加温湿化高流量氧疗(HFNC)治疗小儿重症肺炎的疗效及对血气指标、基质金属蛋白酶9(MMP-9)、肿瘤坏死因子α(TNF-α)的影响。方法 选取2018年5月—2020年8月河北省人民医院收治的123例重症肺炎患儿作为研究对象,按照随机抽样法分为观察组(HFNC治疗,n=62)与对照组(面罩吸氧治疗,n=61)。对比两组临床症状、动脉血二氧化碳分压(PaCO_(2))、血氧分压(PaO_(2))、TNF-α、MMP-9、血氧饱和度/吸入氧浓度与呼吸频率的比值(ROX指数)。结果 观察组的退热时间、体征消失时间、咳嗽咳痰消失时间、住院时间分别为(5.21±1.02)d、(10.02±1.32)d、(7.41±0.96)d、(9.02±2.69)d,均短于对照组(t=5.688、10.332、10.253、2.180,P<0.05)。观察组治疗后2、6、12、24 h的ROX指数分别为(6.31±1.62)、(9.85±1.96)、(11.65±2.39)、(13.46±3.25),均高于对照组(t=2.467、3.380、4.251、4.902,P<0.05);治疗后,观察组的PaCO_(2)(35.69±5.21)mmHg低于对照组,而PaO_(2)(87.52±18.69)mmHg高于对照组(t=2.379、4.647,P<0.05);治疗后,观察组的MMP-9、TNF-α分别为(6.32±1.05)pg/mL、(10.40±1.30)pg/mL,低于对照组(t=13.425、13.060,P<0.05)。结论 HFNC用于重症肺炎患儿中具有显著效果,有利于改善患儿血气指标,降低MMP-9、TNF-α水平。

呼吸机与PS联合治疗新生儿重症MAS前后OI的变化研究

目的探究呼吸机与肺表面活性物质(PS)联合治疗新生儿吸入综合征(MAS)的临床效果。方法选择2018年2月—2020年4月在该院接受治疗的102例患儿,随机投掷法分为对照组(行呼吸机治疗)与观察组(行呼吸机与PS联合治疗),每组51例。比较两组氧合指数、血气分析指标、呼吸机参数、呼吸机上机、住院时间。结果经治疗后,观察组治疗后12 hOI(13.11±1.75)、24 h(12.04±1.37)、36 h(11.12±1.13)%均低于对照组,差异有统计学意义(t=12.782、11.775、14.698,P<0.05);治疗后,观察组PaCO_(2)、PIP、MAP、FiO_(2)低于对照组,PaO_(2)高于对照组,差异有统计学意义(P<0.05);观察组呼吸机上机时间、住院时间均低于对照组,差异有统计学意义(P<0.05)。结论呼吸机联合PS治疗该疾病效果显著。