Exploration of Therapeutic Measures and Clinical Efficacy for Recurrent Respiratory Infections in Children

Objective:To explore the treatment strategies and clinical effects for recurrent respiratory infections in children.Methods:From May 2022 to May 2024,100 pediatric patients with recurrent respiratory infections were selected in this study and evenly divided into two groups.The control group(50 patients)was treated with conventional therapy supplemented with budesonide,while the observation group(50 patients)received pidotimod treatment in addition to the control group’s treatment.Subsequently,the duration of clinical symptom improvement,respiratory function enhancement,serological index changes,reinfection status,and parental satisfaction were compared between the two groups.Results:In terms of clinical symptoms,the observation group showed significantly shorter durations of fever reduction,cough relief,tonsil swelling reduction,and disappearance of fine wet rales compared to the control group(average reduction times were 1.6 days,2.3 days,2.1 days,and 1.9 days,respectively,P<0.05).Regarding respiratory function,the observation group experienced a 12%increase in peak expiratory flow rate variability,a 0.6-liter increase in lung capacity,a 0.7-liter increase in forced lung capacity,and a 0.5-liter increase in forced expiratory volume in the first second after treatment,all significantly higher than the control group(P<0.05).Serological testing revealed that interferon-γand interleukin-2 levels increased by 15%and 18%,respectively,while interferon-α,interleukin-5,and interleukin-4 levels decreased by 10%,12%,and 9%,respectively,in the observation group,showing significant differences compared to the control group(P<0.05).Additionally,the reinfection rate in the observation group(10%)was significantly lower than that in the control group(30%),with an average reduction of two reinfections within one year and a 3.2-day shorter infection control time(P<0.05).In terms of parental satisfaction,the observation group achieved 95%,significantly higher than the 70%in the control group(P<0.05).Conclusion:The addition of pidotimod to conventional therapy for pediatric patients with recurrent respiratory infections can significantly alleviate clinical symptoms,promote the recovery of respiratory function,regulate serological indicators,effectively reduce the risk of reinfection,and improve parental satisfaction.This method deserves widespread clinical application.

Effect of Photoperiod Treatments on Dormancy Induction and Changes in Correlated Respiratory Rate of Nectarine Peach Bud

The responses of dormancy induction to illumination and the characteristics of respiratory rate were studied with the nectarine peach bud in this article. The trial was conducted with nectarine （Prunus persica var. nectariana cv. Shuguang） and involved three treatments： a short day treatment （8 h）, a long day treatment （16 h）, and the normal condition as the control. The dormancy status was determined with the growth of shoot and the sprouting ability, and the respiratory rate was mensurated with oxygen electrode. Short day treatment could induce the growth stopping of peach shoots ahead, promote the development of dormancy, and induce buds into dormancy with 21 d previous to control. Long day treatment postponed the growth stopping and the induction and development of dormancy. The respiratory rate decreased according to the development of dormancy induction. The minimum respiratory rate appeared about 7 days after the start of dormancy induction. Bud respiratory rate increased during this period and then declined and remained at low level during dormancy period. Long day reduced buds respiratory rate slightly. Short day could induce dormancy obviously, and long day postponed dormancy induction. The changes of respiratory rate were correlated with the development of dormancy induction, and the bud respiratory rate was also affected by photoperiod.

Effects of Cinnamon Acid on Respiratory Rate and Its Related Enzymes Activity in Roots of Seedlings of Malus hupehensis Rehd.

This paper studied the effects of cinnamon acid treatments on the respiratory rate and related enzymes activity in the seedling roots of Malus hupehensis Rehd.It would provide information for understanding the mechanisms of inhibition damage caused by continuous cultivation of apple tree.20 mL of solution containing different concentrations of cinnamon acid was added into container with the tested seedlings.After treatment,the samples were taken periodically and the respiratory rates were measured by OXY-LAB oxygen electrodes under 25°C stable temperature and then the activities of related enzymes were measured.The rates of total respiration and other 2 pathways [tricarboxylic acid cycle （TCA） and pentose phosphate pathway （PPP）] appeared initially an increasing treads and late （on the 3rd d） began to decline.However,they again appeared an increase trend at the end period,on the contrast,the respiratory rate of embden-meyer- hot-parnas （EMP） pathway appeared a stead decline tread but it had a recover on the last day.The respiratory rate of total and 3 pathways were decreased under 125 mg kg-1 （soil）.The dynamic trends of the enzymes activities of pyrophosphate-dependent phosphofructokinase （PFK）,glucose-6-phosphate dehydrogenase （G-6-PDH） and malate dehydrogenase （MDH） showed similarly.In conclusion,treatments of certain concentration of cinnamon acid would inhibit the respiratory rate and related enzymes activity of roots of M.hupehensis Rehd.And the inhibition degrees were positively related with concentration of cinnamon acid treatments.

Effects of Nitrogen Fertilizer Treatments on Caryopsis Filling and Respiratory Rate of Rice

An experiment was conducted to study the effects of nitrogen （N） rate and application time on grain filling and respiratory trait of caryopsis in two rice varieties, IR36 and Dali. The treatments were consisted of no N application topdressing at both tillering and booting stages （CK）, 6 g/pot of N topdressing at the tillering stage and 2 g/pot of N topdressing at the booting stage, 2 g/pot of N topdressing at the tillering stage and 6 g/pot of N topdressing at the booting stage. The results showed that the proper utilization of N fertilizer can be helpful to maintain the higher water content, higher respiratory rate and higher dehydrogenase activity of rice caryopsis in late filling phase, and prolong the course for filling and maintaining higher respiratory rate and dehydrogenase activity of rice caryopsis. More N application at booting was more effective compared to more N application at tillering.

Effects of GA3 and ABA on the respiratory pathways during the secondary bud burst in black currants

The effects of exogenous gibberellic acid (GA(3)) and abscisic acid (ABA) on the total respiratory rate, percentages of total respiratory rate contributed by respiratory pathways [Embden-Meyerhof- Parnas Pathway (EMP), Pentose Phosphate Pathway (PPP), and Tricarboxylic Acid Cycle (TCA)], and conversion of starch to soluble sugars in the buds of black currants during secondary bud burst were investigated to determine the relationship between respiratory rates and secondary bud burst. 'Adelinia', a black currant cultivar that is prone to secondary bud burst after the first harvest, was used in this study. Mature bushes of Adelinia were sprayed with 30 mg/L GA(3) and 50 mg/L ABA to manipulate bud burst. The results showed that exogenous applications of GA(3) and ABA had opposite effects on bud respiratory rate. Generally, GA(3) treatment increased the total respiratory rate and respiratory rate of the TCA and PPP, and the respiratory rates after GA(3) treatment were higher than those of control. While ABA treatment mostly decreased the total respiratory rate and the respiratory rate of TCA and PPP in buds in comparison to control. In terms of the percentage of the three respiratory rates in comparison to the total respiratory rate, GA(3) treatment significantly increased the percentage of TCA and PPP respiratory rate in comparison to the control (P < 0.01), whereas ABA decreased the rates. GA(3) significantly increased the content of soluble sugars and decreased the starch content, while the starch content in buds after ABA treatment was significantly higher than that of the control. All results showed that PPP is a critical process for the second bud burst in black currants. While the EMP-TCA pathway is still dominant in bud respiration, provides a series of basic materials and energy (ATP). The conversion of starch to soluble sugars is essential for bud burst. Thus, we conclude that an energy shortage is a main contributor in ABA inhibition of the secondary bud burst of black currants.

Automatic detection of respiratory rate from electrocardiogram,respiration induced plethysmography and 3D acceleration signals

Respiratory monitoring is increasingly used in clinical and healthcare practices to diagnose chronic cardio-pulmonary functional diseases during various routine activities.Wearable medical devices have realized the possibilities of ubiquitous respiratory monitoring,however,relatively little attention is paid to accuracy and reliability.In previous study,a wearable respiration biofeedback system was designed.In this work,three kinds of signals were mixed to extract respiratory rate,i.e.,respiration inductive plethysmography(RIP),3D-acceleration and ECG.In-situ experiments with twelve subjects indicate that the method significantly improves the accuracy and reliability over a dynamic range of respiration rate.It is possible to derive respiration rate from three signals within mean absolute percentage error 4.37%of a reference gold standard.Similarly studies derive respiratory rate from single-lead ECG within mean absolute percentage error 17%of a reference gold standard.

Effect of music on blood pressure, pulse rate and respiratory rate of asymptomatic individuals: A randomized controlled trial

A slight reduction of blood pressure and heart rate can reduce the risk of developing cardiovascular disease. Maintenance of the respiratory rate within the normal range has also being identified as crucial for a healthy heart. Use of Indian and western music have been considered among many preventive programmes for long time in order to risk reduction associated with cardio vascular diseases. Therefore the aim of this study is to describe the effect of Indian classical music on systolic and diastolic blood pressure, pulse rate and respiratory rate in asymptomatic individuals aged 45 to 65 years. Methodology: A community based randomized intervention study was conducted in 252 asymptomatic individuals. The study group (n = 127) listened to a music based on Indian classical system (entire track of 22 minutes). The control group (n = 125) was kept silent for a similar time period. Systolic and diastolic blood pressure, pulse rate and respiratory rate of each study participant were monitored before and after the intervention. Results: Statistically significant reduction in systolic blood pressure (8.53 mmHg), diastolic blood pressure (5.8 mmHg), pulse rate (5.16 breaths per minute) and respiratory rate (2.55 per minute) were observed in the study group after listening to the music (p < 0.01). In the control group, changes observed during the period of intervention were not significant (p > 0.05). The reduction was independent of gender, age, education level, practicing a mind relaxation technique and preferred type of music of the participant. Conclusions: Listening to Indian classical music for about 22 minutes significantly reduced systolic and diastolic blood pressure, pulse rate and respiratory rate of asymptomatic individuals. Hence, music may have a potential benefit in cardio vascular disease preventive programmes.

Effects of waterborne Fe(Ⅱ) on juvenile turbot Scophthalmus maximus:analysis of respiratory rate,hematology and gill histology

The concentration of Fe(Ⅱ) is high in some groundwater supplies used in turbot culture,and the toxicity of waterborne Fe(Ⅱ) is unknown.We investigated the stress responses of juvenile turbot,Scophthalmus maximus,exposed to Fe(Ⅱ) of different concentrations (0.01,0.05,0.1,0.5,1,and 2 mg/L) for 1,7,14,and 28 d,under the same ambient conditions of other parameters.Changes in respiratory rate,hematological parameters,and gill structure were determined.The results show that waterborne Fe(Ⅱ) did not cause severe hematological perturbation to turbot.A low-medium Fe(Ⅱ) concentration (lower than 0.1 mg/L) could boost the respiratory rate,and caused no or very limited damage to fish.A high Fe(Ⅱ) concentration (0.1 mg/L or higher),however,caused gill damage,such as vacuoles in branchial lamellae,epithelial necrosis,and hypertrophy of epithelial cells,and even death after extended exposure time.Therefore,excess waterborne Fe(Ⅱ) and long-term exposure to Fe(Ⅱ) could be responsible for poor growth and high mortality of turbot in culture.The concentration of waterborne Fe(Ⅱ) in turbot culture should be kept below 0.1 mg/L.

基于电磁感应自驱动传感器的呼吸率监测系统研究

呼吸率是呼吸功能的一个重要参数,实时监测呼吸率对发现和预防呼吸疾病有着重要意义。设计了一种基于电磁感应自驱动呼吸气流传感器的呼吸率监测系统,该系统将传感器置于口腔/鼻下通过监测呼吸气流的变化来监测人体的呼吸率。实验测得传感器在呼吸缓慢、呼吸正常、呼吸急促时周期分别为3.8,2.3,1.6 s,小于人呼吸周期时间(3~6 s),系统采用蓝牙通信技术传输数据,方便测试者移动。该系统实现了对人体呼吸率稳定、实时、准确的采集,为后续呼吸疾病的预防和诊断提供了一定的研究价值。

分阶段式呼吸肌训练对提高呼吸衰竭患者无创通气撤机成功率的影响

目的探究分阶段式呼吸肌训练对提高呼吸衰竭患者无创通气撤机成功率的影响。方法选取2020年1月—2022年12月在南京医科大学附属淮安第一医院呼吸与危重症医学科(pulmonary and critical care medicine,PCCM)治疗的102例呼吸衰竭患者为研究对象。采用随机数字表法将患者分为对照组和观察组,每组51例。对照组实施常规护理干预,观察组在对照组基础上实施分阶段式呼吸肌训练。分别于干预前和干预2周后比较2组患者撤机成功率、机械通气时间及呼吸肌力水平及氧合指数情况。结果干预2周后,观察组撤机成功率高于对照组,且机械通气时间短于对照组,差异均有统计学意义(P<0.05);干预后,2组最大口腔吸气压(MIP)、最大口腔呼气压(MEP)及氧合指数均高于干预前,且观察组高于同期对照组,差异有统计学意义(P<0.05)。结论分阶段式呼吸肌训练在临床护理中效果较好,可促进呼吸衰竭患者呼吸肌力恢复,改善膈肌功能,缩短机械通气时间,提高撤机成功率。

控制呼吸持续性监护仪临床应用的可行性和有效性

目的:观察利用人工气道内温度节律性变化原理设计的控制呼吸持续性监护仪在不同人群和不同人工气道内的应用,探讨其监测控制呼吸持续性的可行性和有效性,为临床呼吸监测提供新方法。方法:选择择期行全身麻醉术的成人患者60例,1~3岁幼儿患者30例,美国麻醉师协会(ASA)分级Ⅰ-Ⅱ级;60例成人患者随机分为成人气管插管组(ATI组)和成人喉罩组(ALM组),每组30例,1~3岁幼儿患者30例设为幼儿气管插管组(CTI组)。全麻诱导后,CTI组和ATI组患者行气管插管,ALM组患者置入喉罩,连接麻醉机行机械通气,连接控制呼吸持续性监护仪,观察监护仪是否能探测出各组患者呼吸频率(RR),比较各组监护仪探测的RR和麻醉机设定频率;3组患者均于手术开始前模拟呼吸回路断开、麻醉机手控未转换为机控和呼吸回路缓慢漏气3种临床常见控制呼吸持续性改变场景,比较各组间监护仪发出报警方式和报警时间。结果:3组患者应用控制呼吸持续性监护仪均能检测出RR,各组内患者RR和麻醉机设定频率比较差异无统计学意义(P>0.05)。在模拟3种常见呼吸持续性改变的场景中,3组患者呼吸持续性监护仪均发出内容为“注意,呼吸停止”的人工语音报警信号,报警信号均被注意到,ATI组和ALM组控制呼吸持续性监护仪开始报警时间比较差异无统计学意义(P>0.05)。与回路缓慢漏气比较,同一组患者呼吸回路断开和手控未转换为机控场景时开始报警时间缩短(P<0.05)。结论:在不同人群和不同人工气道内利用探测人工气道内温度节律性升降变化原理设计的控制呼吸持续性监护仪临床应用具有可行性及有效性,可为术中呼吸持续性监测和保障呼吸安全提供新方法。

基于超参数优化算法的随机森林模型预测奶牛呼吸频率

奶牛呼吸频率是评估环境造成的奶牛热应激程度的重要指标之一。该研究基于随机森林(random forest,RF)算法提出了适用于生产条件下的奶牛个体呼吸频率准确预测模型,为了平衡模型精度与计算效率问题,利用遗传算法(genetic algorithm,GA)、差分进化(differential evolution,DE)算法、粒子群优化(particle swarm optimization,PSO)算法、贝叶斯优化(Bayesian optimization,BO)算法对模型超参数进行优化,并与网格搜索(grid search,GS)下的人工神经网络(artificial neural network,ANN)和极限梯度提升机(extreme gradient boosting,XGBoost)模型进行了对比分析。研究结果表明,使用融合环境参数的修正温湿指数(adjusted temperature-humidity index,ATHI)、时间区域、奶牛产奶量、泌乳天数、身体姿势以及胎次作为输入特征时,基准RF模型的预测性能最佳。在此基础上,4种智能优化算法下的RF模型性能优于GS-ANN和GS-XGBoost,其中BO-RF的综合性能最优,其决定系数、平均绝对误差、平均绝对百分比误差以及均方根误差分别为0.614次/min、7.723次/min、14.4%、9.737次/min,超参数优化耗时约为DE-RF的1/220。特征重要性分析表明,输入因子对奶牛呼吸频率的影响程度不同,ATHI是影响力最高的因子,相对重要性(relative importance,RI)为0.73,其次是时间区域(RI=0.09)和奶牛产奶量(RI=0.07)。研究为奶牛生产、健康评价及牛舍环境精准调控提供了有效方法和基础。

心率变异性生物反馈调节自主神经系统的机制及应用

背景:心率变异性生物反馈是采用共振频率下的深慢呼吸方式在心血管系统中引起有节奏的高幅度振荡,从而刺激和锻炼自主神经反射及压力反射的一种呼吸训练方式。然而,目前的研究尚未系统综述心率变异性生物反馈是如何调节自主神经功能并产生作用的。研究者们对心率变异性生物反馈的机制缺乏全面认识,且对其应用进展及方案尚不完全清楚。目的:对国内外现有的心率变异性生物反馈对不同人群症状影响的试验研究进行梳理,介绍心率变异性生物反馈调节自主神经系统的机制及应用进展。方法:以“心率变异性生物反馈,共振呼吸,自主神经,心率变异性,生物反馈,呼吸训练”“Heart rate variability biofeedback,Resonance breathing,Heart rate variability,Autonomic nerve,Breathing training,Chronic diseases,Mental illness,biofeedback”等为检索词在中国知网、万方、PubMed及Web of Science等文献数据库进行检索,根据纳入和排除标准共获得相关文献75篇。结果与结论:①机体的振荡系统与共振系统是心率变异性生物反馈产生作用的前提,振荡反映了外部刺激和自身调节的反射系统的运作,共振则是两个系统的同步振荡引起更高的振幅运作。②交感神经和副交感神经平衡是维持稳定的内环境的前提,自主神经系统紊乱会伴随心率变异性降低并与相关疾病的进展密切相关。心率变异性生物反馈是基于心血管系统的共振特性,以共振频率下的深慢呼吸方式在心血管系统中引起有节奏的高幅度振荡,改善交感和副交感系统反射的调节功能,增强两个系统之间的平衡调节。③心血管系统共振的两个主要机制是压力反射闭环通路和呼吸性窦性心律失常,两个机制以及压力反射特有的延迟共同作用导致在共振频率节奏的呼吸时,心率与呼吸呈现0°相位角的振荡,血压与呼吸呈现180°相位角振荡,是一种易操作、效果好的周期性刺激人体心血管振荡系统的训练方法。④目前心率变异性生物反馈大多应用于心理疾病、慢病以及体育领域,但其存在干预机制及功效不清,干预内容、干预频率及干预时间存在差异,未有研究针对不同类型人群对应的干预方式做相关综述研究。⑤心率变异性生物反馈作为一种非药物、非侵入性的干预手段,可以显著提高心率变异性,调节交感神经与副交感神经平衡,改善自主神经系统的稳定性和弹性。未来建议探索其诱发心血管共振通路的机制与应用情况,添加长期随访,以评估其在不同领域中的长期应用价值,为一些复杂疾病的综合治疗提供新的方向和策略。

美托洛尔对伴长RR间期的持续性心房颤动患者的影响

目的评价美托洛尔在伴长RR间期(RR间期>1.5 s)的持续性心房颤动(简称房颤)患者中应用的疗效及安全性。方法 100例持续性房颤伴RR间期>1.5 s的患者,采用美托洛尔25 mg每日2次,治疗2周。观察治疗前后24 h和清醒状态时有RR间期≥2.5 s的患者比率,最长RR间期、平均心室率、最大心室率、最小心室率及心率变异性(HRV)的时域参数[24 h RR间期均值的标准差(SDNN)、相邻RR间期差值均方根(RMSSD)]和频域参数[高频(HF)、低频成分(LF)]。结果除3例自发转复为窦性心律,1例应用地高辛,1例失访外,最终入选95例。治疗后,最长RR间期从2 200±540(1 500～3 520)ms延长到2 400±490(1 510～3 560)ms(P<0.001);平均心室率、最大心室率、最小心室率均显著降低(79.78±13.31次/分vs 93.67±15.74次/分,151.82±25.08次/分vs 175.64±24.32次/分,40.78±9.79次/分vs 47.04±11.49次/分,P均<0.01);SDNN、RMSSD、HF和LF均显著增加(233.9±40.8 ms vs 209.7±54.2 ms,270.1±74.0 ms vs 240.2±40.8 ms,18 572.2±6 667.4 ms2 vs 13 997.0±5 491.3 ms2,11 373.7±4 486.6 ms2 vs 8 599.4±3 669.3 ms2,P均<0.01);全天有RR间期≥2.5s的患者,治疗前后无差异[36.8%(35/95)vs 28.4%(27/95),P>0.05];清醒状态有RR间期≥2.5 s的患者,治疗后较治疗前无明显增多[8.4%(8/95)vs 6.3%(6/95),P>0.05]。无近似晕厥及晕厥等不良事件发生。结论对于有β受体阻滞剂适应证伴有长RR间期的持续性房颤患者,口服美托洛尔仍然是安全有效的。

粤东地区2019~2022年儿童呼吸道感染病原学分析

目的分析粤东地区2019~2022年儿童呼吸道感染病原学分布情况,为临床诊疗提供参考依据。方法收集2019年5月~2022年10月期间咽拭子标本(来源均为急性呼吸道感染至汕头市中心医院就诊患儿)3052份,提取病原体核酸,应用逆转录-聚合酶链式反应(RT-PCR)、多重聚合酶链式反应(PCR)技术进行扩增后,进行15种(型)常见呼吸道病原体的筛查,将其分为单纯DNA病毒组、单纯RNA病毒组、单纯细菌组、单纯肺炎支原体组、混合DNA和RNA病毒组、混合病毒和细菌组、混合肺炎支原体和病毒或细菌组。分析儿童呼吸道感染病原学检测结果、各组的性别构成情况,比较各年龄段儿童呼吸道病原体检测阳性情况、月份分布情况。结果呼吸道感染患儿的咽拭子标本3052份,其中阳性2714份,阴性338份,呼吸道感染阳性患儿的性别比例、年龄分布、疾病类型、月份分布和就诊时体温与呼吸道感染阴性患儿有统计学差异(P<0.05)。2714例呼吸道感染阳性患儿中,检出率最高的为巨细胞病毒759例,检出率为28.0%。2714例呼吸道感染患儿中,男性1643例(60.5%),女性1071例(39.5%)。同一病原体的男性发病率明显高于女性。单纯肺炎支原体感染发病率随年龄增长逐渐增加;单纯DNA病毒、单纯RNA病毒、单纯细菌、混合DNA和RNA病毒、混合病毒和细菌发病率随年龄增长逐渐降低。单纯DNA病毒组、单纯RNA病毒组、单纯肺炎支原体组、混合DNA和RNA病毒组、混合肺炎支原体和病毒或细菌组7~9月发病率最高,分别为45.3%、40.7%、46.9%、43.9%、47.4%,单纯细菌组、混合病毒和细菌组4~6月发病率最高,分别为29.3%、29.3%。结论粤东地区儿童急性呼吸道感染以巨细胞病毒为主;发病率男性均比女性高;单纯肺炎支原体感染发病率随年龄增长逐渐增加,单纯DNA病毒、单纯RNA病毒、单纯细菌、混合DNA和RNA病毒、混合病毒和细菌发病率随年龄增长逐渐降低;7~9月呼吸道感染首先应警惕病毒和肺炎支原体感染,如果7~9月呼吸道感染考虑存在细菌感染,应警惕混合病毒或肺炎支原体感染可能。

广东部分地区猪场PRRS的血清学调查

2008年7月至2009年1月,应用酶联免疫吸附反应法对广东省茂名、惠州、东莞、四会、鹤山5个地区的40个中小规模猪场进行了猪繁殖与呼吸综合征(PRRS)的血清学调查。结果显示,未进行疫苗免疫接种的猪场PRRSV的感染率高达100%,平均抗体阳性率为66.77%,其中后备母猪为87.50%,生产母猪为80.77%,仔猪为57.21%;进行过疫苗免疫接种的猪场PRRS平均抗体阳性率82.82%,其中后备母猪为87.06%,生产母猪为82.40%,仔猪为81.89%。由此可见,猪繁殖与呼吸综合征野毒在广东省中小规模猪场普遍存在,而且感染率差异显著(P<0.01),这可能与各个猪场的饲养环境、管理水平和防疫措施等有关。

2020年云南省鸡呼吸系统疫病病因分析

为了分析云南省2020年度鸡呼吸系统疫病病因,分别在昆明、红河、曲靖、大理、楚雄、昭通等地111个养鸡场采集疑似发生呼吸系统疫病鸡肺脏、脾脏、喉气管等组织混合样品111份。采用PCR检测方法对疑似样品进行副鸡禽杆菌、鸡毒支原体(MG)、滑液囊支原体(MS)、新城疫病毒(NDV)、传染性支气管炎病毒(IBV)、传染性喉气管炎病毒(ILTV)、禽流感病毒(AIV)、鼻气管鸟杆菌(ORT)等传染性疾病病原核酸检测,对部分核酸样品进行测序验证。结果表明,副鸡禽杆菌、MG、MS、NDV、IBV、ILTV、ATV、ORT的检测阳性率分别为18.92%(21/111)、10.81%(12/111)、5.41%(6/111)、4.50%(5/111)、2.70%(3/111)、39.64%(44/111)、9.00%(10/111)、18.92%(21/111);混合感染占32.43%(36/111),2种、3种和4种病原混合感染分别占18.92%(21/111)、11.71%(13/111)和1.80%(2/111)。由此可见,云南省2020年度鸡呼吸系统疾病由多种原因引起,其中以副鸡禽杆菌、ILTV、ORT为主。

急性呼吸窘迫综合征患者死亡率预测的两阶段堆叠异构集成模型

目的建立一个机器学习模型能够准确预测急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)患者死亡风险,选取合适的填充方式解决现有电子健康记录(electronic health record,EHR)中存在的稀疏性、不规则性问题,辅助医生进行临床决策。方法从重症监护医学信息数据库(medical information mart for intensive care,MIMIC-Ⅲ)中筛选符合“柏林定义”的ARDS患者,并对患者入院24 h内的生命体征、实验室指标、诊断代码、影像学报告等数据进行回顾性分析,首先使用非负潜在因子分解填补缺失值,然后构建两阶段的堆叠异构集成学习方法,预测患者30 d内的死亡风险,采用受试者工作特征曲线下面积(area under the receiver operation characteristic curve,AUROC)、准确度、精确度、F1值等指标对模型进行评价,并进行特征重要性分析。结果本研究共纳入2576个患者,80%用于训练,20%用于模型测试。利用不同填充方式对数据进行处理,非负潜在因子分解相较于其他填充方式能够更好地保留原数据的分布结构,有着更高的填充精度。对填充好的数据进行建模,两阶段堆叠集成模型的准确度为0.841,AUROC为0.846,F1值为0.586,相较于其他机器学习模型展示出了更好的预测能力。结论两阶段的堆叠异构集成学习模型能够较好地实现对ARDS患者死亡风险预测。

自动挤压控制潮气量的简易呼吸器研制与功能测试

目的研制一种能自动挤压控制潮气量的简易呼吸器并探讨其功能。方法标准测试条件下,将该仪器、呼吸机检测仪和模拟肺通过呼吸管路连接,不同干预措施下对其进行功能测试,记录潮气量、呼吸频率和吸呼比。计量资料采用方差分析或Friedman检验,计数资料采用卡方检验或Fisher精确检验进行比较。最后评估其呼吸参数是否满足性能指标要求,从而验证该仪器主要呼吸参数的准确、使用的安全性和稳定性。结果在标准测试条件下,自动挤压并精准控制潮气量的简易呼吸器设定潮气量、呼吸频率、吸呼比输出的最大误差分别在±15%、±10%、±10%以内,部分常用呼吸参数校准点均有较高的准确性,且操作者通气3 h,呼吸参数数据仍然保持准确且稳定。结论自动挤压并精准控制潮气量的简易呼吸器的呼吸参数数据输出是准确、稳定、可靠的,一定程度上提高了简易呼吸器通气效率,节省操作人力及培训成本。

转变体位护理对新生儿肺炎呼吸频率及康复进程的影响

目的探讨转变体位护理对新生儿肺炎呼吸频率(RR)及康复进程产生的影响。方法选择安徽省太和县人民医院2021年1月至12月收治的89例新生儿肺炎患儿作为研究对象,采用随机数字表法将其分为常规组和干预组。常规组患儿45例,治疗期间行呼吸道常规护理;干预组患儿44例,治疗期间除行常规护理外行转变体位护理干预。观察干预5 d后患儿RR、经皮血氧饱和度(SpO_(2))变化及症状改善时间。结果整体分析发现:RR时间点比较、交互作用差异均有统计学意义(P<0.05);SpO_(2)组间比较、时间点比较、交互作用差异均有统计学意义(P<0.05)。进一步两两比较,组内比较:干预组入院第1、3、5天RR比较,入院第3、5天SpO_(2)与入院第1天比较,差异有统计学意义(P<0.05);常规组入院第3、5天RR与第1天比较,入院第5天SpO_(2)与入院第1天比较,差异有统计学意义(P<0.05)。组间比较:干预组入院第1、3、5天的RR均低于常规组,SpO_(2)均高于常规组(P<0.05)。干预后干预组体温异常、呼吸困难、气促、咳嗽、湿啰音消失时间均短于常规组,差异有统计学意义(P<0.05)。结论新生儿肺炎患儿治疗中实施转变体位护理,可有效促进患儿RR、SpO_(2)获得更好的改善,加速患儿临床症状的改善,有助于康复进程缩短。