OBJECTIVE To comprehend characteristics and risk factors of lower respiratory tract infection after tracheotomy.METHODS Lower respiratory tract infection condition of 60 cases with tracheotomy was investigated.Risk factors were analyzed.RESULTS The prevalence of nosocomial infection was 93.3%,mainly lower respiratory tract infection(82.1%).The most common pathogens were Gram-negative bacilli.This group of patients had the seriously underlying diseases.In the treatment they carried on the trachea intubation,the tracheotomy,oxygen inhalation,sputum aspiration,atomization and so on.The time the tracheotomy and days in hospital be longer,the lower respiratory tract infection be higher.CONCLUSIONS The trachea intubation,the tracheotomy,the time of tracheotomy and the longer days in hospital may be the risk factors which can cause the lower respiratory tract infection.

OBJECTIVE Toinvestigatetheantidepressantandantianxietyeffectofproanthocyani-dins(OPC)inchronicallystressedratsanditsunderlyingmechanism.METHODS Onemethodwas selected from 8 different stress methods each day,and the rats were treated with OPC (25,50 and 1 00 mg·kg -1 )1 h before the stress method.The chronically stressed model was established.After 21 d stress experi ment,the i mmobility ti me in force swi mming test,sucrose consu mption and the nu mber of marbles buried in the marble burying test were observed respectively each day.OPC (25,50 and 1 00 mg·kg -1 )was given 1 h before each test.In addition,Western blotting was used to analyze the expression of brain derived neurotrophic factor (BDNF) and phosphorylated cyclic AMP response element-bindingprotein(p-CREB)inthehippocampusandfrontalcortex.RESULTS Comparedwith the control group,the chronically stressed group showed obvious depressive-like and anxiety-like behav-ior,while the immobility time decreased from (90.57 ±4.27)s in chronically stressed group to (78.25 ± 2.53)s (P<0.05),(72.12 ±3.21 )s(P<0.05)and (60.77 ±3.41 )s (P<0.05)when ig given OPC 25,50 and 100 mg·kg -1 respectively,the ratio of sucrose preference increased from (42.80 ±4.92)%to (67.54 ±4.32)%(P<0.05)and (72.21 ±7.99)%(P<0.05)when ig given OPC 50 and 1 00 mg· kg -1 respectively,the number of buried marbles decreased from 1 .57 ±0.21 in chronically stressed group to 0.63 ±0.26 (P<0.05)and 0.44 ±0.1 8 (P<0.05)when ig given OPC 50 and 1 00 mg·kg -1 respectively.The expression of p-CREB in the hippocampus and frontal cortex distinctively increased in OPC group (25,50 and 100 mg·kg -1 )(P<0.05),so did the expression of BDNF in the hippocampus andfrontalcortexinOPCgroup(50and100mg·kg-1)(P<0.05).CONCLUSION OPCcanreverse the depressive-like and anxiety-like behavior in chronically stressed rats,which may be related to the cAMP-CREB-BDNF signal transduction cascades.

Purpose To reconstruct perfusion computerized tomography angiography (PCTA) images from the volume data of low-dose brain CT perfusion scan with iterative reconstruction algorithm, to analyze the capability of PCTA on the display of brain arteries, and to explore the methods to reduce the radiation dose for stroke CT examinations. Materials and Methods This was a prospective study, 55 patients (605 arterial segments) with clinical diagnosis of ischemic cerebrovascular disease underwent cranial CT scan, iterative algorithm low-dose brain CT perfusion scan and conventional cranial CTA examinations using a 256-slice spiral CT. 11 segments of the cerebral artery in each case were analyzed using conventional CTA results as the reference standard to assess the display of brain arteries in PCTA. Results Effective dose of CT perfusion scan was 2.12 mSv. Among the 580 vessel segments which CTA showed no stenosis or stenosis<30%, only one vessel segment of PCTA was inconsistent with CTA; among the 19 vessel segments which CTA showed stenosis≥30%but not occluded, results of 12 vessel segments in PCTA were consistent with CTA, while the stenosis states were exaggerated by PCTA in the other seven vessel segments;results of the two methods were consistent in six vessel segments which was found occluded by CTA. Kw values were >0.75 for the consistency test between PCTA and CTA on the display of brain arteries. Conclusion Radiation dose of iterative algorithm cranial CT perfusion scan is significantly lower, and the images reconstructed from the volume data of perfusion CT are highly consistent with the CTA results, thus are able to meet the needs of the clinical diagnosis.

Objective:To investigate the effect of care bundles on prevention of nasal medical device-related pressure injury in patients with nasotracheal intubation undergoing oral and maxillofacial surgery under general anesthesia.Methods:This was a retrospective study. Using the convenient sampling method, patients with a surgical time more than 4 hours and a surgical grade of 3 or 4, with nasotracheal intubation undergoing oral and maxillofacial surgery under general anesthesia from Hospital of Stomatology, Sun Yat-sen University were selected. A total of 96 patients from July to December 2019 were in the control group, and 99 patients from July to December 2020 were selected as the observation group. The control group was treated with routine nursing measures, the observation group was subjected to a nursing care bundle. The incidence of nasal pressure injury was observed after the operation, 24, 48, 72 hours after the nasotracheal intubation was removed, and patients′ satisfaction score was compared.Results:The incidence of nasal pressure injury in the control group was 6.25% (6/96). None of the patients in the observation group had any pressure injury, which was significantly lower than the control group (Fisher exact probability method, P=0.013). The satisfaction scores in the observation group was significantly higher than that in the control group (26.88 ± 1.94 vs 24.71 ± 3.33), the difference was statistically significant ( t=-5.54, P<0.01). Conclusions:The care bundle can effectively prevent the occurrence of nasal pressure injury in patients undergoing oral and maxillofacial surgery with nasotracheal intubation and improve patient satisfaction.

The purpose of this study is to systematically determine an optimal percentile cutoff in histogram analysis for calculating the mean parameters obtained from a nonGaussian continuous-time random-walk (CTRW) diffusion model for differentiating individual glioma grades. This retrospective study included 90 patients with histopathologically proven gliomas (42 grade II, 19 grade III, and 29 grade IV). We performed diffusion-weighted imaging using 17 b-values (0-4000 s/mm²) at 3T, and analyzed the images with the CTRW model to produce an anomalous diffusion coefficient (D m ) along with temporal (α) and spatial (β) diffusion heterogeneity parameters. Given the tumor ROIs, we created a histogram of each parameter; computed the P-values (using a Student’s t-test) for the statistical differences in the mean D m , α, or β for differentiating grade II vs. grade III gliomas and grade III vs. grade IV gliomas at different percentiles (1% to 100%); and selected the highest percentile with P < 0.05 as the optimal percentile. We used the mean parameter values calculated from the optimal percentile cut-offs to do a receiver operating characteristic (ROC) analysis based on individual parameters or their combinations.We compared the results with those obtained by averaging data over the entire region of interest (i.e., 100th percentile). We found the optimal percentiles for D m , α, and β to be 68%, 75%, and 100% for differentiating grade II vs. III and 58%, 19%, and 100% for differentiating grade III vs. IV gliomas, respectively. The optimal percentile cut-offs outperformed the entire-ROI-based analysis in sensitivity (0.761 vs. 0.690), specificity (0.578 vs. 0.526), accuracy (0.704 vs. 0.639), and AUC (0.671 vs.0.599) for grade II vs. III differentiations and in sensitivity (0.789 vs. 0.578) and AUC (0.637 vs. 0.620) for grade III vs. IV differentiations, respectively. Percentile-based histogram analysis, coupled with the multi-parametric approach enabled by the CTRW diffusion model using high b-values, can improve glioma grading.