Burns ; complications ; Humans ; Hypoxia ; Ischemia ; Shock ; etiology

Acute respiratory distress syndrome (ARDS) is a clinical syndrome defined by acute onset of hypoxemia and bilateral pulmonary opacities not fully explained by cardiac failure or volume overload. At present, there is no specific drug treatment for ARDS, and the mortality rate is high. The reason may be that ARDS has rapid onset, rapid progression, complex etiology, and great heterogeneity of clinical manifestations and treatment. Compared with traditional data analysis, machine learning algorithms can automatically analyze and obtain rules from complex data and interpret them to assist clinical decision making. This review aims to provide a brief overview of the machine learning progression in ARDS clinical phenotype, onset prediction, prognosis stratification, and interpretable machine learning in recent years, in order to provide reference for clinical.
Humans ; Hypoxia/complications* ; Respiratory Distress Syndrome/etiology* ; Prognosis ; Machine Learning

Animals ; Humans ; Hypertension, Pulmonary ; complications ; Hypothermia ; complications ; Hypoxia ; etiology ; therapy ; Respiratory Distress Syndrome, Adult ; complications ; Shock, Septic ; complications

OBJECTIVETo investigate the risk factors for capillary leak syndrome (CLS) in children with malignant hematologic diseases.

METHODSThirty children with hematological malignancies complicated with CLS were analyzed with multiple logistic regression analysis.

RESULTSAt the test level of 0.05, hypoxemia and septicemia were found to significantly correlate with CLS in these children, and the number of white blood cells before CLS and severe bone marrow suppression were near the test level.

CONCLUSIONHypoxemia and septicemia are risk factors for CLS in children with malignant hematologic diseases.

Capillary Leak Syndrome ; complications ; Child ; Hematologic Neoplasms ; complications ; Humans ; Hypoxia ; complications ; Leukocyte Count ; Risk Factors ; Sepsis ; complications

OBJECTIVETo explore the personality and character of obstructive sleep apnea hypopnea syndrome (OSAHS) patients.

METHODSSubjects, recruited from May 2013 to February 2014, were assigned to the severe OSAHS group (56 cases), mild-moderate OSAHS group (59 cases), and control group (42 cases) on the basis of apnea hyponea index (AHI). Subjects were assigned to the severe hypoxemia group (24 cases), mild-moderate hypoxemia group (91 cases) on the basis of PaO2. The psychological aspects of subjects were assessed by using the Minnesota multiphasic personality inventory (MMPI).

RESULTSCompared between OSAHS group and the control group, differences of 6 clinical scales depression (D), hysteria (Hy), masculinity (Mf), paranoia (Pa), anxiety (A), ego strength (Es) were significant (t value was 2.609, 2.133, -2.294, 2.520, 2.041, 2.675 respectively, all P < 0.05). The scores of OSAHS group were higher than the control group on five clinical scales, depression (D), hysteria (Hy), paranoia (Pa), anxiety (A), ego strength (ES). The scores of OSAHS group were lower than the control group on clinical scale masculinity (Mf). Compared between severe OSAHS group and mild-moderate OSAHS group, differences of 6 clinical scales depression (D), paranoia (Pa), psychasthenia (Pt) anxiety (A), manifest anxiety scale (MAS), dependency (Dy) were significant (t value was 2.460, 2.086, 2.181, 2.121, 2.954, 1.982, respectively). The scores of severe OSAHS group were all higher than the mild-moderate OSAHS group on these six clinical scales. Compared between severe hypoxemia group and the contrast group, differences of 4 clinical scales depression (D), masculinity (Mf), paranoia (Pa), ego strength (Es) were significant (t value was respectively 2.992, -2.221, 2.164, 2.165, all P < 0.05). The scores of severe hypoxemia group were higher than the control group on 3 clinical scales, depression (D), paranoia (Pa), ego strength (ES), and lower than the control group on clinical scale masculinity (Mf). Compared between severe hypoxemia group and mild-moderate hypoxemia group, psychasthenia (Pt) were significant (t value was 1.984). The scores of severe hypoxemia group were higher.

CONCLUSIONSCompared with health people, OSAHS patients have special personality and character. The degree of OSAHS can infect the personality and character of OSAHS patients.

Case-Control Studies ; Depression ; complications ; Humans ; Hypoxia ; complications ; MMPI ; Personality ; Sleep Apnea, Obstructive ; psychology

OBJECTIVETo investigate the comorbidity rate of depression symptoms in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) in Henan province and to ascertain the risk factors.

METHODSOne thousand three hundred and twenty-seven patients with OSAHS determined by overnight polysomnogram (PSG) were enrolled in this study. After screening the Symptom Checklist 90 (SCL-90) and Self-rating Depression Scale (SDS), the patients were divided into two groups: OSAHS (control group, n = 698) and OSAHS+depression (n = 629). The correlation was explored between the depression symptoms in patients with OSAHS and the sociodemographic variables and health status including smoking, drinking, marital status, apnea hyponea index (AHI), anoxicity, Family Burden Scale of Disease (FBS), Family APGAR Index (APGAR), Perceived Social Support Scale (PSSS) and so on. Furthermore, In-depth analyses were carried out between the depression symptoms in patients with OSAHS and the social and family factor items (FBS, APGAR and PSSS).

RESULTSThe comorbidity rate of depression symptoms in patients with OSAHS in Henan province was 47.4%, and was correlated with the gender, marital status, FBS, APGAR, AHI, PSSS and anoxicity. Logistic regression analysis indicated that single marital status, APGAR, AHI, PSSS, hypoxemia and heart disease were all independent risk factors for depression in OSAHS patients. The total of the FBS score and three of its subfactors scores (family daily activities, family relationships and mental health of family members) were higher, and the total of the APGAR score and two of its subfactors scores (adaptabilith and affection) were lower in OSAHS with depression compared with the control group (P < 0.05). Besides, the total score for the PSSS AND Scores for its two subfactors (family support and social support) were all lower in OSAHS patients with depression than those of the control group (P < 0.05).

CONCLUSIONIn patients with OSAHS, depression symptoms are common and are associated with marital status, AHI, anoxicity, concomitant diseases (hypertension, heart disease), concerns and supports from the family and society.

Depression ; complications ; Humans ; Hypertension ; Hypoxia ; Polysomnography ; Research ; Risk Factors ; Sleep Apnea, Obstructive ; complications ; Smoking

Objective To investigate the characteristics of nocturnal intermittent hypoxemia in patients with heart failure(HF) with preserved ejection fraction(HFpEF).Methods Patients(n=854) who completed sleep test and echocardiography from January 2011 to December 2014 were retrospectively studied. HF patients with an ejection fraction(EF) of ≥50% were included in the HFpEF group(n=112) while HF patients with an EF of <50% included in the group of HF patients with reduced EF(HFrEF)(n=104). Respiratory events and minimum nocturnal saturation(minSaO) were recorded by home sleep testing,and the percentage of total sleep time with saturation <90%(T90SaO) were calculated.Results Compared with patients without HF,subjects with HFpEF and HFrEF had more breathing events[13(5,29)/h vs. 18(6,36)/h,and 21(8,45)/h,P<0.001],lower minSaO[85(80,87)% vs. 82(77,86)% and 83(78,87)%,P<0.001] and relatively longer T90SaO[3.0(0.4,15.5)% vs. 6.0(1.5,24.8)% and 6.7(1.3,14.4)%,P<0.001]. The HFpEF group had significantly higher odds of moderate-severe hypoxemia(minSaO<85%) during sleep than those without HF(OR=2.02,95%CI=1.34-3.11,P<0.001),with the significance persisting after adjusting for covariates including age,gender,hypertension,diabetes,coronary heart disease,renal dysfunction,and smoking(OR=1.85,95%CI=1.20-2.90,P=0.006).Conclusion Patients with HFpEF have frequent nocturnal intermittent hypoxemia,which warrants further investigations to evaluate if remission of night-time hypoxemia may improve long-term prognosis in this cohort.
Echocardiography ; Heart Failure ; complications ; Humans ; Hypoxia ; complications ; Oxygen ; blood ; Polysomnography ; Prognosis ; Retrospective Studies ; Sleep ; Stroke Volume

Obstructive sleep apnea syndrome (OSAS), a prevalent sleep disorder in children, is characterized by recurring upper airway obstruction during sleep. OSAS in children can cause intermittent hypoxia and sleep fragmentation, ultimately affect brain development and further lead to cognitive impairment if lack of timely effective intervention. In recent years, magnetic resonance imaging (MRI) and electroencephalogram (EEG) have been employed to investigate brain structure and function abnormalities in children with OSAS. Previous studies have indicated that children with OSAS showed extensive gray and white matter damage, abnormal brain function in regions such as the frontal lobe and hippocampus, as well as a significant decline in general cognitive function and executive function. However, the existing studies mainly focused on the regional activity, and the mechanism of pediatric OSAS affecting brain networks remains unknown. Moreover, it's unclear whether the alterations in brain structure and function are associated with their cognitive impairment. In this review article, we proposed two future research directions: 1) future studies should utilize the multimodal neuroimaging techniques to reveal the alterations of brain networks organization underlying pediatric OSAS; 2) further investigation is necessary to explore the relationship between brain network alteration and cognitive dysfunction in children with OSAS. With these efforts, it will be promising to identify the neuroimaging biomarkers for monitoring the brain development of children with OSAS as well as aiding its clinical diagnosis, and ultimately develop more effective strategies for intervention, diagnosis, and treatment.
Humans ; Child ; Sleep Apnea, Obstructive/complications* ; Cognition ; Hypoxia/complications* ; Hippocampus ; Frontal Lobe

Diffuse malignant mesothelioma is a rare malignant tumor having poor prognosis. There is still no widely acceptable staging system of the disease and pathologic diagnosis is difficult. Although surgical treatment for diffuse malignant mesothelioma has been controversial, extrapleural peumonectomy in selected patients could prolong the survival when it was combined with adjuvant chemotherapy and radiation therapy. We experienced 4 cases of diffuse malignant mesothelioma for 7 years since 1992, they were treated with extrapleural pneumonectomy without early postoperative mortality. Three patients underwent adjuvant therapy after surgery; chemotherapy in two, and chemo-radiation therapy in one, but one patient could not receive adjuvant therapy because of postoperative complication of hypoxic brain damage due to cardiac torsion and empyema. In this article, we describe surgical experience of extrapleural pneumonectomy and discuss about the controversial points of the disease.
Chemotherapy, Adjuvant ; Diagnosis ; Drug Therapy ; Empyema ; Humans ; Hypoxia, Brain ; Mesothelioma* ; Mortality ; Pneumonectomy* ; Postoperative Complications ; Prognosis

The delayed-onset focal dystonia is a rare sequela of cerebrovascular disease or diffuse cerebral hypoxic damage. The responsible lesion sites for the dystonia are variable and the pathogenesis is uncertain. We describe two children with delayed-onset focal dystonia as a complication of perinatal anoxia. The intervals between hypoxic insult and onset of dystonia were 6 years in one and 3 in the other cases. Our patients did not have a focal lesion; one had scattered white matter lesion and the other had a diffuse frontoparietal atrophy. Delayed-onset dystonia after perinatal anoxia can be also caused by non-focal lesion such as diffuse frontoparietal atrophy or cerebral white matter lesion with long interval delay.
Child ; Dystonia/*etiology ; Female ; Humans ; Hypoxia, Brain/*complications ; Male ; Time Factors