Objective To evaluate the value of the change of B-type natriuretic peptide(BNP) in predicting weaning outcome of patients with mechanical ventilation in ICU.Methods We carried out a prospective cohort study on patients in ICU at Fuxing Hospital from July 2013 to January 2014.Patients expected to use mechanical ventilation for more than 24 hours were enrolled in our study.The plasma concentration of BNP was measured at the beginning of spontaneous breathing trial(SBT) and 2 hours after.According to the outcome of SBT,patients were divided into SBT failure group (group A),weaning failure group (group B) and weaning success group (group C).The levels of BNP before and after the SBT were compared among three groups.The receiver operating characteristic (ROC) curve analysis was used to evaluate the changes of BNP (△BNP) and the rate of change (△BNP％) in predicting weaning outcome.Results A total of 56 patients were enrolled in our study,12 in group A,11 in group B and 33 in groupC.In groupC,both△BNPand△BNP％ [7.0,(-1.2,45.5) ng/L;6.1 (-2.1,11.5)％]were significantly lower than those in group A [88.0 (58.0,140.0) ng/L,P ＜ 0.05;20.5 (15.3,40.3) ％,P＜0.001]and group B[46.0 (17.5,91.2) ng/L,P＜0.001;24.3(13.0,32.5) ％,P＜0.001].The area under ROC curve (AUC) of △BNP％ to predict weaning success was 0.88 [95％ CI 0.79-0.97;P ＜0.001] and the cut-off value is 13.4％ with relatively high sensitivity(84.8％)and specificity(82.6％).The AUC of △BNP to predict weaning success was 0.80 [95％ CI 0.69-0.92;P ＜ 0.001] and the cut-off value is 80ng/L with high sensitivity 93.4％ and mediocre specificity (47.9％).Conclusion Either △BNP％ or △BNP in the SBT can predict weaning outcome,in which △BNP％ seems better than △BNP.

Objective:To analyze the implementation of medical emergency team (MET) in Fuxing Hospital of Capital Medical University, and to investigate the characteristics such as the time, department, disease, cause of the MET calls, in order to provide a basis for the improvement of MET's implementation.Methods:A retrospective study was conducted. MET calls that received between January 1st, 2015 and December 31st, 2018 at Fuxing Hospital were collected. The calls' information included the quarter, time, and the patients' gender, age, admission time, department, admission diagnosis, the reason for the calls, the operation and outcome of the MET upon arrival.Results:A total of 846 MET calls were occurred during 4 years from 2015 to 2018. The frequencies of the first and third quarter were relatively high with 28.0% (237/846) and 26.5% (224/846), respectively. The events mainly occurred during the day (08:00-19:59) with 611 calls (72.2%). There were more men [64.3% (544/846)] than women [35.7% (302/846)]. The calls were mainly from the elderly over 60 years old, and gradually increased with age, which distributed the most in patients aging 80-89 years old, accounting for 51.5% of all calls (436/846). Among all the MET events, 80.5% (681/846) were from department of internal medicine, 18.8% (159/846) were from department of surgery, and 0.7% (6/846) were from department of gynecology and obstetrics. The top 3 diseases reported in the calls were respiratory diseases [31.6% (267/846)], nervous system diseases [20.8% (176/846)] and circulatory diseases [9.9% (84/846)]. The reason of MET calls showed that abnormal pulse oxygen saturation [SpO 2, 27.8% (235/846)] were the most among 4 vital signs. After MET rescue, 7.3% (62/846) of the patients died, 48.7% (412/846) were transferred to intensive care unit (ICU) for further treatment, and 41.9% (354/846) remained under observation. Conclusions:The frequency of MET calls in Fuxing Hospital of Capital Medical University was relatively stable over the years, mostly received in the daytime (08:00-19:59) of the first and third quarter. Most of the patients were male aged 80-89 years old. The most MET calls were from department of internal medicine and due to respiratory disease. SpO 2 was the most common abnormal indicator. According to the above characteristics, MET can focus on them in the future.

Objective:To investigate the effect of exposure to occupational hazard factors on serum bilirubin in workers.Methods:In April 2019, using cluster sampling method 5 433 workers exposed to occupational hazard factors from July 2017 to March 2019 were screened out by questionnaire and laboratory test, the date of serum bilirubin were used by the logistic regression analysis of single factor card test and wilcoxon band symbol rank and test.Results:The bilirubin decreases with age, is higher in male than in female, the han is higher than the uygur, and the unmarried workers is higher than the married one, there was significant difference in the levels of bilirubin between different genders, ages, ethnic groups and marriages ( P<0.01) . There were statistically significant differences in bilirubin among the occupational hazard factors ( P<0.01) , the bilirubin level is highest in the exposure to physical factors, followed by chemical factors and dust. The multivariate logistic regression analysis showed that the dust was the main factor affecting bilirubin ( ORdusr/TBIL=2.080, 95% CI: 1.542~2.807, P<0.01) . Abnormal alanine aminotransferase (ALT) and alanine aminotransferase (AST) are consistent with elevated bilirubin. Conclusion:Exposure to occupational hazard factors may lead to elevated serum bilirubin and abnormal liver function transaminase, the prevention and control of occupational hazards and cccupational health monitoring should be strengthened.

Objective:To investigate the effect of exposure to occupational hazard factors on serum bilirubin in workers.Methods:In April 2019, using cluster sampling method 5 433 workers exposed to occupational hazard factors from July 2017 to March 2019 were screened out by questionnaire and laboratory test, the date of serum bilirubin were used by the logistic regression analysis of single factor card test and wilcoxon band symbol rank and test.Results:The bilirubin decreases with age, is higher in male than in female, the han is higher than the uygur, and the unmarried workers is higher than the married one, there was significant difference in the levels of bilirubin between different genders, ages, ethnic groups and marriages ( P<0.01) . There were statistically significant differences in bilirubin among the occupational hazard factors ( P<0.01) , the bilirubin level is highest in the exposure to physical factors, followed by chemical factors and dust. The multivariate logistic regression analysis showed that the dust was the main factor affecting bilirubin ( ORdusr/TBIL=2.080, 95% CI: 1.542~2.807, P<0.01) . Abnormal alanine aminotransferase (ALT) and alanine aminotransferase (AST) are consistent with elevated bilirubin. Conclusion:Exposure to occupational hazard factors may lead to elevated serum bilirubin and abnormal liver function transaminase, the prevention and control of occupational hazards and cccupational health monitoring should be strengthened.

Objective:To explore the accuracy of array comparative genomic hybridization(aCGH) in the unexpected detection of Duchenne muscular dystrophy ( DMD) gene duplication/deletion in prenatal diagnosis. Methods:A retrospective analysis was performed on 31 cases with DMD gene duplication/deletion detected by aCGH among 5 025 prenatal diagnosis samples without family history of DMD in Henan Provincial People's Hospital from July 2018 to December 2019. The multiplex ligation-dependent probe amplification (MLPA) method was used to verify the above results. The American College of Medical Genetics and Genomics (ACMG) guideline was referred for pathogenicity analysis of the detected duplicates/deletions. Descriptive analysis was adopted in analysis. Results:The total unexpected DMD gene duplication/deletion rate was 0.62% (31/5 025), among which 25 cases were with microduplication/microdeletion ≤ 200 kb and six were >200 kb; there were 24 cases of deletion, seven cases of duplication; exon or intron duplication/deletion were accounted for 19 and 12 cases, respectively. According to the five classification standards of ACMG guideline, there were 17 cases with pathogenic variants and 14 cases with uncertain pathogenicity/likely benign variants. Of the 19 with exon mutations, 17 cases were DMD intragenic variants, and two cases involved variants in and outside DMD gene, which were verified by MLPA whose results were all positive. Conclusions:The duplication/deletion of exon region of DMD gene detected by aCGH technique is accurate and reliable, which plays an important role in the diagnosis of DMD. For these cases involved both internal and external regions of DMD gene, aCGH can identify the upstream and downstream breaking points of DMD gene, thus providing the basis for ACMG grading.

AIM: To investigate the efficacy and safety of ZKY001 eye drops with different concentrations in the treatment of corneal epithelial defects(CED)after primary pterygium excision.METHODS: This was a multicenter, randomized, double-blinded, placebo-controlled phase II clinical trial. From March 15, 2022 to November 14, 2022, patients with primary pterygium who had undergone surgery were recruited from 12 tertiary hospitals across China. Using block randomization, 178 patients(178 eyes)were randomly assigned to 3 groups in a 1:1:1 ratio: 0.002% ZKY001 group(n=59), 0.004% ZKY001 group(n=59), and placebo group(n=60, receiving ZKY001 sham eye drops). Subjects in each group received 1 drop of the study drug 4 times per day for 4 d. The percentage of CED area recovery from baseline, the first complete healing time of CED area, the number of first complete healing cases of CED, and changes in visual analogue scale(VAS)scores for eye discomfort including eye pain, foreign body sensation, tearing and photophobia were observed.RESULTS: In terms of improvement in CED, there were no statistically significant differences among the three groups including the first healing time of CED, the percentage improvement in CED area compared to baseline, and the percentage of first healing cases at different follow-up visits(all P>0.05). Numerically, the first healing time of CED was shorter in the test groups compared to the placebo group(67.87±21.688 h for the 0.002% ZKY001 group, 61.48±22.091 h for the 0.004% ZKY001 group, and 68.85±20.851 h for the placebo group). On D1 morning, the percentage improvement in CED area compared to baseline was maximally different from the placebo group, and the numerical difference advantage was maintained at subsequent follow-up visits. The number of first healing cases in the CED area at different follow-up visits was higher in the test groups than the placebo group. In terms of improvement in ocular discomfort, the total VAS scores were lower in the test groups compared to the placebo group, mainly due to reductions in foreign body sensation and pain scores. At D3, the 0.004% ZKY001 group showed statistically significant improvement in foreign body sensation(P<0.017). In terms of safety, the overall incidence of adverse events was low(9.0%)and similar among groups.CONCLUSION: The use of ZKY001 eyedrops after primary pterygium surgery can safely improve the CED repair, and alleviate postoperative symptoms caused by CED.