OBJECTIVE To investigate the application of metagenomic next-generation sequencing(mNGS)of bron-choalveolar lavage fluid(BALF)in the detection of pathogens of pulmonary infection.METHODS The clinical data of 98 patients with pulmonary infections admitted to NO.2 People's Hospital of Fuyang City from Jan.2023 to Jan.2024 were retrospectively analyzed,mNGS and traditional pathogenicity test were performed in BALF,and comprehensive clinical judgment(using a combination of alveolar lavage fluid,sputum,blood,etc.to assess)was used as the gold standard to evaluate the differences between mNGS and traditional pathogenicity tests in the path-ogenic diagnosis of pulmonary infections,compare the pathogen detection rates in pulmonary infections complicat-ed with underlying diseases,severe and non-severe illness and different infection types,and to analyze the impact on clinical adjustment of anti-infection regimens.RESULTS The positive detection rate of mNGS for pulmonary in-fection pathogens was 88.78％,higher than that of traditional pathogenology(P＜0.001).The time required for mNGS was(16.57±2.64)h,shorter than that of traditional pathogenology(P＜0.05).The positive detection rates of mNGS in patients with and without underlying diseases were 93.02％and 85.45％,respectively,higher than those of traditional pathogenology(P＜0.05).The positive detection rates of mNGS in severe and non-severe patients were 91.43％and 87.30％,respectively,higher than those of traditional pathogenology(P＜0.05).A total of 122 strains of pathogens were detected in 87 patients with positive mNGS tests,and EB virus was not de-tected.A total of 75 strains of pathogens were detected in 54 patients with positive traditional pathogenetic tests,and Neisseria,Rhizopus,parvovirus,and Chlamydia psittaci were not detected.The detection rate of bacteria by mNGS was 58.20％,higher than that by traditional pathogenetic tests(P=0.034).The detection rates of mNGS test for monotypic infection and mixed infection were 85.51％and 93.10％,respectively,higher than those by traditional pathogenetic test(P＜0.05).In pulmonary infections,mNGS guided adjustment of anti-infective treat-ment in 53.06％of patients,60.47％of those in the group with underlying pulmonary disease,and 47.27％of those without underlying disease(P=0.194).Among severe cases,68.57％had their anti-infective treatment plan adjusted,compared to 44.44％of non-severe patients(P=0.022).CONCLUSION The mNGS of BALF idenfies some rare pathogens,improves the detection rate of pathogens in pulmonary infections,and may guide the clinical adjustment of anti-infective strategies.

OBJECTIVE To investigate the application of metagenomic next-generation sequencing(mNGS)of bron-choalveolar lavage fluid(BALF)in the detection of pathogens of pulmonary infection.METHODS The clinical data of 98 patients with pulmonary infections admitted to NO.2 People's Hospital of Fuyang City from Jan.2023 to Jan.2024 were retrospectively analyzed,mNGS and traditional pathogenicity test were performed in BALF,and comprehensive clinical judgment(using a combination of alveolar lavage fluid,sputum,blood,etc.to assess)was used as the gold standard to evaluate the differences between mNGS and traditional pathogenicity tests in the path-ogenic diagnosis of pulmonary infections,compare the pathogen detection rates in pulmonary infections complicat-ed with underlying diseases,severe and non-severe illness and different infection types,and to analyze the impact on clinical adjustment of anti-infection regimens.RESULTS The positive detection rate of mNGS for pulmonary in-fection pathogens was 88.78％,higher than that of traditional pathogenology(P＜0.001).The time required for mNGS was(16.57±2.64)h,shorter than that of traditional pathogenology(P＜0.05).The positive detection rates of mNGS in patients with and without underlying diseases were 93.02％and 85.45％,respectively,higher than those of traditional pathogenology(P＜0.05).The positive detection rates of mNGS in severe and non-severe patients were 91.43％and 87.30％,respectively,higher than those of traditional pathogenology(P＜0.05).A total of 122 strains of pathogens were detected in 87 patients with positive mNGS tests,and EB virus was not de-tected.A total of 75 strains of pathogens were detected in 54 patients with positive traditional pathogenetic tests,and Neisseria,Rhizopus,parvovirus,and Chlamydia psittaci were not detected.The detection rate of bacteria by mNGS was 58.20％,higher than that by traditional pathogenetic tests(P=0.034).The detection rates of mNGS test for monotypic infection and mixed infection were 85.51％and 93.10％,respectively,higher than those by traditional pathogenetic test(P＜0.05).In pulmonary infections,mNGS guided adjustment of anti-infective treat-ment in 53.06％of patients,60.47％of those in the group with underlying pulmonary disease,and 47.27％of those without underlying disease(P=0.194).Among severe cases,68.57％had their anti-infective treatment plan adjusted,compared to 44.44％of non-severe patients(P=0.022).CONCLUSION The mNGS of BALF idenfies some rare pathogens,improves the detection rate of pathogens in pulmonary infections,and may guide the clinical adjustment of anti-infective strategies.

Objective To investigate changes of peripheral blood eosinophils(EOS),D-dimer(D-D)and neutrophil/lymphocyte ratio(NLR)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and their relationship with pulmonary ventilation function.Methods Sixty-five AECOPD patients(the observation group)and 65 COPD patients(the control group)were selected respectively and included in this study.Basic data were collected in the two groups of patients,and laboratory indexes were examined.EOS and D-D levels were determined,and NLR was calculated.The lung function indexes including the first second expiratory volume with exertion(FEV1),the first second expiratory volume with exertion as a percentage of expiratory lung capacity with exertion(FEV1/FVC),and blood gas indexes of arterial blood partial pressure of oxygen[p(O2)]and arterial blood partial pressure of carbon dioxide[p(CO2)]were detected.Multifactorial Logistic regression was used to analyze the influencing factors of AECOPD.The nomogram model of AECOPD was established and verified by R4.2.3.Results Compared with the control group,levels of EOS,D-D and NLR were elevated,and FEV1 and FEV1/FVC levels were reduced in the observation group(P＜0.05).Multifactorial Logistic regression analysis showed that elevated EOS,D-D and NLR,and reduced FEV1/FVC and FEV1 were independent risk factors for patients with AECOPD(P＜0.05).The area under the receiver operating characteristic(ROC)curve of AECOPD nomogram model was 0.817(95%CI:0.784-0.904),and the Hosmer-Lemeshow test showed goodness of fit of the model(χ2=4.320,P＞0.05).EOS,D-D and NLR were positively correlated with FEV1 and FEV1/FVC(P＜0.05).Conclusion The elevated levels of EOS,D-D and NLR are risk factors that affect pulmonary ventilation in AECOPD patients,which can be used as an important indicator to evaluate pulmonary ventilation function.

Objective:To analyze the clinical characteristics of critical patients with coronavirus disease 2019 (COVID-19), build an early warning model for severe/critical type, and aim at providing reference for the prediction of severe/critical COVID-19.Methods:The clinical data of COVID-19 patients treated in the Second People' Hospital of Fuyang City from January 20th to February 18th in 2020 were retrospective analyzed, including the demographic and epidemiological date, vital signs and hematology indexes, etc. on admission. Patients were divided into the normal type (set as normal group) and severe/critical type (set as severe group) according to the COVID-19 treatment plan classification standard published by National Health Commission of the People's Republic of China. The differences between two groups were compared, and the variables with statistical significance were incorporated in the multivariate binary unconditional Logistic regression analysis to screen the risk factors of severe/critical type. Risk factors were summarized to establish an early warning model, and the receiver operating characteristic (ROC) curve was carried out to evaluate the significance of the early warning model in the screening of critically COVID-19.Results:A total of 155 patients with COVID-19 were admitted, including 125 patients of normal type and 30 patients of severe/critical type. ① Compared with normal group, patients in severe group were older, and with higher proportion of basic diseases, higher body mass index (BMI), higher incidence of tachypnea, persistent high fever, peripheral blood oxygen saturation (SpO 2) < 0.95, while the white blood cell count (WBC), CD4 + T lymphocyte, CD8 + T lymphocyte, lymphocyte count (LYM) were decreased obviously, the levels of interleukin-6 (IL-6), C-reactive protein (CRP) and serum amyloid a protein (SAA), and CT showed higher incidence of multi-pulmonary lobe lesions. There were no significant differences of gender, travel history from Wuhan, smoking history, shock index (SI) and CD4 +/CD8 + ratio between the two groups. ② Multivariate Logistic regression analysis showed that age ≥60 years old [odds ratio ( OR) = 1.620, P = 0.031], combined with underlying diseases ( OR = 1.521, P = 0.044), persistent high fever ( OR = 2.469, P = 0.014), WBC < 2.0×10 9/L and/or LYM < 0.4×10 9/L ( OR = 3.079, P = 0.006), pulmonary multilobar lesions ( OR = 1.367, P = 0.047), and IL-6 ≥ 30 ng/L ( OR = 2.426, P = 0.010) were the risk factors of severe/critical COVID-19. ③ The OR value corresponding to each risk factors were scored by rounding. Two points were scored for age≥60 years old, with underlying diseases, persistent high fever and IL-6 ≥ 30 ng/L, 3 points for WBC < 2.0×10 9/L and/or LYM < 0.4×10 9/L, 1 point for pulmonary multilobar lesions, and totally calculated as early warning model scores. The early warning model score of the severe group was significantly higher than that of the normal group (9.33±2.79 vs. 5.04±2.38, t = 9.010, P = 0.001). ④ The ROC curve analysis showed the area under ROC curve (AUC) of early warning model on the early screening of severe/critical patients in COVID-19 was 0.944, and 95% confidence interval (95% CI) was 0.903-0.985; and the sensitivity and specificity were 93.3% and 72.0% respectively while the cut-off was 6.5. Conclusions:There are many differences between severe/critical and mild COVID-19 patients. The establishment of early warning model could help to screen severe/critical patients at an early stage, with certain significance for guiding treatment.

Objective:To analyze the effects of hyperbaric oxygen combined with respiratory muscle training on respiratory function and quality of life in stroke patients.Methods:A total of 100 stroke patients admitted to the Department of Neurology of Yantai Mountain Hospital from May 2016 to January 2019 were selected as the research objects. According to the method of random number table, the patients were divided into the combined group (50 cases) and the control group (50 cases). The combined group was given hyperbaric oxygen combined with respiratory muscle training, and the control group was only given respiratory muscle training. The clinical efficacy, respiratory function, arterial blood gas analysis index, quality of life, and adverse reactions were compared between the two groups.Results:The total clinical effective rate of the combined group after hyperbaric oxygen combined with respiratory muscle training was 82.00%, which was significantly higher than that (60.00%) of the control group ( P<0.05). After treatment, the forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and maximum ventilation volume (MVV) of the two groups were significantly higher than those before treatment ( P<0.01); furthermore, those of the combined group were significantly higher than those of the control group, and the differences were statistically significant ( P<0.01). After treatment, arterial oxygen partial pressure(PaO 2), arterial oxygen saturation(SaO 2), and oxygenation index(OI) of the two groups were all significantly higher than those before treatment( P<0.05), and those of the combined group were significantly higher than those of the control group ( P<0.01); the lactic acid(Lac) levels in both groups were significantly lower than those before treatment, and the Lac level in the combined group was significantly lower than that in the control group ( P<0.01). After treatment, The quality of life index (QL-Index) scores of the two groups were significantly higher than those before treatment ( P<0.05), and those of the combined group were significantly higher than those of the control group, and the differences were statistically significant ( P < 0.01). There was no statistically significant difference in the incidence of adverse reactions between the two groups ( P > 0.05). Conclusion:Hyperbaric oxygen combined with respiratory muscle training in the treatment of stroke patients can promote early rehabilitation of the patients, improve respiratory function, and significantly improve their quality of daily life, and thus this therapy is worthy of popularization and application in clinic.

Objective:To explore the effects of hyperbaric oxygen (HBO) combined with warming needle moxibustion on the improvement of physical function, joint range of motion, and inflammatory factors in patients with ankylosing spondylitis (AS).Methods:A total of 128 AS patients admitted to the Department of Traditional Chinese Medicine of Yantai Mountain Hospital from June 2017 to December 2018 were selected as the study objects and randomly divided into control group ( n=64) and observation group ( n=64). The control group was given conventional treatment combined with warming needle moxibustion, and the observation group was given HBO on the basis of the treatments in the control group. The physical function of the patients was assessed by using the Bath Ankylosing Spondylitis Functional Index (BASFI), and the visual analogue scale (VAS) score was included to jointly evaluate the lumbosacral back pain and joint pain. The Bath Ankylosing Spondylitis Metrology Index (BASMI) was used to assess joint range of motion, and the enzyme linked immunosorbent assay (ELISA) was used to detect the changes in inflammatory factor levels before and after treatment. Results:After treatment, the physical function and the severity of pain of the patients in both groups were significantly improved compared with those before treatment ( P<0.05), and the BASFI and VAS scores of the observation group were significantly lower than those of the control group ( P<0.05). Meanwhile, the test results of thoracic range of motion, Schober test, fingertips to floor distance, lumbar lateral flexion, extension of the lumbar spine, and occiput to wall distance were all significantly improved, and the improvements of the above tests in the observation group wee all greater than those in the control group, all with statistically significant differences ( P<0.05). The levels of inflammatory factors, such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and tumor necrosis factor-α (TNF-α) significantly decreased ( P<0.05), moreover, the levels of those factors in the observation group were all lower than those in the control group, all with statistically significant differences ( P<0.05). The total effective rate in the observation group (92.19%) was higher than that in the control group (78.13%), and the difference was statistically significant ( P<0.05). Conclusion:Hyperbaric oxygen combined with warming needle moxibustion can significantly improve the curative effect on AS patients by effectively reducing the levels of inflammatory factors, decreasing the pain, and improving the physical function and joint range of motion, which is worthy of clinical promotion and application.

Objective:To analyze the effects of hyperbaric oxygen combined with respiratory muscle training on respiratory function and quality of life in stroke patients.Methods:A total of 100 stroke patients admitted to the Department of Neurology of Yantai Mountain Hospital from May 2016 to January 2019 were selected as the research objects. According to the method of random number table, the patients were divided into the combined group (50 cases) and the control group (50 cases). The combined group was given hyperbaric oxygen combined with respiratory muscle training, and the control group was only given respiratory muscle training. The clinical efficacy, respiratory function, arterial blood gas analysis index, quality of life, and adverse reactions were compared between the two groups.Results:The total clinical effective rate of the combined group after hyperbaric oxygen combined with respiratory muscle training was 82.00%, which was significantly higher than that (60.00%) of the control group ( P<0.05). After treatment, the forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and maximum ventilation volume (MVV) of the two groups were significantly higher than those before treatment ( P<0.01); furthermore, those of the combined group were significantly higher than those of the control group, and the differences were statistically significant ( P<0.01). After treatment, arterial oxygen partial pressure(PaO 2), arterial oxygen saturation(SaO 2), and oxygenation index(OI) of the two groups were all significantly higher than those before treatment( P<0.05), and those of the combined group were significantly higher than those of the control group ( P<0.01); the lactic acid(Lac) levels in both groups were significantly lower than those before treatment, and the Lac level in the combined group was significantly lower than that in the control group ( P<0.01). After treatment, The quality of life index (QL-Index) scores of the two groups were significantly higher than those before treatment ( P<0.05), and those of the combined group were significantly higher than those of the control group, and the differences were statistically significant ( P < 0.01). There was no statistically significant difference in the incidence of adverse reactions between the two groups ( P > 0.05). Conclusion:Hyperbaric oxygen combined with respiratory muscle training in the treatment of stroke patients can promote early rehabilitation of the patients, improve respiratory function, and significantly improve their quality of daily life, and thus this therapy is worthy of popularization and application in clinic.

Objective:To explore the effects of hyperbaric oxygen (HBO) combined with warming needle moxibustion on the improvement of physical function, joint range of motion, and inflammatory factors in patients with ankylosing spondylitis (AS).Methods:A total of 128 AS patients admitted to the Department of Traditional Chinese Medicine of Yantai Mountain Hospital from June 2017 to December 2018 were selected as the study objects and randomly divided into control group ( n=64) and observation group ( n=64). The control group was given conventional treatment combined with warming needle moxibustion, and the observation group was given HBO on the basis of the treatments in the control group. The physical function of the patients was assessed by using the Bath Ankylosing Spondylitis Functional Index (BASFI), and the visual analogue scale (VAS) score was included to jointly evaluate the lumbosacral back pain and joint pain. The Bath Ankylosing Spondylitis Metrology Index (BASMI) was used to assess joint range of motion, and the enzyme linked immunosorbent assay (ELISA) was used to detect the changes in inflammatory factor levels before and after treatment. Results:After treatment, the physical function and the severity of pain of the patients in both groups were significantly improved compared with those before treatment ( P<0.05), and the BASFI and VAS scores of the observation group were significantly lower than those of the control group ( P<0.05). Meanwhile, the test results of thoracic range of motion, Schober test, fingertips to floor distance, lumbar lateral flexion, extension of the lumbar spine, and occiput to wall distance were all significantly improved, and the improvements of the above tests in the observation group wee all greater than those in the control group, all with statistically significant differences ( P<0.05). The levels of inflammatory factors, such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and tumor necrosis factor-α (TNF-α) significantly decreased ( P<0.05), moreover, the levels of those factors in the observation group were all lower than those in the control group, all with statistically significant differences ( P<0.05). The total effective rate in the observation group (92.19%) was higher than that in the control group (78.13%), and the difference was statistically significant ( P<0.05). Conclusion:Hyperbaric oxygen combined with warming needle moxibustion can significantly improve the curative effect on AS patients by effectively reducing the levels of inflammatory factors, decreasing the pain, and improving the physical function and joint range of motion, which is worthy of clinical promotion and application.

Objective To investigate the prevention effect of intermittent pneumatic compression pump on DVT in patients undergoing knee joint replacement.Methods A total of 318 patients with knee joint replacement in our hospital were selected as study objects,and 108 cases with routine nursing were as control group,and 210 cases with intermittent pneumatic compression were as observation group.The changes of D-D,PLT and Hb,and DVT of two groups were compared.Results PLT and D-D after 6 d of the operation in the observation group was lower than that in the control group,the difference was statistically significant(P ＜0.05).Venous velocity of lower limb after 6 d of operation in the observation group was quicker than that in the control group,the detection rate of DVT was lower than that in the control group,DVT diameter was less than that in the control group,the differences were statistically significant (P ＜ 0.05).Conclusion Intermittent pneumatic compression pump can reduce PLT,D-D and the incidence of DVT after knee replacement.

Objective To investigate the prevention effect of intermittent pneumatic compression pump on DVT in patients undergoing knee joint replacement.Methods A total of 318 patients with knee joint replacement in our hospital were selected as study objects,and 108 cases with routine nursing were as control group,and 210 cases with intermittent pneumatic compression were as observation group.The changes of D-D,PLT and Hb,and DVT of two groups were compared.Results PLT and D-D after 6 d of the operation in the observation group was lower than that in the control group,the difference was statistically significant(P ＜0.05).Venous velocity of lower limb after 6 d of operation in the observation group was quicker than that in the control group,the detection rate of DVT was lower than that in the control group,DVT diameter was less than that in the control group,the differences were statistically significant (P ＜ 0.05).Conclusion Intermittent pneumatic compression pump can reduce PLT,D-D and the incidence of DVT after knee replacement.