OBJECTIVES: To study the clinical value of intestinal regional oxygen saturation (rSO₂) and C-reactive protein (CRP) in the diagnosis of necrotizing enterocolitis (NEC) in preterm infants. METHODS: A prospective observational study was conducted among the preterm infants who were hospitalized in Children's Hospital Affiliated to Anhui Medical University, from October 2020 to December 2021, with 22 infants in the NEC group and 35 infants in the non-NEC group. Intestinal rSO₂ was monitored 24 hours after a confirmed diagnosis of NEC in the NEC group, and serum CRP levels were measured before anti-infection therapy. In the non-NEC group, intestinal rSO₂ monitoring and serum CRP level measurement were performed at the corrospording time points. The two groups were compared in terms of intestinal rSO₂ and serum CRP level. The receiver operating characteristic (ROC) curve was used to analyze the value of intestinal rSO₂ alone, serum CRP alone, and intestinal rSO₂ combined with CRP in the diagnosis of NEC in preterm infants. RESULTS: Compared with the non-NEC group, the NEC group had a significantly lower level of intestinal rSO₂ (P<0.05) and a higher serum CRP level (P<0.05). The ROC curve analysis showed that intestinal rSO₂ had an optimal cut-off value of 50.75% in the diagnosis of NEC in preterm infants, with a sensitivity of 81.8%, a specificity of 85.7%, and an area under the ROC curve (AUC) of 89.4%; CRP had an optimal cut-off value of 12.05 mg/L in the diagnosis of NEC in preterm infant, with a sensitivity of 72.7%, a specificity of 74.3%, and an AUC of 74.8%; intestinal rSO₂ combined with CRP had a sensitivity of 90.9%, a specificity of 77.1%, and an AUC of 91.9% in the diagnosis of NEC. The AUC of intestinal rSO₂ alone in the diagnosis NEC was higher than that of CRP (P<0.05). There was no significant difference in the AUC between intestinal rSO₂ alone and intestinal rSO₂ combined with CRP (P>0.05). CONCLUSIONS The value of intestinal rSO₂ in the diagnosis NEC is higher than that of CRP, and is equivalent to that of the combination of intestinal rSO₂ and CRP in preterm infants.
Infant ; Child ; Infant, Newborn ; Humans ; Enterocolitis, Necrotizing/diagnosis* ; Infant, Premature ; C-Reactive Protein/analysis* ; Oxygen Saturation ; Infant, Newborn, Diseases

Oxygen reserve index (ORI) is a novel dimensionless index used for noninvasive, real-time, and continuous monitoring of oxygenation, and ORI value ranges from 0 to 1, which reflects the range of 100-200 mmHg for arterial partial pressure of oxygen. ORI combined with pulse oximetry may help to accurately adjust the concentration of inspired oxygen and prevent hyperoxemia and hypoxemia. ORI is suitable for various clinical situations, and the medical staff should master this novel parameter and use it properly to assess the oxygenation of patients. In addition, several limitations of ORI should be noticed during clinical application.
Humans ; Oxygen ; Blood Gas Analysis ; Oxygen Inhalation Therapy ; Oximetry ; Hypoxia/therapy*

BACKGROUND: The 2019 novel coronavirus has caused the outbreak of the acute respiratory disease in Wuhan, Hubei Province of China since December 2019. This study was performed to analyze the clinical characteristics of patients who succumbed to and who recovered from 2019 novel coronavirus disease (COVID-19). METHODS: Clinical data were collected from two tertiary hospitals in Wuhan. A retrospective investigation was conducted to analyze the clinical characteristics of fatal cases of COVID-19 (death group) and we compare them with recovered patients (recovered group). Continuous variables were analyzed using the Mann-Whitney U test. Categorical variables were analyzed by χ test or Fisher exact test as appropriate. RESULTS: Our study enrolled 109 COVID-19 patients who died during hospitalization and 116 recovered patients. The median age of the death group was older than the recovered group (69 [62, 74] vs. 40 [33, 57] years, Z = 9.738, P < 0.001). More patients in the death group had underlying diseases (72.5% vs. 41.4%, χ = 22.105, P < 0.001). Patients in the death group had a significantly longer time of illness onset to hospitalization (10.0 [6.5, 12.0] vs. 7.0 [5.0, 10.0] days, Z = 3.216, P = 0.001). On admission, the proportions of patients with symptoms of dyspnea (70.6% vs. 19.0%, χ = 60.905, P < 0.001) and expectoration (32.1% vs. 12.1%, χ = 13.250, P < 0.001) were significantly higher in the death group. The blood oxygen saturation was significantly lower in the death group (85 [77, 91]% vs. 97 [95, 98]%, Z = 10.625, P < 0.001). The white blood cell (WBC) in death group was significantly higher on admission (7.23 [4.87, 11.17] vs. 4.52 [3.62, 5.88] ×10/L, Z = 7.618, P < 0.001). Patients in the death group exhibited significantly lower lymphocyte count (0.63 [0.40, 0.79] vs. 1.00 [0.72, 1.27] ×10/L, Z = 8.037, P < 0.001) and lymphocyte percentage (7.10 [4.45, 12.73]% vs. 23.50 [15.27, 31.25]%, Z = 10.315, P < 0.001) on admission, and the lymphocyte percentage continued to decrease during hospitalization (7.10 [4.45, 12.73]% vs. 2.91 [1.79, 6.13]%, Z = 5.242, P < 0.001). Alanine transaminase (22.00 [15.00, 34.00] vs. 18.70 [13.00, 30.38] U/L, Z = 2.592, P = 0.010), aspartate transaminase (34.00 [27.00, 47.00] vs. 22.00 [17.65, 31.75] U/L, Z = 7.308, P < 0.001), and creatinine levels (89.00 [72.00, 133.50] vs. 65.00 [54.60, 78.75] μmol/L, Z = 6.478, P < 0.001) were significantly higher in the death group than those in the recovered group. C-reactive protein (CRP) levels were also significantly higher in the death group on admission (109.25 [35.00, 170.28] vs. 3.22 [1.04, 21.80] mg/L, Z = 10.206, P < 0.001) and showed no significant improvement after treatment (109.25 [35.00, 170.28] vs. 81.60 [27.23, 179.08] mg/L, Z = 1.219, P = 0.233). The patients in the death group had more complications such as acute respiratory distress syndrome (ARDS) (89.9% vs. 8.6%, χ = 148.105, P < 0.001), acute cardiac injury (59.6% vs. 0.9%, χ = 93.222, P < 0.001), acute kidney injury (18.3% vs. 0%, χ = 23.257, P < 0.001), shock (11.9% vs. 0%, χ = 14.618, P < 0.001), and disseminated intravascular coagulation (DIC) (6.4% vs. 0%, χ = 7.655, P = 0.006). CONCLUSIONS Compared to the recovered group, more patients in the death group exhibited characteristics of advanced age, pre-existing comorbidities, dyspnea, oxygen saturation decrease, increased WBC count, decreased lymphocytes, and elevated CRP levels. More patients in the death group had complications such as ARDS, acute cardiac injury, acute kidney injury, shock, and DIC.
Adult ; Aged ; Aged, 80 and over ; Betacoronavirus ; C-Reactive Protein ; analysis ; Coronavirus Infections ; complications ; mortality ; Female ; Humans ; Male ; Middle Aged ; Oxygen ; blood ; Pandemics ; Pneumonia, Viral ; complications ; mortality ; Retrospective Studies

simultaneous monitoring of blood flow and changes of concentration of oxyhemoglobin (ΔHbO) in brain is a key important method for the research of cerebrovascular disease. In this study, a new monitoring system, combining laser speckle contrast imaging method and spectral analysis method, was proposed, which could be utilized to measure the cerebral blood flow and ΔHbO on mice during traumatic brain injury. The principle of the present system was studied and the hardware platform of the detection system was built. Then, user interface software and algorithms were implemented based on Labview and Matlab software. Finally, the performance of the present system was verified by the experiments.
Algorithms ; Animals ; Blood Gas Analysis ; instrumentation ; Brain ; Cerebrovascular Circulation ; Lasers ; Mice ; Oxygen ; analysis

The aim of this study was to determine the effects of extremely low frequency electromagnetic field (ELF-EMF) on energy metabolism and oxidative stress in Caenorhabditis elegans (C. elegans). Worms in three adult stages (young adult stage, egg-laying stage and peak egg-laying stage) were investigated under 50 Hz, 3 mT ELF-EMF exposure. ATP levels, ATP synthase activity in vivo, reactive oxygen species (ROS) content, and changes of total antioxidant capacity (TAC) were detected, and worms' oxidative stress responses were also evaluated under ELF-EMF exposure. The results showed that ATP levels were significantly increased under this ELF-EMF exposure, and mitochondrial ATP synthase activity was upregulated simultaneously. In young adult stage, worms' ROS level was significantly elevated, together with upregulated TAC but with a decreased ROS-TAC score indicated by principal component analysis. ROS level and TAC of worms had no significant changes in egg-laying and peak egg-laying stages. Based on these results, we concluded that ELF-EMF can enhance worm energy metabolism and elicit oxidative stress, mainly manifesting as ATP and ROS level elevation together with ATP synthase upregulation and ROS-TAC score decrease in young adult C. elegans.
Adenosine Triphosphate ; metabolism ; Animals ; Caenorhabditis elegans ; radiation effects ; Electromagnetic Radiation ; Energy Metabolism ; Mitochondrial Proton-Translocating ATPases ; metabolism ; Oxidative Stress ; Reactive Oxygen Species ; analysis

This article describes the design of a portable blood oxygen simulation system that can be used to simulate various blood gas saturation states of the human body. The system can be used to simulate various states of blood gas saturation, and can also simulate large blood oxygen saturation dynamic range, pulse rate range and perfusion index range. It can be used for testing, but not for clinical examination instruments. Moreover, the system has the characteristics of small size and low cost compared with the commercial blood oxygen simulator. Although the simulation system is not directly used for the detection of blood gas saturation of patients, it is also an essential equipment in the production and testing process, so it has certain practical value.
Heart Rate ; Humans ; Oximetry ; instrumentation ; Oxygen ; analysis

Lymphangioleiomyomatosis (LAM) is a rare diffuse cystic lung disease. Knowledge on LAM-related pulmonary hypertension (PH) is limited. This study aimed to analyze the clinical characteristics of LAM with elevated pulmonary artery pressure (PAP) and evaluate the potential efficacy of sirolimus. The study involved 50 LAM patients who underwent echocardiography. According to the tricuspid regurgitation velocity (TRV), these patients were divided into the TRV ⩽ 2.8 m/s group and TRV > 2.8 m/s group. Both groups comprised 25 females with an average age of 38.6 ± 8.1 and 41.5 ± 8.9 years. In the TRV > 2.8 m/s group, the estimated systolic PAP (SPAP) was significantly elevated (52.08 ± 12.45 mmHg vs. 30.24 ± 5.25 mmHg, P < 0.01). Linear analysis showed that SPAP was correlated with forced expiratory volume in 1 s (FEV), diffusing capacity of the lungs for carbon monoxide, alveolar arterial oxygen gradient (PO), and 6 min walking distance (r =-0.392, -0.351, 0.450, and -0.591, respectively; P < 0.05), in which PO was a risk factor for SPAP elevation (β = 0.064, OR = 1.066, P < 0.05). Moreover, in 10 patients who received sirolimus therapy, SPAP decreased from 57.0 12.6 mmHg to 35.2 ± 11.1 mmHg. The study showed that LAM patients with PH exhibit poor pulmonary function and hypoxemia and may benefit from sirolimus treatment.
Adult ; Carbon Monoxide ; analysis ; Echocardiography ; Exercise Test ; Female ; Hemodynamics ; Humans ; Hypertension, Pulmonary ; physiopathology ; therapy ; Logistic Models ; Lymphangioleiomyomatosis ; physiopathology ; therapy ; Male ; Middle Aged ; Multivariate Analysis ; Oxygen ; blood ; therapeutic use ; Respiratory Function Tests ; Sirolimus ; therapeutic use

OBJECTIVE: To investigate the development and characterizations of the hepatocytes isolated from fetal ovine and to determine the effect of hypoxia on their growth and metabolism. METHODS: Fresh hepatocytes were isolated from the liver of fetal ovine at late gestation, cultured in specific media, and exposed to normoxia (21% O2) or hypoxia (2% O2). The cellular characteristics and population purity were identified by immunocytochemistry and flow cytometry (FCM). The effects of hypoxia on cell cycle and apoptosis of the hepatocytes were evaluated by FCM, whereas the cellular ultrastructure changes were examined with a transmission electron microscope. RESULTS: The cell purity of hepatocytes was over 95%. Under hypoxia exposure, the hepatocytes showed a gradual increase in proportion at the S phase and in proliferative index, followed with a compatible increase in apoptosis and progressively decreased cell viability. Additionally, the organelles of the hepatocytes demonstrated dramatic changes, including swelling of mitochondria, disorder in cristae arrangement, expansion of endoplasmic reticulum, and a large number of circular lipid droplets emerging in the cytoplasm. CONCLUSION Fetal ovine hepatocytes could be primarily cultured in a short-term culture system with a high purity of over 95% and with their preserved original characteristics. Hypoxia could induce changes in ultrastructural and inhibit the proliferation of cultured fetal ovine hepatocytes through apoptotic mechanisms.
Anaerobiosis ; Animals ; Cell Culture Techniques ; Fetus ; physiology ; Hepatocytes ; physiology ; Oxygen ; analysis ; Sheep ; physiology

OBJECTIVE: To investigate the effects of salvianolic acid A (SAA) on cardiomyocyte apoptosis and mitochondrial dysfunction in response to hypoxia/reoxygenation (H/R) injury and to determine whether the Akt signaling pathway might play a role. METHODS: An in vitro model of H/R injury was used to study outcomes on primary cultured neonatal rat cardiomyocytes. The cardiomyocytes were treated with 12.5, 25, 50 μg/mL SAA at the beginning of hypoxia and reoxygenation, respectively. Adenosine triphospate (ATP) and reactive oxygen species (ROS) levels were assayed. Cell apoptosis was evaluated by flow cytometry and the expression of cleaved-caspase 3, Bax and Bcl-2 were detected by Western blotting. The effects of SAA on mitochondrial dysfunction were examined by determining the mitochondrial membrane potential (△Ψm) and mitochondrial permeability transition pore (mPTP), followed by the phosphorylation of Akt (p-Akt) and GSK-3β (p-GSK-3β), which were measured by Western blotting. RESULTS: SAA significantly preserved ATP levels and reduced ROS production. Importantly, SAA markedly reduced the number of apoptotic cells and decreased cleaved-caspase 3 expression levels, while also reducing the ratio of Bax/Bcl-2. Furthermore, SAA prevented the loss of △Ψm and inhibited the activation of mPTP. Western blotting experiments further revealed that SAA significantly increased the expression of p-Akt and p-GSK-3β, and the increase in p-GSK-3β expression was attenuated after inhibition of the Akt signaling pathway with LY294002. CONCLUSION SAA has a protective effect on cardiomyocyte H/R injury; the underlying mechanism may be related to the preservation of mitochondrial function and the activation of the Akt/GSK-3β signaling pathway.
Adenosine Triphosphate ; analysis ; Animals ; Animals, Newborn ; Caffeic Acids ; pharmacology ; Cell Hypoxia ; Cells, Cultured ; Glycogen Synthase Kinase 3 beta ; physiology ; Lactates ; pharmacology ; Mitochondria, Heart ; drug effects ; physiology ; Mitochondrial Membrane Transport Proteins ; drug effects ; Myocytes, Cardiac ; drug effects ; Proto-Oncogene Proteins c-akt ; physiology ; Rats ; Rats, Sprague-Dawley ; Reactive Oxygen Species ; metabolism ; Signal Transduction ; physiology

PURPOSE: This study investigated the incidence of adverse events (AEs) and risk factors associated with sedation using chloral hydrate (CH) for brain magnetic resonance imaging (MRI) in the neonatal intensive care unit (NICU). METHODS: This was a retrospective study of infants who received CH for brain MRI in the NICU. Among the enrolled infants (n=143), 12.6% (n=18) were included in the AE group and 87.4% (n=125) were in the non-adverse event group (NAE). RESULTS: Gestational age (GA) at birth and corrected GA at sedation were 35+0±7+2 and 39+5±3+1 respectively. The rate of AEs was 12.6%, included oxygen desaturation (5.6%), aspiration (4.9%), paradoxical agitation (0.7%), tachycardia or bradycardia (0.7%), and arrest (0.7%). In univariate analysis, the AE group was younger in corrected GA at sedation than the NAE group (37+2 [range, 36+0 to 40+0] vs. 40+1 [range, 38+2 to 41+4], P=0.015). There was no significant difference in CH dosage (50.0 [range, 50.0 to 50.0] vs. 50.0 [range, 50.0 to 50.0], P=0.092), cardiopulmonary (33.3% [n=6] vs. 17.6% [n= 22], P=0.209) and central nervous system (61.1% [n=11] vs. 65.6% [n=82], P=0.054) morbidity. In multivariate analysis, CH dosage was the only significant risk factor for AEs associated with sedation (odds ratio, 1.04; 95% confidence interval, 1.01 to 1.07; P=0.0186). CONCLUSION: AEs associated with sedation using CH are not uncommon and should be considered when using high dose CH for diagnostic testing in the NICU.
Bradycardia ; Brain ; Central Nervous System ; Chloral Hydrate ; Diagnostic Tests, Routine ; Dihydroergotamine ; Gestational Age ; Humans ; Incidence ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Magnetic Resonance Imaging ; Multivariate Analysis ; Oxygen ; Parturition ; Retrospective Studies ; Risk Factors ; Tachycardia