Objective To investigate the predictive value of endotracheal tube cuff pressure change(△Pcuff)on extubation outcome in mechanically ventilated patients with acute exacerbation of chronic obstructive pulmonary diseas(AECOPD).Methods A total of 93 AECOPD patients who underwent mechanical ventilation for at least 48 hours and required extubation through spontaneous breathing trial(SBT)from March 2023 to August 2024 in the Department of Critical Care Medicine of Deyang People's Hospital were selected as study subjects.According to the outcome of extubation,they were divided into successful extubation group and failed extubation group.General clinical data,laboratory results,△Pcuff at the start and at 30min of SBT were compared between two groups.Binary Logistic regression was used to analyze the risk factors affecting the outcome of extubation in AECOPD patients.The predictive value of △Pcuff for extubation outcome was evaluated by receiver operating characteristic(ROC)curve.Results Of the 93 patients,81 were successfully extubed and 12 were failed.Univariate analysis showed that △Pcuff(at the beginning of SBT),△Pcuff(SBT 30min),systolic blood pressure,pH,arterial partial pressure of oxygen,arterial partial pressure of carbon dioxide,and oxygenation index were all factors influencing the outcome of extubation(P＜0.05).Binary Logistic regression analysis showed that △Pcuff(at the beginning of SBT)was an independent risk factor for extubation outcome(P＜0.05).The ROC curve showed that △Pcuff(at the beginning of SBT)predicted extubation outcome with an area under the curve of 0.913,sensitivity of 84.0％,specificity of 83.3％,and Yoden index of 0.673,with an optimal cutoff of 34.5cmH2O(1cmH2O=0.098kPa).Conclusion The △Pcuff(at the beginning of SBT)has a good predictive value for the extubation outcome of mechanically ventilated patients with AECOPD,and the probability of successful extubation of a patient is higher when the △Pcuff is ≥34.5 cmH2O.

Objective To investigate the predictive value of endotracheal tube cuff pressure change(△Pcuff)on extubation outcome in mechanically ventilated patients with acute exacerbation of chronic obstructive pulmonary diseas(AECOPD).Methods A total of 93 AECOPD patients who underwent mechanical ventilation for at least 48 hours and required extubation through spontaneous breathing trial(SBT)from March 2023 to August 2024 in the Department of Critical Care Medicine of Deyang People's Hospital were selected as study subjects.According to the outcome of extubation,they were divided into successful extubation group and failed extubation group.General clinical data,laboratory results,△Pcuff at the start and at 30min of SBT were compared between two groups.Binary Logistic regression was used to analyze the risk factors affecting the outcome of extubation in AECOPD patients.The predictive value of △Pcuff for extubation outcome was evaluated by receiver operating characteristic(ROC)curve.Results Of the 93 patients,81 were successfully extubed and 12 were failed.Univariate analysis showed that △Pcuff(at the beginning of SBT),△Pcuff(SBT 30min),systolic blood pressure,pH,arterial partial pressure of oxygen,arterial partial pressure of carbon dioxide,and oxygenation index were all factors influencing the outcome of extubation(P＜0.05).Binary Logistic regression analysis showed that △Pcuff(at the beginning of SBT)was an independent risk factor for extubation outcome(P＜0.05).The ROC curve showed that △Pcuff(at the beginning of SBT)predicted extubation outcome with an area under the curve of 0.913,sensitivity of 84.0％,specificity of 83.3％,and Yoden index of 0.673,with an optimal cutoff of 34.5cmH2O(1cmH2O=0.098kPa).Conclusion The △Pcuff(at the beginning of SBT)has a good predictive value for the extubation outcome of mechanically ventilated patients with AECOPD,and the probability of successful extubation of a patient is higher when the △Pcuff is ≥34.5 cmH2O.

Objective:To explore the influencing factors for serum concentration of oxcarbazepine active metabolite 10, 11-dihydro-10-hydroxyl carbazepine (MHD), and the effecacy of clinical pharmacists' intervention in administration scheme through serum concentration monitoring.Methods:A total of 96 patients with epilepsy who were treated with oxcarbazepine or oxcarbazepine combined with other drugs in our hospital from August 2017 to December 2021 were selected. Blood samples with monitored MHD concentration during treatment in our hospital in these patients were used as the research objects. Univariate analysis and multivariate linear regression analysis were used to analyze the influence of gender, age, body weight, daily dose of oxcarbamide, liver and kidney functions and medication in serum MHD concentration. For patients with substandard serum MHD concentration or ineffective treatment, clinical pharmacists would intervene the medication regimen and lifestyle; the differences of compliance rate of serum MHD concentration and incidence of adverse reactions were compared between the intervention group and non-intervention group.Results:A total of 190 blood samples were collected from these 96 patients. There was significant difference in serum MHD concentration among samples with different daily doses of oxcarbazepine, different creatinine clearance rate (Ccr), and different medications ( P<0.05). Correlation analysis showed that daily dose of oxcarbazepine was positively correlated with serum MHD concentration ( r=0.655, P<0.001). Multivariate linear regression analysis showed that daily dose of oxcarbazepine ( 95%CI: 0.009-0.014, P<0.001), Ccr ( 95%CI: -0.037-0.007, P=0.005), and combined use of oxcarbazepine with lamotrigine ( 95%CI: 0.526-8.790, P=0.027) or atorvastatin ( 95%CI: 0.213-5.168, P=0.033) were independent influencing factors for serum MHD concentration. For patients whose blood concentration was monitored for the first time, the serum MHD concentration in patients with somnolence and/or dizziness (10.9 [6.7, 14.0] μg/mL) was significantly higher than that in patients without somnolence and/or dizziness (7.5 [5.2, 9.4] μg/mL, P<0.05). The compliance rate of serum MHD in the intervention group (83/85[97.6%]) was statistically higher than that in the non-intervention group (95/105[90.5%]), and the incidence of adverse reactions (11/85[12.9%]) was statistically lower than that in the non-intervention group (28/105[26.7%], P<0.05). Conclusions:The serum MHD concentration is affected by daily dose of oxcarbamide, Ccr, and combined use of oxcarbazepine with lamotrigine or atorvastatin. Clinical pharmacists should be encouraged to participate in clinical drug treatment to achieve better effectiveness and safety of drug treatment.

Objective:To investigate the risk factors of birth weight discordance in dichorionic diamniotic (DCDA) twins.Methods:This study retrospectively analyzed 1 757 cases of DCDA twin pregnancies from 11 Chinese hospitals from January 1, 2014, to December 31, 2017. Birth weight discordance was defined as ≥ 20% difference between the twins. All cases were divided into two groups: the concordant group ( n=1 520) and discordant group ( n=237). General information was compared and the high-risk factors of birth weight discordance were analyzed. Mann-Whitney U test, Chi-square test or Fisher's exact test, and logistic regression analysis were used as statistical methods. Results:Compared with the concordant group, the discordant group showed a higher incidence of hypertensive disorders of pregnancy [24.5% (58/237) vs 12.8% (194/1 520), χ2=22.882, P<0.05], fetal structural malformations [4.2% (10/237) vs 1.0% (15/1 520), χ2=15.160, P<0.05], fetal distress [6.3% (15/237) vs 1.4% (21/1 520), χ2=22.602, P<0.05], umbilical cord abnormalities [3.8% (9/237) vs 1.2% (18/1 520), χ2=7.607, P<0.05] and abnormal placental cord insertion [3.8% (9/237) vs 1.4% (21/1 520), χ2=34.904, P<0.05], but lower incidence of premature rupture of membranes [11.0% (26/237) vs 16.5% (250/1 520), χ2=4.645, P=0.034]. Logistic regression analysis showed that the independent risk factors of birth weight discordance in DCDA twins were hypertensive disorders of pregnancy ( OR=2.258, 95% CI: 1.620-3.184, P<0.001), fetal structural malformations ( OR=4.268, 95% CI: 1.892-9.631, P<0.001), umbilical cord abnormalities ( OR=2.889, 95% CI: 1.245-6.705, P=0.014) and abnormal placental cord insertion ( OR=2.318, 95% CI: 1.012-5.311, P=0.047). Conclusions:Hypertensive disorders of pregnancy, fetal structural malformations, umbilical cord abnormalities and abnormal placental cord insertion may be the risk factors of birth weight discordance in DCDA twins.

Objective To comprehend neonatal fathers′views on breastfeeding and their experience engaging in and supporting breastfeeding,so as to provide theoretical basis for fathers′playing better roles in breastfeeding and promoting breastfeeding.Methods Using phenomenology method,in-depth interviews were conducted to 1 2 neonatal fathers about their experience in their wives′breastfeeding period.Using content analysis method,data were settled,concluded and analyzed.Results In neonatal fathers′experience in breastfeeding period,five themes were extracted,including fuzzy understanding of breastfeeding,tortuous breastfeeding experience,father′s important role in breastfeeding,ways of fathers involving in breastfeeding and professional support fathers required.Conclusions Health professionals in Obstetrical Departments should attach more importance to fathers′role in breastfeeding,give them effective help and professional guidance,so as to strengthen their participation and support in breastfeeding.

Objective To evaluate the effects of breastfeeding intervention on breastfeeding self-efficacy, breastfeeding outcomes among unipara with inverted nipples. Methods From January 2014 to January 2015, 158 patients were sequentially divided into control group and study group. The patients of control group ( n=78 ) received routine care with verbal education about breastfeeding and coaching skill. The patients of study group ( n =80 ) received individualized nursing intervention based on the self-efficacy theory. All the participants completed Breastfeeding self-efficacy scale at discharge, 4 weeks and 8 weeks postpartum. Results At discharge, 4 and 8 weeks postpartum, the mean scores of BSES were (113. 78 ± 16. 91), (121. 20 ± 19. 18), (112. 76 ± 14. 72) and (101. 65 ± 17. 03), (93. 48 ± 14. 01), (98. 65 ± 15. 82) in the study group and control group. The rates of breastfeeding exclusivity were 88. 75%,86. 25%,83. 75% in the study group, higher than 70. 51%,43. 59%,37. 18% in the control group. Among 8 weeks postpartum, the occurrence of galactostasis was lower than that of the control group (P<0. 05), no difference in occurrence of cracked nipple and mastitis (P>0. 05). Conclusions The intervention aimed at increasing self-efficacy can improve maternal breastfeeding self-efficacy and breastfeeding outcomes.

Novel optical materials are crucial for environmental monitoring. Metal nanoclusters ( metal NCs) , typically consisting of several to tens of metal atoms, have attracted more and more attention for recent years. Due to their ultrasmall size, strong fluorescence, low toxicity, excellent stability and unique core-shell structure, metal NCs have been considered as promising optical materials for the construction of excellent fluorescent sensors. In this review, we mainly focus on the recent progress in their applications in environmental monitoring, including the detection of pH, heavy metal ions, inorganic anions and nitroaromatic explosives.

Objective To investigate the association between gene polymorphism of plasminogen activator inhibitor (PAI-1)and ischemic cerebrovascular disease in aged people of Henan Han nationality.Methods A case control method was used,including 408 patients with ischemic cerebrovascular disease and 418 age and gender matched healthy controls.Polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) method was used to determine the distribution of allele and genotype frequencies of PAI-1 844G/A.Results In patient group,the gene frequencies of AA,AG,GG were 18.1％,41.4％,40.4％,and the A and G allele frequencies were 38.8％ and 61.2％,respectively.In the control group,the gene frequencies of AA,AG,GG were 15.8％,47.4％,36.8％,and the A and G allele frequencies were 39.5％ and 60.5％.There were no significant differences in the frequencies of genotypes and alleles between the two groups (P＞0.05).The different genotypes of 844G/A of PAI-1 gene were not associated with hypertension,hyperglycemia,plasma homocysteic acid levels (P ＞ 0.05).Conclusions PAI-1 gene-844G/A polymorphism may not be independent risk factor of ischemic cerebrovascular disease in aged people of Henan Han nationality.

OBJECTIVE: To purify and identify HMGB1 secreted by liver cells HepG2 and immune cells U937. METHODS: We cultured the liver cell lines HepG2 and immune cell lines U937, and stimulated them with HMGB1 (400 ng/mL) for 20 h. Then the supernatant was collected. Ultrafiltration centrifugation, CM-Sepharose cation, DEAE-Sepharose anion exchange chromatography, Sephadex G75-gel filtration chromatography, and immunoprecipitation were used for purification. The molecular weight and identity of HMGB1 was confirmed by SDS-PAGE and Western blot. RESULTS: A sharp stained protein band with a molecular weight of about 26 kD was obtained by SDS-PAGE analysis and shown to be HMGB1 confirmed by Western blot. CONCLUSION High purified HMGB1 can be separated from these two cell lines.
Cell Culture Techniques ; Electrophoresis, Polyacrylamide Gel ; methods ; HMGB1 Protein ; isolation & purification ; metabolism ; Hep G2 Cells ; Hepatocytes ; metabolism ; Humans ; Monocytes ; metabolism ; U937 Cells

Objective To explore the dynamic changes of serum S100B and glial fibrillary acidic protein (GFAP) levels and their clinical significance in patients with delayed encephalopathy after acute carbon monoxide poisoning (DEACMP).Methods By means of enzyme-linked immunno-sorbent assay (ELISA),the serum S100B and GFAP levels from 33 DEACMP patients were assayed,and the condition changes were analyzed with three types of scale:the activity of daily living scale ( ADL),information-memory-concentration test (IMCT) and Hasegawa' s dementia scale(HDS).The comparison with 32 patients of acute carbon monoxide poisoning without DEACMP was also conducted.Results (1) The serum S100B( (0.60 ±0.21)ng/ml) and GFAP( (226.58 ±90.05 )ng/ml) in DEACMP group at acute stage were significantly higher than those in acute-CO-poisoning group ( (0.50 ± 0.20) ng/ml,( 183.04 ± 73.01 ) ng/ml) and those in DEACMP group at convalescent stage ( (0.51 ±0.16) ng/ml,(183.25 ±81.76)ng/ml) (all P values ＜0.05).(2)In DEACMP group,the serum S100B and GFAP at acute and convalescent stages were significantly correlated (at acute stage:r=0.466,P=0.006; at convalescent stage:r=0.365,P=0.037 ).(3)The S100B and GFAP in ineffective DEACMP patients at acute stage were significantly higher than those in the other groups ( all P values ＜ 0.05 ).(4) In DEACMP group,the ADL,HDS and IMCT scores( (45.21 ± 9.69),(8.26 ± 6.31 ),(9.91 ± 7.52) ) at acute stage were significantly different from those at convalescent stages( (33.67 ± 13.62),( 15.91 ± 10.83),( 19.06 ± 10.37 ) ) ( all P values ＜0.01 ).Conclusion There is secondary brain insult (SBI) in DEACMP; glial activation may play an important role.The S100B and GFAP levels may be associated with the prognosis of DEACMP.