Objective To systematically evaluate the impact of cough enhancement techniques on weaning outcomes in adult patients under mechanical ventilation(MV).Methods Databases from the inception to 15th November,2024 were searched for randomised controlled trials(RCTs)on cough enhancement technique in MV patients.The searched databases were CNKI,Wanfang Data base,SinoMed,Vip,PubMed,Web of Science,Cochrane Library,Embase,and CINAHL.Literature and evidence quality were evaluated using Cochrane's evaluation tool for intervention research and the GRADE system,and data were extracted and analysed via Meta-analysis with Review Manager 5.3.Results A total of 27 studies were included,involving 2,322 patients(1,169 in the trial group and 1,153 in the control group).Compared with the control group,the trial group had shorter time of mechanical ventilation[MD=-1.40,95%CI(-1.83,-0.97),P<0.001],lower weaning failure rate[OR=0.48,95%CI(0.27,0.85),P=0.01],higher oxygenation index[MD=35.48,95%CI(21.53,49.43),P<0.001],lower pulmonary atelectasis incidence[OR=0.30,95%CI(0.18,0.49),P<0.001],greater sputum volume[MD=1.88,95%CI(0.76,3.01),P=0.001],shorter ICU stay[MD=-1.90,95%CI(-2.95,-0.85),P<0.001]and lower serum procalcitonin(PCT)[MD=-0.89,95%CI(-1.64,-0.14),P=0.02],all with statistically significant differences.However,there was no significant difference in the ventilator-associated pneumonia(VAP)between the two groups[OR=0.54,95%CI(0.21,1.35),P=0.19].Conclusion Cough enhancement techniques promote sputum discharge,improve infection and oxygenation,shorten mechanical ventilation and ICU stay,reduce weaning failure and atelectasis rates in MV patients.Further studies are required to reduce the incidence of VAP.

Objective To systematically evaluate the impact of cough enhancement techniques on weaning outcomes in adult patients under mechanical ventilation(MV).Methods Databases from the inception to 15th November,2024 were searched for randomised controlled trials(RCTs)on cough enhancement technique in MV patients.The searched databases were CNKI,Wanfang Data base,SinoMed,Vip,PubMed,Web of Science,Cochrane Library,Embase,and CINAHL.Literature and evidence quality were evaluated using Cochrane's evaluation tool for intervention research and the GRADE system,and data were extracted and analysed via Meta-analysis with Review Manager 5.3.Results A total of 27 studies were included,involving 2,322 patients(1,169 in the trial group and 1,153 in the control group).Compared with the control group,the trial group had shorter time of mechanical ventilation[MD=-1.40,95%CI(-1.83,-0.97),P<0.001],lower weaning failure rate[OR=0.48,95%CI(0.27,0.85),P=0.01],higher oxygenation index[MD=35.48,95%CI(21.53,49.43),P<0.001],lower pulmonary atelectasis incidence[OR=0.30,95%CI(0.18,0.49),P<0.001],greater sputum volume[MD=1.88,95%CI(0.76,3.01),P=0.001],shorter ICU stay[MD=-1.90,95%CI(-2.95,-0.85),P<0.001]and lower serum procalcitonin(PCT)[MD=-0.89,95%CI(-1.64,-0.14),P=0.02],all with statistically significant differences.However,there was no significant difference in the ventilator-associated pneumonia(VAP)between the two groups[OR=0.54,95%CI(0.21,1.35),P=0.19].Conclusion Cough enhancement techniques promote sputum discharge,improve infection and oxygenation,shorten mechanical ventilation and ICU stay,reduce weaning failure and atelectasis rates in MV patients.Further studies are required to reduce the incidence of VAP.

Objective To investigate the food allergy situation of children in Changping District of Beijing,and to explore the influence of allergic family history,gender and mode of delivery on food allergy in children,the distribution of food allergy in different age groups,the types of food allergy that are easy to cause in this area,and the comorbidities of food allergy.Methods A total of 515 children aged 0 to 14 years who were admitted to the general pediatric outpatient and emergency department and inpatient of Beijing Changping Hospital from April to November 2023.Using immunoblotting to detect specific immunoglobulin E in the serum of pediatric patients,and using SPSS 26.0 statistical software to perform binomial tests on gender and delivery mode non parameters;Using custom Excel functions to statistically analyze the family history of allergies,the number of people in different age groups,and the frequency of allergic foods in each group;Use a self-made mini program to statistically analyze the combination of comorbid allergic diseases.Results ① The number of male children with food allergies(306 cases)was higher than that of female children(209 cases),and the difference was statistically significant(P＜0.05).(2)There were 109 cases of pediatric patients with parents who had no history of allergic diseases,accounting for 21.17％of the total cases;There were a total of 406 cases where at least one parent had a family history of allergies,accounting for 78.83％of the total cases.Among them,228 cases(44.27％)had one parent with a history of allergies,and 178 cases(34.56％)had both parents with a history of allergies.③ Among 515 children with positive food allergens,there were 10 cases(1.94％)in infancy,37 cases(7.19％)in early childhood,235 cases(45.63％)in preschool,192 cases(37.28％)in school age,and 41 cases(7.96％)in adolescence.The highest positivity rate for food allergens is in milk(444 times),followed by egg white(70 times),cashew nuts(57 times),crab(37 times),beef(26 times),mango(24 times),shrimp(21 times),pineapple(6 times),and shellfish(1 time).Milk protein is the most common allergen in all age groups.(4)Among 515 children with food allergies,399 cases were single food allergies,accounting for 77.47％;116 cases of multiple food allergies(2 or more types of food allergies),accounting for 22.53％.⑤ The most common comorbidity of food allergies is food allergy related gastrointestinal diseases combined with allergic rhinitis,with a total of 267 cases;Secondly,there were 192 cases of allergic rhinitis combined with chronic cough,and 124 cases of food allergy related gastrointestinal diseases combined with chronic cough.Conclusion Milk is the main allergen of food allergy in people of age 14 and under,and gastrointestinal symptoms are the most common in children with food allergy.

ObjectiveTo study the effect of upper limb robot-assisted therapy on upper limb function and cerebral cortex activation in stroke patients using functional near-infrared spectroscopy (fNIRS). MethodsFrom January, 2022 to January, 2023, 32 stroke patients in Zhejiang Rehabilitation Medical Center were randomly divided into control group (n = 16) and experimental group (n = 16). Both groups received routine neurological medication and routine rehabilitation. The control group received routine upper limb exercises, the experimental group received upper limb robot-assisted therapy. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and fNIRS (oxyhemoglobin, deoxyhemoglobin, and total hemoglobin) before and four weeks after treatment. NIRS_SPM was used for activation analysis, Homer2 was used for blood oxygen concentration analysis. ResultsAfter treatment, the score of FMA-UE increased in both groups (|t| > 5.910, P < 0.001), and was higher in the experimental group than in the control group (t = -2.348, P < 0.05). fNIRS activation results showed that, the activation increased in the experimental group after treatment in channel 17 (F = 9.354, P < 0.01), and it was more than that in the control group (F = 5.217, P < 0.05). fNIRS blood oxygen concentration results showed that, the blood oxygen concentration increased in the experimental group after treatment in channel 17 (F = 12.179, P < 0.01), and it was more than that in the control group (F = 4.883, P < 0.05). ConclusionThe upper limb robot-assisted therapy can improve the upper limb motor function and cerebral cortex activation of stroke patients.

Multiple myeloma (MM) is still an incurable hematologic malignancy, which is eagerly to the discovery of novel therapeutic targets and methods. N-acetyltransferase 10 (NAT10) is the first reported regulator of mRNA acetylation that is activated in many cancers. However, the function of NAT10 in MM remains unclear. We found significant upregulation of NAT10 in MM patients compared to normal plasma cells, which was also highly correlated with MM poor outcome. Further enforced NAT10 expression promoted MM growth in vitro and in vivo, while knockdown of NAT10 reversed those effects. The correlation analysis of acetylated RNA immunoprecipitation sequencing (acRIP-seq) and ribosome profiling sequencing (Ribo-seq) combined with RIP-PCR tests identified centrosomal protein 170 (CEP170) as an important downstream target of NAT10. Interfering CEP170 expression in NAT10-OE cells attenuated the acceleration of cellular growth caused by elevated NAT10. Moreover, CEP170 overexpression promoted cellular proliferation and chromosomal instability (CIN) in MM. Intriguingly, remodelin, a selective NAT10 inhibitor, suppressed MM cellular growth, induced cellular apoptosis in vitro and prolonged the survival of 5TMM3VT mice in vivo. Collectively, our data indicate that NAT10 acetylates CEP1 70 mRNA to enhance CEP170 translation efficiency, which suggests that NAT10 may serve as a promising therapeutic target in MM.

Objective:To investigate the characteristics and associated factors of depression in elderly patients with Parkinson's disease(PD).Methods:A total of 1138 elderly PD patients from Xuanwu Hospital of Capital Medical University were consecutively enrolled.The Hamilton Depression 17-item Scale(HAMD-17)was used to diagnose depression(scores ≥14). The depressive characteristics of PD patients with depression and those without depression were compared, and Logistic regression model was used to analyze the clinical risk factors of depression in PD patients.Results:Among the 1 138 PD patients, 233 cases had depression.The incidence of depression in PD patients was 20.5%, and the treatment rate was only 6.0%(14 cases). The main symptoms of depression in PD patients included sleep disturbance(101 cases, 43.3%), depression(57 cases, 24.5%), work and interest loss(49 cases, 21%). Compared to PD patients without depression, PD patients with depression were more likely women(49.4% vs36.3%), and had lower cognitive scores[(25.56 ± 4.22)scores vs(27.07 ± 3.08)scores], higher rate of freezing of gait(51.0% vs24.0%), higher incidence of disability(87.1% vs28.5%)( P<0.05). A comparison of each part of the unified Parkinson's disease rating scale(UPDRS)between the two groups revealed that the scores of activities of daily living[(16.52 ± 8.71)scores vs(10.15 ± 5.48)scores], the motor examination[(33.78 ± 19.48)scores vs(22.87 ±13.08)scores]and the complications of therapy[2.0(0.0, 6.0)scores vs0.0(0.0, 2.0)scores]were higher in the PD patients with depression group than in the PD patients without depression group( P<0.05). Logistic regression analysis showed that women( OR=1.532, 95% CI: 1.073-2.187, P=0.019), disability( OR=6.357, 95% CI: 4.399-9.186, P<0.001), activities of daily living evaluated by UPDRS( OR=1.093, 95% CI: 1.043-1.146, P<0.001)and motor complications( OR=1.100, 95% CI: 1.014-1.193, P=0.022)were independent risk factors for PD depression. Conclusions:Depression was common in PD patients and usually manifested as sleep disturbance and low motivation, women, motor complications, disability and decreased quality of daily living were independent risk factors for depression.

Objective:To investigate the clinicopathological features and prognosis of IgA nephropathy (IgAN) patients with gross hematuria.Methods:The clinical and pathological data of 490 primary IgAN patients admitted in the Affiliated Hospital of Qingdao University from January 2010 to June 2019 were analyzed. Patients were divided into gross hematuria group and non-gross hematuria group. The clinical and pathological features and prognosis were compared between the two groups. All patients were diagnosed by kidney biopsy, and followed up until June 30, 2020. Kaplan-Meier survival curve was used to examine the renal survival,and Cox regression model was used to analyze the risk factors affecting renal survival in two groups.Results:Among 490 patients there were 111 patients (22.7%) in the gross hematuria group and 379 patients (77.3%) in the non-gross hematuria group. Age, hypertension, 24-h urine protein, serum creatinine, blood uric acid, blood triglycerides, total blood cholesterol level, mesangial cell hyperplasia (M1), the proportion of renal tubular atrophy or renal interstitial fibrosis (T1/2) in gross hematuria group were lower than those in non-gross hematuria group ( P<0.05), while the estimated glomerular filtration rate (eGFR) in gross hematuria group was higher than those in non-gross hematuria group ( P<0.05). Four hundred and twenty six patients (86.9%) were followed up for at least 6 months, including 93 patients in gross hematuria group and 333 patients in non-gross hematuria group. There was no statistically significant difference in treatment method between the two groups ( P>0.05). The incidence of end-point events in non-gross hematuria group was higher than that in gross hematuria group [18.6%(62/333) vs. 6.5%(6/93), χ2=8.023, P<0.05]. Kaplan-Meier survival analysis showed that the cumulative renal survival rate of the gross hematuria group was higher than that of the non gross hematuria group (χ2=11.44, P<0.001). Multivariate Cox regression analysis showed that urine protein>1 g/24 h, eGFR<60 ml·min -1·(1.73 m 2) -1, hypertension, hyperuricemia and the elevated serum IgA/C3 were risk factors for renal survival [ HR(95% CI)=3.457(1.137-10.514),2.736(1.073-6.977),2.720(1.144-6.465),2.789(1.102-7.060),1.070(1.009-1.135), all P<0.05]. Conclusions:IgAN patients with gross hematuria has less severe kidney damage and higher cumulative renal survival rate than non-gross hematuria patients. Urinary protein>1.0 g/d, hypertension, hyperuricemia and the elevated serum IgA/C3 are risk factors for adverse end-point events, to which timely attention and corresponding treatment should be given.

Objective:To investigate the feasibility of early off-bed mobility in patients with mechanical ventilation and its effect on delirium and the duration of delirium in the intensive care unit (ICU).Methods:Adult patients who were admitted to ICU of the Affiliated Hospital of Zunyi Medical University from January 1st to December 31st 2020 for invasive mechanical ventilation and no early activity contraindication were selected. The patients were randomly divided into two groups. The experimental group conducted early off-bed mobility, such as using the shift machine off-bed sitting and walking aids to assist standing and walking, and the off-bed mobility is based on patient tolerance. The control group was given early bed activities, including conducting the joint range activity, limb movement, bed sitting, upper limb elastic belt movement, and lower limb cycling, once a day. Each joint moved 15-20 times, a total of 30 minutes. Both groups were treated with anti-infection, mechanical ventilation, analgesia and sedation, and nutrition therapy. After intervention, confusion assessment method for the ICU (CAM-ICU) was used to assess the onset and duration of delirium, physical restraint rate and duration of physical restraint, mechanical ventilation time, and the length of ICU stay.Results:After excluding patients who died or gave up treatment during the intervention period, 266 patients were included, with 133 patients in the experimental group and 133 patients in the control group. There were no significant differences in gender, age, diagnosis, degree of illness, sedative drugs between the two groups. The incidence of the delirium in intervention group was significantly lower than that in control group [26.3% (35/133) vs. 42.1% (56/133), χ 2 = 7.366, P = 0.007], the duration of delirium was shorter than that in control group (hours: 11.26±4.11 vs. 17.00±3.29, t = -4.157, P = 0.000), the rate of physical restraint was lower than that in control group [19.5% (26/133) vs. 45.1% (60/133), χ 2 = 19.864, P = 0.000], the duration of physical restraint was shorter than that in control group (hours: 9.71±4.07 vs. 13.55±7.40, t = -5.234, P = 0.000), the mechanical ventilation time and the length of ICU stay were shorter than those in control group [mechanical ventilation time (hours) : 106.23±42.25 vs. 133.10±41.88, t = -3.363, P = 0.001; length of ICU stay (days) : 8.35±6.21 vs. 13.25±9.98, t =-4.190, P = 0.000]. Conclusions:Early off-bed mobility can reduce physical restraint rate and the incidence of delirium, and thus can accelerate rehabilitation in critically ill patients. Early off-bed mobility is safe and effective for patients with mechanical ventilation in ICU.

Objective: To investigate the neurocognitive characteristics and related factors in the elderly with subjective cognitive decline. Methods: Among the 1 850 elderly volunteers aged over 50, 377 cognitive normal elderly (NC group), 234 subjective cognitive decline (SCD Group) and 291 patients with mild cognitive impairment (aMCI Group) were screened with the brief elderly cognitive screening questionnaire and the elderly rapid cognitive screening scale.They were all received clinical interview and examination and core neurocognitive test. Results: (1) There were statistically significant differences in the three groups on the age, education, occupation, HAMD, low density lipoprotein and blood pressure (P<0.01). (2) The score of the picture-symbol association in SCD group(8.94±4.05)was lower than that in NC group(9.83±4.18)and higher than that in aMCI group (7.12±4.17)(all P<0.05), while the scores of the other neuropsychological tests were higher than those in aMCI group.There were no statistically significant difference between SCD group and NC group on the other neuropsychological tests(P>0.05). (3)The SCD was mainly influenced by age(β=0.063, OR=1.065, 95%CI=1.033-1.099), depression(β=0.182, OR=1.199, 95%CI=1.084-1.327)and hypertension(β=0.473, OR=1.604, 95%CI=1.185-2.171)(all P<0.01). And the aMCI was mainly influenced by age(β=0.078, OR=1.081, 95%CI=1.048-1.115), education(β=-0.174, OR=0.840, 95%CI=0.778-0.907), occupation(β=-0.406, OR=0.666, 95%CI=0.535-0.830)and low density lipoprotein(β=-0.451, OR=0.637, 95%CI=0.497-0.816)(all P<0.01 ). Conclusion Objective neurocognitive function of the elderly with subjective cognitive decline is basically normal.Age, depression and hypertension are risk factors of subjective cognitive decline.

Objective To investigate the influencing factors of epileptic seizure in chronic renal failure (CRF) patients.Methods CRF patients,admitted to our hospital from March 2014 to October 2018,were chosen in our study,and divided into epilepsy group (n=40) and non-epilepsy group (n=3653) according to whether the patients were with or without epilepsy.Clinical data,as length of hospital stays,dialysis methods,presences of infection,sites of infection,and use of antibiotics,and laboratory variables,as blood routine examination,straw aminotransferase (AST),and alanine aminotransferase (ALT),were collected and retrospectively analyzed.Logistic regression analysis was used to determine the independent factors affecting seizures in patients with CRF.Results The patients in the epilepsy group had significantly longer duration of dialysis and length of hospital stays,statistically higher incidence of infection and proportion of dialysis,and significantly worse prognosis than the patients from non-epilepsy group (P＜0.05).The leukocyte count of the epilepsy group was significantly higher than that of the non-epilepsy group,the contents of hemoglobin,ALT and albumin were significantly lower than those of the non-epilepsy group,and the contents of urea nitrogen,creatinine and serum potassium were significantly higher than those of the non-epilepsy group (P＜0.05).Logistic regression analysis showed that epilepsy was associated with serum potassium,creatinine,urea nitrogen and dialysis.Conclusion The etiology of epilepsy is complex,which is related to dialysis,toxin levels,and electrolyte imbalance;the mortality rate of those patients is high and the prognosis is not good.