Objective To explore the influence of intensified blood glucose control on the diaphragmatic function of patients with sepsis in the intensive care unit(ICU).Methods Sixty-six sepsis patients admitted to the ICU of Affiliated Lihuili Hospital of Ningbo University from January to December 2024 were selected and divided into experimental group and control group according to the random number table method,with 33 cases in each group.The experimental group received intensified blood glucose control,while control group received conventional blood glucose control.The diaphragm distance(DD)and diaphragm thickness fraction(DTF)of two groups of patients were continuously measured by bedside ultrasound,and the mechanical ventilation time,weaning outcome and hospital stay were recorded.Results With the prolongation of treatment time and mechanical ventilation time,the DD and DTF of both groups of patients showed an upward trend.There was no statistically significant difference in DD between two groups of patients at different times(P＞0.05).On the 4th and 6th days,the DTF of patients in experimental group was significantly greater than that in control group(P＜0.05).The weaning success rate of patients in experimental group was significantly higher than that in control group(P=0.026).There was no statistically significant difference in mechanical ventilation time,ICU stay time and total hospital stay time between two groups of patients(P＞0.05).There was no statistically significant difference in the incidence of hypoglycemia between two groups of patients(P＞0.05).Conclusion Intensified control of blood glucose can improve diaphragmatic function of patients with sepsis in the ICU,increase the success rate of weaning from the ventilator,and has high safety.

Objective To explore the influence of intensified blood glucose control on the diaphragmatic function of patients with sepsis in the intensive care unit(ICU).Methods Sixty-six sepsis patients admitted to the ICU of Affiliated Lihuili Hospital of Ningbo University from January to December 2024 were selected and divided into experimental group and control group according to the random number table method,with 33 cases in each group.The experimental group received intensified blood glucose control,while control group received conventional blood glucose control.The diaphragm distance(DD)and diaphragm thickness fraction(DTF)of two groups of patients were continuously measured by bedside ultrasound,and the mechanical ventilation time,weaning outcome and hospital stay were recorded.Results With the prolongation of treatment time and mechanical ventilation time,the DD and DTF of both groups of patients showed an upward trend.There was no statistically significant difference in DD between two groups of patients at different times(P＞0.05).On the 4th and 6th days,the DTF of patients in experimental group was significantly greater than that in control group(P＜0.05).The weaning success rate of patients in experimental group was significantly higher than that in control group(P=0.026).There was no statistically significant difference in mechanical ventilation time,ICU stay time and total hospital stay time between two groups of patients(P＞0.05).There was no statistically significant difference in the incidence of hypoglycemia between two groups of patients(P＞0.05).Conclusion Intensified control of blood glucose can improve diaphragmatic function of patients with sepsis in the ICU,increase the success rate of weaning from the ventilator,and has high safety.

Objective:To explore the effects of genotypes of one-carbon metabolism (OCM)-related enzyme single nucleotide polymorphisms (SNPs) sites and anti-epileptic drugs on OCM metabolite levels in epileptic patients, and to screen valproic acid (VPA) teratogenic susceptibility genes.Methods:Three hundred and seventy-two epileptic patients, admitted to our hospital from January 2019 to December 2020, were enrolled in the study; patients taking VPA, levetiracetam (LEV), lamotrigine (LTG) or oxcarbazepine (OXC) for more than 6 months without attack during regular medication were classified as VPA group ( n=95), LEV group ( n=61), LTG group ( n=57) and OXC group ( n=70); firstly diagnosed epileptic patients who had never taken antiepileptic drugs or had not taken antiepileptic drugs in the previous 6 months were assigned into blank control group ( n=89). Plasma folic acid (FA), vitamin B12 (VitB 12) and homocysteine (Hcy) levels were determined by automatic chemiluminescence immunoassay, and genotypes of OCM-related enzyme SNPs sites were detected by Sequenom iPLEX. Results:(1) As compared with LEV group and blank control group, VPA group had significantly decreased FA level and significantly increased Hcy level ( P<0.05). (2) Patients with DNA methyltransferase (DNMT) 3a rs12987326(-178G>A) GA type had significantly higher Hcy level than those with GG type ( P<0.05); patients with DNMT1 rs2288350(82G>C) GC type had significantly higher Hcy level than those with GG type ( P<0.05); patients with DNMT1 rs75616428 (55850G>C) GC type had significantly lower VitB 12 level than those with GG type ( P<0.05). Patients with DNMT1 rs1863771(128G>A) GA+AA type had significantly higher FA level than those with GG type, patients with folate receptor 2 rs2298444(59T>C) CT+CC type had significantly higher Hcy level than those with TT type, patients with 5,10-methylenetetrahydrofolate reductase rs1801131(1298A>C) AC+CC type had significantly higher Hcy level than those with AA type, and patients with DNMT3a rs6722613(2327C>T) CT+TT type had significantly lower VitB 12 level than those with CC type ( P<0.05). Conclusions:Decreased FA and increased Hcy levels can be noted in epileptic patients who used VPA; some gene variations in SNPs of OCM also affect the OCM metabolite levels in epileptic patients. Epileptic patients during pregnancy should avoid using VPA or detecting SNPs genotypes before medication to reduce the incidence of fetal malformation.

Type Ⅰ sialidosis is a neurosomatic disorder related to the storage of lysosomal and induced by shortage of neuraminidase. It is an autosomal recessive disorder, maybe heterogeneous in its onset, clinical manifestations and prognosis. A case of type Ⅰ sialidosis with a missense mutation in the α-N-acetyl-neuraminidase (NEU1) gene is reported. The patient was characterized by reduced visual acuity, ataxia and subcortical myoclonus. Although the macular cherry red spots were not detected in the male patient, his bilateral visual evoked potential showed severely prolonged latencies of P100, which was consistent with continuous decline of his visions. Finally, he was treated with carbamazepine and clonazepam with moderate improvement in the symptom of myoclonus. In order to make the definite diagnosis, the importance of a clinical history integrating all the patient′s clinical manifestations and the mutation in NEU1 gene was highlighted. Regardless of being an uncommon disorder, the burden for those patients with sialidosis was significant. Therefore, this diagnosis in the relevant setting should always be considered.

Objective:To explore the effect of cabinet type water curtain exhaust hood applied to small sandblasting machine to prevent and control silicon dust, and put forward a new idea of dust ventilation protection facilities to effectively protect the occupational health of workers.Methods:From August to October 2018, the cabinet type water curtain exhaust hood of sandblasting room in a research institute was selected as the research object, and the methods of occupational health survey, on-site detection and physical simulation of air distribution were used to conduct on-site detection and smoke emission test on the local exhaust facilities, silica dust concentration, control wind speed and air distribution before and after the transformation line analysis and evaluation.Results:The air distribution simulation experiment showed that the air distribution of the cabinet type water curtain exhaust hood was reasonable and could effectively control the whole range of silica dust emission during the cleaning process. After modification, the capture velocity was increased from 0.01 m/s to 0.53 m/s, and the capture velocity was increased by 98.1%. The time weighted average allowable concentration ( CTWA) of silicon dust (total dust) during sand blasting, cabin opening and cleaning was reduced from 7.00 mg/m 3 to 0.50 mg/m 3. The CTWA of silica dust (exhalation dust) was decreased from 3.36 mg/m 3 to 0.27 mg/m 3, and the CTWA dust reduction rates of total dust and respirable dust were 92.9% and 92.0%, respectively. Conclusion:The combination of cabinet type exhaust hood and water curtain dedusting optimizes the combination mode of dust prevention and control. It has the advantages of high efficiency of dedusting and purification, energy saving and environmental protection, and can be popularized and used in enterprises of the same nature.

Objective:To explore the effect of cabinet type water curtain exhaust hood applied to small sandblasting machine to prevent and control silicon dust, and put forward a new idea of dust ventilation protection facilities to effectively protect the occupational health of workers.Methods:From August to October 2018, the cabinet type water curtain exhaust hood of sandblasting room in a research institute was selected as the research object, and the methods of occupational health survey, on-site detection and physical simulation of air distribution were used to conduct on-site detection and smoke emission test on the local exhaust facilities, silica dust concentration, control wind speed and air distribution before and after the transformation line analysis and evaluation.Results:The air distribution simulation experiment showed that the air distribution of the cabinet type water curtain exhaust hood was reasonable and could effectively control the whole range of silica dust emission during the cleaning process. After modification, the capture velocity was increased from 0.01 m/s to 0.53 m/s, and the capture velocity was increased by 98.1%. The time weighted average allowable concentration ( CTWA) of silicon dust (total dust) during sand blasting, cabin opening and cleaning was reduced from 7.00 mg/m 3 to 0.50 mg/m 3. The CTWA of silica dust (exhalation dust) was decreased from 3.36 mg/m 3 to 0.27 mg/m 3, and the CTWA dust reduction rates of total dust and respirable dust were 92.9% and 92.0%, respectively. Conclusion:The combination of cabinet type exhaust hood and water curtain dedusting optimizes the combination mode of dust prevention and control. It has the advantages of high efficiency of dedusting and purification, energy saving and environmental protection, and can be popularized and used in enterprises of the same nature.