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Background. Noninvasive ventilation (NIV) has been reported to be beneficial for patients with acute respiratory failure in intensive care unit (ICU); however, factors that influence the clinical outcome of NIV were unclarified. We aim to determine the factors that predict the failure of NIV in critically ill patients with acute respiratory failure (ARF). Setting. Adult mixed ICU in a medical university affiliated hospital. Patients and Methods. A retrospective clinical study using data from critical adult patients with initial NIV admitted to ICU in the period August 2016 to November 2017. Failure of NIV was regarded as patients needing invasive ventilation. Logistic regression was employed to determine the risk factor(s) for NIV, and a predictive model for NIV outcome was set up using risk factors. Results. Of 101 included patients, 50 were unsuccessful. Although more than 20 variables were associated with NIV failure, multivariate logistic regression demonstrated that only ideal body weight (IBW) (OR 1.110 (95%1.027–1.201), P=0.009), the maximal heart rate during NIV period (HR-MAX) (OR 1.024 (1.004–1.046), P=0.021), the minimal respiratory rate during NIV period (RR-MIN) (OR 1.198(1.051–1.365), P=0.007), and the highest body temperature during NIV period (T-MAX) (OR 1.838(1.038–3.252), P=0.037) were independent risk factors for NIV failure. We set up a predictive model based on these independent risk factors, whose area under the receiver operating characteristic curve (AUROC) was 0.783 (95% CI: 0.676–0.899, P<0.001), and the sensitivity and specificity of model were 68.75% and 71.43%, respectively, with the optimal cut-off value of 0.4863. Conclusion. IBW, HR-MAX, RR-MIN, and T-MAX were associated with NIV failure in patients with ARF. A predictive model based on the risk factors could help to discriminate patients who are vulnerable to NIV failure.

Introduction: To summarize the experiences of sequential application with noninvasive (NIV) and high-flow nasal cannula oxygen (HFNCO) therapy in the treatment for critically ill patient with severe COVID-19. Case Report: In a mixed Intensive Care Unit, a medical university affiliated hospital in Guizhou Province, China, sequential application with NIV and HFNCO was used in the treatment for a COVID-19 patient with severe acute respiratory distress syndrome (ARDS), and the vital signs and laboratory results were dynamically monitored. A female patient with severe COVID-19 and severe acute respiratory failure was completely recovered from the disease by sequential application with NIV mechanical ventilation and HFNCO therapy. Conclusion: From our limited experience of the case report, NIV and HFNCO could cautiously be used in severe patient with ARDS in condition of close and dynamic monitoring.

Recombinant immunotoxins (RITs) refer to a group of recombinant protein-based therapeutics, which consists of two components: an antibody variable fragment or a specific ligand that allows RITs to bind specifically to target cells and an engineered toxin fragment that kills the target cells upon internalization. To date, over 1,000 RITs have been generated and significant success has been achieved in the therapy of hematological malignancies. However, the immunogenicity and off-target toxicities of RITs remain as significant barriers for their application to solid tumor therapy. A group of RITs have also been generated for the treatment of glioblastoma multiforme, and some have demonstrated evidence of tumor response and an acceptable profile of toxicity and safety in early clinical trials. Different from other solid tumors, how to efficiently deliver the RITs to intracranial tumors is more critical and needs to be solved urgently. In this article, we first review the design and expression of RITs, then summarize the key findings in the preclinical and clinical development of RIT therapy of glioblastoma multiforme, and lastly discuss the specific issues that still remain to forward RIT therapy to clinical practice.

CO/H 2 mixture gas may be generated in the local furnace hopper area under the condition of coal quality variation, and deflagration may be caused during the high temperature coke dropping process. As for the complex dust environment of furnace hopper area, the influence of dust of different categories, particle size and concentration on CO/H 2 deflagration characteristics under the half-opened environment is studied in this paper. The study indicates that: the influence of dust on CO/H 2 deflagration feature mainly results from the release of volatile in dust and the volatile's participation in deflagration reaction. As for high volatile coal dust, volatile releases out and participates in deflagration reaction, which makes the deflagration overpressure of mixture gradually rises with the rising of volatile content; as for low volatile coal dust, the influence of heat absorption for volatile release is greater than the function in which volatile participates in deflagration reaction, thus reducing the deflagration strength. As for Yinbei coal, with the increase of dust concentration, deflagration strength declines firstly and then increases. Experiment also indicates that as for coke dust nearly without volatile, the change of deflagration intensity with dust concentration is not obvious.