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Background The goal of this study was to review relevant randomized controlled trials in order to determine the efficacy of continuous positive airway pressure (CPAP) versus mandibular advancement device (MAD) in the treatment of obstructive sleep apnea (OSA). Methods Using appropriate keywords, we identified relevant studies using PubMed, the Cochrane Library, and Embase. Key pertinent sources in the literature were also reviewed, and all articles published through October 2019 were considered for inclusion. For each study, we used odds ratios (ORs), mean difference (MD), and 95% confidence interval (95% CI) to assess and synthesize outcomes. Results We included 14 RCTs, for a total of 249 patients in the CPAP group and 247 in the MAD group. Compared with MAD, CPAP significantly decreased apnea hypopnea index (AHI) (WMD: −7.08, 95%CI: −9.06∼-5.10) and the percentage of stage 1 and 2 after therapy (WMD: −3.728, 95%CI: −6.912∼-0.543). However, compared with MAD, CPAP significantly decreased the SF-36-social function score (WMD: −3.381, 95%CI: −6.607∼-0.154).There was no significant difference in Epworth sleepiness scale score after therapy between the two groups. Conclusion CPAP has better therapeutic efficacy in OSA patients than MAD.

BACKGROUND: The balance of oxygen delivery and consumption is essential in patients who are critically ill. Mixed venous oxygen saturation (SvO2) is a standard method to evaluate oxygen delivery and consumption during anesthesia. However, SvO2 is monitored through a pulmonary artery catheter, which is invasive. Regional cerebral oxygenation (rScO2) reflects oxygen saturation in a small region of the frontal lobes and is monitored noninvasively through near-infrared spectroscopy. In the present study, the correlation between rScO2 and SvO2 was calculated during off-pump coronary artery bypass grafting surgery to determine whether a positive correlation exists between rScO2 and SvO2. METHODS: A total of 56 subjects were consecutively enrolled in the study. Then rScO2 and SvO2 were simultaneously monitored. The parameters were recorded at 5 time points: T1, 10 min after intubation (1.0 FIO2 for 10 min); T2, 20 min after intubation (0.60 FIO2 for 10 min); T3, at the end of the revascularization of the left anterior descending artery (0.60 FIO2); T4, after protamine infusion (0.60 FIO2); and T5, 10 min after protamine infusion (1.0 FIO2 for 10 min). The correlation between rScO2 and SvO2 and the variation trend between rScO2 and SvO2 when FIO2 increased from 0.60 to 1.0 were analyzed. RESULTS: There was a significant positive correlation between rScO2 and SvO2 at these 5 time points (r2 = 0.77, 0.81, 0.70, 0.83, and 0.92, respectively). There also was a significant positive correlation between Δ rScO2 and Δ SvO2 (n = 112, r2 = 0.72, P CONCLUSIONS: There was a positive correlation between rScO2 and SvO2 during off-pump coronary artery bypass grafting surgery, and there also was a positive correlation in the variation trend between rScO2 and SvO2.

Background The long-term pulmonary function and related physiological characteristics of COVID-19 survivors have not been studied in depth, thus many aspects are not understood. Methods COVID-19 survivors were recruited for high resolution computed tomography (HRCT) of the thorax, lung function and serum levels of SARS-CoV-2 IgG antibody tests 3 months after discharge. The relationship between the clinical characteristics and the pulmonary function or CT scores were investigated. Findings Fifty-five recovered patients participated in this study. SARS-CoV-2 infection related symptoms were detected in 35 of them and different degrees of radiological abnormalities were detected in 39 patients. Urea nitrogen concentration at admission was associated with the presence of CT abnormalities (P = 0.046, OR 7.149, 95% CI 1.038 to 49.216). Lung function abnormalities were detected in 14 patients and the measurement of D-dimer levels at admission may be useful for prediction of impaired diffusion defect (P = 0.031, OR 1.066, 95% CI 1.006 to 1.129). Of all the subjects, 47 of 55 patients tested positive for SARS-CoV-2 IgG in serum, among which the generation of Immunoglobulin G (IgG) antibody in female patients was stronger than male patients in infection rehabilitation phase. Interpretation Radiological and physiological abnormalities were still found in a considerable proportion of COVID-19 survivors without critical cases 3 months after discharge. Higher level of D-dimer on admission could effectively predict impaired DLCO after 3 months discharge. It is necessary to follow up the COVID-19 patients to appropriately manage any persistent or emerging long-term sequelae. Funding Key Scientific Research Projects of Henan Higher Education Institutions

The lungs are one of the most common target organs of diabetic injury in patients with diabetes. Long non-coding RNA (lncRNA) smoke and cancer-associated lncRNA 1 (SCAL1), also known as lung cancer associated transcript 1 (LUCAT1), is known to have a pivotal role in lung cancer. The aim of the current study was to investigate the potential involvement of SCAL1 in diabetic lung disease. The expression levels of SCAL1 were determined by reverse transcription-quantitative PCR in serum samples from healthy controls (n=40), diabetic patients without lung disease (n=56) and diabetic patients with diabetic lung disease (n=44). Receiver operating characteristic analysis was used to evaluate the diagnostic value of serum SCAL1 in discriminating diabetic patients with diabetic lung disease from diabetic patients without lung disease and healthy controls. Pearson's correlation analysis was performed to examine the correlation between SCAL1 and inducible nitric oxide synthase (iNOS) mRNA expression levels in blood and lung tissue samples. Expression levels of iNOS and NO production following treatment with high (30 mM) glucose were examined by western blot analysis and NO assay, respectively. The expression levels of SCAL1 were significantly downregulated in diabetic patients with diabetic lung disease, and downregulated serum expression levels of SCAL1 effectively distinguished diabetic patients with diabetic lung disease from diabetic patients without lung disease and healthy controls. Treatment with high glucose significantly upregulated SCAL1 expression in normal lung cells. Furthermore, the overexpression of SCAL1 inhibited iNOS protein expression and reduced NO production in cells treated with high glucose. In conclusion, the current study demonstrated that lncRNA SCAL1 inhibits iNOS protein expression in lung cells under high-glucose conditions, which suggests that SCAL1 may have potential in the treatment of patients with diabetic lung disease.

The transient traveling waves generated by linghting can be used to linghting location, in order to improve fault identifiaction ability of current traveling wave location device, an identification method of lightning strike and short circuit fault based wavelet energy spctrum and transient waveform characteristics was presented in this paper. Through researched the current signals generated by non-fault lightning strike, fault lightning strike and short-circuit fault on 220kV transmission line, compared of the energy distribution of different transient signals in each prequence band, realized the identification of lightning strike and short-circuit fault; for lightning identification, by waveform characteristics calculated obtaining eigenvalue to identify the non-fault and fault linghtning. PSCAD/EMTDC simulation results identicate that the proposed method is correct and effective.

In order to improve the fault location accuracy, and eliminate the influence of spectral leakage in power transmission line fault location, we proposed a novel fault location scheme for transmission lines based on multi-measurements and phase comparison with Kaiser self-convolution windows FFT, which can locate the fault between two adjacent towers in the fault-prone segment. It is based Kaiser self-convolution window's excellent performance of leakage suppression, which can effectively solve the phase current fault component is relatively large errors due to spectral leakage problem. Firstly, this paper analyzes the causes of the phase spectrum leakage, then elaborates the sidelobe characteristics of Kaiser self-convolution window, and lists phase comparative fault location using steps, finally, verifies the correctness of the proposed method by simulation. The results show that the proposed method can effectively suppress spectral leakage, has a high location accuracy, a wide applicability and its solving of phase difference is precise.

Based on the principle of chaos suppression with the piecewise periodic perturbation, detection of weak periodic signals in strong noise is realized with controlled NBS (Novel butterfly-shaped) model. First, according to the parametric equivalent relationship obtained using segment control mechanism, the parameter range is determined in different periodic states of the chaotic system. Second, combined with Lyapunov exponent criterion, the critical values of detection parameters are determined, which lead to a sudden change of the system dynamical behavior from chaotic state to periodic 3. Finally, the numerical simulation and the measured signals experiment are performed. The results show that the method reacts sensitively for weak signals, possesses the better inhibitory action on the noise, and can effectively improve the signal-to-noise ratio.

Since there were a few articles to report the treatment of severe pulmonary vasoconstriction induced by protamine in cardiac surgery, we described the use of epoprostenol to reverse this condition. A total of 5 cases of severe pulmonary vasoconstriction induced by protamine in cardiac surgery were reviewed. The demographic, clinical data and treatment process were obtained. All the patients were followed up. Severe pulmonary vasoconstriction was occurred 4 to 10 minutes after protamine infusion. The primary sign was sudden hypotension, the pulmonary artery pressure was increased gradually, the arterial oxygen partial pressure was decreased in all the patients. Epoprostenol was infused via pulmonary artery catheter at dosage of 20 to 40 ng/kg·min in all the patients, 2 patients were underwent re-cardiac pulmonary bypass assistance. The hemodynamic instability status lasted 40 to 65 minutes respectively. All the patients were recovered uneventfully. All physicians should alert to the incidence of severe pulmonary vasoconstriction induced by protamine in cardiac surgery. Use epoprostenol through pulmonary artery catheter could treat pulmonary artery vasoconstriction effectively and safely.