Search

Objective To observe the expression of serum interleukin(IL)-17 and procalcitonin(PCT) in elderly patients with severe chronic obstructive pulmonary disease(COPD) accompanied by pulmonary infection,and to explore their predictive value for the prognosis of patients. Methods A total of 120 elderly patients with severe COPD complicated with pulmonary infection admitted to Beijing Rehabilitation Hospital Affiliated with Capital Medical University from March 2021 to May 2022 were selected as the study subjects.All patients were followed up for 6 months. Serum IL-17 and PCT levels were measured,general data were collected,and the above data were statistically analyzed. Results At the end of follow-up,80 patients survived with a survival rate of 66.67% and 40 patients died with a mortality rate of 33.33%.There was no significant difference in gender,age,combined underlying diseases,smoking history and other data between the death group and the survival group(P>0.05);the serum IL-17 and PCT levels in the death group were higher than those in the survival group,and the duration of COPD and pulmonary infection was longer than those in the survival group,and the differences were statistically significant(P0.90. Conclusion Serum IL-17 and PCT levels are associated with prognosis in elderly patients with severe COPD with pulmonary infection and may be risk factors for increased risk of death.

Background: Abdominal organs are important organs that sense and respond to ischemia and hypoxia, but there are few evaluation methods.We use ultrasonography to evaluate abdominal organ function and blood flow in patients with mechanical ventilation (MV) after cardiopulmonary bypass and to obtain a semiquantitative score for abdominal organ function and blood flow. Methods: Patients with cardiopulmonary bypass in the Critical Care Department of Peking Union Medical College Hospital in China from March to July 2021 were enrolled in this prospective observational study. The correlation of the abdominal-visceral-blood-flow-and-function score (AVBFS) with the duration of MV, number of days spent in the intensive care unit (ICU), acute physiology and chronic health evaluation II (APACHE-II), sequential organ failure assessment (SOFA), lactate, epinephrine, and norepinephrine use was analyzed, and the results were used to assess the predictive value of the receiver operating characteristic curve (ROC) regression analysis score for the duration of MV. Results: Of the 92 patients who underwent cardiopulmonary bypass, 41 were finally included. The AVBFS were significantly correlated with the duration of MV, number of days spent in the ICU, APACHE-II score, SOFA score, and norepinephrine use time. The AVBFS in a group of patients using ventilators ≥36 h were significantly higher than those obtained for a group of patients using ventilators

The facial nerve, also known as the seventh cranial nerve, is critical in controlling the movement of the facial muscles. It is responsible for all facial expressions, such as smiling, frowning, and moving the eyebrows. However, damage to this nerve can occur for a variety of reasons, including maxillofacial surgery, trauma, tumors, and infections. Facial nerve injuries can cause severe functional impairment and can lead to different degrees of facial paralysis, significantly affecting the quality of life of patients. Over the past ten years, significant progress has been made in the field of facial nerve repair. Different approaches, including direct suture, autologous nerve grafts, and tissue engineering, have been utilized for the repair of facial nerve injury. This article mainly summarizes the clinical methods and basic research progress of facial nerve repair in the past ten years.

Abstract Background EGFR is an important signal involved in tumor growth that can induce tumor metastasis and drug resistance. Exploring targets for effective EGFR regulation is an important topic in current research and drug development. Inhibiting EGFR can effectively inhibit the progression and lymph node metastasis of oral squamous cell carcinoma (OSCC) because OSCC is a type of cancer with high EGFR expression. However, the problem of EGFR drug resistance is particularly prominent, and identifying a new target for EGFR regulation could reveal an effective strategy. Methods We sequenced wild type or EGFR-resistant OSCC cells and samples from OSCC patients with or without lymph node metastasis to find new targets for EGFR regulation to effectively replace the strategy of directly inhibiting EGFR and exert an antitumor effect. We then investigated the effect of LCN2 on OSCC biological abilities in vitro and in vivo through protein expression regulation. Subsequently, we elucidated the regulatory mechanism of LCN2 through mass spectrometry, protein interaction, immunoblotting, and immunofluorescence analyses. As a proof of concept, a reduction-responsive nanoparticle (NP) platform was engineered for effective LCN2 siRNA (siLCN2) delivery, and a tongue orthotopic xenograft model as well as an EGFR-positive patient-derived xenograft (PDX) model were applied to investigate the curative effect of siLCN2. Results We identified lipocalin-2 (LCN2), which is upregulated in OSCC metastasis and EGFR resistance. Inhibition of LCN2 expression can effectively inhibit the proliferation and metastasis of OSCC in vitro and in vivo by inhibiting EGFR phosphorylation and downstream signal activation. Mechanistically, LCN2 binds EGFR and enhances the recycling of EGFR, thereby activating the EGFR-MEK-ERK cascade. Inhibition of LCN2 effectively inhibited the activation of EGFR. We translated this finding by systemic delivery of siLCN2 by NPs, which effectively downregulated LCN2 in the tumor tissues, thereby leading to a significant inhibition of the growth and metastasis of xenografts. Conclusions This research indicated that targeting LCN2 could be a promising strategy for the treatment of OSCC.

Abstract The problem of compressive detection of multiple targets in a passive bistatic radar system consisting of one illuminator of opportunity and one receiver is considered. Specifically, a measurement matrix is designed to remove the direct‐path and multi‐path interference and obtain the compressive observations simultaneously. Considering that the degree of sparsity, that is, the number of targets, is unknown, an orthogonal matching pursuit (OMP)‐based detector, referred to as the ‖rk‖∞‐based OMP detector, is proposed by analysing the distribution characteristics of the infinite norm of the residual. It is shown that the test statistic of the proposed detector leads to an order statistic, and then a closed‐form expression of probability of false alarm and detection of the proposed detector is provided. Finally, numerical simulations are conducted to verify the theoretical analysis and illustrate the performance of the proposed detector relative to several benchmark detectors.

Background:. It is crucial to improve the quality of care provided to ICU patient, therefore a national survey of the medical quality of intensive care units (ICUs) was conducted to analyze adherence to quality metrics and outcomes among critically ill patients in China from 2015 to 2019. Methods:. This was an ICU-level study based on a 15-indicator online survey conducted in China. Considering that ICU care quality may vary between secondary and tertiary hospitals, direct standardization was adopted to compare the rates of ICU quality indicators among provinces/regions. Multivariate analysis was performed to identify potential factors for in-hospital mortality and factors related to ventilator-associated pneumonia (VAP), catheter-related bloodstream infections (CRBSIs), and catheter-associated urinary tract infections (CAUTIs). Results:. From the survey, the proportions of structural indicators were 1.83% for the number of ICU inpatients relative to the total number of inpatients, 1.44% for ICU bed occupancy relative to the total inpatient bed occupancy, and 51.08% for inpatients with Acute Physiology and Chronic Health Evaluation II scores ≥15. The proportions of procedural indicators were 74.37% and 76.60% for 3-hour and 6-hour surviving sepsis campaign bundle compliance, respectively, 62.93% for microbiology detection, 58.24% for deep vein thrombosis prophylaxis, 1.49% for unplanned endotracheal extubations, 1.99% for extubated inpatients reintubated within 48 hours, 6.38% for unplanned transfer to the ICU, and 1.20% for 48-hour ICU readmission. The proportions of outcome indicators were 1.28‰ for VAP, 3.06‰ for CRBSI, 3.65‰ for CAUTI, and 10.19% for in-hospital mortality. Although the indicators varied greatly across provinces and regions, the treatment level of ICUs in China has been stable and improved based on various quality control indicators in the past 5 years. The overall mortality rate has dropped from 10.19% to approximately 8%. Conclusions:. The quality indicators of medical care in China's ICUs are heterogeneous, which is reflected in geographic disparities and grades of hospitals. This study is of great significance for improving the homogeneity of ICUs in China.

Abstract GSDMD is the key effector of pyroptosis, but its non-pyroptosis-related functions have seldom been reported. Here, we report that GSDMD is overexpressed in different types of tumours, including head and neck squamous-cell carcinoma, and it promotes the sensitivity of tumour cells to cisplatin. Unexpectedly, the enhanced cisplatin sensitivity is mediated by apoptosis but not pyroptosis, the well-known function of GSDMD. Furthermore, we found that GSDMD can activate the unfolded protein response by promoting the phosphorylation of eIF2α. Mechanistically, we demonstrated that GSDMD can directly bind to eIF2α and enhance the interaction between eIF2α and its upstream kinase PERK, leading to eIF2α phosphorylation. Consequently, the protein levels of ATF-4 were upregulated, downstream apoptosis-related proteins such as CHOP were activated, and apoptosis was induced. Remarkably, activation of endoplasmic-reticulum (ER) stress induced by GSDMD promotes cell apoptosis during cisplatin chemotherapy, thereby increasing the treatment sensitivity of tumours. Therefore, for the first time, our work reveals an unreported nonpyroptotic function of the classic pyroptosis protein GSDMD: it promotes cell apoptosis during cisplatin chemotherapy by inducing eIF2α phosphorylation and ER stress, which are related to the drug sensitivity of tumours. Our study also indicated that GSDMD might serve as a biomarker for cisplatin sensitivity.

Abstract Objective Tongue defect reconstruction is one of the key components of tongue cancer surgery. In this study, we used an L-shaped flap design adopted as a simple and efficient method to repair tongue defects after hemiglossectomy. Furthermore, we evaluated and contrasted the clinical effects of two methods, the L-shaped and traditional methods. Study design Fifteen patients in the L-shaped group and 20 patients in the traditional group were evaluated and compared in terms of postoperative complications, dysphagia, language function and appearance satisfaction. Results The results (Table 1) showed that there were 2 cases of donor area invalid traumas, and 2 patients had scar hyperplasia in the traditional group. The degree of global and functional dysphagia of the L-shaped group (2.60 ± 0.29 and 11.47 ± 1.38) was lower than that of the traditional group (3.55 ± 0.29 and 15.75 ± 1.22) (P

BackgroundEsophageal pressure (Pes) can be used as a reliable surrogate for pleural pressure, especially in critically ill patients requiring personalized mechanical ventilation strategies. How to choose the proper esophageal balloon filling volume and then find the optimal value of esophageal pressure remains a challenge. The study aimed to assess the feasibility of catheters for Pes monitoring in mechanically ventilated patients.Materials and methodsTwelve patients under pressure-controlled mechanical ventilation were included in this study. Raw esophageal pressure was recorded at different balloon filling volumes. Then, the P-V curves were determined. VWORK was the intermediate linear section on the end-expiratory P-V curve, and VBEST was the filling volume providing the maximum difference between Pes at end-inspiration and end-expiration. The raw value of Pes was recorded, and the calibrated values of Pes were calculated by calculating the esophageal wall pressure (Pew) and esophageal elastance (Ees).ResultsTwenty-four series of Pes measurements were performed. The mean VMIN and VMAX were 2.17 ± 0.49 ml (range, 1.0–3.0 ml) and 6.79 ± 0.83 ml (range, 5.0–9.0 ml), respectively, whereas VBEST was 4.69 ± 0.16 ml (range, 2.0–8.0 ml). Ees was 1.35 ± 0.51 cm H2O/ml (range, 0.26–2.38 cm H2O/ml). The estimated Pew at VBEST was 3.16 ± 2.19 cm H2O (range, 0–7.97 cm H2O). Patients with a body mass index (BMI) ≥ 25 kg/m2 had a significantly lower VMAX (5.88 [5.25–6] vs. 7.25 [7–8] ml, p = 0.006) and a significantly lower VBEST (3.69 [2.5–4.38] vs. 5.19 [4–6] ml, p = 0.036) than patients with a BMI < 25 kg/m2. Patients with positive end-expiratory pressure (PEEP) ≥ 10 cm H2O had a lower VMIN and VBEST than patients with PEEP < 10 cm H2O, P > 0.05. Patients in the supine position had a higher esophageal pressure than those in the prone position with the same balloon filling volume.ConclusionsCalibration of esophageal pressure to identify the best filling volume of esophageal balloon catheters is feasible. The esophageal pressure can be influenced by BMI, PEEP, and position. It is necessary to titrate the optimal inflation volume again when the PEEP values or the positions change.

BackgroundAdenoid cystic carcinoma (ACC) is a malignant tumor in salivary gland tissue, that is characterized by strong invasiveness and lung metastasis, leading to poor survival rates. RPS3 is been reported to be associated with the biological functions of tumor cells. This study explored the regulatory effect of RPS3 in ACC to provide new therapeutic targets for ACC therapy.MethodsWe reviewed the clinical and pathologic data of 73 ACC patients. The expression of RPS3 was examined in ACC by immunohistochemistry. Transwell, wound healing, half-maximal inhibitory concentration (IC50) and other experiments were used to determine the regulatory effect of RPS3 on ACC functions. Coimmunoprecipitation and mass spectrometry analysis were used to detect the binding proteins of RPS3, mechanisms by which RPS3/STAT1/NF-kB signaling regulates ACC behavior were assessed using western blotting (WB), qPCR, etc. To explore the regulatory effect of RPS3 on ACC in vivo, we constructed nude mouse sciatic nerve infiltration model and a lung metastasis model for studies.ResultsHigh RPS3 expression was associated with metastasis and a poor prognosis in ACC patients. Inhibition of RPS3 expression reduced ACC migration, invasion and cisplatin resistance, and overexpression of RPS3 promoted ACC migration, invasion and cisplatin resistance. Further experiments revealed that RPS3 can activate the STAT1/NF-kB signaling pathway and regulate ACC behavior through binding to STAT1. The incidence of sciatic nerve infiltration and lung metastasis in nude mice after RPS3 knockdown was lower than that of the control group in vivo.ConclusionRPS3 is highly expressed and associated with the prognosis and survival of ACC patients. The RPS3/STAT1/NF-kB pathway may play an important regulatory role in ACC migration, invasion and chemoresistance. As a new therapeutic target of ACC, its clinical application value is worthy of attention and further exploration.

Abstract Concentrating solar thermal power (CSTP) technology has become a hot issue in the present research because of its high conversion efficiency. However, traditional schemes cannot be widely applied due to their complex structure, low power density, and high cost. In view of this, based on a new type of lightweight cable mesh reflector structure and the Rankine cycle, a new conceptual design of thermal‐electric conversion device in CSTP system is proposed. The process of thermal‐electric conversion is actualized through smart and lightweight structural design; the performance estimation of the device is carried out through focusing performance analysis and thermodynamic analysis; the cycling feasibility is verified through multifield coupling simulation analysis. Compared with the existing thermal‐electric conversion devices, the device proposed in this paper has higher power‐to‐weight ratio. And the power generation system that combines the proposed device with the flexible cable net reflector has the characteristics of lightweight, portability, and small land area, which has a great significance for the popularization and application of distributed layout CSTP system.

Abstract Background Weaning post-cardiac surgery patients from mechanical ventilation (MV) poses a big challenge to these patients. Optimized left ventricular-arterial coupling (VAC) may be crucial for reducing the MV duration of these patients. However, there is no research exploring the relationship between VAC and the duration of MV. We performed this study to investigate the relationship between left ventricular-arterial coupling (VAC) and prolonged mechanical ventilation (MV) in severe post-cardiac surgery patients. Methods This was a single-center retrospective study of 56 severe post-cardiac surgery patients from January 2015 to December 2017 at the Department of Critical Care Medicine of Peking Union Medical College Hospital. Patients were divided into two groups according to the duration of MV (PMV group: prolonged mechanical ventilation group, MV > 6 days; Non-PMV group: non-prolonged mechanical ventilation group, MV ≤ 6 days). Hemodynamics and tissue perfusion data were collected or calculated at admission (T0) and 48 h after admission (T1) to the ICU. Results In terms of hemodynamic and tissue perfusion data, there were no differences between the two groups at admission (T0). Compared with the non-prolonged MV group after 48 h in the ICU (T1), the prolonged MV group had significantly higher values for heart rate (108 ± 13 vs 97 ± 12, P = 0.018), lactate (2.42 ± 1.24 vs.1.46 ± 0.58, P

To meet the high precision sun tracking needs of space deployable membrane solar concentrator and other equipment, an existing algorithm for accurately computing the sun position is improved. Firstly, compared with other theories, the VSOP (variation seculaires des orbits planetaires) 87 theory is selected and adopted to obtain the sun position in the second equatorial coordinate system. Comparing the results with data of the astronomical almanac from 2015, it is found that the deviation of the apparent right ascension does not exceed 0.17 arc seconds, while that of the apparent declination does not exceed 1.2 arc seconds. Then, to eliminate the difference in the direction of the sun position with respect to the satellite caused by the size of the satellite’s orbit, a translation transform is introduced in the proposed algorithm. Finally, the proposed algorithm is applied to the orbit of the satellite designated by SJ-4 (shijian-4). Under the condition that both of the existing and improved algorithms adopt the VSOP87 theory to compute sun position in the second equatorial coordinate system, the maximum deviation of the azimuth angle on the SJ-4 is 35.19 arc seconds and the one of pitch angle is 19.93 arc seconds, when the deviation is computed by subtracting the results given by both algorithms. In summary, the proposed algorithm is more accurate than the existing one.

The combination of a solar array and a communication antenna can reduce the entire mass, physical size, and cost in space applications. Currently, related studies mainly focus on the combination of the two structures on the one flat plate structure (FPS). Compared with the FPS, a paraboloid structure has a lower surface density and higher conversion efficiency. Therefore, a novel space large deployable paraboloid structure with power and communication integration (SSPCI) is proposed and designed in detail, for spacecraft on a sun synchronous earth orbit; it consists of a cable mesh membrane reflector (CMMR), an energy conversion device (ECD), and a three-extensible-rod (TER) pointing mechanism. To achieve the goal of integrating power and communication, the TER pointing mechanism drives the CMMR/ECD to track the sun in the sunshine region or to turn to face the ground station/other target in the Earth’s shadow region. Then, through simulation analyses of the deploying process, static force at a limit orientation, and sun tracking process of the SSPCI, it is proved that the SSPCI is feasible and has satisfactory performance. Finally, deploying experiments of the folded hoop of the CMMR and sun tracking experiments of the TER pointing mechanism on the ground were carried out successfully, which proves that the folded hoop can be deployed successfully with fairly high deploying dependability, and the TER pointing mechanism is feasible for the SSPCI from the mechanism principle and the control mode in space applications indirectly. Moreover, the tracking accuracy of the TER pointing mechanism is estimated to be within ±0.4° although the machining precision of its components is not high.

In this paper, a new high-gain antenna with beam control based on multilayer non-uniform metasurfaces (MNMSs) is proposed. The MNMS consists of multilayer non-uniform square and ring metal patches array. The phase-shift of the MNMS element can achieve 310° with the variation of geometrical sizes. Moreover, four high-gain antennas based on MNMS element are designed, fabricated, and measured to realize 0°, 30°, 45°, and 60° beam control in pitching plane, respectively. Relative bandwidth of the proposed high-gain antenna is above 12%. The simulated and measured results of the proposed antennas show that the wide-angle and azimuth direction beam control capability can be effectively realized by integrating different MNMS with the feeding horn antenna.

BackgroundPsittacosis is a zoonotic disease with a low incidence rate and a lack of specificity in clinical manifestations, making it prone to be missed, misdiagnosed, and even cause delayed treatment for patients. Metagenomic next-generation sequencing (mNGS) was successfully performed for the diagnosis of a young patient with psittacosis progressing to acute respiratory distress syndrome (ARDS), and precisely targeted antibiotic treatment was promptly administered. Additionally, a comprehensive review was conducted on 68 cases of psittacosis complicated with ARDS, with the goal of improving the clinical awareness of this disease.Case presentationThis study reports a 37-year-old young female who was infected with Chlamydia psittaci (C. psittaci) after contact with parrots and eventually developed ARDS. The patient initially developed fever and sore throat, followed by cough and expectoration. Despite receiving empirical anti-infection treatment, the condition continued to progress rapidly, and severe dyspnea developed within a short period of time. She was subsequently transferred to the intensive care unit (ICU) and underwent tracheal intubation and mechanical ventilation due to acute respiratory failure. After the DNA sequence of C. psittaci in bronchoalveolar lavage fluid (BALF) was detected through mNGS, the patient received targeted antibiotic treatment with doxycycline and moxifloxacin, and her clinical symptoms gradually improved.ConclusionEpidemiological investigations and the application of mNGS are crucial for the early identification and diagnosis of psittacosis. For suspected psittacosis patients, the application of mNGS technology could promote early identification of pathogens and targeted antimicrobial therapy, which might improve patient prognosis. In addition, young psittacosis patients without underlying disease should also be vigilant about the possibility of developing severe cases.