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OBJECTIVE@#To evaluate the efficacy and safety of less invasive surfactant administration (LISA) in the treatment of neonatal respiratory distress syndrome (NRDS).@*METHODS@#PubMed, Cochrane Library, Embase, China Biology Medicine disc, China Scientific Journal Database, CNKI Database, and Wanfang Database were searched for randomized controlled trials (RCTs) on the use of LISA strategy in the treatment of NRDS. Literature screening and quality assessment were performed according to inclusion and exclusion criteria. Review Manager 5.3 software was used to perform the Meta analysis.@*RESULTS@#A total of 9 RCTs were included, with a total of 1 212 children with NRDS. There were 611 children in the experimental group (treated with LISA strategy) and 601 children in the control group [treated with intubation-surfactant-extubation (INSURE) strategy]. The Meta analysis showed that the use of LISA strategy reduced the rate of mechanical ventilation within 72 hours after birth (OR=0.39, 95%CI: 0.29-0.51, P0.05). There was no significant difference in the rate of repeated use of pulmonary surfactant (PS) between the two groups (P>0.05), but there was a higher incidence rate of PS reflux observed by LISA strategy (OR=2.60, 95%CI: 1.64-4.12, P<0.001).@*CONCLUSIONS@#Compared with INSURE strategy, LISA strategy has advantages in reducing the need for mechanical ventilation and the incidence rates of bronchopulmonary dysplasia and pneumothorax in children with NRDS.
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Humans , Infant, Newborn , China , Infant, Premature , Pulmonary Surfactants , Therapeutic Uses , Respiratory Distress Syndrome, Newborn , Drug Therapy , Surface-Active AgentsABSTRACT
Objective To compare and evaluate the effect of different time series models in predicting incidence of healthcare-associated infection (HAI), and explore the best model for predicting incidence of HAI.Methods Seasonal autoregressive integrated moving average (ARIMA) model, nonlinear autoregressive neural network (NARNN), and ARIMA-back propagation neural network (ARIMA-BPNN) combination model were constructed based on fitting dataset of monthly HAI incidence from 2011 to 2016 (72 months) in a tertiary first-class hospital in Shanghai, predicting dataset of monthly infection incidence from January to December 2017 were used to test the predictive effect of model, the predictive effect of different models was evaluated and compared.Results For the fitting dataset, mean absolute percentage error (MAPE) of ARIMA, NARNN, and ARIMA-BPNN combination model were 13.00％, 14.61％, and 11.95％respectively;and for the predicting dataset, MAPE of ARIMA, NARNN, and ARIMA-BPNN combination model were 15.42％, 26.31％, and 14.87％ respectively.Conclusion Three time series models can effectively predict the incidence of HAI, of which the ARIMA-BPNN combination model showed the best performance in fitting and predicting the occurrence of HAI in this hospital, and can provide data support for the hospital decision-making.
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Objective:To propose a new type of lightweight wearable lower extremity exoskeleton assisted robot system, and explore the feasibility of walking and posture change rehabilitation training for patients with gait disorder and with paraplegia under T4 spinal cord injury (exclusion of lower extremity muscle spasm and obvious pain). Methods:The active and passive hybrid wearable lower extremity exoskeleton assisted robot structure of the hip joint with two-motor active drive and the knee joint passive four-link simulating the instantaneous movement of the human body was designed. Based on modular control, the STM32F767IGT6 and peripheral circuits, attitude acquisition, power supply and crutches module control system were proposed. The exoskeleton robot was worn by a normal person to perform the experiment of leveling, slope and posture transformation and analyze hip/knee /ankle joint angles during exercise, and compare the myoelectric signals of the lateral femoral and medial femoral muscles. Results:The wearer could realize the sitting-standing posture change and the flat/slope walking only based on the exoskeleton robot system, and the hip/knee/ankle angles were basically consistent with the normal walking and the electromyographic signals of the lateral femoral, medial femoral muscle significantly decreased when the robot was worn while walking. Conclusion:The active-passive hybrid lower exoskeleton assisted robot system can still achieve the rehabilitation of walking and posture change while reducing the weight. This verified the feasibility of the assisted robot system with the active dual-motor of the hip joint and the passive four-link structure of the knee joint to help the patients with paraplegia and gait disorder to walk and recover.
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@#Objective To observe the effect of ischemic postconditioning on myocyte apoptosis in hyperlipemia rats with myocardial ischemic reperfusion.Methods Total forty-eight hyperlipemia SD rats were randomly divided into the sham-operation group, ischemic reperfusion group and ischemic postconditioning group with 16 rats in each group. The myocardial ischemic reperfusion model of rat was made. Rats in the ischemic reperfusion group were ligated for 40 min ischemia, and then reperfused for 240 min. Rats in the ischemic postconditioning group were treated for 40 min ischemia, reperfused for 10 s and 10 s ischemia for three cycles, and then reperfused for 240 min. Rats in the sham-operation group were opened the chest to braid for ringer without deligation. The presence of apoptotic myocytes was detected by the method of terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL). Meanwhile, the serum creatine kinase activity and myocardial infarct size were measured.Results The creatine kinase activity was 734.86±25.48 U/L in the ischemic postconditioning group and 967.64±28.16 U/L in the ischemic reperfusion group after reperfusion, all significantly higher than that (274.28±16.94 U/L) in the sham-operation group ( P<0.05), and it was significantly lower in the ischemic postconditioning group than that in the ischemic reperfusion group ( P<0.05). There was no significant difference in ratio of myocardial ischemic size and left ventricle after reperfusion between the ischemic postconditioning group and the ischemic reperfusion group. But the ratio of myocardial necrotic size and ischemic size of the ischemic postconditioning group was 24.8%±6.7% and significantly lower than that (38.2%±7.1%) of the ischemic reperfusion group ( P<0.05). No apoptotic myocardial cells were found after the reperfusion in the sham-operation group. The apoptotic rate in the ischemic postconditioning group (12.7%±2.8%) was significantly lower than that (20.9%±3.7%) in the ischemic reperfusion group ( P<0.05).Conclusion Ischemic postconditioning can relieve the ischemic reperfusion injury in hyperlipemia rats, the mechanism of which may be related with decreased myocardial apoptosis.