A preliminary study on the effects of fecal microbiota transplantation on the intestinal microecology of patients with severe pneumonia during the convalescence period / 中华危重病急救医学

OBJECTIVE@#To investigate the effects of fecal microbiota transplantation (FMT) on intestinal microbiome and organism in patients with severe pneumonia during the convalescence period.@*METHODS@#A prospective non-randomized controlled study was conducted. From December 2021 to May 2022, patients with severe pneumonia during the convalescence period who received FMT (FMT group) and patients with severe pneumonia during the convalescence period who did not receive FMT (non-FMT group) admitted to the First Affiliated Hospital of Guangzhou Medical University were enrolled. The differences of clinical indicators, gastrointestinal function and fecal traits between the two groups were compared 1 day before and 10 days after enrollment. The 16S rDNA gene sequencing technology was used to analyze the changes of intestinal flora diversity and different species in patients with FMT before and after enrollment, and metabolic pathways were analyzed and predicted by Kyoto Encyclopedia of Genes and Genomes database (KEGG). Pearson correlation method was used to analyze the correlation between intestinal flora and clinical indicators in FMT group.@*RESULTS@#The level of triacylglycerol (TG) in FMT group was significantly decreased at 10 days after enrollment compared with before enrollment [mmol/L: 0.94 (0.71, 1.40) vs. 1.47 (0.78, 1.86), P < 0.05]. The level of high-density lipoprotein cholesterol (HDL-C) in non-FMT group was significantly decreased at 10 days after enrollment compared with before enrollment (mmol/L: 0.68±0.27 vs. 0.80±0.31, P < 0.05). There were no significant differences in other clinical indexes, gastrointestinal function or fecal character scores between the two groups. Diversity analysis showed that the α diversity indexes of intestinal flora in FMT group at 10 days after enrollment were significantly higher than those in non-FMT group, and β diversity was also significantly different from that in non-FMT group. Differential species analysis showed that the relative abundance of Proteobacteria at the level of intestinal flora in FMT group at 10 days after enrollment was significantly lower than that in non-FMT group [8.554% (5.977%, 12.159%) vs. 19.285% (8.054%, 33.207%), P < 0.05], while the relative abundance of Fusobacteria was significantly higher than that in non-FMT group [6.801% (1.373%, 20.586%) vs. 0.003% (0%, 9.324%), P < 0.05], and the relative abundance of Butyricimonas, Fusobacterium and Bifidobacterium at the genus level of the intestinal flora was significantly higher than that in non-FMT group [Butyricimonas: 1.634% (0.813%, 2.387%) vs. 0% (0%, 0.061%), Fusobacterium: 6.801% (1.373%, 20.586%) vs. 0.002% (0%, 9.324%), Bifidobacterium: 0.037% (0%, 0.153%) vs. 0% (0%, 0%), all P < 0.05]. KEGG metabolic pathway analysis showed that the intestinal flora of FMT group was changed in bisphenol degradation, mineral absorption, phosphonate and phosphinate metabolism, cardiac muscle contraction, Parkinson disease and other metabolic pathways and diseases. Correlation analysis showed that Actinobacteria and prealbumin (PA) in intestinal flora of FMT group were significantly positively correlated (r = 0.53, P = 0.043), Bacteroidetes was positively correlated with blood urea nitrogen (BUN; r = 0.56, P = 0.029) and complement C3 (r = 0.57, P = 0.027), Firmicutes was positively correlated with BUN (r = 0.56, P = 0.029) and complement C3 (r = 0.57, P = 0.027), Fusobacteria was significantly positively correlated with immunoglobulin M (IgM; r = 0.71, P = 0.003), Proteobacteria was significantly positively correlated with procalcitonin (PCT; r = 0.63, P = 0.012) and complement C4 (r = 0.56, P = 0.030).@*CONCLUSIONS@#FMT can reduce TG level, reconstruct intestinal microecological structure, change body metabolism and function, and alleviate inflammatory response by reducing the relative abundance of harmful bacteria in patients with severe pneumonia during the convalescence period.

Feasibility of body surface electrodes instead of multipair esophageal electrodes for assessment of neural re-spiratory drive in COPD patients / 实用医学杂志

Objective To analyze the feasibility of body surface electrodes instead of multipair esophageal electrodes for the evaluation of neural respiratory drive in patients with COPD. Methods Diaphragm electromyo-gram(EMG)from body surface electrodes and multipair esophageal electrodes,was recorded in 29 patients with stable COPD recruited from outpatient clinic. Changes of neural respiratory drive of two kinds of electrodes during resting and maximal isocapnic ventilation (MIV) were observed before and after inhalation of bronchodilators. Results Ventilation significantly improved ,RMS-sur and RMS-eso significantly decreased after the inhalation of bronchodilators during resting and MIV. RMS-sur and RMS-eso were significantly correlated(r=0.660,P<0.01). Conclusion EMG from the surface electrodes may be a useful and noninvasive technique to evaluate neural respi-ratory drive in patients with COPD.

Feature Extraction for Cough-sound Recognition Based on Principle Component Analysis and Non-uniform Filter-bank / 生物医学工程学杂志

Cough recognition provides important clinical information for the treatment of many respiratory diseases. A new Mel frequency cepstrum coefficient (MFCC) extracting method has been proposed on the basis of the distributional characteristics of cough spectrum. The whole frequency band was divided into several sub-bands, and the energy coefficient for each band was obtained by method of principle component analysis. Then non-uniform filter-bank in Mel frequency is designed to improve the extracting process of MFCC by distributing filters according to the spectrum energy coefficients. Cough recognition experiment using hidden Markov model was carried out, and the results

Detection of aspiration using 99Tcm-sulfur colloid salivary scintigraphy in patients with respiratory tract diseases / 中华核医学与分子影像杂志

Objective To establish and assess the utility of 99Tcm-sulfur colloid (SC) salivary imaging in the routine evaluation of pulmonary aspiration in adult patients with respiratory tract diseases.Methods Eight patients (7 men,1 woman; age range 68 to 80 years,mean age (76 ± 4) years) with respiratory tract disease and history of aspiration by clinical assessment were evaluated prospectively by 99Tcm-SC salivary imaging from April to July 2012.A dose of 74.0 MBq 99Tcm-SC was added to 20 ml saline,mixed well,and administered orally to patients.Dynamic imaging was acquired with posterior projection for 30 min at a rate of 30 s per frame.Two experienced physicians assessed all examination results and reached consensus for final diagnosis.Radioactivity detected at either the bronchi or within the lung fields was reported as positive for aspiration.This study was approved by the institutional review board of Hospital Ethical Committee,and the written informed consent was obtained from patients or their guardians.Results All patients were positive for aspiration by 99Tcm-SC salivary imaging (8/8).Aspiration into bilateral main bronchus was seen in 2 cases,right main bronchus and branch in 4 cases,and left main bronchus and branch in 2 cases.Aspirated tracer could be visualized as early as 3 min,latest at 24 min,and the median was 19 min.Conclusion 99Tcm-SC salivary imaging is useful for the detection of aspiration in adult patients with respiratory tract diseases.

The endpoint detection of cough signal in continuous speech / 生物医学工程学杂志

The endpoint detection of cough signal in continuous speech has been researched in order to improve the efficiency and veracity of manual recognition or computer-based automatic recognition. First, using the short time zero crossing ratio(ZCR) for identifying the suspicious coughs and getting the threshold of short time energy based on acoustic characteristics of cough. Then, the short time energy is combined with short time ZCR in order to implement the endpoint detection of cough in continuous speech. To evaluate the effect of the method, first, the virtual number of coughs in each recording was identified by two experienced doctors using the graphical user interface (GUI). Second, the recordings were analyzed by automatic endpoint detection program under Matlab7.0. Finally, the comparison between these two results showed: The error rate of undetected cough is 2.18%, and 98.13% of noise, silence and speech were removed. The way of setting short time energy threshold is robust. The endpoint detection program can remove most speech and noise, thus maintaining a lower rate of error.

Research on a new method to trigger ventilator based on electromyogram / 生物医学工程学杂志

In order to improve synchrony between a ventilator and its patient, a new method for triggering a ventilator based on diaphragmatic electromyogram (EMG) is introduced. The methods to extract and process diaphragmatic EMG signals are studied. It has been shown that the characteristic parameters of a respiration activity, such as inspiratory beginning point, expiratory beginning point and respiration period, can be detected from diaphragmatic EMG envelop instead of traditional flux curve. A new parameter, designated as diaphragmatic "Intensity of EMG" for short "IEMG", is defined. Repeat respiration tests have disclosed that there is relatively high correlation between the diaphragmatic IEMG curve and its corresponding cubage curve. These results primarily demonstrate that the new synchronization method may be feasible.

The collection of sternocleidomastoid muscle EMG and its significance for monitoring of the central drive / 中国实用内科杂志

Objective To investigate the methods of recording EMGscm and its significance in monitoring of central drive.Methods Three methods of collecting EMGscm were compared.The subjects were asked to re-breath until the highest PCO2-ET was reached and the EMGscm,Flow,VT(tidal volume),Ttot(Total time of respiratory cycle),and PCO2-ET were measured during the re-breathe.Results (1)The EMGscm did not appeared until the PCO2-ET reached the value of(48.2?2.6)mm Hg.The value of PCO2-EThighest was(81.2?6.6)mm Hg.(2)As the PETCO2 increased,the Ttot became shorter and shorter,from(2.91?0.85)s to(1.92?0.39)s,while the VT became higher and higher,from(0.68?0.27)L to(2.21?0.37)L.There was a statistical relationship between the Ttot(or VT)and the PCO2-ET,and their correlative coefficient was respectively(0.86?0.12)and(0.89?0.13)(both P

The changes of SARS-IgG,X-ray of lung and lung function in patients with severe acute respiratory syndrome / 中国实用内科杂志

Objective To investigate the changes of SARS-IgG in serum,X-ray of lung and lung function in severe acute respiratory syndrome(SARS)patients.Methods During the period of 2003-06~2004-04,the SARS-IgG in serum,X-ray of lung and lung function tests were checked up in 103 SARS patients by Guangzhou Institute of Respiratory Disease in regularly every 3 months after their discharge from hospital and the SARS-IgG level in serum was compared with another 20 healthy medical workers.Results 1.On the third day after the onset of SARS disease,the optical density(OD)value of SARS-IgG in serum was(0.063?0.012)which was significantly higher than the normal control group. Moreover,from then on,it increased step by step and went up greatly in the third week(0.180?0.202)and attained the highest level(1.730?0.331)in the fourth month. Then it decreased step by step and in the 17th month,it dropped to(0.668?0.109).2.The chest X-ray of 32.3%of 62 cases became normal in the first 3 months after onset of SARS and that of 56.5% did in the 17th month.However,if 22 cases were taken into account,who did not have a re-check,80% of the cases became normal and the left 5 cases were severe patients. 3.The lung function of 16 of 25 cases became normal in 6 months after onset and among the other 9 cases,the lung function of 4 cases had an improvement in the following 3 to 6 months.Conclusion The OD value of SARS-IgG in serum in the third day can be used as a screening test of SARS. Its remarkable increase in the third week will support the diagnosis.The chest X-ray and lung function of SARS patients will improve gradually and become normal in the final.

The progress and practice of pulmonary rehabilitation in patients with chronic obstructive pulmonary disease / 中国实用内科杂志

Pulmonary rehabilitation has been shown to be effective in reducing dyspnea and improving exercise capacity and health-related quality of life in people with COPD.COPD patients with varying severity can benefit from pulmonary rehabilitation which includes exercise training,inspiratory muscle training and nutritional intervention,et al.Exercise training is the basis of pulmonary rehabilitation.In the last decade,new strategies have been developed to enhance the effects of pulmonary rehabilitation,which include promoting exercise and activity,education and self-management,psychosocial intervention.Although pulmonary rehabilitation has traditionally been provided in stable COPD patients,pulmonary rehabilitation could be started as soon as infection is controlled for AECOPD patients.As pulmonary rehabilitation is administrated,the patients should be encouraged to do exercise as much as possible with different kind of training.

The analysis and management of the diaphragmatic EMG signal / 医疗卫生装备

The method of triggering the respirator to perform airfeed by the management of the diaphragmatic electromyography (EMG) signal is introduced in this paper. By using LabVIEW, an analysis software of the diaphragmatic electromyographic (EMG) signals is developed to filter the diaphragmatic EMG signal. The characteristics of the filtered signal is analyzed to catch the inspiratory onset, and then a series of signals are sent out duly to trigger the respirator to perform airfeed, and thus the patient's respiration can be synchronized with the respirator.

The application of phrenic nerve conduction time in the resuscitation of anaesthesia / 中国病理生理杂志

AIM: To investigate the application of phrenic nerve conduction time(PNCT) in the recovery of general anaesthesia. METHODS: Pdi (t) and PNCT were measured by cervical magnetic stimulation of phrenic nerves in 8 patients before and after the administration of muscle relaxant. RESULTS: Pdi (t) was reduced from (23.7?2.4) cmH 2O to (11.5?3.4) cmH 2O (reduction rate: 51.5%, P