Research progress of spontaneous respiration in mechanical ventilation of acute respiratory distress syndrome / 中华危重病急救医学

Mechanical ventilation is an important supportive treatment for acute respiratory distress syndrome (ARDS). However, improper mechanical ventilation can cause a "second hit" to the lung, that is, ventilator-induced lung injury (VILI), characterized by translocation of pulmonary inflammatory mediators into the bloodstream, aggravating systemic inflammatory response syndrome, and multiple organ failure. Although the current protective mechanical ventilation strategy plays an important role in supporting treatment, the mortality of ARDS with mechanical ventilation is still very high. Therefore, to explore the strategy of pulmonary protective ventilation has always been the key orientation of ARDS and has important clinical significance. This article reviews the application, advantages and disadvantages of assisted and non-assisted spontaneous respiration in ARDS patients undergoing mechanical ventilation, in order to provide a reference for research and development of new strategies for ARDS protective ventilation.

An epidemiological study of metabolic syndrome in patients with different TSH levels / 中华内分泌代谢杂志

Objective To explore the epidemiological characteristics of the prevalence and incidence of metabolic syndrome(MS) in subjects with different TSH levels, which can provide a certain clinical basis for the prevention and treatment of MS. Methods According to the reference range of the TSH test system in our hospital, the subjects were divided into TSH normal group and TSH elevation group. From May to August of 2011, the whole group sampling method was used to conduct a baseline survey of 10140 permanent residents aged 40 and above in Yunyan district of Guiyang City. A total of 9618 cases were included. The prevalence of MS and its components were calculated with different TSH levels at baseline. After eliminating 3926 MS in 2011, 5692 patients with no MS were followed up for 3 years. Incidence of MS and its components were compared among different TSH levels. The median follow-up was (38. 6 ± 1. 6) months and the completion rate was 75. 40％. Results The total crude and standard prevalence of MS were 40. 82％ and 34. 46％ respectively. The crude and standard prevalence of MS in TSH normal group were 39. 96％ and 33. 90％, respectively, and in TSH elevation group were 44. 3％ and 37. 56％respectively . The comparison of crude prevalence of MS between the two groups was statistically significant (P>0. 05) and the standard prevalence of MS in TSH elevation group was also higher than that in TSH normal group. After 3 years of follow-up, the total crude and standard incidences of MS were 22. 51％ and 20. 64％, respectively. The total crude and standard incidence of MS in TSH normal group were 22. 01％ and 20. 22％, respectively and in TSH elevatlon group were 24. 69％ and 23. 20％, respectively. There was no statistically significant difference between crude incidences of MS in two groups, but the standard incidence of MS in TSH elevation group was higher than that in TSH normal group. Binary Logistic regression analysis showed that there was a positive correlation between TSH and incidence of MS in TSH elevation group. Conclusion Higher than normal levels of TSH may increase the prevalence and incidence of MS and its some components.