Comparison of efficacy between sequential ventilation and conventional invasive mechanical ventilation in the treatment of pulmonary hypertension complicated with respiratory failure.

OBJECTIVE: Pulmonary hypertension (PAH) is a serious progressive and fatal pulmonary disease characterized by elevated pulmonary artery pressure. Mechanical sequential ventilation has been gradually applied in the treatment of patients with PAH complicated with RF, which can effectively reduce the incidence of VAP and better promote the recovery of respiratory function. This study is aimed to determine the efficacy of sequential ventilation and conventional invasive mechanical ventilation in the treatment of pulmonary hypertension (PAH) complicated with respiratory failure (RF). METHODS: A total of 198 patients with both PAH and RF admitted to our hospital were enrolled. Among them, 102 patients were treated with sequential ventilation as a study group (stu group), and 96 patients were treated with conventional invasive mechanical ventilation as a control group (con group). Then the two groups were compared in efficacy and related indexes before and after treatment. RESULTS: The stu group experienced significantly shorter invasive ventilation time, total mechanical ventilation time, and hospitalization time than the con group (all P<0.05), and showed a significantly lower complication rate than the con group (P<0.05). The reintubation rate, weaning failure rate, and ventilator-associated pneumonia (VAP) rate of the stu group were all significantly lower than those of the con group (all P<0.05), and the stu group showed significantly higher pondus hydrogenii (pH) and arterial partial pressure of oxygen (PaO2) and significantly lower arterial carbondioxide partial pressure (PaCO2) than the con group after treatment (all P<0.05). Additionally, after treatment, the level of brain natriuretic peptide (BNP) and pulmonary artery pressure in both groups declined significantly (P<0.05), and the decline of them in the stu group was more significant than that in the con group (P<0.05). Moreover, after treatment, endothelin (ET) and angiotensin II (Ang II) in both groups declined significantly, and the decline of them in the stu group was also more significant than that in the con group (P<0.05). CONCLUSION: Compared with conventional invasive mechanical ventilation, sequential ventilation can effectively minimize the treatment time of patients with PAH complicated with RF, reduce the incidences of adverse events and complications in them, and significantly improve the blood gas analysis indexes and BNP in them, so it is worthy of clinical promotion.

Characteristics of asymptomatic COVID-19 infection and progression: A multicenter, retrospective study.

Novel coronavirus disease 2019 (COVID-19), caused by novel coronavirus SARS-CoV-2, has spread globally since the end of 2019. Asymptomatic carriers are of great concern as they can undermine the interventions to stop the pandemic. However, there is limited information about the characteristics and outcomes of the asymptomatic patients. Therefore, we conducted this retrospective study and retrieved data of 79 asymptomatic COVID-19 patients at admission from three designated hospitals in Wuhan, China. The asymptomatic patients could happen at any age, ranged from 9 to 96 years. These patients also had lower levels of alanine aminotransferase and C-reactive protein. Patchy shadowing was the most common manifestation in computed tomography scan. Some asymptomatic carriers developed mild or moderate symptoms during hospitalization. Age and comorbidities, especially hypertension, may be predictive factors for symptom development in the initially asymptomatic carriers at admission. Early detection and treatment for these presymptomatic patients before symptom onset can shorten the communicable period for the coronavirus and reduce the occurrence of severe cases.

Correlation of GLUT1 and GLUT4 with prognosis of patients with hypothyroidism and cardiac insufficiency.

OBJECTIVE: Hypothyroidism is a disease with symptoms of collective metabolic dysfunction and systemic dysfunction due to the lack of serum thyroid hormones caused by various reasons. GLUT4 is over-expressed in monocytes of patients with hyperthyroidism, there are also studies suggesting that there is a certain regulatory relationship of GLUT1 and GLUT4 with thyroid function. This study is aimed to explore the correlation of glucose transporter 1 (GLUT1) and GLUT4 with prognosis of patients with hypothyroidism and cardiac insufficiency. METHODS: From July 2016 to October 2019, totally 116 patients with cardiac insufficiency complicated with subclinical hypothyroidism treated in our hospital were enrolled in the research group (RG), and 110 patients with cardiac insufficiency but normal thyroid function were enrolled in the control group (CG). Serum GLUT1, GLUT4, free triiodothyronine (FT3), free thyroxine (FT4) and thyroid stimulating hormone (TSH) were detected, and the correlation between them was analyzed. Then the predictive value and risk factors of GLUT1 and GLUT4 for poor prognosis of hypothyroidism complicated with cardiac insufficiency were analyzed. RESULTS: The expression levels of GLUT1, GLUT4, FT3 and FT4 in serum of patients in RG was notably lower than that in CG, and TSH expression was remarkably higher than those in CG (P<0.05). In RG, GLUT1 and GLUT4 expression levels were positively correlated with FT3 and FT4 expression (P<0.05), but negatively correlated with TSH expression (P<0.05). ROC of GLUT1 and GLUT4 in RG in predicting poor prognosis of patients was over 0.8. Low expression of GLUT1 and GLUT4 and diabetes were independent risk factors for poor prognosis in patients with hypothyroidism complicated with cardiac insufficiency. CONCLUSION: GLUT1 and GLUT4 expression levels were significantly decreased in serum of patients with hypothyroidism complicated with cardiac insufficiency. Both of them have high predictive value for poor prognosis of patients, and are independent risk factors for poor prognosis of patients.