查看更多>>摘要：Background:Hypoxia is a significant risk factor of hypertension.However,no studies have used transcutaneous tissue partial pressure of oxygen(TcPO2)and partial pressure of carbon dioxide(TcPCO2)monitors to measure the respective partial pressures in healthy indi-viduals.Oxygen saturation(SpO2)is often used for traditional monitoring of vital signs.This study investigated the changes in TcPO2 and SpO2 values during rapid changes in altitude.The trial was registered at ClinicalTrials.gov(registration no.NCT06076057).Methods:Healthy adult volunteers were instructed to sit vertically in a hypobaric oxygen chamber,which ascended from 0 m to 2500 m at a uniform speed within 10 min.The Danish Radiometer TCM4 was used to measure TcPO2 and TcPCO2 with the ventral side of the upper arm as the measure-ment site.The Shenzhen Kerokan P0D-1 W pulse oximeter was used to measure heart rate and SpO2,with values recorded once every 500 m.Results:Altogether,49 healthy volunteers were recruited between March 2023 and August 2023.With increasing altitude,TcPO2 and SpO2 decreased significantly(P＜0.01).During the ascent from 0 m,TcPO2 began to change statistically at 500 m(P＜0.05),whereas SpO2 began to change statistically at 1000 m(P＜0.05).At the same altitude,the difference in TcPO2 was greater than the difference in SpO2.At 1000 m,there were statistically significant changes in TcPO2 and SpO2(P＜0.001).At altitudes＞500 m,statistical significance was identified between TcPO2 in both sexes(P＜0.05).Statistical significance in TcPCO2 and heart rate was observed at the different elevations(P＜0.05).Conclusion:In acutely changing low-pressure hypoxic environments,TcPO2 changed more dramatically than SpO2.
查看更多>>摘要：Background:This study aims to explore the significance of serum amylase levels in patients with organophosphorus pesticide(OP)poi-soning and to provide a new perspective for evaluating the severity and prognosis of OP poisoning.Methods:The clinical data of 67 patients with acute OP poisoning,who had been treated in the emergency department of the General Hospital of Ningxia Medical University between September 2020 and August 2022,were retrospectively analyzed.Using Spearman rank correlation,serum amylase levels during admission and severity of poisoning correlated with discharge outcomes.Based on serum am-ylase levels,receiver operating characteristic curves were plotted to predict the severity and mortality of patients who experience organ-ophosphate poisoning.The optimal threshold serum amylase level at admission was determined based on the maximum Youden index.Results:Using Spearman rank correlation analysis,serum amylase levels at admission positively correlated with the severity of poisoning and discharge outcomes,but the degree of correlation was weak(rs:0.344;0.264;P＜0.05).The patients'serum amylase levels at ad-mission had receiver operating characteristic area under the curve values of 0.726 and 0.735 to predict the degree of severe poisoning and death,respectively.Based on the maximum Youden index,the optimal threshold of serum amylase were 97.8 and 194.1 U/L when the degree of poisoning was severe and the discharge outcome of patients was died.In comparison to patients with serum amylase levels＜194.1 U/L at admission,the OR values of death in patients with serum amylase levels＞194.1 U/L at admission was 15.944(95％Cl:1.825-139.274).Conclusion:Serum amylase levels in patients with organophosphate poisoning correlate with the degree of poisoning and discharge outcomes.Higher serum amylase level was a risk factor for organophosphorus poisoning death.
查看更多>>摘要：The kidneys are complex organs responsible for waste removal and various regulatory functions.Critically ill patients often experience acute kidney injury(AKI).Although renal replacement therapy is used to manage AKI,nutritional therapy is crucial.Glutamine,an amino acid involved in cellular functions,has potential benefits when administered intravenously to critically ill patients.This administration is as-sociated with reduced mortality rates,infectious complications,and hospitalization duration.However,its use in patients with AKI remains controversial.Glutamine is used by various organs,including the kidneys,and its metabolism affects several important pathways.Intrave-nous glutamine supplementation at specific doses can improve blood marker levels and restore plasma glutamine concentrations.More-over,this supplementation reduces infections,enhances immune responses,decreases disease severity scores,and reduces complica-tions in critically ill patients.However,caution is advised in patients with multiple organ failure,particularly AKI,as high doses of glutamine may increase mortality rates.Hyperglutaminemia can have adverse effects.Monitoring and appropriate dosing can help to mitigate these risks.Kidneys rely on glutamine for various essential functions.Thus,the use of intravenous glutamine in critically ill patients with AKI re-mains controversial.Despite its potential benefits in terms of infection reduction,immunomodulation,and improved outcomes,careful con-sideration of the patient's condition,dosage,and treatment duration is necessary.Further research is needed to establish optimal guide-lines for glutamine administration in this patient population.
查看更多>>摘要：Background:The money tree is a favored indoor potted plant in China.Its seeds resemble chestnuts in both shape and flavor when cooked,which are generally considered non-toxic and safe for consumption.Case presentation:This report presents the first published case of food poisoning due to the ingestion of large amounts of money tree seeds.A 67-year-old man exhibited toxic encephalopathy symptoms and dyspnea after consuming the seeds for approximately 6 months.After empirical mechanical ventilation,therapeutic plasma exchange,and other medical interventions,the patient's clinical status improved significantly.He was subsequently discharged from the hospital.Conclusion:Consuming a substantial quantity of money tree seeds within a limited timeframe can lead to poisoning,resulting in adverse outcomes,particularly toxic encephalopathy.Moreover,plasma exchange may have some therapeutic effect.
查看更多>>摘要：Background:Estimated 4％-8％of pregnancies are complicated by asthma.Adequate management in this population is critical to min-imize complications.Patients presenting with asthma exacerbation are typically managed with standard bronchodilators and systemic cor-ticosteroids.However,additional agents may be used in patients with refractory asthma exacerbation.Ketamine has been used in refrac-tory bronchospasm,although its efficacy in published literature is heterogeneous.Case Presentation:We present a case of a pregnant patient with severe asthma exacerbation refractory to standard and salvage treatment who achieved termination of bronchospasm with ketamine infusion.Conclusion:After receiving ketamine infusion for several days,the patient had improved air flow and achieved successful extubation,without experiencing rebound bronchospasm.Although this individual clinical case alone cannot change guidelines or directives to use in refractory asthma exacerbations,it offers a possible treatment option to patients and providers in unusually severe cases with extenu-ating risk factors.
NETL
NSTL
万方数据