A low-cost machine learning framework for predicting drug-drug interactions based on fusion of multiple features and a parameter self-tuning strategy.

Poly-drug therapy is now recognized as a crucial treatment, and the analysis of drug-drug interactions (DDIs) offers substantial theoretical support and guidance for its implementation. Predicting potential DDIs using intelligent algorithms is an emerging approach in pharmacological research. However, the existing supervised models and deep learning-based techniques still have several limitations. This paper proposes a novel DDI analysis and prediction framework called the Multi-View Semi-supervised Graph-based (MVSG) framework, which provides a comprehensive judgment by integrating multiple DDI features and functions without any time-consuming training process. Unlike conventional approaches, MVSG can search for the most suitable similarity (or distance) measurement among DDI data and construct graph structures for each feature. By employing a parameter self-tuning strategy, MVSG fuses multiple graphs according to the contributions of features' information. The actual anticancer drug data are extracted from the authoritative public database for evaluating the effectiveness of our framework, including 904 drugs, 7730 DDI records and 19 types of drug interactions. Validation results indicate that the prediction is more accurate when multiple features are adopted by our framework. In comparison to conventional machine learning techniques, MVSG can achieve higher performance even with less labeled data and without a training process. Finally, MVSG is employed to narrow down the search for potential valuable combinations.

Distributed Dynamic Event-Triggered Control to Leader-Following Consensus of Nonlinear Multi-Agent Systems with Directed Graphs.

This paper investigates achieving leader-following consensus in a class of multi-agent systems with nonlinear dynamics. Initially, it introduces a dynamic event-triggered strategy designed to effectively alleviate the strain on the system's communication resources. Subsequently, a distributed control strategy is proposed and implemented in the nonlinear leader-follower system using the dynamic event-triggered mechanism, aiming to ensure synchronization across all nodes at an exponential convergence speed. Thirdly, the research shows that under the dynamic event-triggered strategy the minimum event interval of any two consecutive triggers guarantees the elimination of Zeno behavior. Lastly, the validity of the calculation results is verified by a simulation example.

RESTRICTIVE FLUID RESUSCITATION IN SEPTIC SHOCK PATIENTS HAS LOWER MORTALITY AND ORGAN DYSFUNCTION RATES THAN STANDARD THERAPY.

ABSTRACT: Background : The influence of restrictive fluid resuscitation and the early administration of vasopressors on the clinical outcomes in patients with septic shock are not fully understood. The purpose of this study was to evaluate the effects of restrictive fluid management on mortality and organ dysfunction in patients with septic shock. Methods : This study included consecutive patients with septic shock in need of fluid resuscitation. Based on the fluid management provided in the initial resuscitation phase, a comparison was made between a restrictive group and a standard fluid management group. The primary outcome was in-hospital death, whereas secondary outcomes included organ dysfunction and other adverse events. Results : A total of 238 patients were included in this study. Restrictive fluid management was administered to 59.2% of patients, whereas 40.8% received standard fluid management. Restrictive resuscitation was associated with a lower in-hospital mortality rate (24.8% vs. 52.6%), as well as a shorter median intensive care unit stay (8.0 vs. 11.0 days). The restrictive strategy was associated with a significantly lower prevalence of new-onset acute kidney injury (25.5% vs. 51.5%) and a decrease in the incidence of renal replacement therapy (20.6% vs. 40.2%). The standard group had a higher risk of the need for mechanical ventilation and a significantly lower median number of days without a ventilator than the restrictive group. The median duration of vasopressor-free days in the restrictive group was significantly longer than that in the standard group (25.0 vs. 18.0). The administration rate of inotropes in the restrictive group was significantly lower than that in the standard group. A multivariate logistic regression model showed that restrictive fluid management (odds ratio [OR], 0.312; 95% confidence interval [CI], 0.098-0.994) and vasopressor-free days (OR, 0.807; 95% CI, 0.765-0.851) protect against in-hospital death, whereas Acute Physiology and Chronic Health Evaluation II scores (OR, 1.121; 95% CI, 1.018-1.234) were independent risk factors for in-hospital death. Conclusions : Restrictive fluid resuscitation and early vasopressor protocol in patients with septic shock are associated with better outcomes, indicating that this regimen is feasible and safe.

Electromagnetically Navigated Tube Placement Device for Bedside Placement of Small Bowel Feeding Tube on Patients with Acute Severe Pancreatitis: Comparative Study.

BACKGROUND: A developing approach for the bedside installation of feeding tubes is the Electromagnetic Navigation-assisted Tube Placement Device (ENTPD). The ENTPD monitors the tip position of feeding tubes when they are inserted into the digestive tract. It aids in the avoidance of airway misalignment and allows placing into the small bowel. Several recent exploratory studies have shown that ENTPD for nasojejunal feeding tube installation can improve success rates, lower costs, and allow for a more rapid beginning of enteral nutrition. OBJECTIVES: The aim of this study was to compare the effect of using an ENTPD for bedside placement of small bowel feeding tubes with blind placement on patients with acute severe pancreatitis and to see how well the electromagnetic navigation trajectory image (ENTI) and X-ray agreed on the location of the tube tip after placement. METHODS: The study was done prospectively using randomized and single-blind methods. The 65 cases used electromagnetic navigation-assisted placement, and 58 cases were blind placement. For judging the tube tip location, we compared the success rate, median time, number of repeat placements, complications, and agreement of ENTI vs. X-ray. RESULTS: The blind placement group's success rate was 86.21% compared to the ENTPD's 95.38%, P = 0.075. The median time was significantly longer in the blind placement group (116.55 ± 68.62 min vs. 25.37 ±12.63 min, P=0.000); the average number of repeating placements was 3.02 ± 1.21 vs. 1.16 ± 0.31 (Blind placement vs. ENTPD, P = 0.002). It provided a high degree of agreement between ENTI and X-ray after contrast, κ=0.752 [95% confidence interval, 0.67-0.84]. No complications occurred in the two groups. CONCLUSION: ENTPD was used safely and effectively at the bedside to help patients with acute severe pancreatitis get feeding tubes. It not only improved the high successful rate of placement, decreased the time and reduced the exposure to X-ray, but it was also very convenient for bedside placement because of the portable equipment.

Effects of incentive spirometry respiratory trainer device on lung recruitment in non-intubated mechanical ventilation moderate ARDS patients: A retrospective study.

Objectives: A retrospective study was performed to investigate the effects of incentive spirometry (IS)respiratory trainer device on lung recruitment in non-intubated moderate ARDS patients. Method: Moderate ARDS patients who non-intubated from January 2019 to October 2022 were enrolled to the lung recruitment group and the control group. Compared the PaO2/FiO2 (P/F)ratio, lung ultrasound (LUS) score, APACHE-II score, Maximum inspiratory volume during three days (baseline, Day1, Day2, Day3) and the rate of intubation, mean hospital stay, the 28-day in-hospital mortality and the 90-days in-hospital mortality between the two groups. Results: The lung recruitment group 118 patients (73 males, 47.6 ± 16.5y) and the control group 103 patients (62 males, 50.2 ± 14.8y) were included. The P/F ratios, APACHE-II scores, LUS scores, and the maximum inspiratory volume (ml) were significantly different between the two groups (P = 0.000, P = 0.014, P = 0.013 and P = 0.001, respectively).The P/F ratios were higher (252.6 ± 55.6 v.s, 166.96.9re, p = 0.035, day2), (269.8 ± 75.7 v.s 183.9 ± 68.6, p = 0.027, day3), the APACHE-II scores were lower (10.0 ± 2.4 v.s 15.3 1e l p = 0.025, day2), (8.0 ± 1.4 v.s 14.1 ± 2.7, p = 0.000, day3), the LUS scores were higher (16.2res wv.s 21.61.6w, p = 0.043, day2), (11.4 ± 5.9 v.s 20.3 ± 6.9, p = 0.004, day3), the maximum inspiratory volumes were higher (1722.3 ± 432.2 v.s 1310.70.732., p = 0.044, day2), (1913.5467.2 v.s 1299.79452.5, p = 0.018, day3) in Lung Recruitment group than that in Control group. These data at day1, day2, and day3 were significantly improvement than baseline in Lung Recruitment group. Only 36 patients (30.5%) in Lung Recruitment group needed to intubation, while 48 patients (46.6%) in Control group (p = 0.014). The mean hospital stay in lung recruitment group was lower (12.6 ± 4.6 v.s, 18.4 ± 5.3, P = 0.018). The 28-days and the 90-days in-hospital mortality were no statistical significance between the two groups (P = 0.414 and P = 0.418, respectively). Conclusions: Using IS to perform lung recruitment in moderate ARDS patients can improve maximum inspiratory volume, PaO2/FiO2 ratio, LUS scores, and APACHE-II score and reduce the rate of intubation and the mean hospital stay, but the 28 days and the 90-days in-hospital mortality were not improved.

Comparative study of ultrasound-guided microwave ablation and traditional surgery in the treatment of plasma cell mastitis: a multicenter study.

Background: Plasma cell mastitis (PCM) is a benign breast disease that is refractory and difficult to cure. We integrated microwave ablation into the treatment of PCM to compare the clinical value of ultrasound-guided microwave ablation and traditional surgery in the treatment of PCM. Methods: A total of 68 patients with PCM who were admitted to 3 centers (Zhejiang Cancer Hospital, Hebei Province Hospital of Traditional Chinese Medicine, and Yantai Affiliated Hospital of Binzhou Medical university) from January 2017 to June 2019 were selected. All patients were diagnosed with PCM after pathological and clinical manifestations. Among these, 38 cases were treated with ultrasound-guided microwave ablation, and 30 cases were treated with traditional surgery. The operation time, hospitalization time, incision healing, intraoperative blood loss, postoperative pain degree, evaluation of breast shape effect, time taken for postoperative lesion disappearance, effective rate, and recurrence were recorded in the follow-up, and the clinical efficacy was compared and observed. Results: The effective rate of the ablation group was 86.8% (33/38), that of the operation group was 46.7% (14/30), and the difference was statistically significant (95% CI: 2.311-24.618; P<0.05). The average time of the lesion completely disappearing was 75.55±43.59 days in the ablation group and 103.87±45.98 days in the operation group, and the difference was statistically significant (P<0.05). The hospital stays, operation time, and intraoperative blood loss of patients in the ablation group were less than those of the operation group, and the difference was statistically significant (95% CI: -10.69 to -6.27, 95% CI: -77.06 to -51.26, and 95% CI: -21.54 to -13.64; P<0.05). The postoperative pain scoring, operative incision healing at 14 days after the operation, and breast appearance evaluation after treatment in the ablation group were better than those of the operation group, and the difference was statistically significant (P<0.05). Conclusions: Compared with traditional surgery, ultrasound-guided microwave ablation is a more effective treatment option for PCM.

Use of Lung Ultrasound to Differentiate Coronavirus Disease 2019 (COVID-19) Pneumonia From Community-Acquired Pneumonia.

To investigate the feasibility of lung ultrasound in evaluating coronavirus disease 2019 (COVID-19) and distinguish the sonographic features between COVID-19 and community-acquired pneumonia (CAP), a total of 12 COVID-19 patients and 20 CAP patients were selected and underwent lung ultrasound. The modified Buda scoring system for interstitial lung disease was used to evaluate the severity and treatment effect of COVID-19 on ultrasonography. The differences between modified lung ultrasound (MLUS) score and high-resolution computed tomography (HRCT) Warrick score were analyzed to evaluate their correlation. COVID-19 showed the following sonographic features: thickening (12/12), blurred (9/12), discontinuous (6/12) pleural line; rocket sign (4/12), partially diffused B-line (12/12), completely diffused B-line (10/12), waterfall sign (4/12); C-line sign (5/12); pleural effusion (1/12) and pulmonary balloon (Am line, 1/12). The last two features were rarely seen. Differences of ultrasonic features, including lesion range, lung signs and pneumonia-related complications, between COVID-19 and CAP were statistically significant (p˂ 0.05 or 0.001). MLUS scores (p = 0.006) and HRCT Warrick scores (p = 0.015) increased as the severity of COVID-19 increased. The differences between moderate (29.00 [25.75-37.50]) and severe (43.00 [38.75-47.25]) (p = 0.022) or between moderate and critical (47.50 [44.25-50.00]) (p = 0.002) type COVID-19 were statistically significant, compared with those between severe and critical types. Correlation between MLUS scores and HRCT Warrick scores was positive (r = 0.54, p = 0.048). MLUS scores (Z = 2.61, p = 0.009) and HRCT Warrick scores (Z = 2.63, p = 0.009) of five severe or critical COVID-19 patients significantly decreased as their conditions improved after treatment. The differences of sonographic features between COVID-19 and CAP patients were notable. The MLUS scoring system could be used to evaluate the severity and treatment effect of COVID-19.

[Preliminary Study on Detection of Circulating Tumor Cells in Lung Cancer by EGFR/Vimentin/Folic Acid Magnetic Sphere].

BACKGROUND: Circulating tumor cells (CTC) play an important role in the screening and prognosis of lung cancer, but the low efficiency and specificity of CTC isolation obviously restrict its clinical application. The purpose of this study is to explore a new and efficient isolation method of CTC in patients with non-small cell lung cancer (NSCLC) in order to achieve the purpose of early diagnosis of NSCLC. METHODS: Three kinds of immunolipid magnetic spheres of epidermal growth factor receptor (EGFR), vimentin and folic acid (FA) were prepared by thin film method. After characterization, the sorting scheme of cell line was explored, the optimal sorting scheme of NSCLC CTC was constructed, and its clinical application value was studied. RESULTS: The average capture efficiency of EGFR, Vimentin and FA magnetic spheres used alone and in combination to lung cancer cell lines was 78%, 79%, 82% and 91%, respectively. In 60 patients with lung cancer, using 2 CTC per 7.5 mL blood as cutoff value, the positive rates of EGFR, Vimentin and FA magnets used alone and in combination were 65.0%, 33.3%, 93.3% and 100%, respectively. It was also found that the number of CTC detected by combined use of the three magnetic spheres was correlated with clinical stages (P<0.05). CONCLUSIONS: The combination of three kinds of magnetic spheres can separate EGFR+, Vimentin+, FA+ expressed CTC, which is beneficial to the downstream analysis of CTC correlation. This study provides a new method to improve the efficiency of NSCLC CTC capture, and verifies that the captured CTC counting method can be used in the auxiliary diagnosis of lung cancer.

Integration Analysis of m6A-SNPs and eQTLs Associated With Sepsis Reveals Platelet Degranulation and Staphylococcus aureus Infection are Mediated by m6A mRNA Methylation.

Sepsis is a major threat with high mortality rate for critically ill patients. Response to pathogen infection by the host immune system is a key biological process involved in the onset and development of sepsis. Heterogeneous host genome variation, especially single nucleotide polymorphisms (SNPs), has long been suggested to contribute to differences in disease progression. However, the function of SNPs located in non-coding regions remains to be elucidated. Recently, m6A mRNA modification levels were revealed to differ at SNPs. As m6A is a crucial regulator of gene expression, these SNPs might control genes by changing the m6A level on mRNA. To investigate the potential role of m6A SNPs in sepsis, we integrated m6A-SNP and expression quantitative trait loci (eQTLs) data. Analysis revealed 15,720 m6A-cis-eQTLs and 381 m6A-trans-eQTLs associated with sepsis. We identified 1321 genes as locations of m6A-cis-eQTLs. These were enriched in platelet degranulation and Staphylococcus aureus infection pathways, which are vital for the pathophysiological process of sepsis. We conclude that m6A modification of mRNA plays a very important role in sepsis, with m6A-cis-eQTLs potentially having the most effect on individual variation in sepsis progression.

MoS2@polydopamine-Ag nanosheets with enhanced antibacterial activity for effective treatment of Staphylococcus aureus biofilms and wound infection.

Developing novel antibacterial agents to combat bacterial infection has been an everlasting task for scientists, due to the drug resistance evolved by bacteria during antibiotic treatment. In this work, we used polydopamine (PDA) to modify MoS2 nanosheets (MoS2 NSs) and then grew silver nanoparticles (AgNPs) on their surface to form MoS2@PDA-Ag nanosheets (MPA NSs) as multimodal antibacterial nanoagents to treat Staphylococcus aureus (S. aureus) biofilms and S. aureus infected wounds. In vitro results show that treatment with MPA NSs under near-infrared (NIR) laser irradiation can efficiently eradicate the established S. aureus biofilms with 99.99% of the bacteria inside biofilms killed, which shows significantly enhanced therapeutic efficacy compared with the MPA only group or the NIR laser irradiation only group. Remarkably, MPA NSs were also successfully used to treat S. aureus infected wounds in mice under NIR laser irradiation. In vivo experiments demonstrate that about 99% of bacteria in wounds were killed and the healing of the infected wounds was promoted. Overall, this work demonstrates that MPA NSs with enhanced antibacterial activity are promising nanoagents to treat S. aureus biofilms and S. aureus infected wounds.

The construction of EpCAM/vimentin-PLGA/lipid immunomagnetic microspheres and the isolation of circulating tumor cells from lung cancer.

This study aims to investigate the isolation effect of the epithelial cell adhesion molecule (EpCAM) and the vimentin antibody PLGA/lipid magnetic microsphere on the isolation and identification of lung cancer circulating tumor cells (CTC) in the isolation and identification system of lung cancer CTC. The synthesis of the magnetic microsphere was achieved by the composite package of Fe3O4 magnetite nanoparticles with poly (lactic-co-glycolic acid) carboxylic acid endcap (PLGA-COOH) and octadecyl quaternized carboxymethyl chitosan (OQC), immunomagnetic microspheres (IMS) was prepared by linking an EpCAM antibody and a vimentin antibody. Blood samples of tumor-bearing nude mice (A549 lung cancer cells) were collected. Through a separation technique, the CTCs were captured by the EpCAM immunomagnetic microspheres (EpCAM-MS) and vimentin immunomagnetic microspheres (Vim-MS), and the cells were then counted and compared with the pathological condition of the tumor tissues. The results showed that self-prepared EpCAM-MS and Vim-MS could effectively capture lung cancer CTC and match the pathological findings.

The ICU Is Becoming a Main Battlefield for Severe Maternal Rescue in China: An 8-Year Single-Center Clinical Experience.

OBJECTIVES: To review the characteristics of and to identify the reasons for severe maternal admissions to the ICU. DESIGN: This was an analytical, observational, open, and retrospective study. SETTING: In our ICU. PATIENTS: A total of 487 severe maternal cases were reviewed during the 8-year study period of January 2009 to December 2016. INTERVENTION: None. MEASUREMENTS AND MAIN RESULTS: A total of 487 severe maternal cases (12.6%) among the 3,867 patients admitted to ICU were reviewed. Of these, 361 patients were admitted for obstetric reasons, mainly pregnancy-induced hypertension (58.7%) and postpartum hemorrhage (36.8%). The remaining 126 patients were admitted for nonobstetric reasons, including cardiac-related disease (31.0%), immune-related disease (24.6%), and sepsis (20.6%). A total of 249 patients experienced combined comorbidities: the most common was a scarred uterus (100 patients; 40.2%), followed by endocrine-related disease (25.3%), immune-related disease (21.3%), and cardiac-related disease (18.1%). Central venous insertion (90.6%) was the most common intervention, followed by arterial catheter insertion (33.7%), mechanical ventilation (11.7%), blood purification (5.7%), and invasive hemodynamic monitoring (3.7%). Nine patients died during the study period, of which the death of four could have been avoided. CONCLUSIONS: The number of severe maternal cases has increased annually in our ICU. Although obstetric causes remained the most common reason for admission, the nonobstetric causes and basic complications were too complex, dangerous, and beyond the reach of the obstetrician with regard to monitoring and treatment. We call for a multidisciplinary team mainly composed of ICU staff to improve severe maternal outcomes.

MicroRNA-148b is a potential prognostic biomarker and predictor of response to radiotherapy in non-small-cell lung cancer.

miR-148b has been found to be aberrantly expressed in various tumor types. It has recently been reported to be involved in regulating radioresistance in non-small cell lung cancer (NSCLC) cells. However, its expression level and association with radiosensitivity in human patient samples have not been investigated. Real-time PCR was used to evaluate the expression levels of miR-148b. Χ (2) test was performed to analyze the association between miR-148b expression levels and clinicopathological factors or radiosensitivity. Kaplan-Meier survival curve was constructed to estimate the overall survival (OS), and the differences in survival were compared using the log-rank test. Cox regression analysis was conducted to determine the prognostic value of miR-148b. The relative level of miR-148b was significantly decreased in NSCLC tissues compared with matched non-cancerous tissues (P < 0.0001), and it was higher in tissues of patients who are good responders compared to those who are poor responders to radiotherapy (P < 0.0001). Lower expression of miR-148b was positively associated with high tumor stage (P = 0.0407) and radioresistance (P = 0.0002), and it predicted poor survival in patients with (P = 0.0129) or without (P = 0.0094) radiotherapy treatment. miR-148b was an independent prognostic factor for NSCLC as demonstrated by Cox proportional hazards risk analysis. miR-148b may serve as a prognostic biomarker of poor survival and a novel predictor of response to radiotherapy treatment in NSCLC.

MicroRNA-200a Targets EGFR and c-Met to Inhibit Migration, Invasion, and Gefitinib Resistance in Non-Small Cell Lung Cancer.

Lung cancer, especially non-small cell lung cancer (NSCLC), is the major cause of cancer death worldwide. Mutations in epidermal growth factor receptor (EGFR) and hepatocyte growth factor receptor (c-Met), both of which are receptor tyrosine kinases, have been identified in a considerable percentage of NSCLC patients. EGFR and c-Met share the same downstream pathways and cooperate not only in promoting metastasis but also in conferring resistance to tyrosine kinase inhibitor (TKI) therapies in NSCLC. MicroRNAs (miRNAs) are a family of small non-coding RNAs, usually 21-25 nucleotides long, and are critical in regulating gene expression. Abnormal miRNA expression has been implicated in the initiation and progression in many forms of cancers, including lung cancer. In this study, we found that miR-200a is downregulated in NSCLC cells, where it directly targets the 3'-UTR of both EGFR and c-Met mRNA. Overexpression of miR-200a in NSCLC cells significantly downregulates both EGFR and c-Met levels and severely inhibits cell migration and invasion. Moreover, in NSCLC cell lines that are resistant to gefitinib, a drug often used in TKI therapies to treat NSCLC, miR-200a expression is able to render the cells much more sensitive to the drug treatment.

Endothelial PAS domain-containing protein 1 confers TKI-resistance by mediating EGFR and MET pathways in non-small cell lung cancer cells.

Mutations in epidermal growth factor receptor (EGFR) rendering it constitutively active is one of the major causes for metastatic non-small-cell lung cancer (NSCLC), and EGFR-targeted therapies utilizing tyrosine kinase inhibitors (TKIs) are often used clinically as the first-line treatment. But approximately half of NSCLC patients develop resistance to these therapies, where the MET proto-oncogene is amplified by EGFR through the hypoxia-inducible factor (HIF)-1α. Here we report that endothelial PAS domain-containing protein 1 (EPAS1), with 48% sequence identity to HIF-1α, specifically binds to TKI-resistant T790M EGFR, but not to wild-type EGFR, in NSCLC cell lines. Expression of EPAS1 enhances amplification of MET when simultaneously expressed with T790M EGFR but not with wild-type EGFR, and this enhancement is independent of ligand binding domain of EGFR. MET amplification requires EPAS1, since EPAS1 knock-down reduced MET levels. When NSCLC cells expressing T790M EGFR were treated with TKIs, reduced EPAS1 levels significantly enhanced the drug effect, whereas over-expression of EPAS1 increased the drug resistant effect. This EPAS1-dependent TKI-resistance was abolished by knocking-down MET, suggesting that EPAS1 does not cause TKI-resistance itself but functions to bridge EGFR and MET interactions. Our findings suggest that EPAS1 is a key factor in the EGFR-MET crosstalk in conferring TKI-resistance in NSCLC cases, and could be used as a potential therapeutic target in TKI-resistant NSCLC patients.

[Phytoplankton community structure and its succession in isolated lakes of Poyang-Junshan Lake].

As one of the human activities that transform nature, construction of dams and dykes may impose significant effects on lake ecosystems. Due to lacking of comparative data for ecological monitoring, how the changes of phytoplankton community structure respond to altered hydrological connectivity between lakes and other water bodies is still unknown. This work chose Junshan Lake, the typical isolated lake from Poyang Lake floodplain, to investigate the succession in phytoplankton communities responding to altered connectivity. Phytoplankton samples were collected during the wet and dry seasons in Junshan Lake, to analyze the phytoplankton community structure. The results showed that, fifty three genera from six phyta were identified in Junshan Lake, with Chlorophyta (47.2%), Bacillariophyta (22.2%), Cyanophyta (14.8%) and Euglenophyta (9.3%) being the main phyta. The dominant species were Ceratium hirundinella (20.5%), Anabeana spp. (18.5%) and Microcystis spp. (12.9%) during the wet seasons. Cryptomonas ovate (38.4%), Aulacoseira granulata (15.2%) and Microcystis spp. (10.5%) dominated during the whole dry seasons. The total phytoplankton abundance was mainly composed of Cyanophyta (85.4% -87.0%). The total phytoplankton biomass was dominantly made up of Cyanophyta (45.0%), Dinophyta (21.1%), Bacillariophyta (15.6%) and Chlorophyta (11.5%) during the wet seasons. Cryptophyta (38.2%), Bacillariophyta (31.3%) and Cyanophyta (21.1%) were the main contributors of the total phytoplankton biomass during the dry seasons. The phytoplankton community structure changed from Dinophyta-Bacillariophyta type during the wet seasons of 2007-2008 to Cyanophyta- Dinophyta type during the wet seasons of 2012-2013, and changed from Dinophyta- Bacillariophyta type during the dry seasons of 2007-2008 to Cryptophyta- Bacillariophyta- Cyanophyta type during the dry seasons of 2012-2013. The abundance and biomass increased from 2.66 x 10(6) cell L(-1) during 2007-2008 to 6.77 x 10(7) cell x L(-1) during 2012- 2013, and from 0.72 mg x L(-1) during 2007-2008 to 12.30 mg x L(-1) during 2012-2013, respectively. The succession pattern of phytoplankton community in the Junshan Lake showed a decrease in the proportion of oligotrophic species as Chrysophyta and Dinophyta, and an increase in eutrophic species as Cyanophyta and Cryptophyta. Thus, being isolated from Poyang Lake might alter hydrologic factors so that the water exchange time became longer and the water flow became slower which could promote the growth and aggregation of phytoplankton eutrophication indicator species in Junshan Lake.

[Use of an electromagnetic device for insertion of bedside nasojejunal feeding tube in critically ill patients].

OBJECTIVE: To evaluate the efficacy of an electromagnetic device for correct bedside placement of nasojejunal feeding tube for patients in intensive care unit (ICU). METHODS: The clinical data of 109 patients in ICU who accepted bedside nasojejunal feeding tube placement from January 2010 to September 2012 were retrospectively analyzed. All the patients were divided into three groups according to the difference in type of nasojejunal feeding tube and the placement technique: control group 1 (n=48, Flocare feeding tube and bedside blind insertion group), control group 2 (n=28, Corflo(®) feeding tube and bedside blind insertion group), observation group (n=33, Corflo(®) feeding tube and electromagnetic tube placement device group). The success rate, the times of placement, duration of nasojejunal feeding, and safety were compared among three groups. RESULTS: The success rate of control group 2 and observation group were higher than control group 1 (71.43%, 90.91% vs. 33.33%), rate of partial success and failure rate were lower than those of control group 1 (partial success rate: 17.86%, 3.03% vs. 35.42%; failure rate: 10.71%, 6.06% vs. 31.25%, all P<0.05), and no differences were found between control group 2 and observation group. The average times for successful placement in observation group was lower than that of control group 1 and control group 2 (1.6±0.5 vs. 6.6±3.2, 5.8±2.3, both P<0.05), and the average time for successful placement was shorter in observation group than that of control group 1 and control group 2 (12.48±3.78 minutes vs. 25.27±3.61 minutes, 23.58±4.87 minutes, both P<0.05), but there was no difference between control group 1 and control group 2. No complications occurred in all three groups. CONCLUSION: Placement of a nasojejunal tube with the aid of an electromagnetic device is an excellent method for enteral nutrition, as it is safer, more efficient, with high successful rate, less time spending, and easier to master for beginners.