Multi-User Computation Offloading and Resource Allocation Algorithm in a Vehicular Edge Network.

In Vehicular Edge Computing Network (VECN) scenarios, the mobility of vehicles causes the uncertainty of channel state information, which makes it difficult to guarantee the Quality of Service (QoS) in the process of computation offloading and the resource allocation of a Vehicular Edge Computing Server (VECS). A multi-user computation offloading and resource allocation optimization model and a computation offloading and resource allocation algorithm based on the Deep Deterministic Policy Gradient (DDPG) are proposed to address this problem. Firstly, the problem is modeled as a Mixed Integer Nonlinear Programming (MINLP) problem according to the optimization objective of minimizing the total system delay. Then, in response to the large state space and the coexistence of discrete and continuous variables in the action space, a reinforcement learning algorithm based on DDPG is proposed. Finally, the proposed method is used to solve the problem and compared with the other three benchmark schemes. Compared with the baseline algorithms, the proposed scheme can effectively select the task offloading mode and reasonably allocate VECS computing resources, ensure the QoS of task execution, and have a certain stability and scalability. Simulation results show that the total completion time of the proposed scheme can be reduced by 24-29% compared with the existing state-of-the-art techniques.

Phase 1 Healthy Volunteer Study of AL01211, an Oral, Non-brain Penetrant Glucosylceramide Synthase Inhibitor, to Treat Fabry Disease and Type 1 Gaucher Disease.

Glycosphingolipid (GSL) storage diseases are caused by deficiencies in the enzymes that metabolize different GSLs in the lysosome. Glucosylceramide synthase (GCS) inhibitors reduce GSL production and have potential to treat multiple GSL storage diseases. AL01211 is a potent, oral GCS inhibitor being developed for the treatment of Type 1 Gaucher disease and Fabry disease. AL01211 has minimal central nervous system penetration, allowing for treatment of peripheral organs without risking CNS-associated adverse effects. AL01211 was evaluated in a Phase 1 healthy volunteer study with single ascending dose (SAD) and multiple ascending dose (MAD) arms, to determine safety, pharmacokinetics including food effect, and pharmacodynamic effects on associated GSLs. In the SAD arm, AL01211 showed a Tmax of approximately 3.5 hours, mean clearance (CL/F) of 130.1 L/h, and t1/2  of 39.3 hours. Consuming a high-fat meal prior to dose administration reduced exposures 3.5-5.5-fold, indicating a food effect. In the MAD arm, AL01211 had an approximately 2-fold accumulation, reaching steady-state levels by 10 days. Increasing exposure inversely correlated with a decrease in GSL with plasma glucosylceramide and globotriacylceramide reduction from baseline levels, reaching 78% and 52% by day 14, respectively. AL01211 was generally well-tolerated with no AL01211 associated serious adverse events, thus supporting its further clinical development.

High prevalence and distinctive clinical features of LMNA-associated atrioventricular block in young patients.

BACKGROUND AND AIMS: Atrioventricular block (AVB) is a degenerative disease and more commonly encountered in elderly patients, but unusual and often of unknown etiology in young patients. This study aimed to investigate the potential contributions of genetic variations to AVB of unknown reasons in young patients. METHODS: We enrolled 41 patients aged <55 years with high-degree AVB of unknown etiology whose clinical and genetic data were collected. RESULTS: Genetic variants were identified in 20 (20/41, 48.8%) patients, 11 (11/20, 55%) of whom had LMNA variants including 3 pathogenic (c.961C > T, c.936+1G > T and c.646C > T), 4 likely pathogenic (c.1489-1G > C, c.265C > A, c.1609-2A > G and c.1129C > T) and 3 of uncertain significance (c.1158-3C > G, c.776A > G and c.674G > T). Compared to those without LMNA variants, patients with LMNA variants demonstrated a later age at onset of AVB (41.45 ± 9.89 years vs 32.93 ± 12.07 years, P = .043), had more prevalent family history of cardiac events (81.8% vs 16.7%, P < .000), suffered more frequently atrial (81.8% vs 10.0%, P < .000) and ventricular (72.7% vs 10.0%, P < .000) arrhythmias, and were more significantly associated with enlargement of left atrium (39.91 ± 7.83 mm vs 34.30 ± 7.54 mm, P = .043) and left ventricle (53.27 ± 8.53 mm vs 47.77 ± 6.66 mm, P = .036). CONCLUSIONS: Our findings provide insights into the genetic etiology of AVB in young patients. LMNA variants are predominant in genotype positive patients and relevant to distinctive phenotypic properties.

The efficacy of transcutaneous electronic acupoint stimulation for improving postoperative recovery after gynecologic surgery: A systematic review and meta-analysis.

BACKGROUND: This systematic review and meta-analysis aimed to evaluate the efficacy of transcutaneous electronic acupoint stimulation (TEAS) for improving postoperative recovery after gynecologic surgery. METHODS: We performed a thorough search of 6 databases until March 2023, identifying 12 randomized controlled trials that met our predefined inclusion criteria and encompassed a total of 1510 patients. For continuous outcomes, we calculated the weighted mean difference (WMD), and for binomial outcomes, we used the risk ratio (RR). We evaluated heterogeneity among the included studies using Cochran I2 and Q statistics, utilizing a random-effects model when the I2 value exceeded 50%. To assess publication bias, we employed Egger test. RESULTS: Our analysis found that TEAS significantly reduced the risk of postoperative nausea (RR: 0.60, 95% CI: 0.43-0.83, P = .002) and postoperative vomiting (RR: 0.54, 95% CI: 0.43-0.67, P < .001), visual analogue scale (WMD: -0.47, 95% CI: -0.76 to -0.17, P = .002), as well as shortened the time to first bowel movement (WMD: -18.43, 95% CI: -20.87 to -15.99, P < .001) and time to first flatus (WMD: -8.98, 95% CI: -12.46 to -5.51, P < .001) compared to the conventional group. CONCLUSIONS: Our findings suggested that TEAS may improve postoperative recovery following gynecologic surgery. However, to confirm these results, larger randomized controlled trials encompassing a more diverse range of patient populations are urgently required.

A Game-Based Computing Resource Allocation Scheme of Edge Server in Vehicular Edge Computing Networks Considering Diverse Task Offloading Modes.

Introducing partial task offloading into vehicle edge computing networks (VECNs) can ease the burden placed on the Internet of Vehicles (IoV) by emerging vehicle applications and services. In this circumstance, the task offloading ratio and the resource allocation of edge servers (ES) need to be addressed urgently. Based on this, we propose a best response-based centralized multi-TaV computation resource allocation algorithm (BR-CMCRA) by jointly considering service vehicle (SeV) selection, offloading strategy making, and computing resource allocation in a multiple task vehicle (TaV) system, and the utility function is related to the processing delay of all tasks, which ensures the TaVs's quality of services (QoS). In the scheme, SeV is first selected from three candidate SeVs (CSVs) near the corresponding TaV based on the channel gain. Then, an exact potential game (EPG) is conducted to allocate computation resources, where the computing resources can be allocated step by step to achieve the maximum benefit. After the resource allocation, the task offloading ratio can be acquired accordingly. Simulation results show that the proposed algorithm has better performance than other basic algorithms.

Physical exercise can enhance meaning in life of college students: the chain mediating role of self-efficacy and life satisfaction.

Meaning in life refers to an individual's capacity to understand and grasp the meaning of their own existence, as well as being aware of the goals, tasks, or missions in their personal life. Previous studies have found that college students lack meaning in life, but physical exercise can enhance it. In this study, 3,196 college students completed self-report questionnaires to assess self-efficacy, life satisfaction, physical exercise, and meaning in life. The results revealed that the physical exercise not only influenced an individual's perceived meaning in life directly, but also influenced it through self-efficacy. Furthermore, it confirmed the chain mediating role of self-efficacy and life satisfaction, whereby engaging in physical exercise can ultimately impact meaning in life through self-efficacy and life satisfaction. This discovery can help educators create interventions to improve college students' physical exercise engagement and overall life satisfaction.

Identification of inflammatory-related gene signatures to predict prognosis of endometrial carcinoma.

Little is known about the prognostic risk factors of endometrial cancer. Therefore, finding effective prognostic factors of endometrial cancer is the vital for clinical theranostic. In this study, we constructed an inflammatory-related risk assessment model based on TCGA database to predict prognosis of endometrial cancer. We screened inflammatory genes by differential expression and prognostic correlation, and constructed a prognostic model using LASSO regression analysis. We fully utilized bioinformatics tools, including ROC curve, Kaplan-Meier analysis, univariate and multivariate Cox regression analysis and in vitro experiments to verify the accuracy of the prognostic model. Finally, we further analyzed the characteristics of tumor microenvironment and drug sensitivity of these inflammatory genes. The higher the score of the endometrial cancer risk model we constructed, the worse the prognosis, which can effectively provide decision-making help for clinical endometrial diagnosis and treatment.

Non-coding RNAs-EZH2 regulatory mechanisms in cervical cancer: The current state of knowledge.

Cervical cancer (CC) is among the leading causes of death in women worldwide. Both genetic and epigenetic regulators are required for the tumorigenesis and progression of CC. Non-coding RNAs (ncRNAs) are a group of RNAs that don't code for proteins yet constitute a large part of the human transcriptome, including long non-coding RNAs (lncRNAs), microRNAs (miRNAs), circular RNAs (circRNA), and other forms of non-coding RNAs. Deregulation of lncRNA, miRNA, and circRNA is implicated in the oncogenesis and development of cervical malignancies, acting as oncogenic drivers or tumor suppressors. Enhancer of zeste homolog 2 (EZH2) is the enzymatic subunit of Polycomb Repressive Complex 2 (PRC2), which functions to methylate histone H3 lysine 27 to silence gene transcription. Converging lines of evidence have revealed the oncogenic role played by EZH2 in cancers. EZH2 is upregulated in CC tissues with a robust correlation to the advanced stage, metastasis, and poor survival rate in patients. The elucidation of the roles of EZH2 in cancer has driven the development of therapeutic EZH2 inhibitors, which are approaching phase I or phase I/II clinical trials. Here we review the ncRNA-EZH2 regulatory pathways in CC that unify EZH2 and ncRNAs as an integrated system in the development of CC. Given the emerging findings for the role of the ncRNA-EZH2 regulatory axis in CC, it will be of great interest to develop novel therapeutic strategies based on their relationship.

The effect of the brightness metaphor on memory.

Brightness-based metaphor effects on perception have been widely documented. For example, moral content makes perception brighter. But does moral content make a bright memory brighter? We tested the effect of the moral brightness metaphor on different cognitive processes (perception, working memory, and long-term memory), and extended evidence of the relationship between brightness and moral concepts to the relationship between brightness and positive concepts. Different samples of college students participated in five experiments. In all experiments, moral (immoral) and positive (negative) pictures of varying levels of brightness were presented, and then participants reconstructed the brightness of each picture using a keyboard to adjust the brightness of an picture. Together, the results of ANOVAs across experiments showed that the metaphorical effect of brightness played no role in perception or working memory, but there was a significant increase in brightness in long-term memory. These results support the non-unidirectionality of metaphor, and extend the conceptual metaphor theory and simulating sensorimotor metaphors theory by enhancing the effect of metaphor through the cognitive mechanism of long-term memory.

Dispositional mindfulness and self-referential neural activity during the resting state.

Mindfulness-based interventions have been shown to impact a broad range of outcomes including enhanced attention, memory, and self-regulation. Previously, mindfulness training has been negatively correlated with brain activity across the default mode network nodes following mindfulness-based practice. Currently, little research has been done to understand the neural basis of differences in mindfulness levels in untrained individuals. In this study, we explored the relationship between the amplitude of low-frequency fluctuation (ALFF) and fractional ALFF (fALFF) during the resting state and the level of dispositional mindfulness, which was measured by using the Five Facet Mindfulness Questionnaire (FFMQ). The results showed that the total scores on the FFMQ were negatively correlated with the spontaneous activation of left premotor cortex. This indicates that individuals with higher levels of dispositional mindfulness might require less effort to control their irrelevant motor responses.

A novel D2D-MEC method for enhanced computation capability in cellular networks.

Device-to-device (D2D) communications and mobile edge computing (MEC) used to resolve traffic overload problems is a trend in the cellular network. By jointly considering the computation capability and the maximum delay, resource-constrained terminals offload parts of their computation-intensive tasks to one nearby device via a D2D connection or an edge server deployed at a base station via a cellular connection. In this paper, a novel method of cellular D2D-MEC system is proposed, which enables task offloading and resource allocation meanwhile improving the execution efficiency of each device with a low latency. We consider the partial offloading strategy and divide the task into local and remote computing, both of which can be executed in parallel through different computational modes. Instead of allocating system resources from a macroscopic view, we innovatively study both the task offloading strategy and the computing efficiency of each device from a microscopic perspective. By taking both task offloading policy and computation resource allocation into consideration, the optimization problem is formulated as that of maximized computing efficiency. As the formulated problem is a mixed-integer non-linear problem, we thus propose a two-phase heuristic algorithm by jointly considering helper selection and computation resources allocation. In the first phase, we obtain the suboptimal helper selection policy. In the second phase, the MEC computation resources allocation strategy is achieved. The proposed low complexity dichotomy algorithm (LCDA) is used to match the subtask-helper pair. The simulation results demonstrate the superiority of the proposed D2D-enhanced MEC system over some traditional D2D-MEC algorithms.

Effects of atorvastatin on the insulin resistance in women of polycystic ovary syndrome: A systematic review and meta-analysis.

BACKGROUND: Atorvastatin treatment has been suggested as a therapeutic method for women with polycystic ovary syndrome (PCOS) in many clinical studies. Nonetheless, the effects of atorvastatin on insulin resistance in PCOS patients still remain controversial. OBJECTIVE: The aim of this report was to evaluate the effects of atorvastatin therapy on the insulin resistance in the treatment of PCOS compared to that of placebo, in order to confer a reference for clinical practice. METHODS: Randomized controlled trials (RCTs) of atorvastatin for PCOS published up to August, 2020 were searched. Standardized mean difference (SMD) and 95% confidence interval (CI) were calculated, and heterogeneity was measured by the I2 test. Sensitivity analysis was also carried out. The outcomes of interest were as follows: fasting glucose concentration, fasting insulin level, homeostasis model assessment of insulin resistance (HOMA-IR) or body mass index (BMI) value. RESULTS: Nine RCTs with 406 participants were included. The difference of fasting glucose concentration in PCOS patients between atorvastatin group and placebo group was not statistically significant (8 trials; SMD -0.06, 95% CI -0.31 to 0.20, P = .66). PCOS patients in atorvastatin group had lower fasting insulin level than those in placebo group (7 trials; SMD -1.84, 95% CI -3.06 to -0.62, P < .003). The homeostasis model assessment of insulin resistance (HOMA-IR) value showed significant decrease in the atorvastatin therapy compared to placebo (6 trials; SMD -4.12, 95% CI -6.00 to -2.23, P < .0001). In contrast to placebo, atorvastatin therapy did not decrease the BMI value significantly in PCOS patients (7 trials; SMD 0.12, 95% CI -0.07 to 0.31, P = .22). CONCLUSIONS: Atorvastatin therapy can reduce insulin resistance in the treatment of patients with PCOS. In addition, further large-sample, multi-center RCTs are needed to identify these findings.

Identification Study of Edible Oil Species with Laser Induced Fluorescence Technology Based on Liquid Core Optical Fiber.

A laser- induced fluorescence detection set based on liquid core optical fiber was established in this study. Eight edible oils were discriminated by using this detection set combined with chemometrics method. The effect of length of liquid core optical fiber on laser induced fluorescence spectrum was explored, and the differences between the spectra of different edible oils were analyzed. The fluorescence spectra of 320 samples covering 8 types of edible oil were measured in 1 meter liquid core optical fiber. Principal component analysis was used in fluorescence data dimensionality reduction process. Partial least squares discriminant analysis (PLS-DA) method was used to develop the identification model to distinguish edible oil species. The results showed that the oil fluorescence intensity is greatly enhanced when liquid core optical fiber was used. With the increase of liquid core optical fiber length，the peaks of laser induced edible oil fluorescence spectra increased and the fluorescence spectra will produce red shift. The red shift tended to a constant value when the fiber length was more than 80 cm. The fluorescence spectra of different edible oils were quite different, its can be used to distinguish different types of edible oil. Principal component scores chart were get using PC1 and PC2 of edible oils fluorescence data which result in a trend of certain gather of same type of edible oil. The recognition rates of PLS-DA model for the calibration set and prediction set were both 100%. The study shows that the developed device in this study has high accuracy for identifying the edible oil species.

[Effect of Characteristic Variable Extraction on Accuracy of Cu in Navel Orange Peel by LIBS].

Heavy metals pollution in foodstuffs is more and more serious. It is impossible to satisfy the modern agricultural development by conventional chemical analysis. Laser induced breakdown spectroscopy (LIBS) is an emerging technology with the characteristic of rapid and nondestructive detection. But LIBS' s repeatability, sensitivity and accuracy has much room to improve. In this work, heavy metal Cu in Gannan Navel Orange which is the Jiangxi specialty fruit will be predicted by LIBS. Firstly, the navel orange samples were contaminated in our lab. The spectra of samples were collected by irradiating the peel by optimized LIBS parameters. The laser energy was set as 20 mJ, delay time of Spectral Data Gathering was set as 1.2 micros, the integration time of Spectral data gathering was set as 2 ms. The real concentration in samples was obtained by AAS (atom absorption spectroscopy). The characteristic variables Cu I 324.7 and Cu I 327.4 were extracted. And the calibration model was constructed between LIBS spectra and real concentration about Cu. The results show that relative error of the predicted concentrations of three relational model were 7.01% or less, reached a minimum of 0.02%, 0.01% and 0.02% respectively. The average relative errors were 2.33%, 3.10% and 26.3%. Tests showed that different characteristic variables decided different accuracy. It is very important to choose suitable characteristic variable. At the same time, this work is helpful to explore the distribution of heavy metals between pulp and peel.

Inguinoscrotal hernia of the ureter combined with renal pelvic carcinoma.

Inguinoscrotal herniation of the ureter is a rare finding, with the potential for serious surgical complications. Here we report an extremely rare case of inguinoscrotal hernia of the ureter combined with renal pelvic carcinoma. This 61-year-old man was diagnosed with right renal pelvic tumor, bilateral hydronephrosis with inguinoscrotal hernia of the right ureter, and left ureteral calculus. He was successfully treated with right nephroureterectomy, inguinoscrotal hernia repair, and left ureterolithotomy. Pathologic examinations revealed a high-grade transitional cell carcinoma.

A further insight into the biosorption mechanism of Pt(IV) by infrared spectrometry.

BACKGROUND: Platinum nanomaterial is one of the significant noble metal catalysts, and the interaction of platinum with microbe is one of the key factors in influencing the size and the distribution of the platinum nanoparticles on the microbial biomass. Some properties of Pt(IV) adsorption and reduction by resting cells of Bacillus megatherium D01 biomass have once been investigated, still the mechanism active in the platinum biosorption remains to be seen and requires further elucidating. RESULT: A further insight into the biosorption mechanism of Pt(IV) onto resting cells of Bacillus megatherium D02 biomass on a molecular level has been obtained. The image of scanning electron microscopy (SEM) of the D02 biomass challenged with Pt(IV) displayed a clear distribution of bioreduced platinum particles with sizes of nanometer scale on the biomass. The state of Pt(IV) bioreduced to elemental Pt(0) examined via X-ray photoelectron spectroscopy (XPS) suggested that the biomass reduces the Pt(IV) to Pt(II) followed by a slower reduction to Pt(0). The analysis of glucose content in the hydrolysates of D02 biomass for different time intervals using ultraviolet-visible (UV-vis) spectrophotometry indicated that certain reducing sugars occur in the hydrolyzed biomass and that the hydrolysis of polysaccharides of the biomass is a rapid process. The infrared (IR) spectrometry on D02 biomass and that challenged with Pt(IV), and on glucose and that reacted with Pt(IV) demonstrated that the interaction of the biomass with Pt(IV) seems to be through oxygenous or nitrogenous chemical functional groups on the cell wall biopolymers; that the potential binding sites for Pt species include hydroxyl of saccharides, carboxylate anion and carboxyl of amino acid residues, peptide bond, etc.; and that the free monosaccharic group bearing hemiacetalic hydroxyl from the hydrolyzed biomass behaving as an electron donor, in situ reduces the Pt(IV) to Pt(0). And moreover, the binding of the Pt(IV) to the oxygen of the carbonyl group of peptide bond caused a change in the secondary structure of proteins; i.e. a transformation, in polypeptide chains, of beta-folded to alpha-helical form; it might be expected to be more advantageous than beta-folded form to the platinum nanoparticles under shelter from gathering although the both special conformations of proteins could be much probably responsible for the stabilization of the particles. CONCLUSION: That knowledge could serve as a guide in the researches for improving the preparation of highly dispersive supported platinum catalyst and for fabricating new advanced platinum nanostructured devices by biotechnological methods.

Factors related to female sex workers' willingness to utilize VCT service: a qualitative study in Jinan city, northern China.

While national HIV prevalence remains low in China, female sex workers (FSWs) have become infected at high rates. Free voluntary HIV counseling and testing (VCT) has been offered in recent years; however, its utilization rate is low. This study explored factors related to FSWs' willingness to utilize a VCT clinic. Qualitative interviews informed by the Ecological Perspective were conducted to interview 17 FSWs and 12 managers from 23 selected entertainment establishments in Jinan, the capital of Shandong province in northern China. While the majority of FSWs professed willingness to use VCT services, they described barriers to actual utilization of services which included: misunderstandings about HIV; low perceived risk and HIV prevalence; mistrust of the free VCT; and especially anxiety about the implications of possible test results. This research suggests that increasing FSWs' utilization of VCT will require increased knowledge of HIV and VCT, and acceptance of testing and on-site VCT services.

[Tendency and mathematical model of relationship of blood ATP content with temperature and time of preservation].

To investigate the relationship of blood ATP content with temperature and time of preservation and to establish its mathematical model, adenosine triphosphate (ATP) concentration was applied as the index of the quality of erythrocytes; systematical study on variation of blood preserved in a series of different temperatures from 4 degrees C to 32 degrees C was performed, and a series of experimental data were obtained. The results showed that when the ATP concentration y = f (d, t, s) in preserved blood was given as the continuous function of the time (d), the temperature (t) and the initiate ATP concentration (s), the model was fitted with the theory of linearity regression in symbolic statistics, and the general mathematical physical equation of the variation of preserved blood quality was deduced. According to the equation, the whole blood in CPDA-1 solution could be efficiently stored for 35, 35, 29, 22, 18, 18, 13, 8, 7, 6, 6, 5, 4, 4 and 3 days in 4, 6, 8, 10, 12, 14, 16, 18, 20, 22, 24, 26, 28, 30 and 32 degrees C, respectively. In conclusion, the general tendency of the variation of preserved blood quality according to the temperature and the time was systematically disclosed for the first time, which would be propitious to estimate the blood quality in various temperatures and to instruct clinical blood transfusion.

[Effect of jianxin pinglu pill on arrhythmia and aquaporin 4 expression in rats with myocardial ischemia/reperfusion injury].

OBJECTIVE: To explore the effect of jianxin pinglu pill (JPP) on arrhythmia and aquaporin 4 (AQP4) in rats with myocardial ischemia/reperfusion (I/R) injury. METHODS: The effects of JPP on arrhythmia, mortality and AQP4 on I/R injured rats model induced by blocking left coronary artery were observed using II lead of ECG, HE stain and AQP4 immunohistochemical stain. RESULTS: JPP showed significant effect in lowering the arrhythmia occurrence and mortality, reducing myocardial ischemic edema and injury, strengthening AQP4 expression in myocardial tissue. CONCLUSION: JPP has the effect of preventing I/R induced arrhythmia, it might be related with its action in up-regulating AQP4 expression level in myocardium and reducing the intracellular edema.

[Acute respiratory failure and noninvasive positive pressure ventilation treatment in patients with severe acute respiratory syndrome].

OBJECTIVE: To describe the blood gas features and short-term outcomes of noninvasive positive pressure ventilation (NPPV) treatment for acute respiratory failure (ARF) in patients with severe acute respiratory syndrome (SARS) in this retrospective case series study sought. METHODS: Between April 22 and May 1, 2003, 120 clinically compatible SARS patients were admitted to a special hospital for infectious diseases in Beijing. All patients' records were reviewed. The outcome variables of NPPV therapy were analyzed. RESULTS: At 6 weeks of SARS onset, 25% (30/120) patients had respiratory failure with ALI/ARDS. 16 (53%) had hypercapnia (PaCO(2) > 45 mm Hg) during the course of SARS. 28 of them received NPPV therapy. One was intolerable to NPPV treatment. In the remaining 27 patients, NPPV was initiated 1.2 +/- 1.6 (0 - 10) days after onset of respiratory failure. One hour of NPPV therapy led to significant increases in PaO(2), SpO(2) and PaO(2)/FiO(2), and decrease in respiratory rate (all P < 0.01). 18 of the 27 patients were weaned successfully from NPPV. The mean duration of NPPV use was 10 +/- 6 (5 - 30) days. In addition to one patient who was intolerable to NPPV treatment, intubation was required in other 9 patients who initially had a favorable response to NPPV. Remarkable pulmonary barotrauma was noted in 7 of the 120 (5.8%) patients with SARS, among which 1 developed 2 days after intubation, and 6 occurred while the patients were on NPPV, the incidence being 22% (6/27) in patients using NPPV. The fatality rate at 13 weeks of SARS onset was 6.7% (8/120) in the patient cohort, and 26.7% (8/30) in the ALI/ARDS patients. No SARS occurred in medical staff taking care of NPPV patients. CONCLUSIONS: Some of the SARS patients with ALI/ARDS could experience CO(2) retention, which might be related to the impairment of respiratory muscles. It is proved to be feasible and appropriate for NPPV treatment of respiratory failure in SARS patients who were at high risk of intubation related complications. As there was a high incidence of remarkable barotrauma, a careful lung protective strategy is necessary during the administration of NPPV as well as invasive mechanical ventilation.