Effect analysis of nasotracheal suction mechanical ventilation treatment of cerebral ischemic stroke induced by sleep apnea.

OBJECTIVE: To investigate the difference between the clinical effects of nasotracheal suction (NTS) mechanical ventilation and noninvasive positive pressure ventilation (CPAP) treatment of cerebral ischemic stroke (IS) induced by sleep apnea. PATIENTS AND METHODS: Fifty-three patients diagnosed with cerebral IS caused by sleep apnea from February 2013 to February 2014 were selected for this study from our hospital. After the approval of the hospital's Ethics Committee and patients' signed consent, the patients were randomly divided into a test group (n=29 cases) and a control group (n=24 cases). All patients were given conventional treatment for stroke. The control group received the noninvasive ventilator application with CPAP model. The test group was treated with nasal endotracheal suction of mechanical ventilation treatment. Using the NIHSS scale and Barthel index, we compared the status of the nervous system on admission and after seven days stroke recovery treatment of the two groups. Through the comparison of apnea-hypopnea index (AHI), oxygen desaturation index (ODI), LSaO2 and MSaO2 of the two groups on the seventh day, we compared the efficacy of the obstructive sleep apnea-hypopnea syndrome (OSAHS). RESULTS: The NIHSS score and Barthel index score of mild, moderate and severe were compared on the OSAHS patients at admission, and the difference was not statistically significant (p > 0.05). After treatment, all patients showed lower NIHSS score and increased Barthel scores, and the difference had statistical significance (p < 0.05). For the mild OSAHS patients, we compared the NIHSS score and Barthel index score of the test and control group, and the difference was not statistically significant (p > 0.05). For the moderate and severe OSAHS patients, the NIHSS score of the test group decreased significantly. However, the Barthel index scores increased significantly, and the difference had statistical significance (p > 0.05). The AHI, LSaO2, MSaO2, and ODI index of the two groups of patients were compared with the treatment, and the differences were not statistically significant (p > 0.05). After treatment, the AHI and the ODI index of the two groups decreased, LSaO2 and MSaO2 index increased, and AHI and ODI index of the test group decreased more than that of the control group. However, the LSaO2 and the MSaO2 index increased, and the difference had statistical significance (p > 0.05). The total effective rate of patients of the test group was higher than that of the control group, but no effectiveness and overall mortality was lower than the control group. The difference was statistically significant (p > 0.05). CONCLUSIONS: Compared with noninvasive ventilator therapy, nasotracheal suction mechanical ventilation and noninvasive positive pressure ventilation treatment of cerebral IS induced by sleep apnea can naturally improve the prognosis of nervous system recovery, and improve the respiratory ventilation function. This may be a better treatment option for moderate and severe sleep apnea patients that is worthy of clinical application.

Plasma levels of TNF-α and MMP-9 in patients with silicosis.

OBJECTIVE: Silicosis is usually recognized at later stages of the disease, and early biomarkers for silicosis will be useful for timely diagnosis. We aimed at examining plasma levels of TNF-α and MMP-9, and correlation between these, in patients with different stages of silicosis in order to test suitability of these inflammatory factors as early biomarkers for silicosis. PATIENTS AND METHODS: TNF-α and MMP-9 were quantified by ELISA in plasma specimens from 30 healthy individuals (control group), 28 individuals exposed to silica dust but without clinical disease, and 30 patients with silicosis. RESULTS: Plasma levels of TNF-α and MMP-9 were increased in individuals exposed to silica dust (p < 0.05 vs. control individuals) and were further elevated in patients with silicosis (p < 0.05 vs. control individuals and individuals exposed to silica dust). There was a significant correlation between plasma levels of TNF-α and MMP-9 both in individuals exposed to silica dust (r = 0.696, p < 0.01) and patients with silicosis (r = 0.768, p < 0.01). CONCLUSIONS: Plasma levels of TNF-α and MMP-9 are increased prior to development of clinically recognized silicosis, suggesting that these biomarkers are involved in the onset and development of silicosis. Combined detection of TNF-α and MMP-9 may be useful for early diagnosis of silicosis.