Self-reported sleep characteristics are linked to type 2 diabetes in middle-aged and elderly individuals: a cross-sectional study based on NHANES.

OBJECTIVE: This study was aimed to evaluate the link between sleep characteristics and type 2 diabetes of middle-aged and elderly individuals. METHODS: Twenty thousand four hundred ninety-seven individuals enrolled in National Health and Nutritional Examination Survey (NHANES) form periods of 2005-2008 were included in this study, and 3965 individuals aged 45 years and older with complete data were detected. Variables related to sleep characteristics were analyzed by univariate analysis to identify the risk factors of type 2 diabetes, the logistic regression model was used to test for the tendency across the sections of sleep duration, and the link between sleep duration and risk of type 2 diabetes was manifested as odds ratio (OR) and 95% confidence interval (CI). RESULTS: Six hundred ninety-four individuals with type 2 diabetes were identified and enrolled in the type 2 diabetes group, while the remaining individuals (n = 3271) were enrolled in the non-type 2 diabetes group. Individuals in the type 2 diabetes group (63.9 ± 10.2) were older than those in the non-type 2 diabetes group (61.2 ± 11.5, P < 0.001). Factors of taking longer time to fall asleep (P < 0.001), sleeping less (≤ 4 h) or more (≥ 9 h) (P < 0.001), having trouble in falling asleep (P = 0.001), frequent snoring (P < 0.001), frequent sleep apnea (P < 0.001), frequent nighttime awakenings (P = 0.004), and frequent excessive daytime sleepiness (P < 0.001) were linked to the risk of type 2 diabetes. CONCLUSION: Our study revealed that sleep characteristics were closely linked to type 2 diabetes in middle-aged and elderly individuals, and a longer sleep duration might have protective effects against type 2 diabetes, but it should be constrained within 9 h/night.

Cellular Imaging Analysis Algorithm-Based Assessment and Prediction of Disease in Patients with Acute Lung Injury.

This paper uses cellular imaging analysis algorithms to assess and predict the condition of patients with acute lung injury. Given the unique optical properties of UCNPs, this paper designs a ratiometric upconversion fluorescent nanoprobe for the determination of nitric oxide (NO) content in living cells and tissues. To address the image degradation phenomenon of optical sections, this paper uses a blind deconvolution method to abate the degradation effect caused by the scattered focus surface, thus completing the image recovery. After that, grayscale and binarization are performed using the weighted average method and the Otsu method. In this paper, we propose a migration learning-based Resnet-50 network for the triple classification of unlabeled leukocytes based on the characteristics of cell images acquired by a miniaturized label-free microfluidic cell imaging detection device. The migration learning can rapidly optimize the network parameters, the short connection structure of Resnet-50 is more suitable for feature extraction of unlabeled leukocytes than the InceptionV3 model without a short connection structure, and the accuracy of the Resnet-50 network can reach 94% in the test set. In this paper, we propose two tracking algorithms based on the dynamic Gaussian mixture model and mathematical morphology-based algorithms suitable for cells of different shapes for cell tracking in microscopic images, neuronal cell labeling in fluorescent images, and cell segmentation in mice. These methods have the advantages of low cost, speed, reproducibility, and objectivity, and we hope that their elicitation will be useful for relevant cell biology research.

Clinical evaluation of prone position ventilation in the treatment of acute respiratory distress syndrome induced by sepsis.

BACKGROUND: Acute respiratory distress syndrome (ARDS) is an acute, diffuse, inflammatory lung injury. Previous studies have shown prone position ventilation (PPV) to be associated with improvement in oxygenation. However, its role in patients with ARDS caused by sepsis remains unknown. AIM: To analyze the clinical effects of PPV in patients with ARDS caused by sepsis. METHODS: One hundred and two patients with ARDS were identified and divided into a control group (n = 55) and a PPV treatment group (n = 47). Outcomes included oxygenation index, lung compliance (Cst) and platform pressure (Pplat), which were compared between the two groups after ventilation. Other outcomes included heart rate (HR), mean arterial pressure (MAP), central venous pressure (CVP), left ventricular ejection fraction (LVEF), the length of mechanical ventilation time and intensive care unit (ICU) stay, and levels of C-reactive protein (CRP), procalcitonin (PCT), and interleukin-6 (IL-6) after ventilation. Finally, mortality rate was also compared between the two groups. RESULTS: On the first day after ventilation, the oxygenation index and Cst were higher and Pplat level was lower in the PPV group than in the conventional treatment group (P < 0.05). There were no significant differences in oxygenation index, Cst, and Pplat levels between the two groups on the 2nd, 4th, and 7th day after ventilation (P > 0.05). There were no significant differences in HR, MAP, CVP, LVEF, duration of mechanical ventilation and ICU stay, and the levels of CRP, PCT, and IL-6 between the two groups on the first day after ventilation (all P > 0.05). The mortality rates on days 28 and 90 in the PPV and control groups were 12.77% and 29.09%, and 25.53% and 45.45%, respectively (P < 0.05). CONCLUSION: PPV may improve respiratory mechanics indices and may also have mortality benefit in patients with ARDS caused by sepsis. Finally, PPV was not shown to cause any adverse effects on hemodynamics and inflammation indices.

Safety and Efficacy of Sufentanil and Fentanyl Analgesia in Patients with Traumatic Brain Injury: A Retrospective Study.

BACKGROUND This study aimed to retrospectively assess and compare the safety and efficacy of sufentanil and fentanyl in the treatment of patients with traumatic brain injury. MATERIAL AND METHODS A total of 85 patients with traumatic brain injury from June 2016 to September 2018 were included in this study, and were enrolled into a sufentanil group and a fentanyl group according to different treatment methods. The patients in both groups were assessed with the Critical care Pain Observation Tool (CPOT) for analgesic score, and Richmond Agitation-Sedation Scale (RASS) for sedation score. RESULTS The scores of CPOT and RASS in the 2 groups were significantly lower than before treatment (P<0.05), but there was no significant difference between the 2 groups (P>0.05). The heart rate (HR), rate of spontaneous respiration (RR), and mean arterial pressure (MAP) of the 2 groups were significantly lower than before treatment (P<0.05), and the RR of the sufentanil group was significantly lower than that of the fentanyl group at all time points after treatment (P<0.001). CONCLUSIONS Sufentanil has a rapid onset of effect, and it is safe, stable, and effective for patients with traumatic brain injury in the intensive care unit (ICU). Compared with fentanyl, sufentanil can also effectively shorten mechanical ventilation time, time to obtain satisfactory sedation and analgesia, and the length of hospitalization in the ICU.

[Study on the effect of sedation strategy guided by driving pressure on prognosis of patients with mechanical ventilation].

OBJECTIVE: To evaluate the effect of airway driving pressure (ΔP) guided sedation strategy on the prognosis of patients with mechanical ventilation. METHODS: Patients who needed invasive mechanical ventilation and admitted to the department of intensive care unit (ICU) of Jiangxi Provincial People's Hospital from January 2017 to December 2018 were enrolled. The patients were divided into study group and control group according to the random number table. After informed consent of patients or their families, both groups received routine treatment in ICU. The control group was treated with light sedation strategy, the Richmond agitation sedation score (RASS) was performed every 4 hours, and the target was RASS > -3. ΔP in the study group was measured once a day, and the sedative target of patients with low driving pressure (ΔP ≤ 14 cmH2O, 1 cmH2O = 0.098 kPa) was RASS > -3, while the patients with high driving pressure (ΔP > 14 cmH2O) was RASS ≤ -3. The evaluation was conducted at 28 days after admission to ICU, and the patients were followed up to 60 days. The main outcome was days without mechanical ventilation in 28 days. The secondary outcomes were the rate of extubation, discharge outcome, incidence of ventilator associated pneumonia (VAP) and delirium, and 60-day survival rate. RESULTS: A total of 60 patients with respiratory failure due to various reasons were recruited, 30 in each group. There was no significant difference in gender, age, primary disease, severity of disease or ΔP between the two groups. The days without mechanical ventilation within 28 days in the study group were significantly more than that in the control group [days: 20 (0, 23) vs. 12 (0, 16), P = 0.018], and the incidences of VAP (3.3% vs. 16.7%, P = 0.045) and delirium (0% vs. 10.0%, P = 0.038) were significantly lower than that in the control group. There were no significant differences in the rate of extubation (73.3% vs. 66.7%, P = 0.273), discharge outcome [improvement (cases): 24 vs. 21, unhealed (cases): 2 vs. 5, deaths (cases): 4 vs. 4, P = 0.506] and 60-day survival rate (83.3% vs. 76.7%, P = 0.519) between the study group and control group. CONCLUSIONS: Compared with light sedation strategy, ΔP directed sedation strategy can effectively shorten the duration of mechanical ventilation and reduce the incidence of VAP and delirium in the ICU patients.

Giant primitive neuroectodermal pelvic tumour: a case report and literature review.

Primitive neuroectodermal tumours (PNETs) are rare malignant small round cell tumours. Notably, despite widespread reports of PNET in multiple parts of the body, it is extremely rare in the pelvis. Here, a rare case of giant PNET of the pelvis, that was treated with surgical intervention comprising hemipelvectomy and amputation, is reported. A 42-year-old female patient presented with an enlarged mass on the left hip and severe pain in the left lower extremity for the previous 6 months. Preoperative imaging examinations indicated an irregular soft tissue-like signal shadow sized 19 × 15 × 12 cm at the left ilium and sacrum. After surgical intervention involving left hemipelvectomy and amputation, the tumour was diagnosed by pathology as PNET. During the courses of postoperative radiotherapy and chemotherapy, local recurrence and distant metastasis occurred, and the patient died 9 months following surgical treatment. To the best of the authors' knowledge, the current case is the largest pelvic PNET resection reported to date. Pelvic PNET is extremely malignant and has a high mortality rate regardless of surgical treatment, however, surgical resection of the lesion may relieve the symptoms, extend life, and improve quality of life to a certain extent.

[Influence of air pollution on the development of intensive care unit pneumonia patients: a summary of 2 454 cases from 2014 to 2016 in Nanchang City].

OBJECTIVE: To analyze the main characteristics of air pollution in Nanchang City, and discuss the correlation between air pollution exposure (especially PM2.5) and the development of pneumonia related intensive care unit (ICU) patients and their lag effect. METHODS: 2 454 patients who lived in Nanchang City admitted to ICU of Jiangxi Provincial People's Hospital from January 1st, 2014 to December 31st, 2016 were enrolled. According to the diagnosis, the patients were divided into pneumonia group (156 cases) and non-pneumonia group (2 298 cases). The general clinical characteristics of patients and air pollution concentration in Nanchang in the year between 2014-2016 were collected. Multiple regression model was used to analyze the influence of meteorological factors on the condition of ICU patients associated with pneumonia. Using odds ratio (OR), the correlation intensity of air pollution exposure and pneumonia related ICU patients' development was reflected, and the confidence level of association intensity was reflected by the 95% confidence interval (95%CI). The distribution lag nonlinear model (DLNM) was established to evaluate the effect of air mass parameters on the time lag effect. RESULTS: The results of air pollution analysis in Nanchang City in the year between 2014-2016 showed that the annual average concentration of carbon monoxide (CO), sulfur dioxide (SO2) and nitrogen dioxide (NO2) was low and maintained at the same level in the year between 2014-2016. The annual average concentration of CO and NO2 increased in the year between 2014-2016, but the average annual concentration of SO2 decreased rapidly in the year between 2014-2016, and the average annual concentration of PM2.5 tended to slow down after the year between 2014-2016. The annual average concentration of PM10 decreased in the year between 2014-2016, but continued to rise in the year between 2014-2016. The annual mean concentration of O3 showed a trend of continuous increase from the year between 2014-2016. The age of pneumonia group was generally higher than that of non-pneumonia group, most of them were male, and had higher expected mortality and acute physiology and chronic health evaluation II (APACHE II) score. The average air temperature in the pneumonia group was lower than that in the non-pneumonia group on the day of entering the group, and the air pollutants such as PM2.5 and PM10 were significantly higher than those in the non-pneumonia group. The analysis of multiple regression models showed that PM2.5 and air temperature were significantly related to patients with ICU pneumonia on the day of entry (PM2.5: OR = 1.02, 95%CI = 1.00-1.03, P < 0.05; air temperature: OR = 0.96, 95%CI = 0.92-0.98, P < 0.05), and the effect of PM2.5 on patients with ICU pneumonia could last for at least 5 days (OR = 1.04, 95%CI = 1.00-1.09, P < 0.05), and the effect disappeared until the 7th day. According to the analysis of the influence of different concentrations of PM2.5 on ICU pneumonia patients, when the PM2.5 concentration reached 200 µg/m3, its effect on ICU pneumonia patients would last for 5 days (OR = 1.45, 95%CI = 1.07-1.76, P < 0.01). CONCLUSIONS: PM2.5 and air temperature are significantly related to the condition of ICU patients with pneumonia, and the influence of high concentration of PM2.5 on ICU patients with pneumonia has a lag effect.