Respiratory Group Research Articles

Effect of Quality Control Circle Activity Nursing Combined with Respiratory Function Exercise Nursing on Patients with Esophageal Cancer.

Objective To explore the effect of quality control circle activity nursing combined with respiratory function exercise nursing on esophageal cancer patients' immune function and nutritional status. Methods The clinical case data of 119 esophageal cancer patients admitted to our hospital were selected as the research objects from May 2019 to July 2021. They were divided into the quality control circle activity care group (QCCAC) (9 cases dropped due to incomplete case data, n= 50) and respiratory function exercise care group (10 cases dropped due to incomplete case data, n=50) by the random number table method, the respiratory function exercise care group was treated with respiratory function exercise care, while the QCCAC group was treated with QCCAC. Changes in lung function, immune function, and nutritional status before and after nursing were compared in the two groups of patients. Results Before nursing, there was no significant difference in pulmonary function indexes, immune function indexes, and the level of nutritional status indicators between the two groups (P > 0.05). After nursing, the finger pulse oxygen saturation, vital capacity (VC), respiratory rate, forced vital capacity (FVC), deep inspiratory volume (IC), and maximum ventilation (MVV) of the QCCAC improved, and the QCCAC group was significantly higher than the respiratory function exercise care group (P < 0.05). After nursing, the QCCAC's CD3+, CD4+, IgG, IgM, and IgA levels increased, and the QCCAC group was significantly higher than the respiratory function exercise care group. The CD8+ level decreased, and the QCCAC was lower than the respiratory function exercise care group (P < 0.05). After continuous nursing, the QCCAC's D-lactic acid, DAO, FFMI, Hb, ALB, PA, and other nutritional evaluation indexes all increased, and the QCCAC was significantly higher than the respiratory function exercise care group (P < 0.05). Conclusion Quality control circle activity nursing combined with respiratory function exercise nursing can effectively improve the immune function, respiratory function, and nutritional status of esophageal cancer patients.

Respiratory deficits in a female rat model of Parkinson's disease.

What is the central question of this study? How does the 6-hydroxydopamine (6-OHDA)-induced Parkinson's disease model affect the respiratory response in female rats? What effect does ovariectomy have on that response? What is the main finding and its importance? The results suggest a protective effect of ovarian hormones in maintaining normal neuroanatomical integrity of the medullary respiratory nucleus in females. It was observed that ovariectomy alone reduced neurokinin-1 density in the pre-Bötzinger complex and Bötzinger complex, and there was an incremental effect of 6-OHDA and ovariectomy on retrotrapezoid nucleus neurons. Emerging evidence indicates that the course of Parkinson's disease (PD) includes autonomic and respiratory deficiencies in addition to the classical motor symptoms. The prevalence of PD is lower in women, and it has been hypothesized that neuroprotection by ovarian hormones can explain this difference. While male PD animal models present changes in the central respiratory control areas, as well as ventilatory parameters under normoxia and hypercapnia, little is known about sex differences regarding respiratory deficits in this disease background. This study aimed to explore the neuroanatomical and functional respiratory changes in intact and ovariectomized (OVX) female rats subjected to chemically induced PD via a bilateral intrastriatal injection of 6-hydroxydopamine (6-OHDA). The respiratory parameters were evaluated by whole-body plethysmography, and the neuroanatomy was monitored using immunohistochemistry. It was found that dopaminergic neurons in the substantia nigra and neurokinin-1 receptor density in the rostral ventrolateral respiratory group, Bötzinger and pre-Bötzinger complex were reduced in the chemically induced PD animals. Additionally, reduced numbers of Phox2b neurons were only observed in the retrotrapezoid nucleus of PD-OVX rats. Concerning respiratory parameters, in OVX rats, the resting and hypercapnia-induced tidal volume (VT ) is reduced, and ventilation ( ) changes independently of 6-OHDA administration. Notably, there is a reduction in the number of retrotrapezoid nucleus Phox2b neurons and hypercapnia-induced respiratory changes in PD-OVX animals due to a 6-OHDA and OVX interaction. These results suggest a protective effect induced by ovarian hormones in neuroanatomical changes observed in a female experimental PD model.

Daiana Stolz: transforming the agenda for lung health

When I meet Daiana Stolz over videocall, she has travelled from the University of Freiburg, Germany, where she is Director and Chair of the Clinic of Respiratory Medicine in the Faculty of Medicine, to University Hospital Basel, Switzerland, where she is Professor and Attending for Respiratory Medicine and Research Group Leader of Pulmonary Medicine in the Clinic of Respiratory Medicine and Pulmonary Cell Research. “I'm currently balancing between the two research groups”, she says. At these institutions, she does clinical and translational research focusing on chronic obstructive pulmonary disease (COPD), asthma, and respiratory infection. Towards the elimination of chronic obstructive pulmonary disease: a Lancet CommissionDespite substantial progress in reducing the global impact of many non-communicable diseases, including heart disease and cancer, morbidity and mortality due to chronic respiratory disease continues to increase. This increase is driven primarily by the growing burden of chronic obstructive pulmonary disease (COPD), and has occurred despite the identification of cigarette smoking as the major risk factor for the disease more than 50 years ago. Many factors have contributed to what must now be considered a public health emergency: failure to limit the sale and consumption of tobacco products, unchecked exposure to environmental pollutants across the life course, and the ageing of the global population (partly as a result of improved outcomes for other conditions). Full-Text PDF

Hospital and Neurodevelopmental Outcomes in Nano-Preterm Infants Receiving Invasive vs Noninvasive Ventilation at Birth

Infants with gestational age between 22 0/7 and 23 6/7 weeks (referred to as nano-preterm infants) are at very high risk of adverse outcomes. Noninvasive respiratory support at birth improves outcomes in infants born at 24 0/7 to 27 6/7 weeks' gestational age. Evidence is limited on whether similar benefits of non-invasive respiratory support at birth extend to nano-preterm infants. To evaluate the hypothesis that intubation at 10 minutes or earlier after birth is associated with a higher incidence of bronchopulmonary dysplasia (BPD) or death by 36 weeks' postmenstrual age (PMA) in nano-preterm infants. This observational cohort study included all nano-preterm infants at a level IV neonatal intensive care unit who were delivered from January 1, 2014, to June 30, 2021. Infants receiving palliative or comfort care at birth were excluded. Infants were grouped based on first intubation attempt timing after birth (>10 minutes after birth and ≤10 minutes as noninvasive and invasive respiratory support at birth groups, respectively). The primary outcome was the composite outcome of BPD (physiological definition) or death by 36 weeks' PMA. All 230 consecutively born, eligible nano-preterm infants were included, of whom 88 (median [IQR] gestational age, 23.6 [23.4-23.7] weeks; 45 [51.1%] female; 54 [62.1%] Black) were in the noninvasive respiratory support at birth group and 142 (median [IQR] gestational age, 23.0 [22.4-23.3] weeks; 71 [50.0%] female; 94 [66.2%] Black) were in the invasive respiratory support at birth group. The incidence of BPD or death by 36 weeks' PMA did not differ between the noninvasive and invasive respiratory support groups (83 of 88 [94.3%] in the noninvasive group vs 129 of 142 [90.9%] in the invasive group; adjusted odds ratio, 2.09; 95% CI, 0.60-7.25; P = .24). Severe intraventricular hemorrhage or death by 36 weeks' PMA was lower in the invasive respiratory support at birth group (adjusted odds ratio, 2.20; 95% CI, 1.07-4.51; P = .03). This cohort study's findings suggest that noninvasive respiratory support in the first 10 minutes after birth is feasible but is not associated with a decrease in the risk of BPD or death compared with intubation and early surfactant delivery in nano-preterm infants.

Dual orexin receptor blocker suvorexant attenuates hypercapnic ventilatory augmentation in mice

Suvorexant (Belsomra(R)), a dual orexin receptor antagonist widely used in the treatment of insomnia, inhibits the arousal system in the brain. However, the drug’s ventilatory effects have not been fully explored. This study aims to investigate the expression of orexin receptors in respiratory neurons and the effects of suvorexant on ventilation. Immunohistology of brainstem orexin receptor OX2R expression was performed in adult mice (n = 4) in (1) rostral ventral respiratory group (rVRG) neurons projecting to the phrenic nucleus (PhN) retrogradely labeled by Fluoro-Gold (FG) tracer, (2) neurons immunoreactive for paired like homeobox 2b (Phox2b) in the parafacial respiratory group/retrotrapezoid nucleus (pFRG/RTN), and (3) neurons immunoreactive for neurokinin 1 receptor (NK1R) and somatostatin (SST) in the preBötzinger complex (preBötC). Additionally, we measured in vivo ventilatory responses to hyperoxic hypercapnia (5% CO2) and hypoxia (10% O2) before and after suvorexant pretreatment (10 and cumulative 100 mg/kg) in unrestrained mice (n = 10) in a body plethysmograph. We found the OX2R immunoreactive materials in pFRG/RTN Phox2b and preBötC NK1R/SST immunoreactive neurons but not in FG-labeled rVRG neurons, which suggests the involvement of orexin in respiratory control. Further, suvorexant expressly suppressed the hypercapnic ventilatory augmentation, otherwise unaffecting ventilation. Central orexin is involved in shaping the hypercapnic ventilatory chemosensitivity. Suppression of hypercapnic ventilatory augmentation by the orexin receptor antagonist suvorexant calls for caution in its use in pathologies that may progress to hypercapnic respiratory failure, or sleep-disordered breathing. Clinical trials are required to explore the role of targeted pharmacological inhibition of orexin in ventilatory pathologies.

Krebs von den Lungen-6 glycoprotein circulating levels are not useful as prognostic marker in COVID-19 pneumonia: A large prospective cohort study.

Coronavirus disease 2019 (COVID-19) has rapidly expanded worldwide. Currently, there are no biomarkers to predict respiratory worsening in patients with mild to moderate COVID-19 pneumonia. Small studies explored the use of Krebs von de Lungen-6 circulating serum levels (sKL-6) as a prognostic biomarker of the worsening of COVID-19 pneumonia. We aimed at a large study to determine the prognostic value of sKL-6 in predicting evolving trends in COVID-19. We prospectively analyzed the characteristics of 836 patients with COVID-19 with mild lung disease on admission. sKL-6 was obtained in all patients at least at baseline and compared among patients with or without respiratory worsening. The receiver operating characteristic curve was used to find the optimal cutoff level. A total of 159 (19%) patients developed respiratory worsening during hospitalization. Baseline sKL-6 levels were not higher in patients who had respiratory worsening (median {IQR} 315.5 {209–469} vs. 306 {214–423} U/ml p = 0.38). The last sKL-6 and the change between baseline and last sKL-6 were higher in the respiratory worsening group (p = 0.02 and p < 0.0001, respectively). The best sKL-6 cutoff point for respiratory worsening was 497 U/ml (area under the curve 0.52; 23% sensitivity and 85% specificity). sKL-6 was not found to be an independent predictor of respiratory worsening. A conditional inference tree (CTREE) was not useful to discriminate patients at risk of worsening. We found that sKL-6 had a low sensibility to predict respiratory worsening in patients with mild-moderate COVID-19 pneumonia and may not be of use to assess the risk of present respiratory worsening in inpatients with COVID-19 pneumonia.

Dietary selection of metabolically distinct microorganisms drives hydrogen metabolism in ruminants

Ruminants are important for global food security but emit the greenhouse gas methane. Rumen microorganisms break down complex carbohydrates to produce volatile fatty acids and molecular hydrogen. This hydrogen is mainly converted into methane by archaea, but can also be used by hydrogenotrophic acetogenic and respiratory bacteria to produce useful metabolites. A better mechanistic understanding is needed on how dietary carbohydrates influence hydrogen metabolism and methanogenesis. We profiled the composition, metabolic pathways, and activities of rumen microbiota in 24 beef cattle adapted to either fiber-rich or starch-rich diets. The fiber-rich diet selected for fibrolytic bacteria and methanogens resulting in increased fiber utilization, while the starch-rich diet selected for amylolytic bacteria and lactate utilizers, allowing the maintenance of a healthy rumen and decreasing methane production (p < 0.05). Furthermore, the fiber-rich diet enriched for hydrogenotrophic methanogens and acetogens leading to increased electron-bifurcating [FeFe]-hydrogenases, methanogenic [NiFe]- and [Fe]-hydrogenases and acetyl-CoA synthase, with lower dissolved hydrogen (42%, p < 0.001). In contrast, the starch-rich diet enriched for respiratory hydrogenotrophs with greater hydrogen-producing group B [FeFe]-hydrogenases and respiratory group 1d [NiFe]-hydrogenases. Parallel in vitro experiments showed that the fiber-rich selected microbiome enhanced acetate and butyrate production while decreasing methane production (p < 0.05), suggesting that the enriched hydrogenotrophic acetogens converted some hydrogen that would otherwise be used by methanogenesis. These insights into hydrogen metabolism and methanogenesis improve understanding of energy harvesting strategies, healthy rumen maintenance, and methane mitigation in ruminants.

Characterisation of Disease Patterns of Dermatomyositis with Different Initial Manifestations.

PurposeTo determine the characteristics and prognoses of dermatomyositis (DM) by comparing the difference in initial symptoms.Patients and MethodsA retrospective analysis was performed on the patients diagnosed with DM from 1 January 2019 to 1 January 2021. Based on the firstly presented symptoms, patients were divided into five groups, namely rash group, muscle weakness group, arthritis group, respiratory symptom group and atypical symptom group. Clinical and laboratory data were recorded. All patients were followed up until 31 May 2021.ResultsIn total 136 DM patients, rash (40%) was the most common initial symptom, followed by respiratory symptoms (22%), arthritis (20%), muscle weakness (10%) and atypical symptoms (8%). Rash group and atypical group had a higher positive rate of anti-TIF1γ antibodies than arthritis group and respiratory symptom group (P < 0.05). Respiratory symptom and arthritis groups had a higher positive rate of anti-Ro52 antibodies than rash and muscle weakness groups (P < 0.05). Respiratory group had a higher incidence of ILD than rash and atypical groups. The FVC and DLCO in respiratory group were significantly lower than rash group, arthritis group and atypical group (P < 0.05). The survival rate of rash group was significantly higher than muscle weakness group and arthritis group (P < 0.05).ConclusionDM patients with different initial manifestations had different myositis antibodies and prognoses.

Fetal Ductus Arteriosus Premature Constriction.

This study aimed to investigate the connections between the echocardiography indices of fetal ductus arteriosus premature constriction and newborn prognosis by analyzing 22 cases of spontaneous fetal ductus arteriosus premature constriction.An ultrasonic instrument was used to observe prenatal fetal heart state, combine clinical examination data and echocardiographic results after delivery, summarize the ultrasound manifestations and imaging characteristics, and analyze the prognosis of the fetus.In all cases, fetal ductus arteriosus premature constriction occurred in the third trimester of pregnancy (34 + 1 to 41 weeks), and no abnormality in extracardiac organs were observed. Seven neonates required respiratory support due to the accompanying severe tricuspid regurgitation. The remaining 15 neonates did not receive respiratory support, including 4 with severe tricuspid regurgitation, 5 with moderate regurgitation, and 6 with mild regurgitation. Significant differences were observed in the fetal right atrium size and tricuspid regurgitation severity between the neonatal respiratory support group and non-respiratory support group. Furthermore, there were statistical differences in the ductus arteriosus inner diameter and pulsation index between the two groups.The severity of fetal ductus arteriosus premature contraction accompanied by tricuspid regurgitation and right atrium enlargement can predict the immediate prognosis of the newborn and provide guidance for the clinical judgment of the timing of pregnancy termination.

Frequency of Detection and Prevalence Factors Associated with Common Respiratory Pathogens in Equids with Acute Onset of Fever and/or Respiratory Signs (2008-2021).

A voluntary biosurveillance program was established in 2008 in order to determine the shedding frequency and prevalence factors for common respiratory pathogens associated with acute onset of fever and/or respiratory signs in equids from the USA. Over a period of 13 years, a total of 10,296 equids were enrolled in the program and nasal secretions were analyzed for the qPCR detection of equine influenza virus (EIV), equine herpesvirus-1 (EHV-1), EHV-4, equine rhinitis A and B virus (ERVs), and Streptococcus equi subspecies equi (S. equi). Single infections with respiratory pathogens were detected in 21.1% of the submissions with EIV (6.8%) and EHV-4 (6.6%) as the two most prevalent viruses, followed by S. equi (4.7%), ERVs (2.3%), and EHV-1 (0.7%). Multiple pathogens were detected in 274 horses (2.7%) and no respiratory pathogens in 7836 horses (76.2%). Specific prevalence factors were determined for each of the six respiratory pathogen groups; most differences were associated with age, breed, and use of the horses, while the clinical signs were fairly consistent between viral and bacterial respiratory infections. Monitoring the frequency of detection of common respiratory pathogens is important in order to gain a better understanding of their epidemiology and to implement management practices aimed at controlling disease spread.

Analysis of specific sIgE detection of house dust mites and aspergillus fumigatus in 2 535 patients with respiratory allergic diseases and respiratory infectious diseases in the Guangzhou area

Objective: To compare the specific IgE positive rates of the patients between allergic respiratory diseases and respiratory infectious diseases in Guangzhou, the relationship between the co-sensitization of house dust mite (HDM) allergen and Aspergillus fumigatus (AF) allergen and asthma, allergic rhinitis with asthma, pneumonia, upper respiratory infections, bronchitis, serum total immunoglobulin E (total Immunoglobulin E, tIgE) and age were analyzed, to provide the basis for the prevention and treatment of respiratory allergic diseases and respiratory infectious diseases in this area. Methods: A total of 2 535 patients with confirmed respiratory allergic diseases and respiratory infectious diseases were selected retrospectively from the outpatient or inpatient department of the First Affiliated Hospital of Guangzhou Medical University from April 2017 to June 2021 and detected HDM and AF specific IgE (sIgE) by the ImmunoCAP system. The age range was 1 to 89 years. The median age was 5 years. The average age was 9. ≤3 years old group n=894, 4-6 years old group n=721, 7-18 years old group n=615, 19-49 years old group n=207, >49 years old group n=98. There were 1 596 males (62.96%) and 939 females (37.04%). There were 1 279 cases of allergic diseases and 1 256 cases of respiratory infectious diseases. The different disease groups were divided into asthma group (411 cases), allergic rhinitis group (458 cases), allergic rhinitis combined with asthma group (410 cases), pneumonia group (463 cases), upper respiratory tract infection group (299 cases) and bronchitis group (494 cases). The difference of specific IgE (sIgE) and tIgE between HDM and AF was analyzed. For statistical analysis, continuous variables were tested by Mann-Whitney U. Classification data by chi-square test or Fisher's exact test. Results: 1 313 (51.79%) patients were sIgE positive for HDM allergen, 65 (2.56%) were sIgE positive for AF allergen, and 50 (1.97%) were both positive. In the respiratory allergic disease group, 877 cases (68.57%,877/1 279) were positive for HDM allergen sIgE, 57 cases (4.46%,57/1 279) were positive for AF allergen sIgE, and 44 cases (3.44%,44/1 279) were both positive; 436 cases (34.71%,436/1 256) of respiratory infectious diseases were positive for HDM allergen sIgE, 8 cases (0.64%,8/1 256) were positive for AF allergen sIgE, and 6 cases (0.48%,6/1 256) were both positive. In monosensitization, the HDM allergen sIgE sensitization rate was the highest in the allergic rhinitis & asthma group, at 80.24% (329/410). The positive rate of HDM allergen sIgE in male patients was 53.76%(858/1 596), and the positive rate in female patients was 46.22%(434/939), and the difference between the two was statistically significant (χ2=13.449, P<0.001). In polysensitization, asthma patients (5.35%,22/411) had the highest positive rate of HDM sensitization with AF, followed by allergic rhinitis patients (3.06%,14/458), allergic rhinitis with asthma (1.95%,8/410). The positive rate of respiratory infectious diseases such as pneumonia (0.43%,2/463), upper respiratory infections (0.33%,1/299), and bronchitis (0.61%,3/494) with AF was extremely low. The positive rate of HDM combined with AF in infants(≤3 years old group,0.34%, 3/894; 4-6 years old group, 0.97%, 7/721)was significantly lower than that in teenagers and adults(7-18 years old group,3.58%, 22/615; 19-49 years old group,6.28%, 13/207;>49 years old group,5.10%, 5/98).In the patients with HDM and AF combined sensitization, HDM sIgE levels were distributed in all grades, and AF sIgE levels were mainly in grades 1, 2, and 3. Conclusion: The positive rate of HDM combined with AF was higher in patients with respiratory allergic diseases such as asthma, allergic rhinitis, and allergic rhinitis combined with asthma, suggesting that clinical attention should be paid to the combination of HDM and AF in patients with asthma and allergic rhinitis, especially adults, more likely to be combined with AF.

Positioning for acute respiratory distress in hospitalised infants and children.

Positioning for acute respiratory distress in hospitalised infants and children.

Sexual, physical, mental and sleep sequelae four months after SARS-CoV-2 disease

Long term sequelae can be observed after SARS-CoV2. To describe the sexual, physical, mental and sleep sequelae four months after SARS-CoV2 diagnosis. Patients recovering from SARS-CoV2 with different degrees of disease severity were consecutively included and separated in two study groups, namely Group 1 including patients that had an acute respiratory distress syndrome (ARDS) and Group 2 including those with mild or moderate COVID-19. Handgrip strength, respiratory polygraphy (RP), Quality of life using the SF-12 questionnaire, and the international index of erectile (IIEF-5) function were assessed. Twenty patients who had ARDS, and 10 without ARDS were included. Erectile dysfunction was observed in 77 and 10% of patients with and without ARDS, respectively (p < 0.01). The figures for sleep obstructive apnea were 82 and 40% respectively (p = 0.02) and for the physical domain SF-12 score were 39.2 and 47.9 points respectively (p = 0.01). No differences in muscle strength were observed. After a multivariable analysis, previous ARDS due to COVID-19 was independently associated with erectile dysfunction, with an odds ratio of 30.6 (95% confidence intervals, 3.08300.3, p = 0.003). Among men with ARDS due to COVID-19, the prevalence of erectile dysfunction was high and independently associated with a severe disease four months after discharge.

Clinical significance of respiratory virus coinfection in children with Mycoplasma pneumoniae pneumonia

BackgroundThe prevalence of refractory Mycoplasma pneumoniae (MP) pneumonia has been increasing. However, few studies have investigated the impact of respiratory virus coinfection in patients with MP pneumonia, and their results have been inconclusive. This study aimed to investigate the impact of respiratory virus coinfection in children hospitalized with MP pneumonia.MethodsThis study enrolled 145 children hospitalized with MP pneumonia between May 2019 and March 2020. The patients were divided into two groups: the respiratory virus coinfection and non-coinfection groups. All the children underwent polymerase chain reaction testing for respiratory virus infection. Information on clinical, laboratory, and radiologic findings were obtained retrospectively via medical chart reviews.ResultsChildren in the respiratory virus coinfection group were younger than those in the non-coinfection group. Respiratory virus coinfection in children hospitalized with MP pneumonia was significantly associated with persistence of fever more than 6 days (adjusted odds ratio [aOR], 2.394; 95% confidence interval [95% CI], 1.172–4.892), severe pneumonia (aOR, 4.602; 95% CI, 1.154–18.353), and poor response to the stepwise approach for MP pneumonia (aOR, 4.354; 95% CI, 1.374–13.800). In addition, higher levels of liver enzymes and lactate dehydrogenase at admission were associated with respiratory virus coinfection in children with MP pneumonia.ConclusionsThe results of this study suggest that respiratory virus coinfection in children hospitalized with MP pneumonia may be associated with refractory MP pneumonia.

The effect of oral or respiratory exposure to limonene on goat kid performance and meat quality

Pasture contains a lot of terpenes, able to pass throughout oral assumption and inhalation into meat. The aim of this paper was to verify if limonene accumulates in meat after oral or respiratory exposure and to assess its effects on animal oxidative status and meat quality. Thirty-six goat kids were involved and assigned for 1 week to three treatment groups: control group (CG); an oral group (OG), where limonene was administered directly into the mouth (drenched); and a respiratory group (RG), in which limonene was administered via inhalation. The meat limonene concentration for the OG was the highest (P < 0.01), although RG showed the highest rate of transfer (P < 0.001). Limonene gives the possibility to delay lipid oxidative processes, reducing discoloration and rancidity in meat. However, the respiration route seems to be able to guarantee a greater limonene transfer into meat compared to the oral one.

Prognostic Factors for Respiratory Dysfunction for Cervical Spinal Cord Injury and/or Cervical Fractures in Elderly Patients: A Multicenter Survey.

Retrospective Cohort Study. The purpose of this study was to investigate the prognosis of respiratory function in elderly patients with cervical spinal cord injury (SCI) and to identify predictive factors. We included 1353 cases of elderly cervical SCI patients collected from 78 institutions in Japan. Patients who required early tracheostomy and ventilator management and those who developed respiratory complications were defined as the respiratory disability group. Patients' background characteristics, injury mechanism, injury form, neurological disability, complications, and treatment methods were compared between the disability and non-disability groups. Multiple logistic regression analysis was used to examine the independent factors. Patients who required respiratory management for 6 months or longer after injury and those who died of respiratory complications were classified into the severe disability group and were compared with minor cases who were weaned off the respirator. A total of 104 patients (7.8%) had impaired respiratory function. Comparisons between the disabled and non-disabled groups and between the severe and mild injury groups yielded distinct trends. In multiple logistic regression analysis, age, blood glucose level, presence of ossification of posterior longitudinal ligament (OPLL), anterior vertebral hematoma, and critical paralysis were selected as independent risk factors. Age, OPLL, severe paralysis, anterior vertebral hematoma, hypoalbuminemia, and blood glucose level at the time of injury were independent factors for respiratory failure. Hyperglycemia may have a negative effect on respiratory function in this condition.

Treatment and prevention of various forms of laryngitis on the background of acute respiratory infections

Introduction. The relevance of the search for effective methods of treatment of various forms of laryngitis is associated with a high frequency of occurrence, which has a certain seasonality. Optimization of treatment tactics is dictated by the variability of etiopathogenetic mechanisms, with a certain similarity of clinical symptoms, and the reactivity of the mucous membrane to inflammation. The methods of treatment described in the literature are diverse and lead to the search for therapeutic adjustments.Objective. To increase the effectiveness of the treatment of various forms of acute laryngitis using the multicomponent drug Homeovox® in complex therapy.Materials and methods. A randomized simple controlled clinical trial involved 132 patients with acute laryngitis of various etiologies. Efficacy in terms of recovery time and safety were evaluated in two parallel groups: group 1, patients with acute laryngitis on the background of acute respiratory viral infection and group 2, patients with acute laryngitis on the background of a new strain “omicron”, COVID-19. In the course of treatment, both groups were divided into 2 subgroups: 1st – patients who received standard conservative therapy and the 2nd – persons who, in addition to complex therapy, received the drug – Homeovox®. Treatment results were assessed using the VAS scale, quality of life was assessed using the SNOT-22 questionnaire, cognitive functions were evaluated using standard psychological tests.Results and discussion. The use of the multicomponent preparation Homeovox®, which has multidirectional mechanisms of action in the complex therapy of patients with various forms of acute laryngitis, improved clinical symptoms, quality of life and recovery time. Good portability, high efficiency and safety were noted.Conclusions. The use of the preparation Homeovox® in the treatment of various forms of acute laryngitis has demonstrated its ability to quickly stop the symptoms of the disease and significantly improve the quality of life of patients.

Investigation of the relationship between community-acquired respiratory distress syndrome toxin and the high-mobility group box protein 1-toll-like receptors-myeloid differentiation factor 88 signaling pathway in Mycoplasma pneumoniae pneumonia

BackgroundIn recent years, reports of refractory Mycoplasma pneumoniae pneumonia (RMPP) have gradually increased, including reports on how these conditions threaten the lives of children. However, the specific mechanism of Mycoplasma pneumoniae pneumonia (MPP) remains unclear. This study aimed to investigate the relationship between community-acquired respiratory distress syndrome toxin (CARDS TX) and High-mobility group box protein 1-Toll-like receptors-Myeloid differentiation factor 88 (HMGB1-TLRs-MyD88) in MPP and to examine the immune pathogenesis of Mycoplasma pneumoniae infection.MethodsChildren who were diagnosed with MPP and examined by bronchoscopy were included in the MPP group. Additionally, children who underwent bronchoscopy because of bronchial foreign bodies in the same period were included in the control group. Gene expression of CARDS TX, HMGB1, Toll-like receptor 2 (TLR2), Toll-like receptor 4 (TLR4), MyD88, and cluster of differentiation 14 (CD14) in bronchoalveolar lavage fluid (BALF) were detected using real-time reverse transcription-polymerase chain reaction. Correlations between CARDS TX and HMGB1-TLRs-MyD88 were analyzed.ResultsCARDS TX, HMGB1, TLR2, MyD88, and CD14 mRNA expression in BALF in the MPP group was significantly higher than that in the control group (all P < 0.05). CARDS TX mRNA expression was positively correlated with HMGB1, TLR2, MyD88, and CD14 mRNA expression (all P < 0.05). Furthermore, HMGB1 mRNA expression was positively correlated with TLR2, MyD88, and CD14 mRNA expression (all P < 0.05).ConclusionsCARDS TX may participate in the immune pathogenesis of MPP through the HMGB1-TLRs/CD14-MyD88 pathway.

Plausible presynaptic effects of opioids on pontine inspiratory circuits: New insights from a joint neural biomechanical model

Administration of opioids significantly effects tidal volume, respiratory rate, and blunts CO2 responsiveness. The precise neural mechanisms that determine the respiratory depressant effects of opioids are controversial. One hypothesis is that mu‐opioid agonists hyperpolarize neurons located in the pons and this action prolongs inspiratory cycle duration. We tested the plausibility of this hypothesis by employing a neuromechanical model of the respiratory control system. We targeted medullary inspiratory neuron axon terminals that influence 4 neuronal populations within the pons that had an inspiratory component to their discharge (inspiratory (I), expiratory/inspiratory (EI), rostral inspiratory/expiratory (rIE), and caudal inspiratory/expiratory (cIE)) neurons). We systematically decreased the conductance of these synapses by 25, 50, 75 and 100 percent and monitored the effect on the respiratory motor pattern. Simulations revealed that decreasing the conductance of synapses from medullary inspiratory neurons to neuronal populations in the pons altered the breathing pattern. In general, a reduction in synaptic conductance from medullary inspiratory neurons to each of the 4 pontine neuron populations decreased their excitability. Decreasing the synaptic conductance from the medullary inspiratory decrementing (I‐Dec) population to the: 1) I pons population resulted in a decrease in phrenic burst frequency and a decrease in the Inspiratory‐Driver (I‐Driver) population excitability, 2) EI pons population resulted in a decrease in I pons excitability and phrenic neurogram magnitude, 3) rIE population did not reveal significant changes in the breathing pattern from control, and 4) cIE population resulted a decrease in I‐Driver population excitability, phrenic neurogram amplitude and phrenic burst frequency. Decreasing conductance of synapses from the inspiratory augmenting (I‐Aug) population to the I pons, cIE, or rIE populations resulted in decreases in phrenic neurogram magnitude. Our simulation data support the plausibility of presynaptic effects of opioids within the pontine respiratory group that induce respiratory depression. Further, these presynaptic effects can induce selective alterations in inspiratory drive and/or breathing cycle timing.

Opioid inhibition of projection‐specific, respiratory‐related pontomedullary neurons

Opioids depress breathing by inhibition of inter‐connected respiratory nuclei in the pons and medulla. We have previously shown that mu opioid receptor (MOR) agonists hyperpolarize a population of neurons in the dorsolateral pons due to activation of G protein‐mediated inwardly rectifying potassium conductance. However, we do not know the projection target of MOR‐expressing, dorsolateral pontine neurons, if they project at all. Here, we show that MOR‐expressing, dorsolateral pontine neurons project to core respiratory nuclei in the ventrolateral medulla, identifying projection‐related heterogeneity of dorsolateral pontine neurons vulnerable to opioid inhibition. First, retrograde DIO‐eGFP injections into the ventrolateral medulla of oprm1‐cre mice showed that dorsolateral pontine neurons project to the Bötzinger complex (BötC), pre‐Bötzinger complex (preBötC), and rostral ventral respiratory group (rVRG), and are distinct from calcitonin gene‐related peptide (CGRP)‐expressing parabrachial neurons. Second, we performed whole‐cell, voltage‐clamp recordings from dorsolateral pontine Kölliker‐Fuse neurons that were retrogradely labeled by fluorescent bead injections into the ventrolateral medulla of wild‐type mice. MOR‐mediated outward currents were identified in dorsolateral pontine neurons that project to the BötC, preBötC, and rVRG, confirming that these projection neurons are functionally inhibited by MORs and vulnerable to opioid inhibition. Together, these approaches demonstrate that MOR‐expressing, dorsolateral pontine neurons project to medullary respiratory nuclei and further unravel mechanisms of opioid‐induced respiratory depression.