Background Unplanned extubation is associated with adverse outcomes in intensive care unit. The massive burn patient differs from other critically ill patients in many ways. However, little is known about the unplanne...Background Unplanned extubation is associated with adverse outcomes in intensive care unit. The massive burn patient differs from other critically ill patients in many ways. However, little is known about the unplanned decannulation （UD） in Burn Intensive Care Unit. This paper describes the special features of the circumstances and outcome of UD of tracheotomy tube in massive burn patients. Methods A case series study was performed between January 1999 and December 2008 and UD of tracheotomy tube was analyzed retrospectively. A total of 21 patients with 29 UD events were identified. Demographic data, diagnosis, intervention, UD events and outcome of UD patients were collected. Differences in proportions were compared using the chi-square （X2） or Fisher＇s exact test. Results Patients with UD were often burned with head and neck （67%） and combined with inhalation injury （62%）. The majority of them （76%） were transferred patients, occurred early （55%） and were accidental UD （79%）. UD events tended to happen in day shift （90%） and to be associated with the medical procedure that was performing by caregivers at besides （79%）. Loose of the stabilizing rope, medical procedure and tracheotomy malposition were the main causes of UD. Early UD and reintubation failure were associated with patients＇ death. Conclusions UD happened to massive burn patients can lead to patient death. Careful management of respiratory tract was essential for massive burn patients.展开更多
The energy-resolved neutron imaging spectrometer(ERNI)will be installed in 2022 according to the spectrometer construction plan of the China Spallation Neutron Source(CSNS).The instrument requires neutron detectors wi...The energy-resolved neutron imaging spectrometer(ERNI)will be installed in 2022 according to the spectrometer construction plan of the China Spallation Neutron Source(CSNS).The instrument requires neutron detectors with the coverage area of approximately 4 m^(2)in 5°-170°neutron diffraction angle.The neutron detection efficiency needs to be better than 40%at 1 A neutron wavelength.The spatial resolution should be better than 3 mm×50 mm in the horizontal and vertical directions respectively.We develop a one-dimensional scintillator neutron detector which is composed of the^(6)Li F/Zn S(Ag)scintillation screens,the wavelength-shifting fiber(WLSF)array,the silicon photomultipliers(Si PMs),and the self-designed application-specific integrated circuit(ASIC)readout electronics.The pixel size of the detector is designed as 3 mm×50 mm,and the neutron-sensitive area is 50 mm×200 mm.The performance of the detector prototype is measured using neutron beam 20#of the CSNS.The maximum counting rate of 247 k Hz,and the detection efficiency of63%at 1.59 A are obtained.The test results show that the performance of the detector fulfills the physical requirements of the ERNI under construction at the CSNS.展开更多
BACKGROUND The VPS33B(OMIM:608552)gene is located on chromosome 15q26.1.We found a female infant with autosomal recessive arthrogryposis,renal dysfunction and cholestasis syndrome 1(ARCS1)caused by mutation in VPS33B....BACKGROUND The VPS33B(OMIM:608552)gene is located on chromosome 15q26.1.We found a female infant with autosomal recessive arthrogryposis,renal dysfunction and cholestasis syndrome 1(ARCS1)caused by mutation in VPS33B.The child was diagnosed with ARCS1(OMIM:208085)after the whole exome sequencing revealed two heterozygous mutations(c.96+1G>C,c.242delT)in the VPS33B gene.CASE SUMMARY We report a Chinese female infant with neonatal cholestasis disorder,who was eventually diagnosed with ARCS1 by genetic analysis.Genetic testing revealed two new mutations(c.96+1G>C and c.242delT)in VPS33B,which is the causal gene.The patient was compound heterozygous,and her parents were both heterozygous.CONCLUSION This study extends the mutational spectrum of the VPS33B gene to provide a molecular basis for the etiological diagnosis of ARCS1 and for genetic counseling of the family.展开更多
文摘Background Unplanned extubation is associated with adverse outcomes in intensive care unit. The massive burn patient differs from other critically ill patients in many ways. However, little is known about the unplanned decannulation （UD） in Burn Intensive Care Unit. This paper describes the special features of the circumstances and outcome of UD of tracheotomy tube in massive burn patients. Methods A case series study was performed between January 1999 and December 2008 and UD of tracheotomy tube was analyzed retrospectively. A total of 21 patients with 29 UD events were identified. Demographic data, diagnosis, intervention, UD events and outcome of UD patients were collected. Differences in proportions were compared using the chi-square （X2） or Fisher＇s exact test. Results Patients with UD were often burned with head and neck （67%） and combined with inhalation injury （62%）. The majority of them （76%） were transferred patients, occurred early （55%） and were accidental UD （79%）. UD events tended to happen in day shift （90%） and to be associated with the medical procedure that was performing by caregivers at besides （79%）. Loose of the stabilizing rope, medical procedure and tracheotomy malposition were the main causes of UD. Early UD and reintubation failure were associated with patients＇ death. Conclusions UD happened to massive burn patients can lead to patient death. Careful management of respiratory tract was essential for massive burn patients.
基金the National Natural Science Foundation of China(Grant Nos.11875273,U1832111,61964001,and 12275049)the Science Foundation of Guangdong Province of China(Grant No.2020B1515120025)+3 种基金the Neutron Physics Laboratory Funding of China Academy of Engineering Physics(Grant No.2018BC03)the General Project of Jiangxi Province Key Research and Development Program(Grant No.20212BBG73012)the Key Scientific Research Projects of Henan Higher Education Institutions(Grant Nos.23A490002 and 24A490001)the Engineering Research Center of Nuclear Technology Application(Grant No.HJSJYB2021-4)。
文摘The energy-resolved neutron imaging spectrometer(ERNI)will be installed in 2022 according to the spectrometer construction plan of the China Spallation Neutron Source(CSNS).The instrument requires neutron detectors with the coverage area of approximately 4 m^(2)in 5°-170°neutron diffraction angle.The neutron detection efficiency needs to be better than 40%at 1 A neutron wavelength.The spatial resolution should be better than 3 mm×50 mm in the horizontal and vertical directions respectively.We develop a one-dimensional scintillator neutron detector which is composed of the^(6)Li F/Zn S(Ag)scintillation screens,the wavelength-shifting fiber(WLSF)array,the silicon photomultipliers(Si PMs),and the self-designed application-specific integrated circuit(ASIC)readout electronics.The pixel size of the detector is designed as 3 mm×50 mm,and the neutron-sensitive area is 50 mm×200 mm.The performance of the detector prototype is measured using neutron beam 20#of the CSNS.The maximum counting rate of 247 k Hz,and the detection efficiency of63%at 1.59 A are obtained.The test results show that the performance of the detector fulfills the physical requirements of the ERNI under construction at the CSNS.
基金Supported by the Hainan Province Clinical Medical Center,No.(2021)75 and(2021)276。
文摘BACKGROUND The VPS33B(OMIM:608552)gene is located on chromosome 15q26.1.We found a female infant with autosomal recessive arthrogryposis,renal dysfunction and cholestasis syndrome 1(ARCS1)caused by mutation in VPS33B.The child was diagnosed with ARCS1(OMIM:208085)after the whole exome sequencing revealed two heterozygous mutations(c.96+1G>C,c.242delT)in the VPS33B gene.CASE SUMMARY We report a Chinese female infant with neonatal cholestasis disorder,who was eventually diagnosed with ARCS1 by genetic analysis.Genetic testing revealed two new mutations(c.96+1G>C and c.242delT)in VPS33B,which is the causal gene.The patient was compound heterozygous,and her parents were both heterozygous.CONCLUSION This study extends the mutational spectrum of the VPS33B gene to provide a molecular basis for the etiological diagnosis of ARCS1 and for genetic counseling of the family.
