简介：Non-invasiveventilation(NIV)istheprovisionofventilatorysupportwithoutinstrumentationoftheairway.Itcanbeachievedusinganegative-pressuremachine(e.g.‘ironlung')or,morecommonly,withpositivepressureadministeredthroughawell-fittingmask.Thiscontributionconsiderspositivepressureventilationonly;negativepressureisnowseldomused.

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简介：AbstractFor the detection of steatosis, quantitative ultrasound imaging techniques have achieved great progress in past years. Magnetic resonance imaging proton density fat fraction is currently the most accurate test to detect hepatic steatosis. Some blood biomarkers correlate with non-alcoholic steatohepatitis, but the accuracy is modest. Regarding liver fibrosis, liver stiffness measurement by transient elastography (TE) has high accuracy and is widely used across the world. Magnetic resonance elastography is marginally better than TE but is limited by its cost and availability. Several blood biomarkers of fibrosis have been used in clinical trials and hold promise for selecting patients for treatment and monitoring treatment response. This article reviews new developments in the non-invasive assessment of non-alcoholic fatty liver disease (NAFLD). Accumulating evidence suggests that various non-invasive tests can be used to diagnose NAFLD, assess its severity, and predict the prognosis. Further studies are needed to determine the role of the tests as monitoring tools. We cannot overemphasize the importance of context in selecting appropriate tests.

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简介：瞄准：评估影响多囊肝疾病的非侵略、侵略的治疗的结果的因素。方法：有到2006年6月的从1986年7月的完全的后续的病人的临床的文件的分析。结果：41个病人(男性，7；女性，34)，11.9年变老的47.8+/-，和5.7+/-6.7年后续，被学习。硷性磷酸酯酶(AP)举起(15%病人)与侵略治疗的要求被联系(信息技术，P=0.005)。信息技术率是更高的在比非征兆的病人征兆(65.4%对14.3%，P=0.002)，并且在拿神经质的代替治疗(HRT)的女人(P=0.001)。包囊复杂并发症(CC)是更经常的(22%)在征兆的病人组织(P=0.023)。有身体质量的病人索引(BMI)>(59%)25在它以后有一个趋势到复杂并发症(P=0.075)。腹的疼痛为信息技术(78%)是最普通的症状(56%)和指示。十九个病人(46%)要求了第一种信息技术：12开的开窗术()，4laparoscopic开窗术(LF)和有肝的切除术(FHR)的3开窗术。三要求了第二种信息技术，并且一个人要求了第三个过程。复杂并发症在32%由于第一种信息技术被发现(16.7%，LF25%，FHR66.7%)，并且在在66.7%的第二种信息技术(100%)。后续死亡率是0。结论：症状，提高的AP，和CC的存在与信息技术要求被联系。HRT与症状和信息技术要求的存在被联系。有BMI>的病人25有一个趋势产生信息技术复杂并发症。复杂并发症的比例在FHR和秒信息技术组是更高的。RS是更经常的在以后。

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简介：AbstractBackground:Although existing mycological tests (bronchoalveolar lavage [BAL] galactomannan [GM], serum GM, serum (1,3)-β-D-glucan [BDG], and fungal culture) are widely used for diagnosing invasive pulmonary aspergillosis (IPA) in non-hematological patients with respiratory diseases, their clinical utility in this large population is actually unclear. We aimed to resolve this clinical uncertainty by evaluating the diagnostic accuracy and utility of existing tests and explore the efficacy of novel sputum-based Aspergillus assays.Methods:Existing tests were assessed in a prospective and consecutive cohort of patients with respiratory diseases in West China Hospital between 2016 and 2019 while novel sputum assays (especially sputum GM and Aspergillus-specific lateral-flow device [LFD]) in a case-controlled subcohort. IPA was defined according to the modified European Organization for Research and Treatment of Cancer/Mycoses Study Group criteria. Sensitivity and specificity were computed for each test and receiver operating characteristic (ROC) curve analysis was performed.Results:The entire cohort included 3530 admissions (proven/probable IPA = 66, no IPA = 3464) and the subcohort included 127 admissions (proven/probable IPA = 38, no IPA = 89). Sensitivity of BAL GM (≥1.0 optical density index [ODI]: 86% [24/28]) was substantially higher than that of serum GM (≥0.5 ODI: 38% [39/102]) (χ2 = 19.83, P < 0.001), serum BDG (≥70 pg/mL: 33% [31/95]) (χ2 = 24.65, P < 0.001), and fungal culture (33% [84/253]) (χ2 = 29.38, P < 0.001). Specificity varied between BAL GM (≥1.0 ODI: 94% [377/402]), serum GM (≥0.5 ODI: 95% [2130/2248]), BDG (89% [1878/2106]), and culture (98% [4936/5055]). Sputum GM (≥2.0 ODI) had similar sensitivity (84% [32/38]) (Fisher’s exact P = 1.000) to and slightly lower specificity (87% [77/89]) (χ2 = 5.52, P = 0.019) than BAL GM (≥1.0 ODI). Area under the ROC curve values were comparable between sputum GM (0.883 [0.812-0.953]) and BAL GM (0.901 [0.824-0.977]) (P = 0.734). Sputum LFD had similar specificity (91% [81/89]) (χ2 = 0.89, P = 0.345) to and lower sensitivity (63% [24/38]) (χ2 = 4.14, P = 0.042) than BAL GM (≥1.0 ODI), but significantly higher sensitivity than serum GM (≥0.5 ODI) (χ2 = 6.95, P = 0.008), BDG (χ2 = 10.43, P = 0.001), and fungal culture (χ2 = 12.70, P < 0.001).Conclusions:Serum GM, serum BDG, and fungal culture lack sufficient sensitivity for diagnosing IPA in respiratory patients. Sputum GM and LFD assays hold promise as rapid, sensitive, and non-invasive alternatives to the BAL GM test.

简介：NICFEDexpertsystem-arule-based"non-invasivecardiacfunctionevaluationandcardiacdiseasesdiagnosingexpertsystem"-isdiscussedinthispaper.Thesys-temcanberegardedasaninterpretationexpertsystemandasadiagnosticexpertsystem.Whenitisappliedtoevaluatecardiacfunction,itcanexplainmorethanonehundredparametersdetectedby"MCA-Ⅲcardiacfunctiondeviceofmulti-domainandmultidemension".Withtheseparametersthecardiacfunctionintimedomain,fre-

简介：AbstractPreimplantation genetic testing (PGT) is a widely adopted screening method that can be performed to identify and select embryos with normal ploidy; however, PGT relies on embryo biopsy, that is, polar body, embryo cells, or trophectoderm biopsy, to obtain embryonic DNA, increase its technical limitations. Studies have indicated that biopsy may have an influence on the quality and development of embryos, and increase the chance of abnormal epigenetic modifications. Therefore, non-invasive PGT (niPGT) detection of cell-free DNA (cfDNA) has gradually become a hot research topic in the field of assisted reproduction. Studies showed cfDNA could be detected in blastocyst fluid and spent culture medium (SCM) in vitro cultured embryos. The cfDNA collection requires less skill and makes lower risk to embryos. Some studies have been conducted to evaluate the feasibility of SCM-based niPGT approaches. When comparing the ploidy consistency of cfDNA in SCM, its consistency to the conventional PGT for aneuploidies results fluctuated widely, it is critical to recognize the factors influencing accuracy. These contradictory results may be related to factors such as the difference in SCM sampling methods and sampling time, and the definition of consistency. In this review, we aimed to comprehensively summarize how researchers use embryonic cfDNA to conduct niPGT detection. It also systematically reviews the factors affecting the accuracy of the test and its underlying issues, as well as prospective applications. We hope to provide a basis for future niPGT research and a useful reference for the standardized operation of niPGT that can be widely applied in clinical practice.

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简介：ObjectiveTotestCalciumion(Ca2+)flowattheheadandendofouterhaircells(OHCs)inrestingstateandinresponsetoNimodipinetreatment.MethodsNon-invasivemicro-testtechniqueswereusedtostudyCa2+inisolatedOHCsinadultguineapigs.ResultsFourtypesofCa2+transportwereidentifiedinOHCsonbasilarmembranetissuefragments:influxattheheadofwitheffluxatthebottom(type1):effluxattheheadofOHCswithinfluxatthebottom(type2);influxatthebothheadandbottom(type3);andeffluxatthebothheadandbottom(type4).However,onlytype1andtype3ofCa2+iontransportweredetectedinthecochlea.WeproposethatCa2+iontransportexistsinadultguineapigcochlearOHCsinrestingstateandisvariable.Ca2+flowinOHCcanbeinhibitedbyNimodipineinrestingstate.

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简介：AbstractIntroduction:While majority of infants with bronchopulmonary dysplasia (BPD) can be discharged home without low flow oxygen or on supplemental low flow oxygen, some require long term home mechanical ventilation.Case presentation:We present a case of an extremely premature infant with severe bronchopulmonary dysplasia who was successfully managed at home on a new feature of non-invasive ventilation called average volume assured pressure support (AVAPS) without the need for tracheostomy. The AVAPS feature enables the machine to deliver a consistent tidal volume by automatically adjusting the inspiratory pressure within a set range.Conclusion:The use of AVAPS feature in our case improved ventilation as indicated by a more stable gas exchange profile, making home non-invasive ventilation a more practicable method of managing severe BPD in this infant.

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简介：AbstractBackground:One inevitable shortcoming of non-invasive prenatal screening (NIPS)/cell-free DNA (cfDNA) sequencing is the uninterpretable ( "no-call" ) result, which is mainly caused by an insufficient fetal fraction. This study was performed to investigate the factors associated with a successful second NIPS in these cases and determine the optimal management for women with initial no-call results.Methods:We retrospectively analyzed the data of women who underwent NIPS with initial no-call results due to an insufficient fetal fraction from 2017 to 2019 in our center. We compared these women’s maternal and pregnancy information with the data of women who had attained a successful second NIPS result and women who had received no-call results for a second time.Results:Among the 33,684 women who underwent NIPS, 137 with a no-call result underwent a retest. Comparison between the 87 (63.50%) women with a successful retest and the other 50 (36.50%) women showed a significant difference in both the initial fetal fraction and maternal body mass index (BMI), whereas the other factors showed no significant differences. In addition, with an initial fetal fraction of < 2.00%, the retest success rate was very limited.Conclusions:We identified two major factors associated with a successful NIPS retest: the initial fetal fraction and the maternal BMI. These findings suggest the need for specialized management for this subset of women and would be instructional for the counseling for these women.