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Objective — To compare the effects of two prone position ventilation methods on children with respiratory failure, to obtain a safer and more effective way to guide clinical nursing work. Methods — 48 cases of children who were admitted to the intensive care unit of our hospital from February 2018 to August 2019 and applied mechanical ventilation were divided into groups based on a random number table. The odd numbers were included in the experimental group (continuous prone position ventilation group, the duration of continuous prone position exceeded 12 hours, a total of 25 cases). The even numbers were included in the control group (intermittent prone position ventilation group, prone position for 3 hours at a time, alternating with supine position and lateral position, total prone position duration 12 hours, a total of 23 cases). Oxygenation index (OI), PH value, arterial partial pressure of carbon dioxide (PCO2), arterial partial pressure of oxygen (PO2) at 24h, 48h, 72h of the two groups of children, as well as their ventilator use time and ICU hospital stay were compared. Results — Continuous prone position ventilation and intermittent prone position ventilation have no statistical significance on arterial blood carbon dioxide partial pressure (PaCO2), arterial blood oxygen partial pressure (PaO2), ventilator duration, ICU length of stay in children with respiratory failure (P>0.05), but with the increase of the total length of the prone position, when reaching more than 36 hours, the trend of oxygenation index (OI) of the experimental group and the control group can be seen to decline. Conclusion — In this study, by comparing the effects of two prone position ventilation modes, it was found that intermittent prone position ventilation and continuous prone position ventilation had no difference in the treatment of children with respiratory failure. When children are treated in continuous prone and intermittent prone positions, the total prone position can last up to 36 hours, which can effectively improve the clinical treatment effect. In view of the characteristics of pediatric patients and the difficulty in nursing critically ill patients with tracheal intubation, it is recommended that pediatric patients can use intermittent prone ventilation to complete treatment when the cumulative time in the prone position reaches more than 36 hours.

Synthetic strategies that enable rapid construction of covalent organic nanotubes with an angstrom-scale tubular pore remain scarcely reported. Reported here is a remarkably simple and mild one-pot polymerization protocol, employing POCl3 as the polymerization agent. This protocol efficiently generates polypyridine amide foldamer-based covalent organic nanotubes with a 2.8 nm length at a yield of 50 %. Trapping single-file water chains in the 2.8 A tubular cavity, rich in hydrogen-bond donors and acceptors, these tubular polypyridine ensembles rapidly and selectively transport water at a rate of 1.6×109 H2 O⋅S-1 ⋅channel-1 and protons at a speed as fast as gramicidin A, with a high rejection of ions.

The human stimulator of interferon genes protein (hSTING) can bind cyclic dinucleotides (CDNs) to activate the production of type I interferons and inflammatory cytokines. These CDNs can be either bacterial secondary messengers, 3'3'-CDNs, or endogenous 2'3'-cGAMP. cGAMP, with a unique 2'-5' bond, is the most potent activator of hSTING among all CDNs. However, current understanding of the molecular principles underlying the unique ability of 2'3'-cGAMP to potently activate hSTINGs other than 3'3'-CDNs remains incomplete. In this work, molecular dynamics simulations were used to provide an atomistic picture of the binding of 2'3'-cGAMP and one 3'3'-CDN (c-di-GMP) to hSTING. The results suggest that hSTING binds more strongly to 2'3'-cGAMP than to c-di-GMP, which prefers to bind with a more open and flexible state of hSTING. Finally, a potential "dock-lock-anchor" mechanism is proposed for the activation of hSTING upon the binding of a potent ligand. It is believed that deep insights into understanding the binding of hSTING with 3'3'-CDNs and the endogenous 2'3'-cGAMP would help to establish the principles underlying powerful 2'3'-cGAMP signaling and the nature of hSTING activation, as well as related drug design.