Objective To evaluate the effects of the polypeptide growth factors on the periodontal ligament cell(PDLC) based on a comprehensive review onthe literature concerned. Methods The recent literature related to the effects of the polypeptide growth factors on the PDLC were extensivelyand comprehensively reviewed and a corresponding evaluation was made. Results The proliferation and the multidirectional differentiation of thePDLC were found to be the basis for the regeneration of the periodontal tissues. The effects of the polypeptide growth factors on the function of the PDLC became a hot issue of the research on the regeneration of the periodontal tissues. The polypeptide growth factors were found to play an important role in the migration, growth, proliferation, differentiation, and synthesis of protein and matrixof the PDLC. Conclusion The polypeptide growth factors can beused in the periodontal regeneration treatment, but a further research is stillrequired to improve this kind of treatment.
Objective To investigate the effects of combined abdominal weight training and mechanical insufflation-exsufflation (MI-E) on peak cough flow (PCF) and diaphragmatic function in patients with severe pneumonia undergoing invasive mechanical ventilation, and evaluate the predictive value of PCF combined with diaphragmatic ultrasound parameters for weaning success. Methods A prospective randomized controlled trial was conducted. A total of 105 patients with severe pneumonia undergoing mechanical ventilation were enrolled and randomly divided into three groups: a basic care group (Group A), an abdominal weight-loading group (Group B), and an abdominal weight-loading combined with MI-E group (Group C). Ultimately, 96 patients completed the study, with 32 patients in each group. All three groups received the corresponding interventions for 7 days. On day 1 and day 7 of the intervention, the following parameters were measured: peak cough flow (PCF), maximal inspiratory pressure (MIP), maximum transdiaphragmatic pressure (Pdimax), diaphragmatic excursion (DD), diaphragmatic thickening fraction (DTF), and diaphragmatic rapid shallow breathing index (D-RSBI). After one week of intervention, a spontaneous breathing trial (SBT) was performed to assess the weaning success rate. Results Compared with Group A and Group B, Group C showed significantly higher PCF, DD, DTF, MIP and Pdimax on day 7 (all P<0.05), and significantly lower D-RSBI (P<0.05). The weaning success rates in the three groups were 34.4% (11/32) in Group A, 56.2% (18/32) in Group B, and 78.1% (25/32) in Group C, with Group C being significantly higher than Group A and Group B (P<0.05). The patients in the weaning success group (n=54) had higher PCF, DD, DTF, and MIP, and lower D-RSBI compared with the weaning failure group (n=42) (all P<0.05). Multivariate logistic regression with weaning failure as outcome showed that higher PCF (OR=0.89, 95%CI 0.83-0.95), DD (OR=0.72, 95%CI 0.60-0.87), and DTF (OR=0.92, 95%CI 0.86-0.97) were protective factors against weaning failure (all P<0.05), while higher D-RSBI (OR=1.15, 95%CI 1.05-1.26) was a risk factor (P=0.002). Receiver operating characteristic curve analysis showed that the areas under the curve (AUC) for PCF, DD, DTF, and D-RSBI in predicting weaning success were 0.81, 0.78, 0.80, and 0.75, respectively, while the AUC of the combined PCF+DD+DTF model reached 0.91 (95%CI 0.86-0.96), with a sensitivity of 87.7% and a specificity of 87.1%. Conclusions Abdominal weight training combined with MI-E can significantly improve peak cough flow, diaphragmatic function, and weaning success rate in mechanically ventilated patients with severe pneumonia. The prediction model combining PCF, DD, and DTF demonstrates excellent predictive value for weaning success.
