Zhonghua wei zhong bing ji jiu yi xue最新文献

{"title":"[Construction and validation of a prediction model for prolonged hospitalization in patients with severe acute pancreatitis].","authors":"Qianqian Liu, Liuyi Ma, Dongdong Han, Min Gao, Yuan Tian, Xiaoyan Zhou","doi":"10.3760/cma.j.cn121430-20240208-00122","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240208-00122","url":null,"abstract":"<p><strong>Objective: </strong>To construction the risk factors associated with prolonged hospitalization in patients with severe acute pancreatitis (SAP) and develop a prediction model for assessing these risks.</p><p><strong>Methods: </strong>SAP patients admitted to the department of emergency of Hebei Province Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2015 to December 2023 were retrospectively selected as the study subjects. The 75% of hospital stay was used as the cut-off point, and the patients were categorized into a normal group and an extended group. Clinical indicators of patients were collected, and independent risk factors for prolonged hospital stay in SAP patients were analyzed using multifactor Logistic regression. A prediction model was established, and a nomogram was created. The efficiency of the prediction model was evaluated using a receiver operator characteristic curve (ROC curve). The accuracy of the model was assessed using Hosmer-Lemeshow goodness-of-fit test. Decision curve analysis (DCA) was employed to evaluate the clinical applicability of the model. Finally, internal validation of the model was conducted using Bootstrap method.</p><p><strong>Results: </strong>A total of 510 patients with SAP were included, and the length of hospital stay was 18 (6, 44) days, including 400 cases in the normal group (<24 days) and 110 cases in the extended group (≥24 days). Multivariate Logistic regression analysis showed that abdominal effusion [odds ratio (OR) = 4.163, 95% confidence interval (95%CI) was 2.105-8.234], acute physiology and chronic health evaluation II (APACHE II; OR = 1.320, 95%CI was 1.185-1.470), C-reactive protein (CRP; OR = 1.006, 95%CI was 1.002-1.011), modified CT severity index (MCTSI; OR = 1.461, 95%CI was 1.213-1.758), procalcitonin (PCT; OR = 1.303, 95%CI was 1.095-1.550) and albumin (OR = 0.510, 95%CI was 0.419-0.622) were independent risk factors for prolonged hospital stay in SAP patients (all P < 0.01). ROC curve analysis showed that the area under the curve (AUC) of the model was 0.922 (95%CI was 0.896-0.947), the optimal cut-off value was 0.726, the sensitivity was 87.3%, and the specificity was 85.3%. Hosmer-Lemeshow test showed that χ ² = 5.79, P = 0.671. It showed that the prediction model had good prediction efficiency and fit degree. The DCA curve showed that the prediction probability of the model could bring more clinical benefits to patients at 0.1 to 0.7. Bootstrap internal verification showed that the model had a high consistency (AUC = 0.916).</p><p><strong>Conclusions: </strong>Abdominal effusion, high APACHE II score, high CRP, high MCTSI, high PCT and low albumin level are significantly associated with prolonged hospital stay in SAP patients. The prediction model can help clinicians make more scientific clinical decisions for SAP patients.</p>","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"36 11","pages":"1174-1178"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The value of coagulation indicators combined with sequential organ failure assessment in assessing disease severity and prognosis of elderly patients with sepsis].","authors":"Libing Ma, Siyu Tian, Xiaojun Yang","doi":"10.3760/cma.j.cn121430-20240424-00374","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240424-00374","url":null,"abstract":"<p><strong>Objective: </strong>To explore the value of coagulation indicators and related critical scores in evaluating the severity and prognosis of elderly sepsis patients.</p><p><strong>Methods: </strong>Patients admitted to the intensive care unit (ICU) of General Hospital of Ningxia Medical University aged ≥60 years with a definite diagnosis of sepsis from May 2020 to May 2022 were retrospectively included. General epidemiological data, coagulation indices such as prothrombin time (PT), international normalized ratio (INR), prothrombin activity (PTA), activated partial thromboplastin time (APTT), prothrombin time (TT), fibrinogen (FIB), D-dimer, platelet count (PLT), and other laboratory indices within 24 hours of admission to the ICU, acute physiology and chronic health evaluation (APACHE), sequential organ failure assessment (SOFA), sepsis-related complications, and 28-day prognosis were collected. Patients were divided into shock and non-shock groups according to whether septic shock occurred or not, and into death and survival groups according to 28 days outcomes, and the differences of each index between the groups were compared. Independent risk factors for septic shock and 28-day death were analyzed by using univariate and multivariate Logistic regression, and the receiver operator characteristic curve (ROC curve) were further plotted to assess the value of independent risk factors in predicting the occurrence of septic shock and 28-day death in elderly patients with sepsis.</p><p><strong>Results: </strong>A total of 295 elderly patients with sepsis were included, 192 (65.08%) developed septic shock, and 126 (42.71%) died at 28 days. Multivariate binary Logistic regression analysis showed that SOFA score and PT-INR were independent risk factors for septic shock and 28-day death in elderly patients with sepsis [septic shock: odds ratio (OR) and 95% confidence interval (95%CI) were 1.340 (1.186-1.513) and 1.720 (1.235-2.396), respectively; 28-day death: OR and 95%CI were 1.188 (1.044-1.351) and 4.546 (2.613-7.910), respectively, all P < 0.01]. ROC curve analysis showed that SOFA score and PT-INR had certain predictive values for septic shock occurrence and 28-day death in elderly patients with sepsis, and the area under the curve (AUC) for septic shock occurrence were 0.743 and 0.564, respectively. The AUC of 28-day death was 0.711 and 0.651, respectively. The combined predicted AUC was 0.761 and 0.817, the sensitivity was 78.1% and 65.1%, and the specificity was 63.1% and 85.8%, respectively.</p><p><strong>Conclusions: </strong>PT-INR and SOFA score have potential predictive value in the assessment of the severity and prognosis of elderly patients with sepsis, and their combined prediction accuracy is higher.</p>","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"36 11","pages":"1133-1139"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Design and application of a real-time feedback APP device for cardiopulmonary resuscitation].","authors":"Xurong Wang, Yidan Yang, Zhongyi Chen","doi":"10.3760/cma.j.cn121430-20240425-00379","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240425-00379","url":null,"abstract":"<p><p>The rates of recovery of spontaneous circulation, admission survival, and discharge survival of out-of-hospital cardiac arrest (OHCA) patients in China are much lower than the world and Asian averages, and the data on the survival of in-hospital cardiac arrest (IHCA) patients are also less favorable. The variable quality of cardiopulmonary resuscitation (CPR) and the low percentage of bystander CPR participation are the main reasons for these phenomena. Real-time feedback devices are an effective strategy to address these issues and have been recommended for use in several guidelines. However, the existing CPR feedback devices have the problems of being inconvenient to operate and expensive to popularize. Therefore, members of the CPR training team of Loudi Central Hospital designed a CPR real-time feedback APP device, which has been granted the right of National Invention Patent of China (patent number: ZL 2021 1 1118500.1). The device consists of a feedback device and a mobile device (there are two versions: healthcare professionals and non-healthcare professionals). The feedback device consists of a pressing plate and a soft rubber plate. The inner side of the soft rubber plate is covered with sensor monitoring points. On each sensor monitoring point, there are micro pressure sensors and micro acceleration sensors. When performing chest compressions, the sensors will transmit the relevant data to the cell phone feedback APP. By sampling and analyzing the data and building a three-dimensional dynamic model, the feedback APP accurately judges the effect of chest compressions based on factors such as the strength of the compressions, the frequency of the compressions and the depth of the compressions, corrects and provides voice guidance for the subsequent CPR process in real time, guides the rescuers to follow the standardized procedures for rescue, and improves the survival rate and neurological recovery of the CPR patients. The device improves CPR with exact effect, real-time accuracy, simple operation, easy to promote, and applicable to all populations. It has good clinical application and socialization popularization value, and can be equipped in medical institutions and public places.</p>","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"36 11","pages":"1209-1212"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Effect of pulmonary rehabilitation training in patients with tracheostomy and non-mechanical ventilation: a prospective cohort study].","authors":"Jianhua Wu, Runling Guo, Yanhong Tian, Ying Wang","doi":"10.3760/cma.j.cn121430-20240304-00189","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240304-00189","url":null,"abstract":"<p><strong>Objective: </strong>To explore the clinical application effects of early pulmonary rehabilitation training based on bundle airway management in patients with tracheostomy and non-mechanical ventilation.</p><p><strong>Methods: </strong>Used convenience sampling, adult patients who underwent tracheostomy and non-mechanical ventilation admitted to Fenyang Hospital of Shanxi Province from January 2022 to May 2023 were enrolled. Patients were divided into control group and observation group based on their admission dates. The control group implemented bundle airway management based on the Airway care for patients with tracheostomy and non-mechanical ventilation. The observation group received additional pulmonary rehabilitation training implemented by a specialized respiratory rehabilitation team. The primary outcomes included hospital stay duration, improvement rate of muscle strength, diaphragmatic mobility, and successful extubation rate. Secondary outcomes included the incidence of pulmonary infection, improvement rate of self-care ability, and the duration of tracheal tube placement in extubated patients.</p><p><strong>Results: </strong>A total of 41 patients were included in the control group and 39 patients in the observation group. There were no significantly differences in gender, age, first diagnosis of disease, and activities of daily living (ADL) score at admission between the two groups, indicating balanced baseline data and comparability. Compared with the control group, the observation group had a significantly shorter hospital stay (days: 38.33±17.58 vs. 51.34±27.06), a higher improvement rate of muscle strength (76.92% vs. 39.02%), greater diaphragmatic mobility (cm: 1.86±0.64 vs. 1.44±0.57), and a higher success rate of tracheostomy tube extubation (38.46% vs. 17.07%), the duration of tracheal tube placement in successfully extubated patients was significantly reduced (days: 33.26±17.87 vs. 50.60±21.98), with all differences being statistically significant (all P < 0.05). Although the improvement rate of ADL score (56.41% vs. 36.59%) and the incidence of pulmonary infection (5.13% vs. 7.32%) in the observation group were better than those in the control group, but there were no differences (both P > 0.05).</p><p><strong>Conclusions: </strong>The addition of pulmonary rehabilitation training in bundle airway management can enhance exercise tolerance, improve respiratory function, promote sputum clearance, increase successful extubation rates, shorten hospital stays, and facilitate early recovery in patients with tracheostomy and non-mechanical ventilation.</p>","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"36 11","pages":"1153-1156"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Sulforaphane alleviates acute liver injury induced by diquat in mice by activating Keap1/Nrf2 signaling pathway].","authors":"Jianhong Wang, Liang Peng, Liaozhang Wu, Shan Huang, Guoli He, Pei Shen, Jing Liang, Tingting Huang, Jiaming Huang, Hong Zhong, Manhong Zhou","doi":"10.3760/cma.j.cn121430-20230628-00474","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20230628-00474","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate the protective effect and possible mechanism of sulforaphane (SFN) on acute liver injury in mice induced by diquat (DQ) poisoning.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Forty-eight male C57BL/6 mice were divided into Control group, DQ model group (DQ group), SFN intervention group (DQ+SFN group), and SFN control group (SFN group) using a random number table method, with 12 mice in each group. Acute liver injury mice model was established by one-time intraperitoneal injection of 1 mL of 40 mg/kg DQ solution at once. SFN group was injected with 1 mL of ddH&lt;sub&gt;2&lt;/sub&gt;O. After 4 hours of molding, 0.5 mL of 5 mg/kg SFN solution was injected into the peritoneal cavity of the DQ+SFN group and SFN group, once daily for 7 consecutive days. DQ group and Control group were injected with an equal amount of ddH&lt;sub&gt;2&lt;/sub&gt;O. Then, the mice were euthanized to collect liver tissue and blood samples, and the levels of plasma biomarkers alanine aminotransferase (ALT) and aspartate aminotransferase (AST), as well as oxidative stress indicators such as superoxide dismutase (SOD), glutathione (GSH), and malondialdehyde (MDA) in liver tissue were measured. The changes of liver structure were observed under transmission electron microscopy. The apoptosis and reactive oxygen species (ROS) level in liver tissue were observed under fluorescence microscope. Western blotting was used to detect the protein expressions of nuclear factor E2-related factor 2 (Nrf2), hemeoxygenase-1 (HO-1), Kelch-like ECH-associated protein 1 (Keap1), and cleaved caspase-9 in liver tissue.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Compared with the Control group, the liver mitochondria in the DQ group showed severe swelling, partial dissolution of the matrix, and cristae rupture and loss; the levels of plasma AST and ALT significantly increased, the MDA content in the liver increased, the activities of SOD and GSH decreased, the level of ROS significantly increased, the number of apoptotic cells in the liver significantly increased, the protein expressions of Nrf2 and HO-1 significantly decreased, and the protein expressions of Keap1 and cleaved caspase-9 significantly increased. Compared with the DQ group, the mitochondrial damage in the DQ+SFN group was reduced, the levels of plasma AST and ALT were significantly reduced [ALT (U/L): 58.22±4.39 vs. 79.94±3.32, AST (U/L): 177.64±8.40 vs. 219.62±11.60, both P &lt; 0.01], the liver MDA content decreased, and the activities of SOD and GSH increased [MDA (μmol/g: 5.63±0.18 vs. 5.96±0.29, SOD (kU/g): 102.05±4.01 vs. 84.34±5.34, GSH (mmol/g): 16.32±1.40 vs. 13.12±1.84, all P &lt; 0.05], the production of ROS in liver tissue was significantly reduced [ROS (fluorescence intensity): 115.90±10.89 vs. 190.70±10.16, P &lt; 0.05], and apoptotic cells were significantly reduced (cell apoptosis index: 4.39±1.00 vs. 10.71±0.56, P &lt; 0.01), the protein expressions of Nrf2 and HO-1 were significantly increased, while the protein expressions ","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"36 11","pages":"1183-1189"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Application progress of ROX index in evaluating the efficacy of pediatric high-flow nasal cannula oxygen therapy].","authors":"Shaodong Zhao, Hongjun Miao","doi":"10.3760/cma.j.cn121430-20240326-00289","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240326-00289","url":null,"abstract":"<p><p>Respiratory support is one of the key technologies for treating pediatric respiratory diseases. High-flow nasal cannula oxygen therapy (HFNC) represents a novel method of assisted respiratory support. The commonly used indicator for assessing HFNC efficacy in clinical practice is oxygenation index (PaO₂/FiO₂). However, this parameter has several limitations when evaluating the efficacy of HFNC in pediatrics. The ROX index, introduced in recent years, offers a more sensitive and specific assessment tool. This article reviews the application of the ROX index in assessing the efficacy of HFNC for pediatric respiratory failure, aiming to provide a more accurate assessment method.</p>","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"36 11","pages":"1230-1232"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Design and application of a prone and side lying double-purpose inflatable mattress for acute respiratory distress syndrome].","authors":"Jian Guo, Shanyan Wu, Bohui Cha, Shuaicheng Wu, Qiaoqing Chen","doi":"10.3760/cma.j.cn121430-20240823-00718","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240823-00718","url":null,"abstract":"<p><p>Acute respiratory distress syndrome (ARDS) is a leading cause of high mortality in critically ill patients in intensive care units (ICU). Prone ventilation is one of the important treatment methods for ARDS, but due to the severity of the patients' conditions, their physical weakness, and poor cooperation, it is difficult for them to adjust to the prone position on their own. This requires a large number of medical staff to adjust the patient to a prone position and implement prone ventilation for than 12 hours daily to achieve therapeutic effects. Clinical implementation often faces challenges such as a shortage of staff, patient discomfort, difficulty in changing positions prolonged time leading to bedsores, and lack of auxiliary equipment. It is particularly challenging for ARDS patients, especially those in critical condition, to adjust their on their own. Therefore, healthcare workers from the department of emergency of Yingtan 184 Hospital designed a prone and side lying double-purpose inflatable mattress for ARDS, and obtained the National Utility Model Patent of China (patent number: ZL 2023 2 1249425.7). The prone and side lying dual-purpose inflatable mattress mainly consists of a main mattress, a forehead pad, a prone position pad, and bilateral side lying position pads. The prone position pad and the lateral position pad on both sides are relatively independent, and can be inflated separately through their inflation nozzles to meet the ventilation needs of ARDS patients in prone or lateral positions, making it easy to adjust the patient's position. This mattress is reasonably designed, simple in structure, easy to operate, comfortable, and practical. It has transformation, promotion, and application value.</p>","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"36 11","pages":"1213-1215"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Establishment and validation of a sepsis 28-day mortality prediction model based on the lactate dehydrogenase-to-albumin ratio in patients with sepsis].","authors":"Zhiyang Wang, Fang Huang, Shifeng Li, Xinyue Li, Yujie Liu, Bin Shao, Meili Liu, Yunnan Yao, Jun Wang","doi":"10.3760/cma.j.cn121430-20231012-00865","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20231012-00865","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To develop and validate a predictive model of 28-day mortality in sepsis based on lactate dehydrogenase-to-albumin ratio (LAR).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Sepsis patients diagnosed in the department of intensive care medicine of the First Affiliated Hospital of Soochow University from August 1, 2017 to September 1, 2022 were retrospective selected. Clinical data, laboratory indicators, disease severity scores [acute physiology and chronic health evaluation II (APACHE II), sequential organ failure assessment (SOFA)] were collected. Patients were divided into death group and survival group according to whether they died at 28 days, and the difference between the two groups was compared. The dataset was randomly divided into training set and validation set according to 7 : 3. Lasso regression method was used to screen the risk factors affecting the 28-day death of sepsis patients, and incorporating multivariate Logistic regression analysis (stepwise regression) were included, a prediction model was constructed based on the independent risk factors obtained, and a nomogram was drawn. The nomogram prediction model was established. Receiver operator characteristic curve (ROC curve) was drawn to analyze and evaluate the predictive efficacy of the model. Hosmer-Lemeshow test, calibration curve and decision curve analysis (DCA) were used to evaluate the accuracy and clinical practicability of the model, respectively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 394 patients with sepsis were included, with 248 survivors and 146 non-survivors at 28 days. Compared with the survival group, the age, proportion of chronic obstructive pneumonia, respiratory rate, lactic acid, red blood cell distribution width, prothrombin time, activated partial thromboplastin time, alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen, creatinine, blood potassium, blood phosphorus, LAR, SOFA score, and APACHE II score in the death group were significantly increased, while oxygenation index, monocyte count, platelet count, fibrinogen, total cholesterol, triglycerides, high-density lipoprotein, low-density lipoprotein, and blood calcium were significantly reduced. In the training set, LAR, age, oxygenation index, blood urea nitrogen, lactic acid, total cholesterol, fibrinogen, blood potassium and blood phosphorus were screened by Lasso regression. Multivariate Logistic regression analysis finally included LAR [odds ratio (OR) = 1.029, 95% confidence interval (95%CI) was 1.014-1.047, P &lt; 0.001], age (OR = 1.023, 95%CI was 1.005-1.043, P = 0.012), lactic acid (OR = 1.089, 95%CI was 1.003-1.186, P = 0.043), oxygenation index (OR = 0.996, 95%CI was 0.993-0.998, P = 0.002), total cholesterol (OR = 0.662, 95%CI was 0.496-0.865, P = 0.003) and blood potassium (OR = 1.852, 95%CI was 1.169-2.996, P = 0.010). A total of 6 predictor variables were used to establish a prediction model. ROC curve showed that the area under the curve (AUC) ","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"36 11","pages":"1140-1146"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Analysis of the incidence and risk factors of sarcopenia in elderly intensive care unit patients: a prospective cohort study].","authors":"Yuehao Shen, Linlin Li, Haiying Liu, Yue Zhang, Dongxue Huang, Liuqing Duan, Lina Zhao, Keliang Xie","doi":"10.3760/cma.j.cn121430-20240819-00706","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240819-00706","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate and analysis of the occurrence and influencing factors of sarcopenia in elderly critically ill patients in the intensive care unit (ICU).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A prospective cohort study was conducted. Elderly patients (aged ≥ 60 years) admitted to the ICU of Tianjin Medical University General Hospital from November 2023 to June 2024 were enrolled. Clinical records were collected, and conduct muscle mass and strength measurements, as well as upper arm circumference and calf circumference were measured. Appendicular skeletal muscle index (ASMI) of less than 7.0 kg/m&lt;sup&gt;2&lt;/sup&gt; for males and less than 5.7 kg/m&lt;sup&gt;2&lt;/sup&gt; for females was defined as reduced muscle mass, grip strength of less than 28 kg for males and less than 18 kg for females was defined as decreased muscle strength, patients meeting both low muscle mass and low muscle strength criteria were diagnosed with sarcopenia. According to the diagnostic criteria for sarcopenia, patients were divided into sarcopenia group and non-sarcopenia group. Multivariate Logistic regression analysis was applied to identify risk factors for sarcopenia in the elderly and to develop a predictive model for the occurrence of sarcopenia. The predictive value of various risk factors for sarcopenia in elderly critically ill patients was evaluated by receiver operator characteristic curve (ROC curve). The Kaplan-Meier curve for the length of ICU stay of two groups patients were drawn.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Finally, 540 elderly critically ill patients were included, including 43 patients with sarcopenia, and the incidence of sarcopenia was 8.0%. Univariate analysis showed that there were significantly differences in body mass index (BMI), number of hospitalizations in the past year, the length of ICU stay, ventilation mode, duration of mechanical ventilation, pre-admission exercise habits, nutritional support methods, upper arm circumference, calf circumference, and albumin infusion between the sarcopenia group and the non-sarcopenia group. Multivariate Logistic regression analysis showed that BMI [odds ratio (OR) = 0.79, 95% confidence interval (95%CI) was 0.67-0.93, P = 0.004], calf circumference (OR = 0.64, 95%CI was 0.54-0.76, P &lt; 0.001), and duration of mechanical ventilation (OR = 1.06, 95%CI was 1.01-1.12, P = 0.034) were associated with an increased risk of sarcopenia in elderly critically ill patients. The ROC curve results showed that the area under the curve (AUC) and 95%CI of BMI, calf circumference, and duration of mechanical ventilation for predicting sarcopenia in elderly critically ill patients were 0.828 (0.767-0.888), 0.889 (0.844-0.933), and 0.397 (0.299-0.496), respectively, with cut-off values of 22.95 kg/m&lt;sup&gt;2&lt;/sup&gt;, 28.25 cm, and 50.50 days, respectively. The Kaplan-Meier curve showed that the cumulative survival rate of patients with sarcopenia was significantly lower than that of the non-sarcopenia group (Log-Rank test","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"36 11","pages":"1196-1202"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Survey on the current situation of human resources and basic configuration of the intensive care medicine in Xinjiang Production and Construction Corps from 2019 to 2021].","authors":"Xueting Li, Qi Zhang, Mengting Qin, Ling Huang, Hang Xu, Shan Ren","doi":"10.3760/cma.j.cn121430-20231029-00920","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20231029-00920","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To comprehensively understand the basic situation of critical care medicine in Xinjiang Production and Construction Corps in order to promote the standardization, specialization, and systematization of quality control in critical care medicine.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A survey was conducted from January 1, 2019, to December 31, 2021, using a questionnaire to investigate the human resources and basic allocation of comprehensive intensive care medicine departments in Xinjiang Production and Construction Corps division level hospitals and surrounding second-class hospitals. The survey content includes: basic situation of medical units, intensive care unit (ICU) basic information, ICU personnel situation, ICU equipment configuration situation, ICU performance situation, etc. The survey questionnaire was distributed in March 2022, with dedicated ICU attending physicians or above designated by each ICU as the contact person for the survey.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Sixteen questionnaires were distributed and returned, all of which were included from 16 comprehensive intensive care medicine departments in the Corps and surrounding areas, including 5 second class first class hospitals and 11 third class first class hospitals. There were 196 beds in 16 ICU units, and the ICU bed ratio (1.99% overall, 1.77% in third class first class hospitals) was lower than the 2%-8% stipulated in the Guidelines for the Construction and Management of Critical Care Medicine (Trial) issued by the National Health Commission. Only ICU beds in second class first class hospitals accounted for 2.65%, meeting this standard. The comprehensive ICU doctor-bed ratio in 16 hospitals was 0.55 : 1, third class first class hospitals was 0.60 : 1, and second class first class hospitals was 0.44 : 1, compared with 0.8 : 1 stipulated in the ministerial guidelines, there was a certain gap. Among the 108 doctors in 16 ICUs, only four have a master's degree or above. Associate senior and above professional and technical titles accounted for 27.78%, less than one third. Among the 334 nursing staff, there were no personnel with a master's degree or above, and only 10 personnel with associate senior or above professional and technical titles. From 2019 to 2021, there were 1 new master's degree personnel, 2 new senior professional and technical personnel, and 12 deputy senior professional and technical personnel. It indicating that the proportion of highly educated and experienced physicians and nurses were lower, team building lags behind, talent introduction were lower, and highly educated talents were scarce. The statistical analysis results of the absolute growth of core technology showed that the growth of core technology was slow, the progressiveness was insufficient, and the professional technical ability was insufficient.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The construction of critical care majors and talent echelons in the Xinjiang Production ","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"36 11","pages":"1203-1208"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}