Objective:To analyze the clinical characteristics of patients with cardiac arrest caused by poisoning, explore the differences in the corresponding emergency measures and emergency effects under different causes of poisoning, and improve the success rate of out-of-hospital cardiac arrest rescue.Methods:All out-of-hospital toxic cardiac arrest patients admitted to Beijing Emergency Medical Center from January 2021 to December 2021 were retrospectively included.Results:A total of 38 patients with a median age of 43 years, including 26(68.4%) were male. There were 20 cases of acute alcoholism (52.6%), and 9 (23.7%) cases of carbon monoxide and drug poisoning respectively. In 38 cases, only 2 cases achieved return of spontaneous circulation, and no cases survived more than 24 hours.Conclusions:Poisoning induced cardiac arrest is one of the non-cardiac causes of out-of-hospital cardiac arrest, responsible for 1.7%. Alcoholism is the main poisoning cause of noncardiac out-of-hospital cardiac arrest in Beijing, prevent the poisoning and quickly identify the cause of the poisoning and give the correct rescue measures is very important for cardiac arrest.

BACKGROUND:Acupoint embedding and floating needle therapy are two methods for the treatment of knee osteoarthritis,but there are few reports on the combined treatment of the two methods. OBJECTIVE:To investigate the therapeutic effect of acupoint embedding combined with floating needle therapy on different stages of knee osteoarthritis using generalized estimating equations. METHODS:A total of 436 patients with knee osteoarthritis admitted to Dongguan Hospital of Traditional Chinese Medicine from February 2019 to February 2023 were selected as the research subjects.All patients were randomly divided into a control group with floating needle therapy(n=218)and an observation group with acupoint embedding method combined with floating needle therapy(n=218).Staging was performed according to the K-L staging method.In the control group,there were 57 cases in stage Ⅰ,62 in stage Ⅱ,49 in phase Ⅲ,and 50 in stage Ⅳ,while in the observation group,there were 48 cases in stage Ⅰ,66 in stage Ⅱ,63 in phase Ⅲ,and 41 in stage Ⅳ.The levels of indexes and clinical efficacy were compared between groups before and after treatment.Generalized estimating equation model was used to analyze the influencing factors of clinical efficacy and the interaction effect of different time points,different methods and different stages on therapeutic efficacy. RESULTS AND CONCLUSION:There was no significant difference in baseline data between the observation group and the control group,as well as between the patients of different stages(P>0.05).After treatment,the cure rate of stage Ⅰ patients was the highest after treatment,and the total improvement rate in the observation group was significantly higher than that in the control group.There were significant differences in the cure rate among different stages in each group(P<0.05).After treatment,all indicators in the two groups were significantly decreased.In the control group,there were significant differences in various indicators of patients at different stages after 4 weeks of treatment(P<0.05).In the observation group,after 2 weeks of treatment,there were significant differences in various indicators of patients at different stages(P<0.05),and all the indexes in the observation were lower than those in the control group after 4 weeks of treatment(P<0.05)and the therapeutic effect in the observation group was better than that in the control group.Generalized estimating equation model analysis showed that trauma history,interleukin-6 level,treatment method,treatment time and K-L stage all significantly affected the clinical efficacy in patients.In the interaction effect analysis,after 2 weeks of treatment,there was a significant difference in the visual analogue scale score between the two groups in stages Ⅲ and Ⅳ(P<0.05).After 4 weeks of treatment,there was a significant difference in the visual analogue scale score between the two groups in stages Ⅱ,Ⅲ,and Ⅳ(P<0.05).To conclude,acupoint embedding combined with floating needle therapy is superior to floating needle therapy alone in the treatment of different stages of knee osteoarthritis.Trauma history,interleukin-6 level,treatment method,treatment time and K-L stage significantly influence the therapeutic effect.

Objective:To systematically review the risk prediction models for cognitive impairment in stroke patients, aiming to provide references for clinical healthcare professionals in selecting or constructing high-quality risk assessment tools.Methods:A computerized search was conducted in PubMed, Embase, Web of Science, OVID, Cochrane Library, SinoMed, CNKI, Wanfang Database, and VIP to identify studies related to risk prediction models for cognitive impairment in stroke patients. The search was limited to articles published up to August 1, 2023. Two researchers independently screened the literature, extracted data, and assessed the risk of bias and applicability of the included studies using PROBAST.Results:A total of 26 articles were included. The applicability of the studies was generally good, but all studies had some degree of bias risk, mainly arising from unreasonable study designs, inappropriate time intervals between predictor assessment and outcome determination, insufficient sample sizes, unreasonable handling of continuous variables, omission of missing data, lack of reporting of calibration, and overfitting of the models. Meta-analysis results showed that age ( OR=0.05, 95% CI: 0.033-0.057), education level ( OR=-0.13, 95% CI: -0.171 - -0.082), history of diabetes ( OR=2.32, 95% CI: 1.867-2.881), history of hypertension ( OR=0.67, 95% CI: 0.420-0.918), and NIHSS score ( OR=0.40, 95% CI: 0.331-0.469) were factors for cognitive impairment in stroke patients. Conclusions:While various risk prediction models for cognitive impairment in stroke patients exist, they suffer from methodological flaws and high bias risks, with some commonalities and controversies in predictors. Future research should adhere to the principles of transparent reporting of individual prognosis or diagnosis of multivariate prediction models, develop localized prediction models with low bias risk and good applicability, and conduct internal and external validations to demonstrate their applicability and feasibility in clinical practice.

Objective To explore a method of subsection adjustment for the proportion of three capacity nutrients in patients with metabolic syndrome (MS).Methods Totally 334 MS patients who were diagnosed in the physical examination center and the department of endocrinology and nutrition of Xi'an Central Hospital Affiliated to Xi'an Jiaotong University of School of Medicine were enrolled in this study.According to calculator random digital method,the patients were divided into intervention group (n=168) and the control group (n=166).The energy of two groups were calculated according to the following formula,y =13.5-0.025x1 + 0.215x2-0.006x3+0.342x4-0.268x5+0.623x6 (x1:age,x2:activity intensity index,x3:waist circumference,x4:environmental temperature,x5:BMI,x6:sex).The limit of daily energy was set to 5.02-7.53 MJ.The proportion of the three major nutrients for energy was adjusted of different energy segments of intervention group.When the daily energy was 5.02 MJ,the protein energy ratio was 30％,and the energy increased by 0.42 MJ per time while the protein energy supply ratio was reduced by 2.5％.The energy ratio of carbohydrate was 40％,and the energy increased 0.42 MJ per time while the energy ratio increased by 2.5％.The energy ratio of fat was 30％ on various stages of energy supply.The energy proportions of the three major nutrients in the control group were as follows:protein 15％,fat 25％,and carbohydrate 60％.Results After the intervention by 6 months,the 2-hour postprandial blood glucose of intervention group decreased from (9.22±5.57) mmol/L to (6.05±4.68) mmol/L,the hemoglobin A 1 c decreased from (6.79 ± 1.12) ％ to (5.56± 1.32) ％,and the triglyceride decreased from (3.14±1.73) mmol/L to (1.72±1.17) mmol/L.There was significant difference compared with those in control group (P =0.000,0.027,0.034).Conclusion The proportions of the three major nutrients in MS can remarkably improve the glucose and lipid metabolism in MS patients.

Objective:To study the epidemic characteristics of kala-azar in Shaanxi Province, and to provide scientific basis for formulating effective prevention and control measures.Methods:Information of kala-azar confirmed cases and clinically diagnosed cases whose current addresses were reported in Shaanxi Province in the Surveillance Report Management System of China Disease Control and Prevention Information System from 2011 to 2022 was collected. Trend analysis was made on the number of cases in each year, and descriptive epidemiological methods were used to analyze the onset time, regional and population distribution characteristics and the time interval from onset to diagnosis of kala-azar cases.Results:A total of 225 kala-azar cases were reported in Shaanxi Province from 2011 to 2022, and the number of cases showed an increasing trend (χ 2trend = 98.50, P < 0.001), with the highest number in 2020 (42 cases). The onset time was mainly from March to May (77 cases, 34.22%). The top three cities with the number of reported cases were Hancheng (65 cases, 28.89%), Shangluo (47 cases, 20.89%) and Weinan cities (44 cases, 19.56%). The male to female ratio was 1.74∶1.00 (143/82), the age of onset was mainly concentrated in the age group of 36 - 60 years old (111 cases, 49.33%), and the occupation was mainly farmers (150 cases, 66.67%). The median interval from onset to diagnosis was 11 days, and 78.22% (176/225) of the cases were diagnosed within 1 month. Conclusions:From 2011 to 2022, the overall incidence of kala-azar in Shaanxi Province has showed an upward trend, with the main population being middle-aged male farmers. The main affected areas are Hancheng, Shangluo and Weinan cities. It is urgent to strengthen the surveillance and prevention and control of kala-azar in key populations and key regions.

ObjectiveTo investigate the efficacy and safety of Shengxiantang in the treatment of early Parkinson's disease with autonomic dysfunction of Qi deficiency pattern. MethodA total of 82 eligible patients were randomized into control group （41 cases） and traditional Chinese medicine （TCM） group （41 cases）. On the basis of standardized treatment of western medicine， TCM group was prescribed Shengxiantang while control group were treated with placebo for 12 consecutive weeks additionally. Scale for Outcomes in Parkinson's Disease-Autonomic （SCOPA-AUT） questionnaire， Unified Parkinson's Disease Rating Scale （UPDRS）， Traditional Chinese Medicine Qi Deficiency Symptom Score of Parkinson's Disease （TCMQDSSPD）， serum levels of glutathione peroxidase （GPx） and superoxide dismutase （SOD）， daily dosage of pramipexole and levodopa and benserazide hydrochloride， and safety index were evaluated both before and after treatment. ResultAfter treatment， the total score of SCOPA-AUT， gastrointestinal score， urinary score， and thermoregulatory score in the control group were higher than those before treatment （P<0.01）， while the above sores in the TCM group were lower than those before treatment （P<0.05， P<0.01）. In addition， the cardiovascular score， pupillomotor score， and sexual score in two groups showed no significant difference from those before treatment. After treatment， the total score of SCOPA-AUT， gastrointestinal score， urinary score， and thermoregulatory score in the TCM group were lower than those in the control group （P<0.05， P<0.01）， and cardiovascular score， pupillomotor score， and sexual score showed no significant difference between two groups. After treatment， the total score of TCMQDSSPD， main symptom scores， and minor symptom scores in the control group had no significant difference from those before treatment. The total score of TCMQDSSPD and minor symptom scores of TCM group were lower than those before treatment （P<0.01）， while the main symptom scores of the TCM group showed no significant difference from those before treatment. After treatment， the UPDRS score， serum GPx and SOD levels， and daily dosage of pramipexole and levodopa and benserazide hydrochloride demonstrated no significant difference from those before treatment in the two groups and between the two groups. No abnormality was found in the safety indexes. ConclusionBased on the standardized treatment of western medicine， Shengxiantang can effectively and safely improve the autonomic symptoms of gastrointestinal system， urinary system， and thermoregulation， as well as the symptoms of Qi deficiency syndrome in early Parkinson's disease with autonomic dysfunction.