Extracorporeal membrane oxygenation (ECMO) is a technique in which breathing and circulation are supported extracorporeally. Severe trauma may induce cardiopulmonary failure, for which ECMO can play an adjunctive role in the salvage treatment of circulatory and respiratory failure when conventional treatments are ineffective. Bypass with ECMO can rapidly improve the state such as circulatory failure and hypoxemia in critically ill patients in short term and can partially or fully replace their cardiopulmonary function in long term, winning valuable time for normal recovery of cardiopulmonary function. Because of the physical state of severe trauma patients and the ECMO equipment, there are still various complications clinically. Trauma patients show high risk of bleeding, vulnerability to wound infection and probability of combined organ injury and dysfunction, so more comprehensive measures for the prevention and treatment of complications during the use of ECMO therapy are required. The authors review the research progress in complications and corresponding prevention and treatment strategies during ECMO support for severe trauma, aiming to provide a reference to prevent and treat these complications.

Objective:To investigate the clinical efficacy of ear acupoint pressing beans combined with escitalopram tablets in the treatment of depression.Methods:A total of 100 patients with depression who received treatment in the Department of Psychiatrics, The Third People's Hospital of Yongkang from October 2021 to February 2023 were included in this randomized controlled study. These patients were randomly divided into a control group and an observation group, with 50 patients in each group, using a random number table method. The control group was treated with escitalopram tablets, while the observation group was treated with ear acupoint pressing beans combined with escitalopram tablets. The two groups were treated for 8 weeks. Hamilton Depression Scale (HAMD), traditional Chinese medicine syndrome scores, Pittsburgh Sleep Quality Index (PSQI), serotonin levels, clinical efficacy, and adverse reactions were recorded in each group.Results:After treatment, the HAMD scores in each group were significantly decreased compared with those before treatment (both P < 0.001). After treatment, the HAMD scores in the observation group were significantly lower than those in the control group [(15.89 ± 1.08) points vs. (19.24 ± 1.27) points, t = 14.21, P < 0.001]. After treatment, the traditional Chinese medicine syndrome scores in each group were significantly lower than those before treatment (both P < 0.001). After treatment, the traditional Chinese medicine syndrome scores in the observation group were significantly lower than those in the control group [(6.83 ± 1.24) points vs. (9.78 ± 1.80) points, t = 9.54, P < 0.001]. After treatment, the PSQI scores in each group were significantly decreased compared with those before treatment (both P < 0.001). After treatment, the PSQI scores in the observation group were significantly lower than those in the control group [(7.00 ± 1.34) points vs. (9.48 ± 1.82) points, t = 7.76, P < 0.001]. After treatment, the levels of serotonin in each group were significantly decreased compared with those before treatment (both P < 0.001). The levels of serotonin in the observation group were significantly higher than those in the control group [(40.65 ± 5.37) μg/L vs. (32.52 ± 4.20) μg/L, t = 8.43, P < 0.001]. The total effective rate in the observation group was significantly higher than that in the control group [94% (47/50) vs. 80% (40/50), χ2= 4.33, P = 0.037]. The incidence of adverse reactions in the observation group was significantly lower than that in the control group [8% (4/50) vs. 10% (5/50), χ2= 0.12, P = 0.727]. Conclusion:The combination of ear acupoint pressing beans and escitalopram tablets shows good clinical efficacy in the treatment of depression. This combined therapy can reduce symptoms, improve sleep quality, increase serotonin levels and also has fewer adverse reactions, making it a worthy candidate for clinical promotion.

Objective To provide reference for clinical pharmacists to participate in rational drug use through case study. Methods Clinical pharmacists participated in the optimization of treatment plan and performed pharmaceutical care for the patients according to their own characteristics, drug interactions, compatibility contraindications and adverse drug reactions. Results Clinical pharmacists provided pharmaceutical care for the patients with cerebrovascular diseases, Parkinson's disease, encephalitis and other diseases in the Department of Neurology by using pharmaceutical expertise, retrieved evidence-based support from literature and participating in the formulation of treatment plans. Those achieved individualized drug treatment, improve patient compliance, reduced the occurrence of unreasonable usage and dosage, inappropriate drug combination and improper drug selection, the treatment of adverse drug reactions, drug safety, and rational drug use. Conclusion Clinical pharmacists need to use their sound professional ability and good communication skills to help doctors make individualized drug delivery plans to ensure the safety, effectiveness and economy of drug treatment.