Objective:To retrospectively analyze the establishment and implementation effect of ECPR rapid response medical team in emergency department, and to explore a more efficient rescue mode.Methods:A total of 41 patients who started ECPR in the emergency room of a tertiary hospital in Beijing from November 2017 to September 2022 were selected as subjects. The 14 patients treated by the ECPR rapid response medical team in the emergency department were set as the experimental group, and the 27 patients treated by the ECPR team of the MDT mode led by the cardiac surgeon were set as the control group. The ECPR start-up time, pipeline pre-filling time, ECPR start-up to ECMO successful operation time, complication rate and treatment success rate were compared between the two groups.Results:There was no significant difference in the outcome between the two groups (all P>0.05), but the total time (min) of ECPR implementation by the rapid response medical team in the emergency department was shorter (20.86 ± 10.86 vs. 23.04 ± 11.40), the incidence of complications was lower, and the success rate of treatment was higher (28.57 % vs. 25.93 %). Conclusion:Establishing a mature ECPR rapid response team dominated by emergency medical care helps improve the rescue coordination and work efficiency, thereby providing the emergency protection and management of full -chain for the treatment of critical condition.

The shortage of emergency and critical care resources has become increasingly prominent,seriously reducing the quality and safety of care.How to improve the efficiency of the emergency and critical care platform is an urgent problem to be solved.Since 2020,the emergency department of Peking University Third Hospital has achieved an increase of 10%-20%in the annual visits of emergency and critically ill patients,the reduction of the emergency department length of stay and the improvement of survival rate using Objectives and Key Results(OKR)as an advanced management tool.It provides a new paradigm for improving efficiency of emergency department in large general hospitals.

Objective Using middle cerebral artery occlusion (MCAO) model to observe protective effect of effective components of bezoar on brain damage.To discuss the anti-cerebral ischemia mechanism and compare the efficacy of effective components of bezoar from the endoplasmic reticulum stress intervention angle.Methods Rats were stratified randomly divided into sham group,model group,Qingkailing group (positive drug,3 mL/kg),taurine group,ursodeoxycholic acid (UDCA,78 mg/kg) group,taurine-conjugated ursodeoxycholic acid (TUDCA,100 mg/kg) group.Through establish MCAO model in rats,observed the scores of the neurologic impairment,measured infarct volume by TTC.Immunohistochemistry and Western blotting were Used to detect the content of P-PERK,P-EIF2α,and ATF4.Results Compared with sham group,neurologic impairment scores of model group significantly reduced (P ＜ 0.01).Compared with model group,Qingkailing group,UDCA group,and TUDCA group significantly improved neurological function in rats (P ＜ 0.05,0.01).Compared model group,all the treatment groups could significantly reduce the volume of cerebral infarction (P ＜ 0.01).Compared with sham group,expression of P-PERK,P-EIF2α,and ATF4 was significantly increased (P ＜ 0.01).Compared with model group,all the treatment groups reduced the expression of P-PERK,P-EIF2α,and ATF4 in varying degrees,effect of Qingkailing and TUDCA were more obvious.Conclusion The effective components ofbezoar alleviate cerebral ischemia reperfusion injury in rats by inhibiting endoplasmic reticulum stress,the effect of TUDCA is better than that of taurine and UDCA.

The theory of preventive treatment of disease in Jinguiyaolue (Synopsis of Prescriptions of the Golden Chamber) includes following 4 aspects:preventing disease at the first,stopping disease transmission,treating disease overall and deciding diagnosis and treatment plan before disease onset.There are 3 theoretical principles for this theory:disease preventive principle,overall therapeutic principle,and principle for selecting diagnosis and treatment steps.The therapeutic principles for damp disease,phlegm-fluid retention,water-qi disease in Jinguiyaolue is analyzed based on the theory for getting ZHANG Zhong-jing's therapeutic thinking,expand understanding to original texts,and enrich the content of modern system of pattern differentiation and treatment.

Objective:To explore the incidence of low anterior resection syndrome (LARS) in patients undergoing sphincter-preserving surgery for rectal cancer and analyze related factors.Methods:This study was a cross-sectional survey. From 2021 to 2023, convenience sampling was used to select 195 patients with rectal cancer who underwent sphincter-preserving surgery at Peking University Third Hospital as participants. The patients were surveyed using the General Information Questionnaire, LARS Scale, Visual Analog Score, and Chinese version of Insomnia Severity Index.Results:A total of 195 questionnaires were distributed, and 156 valid questionnaires were collected, with a valid response rate of 80.00% (156/195). The incidence of LARS in 156 rectal cancer patients with sphincter-preserving surgery was 36.54% (57/156), and the incidence of severe LARS was 15.38% (24/156). Binomial Logistic regression analyses showed that gender ( OR=0.445, P=0.034) and preoperative neoadjuvant chemoradiotherapy ( OR=6.343, P<0.01) were influencing factors for the occurrence of LARS in patients with rectal cancer after sphincter-preserving surgery. Preoperative neoadjuvant chemoradiotherapy ( OR=3.322, P=0.047) and intraoperative prophylactic stoma ( OR=4.855, P=0.035) were influencing factors for severe LARS. LARS score was positively correlated with anxiety score ( r=0.238, P=0.003) and total insomnia score ( r=0.168, P=0.036) in patients with rectal cancer who underwent sphincter-preserving surgery. Conclusions:Preoperative neoadjuvant chemoradiotherapy is an independent risk factor for postoperative LARS and severe LARS in rectal cancer patients undergoing sphincter-preserving surgery. LARS is correlated with patients' anxiety and insomnia.

Objective:The Qinzhi Zhudan formula(QZZD)exhibits a prominent therapeutic effect in the treatment of vascular dementia(VaD).This study combined a network pharmacology approach and experimental validation to identify the underlying biological mechanism of QZZD against VaD.Methods:Male Wistar rats received bilateral common carotid artery occlusion(BCCAO)surgery,and after 4 weeks of intragastric administration of QZZD,the therapeutic effect was assessed using the Morris water maze test and cerebral blood flow(CBF)assessment.Hematoxylin and eosin staining,Nissl staining,and electron microscopy were used to measure the histopathological changes in the neurons of rats.The effect of QZZD treatment on hippocampal neurotransmitters was assessed by high-performance liquid chromatography with electrochemical detection and liquid chromatography mass spectrometry.Immunofluorescence was used to observe VaD-induced microglia activation.The inflammatory cytokine levels were assessed by enzyme linked immunosorbent assay.Western blot was used to examine the TNFR1-mediated TNF pathway,which was screened out by network pharmacology analysis.Results:QZZD treatment alleviated pathological changes and neuronal damage in VaD rats and atten-uated their cognitive impairment.In addition,QZZD increased CBF and the expression of acetylcholine and 5-hydroxytryptamine in the hippocampal region.Notably,QZZD inhibited microglial activation and the expression of IL-6 and TNF-a.Network pharmacology and western blot indicated that QZZD inhibited the levels of TNFR1,NF-KBp65,p-ERK,TNF-α,and IL-6,which are related to the TNFR1-mediated TNF signaling pathway.Conclusion:QZZD clearly improved learning and memory function,reduced brain pathological damage,elevated CBF and hippocampal neurotransmitter levels,and alleviated neuroinflammation of VaD rats partly by inhibiting the TNFR1-mediated TNF pathway,indicating its potential value in the clinical therapy of VaD.

Objective:To establish the nutrition literacy core items for preschool children in China.Methods:The framework system and preliminary items of nutrition literacy were established through literature review and experts consultation. E-Delphi method was used to determine the nutrition literacy items. Nine experts in the field of nutrition, child and adolescent health, health education were invited to score the importance of each nutrition literacy item via Email. The judgment basis and familiarity of experts towards the items, active coefficient, authority coefficient and harmony coefficient were evaluated and analyzed to generate the final list of nutrition literacy items.Results:In the first round of E-Delphi consultation, the active coefficient and authority coefficient were 88.9%(8/9) and(0.88±0.07).The harmony coefficient was 0.350 (χ 2=36.432, P=0.001). In the second round, the active coefficient and authority coefficient were 100% (9/9) and (0.89±0.11).The harmony coefficient was 0.347 (χ 2=34.330, P<0.001). After qualitative and quantitative analyses, we identified the final list of nutrition literacy items consisting of two scales (basic knowledge, lifestyles and dietary behaviors), six subscales (food knowledge, food characteristic, food choice, dietary behavior, dietary safety, and physical activity)with 14 items in total. Conclusion:The framework system and core items of nutrition literacy are established for Chinese preschool children, which could provide a reference basis for the implementation of nutrition education project and the establishment of standardized evaluation tools.

Objective:To establish the nutrition literacy core items for preschool children in China.Methods:The framework system and preliminary items of nutrition literacy were established through literature review and experts consultation. E-Delphi method was used to determine the nutrition literacy items. Nine experts in the field of nutrition, child and adolescent health, health education were invited to score the importance of each nutrition literacy item via Email. The judgment basis and familiarity of experts towards the items, active coefficient, authority coefficient and harmony coefficient were evaluated and analyzed to generate the final list of nutrition literacy items.Results:In the first round of E-Delphi consultation, the active coefficient and authority coefficient were 88.9%(8/9) and(0.88±0.07).The harmony coefficient was 0.350 (χ 2=36.432, P=0.001). In the second round, the active coefficient and authority coefficient were 100% (9/9) and (0.89±0.11).The harmony coefficient was 0.347 (χ 2=34.330, P<0.001). After qualitative and quantitative analyses, we identified the final list of nutrition literacy items consisting of two scales (basic knowledge, lifestyles and dietary behaviors), six subscales (food knowledge, food characteristic, food choice, dietary behavior, dietary safety, and physical activity)with 14 items in total. Conclusion:The framework system and core items of nutrition literacy are established for Chinese preschool children, which could provide a reference basis for the implementation of nutrition education project and the establishment of standardized evaluation tools.

Objective To explore the medication law of Professor Wang Qingguo for the treatment of insomnia based on data mining technology.Methods Paper-based prescriptions for Professor Wang Qingguo's treatment of insomnia from December 2016 to August 2023 were collected and a database was constructed.The screened prescriptions were subjected to data mining such as frequency statistics,association rule analysis,and clustering analysis.Results Totally 399 effective outpatient prescriptions were screened-out,involving 276 kinds of Chinese materia medica,with a total frequency of 6738 times.There were 38 Chinese materia medica with a frequency of use≥50.The properties were mainly warm,cold and mild,the tastes were mainly sweet,bitter and pungent,and mainly belong to the lung,spleen and heart meridians.Association rule analysis showed that the most commonly used drug combinations were"Fructus Tritici Levis-Scutellariae Radix-Bupleuri Radix","Pericarpium Citri Reticulatae-Scutellariae Radix-Pinelliae Rhizoma",etc.Association rule network analysis obtained a core prescription containing 12 kinds of Chinese materia medica for insomnia.Four new drug combinations were obtained by clustering analysis.Conclusion Professor Wang's treatment of insomnia has the characteristics of following the original meaning of Huang Di Nei Jing and Nan Jing,making good use of the classical prescription,applying combined prescription,flexible use of prescription,combining ancient and modern prescriptions,using specific medicine.It deeply reflects the academic view of"Tongping Zhihe".