Extracorporeal membrane oxygenation (ECMO) is primarily used in clinical practice to provide continuous extracorporeal respiratory and circulatory support for patients with severe heart and lung failure, thereby sustaining life. It is a key technology for managing severe heart failure and respiratory failure that are difficult to control. With the accumulation of clinical experience in ECMO for circulatory and/or respiratory support, as well as advancements in biomedical engineering technology, more portable and stable ECMO devices have been introduced into clinical use, benefiting an increasing number of critically ill patients. Although ECMO technology has become relatively mature, the timing of ECMO initiation, management of sudden complications, and monitoring and early warning of physiological indicators are critical factors that greatly affect the therapeutic outcomes of ECMO. This article reviews traditional methods and artificial intelligence techniques used in risk assessment related to ECMO, including the latest achievements and research hotspots. Additionally, it discusses future trends in ECMO risk management, focusing on six key areas: multi-center and prospective studies, external validation and standardization of model performance, long-term prognosis considerations, integration of innovative technologies, enhancing model interpretability, and economic cost-effectiveness analysis. This provides a reference for future researchers to build models and explore new research directions.
Extracorporeal Membrane Oxygenation ; Humans ; Artificial Intelligence ; Risk Assessment ; Respiratory Insufficiency/therapy* ; Heart Failure/therapy*

Objective:To explore the effects of small-group collaborative stratified teaching in critical care medicine training for professional postgraduate students.Methods:We randomly assigned 71 professional postgraduate students who entered the Intensive Care Unit of The Affiliated Hospital of Qingdao University for standardized training between June 2020 and November 2020 into experimental group and control group. An entrance examination was taken after one week of unified training. Then the experimental group adopted small-group collaborative stratified teaching, while the control group adopted traditional teaching for training. After two months of training, the Mini-Clinical Evaluation Exercise (Mini-CEX) assessment, post competency assessment, exit examination, and teaching satisfaction evaluation were conducted. SPSS 25.0 was used for the t test and chi-square test. Results:In the Mini-CEX assessment, the experimental group had significantly higher scores in history-taking skills [(7.42±0.60) vs. (7.00±0.55)], physical examination [(7.47±0.56) vs. (6.94±0.24)], communication skills [(7.56±0.50）vs.(7.24±0.49)], clinical dialectical thinking [(7.53±0.56) vs. (7.03±0.39)], clinical judgement [(7.50±0.51) vs.(6.90±0.42)], organization/efficiency [(7.58±0.50) vs. (7.15±0.44)], and overall clinical competence [(7.64±0.49) vs. (7.17±0.39); all P<0.05] than the control group. In the post competency assessment, the experimental group had significantly better performance in clinical basic competence [(89.15±9.12) vs. (86.24±10.23)], medical knowledge application [(48.37±5.87) vs. (46.98±3.68)], teamwork [(48.10±3.55) vs. (45.96±4.83)], information and management [(68.52±7.61) vs. (66.38±5.54)], and academic research [(22.18±0.95) vs. (20.87±1.22); all P<0.05] than the control group. The experimental group was also significantly superior to the control group in terms of the exit examination score and teaching satisfaction (both P<0.05). Conclusions:Small-group collaborative stratified teaching can improve the quality of critical care medicine training for professional postgraduate students, and strengthen their clinical comprehensive abilities and post competencies.

A 41-year-old male was presented with rapidly progression memory impairment for 2 months and episodic limb shaking for 2 weeks as the main manifestations.Physical examination showed verbal disadvantage with decreased memory,attention,comprehension,and orientation.Serum vitamin B12 levels decreased,serum anti gastric parietal cell antibodies and anti-intrinsic factor antibodies were positive.Blood analysis showed macrocytic anemia,neuropsychological scale showed functional impairment in multiple cognitive domains,electrophysiological examination showed peripheral nerve damage,cerebrospinal fluid and imaging examination showed no abnormalities.The patient was diagnosed as having vitamin B12 deficiency dementia,vitamin B12 deficiency related involuntary movement and pernicious anemia.Supplementing with B vitamins and folic acid significantly improved cognitive impairment and eliminated symptoms of limb shaking.The purpose of this case report is to enhance the understanding of clinical doctors about dementia and involunting movement caused by vitamin B12 deficiency,in order to diagnose and treat it early.

Objective To investigate the effects of information-knowledge-attitude-practice(IKAP)management mode on mental state,self-efficacy and hearing recovery in middle-aged and elderly patients with unilateral sudden deafness.Methods A total of 80 middle-aged and elderly patients with unilateral sudden deafness treated in the Department of Otolaryngology,Head and Neck,Jinhua People's Hospital from January 2020 to December 2021 were selected as the study objects,and were divided into observation group and control group according to random number table method,with 40 cases in each group.The control group was given routine intervention,and observation group was given comprehensive health intervention under IKAP management mode based on control group.After 6 months of intervention,the mental state,self-efficacy,hearing recovery and satisfaction with intervention services were compared between the two groups.Results Compared with before intervention,the scores of self-rating anxiety scale(SAS)and self-rating depression scale(SDS)in both groups decreased.The reduction effect of observation group was more obvious(P<0.05).The scores of all dimensions in the self-efficacy scale were improved in both groups,and the improvement effect was more obvious in observation group(P<0.05).The significant efficiency of hearing recovery,effective rate of recovery and satisfaction degree of intervention service in observation group were higher than those in control group(P<0.05).Conclusion IKAP management mode can improve the hearing level of middle-aged and elderly patients with unilateral sudden deafness,help patients to improve anxiety and depression,and improve patients'self-efficacy and satisfaction.

At present, China has entered a deeply aging society, and preparing for elderly care actively can respond to the aging population. This article reviews the theoretical basis, research status, evaluation tools, and influencing factors of elderly care preparation, aiming to provide reference for deepening the elderly care preparation work and achieving healthy aging.

OBJECTIVE: To test the reliability and validity of the Chinese version of parenting sense of competence scale (PSOC) in Chinese mothers of preschool children, and to explore the perception of preschool children's mothers on their own parenting skills and their comfort of being a parent in Yanqing District of Beijing. METHODS: A cross-sectional survey was conducted using a convenience sample in 1 384 preschool children's mothers in Yanqing District of Beijing. SPSS 21.0 and Mplus 7.4 software were used for statistical analysis to test the structural validity, criterion related validity, internal consistency and split half reliability of the scale, and to analyze the score of the scale and its influencing factors. RESULTS: The PSOC had good reliability and validity. Exploratory factor analysis showed that each item of the PSOC had more than 0.4 factor loading in efficacy factor or satisfaction factor, and there was no double load phenomenon. Confirmatory factor analysis showed that the factor loadings ranged from 0.212 to 0.843 in efficacy factor and satisfaction factor, respectively. The goodness of fit test showed that all the fitting indexes were within the acceptable range, and the correlation between the effectiveness subscale and the satisfaction subscale was high. The Cronbach's α coefficient of the whole scale, the efficacy subscale and the satisfaction subscale were 0.872, 0.802, and 0.874, respectively. The Spearman-Brown coefficient of PSOC was 0.851. The average score of the whole scale, the efficacy subscale, and the satisfaction subscale were 72.33±11.31, 35.54±5.91, and 36.79±7.11, respectively, and the score of parenting competence in Chinese mothers of preschool children was influenced by the mother's educational level and the annual income of her family. CONCLUSION The PSOC has satisfactory reliability and validity in Chinese mothers of preschool children. It can be used as an evaluation instrument for measuring the parenting competency, self perceived efficacy and satisfaction in the mainland Chinese mothers of preschool children. The competency of preschool children's mothers in Yanqing District of Beijing is very good, which may be related to the higher education level of the mothers and the higher annual income of their families in this study.
Beijing ; Child, Preschool ; China ; Cross-Sectional Studies ; Female ; Humans ; Mothers ; Parenting ; Psychometrics ; Reproducibility of Results ; Surveys and Questionnaires

Objective: To investigate the relationships of intracranial compartment volumes with the severity of clinical symptoms before surgery, and the degree of symptom improvement one year after cerebrospinal fluid(CSF)shunt surgery in patients with idiopathic normal pressure hydrocephalus(iNPH). Methods: Twenty-one patients meeting the diagnosis criteria of international guidelines of iNPH and undergoing CSF shunt surgery in Department of Neurosurgery in our hospital from 2016 to 2017 were included.All patients underwent brain MRI measurement before surgery, and were evaluated by using 3-meter timed up and go test(TUG), minimum mental state examination(MMSE), idiopathic normal pressure hydrocephalus grading scale(iNPHGS)and modified Rankin scale(mRS)before and one year after CSF shunt procedures.The ventricular volume, brain volume, pericerebral CSF volume, total intracranial volume and Evans' index were measured in the pre-operative imaging of the brain.The following four pre-operative intracranial compartment volumes were calculated: the relative ventricular volume, brain volume ratio, pericerebral CSF volume ratio and the ratio of ventricular volume to pericerebral CSF volume. Results: The scores of gait, cognitive function and urinary function were improved after surgery in iNPH patients(all P<0.05). There were no significant difference in the correlation of intracranial compartment volumes(the relative ventricular volume, brain volume ratio, pericerebral CSF volume ratio and the ratio of ventricular volume to pericerebral CSF volume)and Evans' index with the severity of clinical symptoms including gait, cognitive function and urinary function before surgery, and with the degree of symptom improvement one year after surgery in iNPH patients(all P>0.05). There was no significant difference in intracranial compartment volumes between patients having improvement in mRS, TUG, MMSE and iNPHGS and patients having no improvement one year after surgery in iNPH patients(all P>0.05). Conclusions Patients with iNPH can benefit from CSF shunt surgery and have improvements of clinical symptoms including gait, cognitive function and urinary function.Preoperative intracranial compartment volumes(the relative ventricular volume, brain volume ratio, pericerebral CSF volume ratio and the ratio of ventricular volume to pericerebral CSF volume)and Evans' index have no correlations with the severity of clinical symptoms before surgery, and have no correlations with the degree of symptom improvement one year after surgery in iNPH patients.For this reason, preoperative intracranial compartment volumes and Evans' index cannot be used to predict whether or not CSF shunt surgery can improve specific clinical symptoms.

OBJECTIVE:To provide reference for investigating the nutrition situation of the inpatients in departments of spinal surgery and minimally invasive spinal surgery and promoting the clinical rational use of nutritional support drugs. METHODS:Des-ignated continuous sampling was used to select the inpatients that fit the conditions in the departments of spinal surgery and mini-mally invasive spinal surgery in our hospital from Jan. to Dec. 2013,and the nutritional risk screening 2002 was used to investigate the patients’nutritional risk at admission and upon discharge,the nutritional support during hospitalization were recorded. RE-SULTS:In the 432 enrolled patients,the overall incidence of nutritional risk was 11.57% at admission,12.40% in spinal surgery and 10.44% in minimally invasive spinal surgery;and the overall incidence of nutritional risk was 19.44% upon discharge, 23.60% in spinal surgery,with statistical significance when compared with admission(P<0.05),while 13.74% in minimally inva-sive spinal surgery,with no statistical significance when compared with admission(P>0.05). The nutritional support rate of 50 pa-tients with nutritional risk at admission was 88.00%,14.14% of 382 non-risk patients still received a redundant nutritional support. The 44 patients with nutritional risk who received nutritional support had the average calories intake of(9.84±8.10)kJ/(kg·d),in-cluding 10.16% lipids and 9.55% protein;all patients who received nutritional support found no patients with enteral nutrition sup-port. CONCLUSIONS:Inpatients in departments of spinal surgery and minimally invasive spinal surgery suffer a lower incidence of nutritional risk at admission,and a higher incidence of nutritional risk in the former one upon discharge. While some patients who received nutritional support show no indication,and administrations of nutritional support are still debatable,the use of drug is irrational.

Objective To explore the systematic , standardized nursing intervention on stress response during perioperative period of Laser Assisted in Situ Keratomileusis (LASIK) patients.Methods A total of 200 cases of LASIK patients were randomly divided into the observation group and the control group with 100 cases in each group.The control group was treated with conventional care , while the observation group was treated with systematic and standardized nursing interventions .The blood pressure and anxiety scores of two groups of patients with heart rate were compared .Results Before the study the blood pressure , heart rate and anxiety scores between the groups had no significant difference (P>0.05).After the nursing intervention, the blood pressure, heart rate and anxiety scores were (112.73 ±16.95) mmHg, (76.43 ±11.29) beat/min and (32.67 ±3.94) in the observation group, which were significantly lower than (129.45 ±21.17) mmHg, (84.32 ±12.13) beat/min and (50.03 ±2.95) in the control group (t =-6.17, -4.76, -35.32, respectively;P<0.01).Conclusions The standardized and systematic nursing intervention can reduce the stress response of patients during the LASIK operation period and can help patients to better adapt to the operation.It can also improve the operation effect , promote the postoperative recovery and prevent the complications .

Alanine Transaminase ; blood ; Animals ; Aspartate Aminotransferases ; blood ; Cytokines ; genetics ; Ethanol ; administration & dosage ; toxicity ; Gene Expression Regulation ; drug effects ; Interleukin-18 ; genetics ; Liver Diseases, Alcoholic ; blood ; genetics ; pathology ; Male ; Platelet-Derived Growth Factor ; genetics ; Rats ; Rats, Wistar ; Transforming Growth Factor beta ; genetics ; Triglycerides ; blood