Objectives:To develop a risk prediction model for sudden cardiac arrest(CA)in children with congenital heart disease(CHD)after surgery and validate its predictive efficacy,providing a reference for the prevention of CA and risk stratification.Methods:Medical records were retrospectively analyzed from 5 029 children who were hospitalized in Fuwai Hospital,Chinese Academy of Medical Sciences from January 1,2020 to May 31,2022 and underwent CHD surgery.The patients were divided into two groups:those who experienced CA after surgery(n=33)and those who did not(n=4 996).A random forest model for predicting the risk of postoperative CA was established on the training dataset using R software,and the predictive effect of the model was evaluated on the validation dataset using indicators of predictive accuracy,sensitivity,specificity,positive predictive value,negative predictive value.Results:The incidence of CA in this center was 0.66%,survival rate is 72.73%.Using the random forest algorithm,the importance of risk factors for sudden CA after CHD surgery was ranked by variable importance scoring,with the following top 6 important predictive variables:blood pressure,lactate levels,heart rate,cardiac rhythm,arterial oxygen partial pressure,and blood oxygen saturation on the first day after surgery.The model established by the random forest algorithm on the training set was validated on the test set,yielding a predictive accuracy of 99.8%,specificity of 87.5%,sensitivity of 99.9%,kappa coefficient of 0.8225,positive predictive value of 99.9%,and negative predictive value of 77.8%.Conclusions:The established prediction model of sudden CA in children with CHD after surgery had good performance.It might help medical staffon decision making of early intervention,preventing the occurrence of CA,and improving the outcomes of children with high risk of CA post surgery.

Objectives:To develop a risk prediction model for sudden cardiac arrest(CA)in children with congenital heart disease(CHD)after surgery and validate its predictive efficacy,providing a reference for the prevention of CA and risk stratification.Methods:Medical records were retrospectively analyzed from 5 029 children who were hospitalized in Fuwai Hospital,Chinese Academy of Medical Sciences from January 1,2020 to May 31,2022 and underwent CHD surgery.The patients were divided into two groups:those who experienced CA after surgery(n=33)and those who did not(n=4 996).A random forest model for predicting the risk of postoperative CA was established on the training dataset using R software,and the predictive effect of the model was evaluated on the validation dataset using indicators of predictive accuracy,sensitivity,specificity,positive predictive value,negative predictive value.Results:The incidence of CA in this center was 0.66%,survival rate is 72.73%.Using the random forest algorithm,the importance of risk factors for sudden CA after CHD surgery was ranked by variable importance scoring,with the following top 6 important predictive variables:blood pressure,lactate levels,heart rate,cardiac rhythm,arterial oxygen partial pressure,and blood oxygen saturation on the first day after surgery.The model established by the random forest algorithm on the training set was validated on the test set,yielding a predictive accuracy of 99.8%,specificity of 87.5%,sensitivity of 99.9%,kappa coefficient of 0.8225,positive predictive value of 99.9%,and negative predictive value of 77.8%.Conclusions:The established prediction model of sudden CA in children with CHD after surgery had good performance.It might help medical staffon decision making of early intervention,preventing the occurrence of CA,and improving the outcomes of children with high risk of CA post surgery.

Objective To explore the effect of continuing care on the intermittent catheterization compliance of patients with neurogenic bladder. Methods From January to December, 2015, 60 patients with neurogenic bladder after spinal cord injury receiving intermittent cathe-terization were randomly assigned to control group (n=30) and intervention group (n=30). The control group received routine discharge in-struction, while the intervention group received continuing care in addition. The intermittent catheterization compliance, residual urine vol-ume, urinary tract infection and quality of life were assessed at discharge and three months after intervention. Results After intervention, the intermittent catheterization compliance was better in the intervention group than in the control group (χ2=7.500, P=0.006). The residual urine volume significantly decreased in both groups (t>12.040, P<0.001), and was less in the intervention group than in the control group (t=-2.190, P=0.032), as well as the urinary tract infection rate (χ2=10.800, P=0.001). The score of quality of life increased significantly after intervention in both groups (t>4.572, P<0.001), and was higher in the intervention group than in the control group (t>5.505, P<0.001). Con-clusion Continuing care could improve the intermittent catheterization compliance, reduce the residual urine volume and the urinary tract in-fection rate, and improve the quality of life in patients with neurogenic bladder after discharge.

The body is equipped with kinds of transporters which generally exist in liver,kidney,and intestine.Multidrug and toxin extrusion proteins(MATEs;SLC47A)are predominantly expressed in the brush-border membrane of proximal tubule epi-thelial cells in the kidney and the canalicular membrane of hepa-tocytes.Functionally,MATEs act as efflux transporters for or-ganic compounds.The article discusses type,structure,poly-morphism and function of MATE1and MATE2-K,and also dis-cusses the effect of single nucleotide polymorphisms (SNPs)in the SLC47A1 gene and SLC47A2 on the pharmacokinetics and pharmacodynamics of metformin and platinum-based chemothera-peutic agents.

Objective To explore the effects of continuing care on the quality of sleep and neurological function rehabilitation in patients after stroke. Methods 60 patients with sleep disorder and hemiplegia after stroke discharging from our hospital during January to December 2014 were randomly assigned to control group (n=30) and intervention group (n=30). The control group received routine discharge instruction, while the intervention group received continuing care. They were assessed with Pittsburgh Sleep Quality Index (PSQI), simplified Fugl-Meyer Assessment (FMA) and modified Barthel Index (MBI) were when discharged and 3 months after intervention. Results The scores of PSQI were lower, the scores of FMA and MBI were higher in the intervention group than in the control group 3 months after intervention (P<0.05). The nursing satisfaction was higher in the intervention group than in the control group (P<0.001). Conclusion Continuing care could improve the sleep quality, and promote the neurological function recovery for patients with sleep disorder after stroke.