Background: Cardiopulmonary resuscitation (CPR) strategies in COVID-19 patients differ from those in patients suffering from cardiogenic cardiac arrest. During CPR, both healthcare and non-healthcare workers who provide resuscitation are at risk of infection. The Working Group for Expert Consensus on Prevention and Cardiopulmonary Resuscitation for Cardiac Arrest in COVID-19 has developed this Chinese Expert Consensus to guide clinical practice of CPR in COVID-19 patients. Main recommendations: 1) A medical team should be assigned to evaluate severe and critical COVID-19 for early monitoring of cardiac-arrest warning signs. 2) Psychological counseling and treatment are highly recommended, since sympathetic and vagal abnormalities induced by psychological stress from the COVID-19 pandemic can induce cardiac arrest. 3) Healthcare workers should wear personal protective equipment (PPE). 4) Mouth-to-mouth ventilation should be avoided on patients suspected of having or diagnosed with COVID-19. 5) Hands-only chest compression and mechanical chest compression are recommended. 6) Tracheal-intubation procedures should be optimized and tracheal-intubation strategies should be implemented early. 7) CPR should be provided for 20-30 min. 8) Various factors should be taken into consideration such as the interests of patients and family members, ethics, transmission risks, and laws and regulations governing infectious disease control. Changes in management: The following changes or modifications to CPR strategy in COVID-19 patients are proposed: 1) Healthcare workers should wear PPE. 2) Hands-only chest compression and mechanical chest compression can be implemented to reduce or avoid the spread of viruses by aerosols. 3) Both the benefits to patients and the risk of infection should be considered. 4) Hhealthcare workers should be fully aware of and trained in CPR strategies and procedures specifically for patients with COVID-19.

Objective:To investigate the prevalence of estimated glomerular filtration (eGFR) and risk factors among middle-aged and elderly residents in Beijing.Methods:In August-December of 2017, 6 549 residents aged 45-79 years old were randomly selected in the study by stratified multi-stage cluster sampling method. The investigation was performed by questionnaire, physical examination and laboratory tests. The contents of questionnaire included the demographic characteristic and prevalence of chronic disease. Blood pressure was tested. Fasting venous blood was collected to test the level of total cholesterol (TC), high density lipoprotein cholesterol (HLDL), low density lipoprotein cholesterol (LDL), triglyceride (TG), fasting blood-glucose (FBG), blood creatinine (Cr) and serum uric acid (UA). The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation was used to estimate GFR(eGFR). The decreased GFR was defined as eGFR less than 60 ml/min per 1.73 m 2. The statistical software SPSS 20.0 was used for analysis. The general linear model, test of independence of rows and columns, logistic regression for complex samples were generalized. The weighted mean and weighted rate were analyzed. Results:The average level of eGFR was (100.51±0.54) ml/min per 1.73 m 2. The rate of decreased GFR was 1.28%, and it showed a higher rate in subjects aged 70-79 years-old, living in urban area, with history of cardiovascular disease, hypertension, diabetes mellitus, hyperuricemia (4.53%, 1.57%, 2.90%, 2.27%, 2.12% and 4.62%; F=30.827, 10.588, 11.466, 34.693, 6.788,51.643, all P<0.05) . Logistic regression analysis of complex sampling showed that 70-79 years old ( OR=4.435, 95 %CI:2.402-8.191), living in urban area ( OR=3.145, 95 %CI: 1.540-6.420), hypertension ( OR=4.663, 95 %CI:2.177-9.988), hyperuricemia ( OR=6.751, 95 %CI:3.363-13.553) were associated with decreased GFR (all P<0.05). Conclusion:The prevalence of the decreased eGFR among middle-aged and elderly residents in Beijing is higher than the average level in the eastern part of China. Hypertension, hyperuricemia, the old age and living in urban are risk factors of decreased GFR.

Objective:To investigate the comprehensive control situation and related factors of diabetes mellitus.Methods:From August to December of 2017, 13 259 residents aged 18 to 79 years old were randomly selected as the subjects by stratified multi-stage cluster sampling method. Questionnaire, physical examination and laboratory tests were conducted. The effective sample size was 13 240. A total of 1 592 diabetes patients were found. In this study, 917 diabetes patients who had been diagnosed before the investigation were selected as subjects. The comprehensive control of diabetes patients was analyzed. The situation of diabetes patients with hypertension, dyslipidemia, overweight and obesity, coronary heart diseases was analyzed. Logistic regression analysis of complex sampling was used to analyze the related factors of diabetes comprehensive control.Results:The average age of 917 patients with diabetes was (58.5±0.7) years old. The proportion of people who participated in diabetes follow-up management was 29.0%. There were 89.5% diabetes patients with one or more chronic diseases. The comprehensive control rate of diabetes mellitus was 2.0%, men and women were 1.8% and 2.3%, respectively ( P>0.05). The rate of comprehensive control among those diabetes patients with chronic diseases was 0.4%, lower than that of those without chronic diseases (15.6%, P<0.05). The comprehensive control rate of people who participated in diabetes follow-up management was 1.4%. The control rate of blood glucose, blood pressure, blood lipid and weight of diabetes mellitus was 30.9%, 30.2%, 17.4% and 27.7%, respectively. Logistic regression analysis of complex sampling showed that excessive intake of red meat, with chronic diseases and qualified core knowledge were all related with comprehensive control of diabetes mellitus, OR value was 31.41, 39.98 and 0.29, P<0.05. Conclusion:The comprehensive control rate of diabetes mellitus was low. Excessive intake of red meat, with chronic diseases and qualified core knowledge were all related with comprehensive control of diabetes mellitus.

Objective:To investigate the comprehensive control situation and related factors of diabetes mellitus.Methods:From August to December of 2017, 13 259 residents aged 18 to 79 years old were randomly selected as the subjects by stratified multi-stage cluster sampling method. Questionnaire, physical examination and laboratory tests were conducted. The effective sample size was 13 240. A total of 1 592 diabetes patients were found. In this study, 917 diabetes patients who had been diagnosed before the investigation were selected as subjects. The comprehensive control of diabetes patients was analyzed. The situation of diabetes patients with hypertension, dyslipidemia, overweight and obesity, coronary heart diseases was analyzed. Logistic regression analysis of complex sampling was used to analyze the related factors of diabetes comprehensive control.Results:The average age of 917 patients with diabetes was (58.5±0.7) years old. The proportion of people who participated in diabetes follow-up management was 29.0%. There were 89.5% diabetes patients with one or more chronic diseases. The comprehensive control rate of diabetes mellitus was 2.0%, men and women were 1.8% and 2.3%, respectively ( P>0.05). The rate of comprehensive control among those diabetes patients with chronic diseases was 0.4%, lower than that of those without chronic diseases (15.6%, P<0.05). The comprehensive control rate of people who participated in diabetes follow-up management was 1.4%. The control rate of blood glucose, blood pressure, blood lipid and weight of diabetes mellitus was 30.9%, 30.2%, 17.4% and 27.7%, respectively. Logistic regression analysis of complex sampling showed that excessive intake of red meat, with chronic diseases and qualified core knowledge were all related with comprehensive control of diabetes mellitus, OR value was 31.41, 39.98 and 0.29, P<0.05. Conclusion:The comprehensive control rate of diabetes mellitus was low. Excessive intake of red meat, with chronic diseases and qualified core knowledge were all related with comprehensive control of diabetes mellitus.

Objective:To understand the awareness of smoking hazards and intention of smoking concession in residents aged 18-65 years in Beijing, and provide scientific evidence for the development and improvement of tobacco control policies and measures.Methods:Data were collected from the 2017 Beijing Non-communicable and Chronic Disease surveillance. A multi-stage stratified cluster sampling method was used to take samples from 165 communities in 16 districts of Beijing. Logistic regression was used to analyze the influencing factors.Results:Among 11 594 participants, 49.93% had no intention of smoking concession. The percentage of refusing smoking concession was higher in men (50.39%) than in women (43.01%), the difference was significant ( χ2=14.211, P=0.002), and higher in suburban residents (56.78%) than in urban residents (45.30%), the difference was significant ( χ2=51.977, P<0.001). For the smoking cessation motivation, "illness" was the reason for more former smokers (29.88%) compared with current smokers (11.50%), the difference was significant ( χ2=85.865, P<0.001). The awareness rates of smoking hazards was higher in women (34.97%) than in men (32.63%), the difference was significant ( Z=5.612, P<0.001), higher in suburban residents (35.44%) than in urban residents (33.03%), the difference was significant ( Z=-3.734, P<0.001), and higher in never smokers (35.15%) than in smokers (30.06%), the difference was significant ( χ2=62.277, P=0.005). Multiple logistic regression analysis results showed people with general awareness ( OR=0.61, 95 %CI: 0.39-0.94) and poor awareness ( OR=0.67, 95 %CI: 0.50-0.90) of smoking hazards were less likely to quit smoking and people with general awareness ( OR=0.64, 95 %CI: 0.53-0.76) and poor awareness ( OR=0.87, 95 %CI: 0.78-0.98) of smoking hazards were more likely to smoke. Conclusions:Smokers aged 18-65 in Beijing had low willingness for smoking cessation. Health problem was main consideration for smoking cessation. Never-smokers had better awareness of smoking hazards than smokers, and the awareness of smoking hazards was an influencing factor of smoking status.

Objective:To investigate the status quo of sleelated problems and relationship with dyslipidemia among adults in Beijing.Methods:From August to December 2017, 13 188 residents aged 18-79 years old were randomly selected as the subjects of this study, by stratified multi-stage cluster sampling method. Questionnaire, physical examination and laboratory testing were used in this study. The questionnaire included demographic characteristics and status quo of sleep. Height and weight were measured, with fasting venous blood collected to test the levels of TC, HDL-C, LDL-C and TG.Results:In Beijing, 52.1% of the adults involved in this study were having sleep-related problems which appeared higher in patients with dyslipidemia (55.1%) than those without (50.7%). Rates of sleep-related problems as snoring, difficult to get into sleep, waking at night, waking early and taking sleeping pills were 30.1%, 18.8%, 24.6%, 20.1% and 3.0%, respectively. The prevalence rates of high TC, high TG and high LDL-C were 7.5%, 23.5% and 6.6%, respectively among subjects with snoring and as, 5.7%, 15.5% and 4.9%, respectively among those without. The average level of TC of people easy to wake at night was 4.74 mmol/L, higher than that of those without (4.66 mmol/L). The prevalence of high TC among those waking at night was 7.5%, higher than that of those without (5.8%). After controlling potential confounding factors as age, sex, smoking, overweight and obesity, snoring was significantly positively correlated to the levels of TC, TG and LDL-C ( P<0.05) and presenting as risk factor for dyslipidemia, with OR=1.248 ( P<0.05). Conclusion:Sleep-related problems appeared serious, with snoring and waking at night the main ones among adults in Beijing. Snoring was significantly positively correlated with the levels of TC, TG and LDL-C and served an independent risk factor for dyslipidemia.

Objective:To understand the status quo of sleep and its associations with serum hemoglobin A1c (HbA1c) among nondiabetic people of 18-79 years old in Beijing.Methods:Data was gathered from the 2017 Beijing Non-communicable and Chronic Disease Surveillance Program. Multiple classified clusters sampling method was used while the 18-79 years old were sampled from the 16 districts of Beijing. Questionnaires would include information on demographic characteristics, chronic diseases and related risk factors, sleep duration and related problems (snore/asphyxia, difficult to get to sleep, waking often during the night, waking up early or taking sleeping pills) within the last 30 days. Complex sampling logistic regression models were established to analyze the association between sleep-related problems and serum HbA1c.Results:A total of 11 608 non-diabetic participants were involved in this study, with average age, reported sleep duration and median of serum HbA1c level as (43.36±15.27) years old, (7.49±1.29) h/d and 5.30%, respectively. 47.38% of them reported having sleep problems within the last 30 days. With the increasing time of sleep, serum HbA1c level was fluctuating significantly ( F=413.06, P<0.01). Significant differences appeared in serum HbA1c levels among different age groups ( t=358.3, P<0.01). Among participants with several kinds of sleep problems, the serum HbA1c levels were significantly higher than those without, through the single factor analysis ( U=15.11, P<0.01). After adjusting for potential confounding factors, the combination of one sleep-related problem ( OR=1.21, 95% CI: 1.03-1.41) and snore/asphyxia were associated with higher serum HbA1c levels (HbA1c≥5.7%) ( OR=1.37, 95% CI: 1.16-1.61). People under 60 years of age were with higher risk of having higher serum HbA1c levels. Conclusion:Duration and sleep-related problems might affect the serum HbA1c levels, especially among those younger than 60 years of age.

Objective To investigate the distribution characteristics and risk factors of intracranial and extracranial aterial lesions in Chinese patients with ischemic stroke . Methods In this multi‐center study ,2 310 continuously inpatients with ischemic stroke diagnosed in 20 stroke screening and prevention project base hospitals from June 2015 to M ay 2016 were enrolled . Carotid ultrasonography and transcranial color‐coded sonography or transcranial Doppler were performed in all patients to confirm the presence of cerebral artery stenosis or occlusion . According to the distribution of lesions ,the subjects were divided into 2 groups :the simple intracranial artery stenosis group and the simple extracranial artery stenosis group . T he difference of risk factors between the two groups was compared . Results Of the 2 310 patients with ischemic stroke ,1 516 ( 65 .6% ) had simple intracranial artery stenosis and 794 ( 34 .4% ) had simple extracranial artery stenosis . T he incidence of anterior circulation artery stenosis was higher in the group of intracranial artery stenosis than that in the extracranial artery stenosis group ( 68 .1% vs 48 .7% , P ＜0 .001) . Posterior circulation artery stenosis and combined anterior with posterior circulation artery stenosis were more common in patients with extracranial artery stenosis group than those in intracranial artery stenosis group ( 36 .4% vs 22 .1% ,14 .9% vs 9 .8% ;all P ＜0 .001) . Univariate analysis of risk factors for stroke showed that patients with intracranial arterial stenosis had a higher prevelence of hypertension , diabetes ,obesity ,and family history of stroke ,and their systolic blood pressure ,diastolic blood pressure , body mass index ( BM I) ,fasting blood‐glucose ,glycosylated hemoglobin ,triacylglycerol ,total cholesterol , and low‐density lipoprotein cholesterol were significantly higher than those in the extracranial arterial stenosis group ( all P ＜ 0 .05 ) . T he proportion of elderly ( ≥ 65 years old ) ,male and smokers in the extracranial arterial stenosis group was significantly higher than that in the intracranial arterial stenosis group ( all P ＜0 .05) . Multivariate logistic regression analysis showed that elderly ( ≥65 years old) ,male , and smoking history were independent risk factors for extracranial arterial stenosis ( OR＝ 2 .012 ,1 .637 , 1 .325 ,respectively ;all P ＜0 .05) . While hypertension ,diabetes ,less physical activity ,and high BM I levels were independent risk factors for simple intracranial arterial disease ( OR ＝ 1 .301 ,1 .252 ,1 .248 ,1 .030 , respectively ;all P ＜0 .05) . Conclusions There are significant differences in the distribution characteristics and risk factors of intracranial and extracranial aterial lesions in patients with ischemic stroke in China .

Objective: To provide basis for early selection of drug intervention or surgical treatment for premature patent ductus arteriosus(PDA) by a dynamic monitoring of serum N-terminal pro-brain natriuretic peptide(NT-proBNP)levels with ultrasonic examination, so as to improve the prognosis of premature infants. Methods: A total of 108 premature infants with gestational age less than 32 weeks and body weight less than 1.5 kg, within 24 h of birth were admitted to the Department of NICU, Harbin Children′s Hospital from June 2016 to December 2018.The serum NT-proBNP levels were measured at 3 d, 6 d, 9 d after birth, and echocardiography was performed at the same time.According to the results of echocardiography and clinical symptoms, infants were divided into haemodynamically significant PDA(hsPDA)(n=29), asymptomatic PDA(asPDA)(n=24)and non-PDA as control group(n=55). Among them, the hsPDA group was further divided into drug treatment group(n=21) and surgical treatment group(n=8). The surgical treatment group was those who failed 2 courses of oral ibuprofen treatment or had contraindications to drug treatment.Arterial catheter ligation was used for surgical treatment group on 9 to 21 days after birth.NT-proBNP levels were detected at 24 hours and 3 days after surgery, and echocardiography was performed at the same time.The levels of serum NT-proBNP were compared between the three groups and before and after the treatment, and the ROC curve of NT-proBNP was drawn to analyze its diagnostic value. Results: (1) At 3 and 6 days after birth, serum NT-proBNP levels were 8 346 pg/ml and 3 340 pg/ml in the hsPDA group, and 2 536 pg/ml and 1 079 pg/ml in the asPDA group, 1 132 pg/ml and 879 pg/ml in the control group, respectively.The levels of NT-proBNP in the hsPDA group were significantly higher than those in the asPDA group(P<0.05), and the levels of NT-proBNP in the asPDA group were higher than those in the control group(P<0.05). At 9 days after birth, serum NT-proBNP levels were 2 231 pg/ml in the hsPDA group, 834 pg/ml in the asPDA group, and 808 pg/ml in the control group.The levels of serum NT-proBNP in the hsPDA group were significantly higher than those in the asPDA group and the control group (P<0.05). There was no significant difference between the asPDA group and the control group (P>0.05). (2)At 3, 6, and 9 d after birth, serum NT-proBNP levels were 9 000 pg/ml, 8 989 pg/ml, 9 000 pg/ml in the surgical treatment group, and 3 741 pg/ml, 2 544 pg/ml and 1 032 pg/ml in the drug treatment group, respectively.The levels of serum NT-proBNP in the surgical treatment group were significantly higher than those in the drug treatment group (P<0.05). The serum NT-proBNP levels in both drug treatment group and surgical treatment group were significantly lower than those before treatment (P<0.05). At 3 d after the operation, the serum NT-proBNP level was 941 pg/ml in the surgical treatment group and 736 pg/ml in the drug treatment group.There was no significant difference between the two groups (P>0.05). (3)At 3 d after birth, the area under the ROC curve of serum NT-proBNP was 0.91 (95%CI 0.865-0.964), and the sensitivity and specificity of NT-proBNP to diagnose hsPDA at 2 343.5 pg/ml were 93.1% and 73.41.% respectively. Conclusion NT-proBNP level monitoring can be used as a sensitive indicator for early identification of hsPDA, and it has a clinical significance for intervention strategy and intervention time selection.

Objective To analyze the correlation between smoking and occurrence of intracranial artery stenosis.Methods From June 2015 to May 2016,a total of 10 711 inpatients with transient ischemic attack (TIA) or ischemic stroke from 20 basel hospitals of nationwide were enrolled using a cross-sectional study,76 patients with unknown smoking and smoking cessation years were excluded.Finally,a total of 10 635 patients were enrolled.Transcranial color coded sonography and/or transcranial Doppler were used evaluate the intracranial artery stenosis lesions.The basic risk factors for cerebrovascular disease (age,sex,smoking and smoking years,whether smoking cessation and years,hypertension,diabetes,hyperlipidemia,atrial fibrillation,and family history of stroke) were recorded.According to the different smoking years,the smoking years were divided into five groups:non-smoking,smoking time ≤10-year,11 to 20-year,21 to 30-year,and >30-year groups for trend chi square test.According to the different smoking cessation years in the smokers,the smoking cessation years were divided into four groups:non-cessation,cessation time 1 to 10-year,11 to 20-year,and >20-year groups for trend chi square test.The effects of different smoking years and different smoking cessation years on the occurrence of intracranial arterial stenosis were analyzed.Results The incidence of intracranial artery stenosis in the smokers (40.4%[1 433/3 547]) was significantly higher than that in the non-smoking patients (29.4%[2 085/7 088]).There was significant difference (χ2=128.850,P<0.01),and the incidence of cerebral infarction in the smokers (91.6%[3 250/3 547]) was significantly higher than the non-smokers (85.0%[6 027/7 088]).There was significant difference (χ2=92.328,P<0.01).Smoking was an independent risk factor for intracranial artery stenosis (OR,1.603;95%CI 1.456-1.765;P<0.01).With the increase of smoking years,the detection rate of intracranial arterial stenosis increased gradually (trend χ2=115.437,P<0.01).Whether giving up smoking had no significant effect on the incidence of intracranial artery stenosis in patients with ≥20 years of smoking (trend χ2=1.043,P=0.307).Conclusions Smoking is an independent risk factor for affecting intracranial artery stenosis;the risk of disease increases with the number of smoking years.Long-term smokers (≥20 years) cannot reduce the effect on intracranial artery stenosis,even if they give up smoking.