Objective To analyze the influencing factors of respiratory failure in patients with sepsis, and to construct and validate a risk prediction model. Methods A total of 308 patients with sepsis in Ganzi Tibetan Autonomous Prefecture People's Hospital from August 2021 to September 2024 were enrolled and divided into a modeling group and a validation group. According to whether respiratory failure occurred during hospitalization, the patients were divided into a respiratory failure group and a non-respiratory failure group. Single-factor and binary logistic regression analysis were used to construct a risk prediction model, and the ROC, calibration, and DCA curves were used to assess the model's predictive performance. Results The incidence of respiratory failure was 20.83% (45/216) in the modeling group and 20.65% (19/92) in the validation group. Albumin, D-dimer, serum calcium, procalcitonin at admission, and sequential organ failure assessment were independent influencing factors of respiratory failure in patients with sepsis. The ROC curve analysis nomogram model predicted that the AUC of respiratory failure in the modeling group was 0.994 (95%CI: 0.985-1.000), and the AUC of the validation group was 0.897 (95%CI: 0.826-0.968). The calibration curve analysis showed that the calibration curve fit well with the ideal curve. DCA curve analysis showed that the net benefit was greater than 0 across all threshold probability ranges. Conclusion The risk prediction model constructed in this study is highly effective and can provide reference for medical staff to evaluate respiratory failure in patients with sepsis.

BACKGROUND:Isoflurane is gradualy popularized in pediatric surgery due to its rapid onset, rapid recovery, and no savings, but its security needs to be further studied. OBJECTIVE:To explore the effect of isoflurane anesthesia on the proliferation and neuronal differentiation of neural stem cels in the dentate gyrus of neonatal rats. METHODS: Rats were randomly divided into isoflurane group and control group, respectively treated with isoflurane inhalation and air inhalation. 5-Bromodeoxyuridine bal glycosides (BrdU) was intraperitonealy injected before drug administration and after drug withdrawal, and 24 hours after secondary injection, the rats were executed to take brain tissues for detection of BrdU expression and brain neurogenic differentiation factor expression. RESULTS AND CONCLUSION:After cessation of anaesthesia processing for the detection of blood glucose and arterial blood gas, a mild rise in PaCO2 was found in the isoflurane group and pH showed a slight drop, but PaO2, BE, SaO2 and blood glucose levels were not changed. Compared with the control group, the isoflurane group did not appear with obvious hypoxia performances after isoflurane anesthesia, including cyanosis and respiratory depression. Rat neural stem cels of the dentate gyrus were mostly distributed in the gate area, and compared with the control group, the number of BrdU-positive cels was less in the isoflurane group (P < 0.05). A large number of new cels in the dentate gyrus expressed NeuroD, and the number of NeuroD+/BrdU+ cels in the gate area was significantly higher than that in the lower region of granule cels. Moreover, the number of NeuroD+/BrdU+ cels in the isoflurane group was significantly higher than that in the control group (P < 0.05). These findings suggest that isoflurane anesthesia can influence the proliferation and neuronal differentiation of neural stem cels in the dentate gyrus of neonatal rats, which inhibits cel proliferation and promotes neuronal differentiation.