Acute respiratory distress syndrome(ARDS)is a key disease in the field of clinical critical illness diagnosis and treatment.Its incidence and mortality rate have always remained high.Due to its high heterogeneity of the cause,specific biomarkers are still lacking in clinical diagnosis,and targeted treatment strategies for its core pathological links still have significant limitations.In view of this,the construction of an ARDS risk prediction model based on multi-dimensional risk factors can provide key evidence-based guidance for clinical medical staff to identify high-risk groups at ARDS in the early stage.This paper aims to review the research progress of ARDS risk factors and prediction models,in order to provide new ideas and references in building more accurate prediction models for ARDS.

Hyperoxia-induced acute lung injury (HALI) is an important complication of clinical oxygen therapy, which is mainly characterized by acute respiratory distress syndrome (ARDS) in adults and broncho-pulmonary dysplasia (BPD) in infants. HALI seriously affects the prognosis and quality of life of patients, so it has received more and more attention. However, the pathogenesis of HALI is complex and unclear, and there is no clear treatment method at present. Non-coding RNA (ncRNA) is an important type of functional RNA transcriptome. Due to the lack of effective open reading frame, ncRNA does not have the function of coding proteins. However, ncRNA can still regulate gene expression at multiple levels and affect the occurrence and development of many diseases. In recent years, a large number of in vitro and in vivo studies have shown that ncRNA is involved in the pathogenesis of HALI and is of great significance. This article reviews the expression and significance of ncRNA in HALI, in order to provide new diagnosis and treatment ideas for the prevention and treatment of HALI.

Blood purification is one of the commonly used techniques for the rescue of critically ill patients, which is used for acute and chronic kidney injury caused by various causes and renal replacement therapy (RRT) for a variety of critical diseases. Its main working principle is to drain the human blood into a variety of dialyzers through the artificial tube, exchange substances through a variety of ways, and remove harmful substances and some metabolites from patients' body. Then the purified blood is transfused back to the body, so as to maintain the patient's internal environment relatively stable. At present, there are different models of hemodialysis machines in clinical practice, but they are bulky and unable to move, and the method of heat dissipation is single, which cannot meet the needs of hemodialysis treatment in transport patients. Therefore, the medical staff of the Second Affiliated Hospital of Zunyi Medical University designed and developed a hemodialysis machine, which is suitable for patients who demand hemodialysis treatment during transport, and obtained the National Invention Patent of China (ZL 2020 1 0864737.3). The hemodialysis machine comprises a main body of the hemodialysis machine and a mobile vehicle. The main body of the hemodialysis machine is placed in the bottom of the mobile vehicle, and a protective cylinder with fixed airbags is designed around the main body of the hemodialysis machine. The fixed airbag is connected to the air storage tank through the pipeline, the air storage tank is connected to the Venturi tube through the control valve, and the throat of the Venturi tube is connected to the disinfection tank and cooling water tank. The outlet end of the Venturi tube is connected with the cooling pipe inside the main part of the hemodialysis machine and the sprinkler head placed on the top of the main body. By adding a mobile vehicle and designing an airbag and protective cylinder, the hemodialysis machine can be applied to the hemodialysis treatment during the transportation of patients. By designing the heat dissipation pipe, the main body of the hemodialysis machine can be cooled, the temperature of the hemodialysis machine can be reduced, and the hemodialysis machine can still work when the fan is damaged. By designing the sprinkler head, it is convenient to automatically disinfect the main screen and control keys of the hemodialysis machine, reduce the risk of cross infection of medical staff in the operation, and increase the safety and practicability of the hemodialysis machine. The hemodialysis machine is convenient, safe and efficient, which can be widely used in the hemodialysis treatment during transported patient, and is worthy of clinical promotion.

Accurately assessing and positioning the current development status of disciplines can help hospitals formulate targeted disciplinary development strategies and achieve disciplinary development goals. In 2022, a large tertiary public hospital established a discipline-demand-oriented " pyramid" hierarchical discipline evaluation system based on Maslow′s need-hierarchy theory. The discipline evaluation system set six levels of evaluation indicators from low to high, including medical quality and safety, department operation, sub specialty construction, scientific and educational achievements, platform construction, and talent cultivation(including 6 primary indicators, 21 secondary indicators, and 44 tertiary indicators). By applying the evaluation system and providing feedback on the evaluation results in the form of " disciplinary diagnostic reports" and " disciplinary evaluation conferences, " the hospital′s discipline construction had been improved at six levels. From 2022 to 2023, the hospital added five national clinical key specialties; The number of sub major construction disciplines increased from 18 in 2021 to 61 in 2023, and patient satisfaction increased from 94.64% to 96.25%. This evaluation system could objectively reflect the level of discipline development, lead the high-quality development of disciplines, and provide references for other public hospitals to promote discipline development.

With the enhancement of public health awareness and advancements in medical technology,intensive care unit (ICU) have been established in medical institutions at or above the second level across the country,enabling an increasing number of patients to receive critical care. However,with the development of critical care medicine,ethical issues have also emerged,especially in terms of ICU medical resource allocation and treatment decisions. This includes ethical principles such as patient autonomy,maximizing patient welfare,fair resource allocation,and medical professional ethics. Fair allocation of limited medical resources,maintaining patient autonomy while maximizing patient welfare during treatment,and adhering to medical ethics and legal principles are critical challenges that ICU clinicians must carefully address and resolve. This article explores the ethical challenges associated with ICU resource allocation and treatment processes,aiming to help clinicians cope with these issues effectively to ensure critically ill patients receive optimal care and support while upholding ethical and legal standards.

Sepsis is an organ dysfunction syndrome secondary to a host's dysfunctional response to infection.Its pathogenesis is complex,and inflammatory factors play an important role in its course.Sepsis has a high mortality and is difficult to treat.Clinicians are constantly exploring new treatment methods to reduce the fatality rate.Blood purification therapy is a developing auxiliary treatment method for sepsis.Blood purification therapies for sepsis include plasma exchange,continuous renal replacement therapy,and hemoperfusion.Though operating through different mechanisms-removing cytokines,endotoxins,or pathogens-these therapies share the goal of improving patient outcomes.This article aims to summarize the application progress of various blood purification methods in the treatment of sepsis,in order to clarify the effectiveness of blood purification therapy in infectious diseases.However,the specific implementation timing and frequency still need further exploration,laying a foundation for subsequent research.

[Abstract] [Objective] To investigate the distribution characteristics and susceptibility of ABO and Rh blood group antigens in patients with pulmonary tuberculosis in Xinjiang, so as to provide a theoretical basis for the prevention and treatment of tuberculosis. [Methods] The clinical information of hospitalized patients with pulmonary tuberculosis from different ethnic groups (n=32 508, infection group) and healthy people (n=15 442, control group) in the Eighth Affiliated Hospital of Xinjiang Medical University and the First Affiliated Hospital of Xinjiang Medical University from 2014 to 2020 was collected, and the frequency distribution of ABO and Rh blood group antigens in the two groups was analyzed retrospectively. [Results] 1) The constituent ratios of pulmonary tuberculosis prevalence in Uygur, Han, HaKazak and Hui people were 51.11%, 33.66%, 9.09% and 6.13% respectively, with significant difference (P<0.001). The prevalence rate of pulmonary tuberculosis in females (52.65%) was higher than in males (47.35%) (P<0.05). 2) The frequency of type B antigen was highest at 30.10%, and the frequency of type AB antigen was the lowest at 10.09% in pulmonary tuberculosis group; The distribution of blood types was B type>O type>A type>AB type. In the control group, the distribution of blood types was O type>A type>B type>AB type. The frequency of type B in Uighur, type O in Kazak, type A in Hui and Han nationalities in the infection group was higher than that in the control group (P<0.001); 3) The distribution of blood type among patients with pulmonary tuberculosis in different ethnic groups was Uygur B>A>O>AB, Kazak O>B>A>AB, Hui A>O=B>AB, Han A>B>O>AB, with significant difference between different ethnic groups (P<0.001). 4) The total positive rate of RhD blood group among pulmonary tuberculosis patients was 97.26%, while the negative rate was 2.74%. Among them, the Uyghur ethnicity has the highest frequency at 4.44%, followed by Kazakh at 2.13%, Hui at 1.26%, Han at 0.58%, with significant differences(P<0.05). [Conclusion] The proportion of pulmonary tuberculosis prevalence among Uygur, Han, HaKazak and Hui people were 51.11%, 33.66%, 9.09% and 6.13%, respectively. The distribution frequency of blood type was B>O>A>AB. Moreover, higher frequencies of tuberculosis in Uygur with type B, Kazak with type O, Hui with type A and Han with type A suggest that these blood types may be susceptible risk factors for pulmonary tuberculosis, which provides new insights for the prevention and control of pulmonary tuberculosis.

With the enhancement of public health awareness and advancements in medical technology,intensive care unit (ICU) have been established in medical institutions at or above the second level across the country,enabling an increasing number of patients to receive critical care. However,with the development of critical care medicine,ethical issues have also emerged,especially in terms of ICU medical resource allocation and treatment decisions. This includes ethical principles such as patient autonomy,maximizing patient welfare,fair resource allocation,and medical professional ethics. Fair allocation of limited medical resources,maintaining patient autonomy while maximizing patient welfare during treatment,and adhering to medical ethics and legal principles are critical challenges that ICU clinicians must carefully address and resolve. This article explores the ethical challenges associated with ICU resource allocation and treatment processes,aiming to help clinicians cope with these issues effectively to ensure critically ill patients receive optimal care and support while upholding ethical and legal standards.

Sepsis is an organ dysfunction syndrome secondary to a host's dysfunctional response to infection.Its pathogenesis is complex,and inflammatory factors play an important role in its course.Sepsis has a high mortality and is difficult to treat.Clinicians are constantly exploring new treatment methods to reduce the fatality rate.Blood purification therapy is a developing auxiliary treatment method for sepsis.Blood purification therapies for sepsis include plasma exchange,continuous renal replacement therapy,and hemoperfusion.Though operating through different mechanisms-removing cytokines,endotoxins,or pathogens-these therapies share the goal of improving patient outcomes.This article aims to summarize the application progress of various blood purification methods in the treatment of sepsis,in order to clarify the effectiveness of blood purification therapy in infectious diseases.However,the specific implementation timing and frequency still need further exploration,laying a foundation for subsequent research.

Objective:To explore the current status of surgery for portal hypertension to grasp current status and future development of surgery in China.Methods:This study is jointly sponsored by China Hepatobiliary & Pancreatic Specialist Alliance & Portal Hypertension Alliance in China (CHESS).Comprehensive surveying is conducted for basic domestic situations of surgery for portal hypertension, including case load, surgical approaches, management of postoperative complications, primary effects, existing confusion and obstacles, liver transplantation(LT), laparoscopic procedures and transjugular intrahepatic portosystemic shunt(TIPS), etc.Results:A total of 8 512 cases of portal hypertension surgery are performed at 378 hospitals nationwide in 2021.Splenectomy plus devascularization predominated(53.0%)and laparoscopy accounted for 76.1%.Primary goal is preventing rebleeding(67.0%) and 72.8% of hospitals used preventive anticoagulants after conventional surgery.And 80.7% of teams believe that the formation of postoperative portal vein thrombosis is a surgical dilemma and 65.3% of hospitals practiced both laparoscopy and TIPS.The major reasons for patients with portal hypertension not receiving LT are due to a lack of qualifications for LT(69.3%)and economic factors(69.0%).Conclusions:Surgery is an integral part of management of portal hypertension in China.However, it is imperative to further standardize the grasp of surgical indications, the handling of surgical operation and the management of postoperative complications.Moreover, prospective, multi-center randomized controlled clinical studies should be performed.